USMLE 6 Attempt for exams ----- Unfair Policy change by the NBME/USMLE folks

[DermViser]

Right now, the NBME is telling programs that a person who makes a 230 on their exam will be a better resident than someone who makes a 215. Is that true? Plenty of people say no. But that's how PDs use the information. It certainly makes the PDs job easier.

Or between a 230/235 and 240. The problem is it's the same score, but the mean for the exam has gone up tremendously. You'll be amazed how allegedly accomplished and smart PDs will think someone who gets a higher score is "smarter". It creates a halo effect. SMH.

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[Makati2008]

Are you serious? You implied I either failed the exam multiple times or had a low score and that was the basis for my post and opinion. Where's the option for passed the first time and did well? That is as snide as it comes and tact went out the window with your comment. Don't dish it out if you can't take it back.

This is an anonymous forum. Stating that I made 250+ on every step adds zero credibility to any of my posts, so I don't see why my exam performance is being repeatedly brought up. But, for what it's worth (which is NOTHING), I passed all my exams first try with plenty of room to spare.

Yep I'm serious. As I stated I was wondering why you were here in the forum about this subject.

Anyway take care.

 

[tco]

It does provide an additional point of consideration if you've passed all of your step exams on the first try (but not necessarily a better argument). Think about it. Who are the people that whine about things being "unfair?" Usually the people that have been "victimized."

 

[Makati2008]

I don't know what a "sloes" is.

How do you outperform someone in watching residents read diagnostic studies? I did an away rotation at an IR program that I could contribute to and learn at (Arkansas). I would not trade that for any other experience. I was the primary operator on more procedures than most residents in a month. I also learned that I, for sure, want to do IR for my career.

What do you mean "going to high tiered programs?" Going for residency or for medical school? I wouldn't change where I went for medical school. I stayed in state and saved a boatload of money. I'll be leaving medical school with 80k in debt. I would not trade that for 300k in debt from a higher tiered program when I got, what I feel was, a tremendous education at my institution. I will argue that my step scores provide evidence that my school's education is just as good (or at least no worse than) any other program in the country. Could I have done better at Duke or MGH or Hopkins? Maybe, but we'll never know. The only thing I know is that I'm definitely competent for my level of training, and I'm confident that I can perform my duties, and I know when to ask for help if I get into trouble. The latter most is a characteristic that might not be present in a resident that takes a step exam more than 3 or 4 times.

Hey sorry tco,
I didn't think about radiology and that being a problem. I assume some of the other areas of medicine would be the same?

A sloe is what EM uses to evaluate applicants against each other(standard letter of eval.)

As far as school I wasn't meaning that. I was meaning the radiology programs(which after your explanation my ideal wouldn't work)

.

 

[colbgw02]

If that's the case, 6 times is a pretty poor "system check" How about 3 times? Or at least a time limit (e.g., you can only take the exam 3 times in 10 years) to allow people to correct for mistakes of the distant past.

I agree. I was surprised to learn that they permit so many retakes. I'm thinking something like no more than 3 chances on any given exam and a limit on the total number of attempts around 6-7 for all steps.

 

[Elisabeth Kate]

I did not know that it was this bad in parts of the country. And it's only going to get worse.

Yay, wide open immigration policies/lack of law enforcement!

Let's not hijack this thread. There are other forums to air out your bigotry.

Nor should there be any policy preventing people from attempting retakes in order to better their score

So Step 1 should be like the MCAT where people with a 260 will take it over to aim for that 280? Ridiculous.

What residency program in the country would take such an applicant without compelling evidence that he could graduate and pass boards? Again, show me one example of this happening, ever

As someone has already told you, no one can show you an example because we're not privvy to that information. None of us know how many times any other candidate took their boards. It's hardly something candidates and PDs broadcast.

Right now, the NBME is telling programs that a person who makes a 230 on their exam will be a better resident than someone who makes a 215

The NBME isn't telling anyone anything. The USMLE was meant to only judge minimal competence. It's PDs who turned it into a competition for the best residency slots.

 

[evilbooyaa]

If on step 1 you score 185, 185, 185, 185, 185, 185, and then 255. Well clearly you decided to get your **** together and study that 7th time. Is that person less competent than somebody who scored 255 the first time? Well no, they both got the same score on a STANDARDIZED OBJECTIVELY GRADED exam. What it amounts to is punishing the retaker for being a lazy ass the first 6 times.

I fundamentally disagree with the argument above. If I were a PD, I would take the guy who scored a 255 the first time 999 out of 1000 times. The 1 time is if the other candidate was holding my family hostage or had really good blackmail on me. Even someone who went 185 -> 255 (with only 1 retake) is a worse candidate for residency (all other things being equal) than the guy who got 255 on the first run.

While the idea of being allowed to take Step exams multiple times is an interesting one, I believe it would artificially inflate the averages for more competitive specialties even further. You give the test more power in determining a candidate's residency prospects when you give them the power to re-take it. As someone who is championing to limit the amount of importance that the Step exams have on a PD's outlook on a candidate, this seems like it goes against what you are championing with the rest of your posts.

 

[Substance]

There should be multiple Steps close together to evaluate a trend of competence and knowledge. Step I is like the Superbowl. If you have a bad day, you lose.

 

[Priapism4tooLong]

well since you guys are talking about the steps...

A wise man once told me, Your medical career is like the human body. I said "what??? huh?? what do you mean??" As you can imagine i was utterly bewildered by this statement. After this he continued to speak words that would change my life, and my medical career forever.

He Said "The Human body wants to STEP forward. Move Forward" I said " Yeah thats true" He said " Just like the human body wants to step forwards you will have to take the STEPS, one and two." - Amazing. Then he said " In order for the human body to work you need to have parts that work, and just like your medical career it will never move forward until you have parts, or subjects that you know. For instance imagine Physiology as being your lungs, now without the lungs as a whole the human body will not function. And without physiology your medical career will not move forward".

I said "wow that is true, without physiology medicine would be impossible, just like it would be to live"

He said " Now imagine pathology/pathophysiology as your liver. Without the liver you would not be able to live and without pathology/pathophysiology you would not be able to take STEPS (steps one and two) In your medical career."

I said "Thats very true"

He said "Now imagine the lungs got an infection. Imagine the infection as the tests you take. How do you fight off the infection? With your immune system and antibiotics!!, And the immune system and antibiotics are your STUDY HABITS, you Want to STUDY HARD so you can fight off the infection! And over come the infection to take your steps!" (I'm guessing he meant one and two)
Then he said "Sometimes you have a little infection (small tests) where you might not need a lot of antibiotics or a strong immune system. Which means you don't have to study as hard. But other times you get big bad infections. Where you need a very strong immune system and strong antibiotics (you want to study harder!)!. You don't want to end up in sepsis!."

 

[DermViser]

well since you guys are talking about the steps...

A wise man once told me, Your medical career is like the human body. I said "what??? huh?? what do you mean??" As you can imagine i was utterly bewildered by this statement. After this he continued to speak words that would change my life, and my medical career forever.

He Said "The Human body wants to STEP forward. Move Forward" I said " Yeah thats true" He said " Just like the human body wants to step forwards you will have to take the STEPS, one and two." - Amazing. Then he said " In order for the human body to work you need to have parts that work, and just like your medical career it will never move forward until you have parts, or subjects that you know. For instance imagine Physiology as being your lungs, now without the lungs as a whole the human body will not function. And without physiology your medical career will not move forward".

I said "wow that is true, without physiology medicine would be impossible, just like it would be to live"

He said " Now imagine pathology/pathophysiology as your liver. Without the liver you would not be able to live and without pathology/pathophysiology you would not be able to take STEPS (steps one and two) In your medical career."

I said "Thats very true"

He said "Now imagine the lungs got an infection. Imagine the infection as the tests you take. How do you fight off the infection? With your immune system and antibiotics!!, And the immune system and antibiotics are your STUDY HABITS, you Want to STUDY HARD so you can fight off the infection! And over come the infection to take your steps!" (I'm guessing he meant one and two)
Then he said "Sometimes you have a little infection (small tests) where you might not need a lot of antibiotics or a strong immune system. Which means you don't have to study as hard. But other times you get big bad infections. Where you need a very strong immune system and strong antibiotics (you want to study harder!)!. You don't want to end up in sepsis!."

Give it up, already. The same story again.

 

[evilbooyaa]

well since you guys are talking about the steps...

A wise man once told me, Your medical career is like the human body. I said "what??? huh?? what do you mean??" As you can imagine i was utterly bewildered by this statement. After this he continued to speak words that would change my life, and my medical career forever.

He Said "The Human body wants to STEP forward. Move Forward" I said " Yeah thats true" He said " Just like the human body wants to step forwards you will have to take the STEPS, one and two." - Amazing. Then he said " In order for the human body to work you need to have parts that work, and just like your medical career it will never move forward until you have parts, or subjects that you know. For instance imagine Physiology as being your lungs, now without the lungs as a whole the human body will not function. And without physiology your medical career will not move forward".

I said "wow that is true, without physiology medicine would be impossible, just like it would be to live"

He said " Now imagine pathology/pathophysiology as your liver. Without the liver you would not be able to live and without pathology/pathophysiology you would not be able to take STEPS (steps one and two) In your medical career."

I said "Thats very true"

He said "Now imagine the lungs got an infection. Imagine the infection as the tests you take. How do you fight off the infection? With your immune system and antibiotics!!, And the immune system and antibiotics are your STUDY HABITS, you Want to STUDY HARD so you can fight off the infection! And over come the infection to take your steps!" (I'm guessing he meant one and two)
Then he said "Sometimes you have a little infection (small tests) where you might not need a lot of antibiotics or a strong immune system. Which means you don't have to study as hard. But other times you get big bad infections. Where you need a very strong immune system and strong antibiotics (you want to study harder!)!. You don't want to end up in sepsis!."

 

[DermViser]

Love this mind picture. I can imagine him saying all that and then (SLAP)

 

[Flamen04]

99% of the people in my class passed with a scored above a 220 on their first try... People asking for more time: 1) are entitled 2) are stubborn 3) are probably not fit for medicine anyways

 

[DermViser]

99% of the people in my class passed with a scored above a 220 on their first try... People asking for more time: 1) are entitled 2) are stubborn 3) are probably not fit for medicine anyways

 

[Beth_W737]

You have no idea if that is completely true, students and schools don't broadcast those who fail. As others have said, you can fail once due to being ill, bad day, test anxiety, etc. One failure does not make you a bad or incompetent doctor but I agree there should be a limit - total of 6-7 tries for all 3 steps.

QUOTE="Flamen04, post: 15273765, member: 209712"]99% of the people in my class passed with a scored above a 220 on their first try... People asking for more time: 1) are entitled 2) are stubborn 3) are probably not fit for medicine anyways[/QUOTE]

 

[drcrispmd]

Honestly I think 4 times between all exams should be the limit because at 4 failure you will be very lucky to get any interviews because programs worry about passing boards.

SGU allows student 2 opportunities to pass Step 1, after that they are dismissed. I think this is a good policy.

 

[Elisabeth Kate]

99% of the people in my class passed with a scored above a 220 on their first try... People asking for more time: 1) are entitled 2) are stubborn 3) are probably not fit for medicine anyways

Enough with the bragging. You can't apply the alleged results of your class with everyone else.

 

[Brain Bucket]

99% of the people in my class passed with a scored above a 220 on their first try... People asking for more time: 1) are entitled 2) are stubborn 3) are probably not fit for medicine anyways

Don't believe you. Proof please.

 

[DermViser]

Enough with the bragging. You can't apply the alleged results of your class with everyone else.

I call BS on saying EVERYONE in his class scoring at least a 220. Yeah, they TOLD you that, bc med students always share their true scores based on their track record.

 

[Flamen04]

It is SDN after all. I really don't care if you believe me or not, but that's the truth. Over 50% scored between 230 - 245. Anywho, I misspoke in my last comment. I meant to stay that I don't agree with people being allowed multiple retakes. It's alright if you have to retake it ONCE, but THATS IT.

 

[DermViser]

It is SDN after all. I really don't care if you believe me or not, but that's the truth. Over 50% scored between 230 - 245. Anywho, I misspoke in my last comment. I meant to stay that I don't agree with people being allowed multiple retakes. It's alright if you have to retake it ONCE, but THATS IT.

What a change in tone from "Step sucked. Worst month of my life. Still recovering from it. You should be scared. But in the end you survive and try to move on."

 

[Flamen04]

What a change in tone from "Step sucked. Worst month of my life. Still recovering from it. You should be scared. But in the end you survive and try to move on."

I don't see how it is a change of tone when we are talking about TWO different subjects entirely. This thread is about allowing multiple retakes. The post you sadly took the time to look through my history and find is from a thread about being scared of step 1. You can think step 1 is a hard and stressful test, yet not agree with people retaking it multiple times.

 

[DermViser]

I don't see how it is a change of tone when we are talking about TWO different subjects entirely. This thread is about allowing multiple retakes. The post you sadly took the time to look through my history and find is from a thread about being scared of step 1. You can think step 1 is a hard and stressful test, yet not agree with people retaking it multiple times.

You said "It's alright if you have to retake it ONCE, but THATS IT."

 

[Flamen04]

You said "It's alright if you have to retake it ONCE, but THATS IT."

I still agree with that... I am sorry, DermViser, the allmighty forum master, that I said I don't agree with people retaking it "multiple times," instead of "more than two times." This is getting to be pointless. As Nsync would say, bye bye bye.

 

[evilbooyaa]

It is SDN after all. I really don't care if you believe me or not, but that's the truth. Over 50% scored between 230 - 245. Anywho, I misspoke in my last comment. I meant to stay that I don't agree with people being allowed multiple retakes. It's alright if you have to retake it ONCE, but THATS IT.

How in the world do you claim to know this? Did you ask ALL of your classmates their Step 1 score, and are such good friends with them that not one of them would consider lying or inflating their score to you?

 

[Flamen04]

How in the world do you claim to know this? Did you ask ALL of your classmates their Step 1 score, and are such good friends with them that not one of them would consider lying or inflating their score to you?

I'm sorry my school doesn't lie to us and gives us an anonymous breakdown of our class Step 1 performance.

 

[Dave89]

I'm sorry my school doesn't lie to us and gives us an anonymous breakdown of our class Step 1 performance.

That's an incredibly stupid idea, IMO.

Once boards are done, they should be done. No more comparing oneself to the mean or median, no more feeling proud or bad about one's performance, no more attempts to find out how other students did... it should just be over, like a bad dream.

 

[evilbooyaa]

I'm sorry my school doesn't lie to us and gives us an anonymous breakdown of our class Step 1 performance.

Lol. Wow, that's dumb.

 

[Flamen04]

I never said no one failed step. 99% isn't 100% last time I checked. But seriously, why is all this attention being given to one post that I made? I swear its being blown up way out of proportion. Stop going off topic and discuss the original topic of the thread: being allowed to take step 5+ times.

 

[Makati2008]

I'm sorry my school doesn't lie to us and gives us an anonymous breakdown of our class Step 1 performance.

How big is your class?

 

[evilbooyaa]

I don't give a crap about the 1% of your class that failed. What I care about is that your school thinks it's a good idea to show a histogram of Step 1 scores like they're showing a histogram of grades from the most recent in-house exam.

 

[Flamen04]

If it makes you feel any better about yourself, its a Caribbean school.

 

[mvenus929]

I don't give a crap about the 1% of your class that failed. What I care about is that your school thinks it's a good idea to show a histogram of Step 1 scores like they're showing a histogram of grades from the most recent in-house exam.

My school provides the information the NBME gives them at the end of each year, which includes how many passed on their first attempt, the average score, etc, and yes, includes a histogram of scores. It's available publicly on our student website, and prospective students can take a look at it too. It's not the end of the world.

 

[DermViser]

If it makes you feel any better about yourself, its a Caribbean school.

No wonder you sound so callous.

 

[DermViser]

My school provides the information the NBME gives them at the end of each year, which includes how many passed on their first attempt, the average score, etc, and yes, includes a histogram of scores. It's available publicly on our student website, and prospective students can take a look at it too. It's not the end of the world.

An NBME comprehensive shelf is not the same as a USMLE score.

 

[evilbooyaa]

If it makes you feel any better about yourself, its a Caribbean school.

Aha. Let me go throw my smug face on.

 

[mvenus929]

An NBME comprehensive shelf is not the same as a USMLE score.

I wasn't talking about a Shelf, I was talking about Step 1. (And Step 2 CK and CS)

 

[DermViser]

I wasn't talking about a Shelf, I was talking about Step 1. (And Step 2 CK and CS)

Then you must go to UVa bc that's the only school that posts their NBME school score reports.

 

[mvenus929]

Then you must go to UVa bc that's the only school that posts their NBME school score reports.

Your powers of deduction are amazing. I was specifically responding to evilbooya saying that it is a bad idea to show histograms of step 1 scores. It's provided by the NBME to every school. If a school wants to send it out to their students, it's not the end of the world.

 

[evilbooyaa]

Your powers of deduction are amazing. I was specifically responding to evilbooya saying that it is a bad idea to show histograms of step 1 scores. It's provided by the NBME to every school. If a school wants to send it out to their students, it's not the end of the world.

If it's not a bad idea, how come there's only one US school that does it? I don't think it's the end of the world, but Step 1 scores are generally more guarded amongst the student body (except between friends) compared to general exam scores.

I don't mean to act like I'm completely over-reacting and saying it's the end of the world, there's just something in my gut that tells me, "this is prob not a good idea".

 

[DermViser]

If it's not a bad idea, how come there's only one US school that does it? I don't think it's the end of the world, but Step 1 scores are generally more guarded amongst the student body (except between friends) compared to general exam scores.

I don't mean to act like I'm completely over-reacting and saying it's the end of the world, there's just something in my gut that tells me, "this is prob not a good idea".

The only reason UVa does it is bc their scores are likely top notch.

 

[Flamen04]

If it's not a bad idea, how come there's only one US school that does it? I don't think it's the end of the world, but Step 1 scores are generally more guarded amongst the student body (except between friends) compared to general exam scores.

I don't mean to act like I'm completely over-reacting and saying it's the end of the world, there's just something in my gut that tells me, "this is prob not a good idea".

I fail to see why. If it's anonymous, there is no harm done. If someone fails, most people end up finding out about it anyways because they mysteriously get pulled out of their current rotation so they can study for the retake. It's not like it's a big secret. You also end up knowing who did well because most likely they are the ones who did well in the first two years. There is also no surprise there. That leaves you with the majority of the class with average scores that no one really cares about.

 

[mvenus929]

If it's not a bad idea, how come there's only one US school that does it? I don't think it's the end of the world, but Step 1 scores are generally more guarded amongst the student body (except between friends) compared to general exam scores.

Just because UVA is the only one who posts theirs publicly doesn't mean that other schools don't share the information with students. And, at least in my class, looking at the histogram of Step 1 scores really isn't that different than looking at other exam scores. You may know a few people up top and a few people down low, but the rest of the people in the middle you can't really guess. We never asked people their scores, just whether they were happy with them. Same went for exams (except it was whether you passed or not).

Maybe because I went to the school where it's the norm, it doesn't bother me, but I don't see how it's much different. *shrug*

 

[evilbooyaa]

Maybe it's my own bias as to not going to a school that thinks that information should privy to the entire class. I'll agree to disagree on that topic.

 

[Brain Bucket]

If it makes you feel any better about yourself, its a Caribbean school.

What does it have, ~30% attrition rate? What you really should be saying is: 30% of my class didn't make it past the first two years.

 

[notbobtrustme]

since when it something to brag about a 230? That's like saying you got an 81% when the class average was 80%.

 

[Winged Scapula]

If it makes you feel any better about yourself, its a Caribbean school.

I think there needs to be some clarification then.

Traditionally, most, if not all, Caribbean schools strictly regulated who was allowed to take the USMLEs. This, coupled with the high attrition rate, meant that only the cream of the crop were taking the exams.

While that's great that your classmates are doing so well it is not a fair comparison to say that everyone scores that highly when a significant number never even take the exam or delay it.

 

[Elisabeth Kate]

since when it something to brag about a 230? That's like saying you got an 81% when the class average was 80%.

When the thread is about people repeatedly failing, proudly proclaiming that 99% of your class got a 230 is bragging, as it would be when you're talking to a buddy who failed when you say you got the 81%.

I think there needs to be some clarification then.

Traditionally, most, if not all, Caribbean schools strictly regulated who was allowed to take the USMLEs. This, coupled with the high attrition rate, meant that only the cream of the crop were taking the exams.

While that's great that your classmates are doing so well it is not a fair comparison to say that everyone scores that highly when a significant number never even take the exam or delay it.

Excellent point.

 

[tantacles]

Then you must go to UVa bc that's the only school that posts their NBME school score reports.

To be fair, my school (US MD) provides histograms of our Step 1 scores as well to our students.

 

[Bacchus]

And to answer the OP, again, no one should be allowed to take the USMLE 5+ times. You shouldn't be taking care of me.