I meant regarding content base. School exams solidify it, and step 1 prep reinforces it
Med schools don't really test Step 1 material as such. Most med school exams focus on more 1-step or 2-step questions, mostly because oftentimes there's no true "cumulative final exam" so it is difficult to make associations with other classes, and professors who teach one subject are often different from the ones that teach another- for example, if you studied pharm with Dr. G, and path with Drs. X, Y and Z, they each write questions that are relevant to their particular field- not necessarily each other. So for me at least it was rare that I'd have a question that required me to first diagnose a disease, then think of what the second-line medication was, then know what the most common dermatologic side effect of that med was in children (that would be a typical Step 1 question).
In a way it makes sense. "Teaching to the Boards" is sort of a dirty phrase that's reserved for caribbean schools. We're supposed to be taught the medicine. However, in my experience at least it's rarely that simple. We spend months and months on anatomy which is extremely under-emphasized on the boards, but again re-emphasized during your surgical clerkship. On the other hand, we spent way less time on microbiology and biochem, which show up way more on Step 1, but way less on the wards. Unfortunately the truth is you really need both, and most physicians would argue that it's more important for us to know anatomy well rather than the urea cycle defects...so what can a med school do? The problem here as far as I'm concerned is the NBME testing stuff we really don't need, not the med schools teaching the wrong things. But this is not a perfect world...
Hmm...I wonder if this problem may be alleviated if pre-clinicals are mostly taught by MD/PhDs (rather than PhDs) since the MD/PhDs would have more direct knowledge of and interest in what is clinically relevant and how the basic sciences actually connect to medicine?
Again, it's sort of irrelevant. The question is- would you rather be taught more of what's important on the wards, or what's heavily tested on Step 1? The two things are often divergent. Honestly I've had to teach a few things to underclassmen, and they're usually shortcuts and easy things to remember on the wards. That's what seems most relevant to me. I couldn't and wouldn't teach Step 1 material because first of all I remember none of it, and second as far as I'm concerned most of it was a waste of time.
In that case you are lucky (which is part of the game), however most questions require more discrimination than that, i.e., you are unlikely to have many questions on which you "get lucky." The kind of question that I posted is on the simpler/easier end of the spectrum.
It's obvious that you have your own opinion and are set in it, and that's fine. Do what works for you. I'm just trying to offer you an alternate perspective so that you might perhaps use that saved time to do things that are more meaningful, enriching, and worthwhile than memorizing random facts that some guy that were important to know because they are tangentially related to research that he does. If you think that will help you in the future, then you should go for it. That's what's great about medical school: there are many different ways for people to arrive at the exact same spot. It all comes down to your priorities and what you want out of the experience.
Agreed.
Look, some people have started studying for Step 1 the day they arrived in med school, and hated having school tests because they felt like they had to study stuff that didn't matter. Others didn't open First Aid until all med school exams were over. Some used P = MD as a reason to slack, hang out with friends, and have a life. Others took it to mean that they had more time to do more important things academically, like worry about the boards early, get more involved with research, network, etc. Different strokes for different folks really. We had a H/P/F preclinical curriculum and in my experience, most who got Honors didn't really gun for it, they just got it cause they were going to work that hard anyway and were getting extremely high scores even when the class was P/F. For us, preclinical Honors are used to determine who'll get "Junior AOA", and that can matter if you want a super competitive specialty to some extent. Still, doing well on Step 1 and very well on your clerkships is far, far more important than getting Honors in whatever preclinical class. My advice is- don't fall behind, study hard, and don't worry too much about grades in your first two years. If you're the type who studies 4 hours and gets H at the end, great. If you're the type that would need to study 8 to get the same result, then don't sweat it.
Oh and PS- to keep the "P = MD" attitude during your clinical years IS crazy. Don't do that.
