Is it worth it to try hard in a (ranked) pass/fail curriculum ?

[Foot Fetish]

So, my school has pass/fail grading, but it's secretly ranked such that your dean's letter will use a different superlative to describe you based on your percentile rank. Also, only the top quarter of the class is eligible for AOA nomination (actually getting it then depends on extracurricular factors)...I'm just 6 weeks into M1, and I have figured out how to ace all my classes , pretty much. I have been beating the class average by a good amount and even getting some 100's. The problem is that I'm fairly sure that I spend an abnormal amount of time studying. Whereas my colleagues are constantly going out to social events and stuff, I literally just study all day everday, stopping only to complete my most basic activities of daily living and to attend mandatory class sessions...I don't even exercise. I just sit in a chair for 8-12 hours per day making and memorizing study materials...I have a bit of on obsessive, perfectionist personality when it comes to things like this....now my question is: is it worth it? My current system is working really well, but do preclinical grades / AOA even matter enough to be putting in this much effort? Would it be more beneficial to study just enough to do average on the exams and then use the rest of my time to study for Step 1 or do research? Being able to take a 30 minute walk without feeling guilty would be great too...

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[Brorthopedic]

Don't expect AOA or a high step 1 score if you're just barely passing. Those matter and I'm not sure how you can achieve the two without doing well in class. So yes, your grades indirectly matter.

 

[Foot Fetish]

Don't expect AOA or a high step 1 score if you're just barely passing. Those matter and I'm not sure how you can achieve the two without doing well in class. So yes, your grades indirectly matter.

How about when I get to M2, and the Step 1 clock starts ticking? How do i balance school curriculum with my personal step 1 curriculum. Wouldnt it be higher yield to focus on step 1 at that point? I figure you would get the most bang for your buck if you study mainly from Step 1 resources and then just go back and fill in whatever gaps there are for school-specific details that you're expected to know for class exams.

 

[whatisthisstuff]

I think you want to do as well as you possibly can. But I would strive to find some balance in your life as far as being a happy person. Not saying that you aren't, but since you are asking the question I'm going to assume its for some reason. I think its important to make time for the things you enjoy. As its been said before, your life won't magically start when you are done with med school, residency, whatever...this is your life too. I can't really tell you how to do this without feeling guilty besides just learning to let go a little bit.

I don't think there necessarily has to be a linear relationship between time put in and the grades you receive. You can always learn to study more efficiently. Most people (including myself) find that making time for the things you enjoy allows you to approach your studies with a little more focus. After a certain point most people tend to lose steam and get burnt out.

You really shouldn't worry about Step 1 yet. But I would learn to balance things more or you will be miserable M2. The load is significantly more (at my school atleast). I will say one thing, many people say the best way to do well on Step 1 is to learn the material really well and get LOTS of practice with it. So this whole idea of focusing more on Step 1 then your classes is kind of silly. Most Step 1 resources are more for review. Now I understand punting some of the random class specific details that can sometimes show up tests and choosing to spend more time with resources that are beneficial for Step. But those resources are also beneficial for your classes, so this idea thats its one or the other is not true.

You won't have as much time as M1 for a long time (random times in M4 maybe) so learn to enjoy it.

 

[WedgeDawg]

AOA will matter for some schools and matter less for other schools. Some residency programs will only take AOA students from school X but will take non-AOA students from school Y (provided they have everything else they're looking for). It always looks nice, but it's never the end all be all, even for specialties like ENT/Derm where 50% of successful applicants have AOA.

 

[muhali3]

The correlation between pre-clinical grades and step 1 score plateaus pretty quickly. Use FA to determine what is step 1 relevant in your class powerpoints, and the stuff that isn't in FA in general will only help you for the class itself. It's up to you how important that remainder is. For me, I usually didn't spend to much time studying that remainder material, because it often was neither step relevant nor clinically relevant.

 

[Foot Fetish]

The correlation between pre-clinical grades and step 1 score plateaus pretty quickly. Use FA to determine what is step 1 relevant in your class powerpoints, and the stuff that isn't in FA in general will only help you for the class itself. It's up to you how important that remainder is. For me, I usually didn't spend to much time studying that remainder material, because it often was neither step relevant nor clinically relevant.

And do you feel it helped you on Step 1?

 

[muhali3]

And do you feel it helped you on Step 1?

There's a venn diagram between First Aid and your class material. And for me personally, focusing on the stuff in First Aid, that was not in my class notes (as opposed to the reverse), I feel helped me on Step 1. For the first two years, I was a pretty average student, maybe a little bit above, but for step 1 I did much above what would be predicted from my class rank.

 

[shouldigomd]

Everyone is different but I wouldn't think about step 1 prep until perhaps your last basic science term. Focus on your classes and exams and you will do yourself a favor come step 1 study time. Why risk doing "average" for hopes of doing amazing on step 1. That is prime to backfire.

 

[muhali3]

Well, the OP is asking if aiming for 100 is really worth the 8-12 hours a day and his personal well-being when it may not matter that much in the end. That's a judgment he has to make, but he's right that pre-clinical grades are not that important in residency selection. Also, I knew early on I was not aiming for any ridiculously competitive specialties so I was content being in the top 50% of the class and only spent a few hours a day studying. I have no regrets over spending my free time doing things I actually cared about (like ECs, hobbies, relationships) instead of combing over powerpoint minutiae repeatedly. But it's all about goals, if you're aiming for dermatology or need to match into MGH for some reason, then you'll need to adjust your strategy accordingly.

 

[jdh71]

Yes. It matters. It helps. You are playing chess. Give yourself every advantage you can. You don't know what you want to do it where you want to do it. Be the best you can. Always.

 

[751866]

So, my school has pass/fail grading, but it's secretly ranked such that your dean's letter will use a different superlative to describe you based on your percentile rank. Also, only the top quarter of the class is eligible for AOA nomination (actually getting it then depends on extracurricular factors)...I'm just 6 weeks into M1, and I have figured out how to ace all my classes , pretty much. I have been beating the class average by a good amount and even getting some 100's. The problem is that I'm fairly sure that I spend an abnormal amount of time studying. Whereas my colleagues are constantly going out to social events and stuff, I literally just study all day everday, stopping only to complete my most basic activities of daily living and to attend mandatory class sessions...I don't even exercise. I just sit in a chair for 8-12 hours per day making and memorizing study materials...I have a bit of on obsessive, perfectionist personality when it comes to things like this....now my question is: is it worth it? My current system is working really well, but do preclinical grades / AOA even matter enough to be putting in this much effort? Would it be more beneficial to study just enough to do average on the exams and then use the rest of my time to study for Step 1 or do research? Being able to take a 30 minute walk without feeling guilty would be great too...

Are you contemplating letting "those rich kids" win??? 🙄

In seriousness, think about your goals. If you want something competitive, class rank might be important. It's better to have too much than not enough.

 

[Foot Fetish]

Are you contemplating letting "those rich kids" win??? 🙄

I know that part of your reply was meant to be sarcastic, but it actually fueled my fire. For better or for worse, that sort of mentality motivates me sometimes.

 

[Redpancreas]

I know that part of your reply was meant to be sarcastic, but it actually fueled my fire. For better or for worse, that sort of mentality motivates me sometimes.

All my male friends with submissive fetishes/tendencies also happen to fuel themselves in this sorta way (n=4). I wonder if there's an correlation and if so if there's a possible mechanism.

As for your question, all my friends with a few exceptions who killed 1st/2nd year like you're claiming you're doing went on to kill step 1. Maybe this answer is really school dependent but at my school focusing on the curriculum helped me out way more than any one resource aside from maybe UWorld..and then focusing on UW and FA during dedicated.


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[Milotic]

I tried hard regardless. Solid 10 hours a day with 12 hours a day on weekend days. No youtube/facebook. Yes bathroom breaks. Didn't really make the cutoff for honors, although I was scoring above average. Didn't make the cutoff for AOA, although I was above average on Step 1 (nothing spectacular). Not currently making the cutoff for honors in third year clerkships, but hitting the higher end of "Pass".

Could I get "Pass" as I have been from trying half as hard? Maybe? Maybe I would've actually failed if my score threshold is different than my classmates. SHOULD I try less if all I am getting is "Pass" and realizing my efforts aren't translating into honors? I may not be able to live on like that.

Should YOU stop trying? I think only if you can look back and have no regrets about it then go for it.

 

[DetectiveAlonzo]

I tried hard regardless. Solid 10 hours a day with 12 hours a day on weekend days. No youtube/facebook. Yes bathroom breaks. Didn't really make the cutoff for honors, although I was scoring above average. Didn't make the cutoff for AOA, although I was above average on Step 1 (nothing spectacular). Not currently making the cutoff for honors in third year clerkships, but hitting the higher end of "Pass".

Could I get "Pass" as I have been from trying half as hard? Maybe? Maybe I would've actually failed if my score threshold is different than my classmates. SHOULD I try less if all I am getting is "Pass" and realizing my efforts aren't translating into honors? I may not be able to live on like that.

Should YOU stop trying? I think only if you can look back and have no regrets about it then go for it.

If you don't mind me asking, how did you do on STEP 1? Higher than 230??

I appreciate your honesty btw. And hell... Not everybody can be number one but all that matters is you tried hard. I have been very happy with how I have been scoring because I know that I atleast give it my all.

 

[piii]

I swear every time you make a post you're looking for some reason to say you're top of your class lol

 

[Psai]

I'd say 6 weeks in was when I realized that I absolutely had to exercise! After that, I prioritized it. My grades were the same/better despite studying less. (I studied a lot, don't get me wrong.) Think about what you will regret 20 years down the line. I don't want to do a competitive residency (even though I'm quite sure I could if I wanted to). Therefore what I would regret was letting my body go to waste so I couldn't enjoy my life, so I prioritized health.

There are a few books on studying in med school aimed at acing step 1, I'd check those out. They're also more time efficient.

👍👍

 

[37Base]

I've followed his threads since the inception.

They started with "Is it okay if I don't have any friends, because I study 20 hours a day and don't need anybody" this then progressed to "is it okay that I get 120% on all exams, I do nothing but study, I am a medical robot nothing can faze me."

He was warned by the community, I can recall many saying, "take a break, make some friends, you're going to burnout, no one can do it." These words were shunned by the man with the fetish for feet.

Now gentleman, we are beginning to see the cracks of the foundation. The rationalization for reducing the study time is emerging. Cognitive dissonance in its purest form. Don't blame it on our own capacity, but instead blame the P/F curriculum for the desire to "do average."

Maybe you could just take a break every once in a while?

 

[Jinxapotato]

Aren't you the guy who says he's so ahead of his class that he doesn't know what to study, then ends up below average?

Short answer: No.
Long answer: Reach average first before thinking about crazy stuff like AOA or high STEP

 

[username456789]

Aren't you the guy who says he's so ahead of his class that he doesn't know what to study, then ends up below average?

Short answer: No.
Long answer: Reach average first before thinking about crazy stuff like AOA or high STEP

IIRC, he's been excelling in all his exams after the first one.

 

[operaman]

Keep working hard and aim for staying on top. There are few students fortunate enough even to have the option of being AOA and top percentile eligible. I would strongly argue in favor of continuing to work hard and see how well you can do. There are probably ways you can refine your studying and still score 100s while also having time for yourself. It may be worth carving out a small amount of personal time and seeing if your scores suffer; I think they probably won't.

As for step one, really learning the material in class is far and away the best prep you can do. People obsess about learning the high yield stuff but forget the substantial number of low yield questions. Yes you should absolutely know the high yield stuff cold, but you are one of the lucky ones who can also learn the rest of it. Incorporate boards materials into your second year studies but keep your focus on actually learning rather than review book learning. This is what I did and first nbme after ms2 before dedicated study period was already well above what I needed to match a very competitive field. Never bought a first aid. Reviewed for about ten days and did questions. Crushed it.

Good prep now will prepare you well for third year too. I felt like a lot of shelf questions could be reasoned through with a good understanding of preclinical material. Not having to worry so much about shelf prep will allow you more time to spend learning from actual patients and picking up actual useful skills that will travel with you to residency and beyond.

So keep up the good work, but take a little time for yourself too. Almost positive your scores won't change much at all.

 

[asdf1192]

people who are aoa are going to be aoa, and people who are not aoa are not going to be aoa. relax and enjoy life

 

[username456789]

Keep working hard and aim for staying on top. There are few students fortunate enough even to have the option of being AOA and top percentile eligible. I would strongly argue in favor of continuing to work hard and see how well you can do. There are probably ways you can refine your studying and still score 100s while also having time for yourself. It may be worth carving out a small amount of personal time and seeing if your scores suffer; I think they probably won't.

As for step one, really learning the material in class is far and away the best prep you can do. People obsess about learning the high yield stuff but forget the substantial number of low yield questions. Yes you should absolutely know the high yield stuff cold, but you are one of the lucky ones who can also learn the rest of it. Incorporate boards materials into your second year studies but keep your focus on actually learning rather than review book learning. This is what I did and first nbme after ms2 before dedicated study period was already well above what I needed to match a very competitive field. Never bought a first aid. Reviewed for about ten days and did questions. Crushed it.

Good prep now will prepare you well for third year too. I felt like a lot of shelf questions could be reasoned through with a good understanding of preclinical material. Not having to worry so much about shelf prep will allow you more time to spend learning from actual patients and picking up actual useful skills that will travel with you to residency and beyond.

So keep up the good work, but take a little time for yourself too. Almost positive your scores won't change much at all.

Agree with pretty much all this. I was the same way.

Study hard and learn the material. Everyone gets the high yield stuff right on Step I. Those people score average. Knowing the lower yield stuff is what gets you higher scores. Obviously, that's more difficult.

I took one of the NBME exams the day after our last M2 exam and was in a similar position - already close to where I wanted to be to apply for Derm.

And I definitely found that crushing the first two years helped immensely with shelf exams/clinical years. It's all related.

 

[Psai]

Agree with pretty much all this. I was the same way.

Study hard and learn the material. Everyone gets the high yield stuff right on Step I. Those people score average. Knowing the lower yield stuff is what gets you higher scores. Obviously, that's more difficult.

I took one of the NBME exams the day after our last M2 exam and was in a similar position - already close to where I wanted to be to apply for Derm.

And I definitely found that crushing the first two years helped immensely with shelf exams/clinical years. It's all related.

No way bro, M1s tell me that everything they try to teach you is low yield. STEP 1 FOREVER

 

[mvenus929]

Honestly, no one is going to be able to tell you whether studying all the time to get ranked highly and get AOA is going to be beneficial to you. One of the smartest guys in my class did just enough studying to pass, and then celebrated his life. Several others spent hours per day studying. I studied hard, but it was important for me to do social things, so I was somewhere in the middle. I didn't get AOA, and neither did the guy barely passing (though I'm fairly certain he got a good step 1 score). But, I got a good residency and will be moving on to fellowship in 2 years, and am highly respected within my residency program. So, it all really does depend on your priorities in life. As they say, you can have a life, sleep, and good grades, but you can't have all three.

 

[operaman]

No way bro, M1s tell me that everything they try to teach you is low yield. STEP 1 FOREVER

Hahaha Exactly!

Step 1: a standardized test where the only people who are 100% sure of what's going to be on it are those who have never actually taken it.

 

[Redpancreas]

Agree with pretty much all this. I was the same way.

Study hard and learn the material. Everyone gets the high yield stuff right on Step I. Those people score average. Knowing the lower yield stuff is what gets you higher scores. Obviously, that's more difficult.

I took one of the NBME exams the day after our last M2 exam and was in a similar position - already close to where I wanted to be to apply for Derm.

And I definitely found that crushing the first two years helped immensely with shelf exams/clinical years. It's all related.

agree. This is the way.


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[DetectiveAlonzo]

How many of y'all didn't ever reach honors in ANY of your course work/classes but were in the top 25%? Do y'all feel that affected your STEP score or preparation at all?

 

[Redpancreas]

How many of y'all didn't ever reach honors in ANY of your course work/classes but were in the top 25%? Do y'all feel that affected your STEP score or preparation at all?

I was in the top 50, only honored a random CV Physio exam and a random Psych exam, no classes.

Don't get discouraged. I think @Milotic has the right idea. He makes it sound painful but he mentions how he never honored but kept trying and it makes a difference in the end.

Never stop grinding your school notes and don't try to take shortcuts like just streaming Pathoma and looking through FA.


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