Changing USMLE to Pass/Fail Implications for Pain

[drusso]

---

Members do not see this ad.

My fellowship program director told me that they used USMLE scores to rank applicants.

 

[pmrmd]

Everything else been dumbed-down already, why not medical school too?

 

[hyperalgesia]

Actually the idea intrigues me. Obviously USLME scores are what most programs use to weed people out, for convenience if nothing else.

But are docs with higher USMLE scores better docs?

Making them pass/fail might force programs to focus more on character/ethical conduct.

 

[deleted131481]

Actually the idea intrigues me. Obviously USLME scores are what most programs use to weed people out, for convenience if nothing else.

But are docs with higher USMLE scores better docs?

Making them pass/fail might force programs to focus more on character/ethical conduct.

While dermatologists I'm sure are the best test takers, I doubt they are better docs than any other specialty.

I suspect this will shift weight to MCAT/med school tier. Sorting through 100s of applications by 1-2 people, there has to be some objective criteria.

Sent from my Pixel 3 using Tapatalk

 

[parliamentarian]

Focus will just shift to step 2, which is much more clinically relevant anyway. Step 2 had already been increasing in importance the past few years.

 

[geauxg8rs]

Actually the idea intrigues me. Obviously USLME scores are what most programs use to weed people out, for convenience if nothing else.

But are docs with higher USMLE scores better docs?
Will weed people based on Med school reputation. Not a good metric
Making them pass/fail might force programs to focus more on character/ethical conduct.

 

[clubdeac]

Focus will just shift to step 2, which is much more clinically relevant anyway. Step 2 had already been increasing in importance the past few years.

It’s been awhile but isn’t Step 2 just one of the three USMLEs and therefore will be pass/fail. What am I missing here

 

[hyperalgesia]

It’s been awhile but isn’t Step 2 just one of the three USMLEs and therefore will be pass/fail. What am I missing here

I think they're talking about getting rid of the numerical scores. A score will still determine whether pass/fail but the actual score will never be released. I don't know who cares about Step 2 or 3 but Step 1 is a huge weeding out tool for residencies.

If they do this, programs like Derm and Neurosurgery will have to really work to keep out the riff raff.

 

[parliamentarian]

I think they're talking about getting rid of the numerical scores. A score will still determine whether pass/fail but the actual score will never be released. I don't know who cares about Step 2 or 3 but Step 1 is a huge weeding out tool for residencies.

If they do this, programs like Derm and Neurosurgery will have to really work to keep out the riff raff.

It’s been awhile but isn’t Step 2 just one of the three USMLEs and therefore will be pass/fail. What am I missing here

Only Step 1 is being switched to pass/fail. Step 2 and Step 3 will continue to have numerical scores.

Step 1 has always been the major weeding tool for residencies but Step 2 has also been heavily considered as of late. My residency did not even rank students who applied but hadn’t yet taken Step 2.

 

[dangEras]

While dermatologists I'm sure are the best test takers, I doubt they are better docs than any other specialty.

I suspect this will shift weight to MCAT/med school tier. Sorting through 100s of applications by 1-2 people, there has to be some objective criteria.

Sent from my Pixel 3 using Tapatalk

Agree with this. Completed my intern year with a cohort of derm, rad, radonc, ophtho residents. Scores, specialty, prior work experience, research, and school pedigree had zero correlation to clinical skills.

Funnily enough, common sense and basic math skills were a far stronger predictor of clinical competence.

 

[dangEras]

I think they're talking about getting rid of the numerical scores. A score will still determine whether pass/fail but the actual score will never be released. I don't know who cares about Step 2 or 3 but Step 1 is a huge weeding out tool for residencies.

If they do this, programs like Derm and Neurosurgery will have to really work to keep out the riff raff.

Local surgical departments to me have already banded together to create a surgical entrance exam. I'm sure they'll have a final product rolled out by the time step 1 scores are phased out.

 

[rastko]

If a fellowship is going through NRMP match, does it mean, that they rank you the same way as for residency and as such, might have cut-off values for step 1 (or perhaps even step 2 CK, AS st.1 is becoming pass/fail)?

 

[georgiamd]

We should just let anyone into medical school if they want to go. Anyone should be able to do rad/onc if they want as well.

this is terrifying

 

[Jcm800]

Everything else been dumbed-down already, why not medical school too?

I think the days of the best and the brightest going in the medicine is over. The best and the brightest will be dentists, Or more likely get a finance degree, coupled with an MBA

 

[SommeRiver]

I think the days of the best and the brightest going in the medicine is over. The best and the brightest will be dentists, Or more likely get a finance degree, coupled with an MBA

...seen dental school loans?

 

[Jcm800]

...seen dental school loans?

I have. I have branch of the family tree that are dentists...They have/will have no problem paying them off...

 

[SommeRiver]

I have. I have branch of the family tree that are dentists...They have/will have no problem paying them off...

Of course they'll pay them off, but they'll be further in debt than an MD, likely with a smaller shovel with which to dig.

To say that smarter ppl will go into dentistry than medicine is at best a stretch, and at worst a statement of lunacy. I can't think of a professional job less desirable than dentistry.

 

[HeyDalaron]

Welcome to the Canadian system.

 

[lonelobo]

Think it has been a while since the smartest people went into medicine....

 

[IkeBoy18]

This predicament might suck for some, might help for others. My step one was abysmal. Step 2 was average. Anesthesia ITEs were all 96+%tile. Missed top 10% on basic by 2 keywords. I got into a very good pain program. Probably weeded out at a lot of programs solely on step 1 though.

 

[Jcm800]

Of course they'll pay them off, but they'll be further in debt than an MD, likely with a smaller shovel with which to dig.

To say that smarter ppl will go into dentistry than medicine is at best a stretch, and at worst a statement of lunacy. I can't think of a professional job less desirable than dentistry.

You are out of touch? my friend. Dentist make tons of money and they work four days a week. Dentistry is in high demand. Not a stretch, not lunacy. Look around. Just because we want something to be, doesnt mean it is

 

[SommeRiver]

You are out of touch? my friend. Dentist make tons of money and they work four days a week. Dentistry is in high demand. Not a stretch, not lunacy. Look around. Just because we want something to be, doesnt mean it is

Not all dentists kill it, and to say "the best and brightest will be dentists" is simply not true.

I would go out on a limb and say there's been no child ever to say he/she wants to be a dentist when they grow.

Not one child in history.

 

[georgiamd]

I believe that is the salary data. However most dentists are not salaried employees, they are business people, almost more than clinicians. Those that own successful practices make much more than that

 

[gaseous_clay]

Only Step 1 is being switched to pass/fail. Step 2 and Step 3 will continue to have numerical scores.

Step 1 has always been the major weeding tool for residencies but Step 2 has also been heavily considered as of late. My residency did not even rank students who applied but hadn’t yet taken Step 2.

Damn I wish they had done this when I was in med school. I didn’t do too well on step 1 but crushed my step 2. Although I don’t think I would’ve chosen a different specialty based on this, I probably would’ve done residency at a different program.

 

[gaseous_clay]

I think the days of the best and the brightest going in the medicine is over. The best and the brightest will be dentists, Or more likely get a finance degree, coupled with an MBA

Dentistry is not that great of a career anymore. They graduate with a lot of student debt and nearly 90% of dental practices are owned by DSOs, similar to anesthesia management companies, where one is simply an employed provider. There are a ton of finance grads with MBAs out there. Only the ones who go to the Harvards, Whartons, and Kelloggs of the world get scooped up by Goldman Sachs and get the high paying entry level jobs.

 

[gaseous_clay]

You are out of touch? my friend. Dentist make tons of money and they work four days a week. Dentistry is in high demand. Not a stretch, not lunacy. Look around. Just because we want something to be, doesnt mean it is

Your friend is the exception, and I bet he does a fair amount of cosmetic dentistry, which is all cash money procedures. That portion of the specialty is not recession proof. He most likely owns his practice and has good business acumen. Talk to a new dental grad and they will tell you a different story...unless you think $200K is a ton of money.

 

[Jcm800]

Your friend is the exception, and I bet he does a fair amount of cosmetic dentistry, which is all cash money procedures. That portion of the specialty is not recession proof. He most likely owns his practice and has good business acumen. Talk to a new dental grad and they will tell you a different story...unless you think $200K is a ton of money.

Not One friend... like a dozen! Maybe it’s location dependent. But in stl and chicago, dentists will rule the roost

now those that join multi state corporate dentist outfits obviously make less...And I will concede that most of these people that I know do in fact own their own practices, and many due cosmetic stuff as well. So there probably is validity to your statement. And perhaps my exposure to a specific cohort, since they are older than new grads, might make me believe that this is more consistent across the board.

However my cousins who are currently in dental school and a recent family member who has just graduated from residency, also seems to agree with me. But they might think 250 is a ton of money (which it is) and this may be where my perspective comes from

 

[SommeRiver]

I believe that is the salary data. However most dentists are not salaried employees, they are business people, almost more than clinicians. Those that own successful practices make much more than that

Not true.

Many do own their practice, but dentistry is no different than any other professional field where private equity and bigger systems buy up every single bit of competition in the area, after which they do whatever TF they want with you.

 

[georgiamd]

Not true.

Many do own their practice, but dentistry is no different than any other professional field where private equity and bigger systems buy up every single bit of competition in the area, after which they do whatever TF they want with you.

I didn’t realize you knew everything about it. I’ll tell my dentist buddies to turn their money back in

 

[gaseous_clay]

I didn’t realize you knew everything about it. I’ll tell my dentist buddies to turn their money back in

He’s not incorrect on these statements. Part of my portfolio is in a private equity group that owns a DSO, and this is exactly their MO.

 

[georgiamd]

He’s not incorrect on these statements. Part of my portfolio is in a private equity group that owns a DSO, and this is exactly their MO.

I wasn’t saying that doesn’t happen. But to paint with such a broad brush is incorrect. There are many dentists making much more than the aforementioned salary data. Especially in the area I’m in.

 

[SommeRiver]

I didn’t realize you knew everything about it. I’ll tell my dentist buddies to turn their money back in

What an absurd post.

 

[gaseous_clay]

I think all this is relative to the amount one thinks is a “lot of money.” I don’t think $250K annual salary is that much once your factor in taxes and student loan debt. It may provide one with a comfortable lifestyle if they are in area with a low COL, but it doesn’t move the needle for me.

 

[SommeRiver]

I think all this is relative to the amount one thinks is a “lot of money.” I don’t think $250K annual salary is that much once your factor in taxes and student loan debt. It may provide one with a comfortable lifestyle if they are in area with a low COL, but it doesn’t move the needle for me.

Some dentists kill it, but they do so based off their ownership of their business. To them I say to make it rain and work hard.

American dream IMO.

...but to say the best and brightest will be dentists is pretty dumb IMO.

I also realize this is an internet forum and not everything we "say" should be taken with 100% seriousness.

We all let stuff fly all the time.

Medicine has changed, but it is still a damn good career and that includes pain.

I don't want to so anything else TBH. My geriatric pts get back out in their gardens and make it to Sunday School after I ablate them.

 

[Jcm800]

Some dentists kill it, but they do so based off their ownership of their business. To them I say to make it rain and work hard.

American dream IMO.

...but to say the best and brightest will be dentists is pretty dumb IMO.

I also realize this is an internet forum and not everything we "say" should be taken with 100% seriousness.

We all let stuff fly all the time.

Medicine has changed, but it is still a damn good career and that includes pain.

I don't want to so anything else TBH. My geriatric pts get back out in their gardens and make it to Sunday School after I ablate them.

Look at the numbers applying to medical school versus dental school, and look at the average gpa and most scores, they are going down... so it’s not a dumb thing to say. You just disagree

 

[Jcm800]

Here’s a “recent article” that proves my point haha...

Med School Applications Decrease for Third Year | News | The Harvard Crimson

Applications to the Medical School have decreased for the third straight year, the Admissions Office announced yesterday. This year, 1,330

www.thecrimson.com

 

[SommeRiver]

Here’s a “recent article” that proves my point haha...

Med School Applications Decrease for Third Year | News | The Harvard Crimson

Applications to the Medical School have decreased for the third straight year, the Admissions Office announced yesterday. This year, 1,330

www.thecrimson.com

1953 publication date. A waste of my time. Thanks.

Dental school is far more expensive, has a 43% higher debt than MD school (American schools), and you spend the rest of your life inside someone's mouth.

...and you think the best and brightest will stop med school applications in favor of dental school...

 

[Jcm800]

1953 publication date. A waste of my time. ...and you think the best and brightest will stop med school applications in favor of dental school...

The 1953 article was a joke.
And yes I think that because it is happening

 

[SommeRiver]

43% higher debt than med school.
Make less money on avg.

....but 4 days per week!!

I know MDs who work 4 days per week.

 

[bedrock]

43% higher debt than med school.
Make less money on avg.

....but 4 days per week!!

I know MDs who work 4 days per week.

But they also start working much sooner. It is like that article that compares what teachers make to a PCP salary over a lifetime. A PCP barely makes more than a teacher because of education debt, and waiting an additional 7 years to start making real money.

Dentists start making money a full 5 years sooner than we do as pain physicians. Takes a long time to catch up.

I'd rather be a dentist than a PCP.

 

[SommeRiver]

But they also start working much sooner. It is like that article that compares what teachers make to a PCP salary over a lifetime. A PCP barely makes more than a teacher because of education debt, and waiting an additional 7 years to start making real money.

Dentists start making money a full 5 years sooner than we do as pain physicians. Takes a long time to catch up.

I'd rather be a dentist than a PCP.

They start off in a bigger hole too, and you're talking general dentistry, not any of the dental specialities that make more.

Your avg pain doctor is making 2.5 times what your avg dentist makes, and in the entire arena of medicine, there are many fields vastly superior to dentistry in terms of income and lifestyle.

"The best and the brightest" are not running off to dental school en masse...

 

[DODOCSS]

brother in law pulls close to 500 working 3.5 days @35, little cosmetics, though he owns the practice

 

[SommeRiver]

Awesome! A successful small business owner. American dream IMO. I hope he continues to do well for himself and work to better his community.

 

[gaseous_clay]

brother in law pulls close to 500 working 3.5 days @35, little cosmetics, though he owns the practice

Is that his gross income after overhead? Also, is the practice open 5 days and he does admin for 1.5 days? Just curious.

 

[Propofool123]

I think the days of the best and the brightest going in the medicine is over. The best and the brightest will be dentists, Or more likely get a finance degree, coupled with an MBA

Those who can’t get into med school go to dental school.

 

[Jcm800]

Those who can’t get into med school go to dental school.
[/QUOTE

Those who can’t get into med school go to dental school.

this used to be the case. And are our egos so fragile we can’t accept that medical school applications are going down, the average scores/grades of medical school applicants are going down, but the opposite is true of dental school applicants. Scores are going up, and the number of applicants are going up. I get the need to feel we are superior, Because it was hard to get into medical school, and still is, but easier and easier nowadays. And harder to get into dental school.

 

[bedrock]

this used to be the case. And are our egos so fragile we can’t accept that medical school applications are going down, the average scores/grades of medical school applicants are going down, but the opposite is true of dental school applicants. Scores are going up, and the number of applicants are going up. I get the need to feel we are superior, Because it was hard to get into medical school, and still is, but easier and easier nowadays. And harder to get into dental school.

Agree with this. When I applied for medical school almost 25 years ago, it was much harder to become a physician than become a dentist. That still holds true, but with much less separation in 2020 compared to then. II applied at almost the worst time possible as acceptance rates for med school had dipped just 1/3 of applicants being accepted, compared to around 50% today.

As physicians make less and less money and become less independent, this is more evident with online information compared to 25 years ago. It makes dentistry more attractive relative to medicine than it used to be. I would have never considered becoming a dentist 25 years ago. Medicine was clearly the superior choice. If I was making that same decision now, I would really think about it.

 

[SommeRiver]

Spend your life in the mouth

Many people can't stomach that thought.

 

[Jcm800]

Spend your life in the mouth

Many people can't stomach that thought.

Bro, think about all the nasty places we could spend our time in. Urology, yikes. General surgery, yuck... ENT? GI? Derm even, some nasty stuff. It can all be pretty Gross. The mouth probably is no better or worse. We have it pretty good in pain management. Even anesthesia can be very gross at times...

 

[SommeRiver]

Bro, think about all the nasty places we could spend our time in. Urology, yikes. General surgery, yuck... ENT? GI? Derm even, some nasty stuff. It can all be pretty Gross. The mouth probably is no better or worse. We have it pretty good in pain management. Even anesthesia can be very gross at times...

There are tons of options however.