Impact of Covid-19 on upcoming application cycle

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
You have no statistical or scientific data to substantiate this claim. The data coming from Italy and China has been limited to suggest this. There may or may not be a “second wave.”
In fact the random sampling of antibodies in people of NY, Mass, Florida, and Cali would all point to more people being already infected. A majority of them asymptomatic and potentially immune moving forward. Will the US continue to have cases and deaths, yes. Will we see an inundation of the health care system moving forward, probably not. The reason being is people in states that have opened are still staying home in large portions. preliminary results seem to indicate that people are still unsure of the risk in an open society. You can disagree with me, but to make an absolute stalemate as to a “second wave” being a direct result of people protesting seems to be intellectually dishonest and unfounded. Time will tell moving forward.

There is likely to be a second wave.

The last two months were meant to buy time to increase test and trace capability, but obviously that hasn't happened. Things will pick up where they left off. The next month has the potential to be worse than the last one.
 

There is likely to be a second wave.

The last two months were meant to buy time to increase test and trace capability, but obviously that hasn't happened. Things will pick up where they left off. The next month has the potential to be worse than the last one.
They juxtapose previous influenza outbreaks with COVID, they talk about immunity may confer benefit, vaccination potential, and then they give three different models that may happen. This is all theoretical. I agree that we may see something moving forward, but we may not. COVID could be similar to previous flu out breaks or it may not. Immunity may or may not help. A vaccine may or may not be available or efficacious. The models may be accurate or not. If we look at the models that were first introduced they have been redacted or revised time and time again.
 
They juxtapose previous influenza outbreaks with COVID, they talk about immunity may confer benefit, vaccination potential, and then they give three different models that may happen. This is all theoretical. I agree that we may see something moving forward, but we may not. COVID could be similar to previous flu out breaks or it may not. Immunity may or may not help. A vaccine may or may not be available or efficacious. The models may be accurate or not. If we look at the models that were first introduced they have been redacted or revised time and time again.
Cancelling aways and virtual interviews are the prudent and responsible measure given what you think is so much uncertainty. If things are so shaky, being proactive and anticipatory is the smart move, right?

I disagree that it is unclear what will happen, though. Infection rates are going to climb as the population begins to strike out of their homes, a lack of suitable testing and tracing capacity will mean unchecked spread until the economy is forced to shut down again or millions of doses of an effective vaccine is distributed. You can probably guess which will happen first.
 
You have no statistical or scientific data to substantiate this claim. The data coming from Italy and China has been limited to suggest this. There may or may not be a “second wave.”
In fact the random sampling of antibodies in people of NY, Mass, Florida, and Cali would all point to more people being already infected. A majority of them asymptomatic and potentially immune moving forward. Will the US continue to have cases and deaths, yes. Will we see an inundation of the health care system moving forward, probably not. The reason being is people in states that have opened are still staying home in large portions. preliminary results seem to indicate that people are still unsure of the risk in an open society. You can disagree with me, but to make an absolute stalemate as to a “second wave” being a direct result of people protesting seems to be intellectually dishonest and unfounded. Time will tell moving forward.

If I rolled my eyes any harder, I'd sprain an eyeball.
 
Cancelling aways and virtual interviews are the prudent and responsible measure given what you think is so much uncertainty. If things are so shaky, being proactive and anticipatory is the smart move, right?

I disagree that it is unclear what will happen, though. Infection rates are going to climb as the population begins to strike out of their homes, a lack of suitable testing and tracing capacity will mean unchecked spread until the economy is forced to shut down again or millions of doses of an effective vaccine is distributed. You can probably guess which will happen first.
your first point will be addressed by the ACGME and all The other organizations on/after may 11th. It may or may not happen. My conjecture is irrelevant.

you can disagree with me, but I never said that infections and deaths would not continue. idk About the infection rate changing, maybe the incidence/prevalence changes. Idk enough about the infection rate to make that claim. I agree with needing more testing. Vaccine may or may not help or even be available within the year, idk.
 
??? Did anyone in the audience raise their hand and ask them rephrase that in a way that makes any sense??

Sorry I probably phrased it weirdly.
There was a discussion about removing Step 2 CS altogether as a requirement.
However, this was not feasible to do now within this year, they would need to discuss it further.
 
Sorry I probably phrased it weirdly.
There was a discussion about removing Step 2 CS altogether as a requirement.
However, this was not feasible to do now within this year, they would need to discuss it further.
Ill never understand how “removing a requirement” isn’t feasible for this year. Like it seems pretty straightforward and easy to remove something and a lot harder to add but that’s just me haha
 
Sorry I probably phrased it weirdly.
There was a discussion about removing Step 2 CS altogether as a requirement.
However, this was not feasible to do now within this year, they would need to discuss it further.
I still don't understand what you're saying... step 2 CS is still going to be administered this year even though there's a huge backlog, but subsequent years might not have to take it either?
 
Ill never understand how “removing a requirement” isn’t feasible for this year. Like it seems pretty straightforward and easy to remove something and a lot harder to add but that’s just me haha
The problem is that these requirements are probably written into the law for states, and medical boards. You would have to remove those, and that requires as much effort as it does to incorporate new requirements.
 
The problem is that these requirements are probably written into the law for states, and medical boards. You would have to remove those, and that requires as much effort as it does to incorporate new requirements.
The PA state board requires submission of your CS transcript.
 
I still don't understand what you're saying... step 2 CS is still going to be administered this year even though there's a huge backlog, but subsequent years might not have to take it either?

What could happen is that a majority of people who need to take it this year for the upcoming cycle, simply do not get to by ERAS opening and/or ranking. Especially if there is a second wave in the fall. Then after making concessions, USMLE realizes how bogus the exam is and scraps it all together. There is not real evidence as to what will happen since people are coming up with things on an almost hourly basis with how to handle things. Only time will tell.

I think a bigger problem is the prometric sites staying closed for step 1 and step 2 CK (and MCAT for premeds). Every week that these stay at home orders get extended, it makes matters worse for the situation. Especially if people out in states that are "reopening" find a spot to take it so that only a minority of people have reportable scores, this creates a potentially very unfair situation for all involved. M1/M2s probably won't be affected as much as M3/M4s and premeds in the end assuming this whole thing lasts 18 months as predicted.

I do seriously wonder if this could result in many MS4s and pre-meds needing to take a gap year in the event that ERAS/program directors/med school admins deciding not to change anything about the timeline.
 
Last edited:
Yeah I still don't understand that defense of Step 2 CS at all. Sounds like someone had been briefed that the revenue it generates is too high to lose the test, but wasn't provided any defensive talking points and had to improvise. "Uh...we can't waive this test with a 4+ month backlog because...uh because COVID was sudden. Yes, too sudden."
 
Also add in that zoom interviews are significantly easier for a prelim than trying to travel during a surgical prelim year! It's a little silver lining for you, at least.

BTW, read your story and it was a horrendous example of some of the fault lines in the system. Really hoping you get wherever you want to go this year, you definitely deserve it!
What story? sorry I am new here.
 
Yeah I still don't understand that defense of Step 2 CS at all. Sounds like someone had been briefed that the revenue it generates is too high to lose the test, but wasn't provided any defensive talking points and had to improvise. "Uh...we can't waive this test with a 4+ month backlog because...uh because COVID was sudden. Yes, too sudden."

I can see one of the problems being the people who already took CS. They'll be applying with a score and if they tell PDs to disregard the score or if they take it off their transcript, they're going to owe all those students the testing fee since they took a test they'll never use.
 
I can see one of the problems being the people who already took CS. They'll be applying with a score and if they tell PDs to disregard the score or if they take it off their transcript, they're going to owe all those students the testing fee since they took a test they'll never use.
1. It is not scored.
2. You can still make people take it in residency .
3. You dont need to disregard anything , the pass rate for CS is high anyway.
 
1. It is not scored.
2. You can still make people take it in residency .
3. You dont need to disregard anything , the pass rate for CS is high anyway.

Sorry, just meant a passing score versus those who failed.
 
I can see one of the problems being the people who already took CS. They'll be applying with a score and if they tell PDs to disregard the score or if they take it off their transcript, they're going to owe all those students the testing fee since they took a test they'll never use.
Yeah, my money says CS gets waived as a requirement to rank/match/graduate, but is still required of us after graduating.
 
why not just get rid of CS for good?

Because there are 25000 or so medical students who take it each year and cutting it out means that ERAS (or whoever rakes in the dough) is out nearly $40 million each year

Wow just typing out how much they actually extort irritates me. And this is just one of 4 exams.

Of course supporters will argue something along the lines that it "demonstrates a baseline clinical competency" but we all know the real reason.
 
Last edited:
Because there are 25000 or so medical students who take it each year and cutting it out means that ERAS (or whoever rakes in the dough) is out nearly $40 million each year

Wow just typing out how much they actually extort irritates me. And this is just one of 4 exams.

Of course supporters will argue something along the lines that it "demonstrates a baseline clinical competency" but we all know the real reason.

I mean, as someone with no skin in the game, I do think we need something besides OSCEs to demonstrate baseline clinical competency. A comprehensive standardized clinical skills exam at the end of MS3 year. But it should be left up to the schools to administer it and it shouldn't cost the students anything.
 
I mean, as someone with no skin in the game, I do think we need something besides OSCEs to demonstrate baseline clinical competency. A comprehensive standardized clinical skills exam at the end of MS3 year. But it should be left up to the schools to administer it and it shouldn't cost the students anything.
You mean like that thing called 3rd and 4th year???
 
Hmm, when did 3rd and 4th year become standardized?
I would argue that a system in which a student evaluated on not failing 24 months of rotations is non-inferior (and in fact, superior) to a test with a 90 something percent pass rate. The argument that someone could slip through the cracks is problematic for two reasons. The first is that a single test day exam is more likely to be beaten by a bad student than 24 MONTHS of evaluation. Also, a good student is more likely to have a bad day that cannot be countered with 23.9 months of work to the contrary in this scenario as well. The second is that CS/PE do not test real life procedures and practices in comparison to rotations (debatable on how out of touch but definitely some amount) so 24 months of actual work with real people would be better.

We don't have to agree here on the standard to hold these people to but when one really fleshes out the supposed argument for these exams it gets even more dumb than just knowing it was for foreigners and monetary gain.

Edit but yeah technically the lcme and coca "standardized" rotations. Are they the standard we want? Idk but they are by definition standardized because whatever the org that confers the degrees says so lol.
 
I would argue that a system in which a student evaluated on not failing 24 months of rotations is non-inferior (and in fact, superior) to a test with a 90 something percent pass rate. The argument that someone could slip through the cracks is problematic for two reasons. The first is that a single test day exam is more likely to be beaten by a bad student than 24 MONTHS of evaluation. Also, a good student is more likely to have a bad day that cannot be countered with 23.9 months of work to the contrary in this scenario as well. The second is that CS/PE do not test real life procedures and practices in comparison to rotations (debatable on how out of touch but definitely some amount) so 24 months of actual work with real people would be better.

We don't have to agree here on the standard to hold these people to but when one really fleshes out the supposed argument for these exams it gets even more dumb than just knowing it was for foreigners and monetary gain.

Edit but yeah technically the lcme and coca "standardized" rotations. Are they the standard we want? Idk but they are by definition standardized because whatever the org that confers the degrees says so lol.

Your logic is off. No one in their right mind believes that all students are judged objectively on every single rotation, particularly elective rotations. There's also a huge difference in preceptors (for goodness sakes, some people have an NP as preceptor, some do outpatient surgery rotations). There's a huge difference in duties for students, from standing around shadowing to being first page. There's nothing about American rotations that's standardized and students aren't judged according to any criteria except what the person grading thinks they earned and the person grading can be a resident, an NP, or a legit attending.

We can argue all day long about how the vast majority of students pass CS. You're absolutely right in saying that. But sometimes, those who fail do so for a reason.
 
Your logic is off. No one in their right mind believes that all students are judged objectively on every single rotation, particularly elective rotations. There's also a huge difference in preceptors (for goodness sakes, some people have an NP as preceptor, some do outpatient surgery rotations). There's a huge difference in duties for students, from standing around shadowing to being first page. There's nothing about American rotations that's standardized and students aren't judged according to any criteria except what the person grading thinks they earned and the person grading can be a resident, an NP, or a legit attending.

We can argue all day long about how the vast majority of students pass CS. You're absolutely right in saying that. But sometimes, those who fail do so for a reason.
So your argument isn't to fix what you actually consider a shortcoming (and many would not agree) but to create/maintain an additional flawed system that also has the feature of not fixing the actual problem either.

Sounds like either arguing in bad faith or you have aspirations to work in admin somewhere.
 
So your argument isn't to fix what you actually consider a shortcoming (and many would not agree) but to create/maintain an additional flawed system that also has the feature of not fixing the actual problem either.

Sounds like either arguing in bad faith or you have aspirations to work in admin somewhere.

What?? You're not even making sense. I never commented on fixing the system, either favorably or unfavorably, but even if I did, that would take years, if not decades. The point is, there should be a standardized clinical skills exam, just as there is a standardized written exam (three of them actually).
 
What?? You're not even making sense. I never commented on fixing the system, but even if I did, that would take years, if not decades. The point is, there should be a standardized clinical skills exam, just as there is a standardized written exam (three of them actually).
I'm just reading your initial post that I responded to. You believe CS/PE should exist to "demonstrate baseline clinical competency" and that without it we have no standard (lol). This is because you don't believe the 24 months of real life clinical work is up to standard as a metric as evidenced by your responses to my rebuttal that it is and even has advantages over 1 stupid test day in a fake setting. So instead of fixing the actual perceived problem with clinical years, as mentioned above, you want to add something else (PE/CS) that doesn't actually provide a meaningful solution and creates more problems but none of the strengths.

If anyone isn't making sense, it's the individual arguing for a pointless exam. I can't make that any clearer.
 
Last edited:
I mean, as someone with no skin in the game, I do think we need something besides OSCEs to demonstrate baseline clinical competency. A comprehensive standardized clinical skills exam at the end of MS3 year. But it should be left up to the schools to administer it and it shouldn't cost the students anything.

How often do you see people getting P/HP/H in clinicals doing badly in residency?
 
How often do you see people getting P/HP/H in clinicals doing badly in residency?

With CS as the roadblock, it's rare, but still happens. Take away CS and allow NPs to judge students and I can't imagine what happens then. Now ask how many people I've seen given a P who realistically sucked as a clinician? You have to be outright deliberately sabotaging your chances to fail a rotation.
 
With CS as the roadblock, it's rare, but still happens. Take away CS and allow NPs to judge students and I can't imagine what happens then. Now ask how many people I've seen given a P who realistically sucked as a clinician? You have to be outright deliberately sabotaging your chances to fail a rotation.

But doesn't that mean people with mostly H and HP are less likely to do bad?

I'm not sure how frequent NP preceptors are though since i thought that was rare.
 
But doesn't that mean people with mostly H and HP are less likely to do bad?

Depends on the rotation and person grading you. I know I got some H's I didn't really deserve (got one on surgery though I couldn't even tie a knot without help). I've also seen other students get H's they don't deserve.

I'm not sure how frequent NP preceptors are though since i thought that was rare.

Not frequent, but I used that to highlight the point that 3rd and 4th year isn't standardized. That's why Step 2 exists (hell, that's why all the Steps exist).
 
Depends on the rotation and person grading you. I know I got some H's I didn't really deserve (got one on surgery though I couldn't even tie a knot without help). I've also seen other students get H's they don't deserve.



Not frequent, but I used that to highlight the point that 3rd and 4th year isn't standardized. That's why Step 2 exists (hell, that's why all the Steps exist).

What about people who got H/HP in your specialty and your experiences working with or training them?
 
Idk how this would work in the US, at least to the level canada is. Canada is having their entire interview season take place in a 20 day window. That could never happen here there is too many applicants.
unless they switch to zoom.
 
I think the big thing here that would mitigate the damage is for a decision to be made in a relatively timely fashion. As applicants we need to know what the landscape is going to look like so we can make adjustments to our application strategy accordingly. The worst case scenario is all these decisions don't get made until the mid-fall, or sporadically as we go along, and in the meantime we are all left in limbo not really knowing what is expected of us or what the plan is.
 
Top