Step 1: now pass/fail!

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Macsoccer42 said:
Not true. Plenty of people in my class took step 2 without taking step 1 and had comlex etc so I am not sure how they did that but it definitely happened or they all lied lol either could be true.
Click to expand...
With the new legislation, step 1 is required to take step 2 CS.

Also, If you want to take step 3, you must take step 1 and step 2 CK,CS

Source: United States Medical Licensing Examination
source: United States Medical Licensing Examination | USMLE Bulletin | Eligibility
 
Last edited:
Scrizzy said:
Planning to attend a DO school this upcoming August. How f#%&ed am I?
Click to expand...

I don't know how the data of all of this is going to change.
I think the best thing to do in Med school hasn't changed: study hard, be a good person, learn to connect with patients, and learn from mentors.
Oh and take a couple of Xanax in the short term?
 
Shameless stolen from reddit
hk0k0big4kg41.png
 
Any idea when they'll release the year this will be enforced? That way maybe us class of 2024 people can stop freaking out lool
 
little_giant said:
Any idea when they'll release the year this will be enforced? That way maybe us class of 2024 people can stop freaking out lool
Click to expand...

If it does end up being implemented in 2022 as they say, then class of 2024 will be the first to take it as P/F (also class of 2023 that take step 1 after third year).
 
It is basically the “Empre Strikes Back”.

The main reason for going to Step 1 Pass/Fail is to correct the prevailing medical student culture of not going to classes, and study from their Timbuktu bedroom/ toilet from who knows where. That dysfunctional study habit engendered by the miss use of Step1 score over the past 15 years will be defund.

Now that professor /students traditional relationship in classroom will come back, especially in schools with traditional grading system.

Knowledge for Step2 is much important, and predictable, than the jumpy, esoteric Step1 knowledge. A good practicing physician will do better on Step2 than Step1 any day.

Step2 score usually jumps 10 points from Step1 now a day. But as import of Step2 exam is elevated, USMLE can certainly make it more differentially tougher.

Top rank schools are not necessarily the winners.

The winners are the top rank school that UNDERPERFORM in Step1, AND low ranking schools that OVER-PERFORM in clinical Step2. There are legions of schools that belong to former and latter.

IMG with great clinical background and done good research here in US are not necessarily hampered. They might be de-shackled from restudying the basic Step1 they haven’t visited many blue moons ago.

Top schools with research offering, students bolster the school reputation with solid Step2, will remain, top dogs, as usual.

Every school will review their curriculum to reflect this new reality. Many will move to pre-clinical/Step1, clinical/Step2, research year model.

Overall. Step1 Pass/Fail is in the right direction.

Empire Strikes Back !
 
my prediction is that 1-2 years from now GME will respond with whatever changes they will make to their process to accommodate the Step 1 scoring system to be rolled out when the P/F Step examinees begin to prepare for ERAS (so probably around 2023-25). Whatever those changes are I hope everyone remembers that GME would have done ABSOLUTELY NOTHING if their hand was not forced in this way and as evidence I offer up all of recorded history. GME reforms have almost always responded to pressure from the bottom up when something GME was doing began to negatively impact UME.

thesheriffofsodium.com

The Match, Part 1: Why do we have a Match?

Not long ago, I interviewed an applicant for our residency program. She explained how, after each one of her interviews, her grandmother calls her and excidedly asks whether she got the job. &#8220…
thesheriffofsodium.com thesheriffofsodium.com
 
I feel like us incoming MD/PhD folks are going to get screwed where there will likely be curriculum changes during our PhD years so coming back for M3/M4 will be a **** show. If our school is true P/F for the first 1.5 years but then changes to grading while we are doing our PhD, do you think they would have to uncover our grades or something?
 
After the internet melting down yesterday I'm actually starting to see all the positives.

I can actually pay attention to lecture material now and focus on learning instead of focusing on cramming for Step 1.

This is a big step in the right direction. I hope there is an equalizer for students from lower ranked medical schools however.

I also hope the AACOM and ACGME does some gatekeeping for DO residency slots to combat PD directors using degree as a screen for residency apps.
 
Cherry1997 said:
I feel like us incoming MD/PhD folks are going to get screwed where there will likely be curriculum changes during our PhD years so coming back for M3/M4 will be a **** show. If our school is true P/F for the first 1.5 years but then changes to grading while we are doing our PhD, do you think they would have to uncover our grades or something?
Click to expand...

I am wondering if many places will switch to a preclinical-PhD-clinical model again. From my understanding, a major reason for having 1 or 2 clerkships before Step 1 was to help scores. Now that Step 1 is P/F and Step 2 matters more, perhaps they will just have us start core clerkships after PhD? Either that or the clinical experiences during graduate school will have to be buffed up.

At any rate, there is all of our first year for PDs to figure this out, and if major changes to the post-PhD phase are made, PDs will have several years to figure that out before their choices affect us
 
SeaHusky said:
If STEP2 CK suddenly has increased emphasis, my primary concern is how we're essentially moving our primary barometer of competitiveness for specialties/programs so much closer to the residency application deadline (unless I'm misreading the schedule).
Click to expand...

The hot new trend has been placing Step 1 at the end of M3, which leads to the same dilemma.

It's not a mystery who scores well on Step 1. It's the same people who score >90% on every in-house exam and perform strongly on the NBME/UWorld self-assessment exams. We can identify almost all of them in less than a semester.
 
Sunbodi said:
After the internet melting down yesterday I'm actually starting to see all the positives.

I can actually pay attention to lecture material now and focus on learning instead of focusing on cramming for Step 1.
Click to expand...

That's nice to hear. For the past year or so I was contemplating going back into private practice because the education side has gotten so bad. I came in thinking I would help educate new generations of physicians, but our roles had largely devolved into running a giant USMLE prep course. That's not how I want to spend my life, so I'm glad there will now be an opportunity for positive change.

Sunbodi said:
This is a big step in the right direction. I hope there is an equalizer for students from lower ranked medical schools however.
Click to expand...

It's called Step 2CK and audition rotations. While not true for certain competitive fields, overall there are more residency positions than US grads, and the match rate has remained steady at 94% for many years. The landscape will evolve, but doors aren't suddenly going to slam shut just because one three digit score disappears.
 
Med Ed said:
The hot new trend has been placing Step 1 at the end of M3, which leads to the same dilemma.

It's not a mystery who scores well on Step 1. It's the same people who score >90% on every in-house exam and perform strongly on the NBME/UWorld self-assessment exams. We can identify almost all of them in less than a semester.
Click to expand...
Is this the case for Step 2 CK however? Students tend to score better on Step 2 CK.

Many students who scored poorly on Step 1, also ended up scoring higher on Step 2 CK indicating the exam is easier in comparison and not based on inherent test taking ability.
 
Sunbodi said:
Many students who scored poorly on Step 1, also ended up scoring higher on Step 2 CK indicating the exam is easier in comparison and not based on inherent test taking ability.
Click to expand...

The 2018 data shows that the 1st time failure rate on Step 1 was 4%, and on Step 2 CK it was 3%. Considering that some people never make it to M3 the overall failure distributions on the two exams are very similar. The mean on Step 2 CK is higher, but that does not necessarily indicate the exam is inherently easier. We can't ignore the fact that students take Step 2 CK (a test of clinical knowledge) after spending a year immersed in clinical practice environments. You get the question right on what imaging study to use for lower back pain because you saw a patient with lower back pain and you remember what imaging study was ordered (and why). In that regard it has always been more logical to use Step 2 CK scores preferentially for resident selection, and now everyone will have to.
 
Med Ed said:
The 2018 data shows that the 1st time failure rate on Step 1 was 4%, and on Step 2 CK it was 3%. Considering that some people never make it to M3 the overall failure distributions on the two exams are very similar. The mean on Step 2 CK is higher, but that does not necessarily indicate the exam is inherently easier. We can't ignore the fact that students take Step 2 CK (a test of clinical knowledge) after spending a year immersed in clinical practice environments. You get the question right on what imaging study to use for lower back pain because you saw a patient with lower back pain and you remember what imaging study was ordered (and why). In that regard it has always been more logical to use Step 2 CK scores preferentially for resident selection, and now everyone will have to.
Click to expand...

I dunno... That sure is some logic and I was planning on just emotional hysteria and an assumption that I was gonna score a 270.
 
As someone entering M1 this coming August, can my school change its curriculum and grading policies before we start or even during the 4 years?
 
Sunbodi said:
Is this the case for Step 2 CK however? Students tend to score better on Step 2 CK.

Many students who scored poorly on Step 1, also ended up scoring higher on Step 2 CK indicating the exam is easier in comparison and not based on inherent test taking ability.
Click to expand...

i wouldnt say easier, i was just better prepared for CK. Things made sense from a clinical perspective. It all had context finally. Preparing for shelf exams greatly helped as well.
 
Jokes on all the schools that stopped mandatory classes and have online lectures.

I can't help but laugh because I'll be vacationing every month now listening to lectures in the Bahamas.
 
Sunbodi said:
Jokes on all the schools that stopped mandatory classes and have online lectures.

I can't help but laugh because I'll be vacationing every month now listening to lectures in the Bahamas.
Click to expand...
Online lectures are fine as long as you keep up with it. My school got rid of lectures after my class, but they have mandatory stuff 3-4 days a week.
 
While I can definitely see the pros of this, to me the cons outweigh them immensely. In effect, the MCAT just became more important than step 1: good luck to all the mid/low tier MDs, DOs, and IMGs. While the MCAT was the great equalizer for people (like me) who went to practically unknown undergrads, that is no longer an option for medical students applying to residency. So what's going to set you apart now--research you're not particularly interested in? Variable and completely subjective clinical year 3 grades? School prestige? The rat race of unofficial checkboxes we saw in undergrad to med school (that I personally loathed) just got extended three years and upward mobility just became a lot harder for those not at T25s.
For many, this will affect the decision on where to attend in unhealthy ways: possible having to choose between wellness and familiarity (i.e. lower ranked state schools) and higher ranked schools in cities you don't particularly enjoy just to keep the doors open for competitive specialties. Like I've seen elsewhere, I feel like this will continue to make medicine an "old boys club." Even if it does get rid of the wellness barrier of overvaluing step 1 scores, now step 2 will become the make-or-break test. It just doesn't make sense. Bad move, NBME.
 
I've read every post on this thread, but I haven't found the answer to my question:
The prediction is that MCAT will be weighed much more heavily for future applicants who will be applying 2020 cycle and beyond. But what about for those in the current cycle who are waitlisted? MCAT was a huge predictor of how one will do on step 1, but since step 1 is now P/F, do you think MCAT scores will be weighed less now for those who are waiting to get off of a waitlist? Obviously this is all hypothesizing but I'm curious to see what yall think.
 
alwayseating said:
I've read every post on this thread, but I haven't found the answer to my question:
The prediction is that MCAT will be weighed much more heavily for future applicants who will be applying 2020 cycle and beyond. But what about for those in the current cycle who are waitlisted? MCAT was a huge predictor of how one will do on step 1, but since step 1 is now P/F, do you think MCAT scores will be weighed less now for those who are waiting to get off of a waitlist? Obviously this is all hypothesizing but I'm curious to see what yall think.
Click to expand...
Doubt it will change because from what people have said is that Step 2 CK will become the new measurement and the biggest predictor of Step 2 CK was Step 1 and the biggest predictor of Step 1 was the MCAT.
 
AmericanArthurDent said:
While I can definitely see the pros of this, to me the cons outweigh them immensely. In effect, the MCAT just became more important than step 1: good luck to all the mid/low tier MDs, DOs, and IMGs. While the MCAT was the great equalizer for people (like me) who went to practically unknown undergrads, that is no longer an option for medical students applying to residency. So what's going to set you apart now--research you're not particularly interested in? Variable and completely subjective clinical year 3 grades? School prestige? The rat race of unofficial checkboxes we saw in undergrad to med school (that I personally loathed) just got extended three years and upward mobility just became a lot harder for those not at T25s.
For many, this will affect the decision on where to attend in unhealthy ways: possible having to choose between wellness and familiarity (i.e. lower ranked state schools) and higher ranked schools in cities you don't particularly enjoy just to keep the doors open for competitive specialties. Like I've seen elsewhere, I feel like this will continue to make medicine an "old boys club." Even if it does get rid of the wellness barrier of overvaluing step 1 scores, now step 2 will become the make-or-break test. It just doesn't make sense. Bad move, NBME.
Click to expand...

Not just the MCAT, but having to be essentially flawless from the young age of 17/18 forward.

I bombed undergrad and even with years of remediation and a 99th/100th percentile MCAT I still struggled this cycle with low tier MDs. Obviously this is n=1, and wouldn't be the case for everyone but it certainly is an uphill battle if you slip up.

Like I've stressed before, hopefully the new meta quickly becomes Step 2CK rather than school name. Personally I would see that as an improvement over the Step 1 metric, but I'm still 'scared' of being part of this transition period.
 
Last edited:
AnonymousDoctorGuyPerson said:
Not just the MCAT, but having to be essentially flawless from the young age of 17/18 forward.

N= 1. I bombed undergrad and even with years of remediation and a 99th/100th percentile MCAT I still struggled this cycle with low tier MDs.

Like I've stressed before, hopefully the new meta quickly becomes Step 2CK rather than school name. Personally I would see that as an improvement over the Step 1 metric, but I'm still 'scared' of being part of this transition period.
Click to expand...
It will be step 2 CK and everyone will essentially be required to take it before residency apps.

A student from a T20 without a Step 2 CK will not be weighed higher than a student from a mid/low tier with a high Step 2 CK. In fact, not taking it will be a shot to the foot moving forward.
 
Sunbodi said:
It will be step 2 CK and everyone will essentially be required to take it before residency apps.

A student from a T20 without a Step 2 CK will not be weighed higher than a student from a mid/low tier with a high Step 2 CK. In fact, not taking it will be a shot to the foot moving forward.
Click to expand...
There's a podcast released on the 12th where they specifically discussed that CK will be "the new Step 1" (sic) so there's that. But I wanna know when people usually do take it currently? I've heard people say they take it right before or concurrently with residency apps.
 
ReturnToMed said:
As someone entering M1 this coming August, can my school change its curriculum and grading policies before we start or even during the 4 years?
Click to expand...
Seriously doubt that, at least for the former At least in my experience, it takes 2-3 three years to pull off a curriculum change. But even grading changes involve endless discussions among the Faculty and deans! That might be pulled off sooner.

I doubt that the trend towards H/F or H/P/F will be reversed, because we like the idea of student not being stressed. Class rank will always be there, because we have your exam scores even though your grades only end up H/P/F or P/F.

Why would a curriculum change just because Step I is P/F?
 
Goro said:
Why would a curriculum change just because Step I is P/F?
Click to expand...

I’ve heard speculation that this might lead to schools shortening the preclinical years (which is already a trend, to be fair) so that students can begin clerkships earlier, and thus take Step 2 CK earlier. But of course this is just speculation.

One thing I noticed on the interview trail was that certain schools heavily emphasized how they’ve integrated step 1 prep into their curriculums, often due to student feedback. I can’t help but imagine this will begin to be less of a trend going forward.
 
tessellations said:
I’ve heard speculation that this might lead to schools shortening the preclinical years (which is already a trend, to be fair) so that students can begin clerkships earlier, and thus take Step 2 CK earlier. But of course this is just speculation.

One thing I noticed on the interview trail was that certain schools heavily emphasized how they’ve integrated step 1 prep into their curriculums, often due to student feedback. I can’t help but imagine this will begin to be less of a trend going forward.
Click to expand...
Please correct me if I'm wrong, but my understanding was that the 1.5 year pre-clinical program was geared specifically to get more people into Primary Care?

I agree that schools can drop the Step I prep spiel, and now focus on pitching how well they'll teaching you in clinical years, for Step II
 
Goro said:
Please correct me if I'm wrong, but my understanding was that the 1.5 year pre-clinical program was geared specifically to get more people into Primary Care?

I agree that schools can drop the Step I prep spiel, and now focus on pitching how well they'll teaching you in clinical years, for Step II
Click to expand...
I know certain schools (like VCU) that aren't geared towards matching students into primary care (e.g. NYU Langone) have an 18-month curriculum to get students into M3 year earlier.
 
FutureSurgical said:
I know certain schools (like VCU) that aren't geared towards matching students into primary care (e.g. NYU Langone) have an 18-month curriculum to get students into M3 year earlier.
Click to expand...

Downstate also has an 18 month pre-clin curriculum with copious clinical exposure from day 1, and I wouldn't say their focus is primary care either.
 
AnonymousDoctorGuyPerson said:
Downstate also has an 18 month pre-clin curriculum with copious clinical exposure from day 1, and I wouldn't say their focus is primary care either.
Click to expand...
Definitely a trend schools have begun adapting in the past decade to reduce the length of pre-clinical, and not necessarily for a PC focus. Michigan and Harvard for example have all reduced preclinical down to ~1 year with 3 years of clinical and career exploration.

Sent from my SM-G973U using SDN mobile
 
When is step 2ck taken by the students. M3 or M4?. With step 2 ck coming to play will that change dynamics of when we should take.
 
DevinBookerMD said:
Can anyone tell me if this should change the school I pick? Deciding between UCI, BU, Einstein, and stony brook. On the waitlist for Keck. Is there a difference in prestige at any of these? I was going to pick UCI before this news fwiw.
Click to expand...


confusing for sure. on one hand, you may have been choosing UCI to save money if you’re instate. Seems crazy to select Keck just for ranking when it would cost you a lot more.
 
Excellent multiple choice takers (I’m one) hardest hit. There was never a level playing field. Your 250 from Podunk U did not make you even with a 240 from Harvard. And the people who go to Harvard were always more likely to get the 250+ anyway.

On the bright side, there are not enough Harvard grads to fill all the residencies that you want. And there’s really no reason why orthopedics or dermatology needs to be practiced by only those medical students with the highest level of skill at minutiae recall and bubble filling. Highly desired specialties aren’t especially reliant on great recall of biochem pathways. What if people could sort themselves into specialties based on their interests and aptitudes? Maybe there will develop some specialty tests designed to measure specialty-relevant characteristics, we’ll see. Actual clinical performance in the field you’re interested in will be more important -probably good. Subjective doesn’t mean random - top students already pulling top quality clinical grades across the board, when I’m reviewing applications.

Anyway there are always unintended consequences and winners and losers when change happens, but the step 1 situation was untenable and unsustainable and had to change some kind of way.
 
You must log in or register to reply here.

Similar threads

hommefatale
Elective Class Pass/Fail
Replies
3
Views
367
Goro
Goro
jakewagmin
Should I pass/fail physics for higher gpa?
Replies
4
Views
398
LunaOri
LunaOri
myribosomesbad
Pass/Fail
Replies
7
Views
1K
Sandman23
S
LMAGZ
Pass/Fail Medical Schools in Texas
Replies
2
Views
2K
wysdoc
wysdoc
dlrs123
  • Question Question
Any way to see school specific Step 1 pass rates?
Replies
1
Views
2K
Hollow Knight
Hollow Knight
Top