Professor told me they are doing away with Step 1 SOON

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

UAAWolf

Full Member
10+ Year Member
Joined
Jul 29, 2009
Messages
1,005
Reaction score
3
Med school prof told me my class (2014) wouldn't even have to take step 1...and that we would just take 1 USMLE at the end.

Is this true? I've heard this from multiple sources...

Members don't see this ad.
 
Med school prof told me my class (2014) wouldn't even have to take step 1...and that we would just take 1 USMLE at the end.

Is this true? I've heard this from multiple sources...

I don't think it is happening yet unless he has some inside information.

http://www.usmle.org/General_Information/CRU/Post-AAMC-USMLE-update.pdf

The first changes in questions based on a 1998 report will begin in 2011. So, I find it unlikely they would make those changes just to eliminate the test. Long-term they plan to implement broader changes to the exam such as possibly combining certain steps. Would be cool if they did combine it though.
 
Members don't see this ad :)
They're combining step 1 and 2 in the next few years. My school is already preparing for that change.

I remember hearing this same rumor as a first year medical student. Four years ago. Don't be a sucker and fall for it until you see a firm commitment and date from the NBME.
 
Yeah...my attitude is to bust my ass regardless. Prof claimed the basic sciences won't matter as much, but why slack off?
 
To be fair, they did say that the minimum pass score for step 1 would go up and they just raised it this year. I think a lot of these rumors may be true. Its just a matter of when it will be implemented. I think if they did, we would get a few years heads up though so i doubt if co2014 is going to be the group that sees this.
 
I remember hearing this same rumor as a first year medical student. Four years ago. Don't be a sucker and fall for it until you see a firm commitment and date from the NBME.

The end.

Assume you'll be doing the Three-Step until officially (read: from the NBME) told otherwise.
 
thank goodness. i dont wanna be a guinea pig.
 
I'm more pumped for Step I than I was for the MCAT..i hope it stays
 
They've been talking about combining steps 1 and 2 for a while now. It's been slowly moving toward that already. For instance, step 1 used to be questions on little factoids (i.e. what is the name of ___). Now, it's all in clinical vignette form. I think these are good changes and I hope they eventually combine it with step 2 to save us all some time and money.
 
They've been talking about combining steps 1 and 2 for a while now. It's been slowly moving toward that already. For instance, step 1 used to be questions on little factoids (i.e. what is the name of ___). Now, it's all in clinical vignette form. I think these are good changes and I hope they eventually combine it with step 2 to save us all some time and money.

I think there have been talks of adding audio to step 1 such as heart sounds and breath sounds. I dont know if i like that. Maybe by step 2, i'll be more comfortable with that, but not step 1
 
Members don't see this ad :)
thank goodness. i dont wanna be a guinea pig.

I think there have been talks of adding audio to step 1 such as heart sounds and breath sounds. I dont know if i like that. Maybe by step 2, i'll be more comfortable with that, but not step 1

It appears that video will be part of some of the new questions. So it seems c/o 2014 will be guinea pigs, of sorts, anyway.

New item formats will be introduced into the Step 2 CK exam during the latter half of 2011, and
into Steps 1 and 3 shortly thereafter. Formats may incorporate video materials, and may include
alternate response formats that more authentically simulate clinical practice.
-from the previously posted USMLE article
 
I think there have been talks of adding audio to step 1 such as heart sounds and breath sounds. I dont know if i like that. Maybe by step 2, i'll be more comfortable with that, but not step 1

There are already audio questions (like heart sounds) on Step 1. There are also video questions. Nothing you guys can't handle though.
 
I think there have been talks of adding audio to step 1 such as heart sounds and breath sounds. I dont know if i like that. Maybe by step 2, i'll be more comfortable with that, but not step 1

Had these on my step 1. Easy points, know what murmurs sound like and where they are best heard. No big deal really.
 
If you read the actual reports, "soon" is "someday."

The last report (I think someone linked it above, but http://www.usmle.org/General_Information/CRU/index.html has an index) was in 2009:

The overall structure of USMLE will remain stable at present, continuing to comprise Steps 1, 2 CK, 2 CS, and 3. In the longer term, it is likely that this structure will evolve to reflect other anticipated changes in exam content, competencies assessed, and testing formats used. Anticipated changes will be guided by CRU recommendations, and will consider (and accommodate to the extent possible) the diverse needs of the USMLE program's various stakeholders.

I will not say there is absolutely no way that there will be changes before class of 2013 (or class of 2014) graduates, but I'd bet a pretty huge amount of money on that statement. Now, the MD/PhDs entering with the class of 2014 might be affected, but they'll be here forever :p
 
I'm just hoping that things stay stable until 2016ish...when I actually apply to residency. It would be kind of a kick in the pants to take step I for absolutely no reason.

On the upside, it would be kind of old-school and endearing like applying with a paper and pencil MCAT score. Still, not much of an upside.
 
I guess the conversion of MCAT from paper to CBT could be a good indicating factor for how long it takes

"On July 18, 2005, the AAMC announced that it would offer the paper-and-pencil version of the MCAT only through August 2006. A subset of testing sites offered a computer-based version of the full-length exam throughout 2005 and 2006. The present, shorter, computer-based version of the test debuted in January 2007. The exam is now offered numerous times annually, and scored more quickly."

After a year's notification, it didn't take very long for the test format to change. I dont know how much additional resistance would have to be taken into account for Step 1. But from this, changes seem to happen quickly. Nothing's for sure. And I personally don't think it's fair to c/o 2013 or c/o 2014 to be put through new changes. Classes should be informed at the start of M1 so they are aware and informed by M2. Also, who knows how valid test prep material will be after the changes.
 
I'm just hoping that things stay stable until 2016ish...when I actually apply to residency. It would be kind of a kick in the pants to take step I for absolutely no reason.

On the upside, it would be kind of old-school and endearing like applying with a paper and pencil MCAT score. Still, not much of an upside.

Paper and pencil MCAT is not old school. Hell, I took the 8 hour paper and pencil MCAT.
 
Paper/pencil->computer MCAT wasn't a big change. It got a bit shorter and switched to computer, but thats not really revolutionary.

A change like getting rid of a step entirely would be in another category entirely. We'll have *years* official warning. Either way though, I highly doubt it will affect any MD students currently in/applying to med school. (Maybe the mudphuds, but god only knows how it will affect the ones caught in the middle there)
 
"Soon" in education terms is different than it is in our terms. There is a lot of development and testing that goes into questions on the USMLE. They are starting to add different question types. (One of our profs. started putting them in our tests) Overall, even if it were a major change it'd affect everyone the same. Not like one school will get special access to everything. Also, they have to let schools know about the changes in order for changes in curriculum to better accomodate anything different that may have not been on the last exam. Curriculum changes are pretty major undertakings and something that might seem simple can still take 6 months to a year to design/implement. God forbid if a school changes from traditional lecture based to systems or pbl. That is usually done in phases to work out kinks as they happen.
 
Paper and pencil MCAT is not old school. Hell, I took the 8 hour paper and pencil MCAT.

so did I, and I'm an MS1 - I took the last ever paper MCAT in August 2006. Then again, I'm an old soul.
 
Paper and pencil MCAT is not old school. Hell, I took the 8 hour paper and pencil MCAT.

I always thought that all of the paper and pencil MCATs were 8 hour exams. At least mine was.

Anyway, I was just trying to make a comparison...although taking the 1600 SAT and talking to a bunch of current high school kids may be more like the picture I was trying to paint...
 
... I dont know how much additional resistance would have to be taken into account for Step 1. ...

The additional resistance comes from virtually every residency in the country, which now uses Step 1 as the primary basis upon which to compare applicants from different med schools. It's not a change in format they are talking about, they are talking about changing the test, combining it with another test that also factors into residency consideration for some students, and moving the timing of the test, which may make it difficult for residencies to consider usefully. This is a HUGE change, and there are tons of implications. It will take a lot of consideration, and residencies will have to figure out some other basis for comparing applicants, possibly putting greater emphasis on shelf exams, or creating their own specialty specific exams or the like. It's not something that gets announced one year and happens in the next. Once it is conclusively decided that it will happen, I suspect we are talking many years of addressing implications and revamping the residency application system before this actually happens. If it does. Don't try to compare it to a mere, paper or online transition where the test and its purpose largely stay the same. It's like comparing an apple to a watermellon.
 
The additional resistance comes from virtually every residency in the country, which now uses Step 1 as the primary basis upon which to compare applicants from different med schools. It's not a change in format they are talking about, they are talking about changing the test, combining it with another test that also factors into residency consideration for some students, and moving the timing of the test, which may make it difficult for residencies to consider usefully. This is a HUGE change, and there are tons of implications. It will take a lot of consideration, and residencies will have to figure out some other basis for comparing applicants, possibly putting greater emphasis on shelf exams, or creating their own specialty specific exams or the like. It's not something that gets announced one year and happens in the next. Once it is conclusively decided that it will happen, I suspect we are talking many years of addressing implications and revamping the residency application system before this actually happens. If it does. Don't try to compare it to a mere, paper or online transition where the test and its purpose largely stay the same. It's like comparing an apple to a watermellon.

yeah that makes sense. there's no way preclinical grades will substitute for step 1 since curriculums vary between schools.
 
My school is not even considering a change in Step I when they review their curriculum each year. According to the vice-dean, this is something that will happen, but is not even in the remote future. They have to make a decision to do it first, and then actually figure out how to replace it. I think we are looking at maybe 6-10 years before this thing gets changed, IMO.
 
My school is not even considering a change in Step I when they review their curriculum each year. According to the vice-dean, this is something that will happen, but is not even in the remote future. They have to make a decision to do it first, and then actually figure out how to replace it. I think we are looking at maybe 6-10 years before this thing gets changed, IMO.

A reasonable estimate.
 
They've been saying they're going to a combined step I/IICK to be taken at the end of 3rd year since I was a second year in med school (2006-2007). There was also talk of getting rid of CS because it's a horrible test and outrageously expensive. The reasoning for the step I/IICK was pretty solid too.....they evidently have been putting Step I style questions in Step II to see how much of this information is retained. As expected.....not much is retained, so their thinking is that we need emphasize the basic sciences much more during out clinical training years than we are now. I would agree with that too. The chief problem with all of this is that residencies would be unable to use a standardized test to weed through appicants since the absolute earliest anyone would take the exam would be the July after their 3rd year.
 
They've been saying they're going to a combined step I/IICK to be taken at the end of 3rd year since I was a second year in med school (2006-2007). There was also talk of getting rid of CS because it's a horrible test and outrageously expensive. The reasoning for the step I/IICK was pretty solid too.....they evidently have been putting Step I style questions in Step II to see how much of this information is retained. As expected.....not much is retained, so their thinking is that we need emphasize the basic sciences much more during out clinical training years than we are now. I would agree with that too. The chief problem with all of this is that residencies would be unable to use a standardized test to weed through appicants since the absolute earliest anyone would take the exam would be the July after their 3rd year.

I don't see this being too much of a problem. The majority of med school applicants took a paper and pencil MCAT in April prior to the application cycle that began in June. So long as everyone takes the new step exam somewhere between July-Sept, there would be ample time to get the results for the residency application cycle. The problem that I see would be that if you fail, there's little time to make it up and you'd be SOL for a residency.
 
Last edited:
... So long as everyone takes the new step exam somewhere between July-Sept, there would be ample time to get the results for the residency application cycle. ...

Not really. There are currently early matches which need the scores earlier. You are also assuming the scores come out rapidly, rather than months later. Interviews for the regular match tend to start as early as October for some fields, so if the scores aren't back by then, this changes residency schedules.
 
Not really. There are currently early matches which need the scores earlier. You are also assuming the scores come out rapidly, rather than months later. Interviews for the regular match tend to start as early as October for some fields, so if the scores aren't back by then, this changes residency schedules.

You could simply adjust the timeline based on the residency you're applying to. If you're applying for early match, take it in July. If you're applying for radonc, derm, or plastics, take it later.

I am assuming the scores would come back in the same amount of time that they currently do. There's no reason that it should take longer than the current 3-4 weeks. Everything is electronic, they should be able to do it quicker, if anything.
 
You could simply adjust the timeline based on the residency you're applying to. If you're applying for early match, take it in July. If you're applying for radonc, derm, or plastics, take it later.

I am assuming the scores would come back in the same amount of time that they currently do. There's no reason that it should take longer than the current 3-4 weeks. Everything is electronic, they should be able to do it quicker, if anything.

It probably could be done, but it still changes everything. Heck, a lot of people take step 2 much later and use a vacation month to study for it. To combine Step 1 and push it into 3rd year means folks will need a block of time prior to that to study. Which I guess means you do away with second year summer and start the cores earlier. And may cut into early fourth year elective time that people currently use to figure out what they want to go into. It really shuffles everything around, and not in a positive way IMHO. I can't imagine this won't be met with huge resistance, both by residencies, and by the folks who organize the curriculum at med schools. All of whom are going to say, hey, what exactly is the problem with the current system. The answer to which likely eludes everyone other than those deadset on a change.
 
yeah, what the hell is wrong with the current system anyway? (aside from step 2 cs)

i mean, i'm gonna take step1 in about two months, and, while i'm moderately nervous about it, i'm damn glad that there's an objective exam that's used to compare students across the country.
 
It probably could be done, but it still changes everything. Heck, a lot of people take step 2 much later and use a vacation month to study for it. To combine Step 1 and push it into 3rd year means folks will need a block of time prior to that to study. Which I guess means you do away with second year summer and start the cores earlier. And may cut into early fourth year elective time that people currently use to figure out what they want to go into. It really shuffles everything around, and not in a positive way IMHO. I can't imagine this won't be met with huge resistance, both by residencies, and by the folks who organize the curriculum at med schools. All of whom are going to say, hey, what exactly is the problem with the current system. The answer to which likely eludes everyone other than those deadset on a change.

It won't be easy, I'll give you that. Anything they do could easily result in a change for the worse.
 
It won't be easy, I'll give you that. Anything they do could easily result in a change for the worse.
I've thought for awhile now that we could probably get rid of MS1 and MS2 summers, compact the preclinical curriculum into 18 months, and get out onto the wards earlier (U Penn does something like this). You could do Step 1 and 2 at month 18 and 30, or you could do just a combined exam at 30. The result would be an extended MS4: You'd still have time for elective/away rotations and get test results back before even the early match specialties. Jan-May, the usual "slacker time" of MS4, could be spent doing long-term research or more electives.
 
I've thought for awhile now that we could probably get rid of MS1 and MS2 summers, compact the preclinical curriculum into 18 months, and get out onto the wards earlier (U Penn does something like this). .

Considering how tired and burnt out i feel now, i dont know what i'd do if you told me i had another 3 months of school left from right now.
 
I remember when Step 2 CS was just a horrible rumor...

FWIW, I think Step 1 is the most irrelevant test ever. I bet 90% of MDs would fail it if they had to take it again. Forcing med students to take it any time after the end of 2nd year (or retain most of that information past 2nd year) is cruel.
 
I remember when Step 2 CS was just a horrible rumor...

FWIW, I think Step 1 is the most irrelevant test ever. I bet 90% of MDs would fail it if they had to take it again. Forcing med students to take it any time after the end of 2nd year (or retain most of that information past 2nd year) is cruel.

Agreed. And while I feel it's good background to have, I think it misses the point to think that the average soon to be resident should have a stronger recollection of biochem or embryology as opposed to simply a strong knowledge base of things like IM, Surg, OB, peds or psych. You don't use the basic science year info in the wards as much as you use the wards info in the wards. So it's this latter that must be emphasized at the latest possible point before you become a resident, and the former can and should be gradually fading with other older memories. You don't use it, you lose it, and this kind of stuff you don't use. So it's appropriate that folks later down the road aren't focusing on what was only meant to be foundation that all physicians should have had at some point. The NBME or AAMC or whomever runs this show should get this.
 
Considering how tired and burnt out i feel now, i dont know what i'd do if you told me i had another 3 months of school left from right now.

You'd grin and bear it. Then in 3 months, you'd realize that it wasn't that bad.

But seriously, you'd have the opportunity to find out before the academic year ever started. They aren't going to tell everyone 3 months in advance that they won't get a Summer break.
 
I've thought for awhile now that we could probably get rid of MS1 and MS2 summers, compact the preclinical curriculum into 18 months, and get out onto the wards earlier (U Penn does something like this). You could do Step 1 and 2 at month 18 and 30, or you could do just a combined exam at 30. The result would be an extended MS4: You'd still have time for elective/away rotations and get test results back before even the early match specialties. Jan-May, the usual "slacker time" of MS4, could be spent doing long-term research or more electives.

I agree that all med schools could take a page out of Baylor/Duke/UPenn handbook. Eliminating MSI Summer would be unfortunate, but not crippling, and our school barely has an MS2 Summer as it is. Something needs to be done to open up more elective time prior to match, so people can actually make an informed decision about their specialty.
 
I agree that all med schools could take a page out of Baylor/Duke/UPenn handbook. Eliminating MSI Summer would be unfortunate, but not crippling, and our school barely has an MS2 Summer as it is. Something needs to be done to open up more elective time prior to match, so people can actually make an informed decision about their specialty.

Well, you'd need the score before you signed up for electives because there's no point taking that derm elective and then find out you scored a 190, and now don't even have a separate Step 2 to try and improve things with a second score. I think it's going to be a mess to retool, and probably the benefits don't outweigh the burdens here.
 
Instead of eliminating MSI summer, which I think is valuable as a lot of people use it for personal gain (getting married, traveling abroad, etc) or professional experience (clinical or research, etc)... I wish there were a push to get rid of some of the redundancy of MS3. In my school, we had to take 2 weeks of geriatrics-- and while I believe that this is an LCME requirement, I never quite understood it because (1) you can't match into geri from med school and (2) most of my patients in my IM clerkship were 65+. Likewise, I had to do a month of family medicine... which was pretty much the same as my (MS4) ambulatory rotation.

If those rotations were eliminated or combined, you could gain an extra month in MS3 for clinical or research electives or to study for whatever changed USMLE step will be at the end of MS3...
 
Instead of eliminating MSI summer, which I think is valuable as a lot of people use it for personal gain (getting married, traveling abroad, etc) or professional experience (clinical or research, etc)...
In my post above, you can see that a lot of these can be done during the proposed extended 4th year.
 
In my post above, you can see that a lot of these can be done during the proposed extended 4th year.

True, but if you do research at the beginning of 4th year (even if it's an "early" 4th year) you probably won't have a chance to get any publications accepted if you do research.

I just think that my MS1 summer was very productive in terms of my CV, in ways that would not have been so if I had to do it after 3rd year.
 
True, but if you do research at the beginning of 4th year (even if it's an "early" 4th year) you probably won't have a chance to get any publications accepted if you do research.

I just think that my MS1 summer was very productive in terms of my CV, in ways that would not have been so if I had to do it after 3rd year.
True. But most student's summer work doesn't result in a poster, let alone a paper. In your situation, you could have just carried out your project over MS1-MS3, instead of over the summer. If students want an intense research training experience (separate from CV enhancement), then the Penn plan would work better than the current schedule. And there's less play in MS3 than MS1 and MS2.
 
Top