Is the 240-->250 jump on Step 1 a big one?

[guitarguy23]

I have a basic goal right now of "250" for Step 1 next summer, but anything over 240 would be amazing. However, I wanted to hear some feedback with regards to the level of knowledge needed for a 240 to 250. I wanted to get an idea of how much work it might take and whether it is "doable". I work hard and do well in class at this point. Thanks!

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[DrOwnage]

So getting a 240 is like sparring with a grizzly bear and winning. However, if you really want a 250, it's more so going to be like fighting a grizzly bear with battle armor on. Most likely it's claws are made of lasers that give you automatic AIDs and its riding a shark that can somehow survive on land. It also pimps you as its disemboweling your face. Did I mention it's also on fire?

 

[NVdisG]

So getting a 240 is like sparring with a grizzly bear and winning. However, if you really want a 250, it's more so going to be like fighting a grizzly bear with battle armor on. Most likely it's claws are made of lasers that give you automatic AIDs and its riding a shark that can somehow survive on land. It also pimps you as its disemboweling your face. Did I mention it's also on fire?

I'll be honest with you DrOwnage, replies like these contribute little value to the thread and forum. Besides giving you a temporary feeling of selfworth as you excitedly reread your post while basking in the glory of all the likes you expect to receive, it does nothing to increase the collective knowledge of the members and guests in this forum. The worst thing is that your post wasn't even funny. Exaggerated recounts of fighting "le sharks w le lazers lolol" are so 2008.

 

[WGB]

There is no good answer to this. It's going to vary from person to person and the resources they've covered, as well as how well they've covered them.

 

[VisionaryTics]

There is no good answer to this. It's going to vary from person to person and the resources they've covered, as well as how well they've covered them.

👍

Much of your score is determined by how hard you studied as an M1/M2, not necessarily the last month before taking Step 1. All things being equal, you should expect to work like the 95th percentile throughout M1/M2 to get a 95th percentile score.

I have never personally subscribed to the "I'm studying high yield boards stuff and ignoring classes" model of Step 1 studying. I was one of a handful of students who actually showed up to class consistently (at a school without a "Step 1-heavy" curriculum). Surprise, surprise, it was that same handful of students who were named junior AOA (which is largely board scores at our school).

 

[KinasePro]

junior AOA (which is largely board scores at our school).

Dayum. Boards-driven AOA election makes sense to me though. We've got too much political bulslhit in the election process at my shop.

 

[VisionaryTics]

Dayum. Boards-driven AOA election makes sense to me though. We've got too much political bulslhit in the election process at my shop.

Theoretically, you have to be the whole package, but basically the top 4% of the Step 1 scorers in our class are eligible, then you need to be top half for grades (not terribly hard), have no professional issues like academic dishonesty, have been involved in some way in research (very loose definition), and be involved some way in student life (very loose definition). It's not elected by the current AOA members or faculty or anything.

 

[KinasePro]

Theoretically, you have to be the whole package, but basically the top 4% of the Step 1 scorers in our class are eligible, then you need to be top half for grades (not terribly hard), have no professional issues like academic dishonesty, have been involved in some way in research (very loose definition), and be involved some way in student life (very loose definition). It's not elected by the current AOA members or faculty or anything.

Sounds like a reasonable, relatively well-rounded set of criteria, though top 4% step is pretty brutal.

Current-AOA-member / faculty election method just bugs me b/c it tends to select for a certain personality type and leaves a good chunk of the "top" students out.

 

[neusu]

I'll be honest with you DrOwnage, replies like these contribute little value to the thread and forum. Besides giving you a temporary feeling of selfworth as you excitedly reread your post while basking in the glory of all the likes you expect to receive, it does nothing to increase the collective knowledge of the members and guests in this forum. The worst thing is that your post wasn't even funny. Exaggerated recounts of fighting "le sharks w le lazers lolol" are so 2008.

IDK, I chuckled

 

[Smokemont]

I'll be honest with you DrOwnage, replies like these contribute little value to the thread and forum. Besides giving you a temporary feeling of selfworth as you excitedly reread your post while basking in the glory of all the likes you expect to receive, it does nothing to increase the collective knowledge of the members and guests in this forum. The worst thing is that your post wasn't even funny. Exaggerated recounts of fighting "le sharks w le lazers lolol" are so 2008.

I thought it was hilarious. Your post, on the other hand, contributed absolutely nothing to the thread. Good day sir.

 

[rodmichael82]

I have a basic goal right now of "250" for Step 1 next summer, but anything over 240 would be amazing. However, I wanted to hear some feedback with regards to the level of knowledge needed for a 240 to 250. I wanted to get an idea of how much work it might take and whether it is "doable". I work hard and do well in class at this point. Thanks!

Focus on your classes

 

[Double A]

So getting a 240 is like sparring with a grizzly bear and winning. However, if you really want a 250, it's more so going to be like fighting a grizzly bear with battle armor on. Most likely it's claws are made of lasers that give you automatic AIDs and its riding a shark that can somehow survive on land. It also pimps you as its disemboweling your face. Did I mention it's also on fire?

this is beautiful. shame on whoever thinks otherwise.

 

[mcloaf]

I'll be honest with you DrOwnage, replies like these contribute little value to the thread and forum. Besides giving you a temporary feeling of selfworth as you excitedly reread your post while basking in the glory of all the likes you expect to receive, it does nothing to increase the collective knowledge of the members and guests in this forum. The worst thing is that your post wasn't even funny. Exaggerated recounts of fighting "le sharks w le lazers lolol" are so 2008.

I found his post much more enjoyable than your soapbox.

 

[Instatewaiter]

I'll be honest with you DrOwnage, replies like these contribute little value to the thread and forum. Besides giving you a temporary feeling of selfworth as you excitedly reread your post while basking in the glory of all the likes you expect to receive, it does nothing to increase the collective knowledge of the members and guests in this forum. The worst thing is that your post wasn't even funny. Exaggerated recounts of fighting "le sharks w le lazers lolol" are so 2008.

Completely disagree with you. They have value because they make people laugh.

Your kind of post has no value. It disrupts the real thread, is boring and bitter.

 

[Instatewaiter]

I have a basic goal right now of "250" for Step 1 next summer, but anything over 240 would be amazing. However, I wanted to hear some feedback with regards to the level of knowledge needed for a 240 to 250. I wanted to get an idea of how much work it might take and whether it is "doable". I work hard and do well in class at this point. Thanks!

Well the mean changes each time so a 240 was not what it once was.

Still, a 240 is roughly 80-83rd precentile and 250 is roughly 90-93rd percentile. So use your class rank to help you determine how likely these scores are.

 

[g8orlife]

Completely disagree with you. They have value because they make people laugh.

Your kind of post has no value. It disrupts the real thread, is boring and bitter.

Cosign.

 

[deleted500612]

So getting a 240 is like sparring with a grizzly bear and winning. However, if you really want a 250, it's more so going to be like fighting a grizzly bear with battle armor on. Most likely it's claws are made of lasers that give you automatic AIDs and its riding a shark that can somehow survive on land. It also pimps you as its disemboweling your face. Did I mention it's also on fire?

Hmmm, I wasn't aware that a face could be disemboweled. I guess the guy must have been a real sh|t head.

 

[ulikedaggers]

Theoretically, you have to be the whole package, but basically the top 4% of the Step 1 scorers in our class are eligible, then you need to be top half for grades (not terribly hard), have no professional issues like academic dishonesty, have been involved in some way in research (very loose definition), and be involved some way in student life (very loose definition). It's not elected by the current AOA members or faculty or anything.

Who does one contact at their school to get this type of detailed information?

 

[SouthernSurgeon]

I'll be honest with you DrOwnage, replies like these contribute little value to the thread and forum. Besides giving you a temporary feeling of selfworth as you excitedly reread your post while basking in the glory of all the likes you expect to receive, it does nothing to increase the collective knowledge of the members and guests in this forum. The worst thing is that your post wasn't even funny. Exaggerated recounts of fighting "le sharks w le lazers lolol" are so 2008.

It was an appropriate response.

The closest anyone can come to answering this question is "I dunno, it's kind of harder I guess?"

The question being asked is analogous to a pre-med asking whether it is more feasible for them to match in integrated plastics or ortho. They have no frame of reference to even start the conversation from.

The OP should work hard in M2. Start studying for Step I next summer and identify realistic goals based on his/her initial performance on qbanks and practice exams, then study their ass off to meet those goals.

 

[D elegans]

Everyone who said working hard during your first two years in total is correct. A lot of Step 1 was not necessarily things I crammed in the last few months. Work hard, use the resources everyone recommends, and do a ton of questions. Best you can do.

 

[swamprat]

Step 1 is overrated.. so is a 250. Honestly I think the new "250" is a "260" and 240 feels average (yes I know the average is a 224 or 225). Whatever. But seriously seemed like everyone and their mother scored at least in the high 230s maybe I just have a smart class.

 

[notbobtrustme]

Step 1 is overrated.. so is a 250. Honestly I think the new "250" is a "260" and 240 feels average (yes I know the average is a 224 or 225). Whatever. But seriously seemed like everyone and their mother scored at least in the high 230s maybe I just have a smart class.

240 puts you in the competitive range for every specialty, even dermatology.

 

[Anastomoses]

👍

Still holding out, eh?

 

[Modeselektor]

I'll be honest with you DrOwnage, replies like these contribute little value to the thread and forum. Besides giving you a temporary feeling of selfworth as you excitedly reread your post while basking in the glory of all the likes you expect to receive, it does nothing to increase the collective knowledge of the members and guests in this forum. The worst thing is that your post wasn't even funny. Exaggerated recounts of fighting "le sharks w le lazers lolol" are so 2008.

I'll be honest with you NVdisG, replies like these contribute little value to the thread and forum. Besides giving you a temporary feeling of selfworth as you excitedly reread your post while basking in the glory of all the likes you expect to receive, it does nothing to increase the collective knowledge of the members and guests in this forum. The worst thing is that your post wasn't even scathing. Exaggerated attempts to put someone down for trying to lighten everyone up "le **** you, le me awesome trollololol" are so lame.

Btw at least his defense mechanism (humour) about the step is mature. Your projection of low selfworth is kinda ****wadish.

 

[VisionaryTics]

Still holding out, eh?

Yep.

 

[shenanigi]

I'll be honest with you DrOwnage, replies like these contribute little value to the thread and forum. Besides giving you a temporary feeling of selfworth as you excitedly reread your post while basking in the glory of all the likes you expect to receive, it does nothing to increase the collective knowledge of the members and guests in this forum. The worst thing is that your post wasn't even funny. Exaggerated recounts of fighting "le sharks w le lazers lolol" are so 2008.

ok

 

[Freddie Mercury]

Well the mean changes each time so a 240 was not what it once was.

Still, a 240 is roughly 80-83rd precentile and 250 is roughly 90-93rd percentile. So use your class rank to help you determine how likely these scores are.

If I recall the 2013 average was 228 with std dev 22, which would make 250 roughly around the 84th percentile.

 

[Instatewaiter]

If I recall the 2013 average was 228 with std dev 22, which would make 250 roughly around the 84th percentile.

Vastly different from what I posted. Thank you for your input.

 

[FIREitUP]

If I recall the 2013 average was 228 with std dev 22, which would make 250 roughly around the 84th percentile.

assuming a normal distribution...which it's not.

 

[KinasePro]

If I recall the 2013 average was 228 with std dev 22, which would make 250 roughly around the 84th percentile.

My score report from this year says average was 224 w/ std of 22.

 

[Freddie Mercury]

assuming a normal distribution...which it's not.

Interesting, in what way is it not normal? I am assuming it is negatively skewed?

My score report from this year says average was 224 w/ std of 22.

I got my number from Wikipedia (http://en.wikipedia.org/wiki/USMLE_Step_1#Scoring) but they don't source it so I'd take your word over their's. Thanks 🙂

 

[Smokemont]

assuming a normal distribution...which it's not.

It's approximately normal, which is good enough.

 

[Wordead]

It's approximately normal, which is good enough.

What are you basing that on? There was a post (Pholston I think) with data that said it was decidedly not a normal distribution.

From that, a 250 is 90%+. Which is significantly different from 84%.

 

[Smokemont]

I'm basing it on practicality. Step 1 is designed to measure a students general medical knowledge as determined that someone should have after 2 years of medical school. The specifics of the test, however, are variable in both space and time. What this means is that if you took the exam an infinite number of times and we plotted your results the distribution would be Gaussian. This shows how your 3 digit score is not very useful anyways and would be better represented as a range, or confidence interval if you're more inclined to stats and probability theory. So how should we compare people?

My point is that it's very complex when you start talking about doing stats with these scores so I think it's best to follow Occam's razor and simply approximate it with statistics based on a normal distribution, since we all can understand that, and I don't see a more accurate method.

Therefore I disagree that a 250 being 84% vs 90% is significant. The practical purpose of the score is to 1)see if you pass and 2)to compare you to others for residency. Basically if you get a 250 it doesn't matter (practically) if its 84 or 90, if you don't get your specialty of choice it was for other reasons.

 

[Wordead]

I'm basing it on practicality. Step 1 is designed to measure a students general medical knowledge as determined that someone should have after 2 years of medical school. The specifics of the test, however, are variable in both space and time. What this means is that if you took the exam an infinite number of times and we plotted your results the distribution would be Gaussian. This shows how your 3 digit score is not very useful anyways and would be better represented as a range, or confidence interval if you're more inclined to stats and probability theory. So how should we compare people?

My point is that it's very complex when you start talking about doing stats with these scores so I think it's best to follow Occam's razor and simply approximate it with statistics based on a normal distribution, since we all can understand that, and I don't see a more accurate method.

Therefore I disagree that a 250 being 84% vs 90% is significant. The practical purpose of the score is to 1)see if you pass and 2)to compare you to others for residency. Basically if you get a 250 it doesn't matter (practically) if its 84 or 90, if you don't get your specialty of choice it was for other reasons.

That's becoming an argument of semantics. I agree with all that in theory but I think we all know that medical students care quite a bit whether we're in the 84th percentile or the 90th. Regardless of residency app implications.

 

[Renaissance Man]

What are you basing that on? There was a post (Pholston I think) with data that said it was decidedly not a normal distribution.

From that, a 250 is 90%+. Which is significantly different from 84%.

That sounds like an interesting post, do you remember where he got that info?

 

[Smokemont]

That's becoming an argument of semantics. I agree with all that in theory but I think we all know that medical students care quite a bit whether we're in the 84th percentile or the 90th. Regardless of residency app implications.

It's neither an argument nor is it based on semantics. As to your last point, I agree that medical students care an inordinate amount about how long their own **** is.

 

[hrandani]

I don't know what step I does test, but it sure as hell doesn't test "general medical knowledge."

You could easily be an excellent doctor and fail step I.

And for anyone who disagrees with that, I went to a CME class at a medical conference by accident, and they were covering basic, basic molecular biology like the role of cytokines in metabolic syndrome... and literally everyone in the room looked like they were being told Santa was real. This isn't sour grapes, I did pretty well. But I'm not going to look back in fondness, in terms of future diagnostic utility and by any other metric than self-flagellation, step I studying was a giant waste of time.

I'm still waiting for that fantasy scenario where I get paged at 2 AM and the nurse is like

WITHOUT ANY OTHER DIAGNOSTIC INFORMATION OR EVEN GENERAL DEMOGRAPHICS REGARDING THE PATIENT, DOCTOR, WHAT IS THE CARDIAC PATHOPHYSIOLOGY INVOLVED IN AN ISOLATED INCIDENCE OF ELEVATED URINARY POTASSIUM. YOU HAVE 70 SECONDS OR THEY DIE

To answer your question: yes, climbing up the tail of a bell curve is by definition going to be exponentially more difficult the further you go.

 

[Wordead]

That sounds like an interesting post, do you remember where he got that info?

That sounds like an interesting post, do you remember where he got that info?

Sorry, been way too long since I saw it. I think someone did quote it within the last 4 months, if you really wanted to search for it.

And I personally think step 1 just tests how much motivation you have relative to other medical students.

 

[Zedor]

That sounds like an interesting post, do you remember where he got that info?

http://forums.studentdoctor.net/thr...istribution-and-percentiles-real-data.909946/

"
260+ -- 97.9
251-260 -- 92.0
241-250 -- 81.6
231-240 -- 67.2
221-230 -- 51.4
211-220 -- 36.5
201-210 -- 21.9
191-200 -- 8.7
181-190 -- 0.92"

Can't comment on the accuracy, but for what its worth

 

[guitarguy23]

http://forums.studentdoctor.net/thr...istribution-and-percentiles-real-data.909946/

"
260+ -- 97.9
251-260 -- 92.0
241-250 -- 81.6
231-240 -- 67.2
221-230 -- 51.4
211-220 -- 36.5
201-210 -- 21.9
191-200 -- 8.7
181-190 -- 0.92"

Can't comment on the accuracy, but for what its worth

Props, Thank you. The numbers make sense to me, even if they are rough approximations.

 

[Ugen]

http://forums.studentdoctor.net/thr...istribution-and-percentiles-real-data.909946/

"
260+ -- 97.9
251-260 -- 92.0
241-250 -- 81.6
231-240 -- 67.2
221-230 -- 51.4
211-220 -- 36.5
201-210 -- 21.9
191-200 -- 8.7
181-190 -- 0.92"

Can't comment on the accuracy, but for what its worth

This is very accurate. Basically the standard deviation is lower for the scores above average and higher for the scores below average. To the OP, going from 240 to 250 would be moving up 10 percentiles which is a lot harder to do when you're already in the 80th percentiles than if you were trying to go from 20-30th percentile.

I think this represents a decent amount more of hard work. When studying for my exam, going from my baseline of 208 to 230's took maybe a couple of weeks of studying. 230's to 240's took a month. 240's to mid 250's on my practice NMBEs took me several months of some pretty hardcore studying and I hovered at 250 for a long time before breaking 260 despite studying the most during that time.

My point is that half a month of studying when you're going from 200's might increase your score by 20 or 30. but when you're at 250 it might only add 5 points.

 

[evilbooyaa]

This is very accurate. Basically the standard deviation is lower for the scores above average and higher for the scores below average. To the OP, going from 240 to 250 would be moving up 10 percentiles which is a lot harder to do when you're already in the 80th percentiles than if you were trying to go from 20-30th percentile.

I think this represents a decent amount more of hard work. When studying for my exam, going from my baseline of 208 to 230's took maybe a couple of weeks of studying. 230's to 240's took a month. 240's to mid 250's on my practice NMBEs took me several months of some pretty hardcore studying and I hovered at 250 for a long time before breaking 260 despite studying the most during that time.

My point is that half a month of studying when you're going from 200's might increase your score by 20 or 30. but when you're at 250 it might only add 5 points.

Good lord. This is like 4+ months of dedicated studying time.