Pass/ Fail Step 1

[aldol16]

Had a path professor who diagnosed Goodpasture her second year of residency, nobody else knew what was going on, but some aspect of it triggered her memories it from step 1 studying. Even if a lot of that knowledge is consciously lost, some residue remains and can be helpful to patients with rare conditions.

But the point is that that isn't the only way to make the diagnosis. As a physician, you will have learned throughout your training that nobody can know everything and that 1) if you don't know, you know how and where to look it up and 2) you have colleagues who do know. Medicine is a team sport, not House MD. Even if Step 1 didn't exist, I would hope that medical school curricula would still cover Goodpasture's so everybody will have learned about it at some point. I would argue that if you're learning a lot of things for the first time during Step 1 studying, then your medical school curriculum isn't sufficient.

Medical training is a lot of repetition. There are concepts from exams that I got 98s on that when I pulled them up to review for Step I could barely remember them. Seeing something in your curriculum isolated in its system isn't the same as seeing it as it ties in to the bigger picture. Step studying ties in a LOT of concepts together and creates that big picture. I'm of the opinion that people would enter rotations less prepared if Step was P/F, as honestly simply passing the test really isn't the most difficult thing if you've put in even average effort in your curriculum and dedicated. The pass rates are very high. Once people hit that passing point they would stop studying and simply go take it. Personally I could have passed Step without any of my dedicated because I was prepping during the semester, and I can tell you for a fact I would start rotations with crap knowledge because of how much i've learned and solidified grinding the last month trying to score as high as I can.

You literally quoted me...

Refer to above since you can't be bothered to scroll up.

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[Neuronom]

Wouldn't this result in a larger proportion of students at ~20 top schools preparing for competitive specialties? Thus, crowding the available resources or otherwise hurting the chances for their peers? Or would this be mediated by the fewer number applying from lower ranked schools

 

[Neopolymath]

I can't even believe there is anything to discuss. This is an awful idea for literally everyone but students at top schools who already don't have to perform well on Step 1 in order secure competitive programs or competitive specialties. People arguing for it are cutting off their noses to spite their faces. Step 1 is only stressful because everything is riding on it BECAUSE the rest of the system is broken. Making Step 1 mean nothing doesn't fix the real issues.

JFC, I'm so glad this is happening after I take the exam. It's just further solidifying the idea that at 18 you better know you want to be a doctor and bust ass to go to a great school. I'm already paying for not knowing what I wanted to do at 18 every day and the further I get from it the more silly it seems. Excel on the MCAT and didactic but because freshman year of college you decide you might want to pursue accounting which means just passing your chemistry classes etc? Well good luck because you are now out of the running for a good school 3 years before you even know that you want to sign your life away to pursing medicine in the first place so now your hardwork during med school doesn't mean ****.

 

[kb1900]

I can't even believe there is anything to discuss. This is an awful idea for literally everyone but students at top schools who already don't have to perform well on Step 1 in order secure competitive programs or competitive specialties. People arguing for it are cutting off their noses to spite their faces.

JFC, I'm so glad this is happening after I take the exam. It's just further solidifying the idea that at 18 you better know you want to be a doctor and bust ass to go to a great school. I'm already paying for not knowing what I wanted to do at 18 every day and the further I get from it the more silly it seems. Excel on the MCAT and didactic but because freshman year of college you decide you might want to pursue accounting which means just passing your chemistry classes etc? Well good luck because you are now out of the running for a good school 3 years before you even know that you want to sign your life away to pursing medicine in the first place so now your hardwork during med school doesn't mean ****.

I think part of it is that students and faculty from top schools are also disproportionately more represented at these meetings/conferences/boards etc.

But I’m just speculating

 

[Neopolymath]

I think part of it is that students and faculty from top schools are also disproportionately more represented at these meetings/conferences/boards etc.

But I’m just speculating

You could be right. I don't know. I try to avoid people into that type of stuff to be frank. I do know that there are students at my school that wish Step 1 was P/F and they are interested in FM. That's silly because it hurts the rest of us and their boards are already effectively P/F anyways so I think more students want this to be a thing than SDN believes. The problem is that it's because they are preclinical students neurotic about boards and this is the easy button answer to make that stress go away. God forbid anyone has any stress.

 

[fldoctorgirl]

You could be right. I don't know. I try to avoid people into that type of stuff to be frank. I do know that there are students at my school that wish Step 1 was P/F and they are interested in FM. That's silly because it hurts the rest of us and their boards are already effectively P/F anyways so I think more students want this to be a thing than SDN believes. The problem is that it's because they are preclinical students neurotic about boards and this is the easy button answer to make that stress go away. God forbid anyone has any stress.

I'm preclinical, don't want anything super competitive, and still think this is a terrible idea

 

[mrbreakfast]

I'll say this:

1)

Wouldn't this result in a larger proportion of students at ~20 top schools preparing for competitive specialties? Thus, crowding the available resources or otherwise hurting the chances for their peers? Or would this be mediated by the fewer number applying from lower ranked schools

This is pretty much what everyone really fears; the name of your med school playing an even more significant role in the match.

2) On clinical performance playing a bigger role: the issue with this is the current issue with clinical evaluation, which is that it seems a large minority of clinical faculty don't take it seriously. You could incorporate NBME shelf grades into the residency app, but what if an applicant smokes the shelf but has mediocre evals, or vice versa?

3) I went to a med school most of you probably haven't heard of and which some of my residency interviewers hadn't either. I got those interviews because of my step scores; I'm pretty sure I wouldn't have gotten 90%+ of the interviews I did if PDs hadn't looked at them. I had a strong app and am super awesome and everything, but my school name probably would've immediately put me in a less-desirable pile without being read.

That's the benefit of a scored step. My scores got me in the room for interviews at big-name places that probably would've just seen my app as a rando from the cornfields otherwise. Standardized tests give people chances they wouldn't otherwise have, and for that, I'll always be a defender of them.

 

[AnatomyGrey12]

God forbid anyone has any stress.

This is the part that blows me away. Anyone who thinks this would ease their stress has their head 3 ft deep into a pile of sand. In fact, it would likely make MORE stress down the line for anyone except those at top 20s.

 

[AnatomyGrey12]

I think part of it is that students and faculty from top schools are also disproportionately more represented at these meetings/conferences/boards etc.

But I’m just speculating

This is probably true. The only written pieces I've seen on it have all been written by students at tip top schools.

I do know that there are students at my school that wish Step 1 was P/F and they are interested in FM. That's silly because it hurts the rest of us and their boards are already effectively P/F anyways so I think more students want this to be a thing than SDN believes. The problem is that it's because they are preclinical students neurotic about boards and this is the easy button answer to make that stress go away. God forbid anyone has any stress.

Yeah it's always the people who don't want anything competitive at all, which then begs the question of why on earth do they care as all they have to do is pass anyway, or the people who are really struggling academically and know they probably won't do well.

 

[Neopolymath]

This is probably true. The only written pieces I've seen on it have all been written by students at tip top schools.

They are just graciously "helping" the rest of us plebs out.

 

[Neuronom]

I'll say this:

1)

This is pretty much what everyone really fears; the name of your med school playing an even more significant role in the match.

2) On clinical performance playing a bigger role: the issue with this is the current issue with clinical evaluation, which is that it seems a large minority of clinical faculty don't take it seriously. You could incorporate NBME shelf grades into the residency app, but what if an applicant smokes the shelf but has mediocre evals, or vice versa?

3) I went to a med school most of you probably haven't heard of and which some of my residency interviewers hadn't either. I got those interviews because of my step scores; I'm pretty sure I wouldn't have gotten 90%+ of the interviews I did if PDs hadn't looked at them. I had a strong app and am super awesome and everything, but my school name probably would've immediately put me in a less-desirable pile without being read.

That's the benefit of a scored step. My scores got me in the room for interviews at big-name places that probably would've just seen my app as a rando from the cornfields otherwise. Standardized tests give people chances they wouldn't otherwise have, and for that, I'll always be a defender of them.

I guess what I meant was wouldn't it slightly hurt those in the top 20s as well? More students at X#5 school might just go for Derm/Ophtho/Ortho right away, therefore, increasing competition within the school for research/shadowing/mentoring for LORs.

Obviously this is less impactful than the other cons listed. But, could it be possible that it would make it more difficult to match into a competitive specialty (and be distinguished from your peers at X#5 school) than if you did well on the Step 1 and allowed the scores to discourage others within the school from applying?

 

[mrbreakfast]

Yeah it's always the people who don't want anything competitive at all, which then begs the question of why on earth do they care as all they have to do is pass anyway, or the people who are really struggling academically and know they probably won't do well.

Yep. The students who are most in favor of pass-fail, and who have most to gain, aren't the students at top-20 programs - it's the students who know they can barely pass the boards in the first place. These are the people who are willing to stand up in front of the entire class at the annual class meeting (which we had) and shout that assigning grades isn't fair; they're also willing to call and write the NBME.

That's silly because it hurts the rest of us

Are you a preclinical student? Because you have classmates who don't care at all how the rest of the class does. They'd be fine if no one matched but them. They'll have a harder time hiding it in clinicals than before.

I guess what I meant was wouldn't it slightly hurt those in the top 20s as well?

Maybe in theory, but take a look at some T20 school match lists. They're already pipelining people to derm and ortho. Also, they're top-20 because of their resources. They can support 20-something ortho applicants.

To your other point: a step score might distinguish you from your classmates at a big-name school, but introduces competition from everywhere else. I already talked about my own experience, but my school matched ~15% of the class into surgical subspecialties/ophtho/derm. P/F step scores wipes that entire class out of competition vs a T20 school, as it does for most med schools in the country.

 

[Slavic Scot]

Is this actually happening?

 

[LebronManning]

Such a ridiculous proposition. Make step 1 P/F and another test will take over the same mania whether it be step 2 or specialty specific exams. Then what?

We need a way of stratifying applicants. Step 1 score shows intelligence and how hard someone worked.

And we already have a pass/fail built into the step 1 score. US MDs to pass step 1 with any score are able to get a residency. Not derm, but a residency, yes. This is not an issue that needs to be fixed.

 

[olabrador23]

Such a ridiculous proposition. Make step 1 P/F and another test will take over the same mania whether it be step 2 or specialty specific exams. Then what?

We need a way of stratifying applicants. Step 1 score shows intelligence and how hard someone worked.

And we already have a pass/fail built into the step 1 score. US MDs to pass step 1 with any score are able to get a residency. Not derm, but a residency, yes. This is not an issue that needs to be fixed.

So true.

The fact is they are currently having the power to do whatever they want to do.

Looking forward to @aProgDirector 's next posting on this subject.

 

[sargon2123]

Also, this will also affect the admissions process for AMGs and IMGs. But more so for AMGs in regards to residency as a student in a higher-tier med school with a lower step 1 score can get into a better residency program than a student in a lower-tier med school but much better step 1 score as now it is P/F. Also, MDs would now pick residency spots and the left over would be given to DO and IMG. So, they would need to give students time to adjust and apply to med schools accordingly.
Unfortunately, thing will also work with connections and networking and 'donations' etc.

It might be even worse. The top MDs might be the ones with any advantage and the rest of the applicants would be would be another distinct tier

 

[Ho0v-man]

What if Bernie gets elected president and decides to socialize medicine and the only way hospitals can make money is to replace us all with nurse practitioners to do procedures for self aware AI?

Just thought the thread needed all of the typical SDN fear in one place.

 

[Neopolymath]

What if Bernie gets elected president and decides to socialize medicine and the only way hospitals can make money is to replace us all with nurse practitioners to do procedures for self aware AI?

Just thought the thread needed all of the typical SDN fear in one place.

What if the AI went to DO AI school not MD AI school?

Phew, we almost missed one

 

[Chibucks15]

What if the AI went to DO AI school not MD AI school?

Phew, we almost missed one

Those robot NPs though are a militant bunch. Watch out for them for sure

 

[ginsengreset]

So does anyone have the faintest idea of what the gist of the InCUS recommendations might be? I can't believe that out of such a large and important conference, the only thing we know (and have been publicly told) is that they all had good ol' nice friendly chat at the conference. But then again, the preliminary recommendations are slated to come out later this month, so perhaps we'll just need to wait.

 

[7331poas]

What if Bernie gets elected president and decides to socialize medicine and the only way hospitals can make money is to replace us all with nurse practitioners to do procedures for self aware AI?

Just thought the thread needed all of the typical SDN fear in one place.

Difference being that this "fear" is actually becoming true

 

[TheRealCookieMonster]

https://www.usmle.org/pdfs/incus/incus_summary_report.pdf

Home | United States Medical Licensing Examination

www.usmle.org

Can someone deal with this. It sounds like they want pass/fail.
But the audio transcript is a big love/hug fest between dave and his special friend... they go on and on about how they want everyone to share perspectives and have open minds and be equal and be nice to everyone involved. I can't bare listening to those goobers.
And I'm too lazy/inept to read the written transcript.
I promise lots of emojis and likes for anyone willing to translate politically correct BS into just regular ****.

 

[deleted958249]

FWIW, it looks like you can voice your opinion regarding the transition to a P/F USMLE in this survey here. Don't know how useful it would be; but just maybe our voices could mean something in the long run.

Online Survey Software: Closed Survey

This survey is currently closed. Please contact the author of this survey for further assistance.

www.surveymonkey.com

 

[dohopeful13]

“Minimize racial demographic descrepancies in USMLE performance”

Hope that doesn’t turn into an SAT scenario where people are getting score docked because of their skin color

 

[dohopeful13]

I also like how they cite that people applying to too many programs is a problem for PDs, as if removing scores won’t make that issue 100 times worse

 

[bball0718]

here's a tl;dr of this June "recommendation", I guess

Changes within the USMLE program should take place to meet the following goals.

1) Reduce the adverse impact of the current overemphasis on USMLE performance in residency screening and selection through consideration of changes such as pass/fail scoring.

The most direct means by which the USMLE program may be able to reduce unintended adverse impact is to consider fundamental changes to its current score reporting practices. Options that garnered significant discussion at InCUS included the following:

(a) Pass/Fail (of Step 1 alone or the entire USMLE sequence);
(b) Categorical/tiered scoring of USMLE (e.g., quartiles, quintiles, or some other division);
(c) A composite score across the assessments within USMLE’s Decision Point 1 (DP1), consisting of aggregate performance information from Step 1, Step 2 CK and Step 2 CS.

These options, along with any potential modifications to these options and/or new options resulting from the period of public commentary, will be shared with USMLE governance and the FSMB and NBME governing boards beginning fall 2019.

Discussions with USMLE governance and the boards of the two organizations will include information and data addressing the relative strengths and challenges of pursuing particular options as mitigating measures to the current state of the UME-GME transition system. Any final recommendation will likely reach USMLE and FSMB/NBME governance for their consideration by the end of 2019 or early 2020.

As an incoming M1 I'm not sure what to think other than I'm horrified of the possibility of preparing my first two years for a scored Step1 only to have it be changed to P/F right before I take it lol

 

[dohopeful13]

The USMLE program is committed to bringing options for change to parent boards and governance in a near-term timeframe. Participants at InCUS, however, recognized the systems- level problems in the UME-GME transition, and the slower rate of potential change for such systems improvements. Over time, it is conceivable that broad systemic changes to the UME- GME transition may occur, particularly with participation from additional organizations from within the house of medicine. Furthermore, advances over time in learning analytics and school- level assessments will likely occur. As these develop over the longer term, the USMLE program will look forward to ongoing discussions over the role of various score reporting practices to best inform medical regulation and medical education.

Honestly, that whole thing reads very non-committal. It's not really emphatic about any one particular change. There's a chance c/o 2023 gets screwed but it sounds like those recommendations will involve studying the issue more closely, which could take years.

 

[TheRealCookieMonster]

Kinda sounds like they are hoping some programs or PDs do their work for them by making a statement that they're going to stop reviewing apps based on score.

 

[Slavic Scot]

But why? I would feel very little motivation to study as hard for anything if step is pass/fail, where a 260 is the same as a 192.

 

[Lucca]

The entirety of the text boils down to the following two most relevant points for med students from what I can read:

1. Change USMLE scoring to either A) P/F, B) Performance tiers (quintiles/deciles etc.), C) Use a new metric which incorporates weighted elements from all the exams to reduce weight of single exam according to some criteria.

2. Take steps to both: A) reduce total number of applications PDs must evaluate and B) improve ability of PDs to assess quality of applicants without relying so much on a single exam.

I’ll have to read everything more carefully but honestly sounds like a win win win given the issues brought up on this and other boards

 

[7331poas]

The entirety of the text boils down to the following two most relevant points for med students from what I can read:

1. Change USMLE scoring to either A) P/F, B) Performance tiers (quintiles/deciles etc.), C) Use a new metric which incorporates weighted elements from all the exams to reduce weight of single exam according to some criteria.

2. Take steps to both: A) reduce total number of applications PDs must evaluate and B) improve ability of PDs to assess quality of applicants without relying so much on a single exam.

I’ll have to read everything more carefully but honestly sounds like a win win win given the issues brought up on this and other boards

How the hell did you reach that conclusion?

 

[TheRealCookieMonster]

 

[Slavic Scot]

The entirety of the text boils down to the following two most relevant points for med students from what I can read:

1. Change USMLE scoring to either A) P/F, B) Performance tiers (quintiles/deciles etc.), C) Use a new metric which incorporates weighted elements from all the exams to reduce weight of single exam according to some criteria.

2. Take steps to both: A) reduce total number of applications PDs must evaluate and B) improve ability of PDs to assess quality of applicants without relying so much on a single exam.

I’ll have to read everything more carefully but honestly sounds like a win win win given the issues brought up on this and other boards

I don't see how scored step 1/step 2 doesn't already accomplish all of those things. Common advice for people that did poorly on Step 1 is "Make sure to kill step 2".

I chose a lower tier school in the interest of money, hopefully that wasn't a mistake!

Point 2 sounds like magical thinking on their part.

Edit: And what issues could possibly be bigger than those caused by making step 1 pass/fail?

 

[studentdocftw]

Pass/fail is an overreaction...get rid of CS and report a STEP score...an average of Step 1 and 2 CK. That would force all students to take Step 2 CK early giving PDs more data to work with..also gives poor Step 1ers a chance at true redemption...getting passed screens they wouldnt have originally.

 

[Lucca]

How the hell did you reach that conclusion?

On one side people are scared that a simple P on Step will make it impossible for them to compete with anyone from a higher ranked school at all levels, but the changes in this document aim to not just change the Step scoring system but also change the way residency applicants are evaluated so that the weight of any single exam is reduced; to me, this signals that PDs were able to convince the testwriters and UME that they couldn’t implode Step 1 without changing the way residency selection was going to work.

On another side many discussed in this thread how Step 1 was being used by PDs to screen applicants and how the score creep has been partially a result of an explosion in the number of apps being sent out and the recommendations discuss that as well.

 

[Slavic Scot]

On one side people are scared that a simple P on Step will make it impossible for them to compete with anyone from a higher ranked school at all levels, but the changes in this document aim to not just change the Step scoring system but also change the way residency applicants are evaluated so that the weight of any single exam is reduced; to me, this signals that PDs were able to convince the testwriters and UME that they couldn’t implode Step 1 without changing the way residency selection was going to work.

On another side many discussed in this thread how Step 1 was being used by PDs to screen applicants and how the score creep has been partially a result of an explosion in the number of apps being sent out and the recommendations discuss that as well.

Obviously it won't be impossible, but much more difficult. I saw no evidence there that they cared about this issue at all.

Good

How does changing step to pass/fail help this?

And you're going to an MSTP at some top 10. You could get a 195 and I a 275 and you'd still match better than me. Step is already essentially pass/fail for you.

 

[NotAProgDirector]

I too reviewed the report. I expected a decision of some sort. They made no decision, just wrote down a list of reasonable options, and then said that other groups should get together and make some sort of a decision. And that we should all just agree and be happy.

So, basically, nothing. They say we should convene a UME/GME panel and make a decision by 2019.

Seems like they convened a panel who decided that there needs to be a panel to make a decision.

 

[Tenk]

I too reviewed the report. I expected a decision of some sort. They made no decision, just wrote down a list of reasonable options, and then said that other groups should get together and make some sort of a decision. And that we should all just agree and be happy.

So, basically, nothing. They say we should convene a UME/GME panel and make a decision by 2019.

Seems like they convened a panel who decided that there needs to be a panel to make a decision.

Well if committees were efficient we wouldn’t need so many!

 

[flyboy3]

But why? I would feel very little motivation to study as hard for anything if step is pass/fail, where a 260 is the same as a 192.

This is a problem I see at a school that has a P/F curriculum and is promoting this flippant attitude of Step1; students just don't care as much about internalizing the material. It has created a somewhat lazy mentality, where a lot of students are doing just enough to pass the curriculum block, and then spending time on social activities / video games / partying etc. outside of medical school. I have conversations with students who are proud of the fact they forgot "all the indications for Iron deficiency anemia" as if the fact that our admin aggressively supports a P/F step1 and de-emphasizing the score makes students feel like there's no need to remember stuff like that. And why not? After passing that block with a P what's the need to internalize it when I can just cram it in during dedicated.

A lot of admins who are promoting P/F have this rose colored tint looking at med students thinking "this will surely help them volunteer more and do more research," when in reality it is just enabling a "good enough" mentality. My personal opinion is that my job the first two years of medical school is to learn everything there is to know conceptually, prove this knowledge on Step1, and put it into practice during clinical years. This is what I want residency directors to see. Otherwise just get rid of the first 2 years of med school, have students take an online class, and get them in the wards to have on the job training early.

 

[Slavic Scot]

This is a problem I see at a school that has a P/F curriculum and is promoting this flippant attitude of Step1; students just don't care as much about internalizing the material. It has created a somewhat lazy mentality, where a lot of students are doing just enough to pass and then spending time on social activities / video games / partying etc. outside of medical school. I have conversations with students who are proud of the fact they forgot "all the indications for Iron deficiency anemia" as if the fact we are P/F makes them feel like there's no need to remember stuff like that. A lot of admins who are promoting P/F have this rose colored tint looking at med students thinking "this will surely help them volunteer more and do more research," when in reality it is just enabling a "good enough" mentality.

My personal opinion is that my job the first two years of medical school is to learn everything there is to know conceptually, prove this knowledge on Step1, and put it into practice during clinical years. This is what I want residency directors to see. Otherwise just get rid of the first 2 years of med school, have students take an online class, and get them in the wards to have on the job training early.

Ok I'll be honest, I do like p/f preclinical , especially since none of the preclinical grading across schools are standardized, so it doesn't make sense to put weight on that metric.

 

[flyboy3]

Ok I'll be honest, I do like p/f preclinical , especially since none of the preclinical grading across schools are standardized, so it doesn't make sense to put weight on that metric.

Oh i'm all for P/F preclinical, the rest of my post was discussing the attitude of P/F on step. Basically students learn the material, take the exams for the block, and forget it because our admin tells them that Step1 isn't important and should be P/F.

 

[Slavic Scot]

I too reviewed the report. I expected a decision of some sort. They made no decision, just wrote down a list of reasonable options, and then said that other groups should get together and make some sort of a decision. And that we should all just agree and be happy.

So, basically, nothing. They say we should convene a UME/GME panel and make a decision by 2019.

Seems like they convened a panel who decided that there needs to be a panel to make a decision.

Thank you for your perspective! If I could ask a few questions:

How would pass/fail step 1 change how you view students from lower-prestige schools? Do percentiles help those students get their foot in the door?

 

[morinphen]

When would be the soonest they could implement whatever changes they decide on, January?

 

[deleted938090]

 

[chlorocruorin]

You’d think the world was catching on fire after reading this thread. I don’t think it would be a bad idea to make it P/F. Why can’t we also assume that residency programs will look more holistically at applicants as a result of P/F instead of assuming the worse. 50 years from now will a med student need to get a 280+ to match derm? Are family docs worse than plastics surgeons? The only thing I knew before getting into medical school about medical school was that you had to pass some board exams to practice in the US. Shouldn’t that be the goal then?

 

[Slavic Scot]

You’d think the world was catching on fire after reading this thread. I don’t think it would be a bad idea to make it P/F. Why can’t we also assume that residency programs will look more holistically at applicants as a result of P/F instead of assuming the worse. 50 years from now will a med student need to get a 280+ to match derm? Are family docs worse than plastics surgeons? The only thing I knew before getting into medical school about medical school was that you had to pass some board exams to practice in the US. Shouldn’t that be the goal then?

A bunch of medical schools claim to view applicants holistically, yet there are many top medical schools guilty of taking 30+% of their class from only 2 undergraduate institutions. And people have different goals than you.

 

[dohopeful13]

You’d think the world was catching on fire after reading this thread. I don’t think it would be a bad idea to make it P/F. Why can’t we also assume that residency programs will look more holistically at applicants as a result of P/F instead of assuming the worse. 50 years from now will a med student need to get a 280+ to match derm? Are family docs worse than plastics surgeons? The only thing I knew before getting into medical school about medical school was that you had to pass some board exams to practice in the US. Shouldn’t that be the goal then?

In a perfect world with surplus residency spots, P/F step would be fine. Unfortunately, there are a now more MD/DO/IMG/FMGs vying for spots than there are spots, and that is only going to get worse. In a competitive environment, there needs to be an objective measure by which to stratify applicants. So while the emphasis on scores sucks, the alternative is emphasis on school prestige, subjective clinical grades, and nepotism. Do we really want our fates sealed before we even step foot in med school? I'd rather have the chance to compete and prove myself.

 

[TheRealCookieMonster]

You’d think the world was catching on fire after reading this thread. I don’t think it would be a bad idea to make it P/F. Why can’t we also assume that residency programs will look more holistically at applicants as a result of P/F instead of assuming the worse. 50 years from now will a med student need to get a 280+ to match derm? Are family docs worse than plastics surgeons? The only thing I knew before getting into medical school about medical school was that you had to pass some board exams to practice in the US. Shouldn’t that be the goal then?

I don't buy into the idea that making USMLE pass/fail makes review more "holistic" (whatever that means). It seems like it would go the opposite direction.

 

[dohopeful13]

View attachment 267421

I would recommend everyone opposed to this do the same during the open commentary period. Because best believe those voices in support of P/F will be loud and active, which is why Incus was held in the first place.

Follow this link and click the respond tab to get to the survey

 

[chlorocruorin]

A bunch of medical schools claim to view applicants holistically, yet there are many top medical schools guilty of taking 30+% of their class from only 2 undergraduate institutions. And people have different goals than you.

I was not stating that was my personal goal, but rather the purpose of Step 1. And yes there are schools guilty. But diversity has been increasing because of the push to look pass numbers. I just don't know why making it P/F has to be necessarily a bad thing. Isn't it just as far fetch to assume RDs will put significant weight on the name of the medical school

In a perfect world with surplus residency spots, P/F step would be fine. Unfortunately, there are a now more MD/DO/IMG/FMGs vying for spots than there are spots, and that is only going to get worse. In a competitive environment, there needs to be an objective measure by which to stratify applicants. So while the emphasis on scores sucks, the alternative is emphasis on school prestige, subjective clinical grades, and nepotism. Do we really want our fates sealed before we even step foot in med school? I'd rather have the chance to compete and prove myself.

I used to believe this, until I saw a few physicians discussing this over social media. Although those are the easiest ways to measure applicants, is it not up to residencies to come up with a correct method of stratifying applicants that would not have our fates sealed before entering medical school? There are pros to P/F which is why it has been proposed. At what point will residencies say we need to stop looking at step 1 scores to stratify applicants. Will my grandchildren need 280 to match into ortho and be deemed a "successful medical student".