How much did MDs study for Step 1 "back in the day"

  • Thread starter Thread starter 787593
  • Start date Start date
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
7

787593

Members do not see this ad.
I had an older physician tell me that studying for Step 1 before dedicated is a waste of time. LMAO. Which got me thinking, did they not study as much for step 1 in the ~1980s? I know an older ENT who matched with a ~220. 😵

Title: MD medical students*
 
I know it's hard to believe but back in the day the USMLE was simply a competency based exam meaning you just had to score above a certain threshold to pass and that was good enough for residency programs. Nowadays, step one is viewed as a marker for competitiveness because most schools have transitioned to pass/fail grading so there is really no other way to compare applicants.
 
Wife and I only studied to pass our respective boards. I think we only studied during dedicated time. Score played a small role in residency selection, unless you failed. Auditions were given more weight. Times change. When you have hundreds of applicants for a handful of slots, you cant read them all, at least that's what several PDs have told me. So they use board scores to screen.
 
Healer@1994 said:
I had an older physician tell me that studying for Step 1 before dedicated is a waste of time. LMAO. Which got me thinking, did they not study as much for step 1 in the ~1980s? I know an older ENT who matched with a ~220. 😵

Title: MD medical students*
Click to expand...

Up through the mid-1980's, when the exam was known as NBME Part I, it was administered on paper and most medical students took it shortly after finishing M2. By that I mean you might finish M2 on a Friday and then sit for Part I on the following Tuesday. It was functionally P/F and that was that. Much more of a recall exam, you prepped for it by studying for the first two years of medical school.

After Step 1 debuted in 1992, it became evident that your three digit score had some correlation to your odds of passing your specialty boards on the first attempt. When PD's figured this out there emerged some pressure to allow students a couple of weeks to review before taking it. This gradually inched up over time.

I took Step 1 almost 20 years ago (got a decent score, too!). My school gave us all a generic plan of about 4 weeks, told us which books to buy (the UFAP of its day) and how many hours to study. Online question banks were fairly new, so most of us relied on hard copy materials. There were no real self assessment tools of any sophistication or widespread use.

Of course, that was back when very few people applied to more than 20 residency programs.

Edited for clarity (posting past my bedtime).
 
Last edited:
Back in the days before internet, there was much less stress as no one really knew what all of this stuff meant. Now, everyone gets stressed out about little numbers.

I got into med school with an excellent GPA but alittle below avg MCAT. Did about 20 hrs of ER volunteering, no research, no physician shadowing. I don't think I could sniff an interview now reading what some of you pre meds do. Hundred of hours of volunteering, volunteering outside the medical field, research, published papers, Nobel prize winners 🙂

Geez..... I am not sure if all of this is necessary or just the hysteria that comes with comparing yourself to others. Sometimes its good to be ignorant or I would have been a stressed out premed.
 
One of my mentors (probably in his 50s) likes to tell his students he took with literally zero prep because he forgot about it. He was hanging out at the med school and someone asked him why he wasn't taking the test with everyone else in his class, so he walked to the lecture hall, sat down, and took the test.
 
Med Ed said:
Up through the 1980's, when the exam was known as NBME Part I, it was administered on paper and most medical students took it shortly after finishing M2. By that I mean you might finish M2 on a Friday and then sit for Part I on the following Tuesday. It was P/F and that was that. Much more of a recall exam, you prepped for it by studying for the first two years of medical school.

After Step 1 debuted in 1992, it became evident that your three digit score had some correlation to your odds of passing your specialty boards on the first attempt. When PD's figured this out there emerged some pressure to allow students a couple of weeks to review before taking it. This gradually inched up over time.

I took Step 1 almost 20 years ago (got a decent score, too!). My school gave us all a generic plan of about 4 weeks, told us which books to buy (the UFAP of its day) and how many hours to study. Online question banks were fairly new, so most of us relied on hard copy materials. There were no real self assessment tools of any sophistication or widespread use.

Of course, that was back when very few people applied to more than 20 residency programs.
Click to expand...
How did applying work back then? LORs? Just the logistics of the paper work etc.
 
Med Ed said:
Up through the 1980's, when the exam was known as NBME Part I, it was administered on paper and most medical students took it shortly after finishing M2. By that I mean you might finish M2 on a Friday and then sit for Part I on the following Tuesday. It was P/F and that was that. Much more of a recall exam, you prepped for it by studying for the first two years of medical school.

After Step 1 debuted in 1992, it became evident that your three digit score had some correlation to your odds of passing your specialty boards on the first attempt. When PD's figured this out there emerged some pressure to allow students a couple of weeks to review before taking it. This gradually inched up over time.

I took Step 1 almost 20 years ago (got a decent score, too!). My school gave us all a generic plan of about 4 weeks, told us which books to buy (the UFAP of its day) and how many hours to study. Online question banks were fairly new, so most of us relied on hard copy materials. There were no real self assessment tools of any sophistication or widespread use.

Of course, that was back when very few people applied to more than 20 residency programs.
Click to expand...


I took NMBE Part 1 in 1990 and it was scored. I guess that qualifies me an as “older physician”. The scoring range was like the SAT’s with median around 500. Above 600 (one std deviation) was considered pretty good and above 700 was considered very good. And the scores were used to screen residency applicants just as they are today. Mid 600s was a reasonable score to match derm/ortho/NS which were very competititive even then.

My friends and I studied 6-8 weeks for it by memorizing actual review books. My friend with the highest score I heard (740) did IM at Brigham and then radiology there AFTER finishing his medicine residency. So he wasn’t smart in every possible way😉

To OP, don’t listen to that fool. All your peers are studying for it so you should too.
 
Last edited by a moderator:
MedicineZ0Z said:
How did applying work back then? LORs? Just the logistics of the paper work etc.
Click to expand...

ERAS was electronic by the time I reached that point, so the application process itself was not very different from now. From a functional standpoint it was certainly less stressful.

That’s not to say people didn’t get stressed. But you didn’t have students with 230+ Steps applying to 60 FM programs just to be safe. I knew someone who applied to 3 FM programs. Matched at #1.
 
Healer@1994 said:
I had an older physician tell me that studying for Step 1 before dedicated is a waste of time. LMAO. Which got me thinking, did they not study as much for step 1 in the ~1980s? I know an older ENT who matched with a ~220. 😵

Title: MD medical students*
Click to expand...
They're not wrong. This coming from a current M4.
If you paid attention during preclinicals, you don't need to pre-study for Step. Dedicated will be plenty.
 
Angus Avagadro said:
Wife applied to 3 programs, but she could have gone anywhere. I applied to 5. Both got 1st choice. But this was before Eras, in the 80s, so all paper apps, letters, secondaries, etc.
Click to expand...
So LOR writers had to mail in copies to a dozen places?
 
Pre study for steps? Not necessary IMO but to each their own. It’s very much a scenario of diminishing returns while wasting valuable free time you could be enjoying your 20’s
 
1995 First Aid: 135 pages of content
2010s First Aid: 500+ pages of content (and the font is much denser)

Had a med school administrator admonish us because we complained that our supposedly dedicated study time had mandatory stuff sprinkled in it and how back in their day they were expected to just take it on a free weekend. 🙄
 
nimbus said:
I took NMBE Part 1 in 1990 and it was scored. I guess that qualifies me an as “older physician”. The scoring range was like the SAT’s with median around 500. Above 600 (one std deviation) was considered pretty good and above 700 was considered very good. And the scores were used to screen residency applicants just as they are today. Mid 600s was a reasonable score to match derm/ortho/NS which were very competititive even then.

My friends and I studied 6-8 weeks for it by memorizing actual review books. My friend with the highest score I heard (740) did IM at Brigham and then radiology there AFTER finishing his medicine residency. So he wasn’t smart in every possible way😉

To OP, don’t listen to that fool. All your peers are studying for it so you should too.
Click to expand...
Interesting, that sounds an awful lot like COMLEX scoring today on the DO side.
 
Absolutely no doubt the game has changed over 3 decades. Medical science has made huge advancements since the HIV crisis in the early 80s. Rapid med school expansion, MD and DO, without corresponding increase in residency slots has made residency application much more competetive. Board study guides became enhanced due to an increase in information plus competetion for who can put out the BEST board study supplement. Trying to decide who had it harder is moot. The only relevant discussion is the residency application game and how best to play it. For the simple fact remains after many decades, it's the only game in town. Either play or take your ball and go home. It is what it is.
 
Angus Avagadro said:
Absolutely no doubt the game has changed over 3 decades. Medical science has made huge advancements since the HIV crisis in the early 80s. Rapid med school expansion, MD and DO, without corresponding increase in residency slots has made residency application much more competetive. Board study guides became enhanced due to an increase in information plus competetion for who can put out the BEST board study supplement. Trying to decide who had it harder is moot. The only relevant discussion is the residency application game and how best to play it. For the simple fact remains after many decades, it's the only game in town. Either play or take your ball and go home. It is what it is.
Click to expand...

Today, we have the internet and a plethora of board prep materials at our disposal. YouTube videos has given us a glimpse into the OR at a hospital across the country doing a rare procedure by the top dog their field. At the push of a button rather than at the behest of a cranky librarian, we are able to quickly and easily read up on the latest research in virtually anything we so desire.

Back then, they had only stone tablets and cave drawings. I would say we have it better.
 
Not even so much back in the day as in ca 2011-2012, I wasn’t aware of anyone studying particularly for boards before mid to late second year. The curriculum is pretty standard, LCME mandates, and prepared you well enough. People studied for this block’s exams.
 
I didn't study for Step 1 prior to dedicated in 2012. Scored in the ~87th percentile nationally. Like someone said above, study well for your courses and dedicated is more than enough.
 
Healer@1994 said:
I had an older physician tell me that studying for Step 1 before dedicated is a waste of time. LMAO. Which got me thinking, did they not study as much for step 1 in the ~1980s? I know an older ENT who matched with a ~220. 😵

Title: MD medical students*
Click to expand...
My brother matched GS at Stanford with a 230, but he was AOA and had a 240+ Step 2. He also went to an avg state MD school and was a 1st gen Doctor, so he didn’t have any special pull. They placed a lot bigger emphasis on stuff like AOA back in the 90’s. It’s really because of the resources available now that people are expected to hit high numbers.
 
It seems like there’s an arms race between the cram materials and practices of medical students and the expectations of residency programs. With rising resources expended on both sides to interview at more programs/interview more candidates for same spots. Mutually assured destruction.
 
MSTPlease said:
I didn't study for Step 1 prior to dedicated in 2012. Scored in the ~87th percentile nationally. Like someone said above, study well for your courses and dedicated is more than enough.
Click to expand...
Yup. I know multiple 250+ scorers who did no Step-focused studying prior to dedicated. Like, sure, they used FA as a reference throughout M1/M2 from time to time. It's got some good mnemonics in it, why not? But otherwise, nah.
 
mehc012 said:
Yup. I know multiple 250+ scorers who did no Step-focused studying prior to dedicated. Like, sure, they used FA as a reference throughout M1/M2 from time to time. It's got some good mnemonics in it, why not? But otherwise, nah.
Click to expand...
I always say run your own race, dont worry what other students are doing. The thing that surprised me the most when I got to med school was that everyone there was smart, but just how many were "Scary" smart really surprised me. I think many who score 250+ with a few weeks of studying might fit into that group. I cant competet at that level and require more study time, so I always run my own race.
 
libertyyne said:
what do you think is on the exam?
Click to expand...
I go to a DO school so I heard its all self study for us for step were on our own meaning our school doesnt really prep us for step. My school apparently teaches to COMLEX (if anything) which sucks so Im hearing everyone who wants to take step just does enough to pass classes in M2 so they can put all their energy into studying step on their own. Its frustrating when schools dont teach to boards but at least i have the opportunity to take step at all
 
Deecee2DO said:
I go to a DO school so I heard its all self study for us for step were on our own meaning our school doesnt really prep us for step. My school apparently teaches to COMLEX (if anything) which sucks so Im hearing everyone who wants to take step just does enough to pass classes in M2 so they can put all their energy into studying step on their own. Its frustrating when schools dont teach to boards but at least i have the opportunity to take step at all
Click to expand...
Don’t take what you hear on here as gospel. Most DO schools do alright. I mean besides OMM the actual medicine is the same on both exams, it’s just the questions that may be different.

SDN is in no way indicative of real life. Definitely helpful in some ways, but never base medical school off of it. Listen to upperclassman more at your own school, because they’ll know more than strangers on the internet
 
Deecee2DO said:
I go to a DO school so I heard its all self study for us for step were on our own meaning our school doesnt really prep us for step. My school apparently teaches to COMLEX (if anything) which sucks so Im hearing everyone who wants to take step just does enough to pass classes in M2 so they can put all their energy into studying step on their own. Its frustrating when schools dont teach to boards but at least i have the opportunity to take step at all
Click to expand...
I think the point is even if schools dont teach towards boards learning the material well helps come dedicated. My school isnt particularly known for teaching towards boards. But if you bust your behind during pre- clinicals the nuts and bolts are the same, its not like losartan has different side effects in MD school vs DO school.
 
Deecee2DO said:
I go to a DO school so I heard its all self study for us for step were on our own meaning our school doesnt really prep us for step. My school apparently teaches to COMLEX (if anything) which sucks so Im hearing everyone who wants to take step just does enough to pass classes in M2 so they can put all their energy into studying step on their own. Its frustrating when schools dont teach to boards but at least i have the opportunity to take step at all
Click to expand...
Don't buy into that. The material is the same. In fact comlex has like 120 more questions so they often cover more of the material but it's the same material. seriously, I did not change how I prepped other than going through some omm a day before COMLEX and I scored 98th-99th percentile on both exams.
 
FourniersGreenGang said:
Don't buy into that. The material is the same. In fact comlex has like 120 more questions so they often cover more of the material but it's the same material. seriously, I did not change how I prepped other than going through some omm a day before COMLEX and I scored 98th-99th percentile on both exams.
Click to expand...
I did very well and used UW plus only OMM questions from COMBANK
 
siliso said:
Not even so much back in the day as in ca 2011-2012, I wasn’t aware of anyone studying particularly for boards before mid to late second year. The curriculum is pretty standard, LCME mandates, and prepared you well enough. People studied for this block’s exams.
Click to expand...

Yeah, I took the Step 1 around that time. Did well but I spent January onwards doing UW questions, listening to Goljan, and then sort of rinse/repeated come dedicated study time.

Definitely there’s higher scores and more stress now due to study materials and more intensive board prep. It’s only going to get worse.
 
The old adage was-
2 weeks, 2 days, and a number 2 pencil.
That was prep time for Step 1, 2, and 3.
It was pretty accurate 20 or so years ago, though replace number 2 pencil with 20 minutes to practice the interface for the then newly electronic step 3.
Paper exams sucked.
Just wait until you have to study for your oral board exam(s) knowing that anthing in your field of study is fair game.
And it’s pass/fail. No pressure.
 
You must log in or register to reply here.

Similar threads

C
the state of step 1
2 3
Replies
131
Views
14K
coconutapple
C
cerebellar
Step 1 advice!
Replies
0
Views
693
cerebellar
cerebellar
E
Uworld step 1 qbank
Replies
0
Views
417
ellebelle_8
E
S
What to do step 1 fail and how to navigate this?
Replies
9
Views
861
janprincetondoc
J
S
M1 Step 1 Advice
Replies
4
Views
954
Goro
Goro
Top