A friend and I were debating this recently. I think that someone who did reasonably well (240s, 250s) could pass Step 1 at the end of their MS4, or even during their intern year. My friend disagrees and thinks that you could maybe pass it after taking Step 2 when that clinical knowledge is fresh, but that too much of that basic science knowledge leaves your head by the end of MS4. Anyone else agree or disagree?