Howard and Meharry USMLE Pass rates

[Skills of House]

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Here's my reasoning:

1. Any student on the pass-fail borderline has approximately equal likelihood of passing or failing.
Ok

2. Say a school with a 98% pass rate has 100 students. Assuming the 2 that failed almost passed, we can conclude that approximately 4 (give or take) of them were on the line. What is the likelihood of a school with 20% of its students being on the line and only 2% failing? Nearly zero.
????????

3. The distribution of scores at any school is smooth and wide. The random events that would lead such a school to having 2% failure and a high percentage in the 180s or 190s are very unlikely.

Again...on what are you basing this????? One thing has nothing to do with the other. Just because most of them passed says nothing at all about their score! It's much more likely to be a normal distribution with passing at the low end and stellars (above 250) at the high, placing most between 200-220. But even that puts about 25% around the low end.


They threw the blame at the medical schools because that was the factor that set these physicians apart. They didn't blame Step 3 or residency programs because that was something that all physicians had in common. Finding differences between groups is how researchers identify potential causes of phenomena.

- Again makes no sense.....there are probably a million other things that set them apart! And how are Step 3 and residency soemthing they had in common? They didn't go to the same programs (weren't even in the same specialty), just like they didn't go to the same med schools. So why is it different? How is medical school, where even schools that give a lot of clinical experience still leave students far short of fully prepared to care for patients, is the end all be all to these physicians actions. Blaming the med school is as random as blaming their kindergarten teachers.

 

[The Buff]

No one is saying you will be a bad doctor or fail step 1 just because you go to Meharry, House. Chill out.

 

[Skills of House]

No one is saying you will be a bad doctor or fail step 1 just because you go to Meharry, House. Chill out.

What are you talking about? I didn't take it that way and that's not what this is about. I'm simply saying that:
1. You can't look at a school's first time Step I pass rate and use that as a gauge for whether or not you will pass, so in effect that pass rate should mean very little to you.
2. Who ever wrote that article should be placing blame on the NBME, LCME, USMLE, residency programs, and licensure agency of the respective states for the incompetency of these physicians, not the medical schools....or certainly not JUST the medical schools.
That being said, I do think it's bad for a school, any school, to be below the national average for first time passers and I would love input as to differences in curriculum. For example, I know some schools start clinicals at the end of second year and some have even already taken Step. Where as for us, we have class through the end of april, then we take a Kaplan course through May, and the Step in early to mid June. Is it similar at your program?

 

[dpgc21]

I am of the belief that the school does not determine your success in medical school or in the medical profession. I believe that it is the student who will play the vital role. If it is true that Howard has a 78% pass rate (Which I do not believe) so what. Does that mean that any incoming first year is relegated to 78% chance of passing, absolutley not. The fact is that Howard is a great school down the road from Georgetown, with a great reputation of producing doctors whom serve the underserved.

Every student is accountable for himself. If you study hard, and put forth the effort, you will pass your boards. If you go to a school that has a 99% pass rate, the same formula applies. You have to study hard, put forth effort and you will pass your boards. Every medical student in my opinion regardless of school is given the same scientific knowledge. Now what the student does with it, is what seperates us all.

 

[lord_jeebus]

- Again makes no sense.....there are probably a million other things that set them apart! And how are Step 3 and residency soemthing they had in common? They didn't go to the same programs (weren't even in the same specialty), just like they didn't go to the same med schools. So why is it different? How is medical school, where even schools that give a lot of clinical experience still leave students far short of fully prepared to care for patients, is the end all be all to these physicians actions. Blaming the med school is as random as blaming their kindergarten teachers.

Well yes, everyone is different. But a disproportionate number of physicians with poor disciplinary records came from these schools.

Perhaps it was something about the schools.

Perhaps it was something about the students that were attracted to these schools.

Perhaps those who attend these schools share some risk factor that makes them more likely to be unfairly singled out.

The reasons behind what is going on are debatable. But you can't say that it's "random." There is a significant difference between groups that canot be explained by chance. The fact that they had such diverse experiences post-med school only underscores the fact that there is something fishy about the med schools themselves.

Say you had a car factory that put out cars that were much more likely to spontaneously explode than those from other car factories. Yet there are different models of cars, purchased by a diverse group of people, and driven all over the country. Would you blame the car factory, or would you say that there are a million things that set these cars apart?

 

[Skills of House]

Well yes, everyone is different. But a disproportionate number of physicians with poor disciplinary records came from these schools.

Perhaps it was something about the schools.

Perhaps it was something about the students that were attracted to these schools.

Perhaps those who attend these schools share some risk factor that makes them more likely to be unfairly singled out.

The reasons behind what is going on are debatable. But you can't say that it's "random." There is a significant difference between groups that canot be explained by chance. The fact that they had such diverse experiences post-med school only underscores the fact that there is something fishy about the med schools themselves.

Say you had a car factory that put out cars that were much more likely to spontaneously explode than those from other car factories. Yet there are different models of cars, purchased by a diverse group of people, and driven all over the country. Would you blame the car factory, or would you say that there are a million things that set these cars apart?

I hear what you're saying, but I think the operative words in your response are "diverse experiences post-medschool"....but you see, this isn't just post-med school. Again, it's post Step 3, post residency, and post full licensure practice as well.
Let's take your car example: Now, if I buy a car and only people associated with that factory (e.g. a dedicated dealership) maintained the car for a year and it just explodes, then obviously I'm going to go back to the factory, especially if it's happening with other cars coming out of that factory. On the other hand if that same car works fine the entire 4 years it's being maintained by the factory and works fine for years outside of being taken care of by the factory (and instead by someone else), but then explodes, of course I'm not going to still blame the factory! That's ridiculous! It's just like computers, cars, hell, any company...what do they always say? If you buy it from them and they're doing the maintenance but something goes wrong, sure they'll take the blame, but you let someone else take over and you can no longer hold them responsible. And it's absurd that you would! I mean the one physician that they really singled out from the Mexican school was a surgeon for God's sake! If you're actually performing surgeries at your med school, then that might be the one thing that makes me want to transfer because that sounds like some pretty high speed, low drag training you have going on!

 

[lord_jeebus]

I hear what you're saying, but I think the operative words in your response are "diverse experiences post-medschool"....but you see, this isn't just post-med school. Again, it's post Step 3, post residency, and post full licensure practice as well.
Let's take your car example: Now, if I buy a car and only people associated with that factory (e.g. a dedicated dealership) maintained the car for a year and it just explodes, then obviously I'm going to go back to the factory, especially if it's happening with other cars coming out of that factory. On the other hand if that same car works fine the entire 4 years it's being maintained by the factory and works fine for years outside of being taken care of by the factory (and instead by someone else), but then explodes, of course I'm not going to still blame the factory! That's ridiculous! It's just like computers, cars, hell, any company...what do they always say? If you buy it from them and they're doing the maintenance but something goes wrong, sure they'll take the blame, but you let someone else take over and you can no longer hold them responsible. And it's absurd that you would! I mean the one physician that they really singled out from the Mexican school was a surgeon for God's sake! If you're actually performing surgeries at your med school, then that might be the one thing that makes me want to transfer because that sounds like some pretty high speed, low drag training you have going on!

So if today, a bunch of 1998 Toyota Camrys started exploding, and it turned out that a disproportionate number of them were made at a given factory, you wouldn't consider looking into that factory?

 

[Skills of House]

So if today, a bunch of 1998 Toyota Camrys started exploding, and it turned out that a disproportionate number of them were made at a given factory, you wouldn't consider looking into that factory?

Well, first off I would need a definition of "a bunch", which is also why this discussion is at a disadvantage seeing as the author of that article didn't list the actual details of the study. But to answer your question, no, I wouldn't. Because after 10 years, there's nothing on a car that's driven regularly that doesn't need to be replaced (except perhaps, the Cat converter). So how are you going to have all of these after market parts on the car and still try to blame the original manufacturer? And the med schools parallel this. If med school knowledge were the only knowledge a physician used and needed to be competent and you were finding problems in competency, then yes, of course it makes sense to go back to the med schools. But this is obviously not the case. Why are interns and residents able to be "pimped"? Because older residents and physicians know that coming out of medical school there's a world of information and skill that we still don't have.

 

[turkleton]

So if today, a bunch of 1998 Toyota Camrys started exploding, and it turned out that a disproportionate number of them were made at a given factory, you wouldn't consider looking into that factory?

So are you proposing we shut down those medical schools? This thread was dicey from the beginning and the conclusions it has produced are proof thereof.

 

[lord_jeebus]

So are you proposing we shut down those medical schools? This thread was dicey from the beginning and the conclusions it has produced are proof thereof.

Did I say that? No

I don't even believe that the med schools are at fault.

I do believe that there is reason to look into the schools to confirm this.

The purpose of my example was to argue that when you get a correlation that's not explained by chance, you can't call it random.

 

[helpfuldoc2b]

SO your telling me that Carribbean Medical Schools have higher USMLE I passing rate than many US Medical Schools? SGU does post an average of 90% pass rate for the past 5 years😕

 

[classof2011]

Uh oh, I think Skills of House took the belt home tonight! 😀 I totally agree with his reasoning. I can understand why (and how) Jeebus, however, came to that conclusion. It is funny that such doctors just happened to be connected to these schools. However, it is also funny how the author forgot to tally up some of the other physicians from other US schools who fell in place with these numbers (whether it was 9x, 8x, or 7x the rate), similar to the mentioned schools, and hence the article implies that "these schools produce 10 times the rate of troubled physicians at [many] US schools" comparing them to the opposite pole. If I can recall, the article plays with words by comparing these schools to some other US schools who have produced very little documented troubled physicians. hmmmmm.

Just as House of S forked to, This article is so clearly faulty that it hurts. Cumon med-group, we are a smart group of students and most of us know that this articles was unleashed to the public to scare America away from minority physicians. Just as the AAMC counters for an increase in the appicant pool, there are these idiotic strategies to prevent minority advancement.

COME OFF IT!!!!

 

[Taus]

SO your telling me that Carribbean Medical Schools have higher USMLE I passing rate than many US Medical Schools? SGU does post an average of 90% pass rate for the past 5 years😕

you can't take that at face value....take a look at the size of the entering class vs. how many actually take the usmle when they are supposed to.....

 

[lord_jeebus]

So how are you going to have all of these after market parts on the car and still try to blame the original manufacturer? And the med schools parallel this.

The point is that anything after-market is somewhat controlled. If there were differences in after-market parts used in exploding and non-exploding cars, that would certainly be worthy of inquiry as well. Because there aren't, why not start an investigation at the one thing that is known to show a correlation? Even if the factory is not at fault it is a good place to look for factors that could contribute to a problem, because there is something statistically unique about it.

How about this.

Say a disproportionate number of young women with clear cell carcinoma of the vagina are found to have been exposed as fetuses to a particular compound. By your logic, we shouldn't bother looking into that because they have been exposed to so many other things since then. 20 years is forever! By your logic, pregnant women would still be getting DES.

You can't let your disagreement with possible conclusions of an inquiry dictate what is worthy of inquiry. Personally, I think further investigation would only show that these schools have nothing to do with behavior deserving disciplinary action, only increased likelihood of being subject to public action. But we'll never know that if no one looks into it.

 

[Skills of House]

The point is that anything after-market is somewhat controlled. If there were differences in after-market parts used in exploding and non-exploding cars, that would certainly be worthy of inquiry as well. Because there aren't, why not start an investigation at the one thing that is known to show a correlation? Even if the factory is not at fault it is a good place to look for factors that could contribute to a problem, because there is something statistically unique about it.

How about this.

Say a disproportionate number of young women with clear cell carcinoma of the vagina are found to have been exposed as fetuses to a particular compound. By your logic, we shouldn't bother looking into that because they have been exposed to so many other things since then. 20 years is forever! By your logic, pregnant women would still be getting DES.

You can't let your disagreement with possible conclusions of an inquiry dictate what is worthy of inquiry. Personally, I think further investigation would only show that these schools have nothing to do with behavior deserving disciplinary action, only increased likelihood of being subject to public action. But we'll never know that if no one looks into it.

Eureka!!! Your example is exactly my point of why you can't just look at someone saying "these Doctors are getting into trouble....must be the medical schools." because (at least according to Robbins) "less than 0.14% of such DES-exposed young women develop adenocarcinoma." Less than 2 tenths of ONE percent!!! Now, since we're talking about cancer here, is it still worth getting rid of, especially when there are better options? Of course. But that doesn't change the fact that even in taking it, the likelihood of cancer was extremely small. And there is absolutely no basis for blaming the med schools when these physicians have been removed from medical school for longer than they were there in the first place!
Let's take a highschool student who attends an inner city school: the student studies calculus and gets a 5 on the AP exam in highschool. In college the student studies fractals, linear algebra, statistics, and even more calculus and graduates with a degree in math. Then after a couple of years working as an actuary (working fine, mind you) this person makes a miscalculation (that any highschool calc student would've been able to point out) that costs the company a 10 million dollar deal. Is the person going to get fired? Yeah, probably. But are you honestly going to say "the person is incompetent because he/she attended an inner city high school"???? Please! That school would say "Look, I don't know what the hell, he learned AFTER leaving, but while here, he gained the required knowledge to be successful...as evidenced by his AP score." The same way any of those medical schools would say "I don't know what they did after they left, but when they were here they passed the national Step 1, Step 2 and Step 2CS." You want to look at the medical schools, that's fine. I'm all for being thorough. But for it to take longer than 30 seconds to realize that it's absurd to place the entire or even majority blame on them (which is precisely what that article did) is ridiculous.

 

[Skills of House]

you can't take that at face value....take a look at the size of the entering class vs. how many actually take the usmle when they are supposed to.....

True...but even if everything was on the same timeline, maybe it's a really good school. I don't really know too much about the carribean schools, besides the flyers that SGU used to send when I was in undergrad. But I do know that according to the USMLE website the 2005 1st time pass rate for non-us/canadian schools was only about 67% and that's pretty much been the trend for the past several years....so I don't know about that over 90% for SGU for the past 5 years. If they are, great! More power to them, but I'd like to see the evidence before jumping in that line.

 

[gostudy]

Some of you people are pathetic. Quit being so damned racist.