School that take Step 1 end of 3rd year?

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flyinglantern22

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Hey everyone! I did some quick searches on SDN for this topic but wanted an updated opinion on this. I apologize if it's not on the right forum.

So one of the schools that I'm considering for matriculation takes their Step 1 after 3rd year and does every well (238 average). The students seem to take Step 1 and then both parts of Step 2 the same year (a couple months apart) in time for residency applications. I've heard the pros and cons of both, but I wanted some more opinions.

What do you you guys think about taking step 1 after 3rd year vs. 2nd year? In hindsight, do you think the extra year of clinical rotations helps solidify the material? Or is it better to just take it after 2nd year?

Thanks!
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I interviewed at a school that has their students take their Step 1 after their third year (FIU) and the students said that taking the test after a year of rotations helped them tremendously.

One M4 I talked to during lunch said that he took an NBME practice test after his second year, without studying, then took another right before he started studying after his third-year rotations (again, without specifically studying for it), and scored 20 points higher. N=1 in this situation, but a 20-point difference is huge.

The students there also mentioned that other schools are considering moving Step 1 to after M3 because of the success shown from the schools who do it this way. I believe that Penn State is switching this year for their incoming M1s and that Harvard is looking into making a switch (although, the latter is just what I have heard).
 
alarita24 said:
I interviewed at a school that has their students take their Step 1 after their third year (FIU) and the students said that taking the test after a year of rotations helped them tremendously.

One M4 I talked to during lunch said that he took an NBME practice test after his second year, without studying, then took another right before he started studying after his third-year rotations (again, without specifically studying for it), and scored 20 points higher. N=1 in this situation, but a 20-point difference is huge.

The students there also mentioned that other schools are considering moving Step 1 to after M3 because of the success shown from the schools who do it this way. I believe that Penn State is switching this year for their incoming M1s and that Harvard is looking into making a switch (although, the latter is just what I have heard).
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The school in talking about in my post is actually FIU too haha, and I spoke to another M4 that said something similar about step. I can definitely see how it can help but it also seems stressful to take all your boards after a year of rotations. But I'm wondering what others think as well so I can get a broader understanding outside of just FIU students.
 
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I heard University of Pennsylvania does this.

I was also really attracted to this but I eventually realized it's almost impossible to know what effect it has besides how students "feel".

How can you say what effect it really has? Schools don't publish their step scores (as far as I know).

In general I feel like it is really tough compare medical schools based on student opinion because no one attends 2 different medical schools.

Now I go to a medical school that accelerates the pre-clinical years and all the medical students say THAT is great and better because it gives you more time on the wards and more time to decide what you want to go into.
 
I've got nothing. You might ask schools, "why have you made this change?" or "why haven't you made this change?" Not every interviewer will know (the basic science people may not, and even some clinicians may not be familiar with the arguments either way) but someone you see on interview day should be able to speak to it.
 
I got the perspectives of students who took it before and after.

The student who took step 1 before rotations said that she was happy to do so because she felt more comfortable during rotations since she was already familiar with the language and the clinical frame of mind. She said that some of her friends who went to different schools and took step 1 after rotations felt completely lost when they first started rotations.

For the students who took step 1 after rotations said that studying for the exam was easier for them because they could remember actual cases that they saw during rotations and that the shelf exams were good practice for the real exam.

I personally would rather take step 1 after rotations, I really do think that it makes the information "stick" more.
 
Step 1 taken after rotations would definitely give you a boost of 5-10 points, there is way more clinical vignettes on the modern step-1 exam than there was in the past. I went to a school where we took Step-1 after our preclinical classes, and missed several questions just because I'd never seen a patient with the condition, whereas if I took the same test at the end of 3rd year I would have gotten those questions easily just because I would have already seen the disease.

As an aside, I think its bulls*** that there isn't a nation-wide standardized time to take Step-1. It's the measuring stick residencies use to compare applicants, and it's inherently unequal if one group of students has an extra year of medical experience to draw on when taking the exam.
 
Columbia takes theirs at the end of their clinical year (so after 2.5 years of school)

Duke takes theirs at the end of their clinical year (so after 2 years of school)

Yale, last year, said they were switching to taking it after their clinical year with their new curriculum, but I have no idea if that went through

That's all I have for certain - I have more rumors, but asking students at those schools would give more verifiable results
 
Iowa takes them after clinicals so December of M3 and then Step 2 fall of M4.


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ortnakas said:
When do students at these schools take Step 2?
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For FIU they take step 1 the summer after their 3rd year, which is their clinical year, and then students say they take step 2 a month or a few months after step 1 during that same year/summer. Not sure about other schools.
 
WedgeDawg said:
Columbia takes theirs at the end of their clinical year (so after 2.5 years of school)

Duke takes theirs at the end of their clinical year (so after 2 years of school)

Yale, last year, said they were switching to taking it after their clinical year with their new curriculum, but I have no idea if that went through

That's all I have for certain - I have more rumors, but asking students at those schools would give more verifiable results
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UCSF will also be taking step 1 at the end of their clinical year (3rd yr)--to take effect for the incoming class of 2016. This has to do with the drastic curriculum overhaul for the new class, more on the rationale here:

http://meded.ucsf.edu/bridges/bridges-curriculum-design-decision-usmle-step-1-exam-date
 
neekzg said:
UCSF will also be taking step 1 at the end of their clinical year (3rd yr)--to take effect for the incoming class of 2016. This has to do with the drastic curriculum overhaul for the new class, more on the rationale here:

http://meded.ucsf.edu/bridges/bridges-curriculum-design-decision-usmle-step-1-exam-date
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Interesting! Didn't know they were moving it too. For places like Columbia and Duke, since their clinical year is year 2, it's a bit different than FIU's which is year 3. But it's good to know there's another school that's doing it after year 3. Has it been absolutely confirmed for UCSF that their step for the class of 2020 (aka incoming class of 2016) will be after year 3 or is it still in the works? Since the article is from 2014.
 
flyinglantern22 said:
Interesting! Didn't know they were moving it too. For places like Columbia and Duke, since their clinical year is year 2, it's a bit different than FIU's which is year 3. But it's good to know there's another school that's doing it after year 3. Has it been absolutely confirmed for UCSF that their step for the class of 2020 (aka incoming class of 2016) will be after year 3 or is it still in the works? Since the article is from 2014.
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As far as I know, yep. Here's a more recent draft of the 4 year curriculum for the class of 2020 (which is also by no means final).

http://meded.ucsf.edu/sites/meded.ucsf.edu/files/field/image/Bridges_calendar updated_July_15_15.jpg#overlay-context=bridges/bridges-beginners (note licensing exams taken around Feb of third year)

Hoping it works out for the best but anything is better than the ~3 weeks that I hear they used to allocate for designated studying time for step 1.
 
I would have hated this, for a few reasons:

1. I did very well on Step 1, taken at the standard time. Delaying it would have just been one more thing hanging over me.
2. The prospect of this seems damned near unfeasable for a standard 2+2 curriculum. So you take Step 1 in like, what, May or June before your fourth year? You apply to ERAS September 15 (earlier if you're doing an early match specialty). This is not enough time, in my opinion, for students to really assimilate what their scores mean, get advised, adjust their plans accordingly, figure out what specialty and in what places to apply, apply to away rotations, find opportunities to enhance resumes if needed, etc.
3. You would have basically no "money in the bank" before clinical rotations. This would make third year incredibly stressful.
4. Students who fail step 1 could be supremely ****ed (more than they already are) because they would be rushing to retake and pass step 1, then take and pass step 2 in time for residency applications (delaying step 2 is not an option for these applicants). If not this, they would certainly need to do this to graduate.

Overall and from an administrative perspective, I just think that in a standard curriculum, taking step 1 any later than when most people take it now is a logistical nightmare waiting to happen.
 
sloop said:
I would have hated this, for a few reasons:

1. I did very well on Step 1, taken at the standard time. Delaying it would have just been one more thing hanging over me.
2. The prospect of this seems damned near unfeasable for a standard 2+2 curriculum. So you take Step 1 in like, what, May or June before your fourth year? You apply to ERAS September 15 (earlier if you're doing an early match specialty). This is not enough time, in my opinion, for students to really assimilate what their scores mean, get advised, adjust their plans accordingly, figure out what specialty and in what places to apply, apply to away rotations, find opportunities to enhance resumes if needed, etc.
3. You would have basically no "money in the bank" before clinical rotations. This would make third year incredibly stressful.
4. Students who fail step 1 could be supremely ****ed (more than they already are) because they would be rushing to retake and pass step 1, then take and pass step 2 in time for residency applications (delaying step 2 is not an option for these applicants). If not this, they would certainly need to do this to graduate.

Overall and from an administrative perspective, I just think that in a standard curriculum, taking step 1 any later than when most people take it now is a logistical nightmare waiting to happen.
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Idk about other schools, but the way we do it is you take step 1 in february after your clinical year (which starts 1.5 years in and ends 2.5 years in) and if you need to retake, you retake in april (which is technically still in your third year going purely by the calendar). I agree that for a 2+2 curriculum it would probably be very logistically difficult.
 
WedgeDawg said:
Idk about other schools, but the way we do it is you take step 1 in february after your clinical year (which starts 1.5 years in and ends 2.5 years in) and if you need to retake, you retake in april (which is technically still in your third year going purely by the calendar). I agree that for a 2+2 curriculum it would probably be very logistically difficult.
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I agree that if you change the curriculum, different stuff can work. However, this opens up a whole different can of worms.

First, these schools do not technically take the exam after "third year" as the title of this thread suggests.

Second, schools with a curriculum that significantly shortens the preclinical years is its own debate unto itself. Comparing schools with these alternate structures to the traditional model is going to involve a whole host of reasons to prefer one curriculum over the other. At this point, honestly, one of the least consequential differences for applicants to consider might be precisely when one takes step 1.
 
sloop said:
I agree that if you change the curriculum, different stuff can work. However, this opens up a whole different can of worms.

First, these schools do not technically take the exam after "third year" as the title of this thread suggests.

Second, schools with a curriculum that significantly shortens the preclinical years is its own debate unto itself. Comparing schools with these alternate structures to the traditional model is going to involve a whole host of reasons to prefer one curriculum over the other. At this point, honestly, one of the least consequential differences for applicants to consider might be precisely when one takes step 1.
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I think you can argue that "3rd year" lacks specificity, but generally I take it to mean the end of the clinical year (of course, open to interpretation), and I think most people posting in this thread do too.

Agree that comparing when schools take step 1 is far less important than other curricular factors (1 vs 1.5 vs 2 years preclinical, for example).
 
sloop said:
I agree that if you change the curriculum, different stuff can work. However, this opens up a whole different can of worms.

First, these schools do not technically take the exam after "third year" as the title of this thread suggests.

Second, schools with a curriculum that significantly shortens the preclinical years is its own debate unto itself. Comparing schools with these alternate structures to the traditional model is going to involve a whole host of reasons to prefer one curriculum over the other. At this point, honestly, one of the least consequential differences for applicants to consider might be precisely when one takes step 1.
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The school that I was specifically referring to (without it being in my original post, but I'll edit that in) is FIU that does the traditional 2+2 curriculum and takes it after their third year. Currently from what I know about second look and such, the M3's are currently studying for their step 1 exams to take, and it'll probably pan out like what you mentioned earlier (take step 1 in the end of May or June, then they take step 2 a month or two after that).

I'm guessing from what you've described, you would rather go to a school that does the traditional step 1 after year 2 VS one that does it after year 3 if both are 2+2 traditional curriculums, right? I'm wondering if that should be a big deciding factor or not when deciding between a school currently, which I am in the process of.
 
WedgeDawg said:
I think you can argue that "3rd year" lacks specificity, but generally I take it to mean the end of the clinical year (of course, open to interpretation), and I think most people posting in this thread do too.

Agree that comparing when schools take step 1 is far less important than other curricular factors (1 vs 1.5 vs 2 years preclinical, for example).
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I apologize, I probably should have been more specific in my post. In my case I mean actual M3 year in a traditional 2+2 curriculum where the first two years and preclinical, and the last two are when rotations are scheduled. Would that change your sentiment?
 
I feel like it would help, given that you'll be much more familiar with many of the things like cardiac drugs etc that you're forced to memorize in med school but you actually use on a day-to-day basis on the wards. You'll probably get a better score, but honestly I'm kind of glad to be rid of this exam before third year so it's one less thing I have to worry about.
 
flyinglantern22 said:
I apologize, I probably should have been more specific in my post. In my case I mean actual M3 year in a traditional 2+2 curriculum where the first two years and preclinical, and the last two are when rotations are scheduled. Would that change your sentiment?
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Yep! I honestly don't know any (as mentioned above, UCSF might be one soon). All the schools I'm aware of have a non-traditional curriculum.
 
flyinglantern22 said:
The school that I was specifically referring to (without it being in my original post, but I'll edit that in) is FIU that does the traditional 2+2 curriculum and takes it after their third year. Currently from what I know about second look and such, the M3's are currently studying for their step 1 exams to take, and it'll probably pan out like what you mentioned earlier (take step 1 in the end of May or June, then they take step 2 a month or two after that).

I'm guessing from what you've described, you would rather go to a school that does the traditional step 1 after year 2 VS one that does it after year 3 if both are 2+2 traditional curriculums, right? I'm wondering if that should be a big deciding factor or not when deciding between a school currently, which I am in the process of.
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As I said above, I think taking step 1 after 3rd year in a 2+2 curriculum has the potential to be disastrous in a lot of ways. I also think it would be a lot more stressful. The only gain, stress wise, would be that second year would be less stressful, but that would be offset by the fact that you still have Step 1 to worry about at the end of third year and it will be heavily testing the material you are learning at that moment.

I'm going through the end of third year as we speak. I will say that I would not want anything to add to the stress of this. It is already immensely stressful even as a very competitive applicant for a non-competitive specialty. There is boatloads of random stuff you need to do to start getting your application ready and schedule fourth year. Additionally there is CS and CK. It's a lot to worry about. In comparison, second year was relatively stress free and stable aside from having to take Step 1. I'm glad I did it when I did.

I've also definitely forgotten a lot of basic science stuff in a year. Third year may help for a question or two (mostly the odd management question that goes beyond basic science application) on step 1 but it will be very low yield for that test.
 
sloop said:
As I said above, I think taking step 1 after 3rd year in a 2+2 curriculum has the potential to be disastrous in a lot of ways. I also think it would be a lot more stressful. The only gain, stress wise, would be that second year would be less stressful, but that would be offset by the fact that you still have Step 1 to worry about at the end of third year and it will be heavily testing the material you are learning at that moment.

I'm going through the end of third year as we speak. I will say that I would not want anything to add to the stress of this. It is already immensely stressful even as a very competitive applicant for a non-competitive specialty. There is boatloads of random stuff you need to do to start getting your application ready and schedule fourth year. Additionally there is CS and CK. It's a lot to worry about. In comparison, second year was relatively stress free and stable aside from having to take Step 1. I'm glad I did it when I did.

I've also definitely forgotten a lot of basic science stuff in a year. Third year may help for a question or two (mostly the odd management question that goes beyond basic science application) on step 1 but it will be very low yield for that test.
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I kinda like duke's system where they do a year of preclinical, a year of clinical then you have a year to do scholarly work. It makes it easy to score higher on step 1
 
Mad Jack said:
I feel like it would help, given that you'll be much more familiar with many of the things like cardiac drugs etc that you're forced to memorize in med school but you actually use on a day-to-day basis on the wards. You'll probably get a better score, but honestly I'm kind of glad to be rid of this exam before third year so it's one less thing I have to worry about.
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You may be overestimating how much basic science is utilized on the floors. Apart from random pimp questions, thinking shifts from mechanisms and biochemistry to broader, algorithm-like approaches.

Apart from the mnemonics and a few adverse effects, I remember very little from the 2-3 pages of FA describing the antiarrhythmics.
 
Dave89 said:
You may be overestimating how much basic science is utilized on the floors. Apart from random pimp questions, thinking shifts from mechanisms and biochemistry to broader, algorithm-like approaches.

Apart from the mnemonics and a few adverse effects, I remember very little from the 2-3 pages of FA describing the antiarrhythmics.
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The adverse effects and such are what I'd figure you'd get used to thinking about on the floor, as well as just getting used to what belongs to what class, and that's what has been killing me. I'm getting better at it, but the sheer volume of drugs still leaves me mixing them up sometimes.
 
Mad Jack said:
The adverse effects and such are what I'd figure you'd get used to thinking about on the floor, as well as just getting used to what belongs to what class, and that's what has been killing me. I'm getting better at it, but the sheer volume of drugs still leaves me mixing them up sometimes.
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If you make an active effort to, sure. But I don't recall ever having thought about moricizine, flecainide, and propafenone on the floors.

Good resources for pharm (besides UWorld) are the FA sections, Kaplan videos, and Lange Pharmcards.
 
Dave89 said:
If you make an active effort to, sure. But I don't recall ever having thought about moricizine, flecainide, and propafenone on the floors.

Good resources for pharm (besides UWorld) are the FA sections, Kaplan videos, and Lange Pharmcards.
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Yeah, I've got everything. But bulk memorization has always been my weakness- trying to get past that. I'm scoring like 75%+ in physio but barely breaking 60% on pharm on Kaplan. Hoping UWorld isn't nearly as bad once I hit it next week.
 
Mad Jack said:
I feel like it would help, given that you'll be much more familiar with many of the things like cardiac drugs etc that you're forced to memorize in med school but you actually use on a day-to-day basis on the wards. You'll probably get a better score, but honestly I'm kind of glad to be rid of this exam before third year so it's one less thing I have to worry about.
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Dave89 said:
You may be overestimating how much basic science is utilized on the floors. Apart from random pimp questions, thinking shifts from mechanisms and biochemistry to broader, algorithm-like approaches.

Apart from the mnemonics and a few adverse effects, I remember very little from the 2-3 pages of FA describing the antiarrhythmics.
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What kind of information is exactly needed to be successful on the wards? Would not having taken step 1 before M3 clinical rotations put you at a significant disadvantage when being pimped or being on the same page as the medical team on the wards?

Thank you!
 
flyinglantern22 said:
What kind of information is exactly needed to be successful on the wards? Would not having taken step 1 before M3 clinical rotations put you at a significant disadvantage when being pimped or being on the same page as the medical team on the wards?

Thank you!
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Not having taken the test? No.

Not having studied the material as though you were taking the test before clinicals? Yes.
 
flyinglantern22 said:
What kind of information is exactly needed to be successful on the wards? Would not having taken step 1 before M3 clinical rotations put you at a significant disadvantage when being pimped or being on the same page as the medical team on the wards?

Thank you!
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Honestly, what's required for success on the wards varies depending on how the rotation is set up. However, in general basic science rarely comes up. It's usually guidelines about clinical indications and management. Things like CHADS2Vasc, lights criteria, Centor criteria, etc. get asked a lot. You also get strange trick management questions about somewhat controversial stuff like "what is the role of bicarbonate in the management of rhabdomyolysis?"

I honestly would have found minimal value in having clinically before step 1.
 
sloop said:
Honestly, what's required for success on the wards varies depending on how the rotation is set up. However, in general basic science rarely comes up. It's usually guidelines about clinical indications and management. Things like CHADS2Vasc, lights criteria, Centor criteria, etc. get asked a lot. You also get strange trick management questions about somewhat controversial stuff like "what is the role of bicarbonate in the management of rhabdomyolysis?"

I honestly would have found minimal value in having clinically before step 1.
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Well, Step 1 is becoming a more and more clinically-oriented test. Take imaging modalities, for instance. Prior to clinicals, I didn't recognize the importance of "ideal" tests for specific diseases (e.g., U/S for hepatobiliary imaging and CT for urolithiasis). I mostly glossed over this stuff in studying for Step 1, placing more emphasis on mechanisms, physiology, etc. Naturally, I got a Q on the real thing asking which imaging was the most appropriate next step. So, I can see where clinicals would help in light of the direction in which the test is going. I just don't understand how students revisit the biochem, anatomy, etc. after a year away from them.
 
Dave89 said:
Well, Step 1 is becoming a more and more clinically-oriented test. Take imaging modalities, for instance. Prior to clinicals, I didn't recognize the importance of "ideal" tests for specific diseases (e.g., U/S for hepatobiliary imaging and CT for urolithiasis). I mostly glossed over this stuff in studying for Step 1, placing more emphasis on mechanisms, physiology, etc. Naturally, I got a Q on the real thing asking which imaging was the most appropriate next step. So, I can see where clinicals would help in light of the direction in which the test is going. I just don't understand how students revisit the biochem, anatomy, etc. after a year away from them.
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Yeah, and I got a question on what cleaning solution to use to clean an OR after a specific patient.

My point is that there will always be a few esoteric questions that may be beyond the scope for most students. Regardless of whatever question stumped you on your test, recall bias does not change the fact that Step 1 really is not that clinically focused a test. It is mostly a pathology test, to be honest. For the one question on lights criteria you might get right on step 1, you are also an extra year out from when you really learned the mechanisms of the anti-rheumatic drugs or the histopathological appearance of ependymoma and Burkitt's lymphoma.

I'm sorry, but having taken this test it is very difficult for me to see how the benefits of having rotations would outweigh the costs. Many, many people have just studied the three resources almost all med students use (UWorld, FA, Pathoma) and done very well on this test—well enough not to close any doors for residency. This would indicate that being exposed to the testable material is not the rate limiting step here.
 
sloop said:
Yeah, and I got a question on what cleaning solution to use to clean an OR after a specific patient.

My point is that there will always be a few esoteric questions that may be beyond the scope for most students. Regardless of whatever question stumped you on your test, recall bias does not change the fact that Step 1 really is not that clinically focused a test. It is mostly a pathology test, to be honest. For the one question on lights criteria you might get right on step 1, you are also an extra year out from when you really learned the mechanisms of the anti-rheumatic drugs or the histopathological appearance of ependymoma and Burkitt's lymphoma.

I'm sorry, but having taken this test it is very difficult for me to see how the benefits of having rotations would outweigh the costs. Many, many people have just studied the three resources almost all med students use (UWorld, FA, Pathoma) and done very well on this test—well enough not to close any doors for residency. This would indicate that being exposed to the testable material is not the rate limiting step here.
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I agree, and having taken it at the "traditional" time after two preclinical years, I'm also of the view that, in the words of Macbeth, "If it were done when 'tis done, then 'twere well it were done quickly."
 
No thanks, I wouldn't want the large stormy cloud that is step 1 over my head during third year.
 
sloop said:
I would have hated this, for a few reasons:

1. I did very well on Step 1, taken at the standard time. Delaying it would have just been one more thing hanging over me.
2. The prospect of this seems damned near unfeasable for a standard 2+2 curriculum. So you take Step 1 in like, what, May or June before your fourth year? You apply to ERAS September 15 (earlier if you're doing an early match specialty). This is not enough time, in my opinion, for students to really assimilate what their scores mean, get advised, adjust their plans accordingly, figure out what specialty and in what places to apply, apply to away rotations, find opportunities to enhance resumes if needed, etc.
3. You would have basically no "money in the bank" before clinical rotations. This would make third year incredibly stressful.
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Some really good points here. If a student goes into clinicals with a 260, (s)he has the freedom to look into fields like Derm, Ophtho, Rad Onc, Plastics, etc. And it would be prudent, because a high score opens doors in every specialty. Conversely, if a student falls in love with Derm on a rotation in 3rd year then has a "bad" day and gets a 235 (or discovers in the study period that (s)he is scoring in a low range), (s)he is stuck having to fall back on one of the "core" specialties or having to quickly do an elective in a not-so-competitive specialty.
 
I don't think the timing of step 1 is an issue worth changing your choice of med school over. If you take step 1 before clinical year, it will (marginally) help you know a few more things on the wards. If you have clinical year before step 1, it will (marginally) make it easier to remember certain step 1 topics.
 
Psai said:
I kinda like duke's system where they do a year of preclinical, a year of clinical then you have a year to do scholarly work. It makes it easy to score higher on step 1
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Wow, completing all the sciences in 1 year? This means that Duke's curriculum goes twice as fast?
 
sloop said:
I would have hated this, for a few reasons:

1. I did very well on Step 1, taken at the standard time. Delaying it would have just been one more thing hanging over me.
2. The prospect of this seems damned near unfeasable for a standard 2+2 curriculum. So you take Step 1 in like, what, May or June before your fourth year? You apply to ERAS September 15 (earlier if you're doing an early match specialty). This is not enough time, in my opinion, for students to really assimilate what their scores mean, get advised, adjust their plans accordingly, figure out what specialty and in what places to apply, apply to away rotations, find opportunities to enhance resumes if needed, etc.
3. You would have basically no "money in the bank" before clinical rotations. This would make third year incredibly stressful.
4. Students who fail step 1 could be supremely ****ed (more than they already are) because they would be rushing to retake and pass step 1, then take and pass step 2 in time for residency applications (delaying step 2 is not an option for these applicants). If not this, they would certainly need to do this to graduate.

Overall and from an administrative perspective, I just think that in a standard curriculum, taking step 1 any later than when most people take it now is a logistical nightmare waiting to happen.
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I think these are really good points to consider.

I'm going to preface this by saying that I am not in medical school yet and I'm only offering second-hand advice. That said, I did apply to FIU and discussed this curriculum with one of my best friends, who is just finishing up M4. In his case, he did not do nearly as well on Step 1 as he wanted/expected and he ended up having to depend on excellent performance during his 3rd year and a drastically improved score on Step 2 to get a residency he wanted. From what he told me, he was incredibly grateful for the time he had to process his Step 1 score and come up with a game-plan to salvage his residency application. His Step 1 score really lit a fire under his ass and kicked him into gear to honor his rotations third year and study his ass off for Step 2, and it ended up paying off for him. N=1, but it might be something to consider. From what he told me, I can't imagine getting a surprisingly low Step 1 score back and then taking Step 2 a month later, but I'm not in medical school yet so I'm not sure how unorthodox this actually is.
 
I'm starting next fall at UW SMPH, and our curriculum is changing for our class. I really like the direction they're taking it - one of the reasons I chose this school. We will have 1.5yr didactic, 2.5yr clinical. Step 1 will be after 1yr of clinical, so after 2.5yrs of school. I think this is a very reasonable compromise to allow us to benefit from the clinical experience and also have enough time to realistically plan for residency apps.
 
Mad Jack said:
Yeah, I've got everything. But bulk memorization has always been my weakness- trying to get past that. I'm scoring like 75%+ in physio but barely breaking 60% on pharm on Kaplan. Hoping UWorld isn't nearly as bad once I hit it next week.
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Less cooking, more grinding.
 
sloop said:
I've also definitely forgotten a lot of basic science stuff in a year. Third year may help for a question or two (mostly the odd management question that goes beyond basic science application) on step 1 but it will be very low yield for that test.
Click to expand...

So you're saying we're not going to be using any step 1 knowledge in real life? I was wondering why my phone has been auto correcting usmle to 'useless'...


Sent from my iPhone using SDN mobile
 
Let's see...my school has 1.5 yrs didactic -> 1 yr clinical -> Step 1 (Taken January of MS3) -> 6 months -> Step 2 -> MS4

I haven't taken the exam since I'm only a first year but I'll argue from a more statistical perspective.

Prior to the current curriculum my school's Step 1 average scores were several points below the national mean with Step 1 pass rates ranging from 95%-98% depending on year. Following the change, the school's average Step 1 scores were a few points above the national mean and with pass rates in the 97%-99% range depending on year. Not so bad in my book.
 
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