While I would agree that some people are prepared to take Step 1 at the very end of 2nd year, many are not. 1st and 2nd year you are learning things for the first time, and let's face it, you learn it the way the specific professor teaches it and tests it. You don't learn it the way you should learn it and more importantly the way the boards tests it. On top of that you are learning 3-4 subjects at once!!! Then you only get a month and half (if even) to prepare and take the boards. And ALL schools have crap that no one likes in reality but does in theory: PBL, PPS (Patient, Physician Society), yada yada yada.
But yes, I agree with the above poster, that UPenn's scores are phenomenal for possibly that very reason. Also one of the threads on SDN in which people filled out that "31 Question" survey. Those in which Step 1 was taken without a school imposed deadline, the Step 1 average was naturally higher (230s even), while those that did not, the average was close to the national average (218).
Well, Penn's entering med students tend to have very high MCAT scores, so we know that they're good at taking standardized tests. It's hard to tell (at this point) how much it matters.
After being on the wards, I honestly don't believe in the argument that clinical experience helps with Step 1. I can barely remember some stuff that I
KNEW for Step 1 - like, for example, how dislocated lenses is part of Marfan's syndrome. Trying to remember that on my current ophtho rotation was like digging back in a messy sock drawer. And none of the stuff that I see routinely on my rotations were on Step 1.
Penn only gives you a month to prepare for Step 1, I believe. It's not like your resident will let you out of the rotation early because you need to study for Step 1. Plus you need to study for your shelf exam while you're ON the rotation, so that cuts into your step 1 study time as well.
I'm not sure if you should make sweeping generalizations about how you "learn" things in med school until you're here. In 2nd year, especially, we didn't learn things the way that a "professor taught them." We learned things the way we were expected to know stuff on the wards.
It's a hard dilemma - if a school teaches towards the wards, it can't teach towards Step 1. If it teaches towards Step 1, it leaves its students woefully underprepared for the wards. It's tough.
A month and a half (six weeks) is a LOT of time to study only for the boards. Your stamina will only hold out for so long. Five weeks is what a lot of people take; 6-7 weeks if they are really masochistic.
Don't use this to decide between schools. It is truly not important. How well you prepare for step 1, regardless of your school, will
ALWAYS come down to how well YOU prepare for it. Always.