Yeah that’s fine. I also said in another thread a while ago that the pass thresholds for Step should drop to 180s because a pass threshold for Step 1 being 196 and for Step 2 being in 214 is completely absurd. So I get your concerns
It should test for minimum competency needed to practice medicine, not to weed people out
I agree with this completely. The test threshold should no longer be about failing doctors. It should be about the minimal competency needed to move on to clinicals.
I understand where you’re coming from. But in my mind that form of thinking is like saying DOs are cats trying to fit in with the lions of MDs.
You aren’t stating the truth… You’re stating your opinion. Go ahead and take STEP 1 and get your pass. PDs care about one thing, an f’ing score not proving your worth.
Whether or not a passing on step 1 matters if you plan on taking step 2 is unknown, but I wanted to add that being able to pass step 1 puts the student on the path to doing well on step 2. If you don't take step 1 I'm not sure a DO student would understand how much more difficult it is compared to COMLEX. The naive plan may be to do well on step 2 but people who don't tale step 1 may be caught off guard by its difficulty, especially if they are only taking NBOME shelf exams. Speaking from experience, percentile wise I am consistently and significantly lower on the NBME exams.
Students should be taking UW1 and UW2… Those are the scores for S1 that matter now. It surprises me that so many students think “my percentile decreases when I take S1 compared to L1, therefor S1 = more complex.” It’s more likely the test are of equal difficulty (I didn’t notice some wild difficulty curve you speak of) but the test takers’ ability have changed compared to the cohort. The one consistent thing was my score was similar to UWSA.
I've seen a lot of programs online that won't even interview without a step 1 score bro. So clearly, showing that you passed does matter. Pass-Fail Step 1 is only a recent development too, so it's not like every single PD no longer cares about Step 1 and almost immediately started drooling at Step 2. Just take both and let's leave it at that.
FWIW, I've spoken directly with multiple PDs in some of the surgical fields that say they "expect to see you pass Step 1", and that "any failed Step 1 would knock you out of the running", and that competitive applicants need to go crush Step 2 out of the park.
No one will see the Step 2 255 because you’ll be auto screened without a Step 1 P.
You might be right; I’ll even concede and say you’re right because I have no skin in the game…
This happens in very run of the mill programs too not just some SDN ivory tower in surgical subs. I have first hand knowledge of that via my med school, faculty friends, and being involved in the process during my TY which involved learning how the other GME programs filter applicants.
What's your criteria for prestigious specialty? Are you referring to surgical subspecialties as prestigious? Or specialties offered at top 10 locations? Because the specialty that I'm thinking of is not a surgical subspecialty and the program that I'm thinking of is most definitely not a top 10 program. Maybe mid-tier, slightly a bit lower at best, but they will definitely not interview you if you don't have a Step 1. Even if there are DOs there and they might have somewhat of an idea how COMLEX works. Step 1 is what they know. There definitely are some programs out there that won't require you to take Step 1 or even report it. But it's not like Harvard or Yale are the only programs asking for a Step 1 score and denying people if they don't have it. If all you're interested in are specialties in locations that are perfectly fine with just COMLEX and won't screen you out for no Step 1, then you'll definitely find those. Not entirely sure how many of those there will be, but it's not like there's thousands of them, waiting for you to apply. You're definitely shooting yourself in the foot by not taking Step 1. You're limiting yourself when you don't necessarily have to. Why put yourself through that if you know it's something that you can change?
I know 100% my program will not look at a DO without a Step 1. I have many friends and contacts at other programs, their programs filter the same way mine does
I honestly can’t imagine programs looking hard enough to tell if that even happened. I had classmates who did anatomy or omm fellowships purely to spend an entire year studying for step 1. Those who performed well did not have anyone bat an eye to my knowledge.
They won’t care. No one will look that in depth anyway. They only see the score.
As someone who has been involved in the process at two places and knows two PDs as family and close friends, I can tell you that the filters and their use are real. It's not some made up thing. It takes 2 seconds and decreases the number of people to sort. It's reality in a world with too many applicants to actually review properly.
The problem with this rationale is ignoring the fact that programs are going to receive too many people with both a P and a good step 2 score to even worry about those with only one or the other.
It's all on a scale. I think it's a fallacy to assume that outside of the top there's a sudden dichotomous switch to where it'll be suddenly not checked. With application numbers sky-rocketing, it's more important now than ever to ensure that all the boxes are checked in order to not be screened out somewhere with the hopes that you'll get love from programs. The number of spots per applicant in competitive fields means there are just too many good applicants with both to fill pretty much every PGY1 categorical spot in the country.
Strong work. Everything you say here is 100% wrong, yet you say it with such confidence…
If you think you can pass Step 1 you should by all means take it. The argument is: will not taking it for whatever reason affect the DO student who is attempting at mid-level specialties? I believe if that DO student excels at the examination with an actual score, then the value of passing Step 1 becomes nearly completely negligible for most mid-level and below specialties.
I find it amusing you are doubling down on this. Residency websites, in my specialty all programs, state that you must pass Step 1 on the first attempt to be eligible for consideration. And you really think programs won’t filter for those that have a P on Step 1? Programs will never see your 250 Step 2 because they absolutely will employ such filters before they even do app reviews. It is nothing but magical thinking to believe otherwise.
I just told you that 4 programs are definitely doing it. The rational is that it takes two seconds to add that filter and every bit counts when you have too many qualified people. I literally just told you what you are saying won't happen is happening lol. It's just convenient.
These two thoughts are contradictory. There's really no reason to not take the exam, other than doubt in one's ability to pass it. Step 1 has many faults, but it is still the first standardized hurdle that board-certified physicians take, and it is an expectation for PDs to see you pass that in order to build confidence in them that you can pass Step 3 after you start at their residency program.
And this is data from 2020, before Step 1 shifted to P/F... +70% for the mid-level specs and +80/90% for the lower-level specs
Agreed.
The people who made these types of arguments at my school were the ones who didn’t match.
but in order to get a solid step 2 score, you're probably more likely than not taking step 1 anyway. I don't think anyone is arguing that it's impossible to match without step 1, but there's no reason to think that only taking comlex is anything but lowering your competitiveness
Your data doesn’t show what you think it shows…
A P on Step 1 is the norm…. It always will be.
The "concrete" data that you are showing is that outside of FM/Peds/OBGYN, is that not taking Step 1, at best, lowers your chance in matching by only 15% and lowers your chance at matching to the mid 70s percentage wise, and at worst, plummets it down to a ~1 in 2 chance of not matching.
You are also assuming people will all of a sudden just stop unchecking a box that they have for years (decades?) just because it went pass fail. It’s easier for the programs to continue to check a box via muscle memory than to objectively think about not checking it this time because it’s pass fail now. You’re also starting to move the goal posts. You’re moving into the nuanced specialty. With the ortho match you are putting your eggs all in the DO basket realistically. Now if you move to something without so many former AOA spots then talk about that. ENT? Derm? Even a step down in competitiveness, rads? Gen surg (previously acgme prior to merger). All of these specialities would check that box.
One thing everyone can agree on is that not taking step 1 will only potentially impede you and will serve no benefit. You kill it? Congrats you have a great equivalency metric. You fail it? Oh no.... just don't report it and apply like you never took it.
Also that data is from 2020. Look at the DO match stats for rads and gas in 2020 compared to this year. I am sure it would change this chart for the worse.
