Originally posted by drymarchon
How do you(or any Duke person here) feel Duke is preparing you for the USMLE?
Also, how do you guys feel about the grading systems?
Unfortunately I can't comment much on the USMLE stuff...I don't know enough about the test to know how well-prepared I should feel.
HOWEVER, I've seen the stats, and Duke students definitely do "above average." That said, it's not all that much above average. But this raises the whole debate about what step I actually says about a school. Rumor has it they'll be changing the test soon, and I've often heard it said that one of the reasons is that students at top schools like Duke, Harvard, etc., which have more "non-traditional" cirrucular approaches tend to perform less well than expected, based on the caliber of students at these schools. On the other hand, I've also heard Duke students say that having earlier clinical experience really made taking the more clinically-oriented board exams easier, and apparently they perform much better on the clinically-oriented boards as compared to step I. That coupled with the open 3rd year during which one has lots of free time to prepare for the exams makes me pretty confident that Duke student's don't need to worry about the boards; even where there are holes in our curriculum (embryology for example!), there's plenty of time to prepare.
In terms of grading, I especially love the whole pass/fail thing! While it's true that Duke is officially H/P/F for the whole first year, I've found it to essentially be P/F for me, since my class is made up of a number of ridiculously brilliant people who always perform really well on exams. In my mind, honors is pretty unattainable in a good majority of classes. We actually often don't even have a curve; most of our classes have had absolutes set for passing, honors, etc.
In any case though, it's CRITICAL to keep in mind that residency directors generally don't care about your first-year performance, especially when coming from a school like Duke or Penn. As long as you pass your classes you're fine. What they DO care about is how you perform on the wards! And Duke's grading system is a little different there. While it's still H/P/F on your external transcript, internally it's Honors/High Pass/Pass/Fail...there might be another level in there somewhere too. Basically, the system is set up such that if you were close to getting honors the deans will see it on your internal record as a high pass, and be able to better recommend you for competitive residencies, etc. It's basically like having A, B, C, but they're called different things. But I still think it changes the mindset, which I find to be a really great thing. We've all been so indoctrinated in the importance of A's as pre-meds that we can't separate that out when we get to med school, where other things are far more important, at least in my opinion (unless maybe you want to go into a ridiculously competitive field like opthalmology, dermatology, surgery, etc.).
I think it's especially great to have a P/F system because it allows me to focus not on memorizing details for an exam, which I'll surely forget a few days later, but rather on integrating the material and making it part of my understanding of patient care. Instead of studying for a test, it allows you to, at least in part, study in order to have the skills to help your patients, and ultimately that's why I'm pursuing a career in medicine!
In general, the pass/fail system is a great way to take the stress off, and refocus your learning! Of course, when I was applying I heard these things about grading systems and though it was just a bunch of bull...trust me, it's not.
