It's Official - USMLE Step 1 will be Pass/Fail in Jan 2022

[paradoxic_toxic]

Recent Announcements | USMLE

www.usmle.org

My take: low-tier MDs, Carribean MDs, and nearly all DOs in class of 2024 will get shafted. More emphasis now placed on Step 2 CK.

Thoughts?

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[Whysoez]

GG !

 

[bassquiat]

I wish they pushed it back a year so applicants who applied mainly to DO knew what they were getting into..

 

[Startingover123]

I wish they pushed it back a year so applicants who applied mainly to DO knew what they were getting into..

Would you have still applied? I imagine low tier schools will hurt from this.

 

[Whysoez]

I wish they pushed it back a year so applicants who applied mainly to DO knew what they were getting into..

Yup, I am one of those people who did not submit any MD app and went all out on DO.

 

[Startingover123]

I wish they pushed it back a year so applicants who applied mainly to DO knew what they were getting into..

Curious to what @Goro thinks.

 

[bassquiat]

Would you have still applied? I imagine low tier schools will hurt from this.

Yes, because I am still going to be a doctor. When I applied, I was mainly interested in just matriculating, and was thinking a solid step 1 score meant I had a decent a competitive residency. If I had known I would have applied to more MD schools and less of the "lower tier"/newer DO schools.

At the end of the day though I'm still happy to have a chance at a US medical school and a career in medicine even if it's in PC. Also, I'm not sure at the moment what will happen by the time we match, like if other factors will be overemphasized like Step 2 CK/LORs/auditions, etc. to compensate.

Yup, I am one of those people who did not submit any MD app and went all out on DO.

Yeah ngl man I feel like **** but I'm still going to work hard and do my best, everything else is out of my control at the moment

 

[PA_dud3]

So this is definitely bad for the DO-only crowd?

 

[Goro]

Curious to what @Goro thinks.

I remember quite recently when the MCAT changed that people were acting as if it was going to be administered in Korean.

The world is still here.

 

[Startingover123]

So this is definitely bad for the DO-only crowd?

Yes unless you only want FM or low tier IM

 

[Retro.viridae]

I'm an M0 so I'm still not completely familiar with the process, but didn't most DO students not take Step 2 before? Won't we just do that now? Or won't programs find a new metric to evaluate students by? I imagine it would be more qualitative than school reputation - perhaps LOR's and auditions.

 

[paradoxic_toxic]

For competitive residencies, it's possible that DO students will have to take Step 2 CK and do extremely well in order to have a shot. @Retro.viridae

 

[DOCMom84]

Yes unless you only want FM or low tier IM

I currently work for a medical school in the Neurosurgery department and our PD said this couldn't be further from the truth. Now, the importance will lie in your letters of recommendation, research, and personal statement. She said for years the ACGME has wanted PDs to steer away from putting such high importance on the scores and she believes this is their way of forcing them to look at all aspects of the applicant. Yes, the ultra competitive specialties will be even tougher but other specialties won't be out of any DOs grasp. Like @Goro said, people freaked out when they changed the MCAT and yet, here we are. Everyone just needs to chill on posting such ominous messages.

 

[Startingover123]

I currently work for a medical school in the Neurosurgery department and our PD said this couldn't be further from the truth. Now, the importance will lie in your letters of recommendation, research, and personal statement. She said for years the ACGME has wanted PDs to steer away from putting such high importance on the scores and she believes this is their way of forcing them to look at all aspects of the applicant. Yes, the ultra competitive specialties will be even tougher but other specialties won't be out of any DOs grasp. Like @Goro said, people freaked out when they changed the MCAT and yet, here we are. Everyone just needs to chill on posting such ominous messages.

What residencies do you think will be open to DOs?

 

[DOCMom84]

What residencies do you think will be open to DOs?

The same that are open to them now. A change in one exam isn’t all of the sudden going to stop DOs from getting into specialties.

 

[Goro]

I currently work for a medical school in the Neurosurgery department and our PD said this couldn't be further from the truth. Now, the importance will lie in your letters of recommendation, research, and personal statement. She said for years the ACGME has wanted PDs to steer away from putting such high importance on the scores and she believes this is their way of forcing them to look at all aspects of the applicant. Yes, the ultra competitive specialties will be even tougher but other specialties won't be out of any DOs grasp. Like @Goro said, people freaked out when they changed the MCAT and yet, here we are. Everyone just needs to chill on posting such ominous messages.

Nobody really knows, but I firmly believe that the sky is NOT falling.

Probably, Step II will be more important,

Even in the uber-residencies, they're more willing to take COMLEX II than COMLEX I.

I suspect that overworked PDs will simply have to go back to the past and do what they did before Step I mania.

So everybody, take two of these:

 

[gulli_97]

Nobody really knows, but I firmly believe that the sky is NOT falling.

Probably, Step II will be more important,

Even in the uber-residencies, they're more willing to take COMLEX II than COMLEX I.

I suspect that overworked PDs will simply have to go back to the past and do what they did before Step I mania.

So everybody, take two of these:
View attachment 295434

What did they do in the past?

 

[Goro]

What did they do in the past?

Actually have to read the application packets.

 

[gulli_97]

Actually have to read the application packets.

But do you not feel that this disadvantages DO students due to the residency merger? I was assuming the step exam being scored would've helped DO students in this manner.

 

[PA_dud3]

Yes unless you only want FM or low tier IM

Yessssss There is hope

 

[arjusmc]

I don't see how the sky is falling here, especially for DO students, maybe I'm just naive. The residencies that wouldn't look at DO students(Or carib MD) still won't. Residencies will probably have to dig into the applications more, which is better IMO. Having not taken step 1/2CK or comlex 1/2, logic would dictate that CK tests should be more important anyways. The emphasis on step 1 never really made sense to me. The match merger and now step 1 becoming p/f has injected a lot of uncertainty. I've noticed a trend around here, anything that is not 100% predictable means the sky is falling.

 

[Goro]

But do you not feel that this disadvantages DO students due to the residency merger? I was assuming the step exam being scored would've helped DO students in this manner.

I have yet to see any evidence that this will happen, other than the anxious ravings of preclinical Med students and pre-meds.

People are even starting to whine about making the MCAT go pass fail!

Frankly, the anxiety is getting to be a bit too much and until we hear from actual program directors and residents who help draw up Rank and interview lists, I would stop worrying about this.

Let's put this in a manner that lights a candle instead of curses the darkness, You are going to be doctors!

 

[deleted92121]

I’m not sure I’m qualified to comment but I may have a different perspective.
I’ve been truly privileged to work with medical students rotating through my trauma center for ten years. I try to chat them up to learn about their experience with medical school and boards. I also help them learn monkey skills like IVs, OG/NG, etc. And we talk shop as much as I can as a paramedic. But here’s the dirty secret; some are wicked book smart but don’t know which end of the IV hits the skin. High Step 1, low clinical acumen or social skills. This isn’t a rule but it happens. These folks have a better shot at derm or ortho or whatever over the more clinical astute student.
So maybe, just maybe, focusing on the clinical knowledge portion of the USMLE AND actual clinical skills evidenced during rotations is a better way to identify the strongest soon-to-be physicians. Sure, there are things to be worked out with timing and so on, but there is potential here.
I will admit I write this with excessive bias as I hope my medical background helps during rotations. But once I matriculate, none of that matters.

 

[WaterFlow]

I have yet to see any evidence that this will happen, other than the anxious ravings of preclinical Med students and pre-meds.

People are even starting to whine about making the MCAT go pass fail!

Frankly, the anxiety is getting to be a bit too much and until we hear from actual program directors and residents who help draw up Rank and interview lists, I would stop worrying about this.

Let's put this in a manner that lights a candle instead of curses the darkness, You are going to be doctors!

Goro, you are truly wise! Thank you for reminding me to chillax

 

[putmeincoach]

Ya'll need to chill lol. Let's wait for further information, esp from PDs and people involved in residency apps on their take and what the new benchmark is.

Once that's done, let's focus on blowing criteria that we can control, likely, aways performance, step 2, and research production/leadership, social skills, out of the water. So that PDs would never want to miss out on an outstanding future doctor like you.

 

[catloverLenny]

Yup, I am one of those people who did not submit any MD app and went all out on DO.

SAME, put my deposit and everything. My stomach has been in knots all day...

 

[sylvanthus]

I do think this is going to hurt DO students. Now PDs are likely to rely on step 2 ck to evaluate applicants, Those poor bastards who are gunning for ortho, ophtho, derm, etc, now have the potential to be doing research in the field, getting LOR in the field, setting up aways, and then having their souls crushed when they get their step 2 ck results back, giving them little time to switch to a backup plan.

Lets be honest also, DO students are less likely to have the opportunities that go with many MD programs for good LOR from those in their chosen field, good research opportunities, networking etc. etc

While the sky isn't falling, I think it is naive to think this wont harm DO students shooting for more competitive specialties.

 

[diamondkings]

The date is 2/13/20... just making sure the sky is still up high where it’s supposed to be? After the big news yesterday, there are a lot of unknowns. On the bright side, only have 1 test to prepare for at the end of 2nd year. Of course Step 2 CK looks to replace step one, but at least from what I’ve read, will it still be possible to attend a fairly good Family Medicine residency as a DO? Will it help a good amount going to a State DO school with its own teaching hospital? Someone give me some breathing room lol.

 

[never-too-late]

Does this affect me at all if i already wanted to do family medicine in a residency that was DO prior to the combining of DO and MD residency programs? I didn’t go all in on DO, but I didn’t get any MD interviews.

 

[ApplicantPerson88]

If I am lucky enough to be accepted into a DO program, I am planning to do primary care with psychiatry and PMR as alternatives if it end up not working well. I think this action along with the MD-DO merger is clearly designed to protect the US MD graduates (~4-5% attrition & not matched/scramble; the P/F Step 1 & residency merger can be a partial solution to both of their problems). I do not know if the AOA would have gone along with the merger if they knew that Step 1 was going to be P/F the next year. I think the summer after MS1 will be even more important because for the people that want a competitive specialty, they will need to find a good mentor who can flood you with publications, networking (4th year clerkship), and LoR. The DO system is undergoing unprecedented change (most likely propelled by the lack of residency spots for MD & DO): first with the grade replacement, now with residency merger, and Step 1 becoming P/F (we can only imagine what the future will bring). Going to the Caribbean now appears even more discouraging than previously (this is from someone who has friends that got into competitive MD residencies from the Caribbean).

 

[arjusmc]

@Goro, do you see Comlex 1 scores actually being looked at by traditionally MD residencies for DOs, considering still has a score and percentile? Not that I'm all that informed on the subject, but from what I understand it was not taken all that seriously in the past.

 

[The Hound]

@Goro, do you see Comlex 1 scores actually being looked at by traditionally MD residencies for DOs, considering still has a score and percentile? Not that I'm all that informed on the subject, but from what I understand it was not taken all that seriously in the past.

Maybe to differentiate DOs from each other, but I seriously doubt they’ll use it to compare us to our MD counterparts.

 

[AnatomyGrey12]

So this is definitely bad for the DO-only crowd?

Yes. Without question. Anyone who says otherwise is incredibly naive.

I remember quite recently when the MCAT changed that people were acting as if it was going to be administered in Korean.

The world is still here.

The MCAT didn't go P/F.... It still maintained a reported percentile... It's not even kind of similar.

I do think this is going to hurt DO students. Now PDs are likely to rely on step 2 ck to evaluate applicants, Those poor bastards who are gunning for ortho, ophtho, derm, etc, now have the potential to be doing research in the field, getting LOR in the field, setting up aways, and then having their souls crushed when they get their step 2 ck results back, giving them little time to switch to a backup plan.

Lets be honest also, DO students are less likely to have the opportunities that go with many MD programs for good LOR from those in their chosen field, good research opportunities, networking etc. etc

While the sky isn't falling, I think it is naive to think this wont harm DO students shooting for more competitive specialties.

Not to mention that the quality of matches in other, less competitive fields will drop as well. In fields like OB/GS/Anesthesia DO's could get to solid low to mid-tier university programs purely because of their scores and how they compared to their MD counterparts. Many of these students were not necessarily superstars either, I'm talking 230-240 type applicants. Taking away Step 1 quite literally cuts out from under these applicants the vehicle that they used to get there. I truly predict we will see fewer and fewer DO's "punching up."

 

[Goro]

Those who know, aren't talking.

Those who are talking, don't know.

 

[Goro]

@Goro, do you see Comlex 1 scores actually being looked at by traditionally MD residencies for DOs, considering still has a score and percentile? Not that I'm all that informed on the subject, but from what I understand it was not taken all that seriously in the past.

Let's try a thought experiment: You're a PD who gets 3000 apps. Here's something with a score, a baseline, a median and a percentile. What do you do?

 

[BASBaseball15]

Let's try a thought experiment: You're a PD who gets 3000 apps. Here's something with a score, a baseline, a median and a percentile. What do you do?

Attending a DO program this fall. I'm sure you're much more educated than I am on the topic. Out of curiosity, do you think the PDs will just use the Step 2 CK the same way they used the Step 1?

 

[arjusmc]

I’d probably make a spread sheet with all the Comlex and step scores from recent DO applicants and how I ranked them. I’d look for correlations. Probably would include how residents did that actually came to my program performed and look at their scores more closely.

Let's try a thought experiment: You're a PD who gets 3000 apps. Here's something with a score, a baseline, a median and a percentile. What do you do?

 

[Goro]

I’d probably make a spread sheet with all the Comlex and step scores from recent DO applicants and how I ranked them. I’d look for correlations. Probably would include how residents did that actually came to my program performed and look at their scores more closely.

Ahh, how refreshing to see someone thinking critically for a change!!!

 

[Goro]

Attending a DO program this fall. I'm sure you're much more educated than I am on the topic. Out of curiosity, do you think the PDs will just use the Step 2 CK the same way they used the Step 1?

I'll be commenting on this issue overall soon. But this is a possibility and a good one for DO students overall.

 

[Whysoez]

I'll be commenting on this issue overall soon. But this is a possibility and a good one for DO students overall.

Now I am quite intrigued

 

[Jeanne d'Arc]

So glad I want to apply this upcoming cycle with IM as my top specialty, I dont know if this news will make getting in easier or not but I will go to whatever school accepts me. I always did think of Anesthesiology being interesting, does anyone here know how hard that will be to get into after this (Assuming I got accepted to a mid or low tier DO school for humble perspectives).

 

[The Hound]

So glad I want to apply this upcoming cycle with IM as my top specialty, I dont know if this news will make getting in easier or not but I will go to whatever school accepts me. I always did think of Anesthesiology being interesting, does anyone here know how hard that will be to get into after this (Assuming I got accepted to a mid or low tier DO school for humble perspectives).

I’ll save you some reading. No one really knows what’s going to happen.

 

[Jeanne d'Arc]

I was thinking the same. It seems like SDN thinks that the world is about to end. Calm down people, use that energy on something else. I dont know what is more thrilling, reading the comments people are making these past few days or watching a movie? I guess ill make popcorn every time I get on here so I can get a laugh at people's absurd opinions. Move on, DO is not dead...

 

[RhesusPuffs]

There is no way this is good for DOs. Just like how there was no way the ACGME AOA merger was good for DOs, yet some people still wanted to be delusional and hold onto that belief. DO prejudice will be stronger than ever before because they don't any other objective measures to use to evaluate a student.

 

[Chibucks15]

Literally none of you know what you’re talking about and that’s fine, you aren’t supposed to yet. But talking in definitives helps no one. There hasn’t been this absolute shut out of DOs in residency apps yet, even with the merged system coming I don’t think that’ll change all that much. Most people went NRMP anyway and matched at a higher rate than ever.
Everyone on here is talking out their ass with no proof of anything. Everyone loves to speculate. Why does everyone assume people will just blow off step since it’s pass fail? This exam isn’t easy regardless.

coming from someone who’s actually taken the damn things and is tired of hearing about how “screwed” everyone is. I’m a non trad and the amount of immaturity seen on here and elsewhere is mind boggling. Not everyone wants to do derm or surgery or whatever. Honestly most of those fields are absolutely awful to most people, hence why most end up IM/FM/EM.

everyone just chill out. Old guy out. Night shifts are fun guys and gals you have time to rant away

 

[BASBaseball15]

There is no way this is good for DOs. Just like how there was no way the ACGME AOA merger was good for DOs, yet some people still wanted to be delusional and hold onto that belief. DO prejudice will be stronger than ever before because they don't any other objective measures to use to evaluate a student.

Source? Or are you just a neurotic and cynical premed/med student who is never happy?

 

[Whysoez]

Source? Or are you just a neurotic and cynical premed/med student who is never happy?

Match 2020 data is not out yet so we do not know atm whether or not the merger was bad for DOs. Step 1 becoming P/F will probably not as bad as speculated, however it introduces more stress (now having to take Step 2) and uncertainty (Not knowing your Step 2/Competitiveness until late 3rd year).

 

[BASBaseball15]

Match 2020 data is not out yet so we do not know atm whether or not the merger was bad for DOs. Step 1 becoming P/F will probably not as bad as speculated, however it introduces more stress (now having to take Step 2) and uncertainty (Not knowing your Step 2/Competitiveness until late 3rd year).

Good point. Also, a lot of DO programs moved to prioritizing the MD residencies last year. The school I currently have my seat deposit at had 90% of their match go to ACGME last year.

 

[Limvostov]

I currently work for a medical school in the Neurosurgery department and our PD said this couldn't be further from the truth. Now, the importance will lie in your letters of recommendation, research, and personal statement. She said for years the ACGME has wanted PDs to steer away from putting such high importance on the scores and she believes this is their way of forcing them to look at all aspects of the applicant. Yes, the ultra competitive specialties will be even tougher but other specialties won't be out of any DOs grasp. Like @Goro said, people freaked out when they changed the MCAT and yet, here we are. Everyone just needs to chill on posting such ominous messages.

So, we discuss board scores all the time for incoming fellows. They matter a lot because of national program rankings from the ITE (in-service training exam). This is how programs are measured against each other and the board pass rate of trainees are predicted. Those with lower board scores tend to score lower on the ITE which has repercussions for the program. We can't moonlight unless our ITE score is high enough... so it can hit your pocketbook too. Having high board scores is relevant. The cohort you're being tested against also has a certain level of being able to take a test and you need to be well within that range to succeed on passing your boards. For cardiology there are many to take (IM, gen cards, echo, nuc med, sub-specialty if applicable...). What we plan to do to weed out lower scores is to have an exam during our interview process. Many residencies already do this as part of the interview day.

 

[WaterFlow]

Got this email from Kaplan. I think its good advice in terms of how to approach studying.