MD Are students at top-10 schools essentially guaranteed 250+ on step 1 if they work super hard?

[TheIllusionist]

STEP1 is a licensing exam. It mostly test crystalized intelligence over fluid intelligence disproportionately more relative to aptitudes tests, such as the MCAT. The MCAT tests longer term skills like critical analysis and comprehension of passages. The STEP1 fundamentally is much more of a knowledge test and is therefore much more studyable. Yes good MCAT scorers tend to do well, but I know enough people that barely cracked 30 that still did well. It's fundamentally more of a test of effort than more gloaded assessments. The hardest part is the volume of material. Those tricky questions everyone talks about are in the fact the minority. Medium and easy questions are the majority and truly make or break scores. they are so much the majority that even though the disparity between good and bad test takes on percentage correct is highest on the hard level questions, because the absolute number of easy and medium level questions is so high, they end up making the difference.

The majority of questions I got stuck on were just facts that I didn't know. There was no magical intuitive reasoning. People act like there is some special secret to knowing crap, but there really isn't. all the kids that did well in my class did UFAP early and hard. Believe in yourself.

STEP1 is WAY more memory heavy than many top scorers would like to admit. As far as domains of intellect go, memory doesn't carry the same prestige as things like deductive reasoning. More is attributed to the latter by some than is warranted in order to satisfy their egos by upping the "genius" prestige of the test. The so called multistep questions are just sequences of facts, often times just reverse rationalized and in fact not truly that intuitive. There are some beautiful questions, but once again they are tremendously in the minority. In fact, I'd argue UWorld has more of those.

Baylor College of Medicine (BCM) has the highest STEP1 scores in the nation, with an average in the mid 240s. I asked students there what the school did well. They basically said that much of the teaching is to the test. Then schools like UCSF have slightly below the national average test scores and places like Yale have scores almost 10 points lower on average relative to BCM and they are ranked higher, with yale having consistently higher MCAT average than BCM.

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[DivineInterventionPod]

Going to a top 10 school does not guarantee success on the USMLEs. Hard work, building a large knowledge base with a dedication to understanding concepts, multiple passes through the material for purposes of remembrance, and the judicious use of high quality practice questions should do the trick. Do this at any school you go to and success is possible.

 

[TheIllusionist]

The kids that I know well personally who happen to go to top 10 schools don't differ that much, in terms of academic talent relative to pretty good state school kids. They're a bit better than the average state med school kids but not by much.

They tend to be a bit more OCD and disciplined. However, the X factor is that they are more opportunistic. They are a lot hungrier, when it comes to chasing prestige and looking good on paper. They network harder and are constantly looking for ways to distinguish themselves. The academic talent spread of US MD students is actually quite narrow, relative to other professional fields, such as consulting, finance, law, accounting, or engineering. In other fields, top school kids are leagues above the rest. In our field, they're somewhat better but not a whole lot. the 90th percentile st pretty much all low ranking US MD schools would be above the 50th percentile at HMS or JHU. That type of situation definitely doesn't arise in the aforementioned fields.

It's the reason that someone from a no name MD school can match in literally any specialty. There is an advantage to going to a top school, but not going doesn't shut you out totally, from even some of the most competitive echelons of the field, like it put would say in the legal field.

Bottom line. Work hard, wherever you are, the game in medicine is actually relatively fair. Your efforts will pay off relatively symmetrically.

 

[takeurmeds02]

Whoever thinks that all med students have to do to get 90% in the usmle is to study harder is dead wrong. And the "top schools" don't always have the top students - nepotism and affirmative action are very alive and well at this level. I worked hard in ms1, ms2 and had an average class rank and comlex. If I had less family obligations maybe i could have broken another layer. But no amount of extra work or desire would have gotten me 250.

What's the relevance of affirmative action in this case? Many of those students just weren't given the tools before the level of medical school. Put them in a medical curriculum on equal footing and that disappears. It doesn't exist because people are dumb, it exists because of known educational gaps.

 

[Oso]

No.

The only thing we are guaranteed is death.

(this is a serious response, it's why I don't think people including average step scores in their 'pros' lists for schools is a great idea ... there are people at top 10's who work hard but don't do as well, and there are people at "low tier" who crush the exam)

 

[intubesteak]

OP, and any other anxious/ambitious pre-M1's, here is what you do:

1. Start with the attitude that anybody can get a 250 is they work hard enough

2. If you don't end up with a 250 and you worked hard, go with the "250 is only attainable for people with the right constellation of intelligence/personality/whatever". Just don't get depressed on us.

3. If you do get a 250, don't be a douche about it

Having taken step one and seen my friends and classmates go through it...

The focus for everyone should not be step1, it should be learning medicine well in classes (NOT the same as getting amazing test grades tho). All of the high scorers that I know from my class busted their chops week in week out for the whole preclinical time. There were essentially no surprises in terms of who did really well. You cannot just show up to step1 studying and except to have a radically different experience than you did in M1 and 2.

You also don't have to be that smart to get 250+. Most of the high scorers I know barely got into medical school in the first place (myself included) and used that experience as motivation to crush it in medical school.