Is it true that you might not to get into the speciality you want if you dont do well on the step 1?

[mrh125]

If so it seems more than a bit crazy that a test like that decides if you have a chance at a particular speciality (put anyone who doesnt do well on that test in a residency they want and they'll probably do damn well in time and pass the exam related to what they're ACTUALLY DOING). This overemphasis on standardized testing is really eroding my interest in medicine. I'd rather not be unable to get into the speciality i want because all the hotshot pro test takers, who have taken tests all their life are better at taking tests than the majority.


I don't even mind college exams or probably exams at med school (when I get in), but stuff like the mcat and step sounds like absolute crap.

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[Euxox]

If so it seems more than a bit crazy that a test like that decides if you have a chance at a particular speciality (put anyone who doesnt do well on that test in a residency they want and they'll probably do damn well in time and pass the exam related to what they're ACTUALLY DOING). This overemphasis on standardized testing is really eroding my interest in medicine. I'd rather not be unable to get into the speciality i want because all the hotshot pro test takers, who have taken tests all their life are better at taking tests than the majority.


I don't even mind college exams or probably exams at med school (when I get in), but stuff like the mcat and step sounds like absolute crap.

Is it true that you might not get into the college you want if you don't do well on the SAT? Yes.
Is it true that you might not into medical school if you don't do well on the MCAT? Yes.
Is it true that you might not get good grades in med school if you don't do well on shelf exams? Yes.
Is it true that you might not get into the specialty you want if you don't do well on Step 1? Yes.
Is it true that you might not become board certified if you don't do well on your specialty's board exam? Yes.
Is it true that you might lose certification if you don't continue do well on your specialty's board exam for the rest of your career? Yes.

There's no point in complaining. Standardized tests are a matter of fact for physicians, and you'll have to learn to get used to them sooner or later.

 

[Oso]

Is it true that you might not get into the college you want if you don't do well on the SAT? Yes.
Is it true that you might not into medical school if you don't do well on the MCAT? Yes.
Is it true that you might not get good grades in med school if you don't do well on shelf exams? Yes.
Is it true that you might not get into the specialty you want if you don't do well on Step 1? Yes.
Is it true that you might not become board certified if you don't do well on your specialty's board exam? Yes.
Is it true that you might lose certification if you don't continue do well on your specialty's board exam for the rest of your career? Yes.

There's no point in complaining. Standardized tests are a matter of fact for physicians, and you'll have to learn to get used to them sooner or later.

you are awesome

 

[RogueUnicorn]

please stop making threads

 

[sinombre]

To be honest, most med school finals probably cover more material than you need to know for the MCAT. So you might dislike exams in medical school more than you think.

 

[baconshrimps]

Here is a better question - is ones performance on the MCAT amenable to how they might perform on USMLE Step 1?

For example, I pulled a 10 in physics, but physics was never really a strong point for me, and arguably I spent more time studying biology (through college*) than I did for physics - so while I realize there will be relative strengths and weaknesses in the basic life sciences in medical school for any medical student, it seems that if you enjoy what you are studying, then you tend to perform better. I know people who absolutely despise biology and I frankly don't understand how they are even attending medical school, but I have a pretty solid foundation in histology, pharmacology, genetics, cell biology, physiology, biochemistry - so is my tendency to score on the lower end of the acceptable MCAT score spectrum an indication of my potential when it comes to USMLE Step 1?

 

[Law2Doc]

Here is a better question - is ones performance on the MCAT amenable to how they might perform on USMLE Step 1?

For example, I pulled a 10 in physics, but physics was never really a strong point for me, and arguably I spent more time studying biology (through college*) than I did for physics - so while I realize there will be relative strengths and weaknesses in the basic life sciences in medical school for any medical student, it seems that if you enjoy what you are studying, then you tend to perform better. I know people who absolutely despise biology and I frankly don't understand how they are even attending medical school, but I have a pretty solid foundation in histology, pharmacology, genetics, cell biology, physiology, biochemistry - so is my tendency to score on the lower end of the acceptable MCAT score spectrum an indication of my potential when it comes to USMLE Step 1?

There is a very minimal correlation between the mcat and steps, bordering on insignificant. I would neither bank on it or worry about it at this juncture.

 

[mcloaf]

I'd rather not be unable to get into the speciality i want because all the hotshot pro test takers, who have taken tests all their life are better at taking tests than the majority.

I know, it's so unfair when people who outperform you get rewarded.

please stop making threads

qft.

 

[Amazingmuzmo]

Lmao you're a joke OP.

"Waaaaaaaaa, people who are smarter than me are being accepted into more competitive positions! So not fair!"

 

[baconshrimps]

There is a very minimal correlation between the mcat and steps, bordering on insignificant. I would neither bank on it or worry about it at this juncture.

That's actually quite a relief. I am interested in Internal Medicine (not the most competitive field, granted) but should I decide to subspecialize I know that my USMLE scores will play a role for fellowship applications, since I will not have taken ABIM before applying for felloswhip. Again, just speculating what the future may hold for me, but it's better to be as best informed as possible with regards to potential outcomes. Thanks for clarifying!

 

[TheWeeIceMan]

Maybe you shouldn't go into medicine. Find one of those careers where everything is completely fair and no one is rewarded for performing better.

 

[Arkangeloid]

Dude, if you're not a good test taker, that means you're not a good student. You can't be a good student without testing well, just as you can't be a good cook if you don't cook good food. IIRC there was a Tosh.0 skit about this very topic.

 

[Catalystik]

I don't even mind college exams or probably exams at med school (when I get in), but stuff like the mcat and step sounds like absolute crap.

At least you can take the MCAT multiple times until you feel the score represents your best. You can only take each of the Steps once, unless you fail it.

 

[circulus vitios]

Look at Charting Outcomes data. Unless you want plastics or maybe derm, you can match into any specialty with mediocre board scores, if you're willing to take a gap year or two kissing ass and doing research to bolster your application.

 

[mrh125]

Dude, if you're not a good test taker, that means you're not a good student. You can't be a good student without testing well, just as you can't be a good cook if you don't cook good food. IIRC there was a Tosh.0 skit about this very topic.

that's a bold assumption. I do very well on regular tests and have a good gpa (also A+s in o-chem, which was a very difficult class), not standardized tests. Not everyone does well on standardized tests and not every person's circumstances are the same. Not doing well on a test doesn't mean someone isn't a good student. Everyone has their own strengths and weaknesses.

 

[mrh125]

Lmao you're a joke OP.

"Waaaaaaaaa, people who are smarter than me are being accepted into more competitive positions! So not fair!"

If it had anything to do with intelligence, I'd be shocked. you're just another condescending premed jackass with comments like that. This is a self-favoring selecting system where those who do well on standardized tests succeed, regardless of the actual merit of those tests.

 

[RogueUnicorn]

yea attack the validity of the test since you're scared of it. good plan.

 

[mrh125]

yea attack the validity of the test since you're scared of it. good plan.

i'm not scared of the test. It just seems like it's a ridiculous way of deciding what someone can or cannot do given that a lower score doesn't even seem to demonstrate that someone is or isn't right for a given speciality and if these people were placed in the speciality you'd see that.

And if someone does score well on this particular exam, what exactly makes them more qualified than anyone else for a given speciality? Summing up a person's entire future and what they can and cant do by a test, instead of experience is just dumb.

 

[Ace-Co-A]

If it had anything to do with intelligence, I'd be shocked. you're just another condescending premed jackass with comments like that. This is a self-favoring selecting system where those who do well on standardized tests succeed, regardless of the actual merit of those tests.

In some ways, I feel ya -- standardized tests are annoying in that so much rides on how well you do on one exam, on one day. But it's not as though they're keeping the information on the test to themselves. Take the MCAT for example: What is on the exam? Or the boards: What is on Step 1?

That took me like 20 seconds. Just study.

 

[darkjedi]

Here is a better question - is ones performance on the MCAT amenable to how they might perform on USMLE Step 1?

For example, I pulled a 10 in physics, but physics was never really a strong point for me, and arguably I spent more time studying biology (through college*) than I did for physics - so while I realize there will be relative strengths and weaknesses in the basic life sciences in medical school for any medical student, it seems that if you enjoy what you are studying, then you tend to perform better. I know people who absolutely despise biology and I frankly don't understand how they are even attending medical school, but I have a pretty solid foundation in histology, pharmacology, genetics, cell biology, physiology, biochemistry - so is my tendency to score on the lower end of the acceptable MCAT score spectrum an indication of my potential when it comes to USMLE Step 1?

There is a very minimal correlation between the mcat and steps, bordering on insignificant. I would neither bank on it or worry about it at this juncture.

While the correlation is most certainly spotty, I wouldn't go so far as to say it is insignificant. I don't think it's too hard to fathom that people who do well on MCAT tend to do well on the Steps or vice versa.

http://internationalgme.org/Resources/Pubs/Donnon et al (2007) Acad Med.pdf

i'm not scared of the test. It just seems like it's a ridiculous way of deciding what someone can or cannot do given that a lower score doesn't even seem to demonstrate that someone is or isn't right for a given speciality and if these people were placed in the speciality you'd see that.

And if someone does score well on this particular exam, what exactly makes them more qualified than anyone else for a given speciality? Summing up a person's entire future and what they can and cant do by a test, instead of experience is just dumb.

Welcome to life. Standardized tests are arguably the best way to gauge potential performance across a population. Is it perfect? Of course not, and it's validity ranges wildly between each test. They are like tools as any other metric and some are designed better than others. Standard rulers are the best way to measure length, but not weight obviously, nor are they going to give you 15 significant digits on the exact length. But they tend to be decent approximations if used properly.

I'm not sure how you are going to gauge people on experience before they have any. Are you going to put the 50,000 premeds in front of an open surgery to see how they perform, hundreds and hundreds of times?

 

[mrh125]

I know, it's so unfair when people who outperform you get rewarded.



qft.

correction: outperform in an area that has a particularly limited scope/value.

 

[V5RED]

correction: outperform in an area that has a particularly limited scope/value.

Can you suggest a reasonable alternative? By that I do not mean just saying they should judge on experience, I am asking if you can come up with a reasonable way for them to implement this.

 

[slopes23]

Go to 3:28 for the joke relative to this thread, or watch the whole thing cause it's just funny.

 

[mcloaf]

correction: outperform in an area that has a particularly limited scope/value.

While I'm somewhat sympathetic to the idea that standardized testing isn't ideal considering how heavily it is used, you'll have to forgive me if I question your qualifications for evaluating step 1's utility in residency matching.

 

[Euxox]

I do very well on regular tests and have a good gpa (also A+s in o-chem, which was a very difficult class), not standardized tests. Not everyone does well on standardized tests and not every person's circumstances are the same. Not doing well on a test doesn't mean someone isn't a good student. Everyone has their own strengths and weaknesses.

You are right, people who perform poorly on the MCAT aren't necessarily bad students. They are either bad students OR they don't spend enough time practicing taking the MCAT. Standardized test taking isn't an innate talent; it is a practiced skill. If you're a good student with a solid grounding in the prereq sciences, you should be able to do well on the MCAT if you work through several hundred MCAT practice problems and five or six full length exams.

I know that it can be frustrating to be evaluated by a single number, but at least with standardized exams you know the rules of the game ahead of time. Do you want to match into plastic surgery? Then get a 245+ on Step 1. Simple and objective requirements.

 

[mrh125]

Can you suggest a reasonable alternative? By that I do not mean just saying they should judge on experience, I am asking if you can come up with a reasonable way for them to implement this.

What about some classes that each person who is interested in a given speciality can take (these classes should be directly relevant to the speciality), which could be used as indicators? If standardization is needed maybe something similar to what is done in AP classes could be applied to this. This of course wouldnt be the only factor involved, obviously.

 

[Euxox]

What about some classes that each person who is interested in a given speciality can take (these classes should be directly relevant to the speciality), which could be used as indicators? If standardization is needed maybe something similar to what is done in AP classes could be applied to this. This of course wouldnt be the only factor involved, obviously.

They already do that, but if classes are the primary evaluation factor, all kinds of other crap gets dragged in. Let's say you want to match into plastics and the Step 1 doesn't exist. Instead, admissions is primarily on your clerkship grades.

* What if your school doesn't offer a plastics rotation? Will that hurt you in the match?
* You found schools that will let you do an away rotation in plastics. Is it better to get a high pass at Harvard or honors at a nearby state school?
* Okay, so you picked a school for your away rotation and did well. But what if your plastics attending is relatively new and unknown? Will his recommendation letter hold a lot of clout with residency PDs?
* You pissed off your plastics attending because he asked you to get him a non-fat, extra-foam, no-water, extra-hot chai tea latte, but you got an extra-fat, no-foam, no-water, extra-hot chai tea latte. Will this affect your evaluation?

Luckily for people who want to match into plastics, none of these things matter as much as their Step 1 scores. Score within a certain target range on Step 1 and, unless there are any major flaws on the rest of your application, you stand a good chance of matching. Sure, standardized exams have their flaws, but in my opinion they do more good than bad.

 

[DrBowtie]

What about some classes that each person who is interested in a given speciality can take (these classes should be directly relevant to the speciality), which could be used as indicators? If standardization is needed maybe something similar to what is done in AP classes could be applied to this. This of course wouldnt be the only factor involved, obviously.

...they do. They are called clinical rotations.

Step 1 is essentially a standardized way to measure mastery of the basic sciences. The more mastery, the more desirable candidate on paper.

 

[LostinLift]

There is a fair amount of leeway in terms of Step 1 standard deviation for students matched into each specialty. If you love Orthopedic Surgery, do research from day 1, have several publications, ace your classes, do great in rotations, do great in away Ortho rotations, have great letters from well known Ortho people but you scored below average for Ortho you still have a great shot at matching, I count 61 people who match with a score below 220 ( Here Page 166 ).

If you are qualified to go into the specialty you're interested in, Step 1 can hold you back, but you can still make it. Typical SDN thinking is that if you're below average in stats you have no shot or less than 10% in most cases. It's good in that it makes you want to be more prepared for classes and tests, but bad in that it can inspire pessimistic thinking.

 

[Ismet]

What about some classes that each person who is interested in a given speciality can take (these classes should be directly relevant to the speciality), which could be used as indicators? If standardization is needed maybe something similar to what is done in AP classes could be applied to this. This of course wouldnt be the only factor involved, obviously.

This already exists. Clinical rotations and shelf exams at the end of each rotation. Each school does it a bit differently, but a portion of each rotation's grade is made up of your performance in the clerkship (via preceptor evaluations) and the standardized shelf exam in that field.

 

[darkjedi]

What about some classes that each person who is interested in a given speciality can take (these classes should be directly relevant to the speciality), which could be used as indicators? If standardization is needed maybe something similar to what is done in AP classes could be applied to this. This of course wouldnt be the only factor involved, obviously.

You already do clerkships in the speciality you plan to match in. People tend to do quite well in clerkships, how do you differentiate? Not to mention how subjective one grader is from another. You can take shelf exams, but again, that's a standardized test like the AP...

Edit: Beat me by a second @Ismet!!

 

[slopes23]

Love how someone who hasn't even gone through medical school is trying to reinvent the wheel, and thinks he knows what would be more effective as if becoming a doctor was a new profession, and school's had no clue what they were doing.

 

[Roxas]

Go to 3:28 for the joke relative to this thread, or watch the whole thing cause it's just funny.

When I saw this thread I thought of the exact same thing. So glad you posted it

 

[dbeast]

yea attack the validity of the test since you're scared of it. good plan.

Thank god you're back. This place was getting boring.

 

[baconshrimps]

When I saw this thread I thought of the exact same thing. So glad you posted it

I, also.

 

[gettheleadout]

Oh god the entitlement...

 

[baconshrimps]

Oh god the entitlement...

@gettheleadout
I just looked at your MDapps.....

 

[mrh125]

Oh god the entitlement...

lmao, entitlement?! to what? If you're paying a small fortune to get where you want and go through the process getting what you want is the expected outcome, otherwise it's little more than just a waste.

Love how someone who hasn't even gone through medical school is trying to reinvent the wheel, and thinks he knows what would be more effective as if becoming a doctor was a new profession, and school's had no clue what they were doing.

love how you think not going through entire process suddenly invalidates my opinion. med schools do know what they're doing, but that doesn't stop it from being a ****ty flawed system.

 

[slopes23]

lmao, entitlement?! to what? If you're paying a small fortune to get where you want and go through the process getting what you want is the expected outcome, otherwise it's little more than just a waste.


love how you think not going through entire process suddenly invalidates my opinion. med schools do know what they're doing, but that doesn't stop it from being a ****** flawed system.

The only flawed system here is your thought process. You concede that medical school's know what they are doing, then go on to contradict this by stating it's a flawed system. Nice.

Also, not having gone through the process does invalidate your opinion, as you don't have the experience to know should or should not be.

 

[mrh125]

The only flawed system here is your thought process. You concede that medical school's know what they are doing, then go on to contradict this by stating it's a flawed system. Nice.

Also, not having gone through the process does invalidate your opinion, as you don't have the experience to know should or should not be.

Actually it doesn't contradict anything and experience indicates very little in this case, plus it takes very little time and thought to see that this process is very analogous to every depersonalized standardized test system such as those run by non-profit$ such as collegeboard. I know that people do best when theyre actually exposed and allowed to work and then tested on relevant material (ex: going through a residency and then being tested on the material you learned which was directly relevant.). Tests such as the step1 and mcat are quick ways of evaluating people in large numbers, but are really artificial glass ceilings. There's nothing say that someone who doesn't get a score in "x" range isn't a good candidate for a given speciality and i'll tell you the same thing a few years from now.

If you put a large number of those people who dont qualify for a given range for a few points in the residencies they wanted they'd still end up doing damn fine in the speciality they wanted. It's an artificial dichotomy.

 

[terp720]

lmao, entitlement?! to what? If you're paying a small fortune to get where you want and go through the process getting what you want is the expected outcome, otherwise it's little more than just a waste.


love how you think not going through entire process suddenly invalidates my opinion. med schools do know what they're doing, but that doesn't stop it from being a ****** flawed system.

Kind of sounds like entitlement to me if you expect to get what you want... Yeah obviously, that's what everyone would like to happen, having put so much effort into the process, but we don't just pay money and get what we want.

 

[masaraksh]

lmao, entitlement?! to what? If you're paying a small fortune to get where you want and go through the process getting what you want is the expected outcome, otherwise it's little more than just a waste.


love how you think not going through entire process suddenly invalidates my opinion. med schools do know what they're doing, but that doesn't stop it from being a ****** flawed system.

Despite what you may think, you're probably not a beautiful and unique snowflake. There are something like 6 MILLION college students just in the US. Sure , most of them are not on the pre-med track, but a ton of them are. And many think they'd make a great dermatologist/etc. Well, its a competitive field, and if you want to get in you clearly need to just study harder and test better. Problem solved.


Oh yeah, and life is not fair. If I had gotten into Harvard, I'm sure I could have done well in my coursework there. But I didn't. Doesn't mean the system is not fair.

 

[mrh125]

Kind of sounds like entitlement to me if you expect to get what you want... Yeah obviously, that's what everyone would like to happen, having put so much effort into the process, but we don't just pay money and get what we want.

then how do you define realistic expectations? if you put in the time and effort and do have the capabilities, why should you get anything less than you deserve? there should be better ways of evaluating people than scores on standardized exams. expecting to get what you want based off of the time and effort you put in is part of the process. going to medical school and being forced to settle for a speciality you arent interested in such as becoming a general practitioner (no offense to them they're awesome) just seems like robbery given the amount of time and money people invest into this stuff. everything is competitive but aren't we going through a shortage in doctors (there were a lot of articles on that a while ago). The residency caps are still there, but there should be some level of being able to get what you want for what you pay for and the time you invest.

 

[mrh125]

Despite what you may think, you're probably not a beautiful and unique snowflake. There are something like 6 MILLION college students just in the US. Sure , most of them are not on the pre-med track, but a ton of them are. And many think they'd make a great dermatologist/etc. Well, its a competitive field, and if you want to get in you clearly need to just study harder and test better. Problem solved.


Oh yeah, and life is not fair. If I had gotten into Harvard, I'm sure I could have done well in my coursework there. But I didn't. Doesn't mean the system is not fair.

there are a diversity of people with different skills, some people dont excel at standardized tests, to just cater to those who can is absurd. not everyone is entitled to harvard obviously, but going to medical school if they are qualified and having a say over their speciality choice instead of being forced into a career based off of test scores seems pretty reasonable. you have a point though, it still seems more like a glass ceiling time thing tho.

 

[deleted407021]

then how do you define realistic expectations? if you put in the time and effort and do have the capabilities, why should you get anything less than you deserve? .

Perhaps your self assessment of time, effort and capabilities aren't enough to get you where you want to go. You must meet some outside standard.

 

[masaraksh]

there are a diversity of people with different skills, some people dont excel at standardized tests, to just cater to those who can is absurd. not everyone is entitled to harvard obviously, but going to medical school if they are qualified and having a say over their speciality choice instead of being forced into a career based off of test scores seems pretty reasonable. you have a point though, it still seems more like a glass ceiling time thing tho.

I didn't even bring up another flaw in your argument which is that you seem to believe that the Step 1 score is the single factor that determines your specialty. Lets say Derm for instance. I mean, if during medical school you do a TON of derm research + take a research year to do more + get first author papers in Derm journals, I would imagine it makes up for a lower Step 1.

 

[mcloaf]

lmao, entitlement?! to what? If you're paying a small fortune to get where you want and go through the process getting what you want is the expected outcome, otherwise it's little more than just a waste.

The only thing you're entitled to by paying for medical school is the chance to graduate with a medical degree if you work enough to graduate. Nobody cares if you think you'd make a great plastic surgeon; you have to work for it and out compete every body else who wants that job. Welcome to the real world.

then how do you define realistic expectations? if you put in the time and effort and do have the capabilities, why should you get anything less than you deserve? there should be better ways of evaluating people than scores on standardized exams. expecting to get what you want based off of the time and effort you put in is part of the process. going to medical school and being forced to settle for a speciality you arent interested in such as becoming a general practitioner (no offense to them they're awesome) just seems like robbery given the amount of time and money people invest into this stuff. everything is competitive but aren't we going through a shortage in doctors (there were a lot of articles on that a while ago). The residency caps are still there, but there should be some level of being able to get what you want for what you pay for and the time you invest.

Again, you don't deserve anything as a medical graduate beyond the chance to participate in the match. Everyone else worked hard and paid just as much money as you did to get there. This is not grade school; nobody cares about effort when what matters is results. If you can't handle this then don't go to medical school to get "robbed". To be frank, I don't know anyone from undergrad who had this attitude and was able to up in medical school.

I didn't even bring up another flaw in your argument which is that you seem to believe that the Step 1 score is the single factor that determines your specialty. Lets say Derm for instance. I mean, if during medical school you do a TON of derm research + take a research year to do more + get first author papers in Derm journals, I would imagine it makes up for a lower Step 1.

^Also this. Step 1 is important, but it's not like your residency application is just a sheet of paper with your name and boards score.

 

[mrh125]

I didn't even bring up another flaw in your argument which is that you seem to believe that the Step 1 score is the single factor that determines your specialty. Lets say Derm for instance. I mean, if during medical school you do a TON of derm research + take a research year to do more + get first author papers in Derm journals, I would imagine it makes up for a lower Step 1.

I know about research and E.C.s, but from what ive read regarding the step 1 and experienced with standardized tests is that they are such a major factor the impact of a lower score on them is hard to ignore. If the opportunities are still there in spite of lower scores that is great.

 

[Euxox]

This has already been said in the thread multiple times: Standardized testing is not a perfect tool for admissions or matching or certification, but it is the best tool available.

Why do I feel like this is related to your other thread about making up for a sub-30 MCAT score? Let's be honest here. If you had a 40 on the MCAT and a 2.7 GPA, would you still be saying that standardized testing is unfair and biased, or would you be railing against GPA?

 

[masaraksh]

Perhaps your self assessment of time, effort and capabilities aren't enough to get you where you want to go. You must meet some outside standard.

I heard for Ortho its your name, board score, + how much you bench. And you better bench more than your step 1