USMLE Step 1 as med school criteria?

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notdeadyet

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I've noticed that folks use all sorts of criteria for judging which the best med school for them to attend is. One criteria I'm seeing a lot of is the averages on the USMLE Step 1.

Do folks really feel that how you will perform on the USMLE Step 1 has a lot to do with the med school you attend? I just presumed that the reason that Harvard has a better USMLE Step 1 average than the University of Backwater Falls is because Harvard attracts better students than UBF. Am I wrong here?
 
What is this step 1 ??
 
That's what I think most of us are looking for... anomolies between entering avg MCAT and avg Step 1. If a school has an entering MCAT of 33 and an avg Step 1 of 338 thats pretty impressive, whereas somewhere with a 35 avg and a 320 Step 1 is a little alarming.
 
But...what you have to ask yourself is why there would be variations between different medical schools if their MCAT averages are the SAME! More effective curriculum? Just inevitable sample variation? It's hard to tell...
 
There are definately a lot of factors involved in how someone does on the boards the 2 most important are probably the person's test taking ability and the amount that person studies for the boards.

All allo schools are going to give you the info pretty much the same. There is going to be very little differences between what is presented. This is very different from Ugrad.

Using the USMLE to decide where you are going to school is foolish. The way the school teaches is one of the least important factors for how you will do on step 1.

Plus, the info given out by schools and what is found on SDN is not always accurate.
 
If a school has an entering MCAT of 33 and an avg Step 1 of 338 thats pretty impressive, whereas somewhere with a 35 avg and a 320 Step 1 is a little alarming.

Huh? Considering Step 1 scores don't even get into the 300s that would be impressive indeed, as well as alarming if a school listed one of the above as their average.:laugh:
Few schools publicize their scores, and the word of mouth scores that make it onto SDN are frequently questionable. Thus I wouldn't use this as a big criteria.
 
oh yeah, i could see being interested in Step 1 scores. but look at how the residency match, too.
 
Huh? Considering Step 1 scores don't even get into the 300s that would be impressive indeed, as well as alarming if a school listed one of the above as their average.:laugh:
Few schools publicize their scores, and the word of mouth scores that make it onto SDN are frequently questionable. Thus I wouldn't use this as a big criteria.


238 and 220 respectively. You know what I meant, sorry I mistyped 🙄

Numbers are from schools I have interviewed at that have explicitly stated their averages during the day. So unless they are flat out lying, they seem pretty legitimate to me.
 
OK. But I'm still not sure I'd be all that alarmed about 220 if close to 100% of the school passed. The national average, I believe is about 214, so the school is still doing above average.

Avg is ~217. Doesn't the average Step 1 score include FMGs and DO students taking Step 1? In that case it is totally possible that the majority of US Allo schools record a greater than average average.
 
If schools refer to their scores in ambiguous terms, such as "average" or "above average," I would be suspicious. But I think it's overly cynical to think that any exact numbers they quote are inflated.

When you're looking at mid-tier schools I think comparing average matriculant MCAT and GPA with average Step 1 is a good indicator of the strength of the curriculum with regard to the material and skills you need to know to do well on Step 1. (That's not to say that other aspects of the curriculum can be assessed this way.) And doing well on Step 1 is important, especially if you're not coming from a top school. So I think it's a legitimate figure to consider, as long as you remember that the number is an AVERAGE, and that you could do much worse or much better than that score. This is an M0 talking, so take this as you will. 🙂
 
Avg is ~217. Doesn't the average Step 1 score include FMGs and DO students taking Step 1? In that case it is totally possible that the majority of US Allo schools record a greater than average average.

Or it may be a lower-than-average average, as FMGs know they have to ace the exam if they want to match anywhere decent (and therefore put more effort into it), while domestic grads just need a decent score. I do know the numbers only include first-time testers.
 
When you're looking at mid-tier schools I think comparing average matriculant MCAT and GPA with average Step 1 is a good indicator of the strength of the curriculum with regard to the material and skills you need to know to do well on Step 1. (That's not to say that other aspects of the curriculum can be assessed this way.) And doing well on Step 1 is important, especially if you're not coming from a top school. So I think it's a legitimate figure to consider, as long as you remember that the number is an AVERAGE, and that you could do much worse or much better than that score. This is an M0 talking, so take this as you will. 🙂

But that assumes you have the USMLE number in the first place. Since they aren't published, you are only going to get USMLE info from places that are happy enough with their scores to make them public knowledge. So once you actually have a number, you know it reflects positively on the school. This defeats the utility of any analysis. I thus continue to think this is not useful.
 
But that assumes you have the USMLE number in the first place. Since they aren't published, you are only going to get USMLE info from places that are happy enough with their scores to make them public knowledge. So once you actually have a number, you know it reflects positively on the school. This defeats the utility of any analysis. I thus continue to think this is not useful.

Not necessarily. Again it's not a matter of the absolute value of a Step 1 average per school, but more a comparison vs MCAT. Assuming the people who did well on MCAT will do well on Step 1 (clearly not a correlation of 1, but still a fair assumption, I believe), you can get the gist of how a school prepares you for Step 1 by comparing roughly how well the entering students did on MCAT and how they end up doing on Step 1. Like I said earlier from 35 with 95th(?) percentile to the national mean of 220 is not so great. Yea yea the MCAT avg includes people that don't go to medical school etc, but the Step 1 mean includes FMG's etc as well so they should be more or less comparable.
 
Avg is ~217. Doesn't the average Step 1 score include FMGs and DO students taking Step 1? In that case it is totally possible that the majority of US Allo schools record a greater than average average.

Averages are based ONLY on US grads - so DOs, but not FMGs.
 
Not necessarily. Again it's not a matter of the absolute value of a Step 1 average per school, but more a comparison vs MCAT. Assuming the people who did well on MCAT will do well on Step 1 (clearly not a correlation of 1, but still a fair assumption, I believe), you can get the gist of how a school prepares you for Step 1 by comparing roughly how well the entering students did on MCAT and how they end up doing on Step 1. Like I said earlier from 35 with 95th(?) percentile to the national mean of 220 is not so great. Yea yea the MCAT avg includes people that don't go to medical school etc, but the Step 1 mean includes FMG's etc as well so they should be more or less comparable.

If you look at the studies that correlate MCAT performance to USMLE, you will see that the correlation is really rather small; purports to follow students at a relatively small percentage of schools over many years (despite changes in student maturity, study habits, changes to the tests etc), and still does not provide the linear analysis (high MCAT = high Step 1) you suggest. I think you are giving a lot more credit to studies than med schools do (as the top med schools frequently don't take the absolute top scorers over folks with other impressive attributes). Your second year med school performance, as well as how well you buckle down and study at the end, will dictate your performance on Step 1 far better than any other indicator. And your MCAT is meaningless when you get to med school -- you will see that the top and bottom of the class rank have little to do with the MCAT score breakdown, but actually can have quite a lot do do with how the Step 1 score pans out.

So use this methodology at your own risk -- it seems a bit illusory to me, and probably doesn't tell you what you think it does. Just my opinion.
 
Assuming the people who did well on MCAT will do well on Step 1 (clearly not a correlation of 1, but still a fair assumption, I believe), you can get the gist of how a school prepares you for Step 1 by comparing roughly how well the entering students did on MCAT and how they end up doing on Step 1.

This is a poor assumption.

Your step 1 score is based on individual performance and has nothing to do with how your school prepares you.

No medical school claims that their average board scores are indicative of the quality of teaching or how well they prepare you.

How can they?

You learn the same $hit in every school in the country and you use the same review books as every other med student.

There is no advantage of going to a Top 10 vs. your state school in terms of doing well on the USMLE.

At most, if a school has a high step 1 average, it means that they tend to admit students who study hard and are good at standardized tests.

Don't you think if a med school found the secret to teach in such a way that ensured students high test scores than every other med school would emulate them? Of course they would!
 
Don't you think if a med school found the secret to teach in such a way that ensured students high test scores than every other med school would emulate them? Of course they would!

Nope. Lots of schools are PROUD of not teaching for the boards. They believe in teaching for knowledge not board prep. There definetly is a difference between schools as far as board prep is concerned... You may learn the same stuff overall, but materials/practice available varies significantly from school to school. UChicago claims that they do nothing specifically to prepare their students other than standard teaching, some schools have extra reviews, and some schools (Case) go out of their way to get extra questions and have faculty teach the method of answering them.

Of course the majority of board prep is up to the individual, its just a matter of whether or not you want every extra bit of help you can get. It's like taking a Kaplan class for MCAT, it doesn't ensure you will do well but it can only help.
 
Nope. Lots of schools are PROUD of not teaching for the boards. They believe in teaching for knowledge not board prep. There definetly is a difference between schools as far as board prep is concerned...

Well, the schools that refuse to teach to the boards tend to be the higher ranked ones, which often means their matriculants generally had higher avg MCAT scores, so that sort of conflicts with what you are saying.
 
Well, the schools that refuse to teach to the boards tend to be the higher ranked ones, which often means their matriculants generally had higher avg MCAT scores, so that sort of conflicts with what you are saying.

Speaking of conflicts, reconcile this one for me:

(1) "Doing well" at any medical school will be virtually the same. It will not be easier to do well at a lower ranked school because Admission Committees have a way of getting rid of the people who made you look good in ugrad.

(2) USMLE scores are more a function of individual performance than school teaching. UPenn and UMich (two schools that we have documented data for) have high averages just because they accept smart students.
 
Well, the schools that refuse to teach to the boards tend to be the higher ranked ones, which often means their matriculants generally had higher avg MCAT scores, so that sort of conflicts with what you are saying.

I don't really see how that conflicts. Plenty of the higher ranked schools claim not to teach to the Boards (Harvard, Yale, etc). And, students at those schools had higher MCAT scores originally. True, Students at those schools still get higher USMLE Scores than average, BUT that indicates neither that teaching didn't have to do with their board score or that teaching had everything to do with the board score. There is no proof that those students (with original high MCATs) couldn't have gotten even higher USMLE1's if the school had taught to the boards. What is more indicative is when schools start with a lower MCAT average and end up with higher board scores (relatively).
 
I don't really see how that conflicts. Plenty of the higher ranked schools claim not to teach to the Boards (Harvard, Yale, etc). And, students at those schools had higher MCAT scores originally. True, Students at those schools still get higher USMLE Scores than average, BUT that indicates neither that teaching didn't have to do with their board score or that teaching had everything to do with the board score. There is no proof that those students (with original high MCATs) couldn't have gotten even higher USMLE1's if the school had taught to the boards. What is more indicative is when schools start with a lower MCAT average and end up with higher board scores (relatively).

Agree.
 
Speaking of conflicts, reconcile this one for me:

(1) "Doing well" at any medical school will be virtually the same. It will not be easier to do well at a lower ranked school because Admission Committees have a way of getting rid of the people who made you look good in ugrad.

(2) USMLE scores are more a function of individual performance than school teaching.

I guess I'm missing your point -- it seems to me that you have listed two statements I agree with.
You will do about the same in any allo med school, in my opinion, because the spread of grades of those who get into med school is not all that broad -- ie you couldn't attend a lower ranked school and expect to be the top of the class because of the school's rank. Everyone in med school has the ability to get the A, and lots of people get unpleasantly surprised by the first tests. And yes, all schools will use similar texts, cover the same material, all students will study the same board review books and all will subscribe to a comparable Q-bank, so the USMLE will be more of a function of individual performance than anything else.

However I don't agree with your last sentence (about Penn and UofMich) per se, because there are also schools not as highly ranked that score just as well. If you are inferring that the board scores should break down in close correlation to the US News rankings, in fact from what I've seen/heard they don't. Your guess is as good as mine as to why some schools in some years do better than others on the board -- I suspect a lot of it is luck in keying in on a certain kind of determination during admissions. Some of it involves keeping folks motivated during the dry science years of school, and some involves having a schedule which gives adequate study time before the test.
 
I don't really see how that conflicts.

I guess it depends on whether I correctly understood what the prior poster was saying.🙂 I read him to suggest that he was looking for discrepancies between high MCAT and USMLE. Schools with good MCAT that do not teach to the boards and still score well on USMLE would be a conflict to the suggestion that schools (rather than individuals) make a huge difference.
 
UChicago claims that they do nothing specifically to prepare their students other than standard teaching, some schools have extra reviews, and some schools (Case) go out of their way to get extra questions and have faculty teach the method of answering them.

You are giving these schools too much credit. These extra questions and faculty review sessions are most likely very low yield.

Check out the Step 1 forum.

No one attributes their spectacular USMLE score to their med school curriculum and how it was taught.

What do these students praise? BRS, HY, QBank, and other commercially available Step 1 prep materials.

The basic science curriculum is going to be standard everywhere you go. If it wasn't, the school wouldn't be accredited. Yes, certain details and minutia are going to be emphasized depending on the lecturer's interests. But its all more or less the same everywhere.
 
some schools offer Qbank to their students and give tests in the same format as the USMLE. Some schools pay for a prep course and give students a lot of time to prepare for the steps. These are the things that interest me and it usually happens that students from these schools may have more average MCAT stats and then their USMLE scores are above par. I do not judge a school by their scores but more for the opportunity that they will afford me to do my best.

my .02
 
some schools offer Qbank to their students and give tests in the same format as the USMLE. Some schools pay for a prep course and give students a lot of time to prepare for the steps. These are the things that interest me and it usually happens that students from these schools may have more average MCAT stats and then their USMLE scores are above par. I do not judge a school by their scores but more for the opportunity that they will afford me to do my best.

my .02

I guess, but would you really turn down a top school for a less prestigious one with a free prep course/Qbank (which you could buy on your own) and stronger USMLE ? You will be the same student at either place and can certainly normalize the opportunity out of your own pocket.
 
I guess, but would you really turn down a top school for a less prestigious one with a free prep course/Qbank (which you could buy on your own) and stronger USMLE ? You will be the same student at either place and can certainly normalize the opportunity out of your own pocket.

you make a good point, but i won't have to worry about that with my stats =P. Also, it is more valuable to me for the school to allow ample time to prepare rather than the Qbank/course option which I could pay for myself as you succintly stated.
 
One of the reasons why I DO believe that the school has a non-negligible effect on one's USMLE score are the differences that exist between average step 1 scores at two schools with the same or essentially the same average GPA and average MCAT scores of matriculants. How do you explain this, since, on average, students at those two schools should be of substantially equal intelligence?
 
One of the reasons why I DO believe that the school has a non-negligible effect on one's USMLE score are the differences that exist between average step 1 scores at two schools with the same or essentially the same average GPA and average MCAT scores of matriculants. How do you explain this, since, on average, students at those two schools should be of substantially equal intelligence?

I personally would explain it by the fact that GPA and MCAT are not the only admissions criteria, nor the only things that correlate to USMLE scores. It is not unusual for the same folks to get accepted by one school and rejected from another, even though the schools numerical stats are essentially equal. Schools really are looking for something different, a "good fit". Perhaps it's a drive, a fire in the belly, the eye of the tiger, that is being selected for -- who knows. But since there is a differential in students selected based on various nonnumerical criteria as well, one would expect USMLE scores to end up different too. That's my take.
 
I personally would explain it by the fact that GPA and MCAT are not the only admissions criteria, nor the only things that correlate to USMLE scores. It is not unusual for the same folks to get accepted by one school and rejected from another, even though the schools numerical stats are essentially equal. Schools really are looking for something different, a "good fit". Perhaps it's a drive, a fire in the belly, the eye of the tiger, that is being selected for -- who knows. But since there is a differential in students selected based on various nonnumerical criteria as well, one would expect USMLE scores to end up different too. That's my take.

I believe jota is referring to UTH and UTMB. In this particular case, it seems like most folks who are accepted at one are also accepted at the other (going just by this year, because its the first year with rolling admissions in TX), so at least in this situation I don't think your interpretation holds.

A general comment: It's naive to think that a school cannot significantly influence its average Step 1's with its curriculum or with the other services it provides. Whether that influence should be important to preallos is up for debate, though.
 
I really think there isn't a link. Some people after getting into awesome medical schools tend to relagate, while others don't. People who end up in the caribbean usually tend to have something to prove- I know so many guys who ended up going to the carribean for med school scoring 99 percentil on their boards. it's just about motivation. i mean if you go to a school like yale- where they don't even have exams or grades, sure it's an awesome school but you might fall back on the motivational aspect. just my two cents: it's all dependent on the person- the schools teach pretty much the same thing the first two years.
 
The range of scores at any school is extreme.

Even if your only goal is to rock Step 1, you will be better off at a school that matches your learning style than a school with the highest mean in the country.

Taking some time to learn about 3rd and 4th year rotations (rarely discussed on the premed side of SDN) will tell you a lot more about a med school's quality of education than its mean USMLE.
 
I really don't understand all these people saying that your medical school doesn't affect your USMLE performance at all.

Go to a medical school in the middle of a warzone, and see how well you concentrate.

Yea I know environment is just that, but if you go to a medical school with poor teaching facilities, teachers with poor accents, etc., they're all going to make for a worse learning experience, which will probably translate into worse scores on average.

Let's put it this way, you have two identical medical schools, they have identical entering stats for the students, they both accept YOU, and the only difference is that one has higher USMLE score averages than the other.

Which one are you going to choose and why?
 
I really think there isn't a link. Some people after getting into awesome medical schools tend to relagate, while others don't. People who end up in the caribbean usually tend to have something to prove- I know so many guys who ended up going to the carribean for med school scoring 99 percentil on their boards. it's just about motivation. i mean if you go to a school like yale- where they don't even have exams or grades, sure it's an awesome school but you might fall back on the motivational aspect. just my two cents: it's all dependent on the person- the schools teach pretty much the same thing the first two years.

And I know the passing rate for Carribean schools is something like 60%, compared to US medical schools of 95% or higher.

Yawn?
 
A general comment: It's naive to think that a school cannot significantly influence its average Step 1's with its curriculum or with the other services it provides. Whether that influence should be important to preallos is up for debate, though.

Here's my take --
It's not really so naive because people are assuming a correlation without access to all the evidence. USMLE scores are not released by all schools, so you really have a small handful of schools, proud enough about their stats to state them officially, to work from. Just because one school does a lot of Step 1 prep, or a curriculum that "teaches to the boards" and its students do well and reports its score to applicants doesn't mean that another dozen schools with comparable credentials don't do the identical, exact same thing and have significantly less impressive scores.
It's also not so naive because, if you talk to med students or peruse the allo board, you will see that the consensus among med students is that the same handful of board review books (First Aid, High Yield, BRS) and the same Q-bank, which are available commercially to all, are the place where the vast majority of med students will do most of their Step 1 studying.
Like it or not, the days of spoon feeding learning are over and med school, the boards and thereafter are more matters of individual effort than anything else.
 
And I know the passing rate for Carribean schools is something like 60%, compared to US medical schools of 95% or higher.

Yawn?

That would certainly not conflict with my suggestion that this is an individual effort/abilities thing. Folks who didn't put in the effort or make the grade in college aren't all magically going to be changed by two years of med school. (some will, though). And since Caribbean schools reportedly put more focus into teaching to the boards than stateside schools (because they feel they have to show results to be viable), this perhaps shows the limitation in what a school can do to prepare you.
However it is not a great basis for comparison because the students were not generally competitive for US allo in the first place, so it's hard to indict or laud the school when they are not working with the same raw materials.
 
I think (as a 4th yr student) the only thing I would be worried about in respect to Step 1 is if a large portion of students failed or did significantly below average each year at "X" school. Beyond that it is highly variable by student.

The core curriculum of the first two years is MOSTLY the same at most US Med schools. And most of us got in with a decent MCAT score (otherwise we wouldn't have gotten in). Generally, it's fair to assume we are all pretty good test takers, otherwise we wouldn't have gotten this far.

Step 1, is, as many pointed out, a highly individual exam, and is unique in that the more you study for it, the better you will do. The key is to realize this ahead of time, and knowing that you might want to apply to a competitive residency. It is the only objective measure, for the most part, that programs have to compare others. And many programs use it as a screening tool (as fair or not fair as it might be)

I wanted a great score, so I studied hard, using many of the review books that everyone else uses. And I got the score I wanted. My friend, who has always been a good test taker (national merit finalist, high MCATS), blew off her boards, thinking she could sail by, and she failed.

I think a match list is much more helpful than an average step 1 score. Look to see how many people are in competitive specialties (or the specialty you want) if that's your thing, or if people are going outside of the region for residency. (If they are all staying at xyz med school, is it because everyone loves it so much, or because no one else wanted them?)
 
A general comment: It's naive to think that a school cannot significantly influence its average Step 1's with its curriculum or with the other services it provides. Whether that influence should be important to preallos is up for debate, though.

In actuality, it's naive to think that your choice in medical school is going to increase your Step 1 score.

This is just another unfounded speculation. Higher ranked schools do not provide better USMLE prep.

Does my school provide special review classes? Yep.
Do students recommend them? Nope.
Did the people with the highest Step 1 scores use them? Nope.
What's the average Step 1 score of my school? 225-230.
 
Not only do all medical schools teach the same information (as already stated above) but a significant number of medical students don't go to class, and teach themselves instead, so teaching facilities, etc, are probably irrelevant if you're trying to correlate that to a school's average USMLE score. The only part of a curriculum that I can possibly see "helping" on the USMLE is maybe PBL, because the boards are clinically based, and you need to get used to looking at questions from a clinical point of view, rather than simply memorizing and then regurgitating facts. However, I would personally rather not suffer through 2 years of PBL, as I can't see that as a beneficial form of learning for me. And, at Duke, we do our clinical rotations before we take the boards anyway.
 
In actuality, it's naive to think that your choice in medical school is going to increase your Step 1 score.

This is just another unfounded speculation. Higher ranked schools do not provide better USMLE prep.

The focus here is on averages and cumulative/collective influence, so ya, it would also be naive to think that a particular school WILL affect ONE person's score. (And I think folks here are more concerned about Step 1 averages at non-top-tier schools than at the highly ranked ones.) I don't think anyone is arguing that a school's average Step 1 is the best predictor of your future score. Only that--when used in comparison to that school's average matriculant GPA and MCAT in the context of other schools' GPA/MCAT/Step 1 averages--it shows that something at that school, whether the environment, the advising, the teaching, whatever, may make a higher score more probable, all other things being equal (you have to make them equal, though).
 
I personally would explain it by the fact that GPA and MCAT are not the only admissions criteria, nor the only things that correlate to USMLE scores. It is not unusual for the same folks to get accepted by one school and rejected from another, even though the schools numerical stats are essentially equal. Schools really are looking for something different, a "good fit". Perhaps it's a drive, a fire in the belly, the eye of the tiger, that is being selected for -- who knows. But since there is a differential in students selected based on various nonnumerical criteria as well, one would expect USMLE scores to end up different too. That's my take.
I understand that admissions criteria encompasses more, but I see that usually explained as schools are looking for the best future DOCTORS, not the best future STUDENTS. IMHO, stats are the best indicator of how good a STUDENT one is (or more accurately, has been,) not how many volunteer hours one has logged, or any of the other non-stat admissions criteria. Wouldn't you agree? What other indicators of one's intelligence/potential as a STUDENT do you think are part of one's application to medical school?
 
I believe jota is referring to UTH and UTMB. In this particular case, it seems like most folks who are accepted at one are also accepted at the other (going just by this year, because its the first year with rolling admissions in TX), so at least in this situation I don't think your interpretation holds.

A general comment: It's naive to think that a school cannot significantly influence its average Step 1's with its curriculum or with the other services it provides. Whether that influence should be important to preallos is up for debate, though.

I wasn't speaking of any schools in particular, but those are good examples. Baylor and UTSW are two other good examples, and my opinion is that Baylor's significantly higher average Step 1 scores (238 vs 226) can be attributed to their curriculum (which does not require students to pass the Step 1 before doing rotations. Therefore, most students spend more time preparing for the Step 1 and, as a result, on average, do better than all other schools in TX, and most other schools in the country.) If the students at Baylor are, on average, any more intelligent than those at UTSW, it is not that significant a difference (based upon average GPA and MCAT scores of matriculants.)

And yeah, you have a good point about people who are accepted to both. Even discounting rolling admissions this year, many, many people are accepted to both Baylor and UTSW.
 
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