Duke MSII here. Thought I would chime in since this is, I think, one of the most misunderstood aspects of DukeMed when I chat with incoming applicants (and when I was first starting out here as well). I could say a lot, but I will try to be brief. Don't read this as an "excuse" for our first year, but rather just some friendly advice to step outside the box when thinking about med school, especially DukeMed.
First, about step 1 scores ... Moral of the story: Duke students do phenomenally in residency match (and that is made public). That's what step 1 really matters for anyway. But to dispell your fears about scores: Duke students have huge flexibility as to when they can take the exam Third Year, and thus how much they'd like to prepare is their own choice. Add the fact that since Duke students already have a clinical year under their belts (which includes 3 elective periods to "try out" specialties/subspecialties), they have a much clearer idea of what they may like to go into. I personally know many who score 240/250, because they choose to make studying for this one standardized test a priority (making you competitive for Ophto, Ortho, Derm, Radiology, etc). Yet I know others who did not make such a high priority of a top score, because they are choosing Family Med, Pediatrics, Internal Medicine, etc. Thus, even if the Step 1 scores were public, Duke's average would be naturally biased. But the moral of the story ... first year prepares you to do very well on step 1, if you choose to put in the study time again before you take it. And unlike most other schools, you get to determine what that looks like (Need 6 dedicated weeks to cram? Need 8 months of gradual study? Have family issues and need to postpone it? Done.)
Moving on ... yes, first year is a long, strenuous stretch of time compared to other med schools' first years. But to be honest, no one told me med school was going to be easy. If you've heard otherwise, then you may want to reconsider the whole shebang! Regardless, don't fall into the trap of thinking you "stop" learning material during your clinical years. We only spend one year in lectures, yes, but that is really just to prepare us enough to start learning medicine on the wards. You may not retain it all, but you don't necessarily retain it much better with 2 years either. I would argue that the best kind of learning is when you are working with patients, where you can still learn and read about things like physiology, pathophysiology, pharmacology but equate them with actual patients (no written test, however good, can achieve that). Actually, someone far more experienced than me came up with such an idea:
"Medicine is learned by the bedside and not in the classroom. Let not your conceptions of disease come from words heard in the lecture room or read from the book. See, and then reason and compare and control. But see first." (Sir William Osler aka legendary Doctor)
Also remember that when choosing a med school, you are choosing a 4-year package. Medicine is a life of learning, and I am happy to know that my 4-year package includes early clinical time (and not just "exposure", but being responsible for patients, taking histories, doing physicals, forming differentials, making treatment plans, performing procedures) as well as an entire dedicated year of research which I would be very hard-pressed to find anywhere else until well into residency (for me, it will be research in global health). Our 4th year is just like any other school's.
But if you take nothing away from all my rambling, know this: DukeMed's community is as much a reason to come here as the curriculum. My class is an amazing group of people--yes, in their accomplishments and professional potential, but also in their humanity, humility, and concern for each other. That question about the most humbling experience? Yeah, that actually matters here. That same community extends well into a multitude of professors, alumni, administrators I've gotten to interact with (and even the Dean herself). Sure, there's a few bad apples but in general, it's pretty awesome.
Basically, it boils down to this re first year: I worked real hard and there were some strenuous times, but I was not nearly as miserable as I thought I would be. In fact, I more often found myself thriving than struggling.
So much for brevity! Best of luck in your application and decisions, those who read this. There are many places you can learn to be a great doctor, and DukeMed is certainly among the best. And don't believe everything you read on SDN. It's a very select population with a very loud voice, and not necessarily representative of the whole. You already know that, but just a friendly reminder.
And I think Duke basketball is pretty good too. (Shameless plug.)
