Opinions on "P=MD"

[airplanes]

What if you go to a school that doesn't rank?

Pass fail school with no ranks? Pay close attention to how M3 grades are handed out because they will mean even more.

---

Members don't see this ad.

 

[notbobtrustme]

What if you go to a school that doesn't rank?

Then you're in great shape because only a few don't rank and they are all very prestigious institutions.

 

[vonburen]

As an entering M1, I'm going in with the idea that I want to learn as much clinically relevant material as I possibly can in my M1 and M2 years. The P=FM is not necessarily true, in the sense that residency programs tend not to look at the preclinical grades as intensely as other factors in the application.

You obviously want good grades because there's gotta be some kind of correlation between grade performance and Step 1 score - and Step 1 >> preclinical grades in terms of matching. I don't think anyone is going to argue that.

 

[TheWeeIceMan]

Pass fail school with no ranks? Pay close attention to how M3 grades are handed out because they will mean even more.

Then you're in great shape because only a few don't rank and they are all very prestigious institutions.

Nope, not prestigious. Mid-tier. Grades are H/HP/P/LP/F and students aren't ranked.

At least, this is what I've been told.

 

[dextor2003]

Nope, not prestigious. Mid-tier. Grades are H/HP/P/LP/F and students aren't ranked.

At least, this is what I've been told.

This could just be me, but H/HP/P/LP/F is pretty much A/B/C/D/F, i.e. I personally wouldn't classify that as P/F

 

[weezynation]

http://www.nrmp.org/data/programresultsbyspecialty2012.pdf

Looks as if "honors in basic science courses" is much less important than just about everything else. Of course you shouldn't slack off though.

 

[MedPR]

Then you're in great shape because only a few don't rank and they are all very prestigious institutions.

SLU doesn't rank.

Edit: and is P/F

Sent from my SGH-T999 using SDN Mobile

 

[DrBowtie]

Plenty of places say they don't rank, but they still have the deans letter stratifying word which aside from AOA is the only point of ranking.

 

[KnuxNole]

While not a deal breaker, it still matters on some level. I think most programs across most specialties will distinguish between a candidate with a class rank in the 70th percentile and one with a rank in the 10th.

That is a good point. I guess where I was coming from is that having a high class rank will only occur for a small portion of the class, where the majority won't have that benefit whatsoever. That probably sounds obvious though, so yeah...>_<

 

[TheWeeIceMan]

This could just be me, but H/HP/P/LP/F is pretty much A/B/C/D/F, i.e. I personally wouldn't classify that as P/F

I didn't say it was P/F. Just that they don't rank.

Plenty of places say they don't rank, but they still have the deans letter stratifying word which aside from AOA is the only point of ranking.

Thanks. That makes sense.

 

[notbobtrustme]

I didn't say it was P/F. Just that they don't rank.

That's not unranked though. Unranked means that every student is equal without regard to grades/board scores. Having a H/HP/P system inherently means there is a ranking of students.

 

[TheWeeIceMan]

That's not unranked though. Unranked means that every student is equal without regard to grades/board scores. Having a H/HP/P system inherently means there is a ranking of students.

Well I guess I'm confused then. This is basically how it was brought up:

Interviewee: Isn't having H/HP/P grades basically the same thing as having letter grades?
Student: Pretty much. However, the school does not rank students so it's not really a drawback.

 

[DrBowtie]

Well I guess I'm confused then. This is basically how it was brought up:

Interviewee: Isn't having H/HP/P grades basically the same thing as having letter grades?
Student: Pretty much. However, the school does not rank students so it's not really a drawback.

Initial impression is that student really doesn't know.

 

[airplanes]

http://www.nrmp.org/data/programresultsbyspecialty2012.pdf

Looks as if "honors in basic science courses" is much less important than just about everything else. Of course you shouldn't slack off though.

Yes, but class ranking/quartile is much higher on that list. And the way that is calculated is by your grades, with clinical grades typically weighted more.Your actual letter grades, as previously explained, matter very little. Residency programs can't and won't bother distinguishing between what a NH at med school X programs means vs a NH at med school Y.

 

[TheWeeIceMan]

Initial impression is that student really doesn't know.

Gotcha. I thought it was odd too, but didn't look further into it.

 

[Dmr6186]

This is something I always wondered as well. So if I'm getting this right, it would go something like this:

1. ROAD speciality - Ace everything and have a good personality on rotations.

2. Mid-competitive specialty and top PCPs - Do well in classes. Making all As is not necessary but can help. Don't worry about minutae for Step 1, but worry about everything else. Shine in rotations.

3. PCP specialty. Pass classes. Pass boards. Show up to rotations. You're a doc. Congrats.

Yes? No?

 

[NickNaylor]

You're right that the coursework doesn't matter relatively as much. But the grades do matter.

For what? What if I go to a school that is P/F and doesn't rank for pre-clinical grades AND doesn't do junior AOA? What possible benefit could grades provide?

I agree with your post, however even what you mentioned is not applicable at every school.

 

[airplanes]

For what? What if I go to a school that is P/F and doesn't rank for pre-clinical grades AND doesn't do junior AOA? What possible benefit could grades provide?

I agree with your post, however even what you mentioned is not applicable at every school.

Okay, fair enough. I would think that my post applies to the vast majority of allopathic schools.

Do they rank you on the deans letter or transcript? Because otherwise, the only way a PD could evaluate your academic performance is via a brief glance at your M3 grades and the reputation of your med school.

 

[weezynation]

Yes, but class ranking/quartile is much higher on that list. And the way that is calculated is by your grades, with clinical grades typically weighted more.Your actual letter grades, as previously explained, matter very little. Residency programs can't and won't bother distinguishing between what a NH at med school X programs means vs a NH at med school Y.

I fully agree. The reason I posted that is because there have been some on here saying letter grades do matter.

 

[pv515]

Okay, fair enough. I would think that my post applies to the vast majority of allopathic schools.

Do they rank you on the deans letter or transcript? Because otherwise, the only way a PD could evaluate your academic performance is via a brief glance at your M3 grades and the reputation of your med school.

And...your step scores. And research.

 

[IslandStyle808]

I understand that, but if it helped her get a great step 1 score and honor most clerkships then it was worth it considering those are among the most important parts of your residency application.

Sent from my SGH-T999 using SDN Mobile

I agree with you on this aspect actually. If you have the time, then it is fine. In the short run it is sure to have benefits (USMLE step 1 & rotations) but in the long run it will hurt you.

However, the thing is there are schools whose pre-clinical curriculum may not help much on the step 1. Since scoring well on the step 1 is >>>>>> than scoring well in class, then it would be better to invest that energy into doing well on the boards. In this scenario, it would be a lot less stressful to have a P/F system. Otherwise, that energy that could be put into something high yield such as the boards will be put into something low yield such as things in class that will never asked in your medical career.

 

[MedPR]

I agree with you on this aspect actually. If you have the time, then it is fine. In the short run it is sure to have benefits (USMLE step 1 & boards) but in the long run it will hurt you.

However, the thing is there are schools whose pre-clinical curriculum may not help much on the step 1. Since scoring well on the step 1 is >>>>>> than scoring well in class, then it would be better to invest that energy into doing well on the boards. In this scenario, it would be a lot less stressful to have a P/F system. Otherwise, that energy that could be put into something high yield such as the boards will be put into something low yield such as things in class that will never asked in your medical career.

How will over studying hurt you in the long run?

Sent from my SGH-T999 using SDN Mobile

 

[Arbor Vitae]

P=FD

/thread

 

[mimelim]

This is something I always wondered as well. So if I'm getting this right, it would go something like this:

1. ROAD speciality - Ace everything and have a good personality on rotations.

2. Mid-competitive specialty and top PCPs - Do well in classes. Making all As is not necessary but can help. Don't worry about minutae for Step 1, but worry about everything else. Shine in rotations.

3. PCP specialty. Pass classes. Pass boards. Show up to rotations. You're a doc. Congrats.

Yes? No?

No. Just no.

First ROAD specialty =! competitive. ROAD refers to lifestyle and that is it. There is tremendous variation in competitiveness between anestesia and the others. Second, Step 1 matters for everyone. You want to match at a top IM residency, you better have 250+. They are as competitive as any super subspecialty.

In short, you have tried to make categorical generalizations about specialties which simply can not be made.

 

[notbobtrustme]

Yes, but class ranking/quartile is much higher on that list. And the way that is calculated is by your grades, with clinical grades typically weighted more.Your actual letter grades, as previously explained, matter very little. Residency programs can't and won't bother distinguishing between what a NH at med school X programs means vs a NH at med school Y.

Even so, class rank has much more to do with your clerkships than with your pre-clinicals.

Most upperclassman on SDN as well as at school place Step I + 3rd year grades + LORs above everything else. If you nail these three, you will match in most any specialty.

 

[IslandStyle808]

How will over studying hurt you in the long run?

Sent from my SGH-T999 using SDN Mobile

Lets say you did well in your boards by studying every single piece of information in your FA and BRS books. Fast forward to residency, you still carry the belief that all knowledge is necessary. There is a high chance you are going to forget a lot of that information in those books. So are you going to study those books again (Step I and even Step II) on top of Step III and the information that you will need to do well in your specific residency program? I really doubt you will be able to keep up with the normal work load of residency and study your Step I and Step II books all at the same time.

Isn't it easier to look up the basic stuff when you need it?

 

[MedPR]

Lets say you did well in your boards by studying every single piece of information in your FA and BRS books. Fast forward to residency, you still carry the belief that all knowledge is necessary. There is a high chance you are going to forget a lot of that information in those books. So are you going to study those books again (Step I and even Step II) on top of Step III and the information that you will need to do well in your specific residency program? I really doubt you will be able to keep up with the normal work load of residency and study your Step I and Step II books all at the same time.

Isn't it easier to look up the basic stuff when you need it?

So someone who is smart enough to do well on step 1 is not smart enough to know that studying basic science minutiae during residency is dumb? I don't think that's a realistic situation.

Like I said, my SO is one of the people who studied and learned all the minutiae during preclinical. She will occasionally look in FA since she knows the book backwards and forwards so finding a piece of specific info is quick and easy, but she certainly doesn't study her step 1 stuff while preparing for rounds or step 2.

That's like saying someone who does well as a biochem major in UG will study their UG biochem books while in med school so being a biochem major and learning everything you can will ultimately hurt you in the long run...

Sent from my SGH-T999 using SDN Mobile

 

[Arbor Vitae]

false

P = nrt/v

also

P = MV

edit: although, P = MDt

 

[cubssox2000]

My school does not rank and we are a 5 point system. Here's what they do to compensate for not ranking:

When your transcript gets sent out to residencies, they send a graph of each course you have taken that shows how many people got Honors, how many got High Pass, etc. They mark out the spot on the graph where you fell. This way they have not officially ranked anyone, but they have shown residencies where you were compared to the rest of the class in each individual subject/rotation.

 

[MedPR]

false

P = nrt/v

also

P = MV

edit: although, P = MDt

Wrong. P=F/A

Sent from my SGH-T999 using SDN Mobile

 

[Arbor Vitae]

Wrong. P=F/A

Sent from my SGH-T999 using SDN Mobile

that is an alternately accepted definition

 

[alpinism]

My school does not rank and we are a 5 point system. Here's what they do to compensate for not ranking:

When your transcript gets sent out to residencies, they send a graph of each course you have taken that shows how many people got Honors, how many got High Pass, etc. They mark out the spot on the graph where you fell. This way they have not officially ranked anyone, but they have shown residencies where you were compared to the rest of the class in each individual subject/rotation.

Lol

They've done studies, ya know? 60% of the time, it works every time.

 

[IslandStyle808]

So someone who is smart enough to do well on step 1 is not smart enough to know that studying basic science minutiae during residency is dumb? I don't think that's a realistic situation.

Like I said, my SO is one of the people who studied and learned all the minutiae during preclinical. She will occasionally look in FA since she knows the book backwards and forwards so finding a piece of specific info is quick and easy, but she certainly doesn't study her step 1 stuff while preparing for rounds or step 2.

That's like saying someone who does well as a biochem major in UG will study their UG biochem books while in med school so being a biochem major and learning everything you can will ultimately hurt you in the long run...

Sent from my SGH-T999 using SDN Mobile

It has nothing to do with intelligence. The brain itself is hardwired to make connections to information that is used constantly and not make connections to information that is not used constantly. If you had a UG biochemistry where learned about plant biochemistry along with animal biochemistry and then shift into medical school, those brain connections about plant biochemistry would go. Would you be willing to relearn that material and established those connection again? This would mean you would have to take time away from something else that is more high yield like knowing disease portion of medical biochemistry. You will not have the time to over study and if you are not constantly using that knowledge it will fade away again (just like all the minute details you remembered before).

 

[KnuxNole]

I honestly didn't think ranking would be a big thing in most places. Thankfully Step 1, clerkships and LORs are key or else the non top 10 percent will go nowhere

 

[airplanes]

Yes, M3 grades, steps, letters all matter relatively more. Key word being relatively.

And...your step scores. And research.

Semantics. By "academic" I mean purely grades and evaluations. Step scores deserve their own category and research is an extra-curricular.

Even so, class rank has much more to do with your clerkships than with your pre-clinicals.

Yes, I've stated that previously.

 

[487806]

false

P = nrt/v

also

P = MV

edit: although, P = MDt

Wrong. P=F/A

Sent from my SGH-T999 using SDN Mobile

Actually, P = IV = F/A, so F = VIA. Never fail through something important!

 

[MedPR]

It has nothing to do with intelligence. The brain itself is hardwired to make connections to information that is used constantly and not make connections to information that is not used constantly. If you had a UG biochemistry where learned about plant biochemistry along with animal biochemistry and then shift into medical school, those brain connections about plant biochemistry would go. Would you be willing to relearn that material and established those connection again? This would mean you would have to take time away from something else that is more high yield like knowing disease portion of medical biochemistry. You will not have the time to over study and if you are not constantly using that knowledge it will fade away again (just like all the minute details you remembered before).

Ok so you maintain that someone who studies minutiae and feels like they need to know everything from pre-clin to do well on Step 1 will continue that mentality (and study pre-clin + step 1 stuff during clerkships and beyond) if they succeed with that strategy on Step 1?

I disagree with that. And we can agree to disagree.

 

[MedPR]

Actually, P = IV = F/A, so F = VIA. Never fail through something important!

F=mg so mg=VIA and g=9.8 so 9.8=VIA/m.

 

[487806]

F=mg so mg=VIA and g=9.8 so 9.8=VIA/m.

I didn't get the hidden message.

 

[IslandStyle808]

Ok so you maintain that someone who studies minutiae and feels like they need to know everything from pre-clin to do well on Step 1 will continue that mentality (and study pre-clin + step 1 stuff during clerkships and beyond) if they succeed with that strategy on Step 1?

I disagree with that. And we can agree to disagree.

If they succeed then yes that is fine. There are only a few people in this world who can retain that much information, not forget it, and have the perfect time management to do so.

Let me ask this then. Would you be willing to study the Robins books which is over a 1000 pages + biochemistry text book (you can't use FA now) to study for step I? Of course there all the details are medically relevant but there is 5 times more minute details than FA. Could you also do this in a time frame of 3 months? I believe it will all be beneficial for USMLE and life.

Well it is fine to agree to disagree in this scenario too.

EDIT: added some more details

 

[MedPR]

If they succeed then yes that is fine. There are only a few people in this world who can retain that much information, not forget it, and have the perfect time management to do so.

Let me ask this then. Would you be willing to study the Robins books which is over a 1000 pages (you can't use FA now) to study for step I? Of course there all the details are medically relevant but there is 10 times more minute details than FA. Could you also do this in a time frame of 3 months? I believe it will all be beneficial for USMLE and life.

Well it is fine to agree to disagree in this scenario too.

I don't think I'll be able to retain every detail of every book typically used to study for step 1. I think that I'll use board materials (like Robbins and Pathoma among others) during M2 and also during dedicated prep time to learn as much as I possibly can to prepare myself for the test.

I intend to study my ass off with the goal of being in the top quartile (the school I'm going to does quartiles) on every test and of course at the end of every block. I plan to learn the big picture stuff inside and out, and then study the minutiae and memorize as much as possible. Do I think this is necessary to do well on Step 1? No. Will spending all that time memorizing stuff be worth it if a single piece of minutiae from M1 helps me quickly answer a question on Step 1 that otherwise would've taken longer (or I would've gotten wrong)? Yes. The bold is the attitude I had when studying for the MCAT. Sure there was no reason to memorize all the amino acid structures, but if I had some free time at work or somewhere that I couldn't do any real studying, I would take a look at the structures just in case they popped up on the real test. That way I wouldn't have to do anything but recognize it and get the answer right. I'm of the opinion that low yield is better than no yield. Obviously not during dedicated board prep where everything will be high yield, but certainly doing M1 where the only other thing I would be doing is playing videogames.

 

[IslandStyle808]

I don't think I'll be able to retain every detail of every book typically used to study for step 1. I think that I'll use board materials (like Robbins and Pathoma among others) during M2 and also during dedicated prep time to learn as much as I possibly can to prepare myself for the test.

I intend to study my ass off with the goal of being in the top quartile (the school I'm going to does quartiles) on every test and of course at the end of every block. I plan to learn the big picture stuff inside and out, and then study the minutiae and memorize as much as possible. Do I think this is necessary to do well on Step 1? No. Will spending all that time memorizing stuff be worth it if a single piece of minutiae from M1 helps me quickly answer a question on Step 1 that otherwise would've taken longer (or I would've gotten wrong)? Yes. The bold is the attitude I had when studying for the MCAT. Sure there was no reason to memorize all the amino acid structures, but if I had some free time at work or somewhere that I couldn't do any real studying, I would take a look at the structures just in case they popped up on the real test. That way I wouldn't have to do anything but recognize it and get the answer right. I'm of the opinion that low yield is better than no yield. Obviously not during dedicated board prep where everything will be high yield, but certainly doing M1 where the only other thing I would be doing is playing videogames.

Yes this is my point exactly. I too push myself to my limits but I realize that my sleep and being able to eat is more important. I would rather get 7 hours of sleep and study 12 hours a day than get 4 hours of sleep and study 15 hours. Your efficiency will go down with the latter. When you go to medical school you may be able to overstudy in MSI but when it comes to MS2, the amount of time you have to study all the material decreases (this is due to the increase in work load). You can't over study and thus it is why you need to focus your time on the high yield material.

 

[MedPR]

Yes this is my point exactly. I too push myself to my limits but I realize that my sleep and being able to eat is more important. I would rather get 7 hours of sleep and study 12 hours a day than get 4 hours of sleep and study 15 hours. Your efficiency will go down with the latter. When you go to medical school you may be able to overstudy in MSI but when it comes to MS2, the amount of time you have to study all the material decreases (this is due to the increase in work load). You can't over study and thus it is why you need to focus your time on the high yield material.

I don't think it will take more than 12 hours per day to do sufficient board prep and still learn minutiae during M2. It wasn't for people I knew during their M2. This was at a school that is going to change its curriculum starting next year to include less minutiae because older students said it was hindering board prep. So even moreso, less time necessary for school stuff.

 

[KnuxNole]

Yes, M3 grades, steps, letters all matter relatively more. Key word being relatively.



Semantics. By "academic" I mean purely grades and evaluations. Step scores deserve their own category and research is an extra-curricular.



Yes, I've stated that previously.

I guess that's a relief haha. Cause if class rank was the deciding factor, I won't be matching whatsoever, and be up a creek with no paddle D:
It's not horrible, but only slightly above average(which honestly I'm fine with...never really cared for AOA).

 

[notbobtrustme]

I don't think I'll be able to retain every detail of every book typically used to study for step 1. I think that I'll use board materials (like Robbins and Pathoma among others) during M2 and also during dedicated prep time to learn as much as I possibly can to prepare myself for the test.

I intend to study my ass off with the goal of being in the top quartile (the school I'm going to does quartiles) on every test and of course at the end of every block. I plan to learn the big picture stuff inside and out, and then study the minutiae and memorize as much as possible. Do I think this is necessary to do well on Step 1? No. Will spending all that time memorizing stuff be worth it if a single piece of minutiae from M1 helps me quickly answer a question on Step 1 that otherwise would've taken longer (or I would've gotten wrong)? Yes. The bold is the attitude I had when studying for the MCAT. Sure there was no reason to memorize all the amino acid structures, but if I had some free time at work or somewhere that I couldn't do any real studying, I would take a look at the structures just in case they popped up on the real test. That way I wouldn't have to do anything but recognize it and get the answer right. I'm of the opinion that low yield is better than no yield. Obviously not during dedicated board prep where everything will be high yield, but certainly doing M1 where the only other thing I would be doing is playing videogames.

I think you underestimate how much minutia there really is for what little pay-off it is. We aren't talking clinical minutia, we are talking basic science, research orientated minutia for the most part. Things like, this protein weighs how much or these two amino acids are different in HbA and HbF (not the names, but the amino acid numbers). Secondly, your goal is admirable. Just about every single incoming student has the same mindset. And you know what? Only a very small percentage can actually keep up that routine without getting burned out.

 

[MedPR]

I think you underestimate how much minutia there really is for what little pay-off it is. We aren't talking clinical minutia, we are talking basic science, research orientated minutia for the most part. Things like, this protein weighs how much or these two amino acids are different in HbA and HbF (not the names, but the amino acid numbers). Secondly, your goal is admirable. Just about every single incoming student has the same mindset. And you know what? Only a very small percentage can actually keep up that routine without getting burned out.

I'll pm you in a couple of years

I don't expect not to burn out. I expect to be able to handle the burn out while still staying on track.

 

[Charles_Carmichael]

I don't expect not to burn out. I expect to be able to handle the burn out while still staying on track.

In my opinion, that's poor strategy. Your goal should be to avoid burnout as much as you can, not expect it and handle it! Burnout is awful. You do not want to burnout during med school and especially not anywhere close to Step I time. It's very hard to work through burnout -- it's difficult to pull yourself out of that funk and get motivated enough to keep studying day-in-and-day-out. The stress of med school makes it even harder.

I'm not trying to scare you or over-exaggerate the harmful effects of burnout. These are definitely real and have the potential to hurt you badly. I think everyone experiences some degree of burnout, unfortunately, especially when it gets closer to Step I time, but do your best to minimize it as much as you can. It's easy to say you'll "handle it" now. It doesn't always work out that way in real life though.

 

[Gut Shot]

I don't expect not to burn out. I expect to be able to handle the burn out while still staying on track.

I remember charging into a particularly challenging portion of M1 with this attitude. Ready to kick ass and take names. Never give up, never surrender.

When the segment ended I limped out... charred, bruised, lightly bleeding from various orifices, and prepared to attenuate my naive enthusiasm.

My performance actually went up after that experience, and it was because I figured out how to better play the game. "Work harder, not smarter" wasn't much of a strategy.

 

[NickNaylor]

I remember charging into a particularly challenging portion of M1 with this attitude. Ready to kick ass and take names. Never give up, never surrender.

When the segment ended I limped out... charred, bruised, lightly bleeding from various orifices, and prepared to attenuate my naive enthusiasm.

My performance actually went up after that experience, and it was because I figured out how to better play the game. "Work harder, not smarter" wasn't much of a strategy.

Yup, 100% agree with this (and Kaushik).

I, too, entered med school with guns blazing and ignoring everything that current med students were saying. I justified it by saying that they weren't me, and that I was somehow special and would be able to do well (hubris much?). I was convinced that I was going to work as hard as necessary to learn every little detail and ace every exam. After all, this is med school, where things matter (lol).

That ended about week 3.

 

[cubssox2000]

I don't think I'll be able to retain every detail of every book typically used to study for step 1. I think that I'll use board materials (like Robbins and Pathoma among others) during M2 and also during dedicated prep time to learn as much as I possibly can to prepare myself for the test.

I intend to study my ass off with the goal of being in the top quartile (the school I'm going to does quartiles) on every test and of course at the end of every block. I plan to learn the big picture stuff inside and out, and then study the minutiae and memorize as much as possible. Do I think this is necessary to do well on Step 1? No. Will spending all that time memorizing stuff be worth it if a single piece of minutiae from M1 helps me quickly answer a question on Step 1 that otherwise would've taken longer (or I would've gotten wrong)? Yes. The bold is the attitude I had when studying for the MCAT. Sure there was no reason to memorize all the amino acid structures, but if I had some free time at work or somewhere that I couldn't do any real studying, I would take a look at the structures just in case they popped up on the real test. That way I wouldn't have to do anything but recognize it and get the answer right. I'm of the opinion that low yield is better than no yield. Obviously not during dedicated board prep where everything will be high yield, but certainly doing M1 where the only other thing I would be doing is playing videogames.

I don't think you realize just how much harder Step 1 is than the MCAT. In comparison, the MCAT is a complete and total joke of a test. Step 1 is a beast that destroys everything in its path. Step 1 doesn't test minutia, school exams do. Step 1 will test basic knowledge of medical sciences and then start pushing out how many steps down the road you can take a question. If you approach Step 1 like the MCAT you will be severely disappointed in how you score.