How effective is your school's USMLE POLICY?

[ennuiescence]

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Greetings. I was curious what your schools' Step 1 policies are, as I have noticed that several top-tier schools (Johns Hopkins, Harvard, Yale, Baylor, UTSW, the list can go on....) allow their students to take Step 1 during or after 3rd year, while several state schools across the country require sitting for it prior to beginning the 3rd year.
Since the higher-ranked medical schools generally possess superior averages, I have pondered as to whether the reinforcement of basic science concepts as they relate to actual clinical experience during rotations promotes higher performance on standardized exams and perhaps a greater appreciation of the curriculum due to its functional application above and beyond what can be taught in a classroom or read in a book. Needless to say, however, that a confounding variable might exist in that top-tier schools generally accept students with proven standardized test-taking skills that have a direct bearing on MCAT scores, but I have read about and seen students from my school and elsewhere obtain higher USMLE scores than students with better MCAT scores.
Much of this has evolved out of studying both Steps 1 and 2 material simultaneously out of the necessity of my current circumstance. I have not taken Step 1 yet, and I attend a state school with a policy requiring us to take Step 1 before MS3.
Out of curiosity, I have studied Kaplan Gastroenterology as part of Internal Medicine for Step 2 after going over Gastrointestinal system material for Step 1 in various review books (Gross, some Devo, Histo, some Biochem, Phy, Path, Pharm, Neuro, Micro, and Immuno) , only to realize that the only differences have generally been the addition of treatment and management issues. Otherwise, I have encountered more than 40% (conservative estimate) of the exact same material for Step 2 in Rheumatology, Neurology, Gastroenterology, Pulmonology, Endocrinology, etc, and I'd venture to estimate that I have read up to 80% of the same material as Step 1.

Any thoughts about:
1. your schools' policies and whether or not their rules are working to achieve, what should be, the overall BOTTOM LINE: HIGHER AVERAGES?
2. whether you have noticed overlap in material b/w steps 1 and 2?
3. whether you have read or observed a positive correlation between the top-tier schools' liberal USMLE policies and higher historical scores?

 

[GreenT]

Well, this is an interesting question. Going into clinics would help establish the main facts about diseases better, however, you do take a hit if you put off taking the board exams after the second year. The reason is because you will not have time on the wards to study for shelf exams and study all the mindless facts that are only on step 1. Things like random enzyme pathways biochem), transcription factors, interleukins, random nit picky stuff. So in some ways you might do better on the pharm and path part of the exam but will take a hit on the micro, mol. bio. and biochem. I have heard many students put it off for a year (pretty much not study) and end up with less time for instense study and the disadvantage of having taken second year courses over a year or two later. I was in the position of having the option of dragging out step 1 prep since I am doing a year of research but everyone talked me out of it and thank god I took it after second year classes. Based on the exam I got studying for a surg or psych shelf would not have helped.
Just my 0.002cents.