How will I know if I am competitive for ROAD if Step 1 is P/F?

[whenthelightsgo_OUT]

Asking because I don’t want to grind research for 3 years only to do trash on step 2

Edit: school I'm choosing is P/F no internal rankings

---

Members don't see this ad.

 

[Doctoscope]

I think that was one of the biggest concerns with it going P/F... it's gonna be hard to tell until STEP 2.

 

[BritainKittenMittens]

Asking because I don’t want to grind research for 3 years only to do trash on step 2

Edit: school I'm choosing is P/F no internal rankings

Most schools are only P/F during pre-clinical, but are graded during clinicals which will be what PDs look at. If you are fortunate enough to go to one of the few schools that is P/F during clinical as well, you don't need to worry at all. Those few schools are top of the top and can do that because they know their students match well regardless.

 

[Shunsui]

Clerkship grades, shelf scores, LORs, evals, AOA, passing Step 1, research

Research in any field will always polish your ERAS so even if you pump out pubs for 3 years and score low on Step 2, you'll still have a boatload of research for your app.

 

[Med Ed]

I think that was one of the biggest concerns with it going P/F... it's gonna be hard to tell until STEP 2.

Prior to the P/F conversion the trend was to push Step 1 later in the curriculum, after the clerkship year. Like or not, since medical students are learning to become clinicians, there is logic to having the high-stakes national exam be a clinically-oriented one that occurs after third year.

To address to OP's question, high USMLE scores do not typically appear out of nothing. Medical students have years of data on exam performance before they take Step 2, and (big surprise) if you're a high scorer in the preclerkship years, and a high scorer on the shelf exams, and a high scorer on the multitude of commercial self-assessment exams, then you're going to do well on Step 2.

In fact, the students who end up being competitive for highly selective fields tend to declare themselves early on as being "total packages." The Step 2 score simply becomes a cap on 3 years of solid performance.

If the concern is that an otherwise mediocre student will have to wait until until late in the game to throw the Step 2 Hail Mary for ortho, then yes, that's going to be a problem. But not a new or surprising one.

 

[Goro]

Asking because I don’t want to grind research for 3 years only to do trash on step 2

Edit: school I'm choosing is P/F no internal rankings

Network
Do research in the field
Shine on audition rotations
Network
Network
Do well on Step 2

If you want to get into an uber-specialty, you earn it. No short cuts.

 

[deleted1114112]

Most schools are only P/F during pre-clinical, but are graded during clinicals which will be what PDs look at. If you are fortunate enough to go to one of the few schools that is P/F during clinical as well, you don't need to worry at all. Those few schools are top of the top and can do that because they know their students match well regardless.

Even at those schools, there will have to be some new way (or just step 2) of stratifying students. Not all will or want to go into those specialties.

 

[whenthelightsgo_OUT]

If you want to get into an uber-specialty, you earn it. No short cuts.

If you grind research for three years you will have a better chance at ROAD then if you dont.

Thank you, this is what I needed to hear.

 

[Doctoscope]

Prior to the P/F conversion the trend was to push Step 1 later in the curriculum, after the clerkship year. Like or not, since medical students are learning to become clinicians, there is logic to having the high-stakes national exam be a clinically-oriented one that occurs after third year.

To address to OP's question, high USMLE scores do not typically appear out of nothing. Medical students have years of data on exam performance before they take Step 2, and (big surprise) if you're a high scorer in the preclerkship years, and a high scorer on the shelf exams, and a high scorer on the multitude of commercial self-assessment exams, then you're going to do well on Step 2.

In fact, the students who end up being competitive for highly selective fields tend to declare themselves early on as being "total packages." The Step 2 score simply becomes a cap on 3 years of solid performance.

If the concern is that an otherwise mediocre student will have to wait until until late in the game to throw the Step 2 Hail Mary for ortho, then yes, that's going to be a problem. But not a new or surprising one.

I see. All I know about Step 1 going P/F is the Armageddon posts on the MD/DO forums, and how if someone goes all in on ortho/some other competitive specialty and scores poorly on Step 2, their life is essentially "over."

 

[Med Ed]

I see. All I know about Step 1 going P/F is the Armageddon posts on the MD/DO forums, and how if someone goes all in on ortho/some other competitive specialty and scores poorly on Step 2, their life is essentially "over."

If I had a nickle.

Interestingly, this year a number of specialties are experimenting with using the supplemental ERAS application for preference signaling. I think this will become more common, and some specialties may exit ERAS altogether if they find they can do it on their own more efficiently.

Preference signaling poses a trade-off to applicants, but it would markedly decrease reliance on Step scores as a screening tool. Overall this would be a good thing.

 

[oldman]

I suspect Sub-I away rotations may become more important as the program directors have a harder time separating out the applicants.

 

[hopkinsgal2022]

Just because you won't get a three-digit score for Step 1, doesn't mean you won't be able to still get an idea of how you would have done. You'll still get three-digit practice test scores on your UWSAs and NBME practice exams during Step 1 dedicated. Use these to predict what your Step 1 score would have been had it been scored; Step 1 scores tend to correlate with Step 2 (with on average an 8-10 point boost for Step 2). Clerkship shelf exam scores also correlate strongly with Step 2; this Reddit Step 2 score predictor spreadsheet generates a Step 2 score, prediction based on your third year shelf exam scores (and practice test scores), that many people say was uncannily accurate for them.

You've all got this. Good luck!