Here is what I've been wondering: how much of the outcome (Step scores, match etc.) is due to student's own abilities/motivation and how much is due to curriculum/peers etc? In other words, if someone accepted to WashU is presumably capable of performing at WashU student level (at least WashU adcoms thought so), will he/she be able to perform at that level elsewhere? Or does the school give you just enough of a push to take you to the top?
Of course, seeing as the null hypothesis is hard/impossible to prove this becomes a merely rhetorical question.
The tuition you're paying at WashU is for the brand name of WashU along with it's clinical (Barnes-Jewish and St. Louis Children's) and research infrastructure prowess that comes with it. It's not paying the for high quality PhD professors who want to help you to do well on the boards. Their employment does not hinge on how well you do on USMLE Step 1, and thus there is no incentive for them to tailor their lectures to include USMLE Step 1 relevant material. Their employment largely hinges on their ability to bring in research grants and to publish in high-impact journals.
That being said, assuming your abilities/motivations are the same regardless of the medical school you're present at, it does help for professors to incorporate boards relevant material in their lectures, for the simple purpose of repetition of exposure, so that when you review later, it truly is in fact, just a review, and not learning things you haven't seen before, for the first time. It helps when professors take the time to write USMLE Step 1 style questions, although the best surrogate is using NBME shelf exams for the basic sciences, so that students get a good idea of what boards questions really look like, and how to start thinking in the way the boards wants you to think.
Several schools have reported in the literature higher USMLE Step 1 scores after incorporating
-- a more integrated, organ systems-based curriculum (vs. by traditional basic science subjects)
-- less real-time contact lecture hours, rather than overloading in didactics from 9 to 5
-- more active learning (i.e. PBL) although this varies
-- writing test questions that emphasize concepts, application, and critical thinking rather than purely rote memorization of minutiae
-- using NBME shelf exams which allows students to actively assess how well they're doing with regards to preparing for Step 1
I would add having enough time scheduled after classes end to be able to review, go through question resources, and cement the material is also critical. All these things help make preparing for USMLE Step 1 easier -- as demonstrated by Baylor which has one of the highest Step scores relative to it's matriculating MCAT/GPA. The average MCAT for WashU is 38, the average MCAT for Baylor is 35.
If your basic science curriculum is 1.5 yrs. vs. 2 (most likely by eliminating redundant topics), then you get nearly six months of early elective time or research vs. your peers, which would undoubtedly help you in the match for competitive specialties. I think Duke goes even further and cuts basic sciences down to 1 year, but most would say that's a little bit extreme, not to mention they take USMLE Step 1 after completing clerkships during their research year in MS-3.
