Step 1 now will be P/F

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GravelRider said:
So you’re agreeing with me that memorizing the Kreb’s cycle for Step 1 is pointless, right? Because the current system doesn’t seem to be working as you are implying. I’m not saying that information is not important, I am saying how that information is taught and how that knowledge is measured is antiquated.
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You could say the same about organic chemistry, or physics, or calculus, or any other hard undergraduate science class that's a medical school prerequisite.

I'll be honest, I couldn't draw the Krebs Cycle if you put a gun to my head, but learning that detail ages ago is part of the foundation and perspective that makes us what we are.

Also, there really is value in making people do something hard, even grueling, even if it's a little bit pointless, to screen out people who can't or won't commit to doing difficult stuff they don't think is very important. How much of our actual jobs are useless but necessary tedium (looking at you, EMR and narcotics accounting and annual mandatory workplace violence training). The actual day-to-day knowledge isn't critical, but the character traits that made it possible to crush Step 1 certainly are.

You can be a reasonably safe, reasonably proficient anesthesiologist just by following cookie-cutter protocols. Is that where we really want the bar to be set?

Check out some of the old threads here about the oral exam. Those threads are saturated with people complaining about that exam and how it should be abolished. Their arguments are mostly without merit IMO, but the one thing they do get sorta right is that it can be a very subjective exam. Now we want to add more subjectivity to the process?

The solution to fix a terrible exam with outsized career consequences is to fix the content on the exam, not to quit grading it.


As a side note, this is catastrophic for FMGs and especially IMGs. Now Caribbean grads have no way to prove that their poor decision to attend a Caribbean school was an anomaly. Why would any PD ever take a chance on them without superstar Step 1 score to indicate they have some potential?
 
pgg said:
You could say the same about organic chemistry, or physics, or calculus, or any other hard undergraduate science class that's a medical school prerequisite.

I'll be honest, I couldn't draw the Krebs Cycle if you put a gun to my head, but learning that detail ages ago is part of the foundation and perspective that makes us what we are.

Also, there really is value in making people do something hard, even grueling, even if it's a little bit pointless, to screen out people who can't or won't commit to doing difficult stuff they don't think is very important. How much of our actual jobs are useless but necessary tedium (looking at you, EMR and narcotics accounting and annual mandatory workplace violence training). The actual day-to-day knowledge isn't critical, but the character traits that made it possible to crush Step 1 certainly are.

You can be a reasonably safe, reasonably proficient anesthesiologist just by following cookie-cutter protocols. Is that where we really want the bar to be set?

Check out some of the old threads here about the oral exam. Those threads are saturated with people complaining about that exam and how it should be abolished. Their arguments are mostly without merit IMO, but the one thing they do get sorta right is that it can be a very subjective exam. Now we want to add more subjectivity to the process?

The solution to fix a terrible exam with outsized career consequences is to fix the content on the exam, not to quit grading it.


As a side note, this is catastrophic for FMGs and especially IMGs. Now Caribbean grads have no way to prove that their poor decision to attend a Caribbean school was an anomaly. Why would any PD ever take a chance on them without superstar Step 1 score to indicate they have some potential?
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Exactly!!! Like it or not, programs need residents who can perform on high stakes examinations. While their ability to retain the Krebs cycle minutia won’t save a life, the ability to learn and rapidly recall other information (like the toxic dose of local anesthetics, signs of malignant hyperthermia, understanding the alveolar gas equation) will make a difference in patient outcomes. How many times do you come into a CRNA room and find the ETCO2 is 22. Why do we adjust the ventilation at this point? Because we’ve been told 35 is a “better number”? Or because we want to avoid cerebral vasoconstriction and hypoperfusion?
We need some comparative measure of medical students ability to learn, retain and demonstrate knowledge in high pressure situations. In a culture of grade inflation and schools stuck in patterns of self promotion desperately pushing to get each student to match (the lowest class rank from most schools MSPE’s is classified with “very good”). How do we wade through a sea of grade inflation or find excellent candidates from some of the mid to low tier schools to find talented applicants?
This is bad for students as well. The wards are now going to be more cutthroat as gunners grab the only available currency left, the rotation honors.

I think (almost) everybody loses in this new scenario. anybody want to startup another step 2 Q bank company with me in hopes of early retirement? 🙂
 
So when do we expect Step 2 to replace Step 1 in importance? 2021 match or will PDs keep using Step 1 as long as they can.
 
The 95% SEE on the steps is a range of 32 points. Basically, your score can differ drastically based on what form the NBME gives you to take (this is probably the reason you anecdotally hear about med students getting a much better or worse score compared to practice exams). These data are partially behind NBME’s opposition to their use in resident selection. If you truly want to distinguish applicants, you need a much more precise tool.

Programs use these scores with cutoffs in practice. Falling bellow it gets your app tossed in the reject pile (for what is essentially luck on exam day. 220 you are out. 232 you are in).
 
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Consequently, I'm LOVING all the memes coming out regarding this.

31pcdl44f3h41.jpg
 
ucladoc2b said:
Programs use these scores with cutoffs in practice. Falling bellow it gets your app tossed in the reject pile (for what is essentially luck on exam day. 220 you are out. 232 you are in).
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If you were that close to making or missing the cutoff, the obvious solution is to be that much better than the cutoff that luck plays no role whatsoever.


It is what it is and life isn't fair, but changing step 1 to P/F is a step in the wrong direction for medical students. Now instead of being sorted based on your Step 1 score, you will be sorted based on the name of your medical school. Hope you ended up at a good one!
 
Mman said:
If you were that close to making or missing the cutoff, the obvious solution is to be that much better than the cutoff that luck plays no role whatsoever.
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I think i scored around 215 on Step 1 a little less on Step 2 and passed CS.
I think i'm an above average anesthesiologist nonetheless.
The system is what it is but clearly having great Step scores doesn't make you a better doctor (plenty of examples in competitive specialties).
 
dhb said:
I think i scored around 215 on Step 1 a little less on Step 2 and passed CS.
I think i'm an above average anesthesiologist nonetheless.
The system is what it is but clearly having great Step scores doesn't make you a better doctor (plenty of examples in competitive specialties).
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And a 215 won't keep you out of Anesthesiology but it may, I stress may, keep you from Matching at MGH, BW, UCSF, Duke, etc. It also may keep you from matching into ORTHO which IMHO you probably really only need a 185 score from what I have seen over my 3 decades.
 
BLADEMDA said:
And a 215 won't keep you out of Anesthesiology but it may, I stress may, keep you from Matching at MGH, BW, UCSF, Duke, etc. It also may keep you from matching into ORTHO which IMHO you probably really only need a 185 score from what I have seen over my 3 decades.
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Is this sarcasm?
 
dhb said:
I think i scored around 215 on Step 1 a little less on Step 2 and passed CS.
I think i'm an above average anesthesiologist nonetheless.
The system is what it is but clearly having great Step scores doesn't make you a better doctor (plenty of examples in competitive specialties).
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I don't think anybody was arguing a Step 1 score was a career defining score. But it is relevant for the residency application process and has some meaning to it and is a useful tool for screening an applicant pool that can be too large to process otherwise. It is also helpful to students to provide them with a level playing field across different schools to try to stand out from peers elsewhere.
 
dhb said:
I think i scored around 215 on Step 1 a little less on Step 2 and passed CS.
I think i'm an above average anesthesiologist nonetheless.
The system is what it is but clearly having great Step scores doesn't make you a better doctor (plenty of examples in competitive specialties).
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The content of Step 1 is not necessary what anesthesiologists use on a daily basis, but this exam does test grit. I am a believer that there is a difference between knowing a lot and being smart. Step 1 tests how much you know, not necessarily how smart you are. This means that people that put in more effort will do better. Although I do not have any data to support this, anecdotally, people that do well on step 1 tend to also be harder workers and that's why they tend to become stronger residents. It is all about work ethics in residency and having the willingness to learn.

Of course, there are exceptions. I was surprised to find out recently that a senior resident that was touted as the strongest resident in the class (also had great ITE and went to a great fellowship) had weak step scores.
 
JiPo said:
The content of Step 1 is not necessary what anesthesiologists use on a daily basis, but this exam does test grit. I am a believer that there is a difference between knowing a lot and being smart. Step 1 tests how much you know, not necessarily how smart you are. This means that people that put in more effort will do better. Although I do not have any data to support this, anecdotally, people that do well on step 1 tend to also be harder workers and that's why they tend to become stronger residents. It is all about work ethics in residency and having the willingness to learn.

Of course, there are exceptions. I was surprised to find out recently that a senior resident that was touted as the strongest resident in the class (also had great ITE and went to a great fellowship) had weak step scores.
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Maybe that individual just wasn't that motivated to "crush" Step 1. For example, my ITE scores were marginal during CA1 and CA2 years. I barely passed the ITE in my CA3 year. But, when it came time for the real exam my score was stellar. I was highly motivated to crush the real exam.

So, please don't discount motivation and hard work when preparing for these types of exams. I think keeping Step 2 "scored" is a good idea and will preserve the ability for lower tier US MD students, DOs and IMGs to get a fair shot at all the specialties. These days getting into a top med school is just as much about "social justice" as it is merit. Many DO students today would be admitted to MD schools a decade or two ago. Step 2 preserves the opportunity for those outstanding students to prove their worth to residency program directors.
 
Just wanted to say thanks for the thoughtful posts throughout this thread. A lot of authentic insight and a reasonable, honest, and mature discussion.
 
nimbus said:
Agree with most of your post but that part is just not true. The top schools still have top scoring incoming classes.


US Medical Schools: MCAT Scores and GPA

Average MCAT scores and premed GPA required for US medical schools admissions.
www.mcattestscores.com
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while that is true, it's also true that they don't admit plenty of people with test scores well above their average because they are taking quite a few with scores well below their average
 
pgg said:
You could say the same about organic chemistry, or physics, or calculus, or any other hard undergraduate science class that's a medical school prerequisite.

I'll be honest, I couldn't draw the Krebs Cycle if you put a gun to my head, but learning that detail ages ago is part of the foundation and perspective that makes us what we are.

Also, there really is value in making people do something hard, even grueling, even if it's a little bit pointless, to screen out people who can't or won't commit to doing difficult stuff they don't think is very important. How much of our actual jobs are useless but necessary tedium (looking at you, EMR and narcotics accounting and annual mandatory workplace violence training). The actual day-to-day knowledge isn't critical, but the character traits that made it possible to crush Step 1 certainly are.

You can be a reasonably safe, reasonably proficient anesthesiologist just by following cookie-cutter protocols. Is that where we really want the bar to be set?

Check out some of the old threads here about the oral exam. Those threads are saturated with people complaining about that exam and how it should be abolished. Their arguments are mostly without merit IMO, but the one thing they do get sorta right is that it can be a very subjective exam. Now we want to add more subjectivity to the process?

The solution to fix a terrible exam with outsized career consequences is to fix the content on the exam, not to quit grading it.


As a side note, this is catastrophic for FMGs and especially IMGs. Now Caribbean grads have no way to prove that their poor decision to attend a Caribbean school was an anomaly. Why would any PD ever take a chance on them without superstar Step 1 score to indicate they have some potential?
Click to expand...

I actually think the anesthesia boards are a good example of an exam done reasonably well. The oral boards are a chance to demonstrate true understanding without necessarily needing to memorize trivial facts. I can still remember my oral boards questions and answers years later. I can’t say the same thing about Step 1. I forgot that nonsense the exact minute I walked out of that exam. When I think about the time spent leading up to that exam, something doesn’t add up for me.

Then again, I think medical school should be shortened to 3 years and every single person should do a real internal medicine internship for a year.
 
A high step 1 score is predictive of your ability to perform well on future multiple choice exams (specialty boards). that’s it. That is why program directors value it so highly. Plenty of $hitty docs with high step scores and vice versa.....
 
GravelRider said:
I actually think the anesthesia boards are a good example of an exam done reasonably well. The oral boards are a chance to demonstrate true understanding without necessarily needing to memorize trivial facts. I can still remember my oral boards questions and answers years later. I can’t say the same thing about Step 1. I forgot that nonsense the exact minute I walked out of that exam. When I think about the time spent leading up to that exam, something doesn’t add up for me.

Then again, I think medical school should be shortened to 3 years and every single person should do a real internal medicine internship for a year.
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I too agree that the anesthesia oral exam has value. Of course, it's easy for me to be philosophical about that and my opinion there is a little shaded by the fact that I'm 10 years out of passing it on my first attempt. Its subjectivity didn't catch me on the wrong side of the error bars. 🙂

The stuff on Step 1 has little direct application to anything I actually do. I too crammed for it and flushed much of it the next day. But the qualities required to do well on it are desirable qualities in physicians.

And again, I have to go back to a different point - if the test is widely agreed to be terrible and irrelevant, the correct fix is to make it less terrible and more relevant, not to quit grading it. Going P/F doesn't fix any of its fundamental problems, but going P/F does have a bunch of undesirable second order effects.


Maybe we should have applicants take classic IQ tests. You know, an hour of answering questions like this:

Aj40r.jpg


Aptitude for actual problem solving isn't tested anywhere at all in the undergrad - med school - residency process. (Maybe some undergrad math and physicis courses.) Maybe we should. It's at least as useful as those stupid OSCEs they have people do now. I'd rather have a resident who's demonstrated clever problem solving skills over the ability to pretend to be empathetic to an actor when delivering bad news. If nothing else, the forum arguments over how pattern shift puzzles don't have any connection to propofol doses would be entertaining.

If I ran the USMLE, I would totally put logic puzzles on it.
 
pgg said:
I too agree that the anesthesia oral exam has value. Of course, it's easy for me to be philosophical about that and my opinion there is a little shaded by the fact that I'm 10 years out of passing it on my first attempt. Its subjectivity didn't catch me on the wrong side of the error bars. 🙂

The stuff on Step 1 has little direct application to anything I actually do. I too crammed for it and flushed much of it the next day. But the qualities required to do well on it are desirable qualities in physicians.

And again, I have to go back to a different point - if the test is widely agreed to be terrible and irrelevant, the correct fix is to make it less terrible and more relevant, not to quit grading it. Going P/F doesn't fix any of its fundamental problems, but going P/F does have a bunch of undesirable second order effects.


Maybe we should have applicants take classic IQ tests. You know, an hour of answering questions like this:

Aj40r.jpg


Aptitude for actual problem solving isn't tested anywhere at all in the undergrad - med school - residency process. (Maybe some undergrad math and physicis courses.) Maybe we should. It's at least as useful as those stupid OSCEs they have people do now. I'd rather have a resident who's demonstrated clever problem solving skills over the ability to pretend to be empathetic to an actor when delivering bad news. If nothing else, the forum arguments over how pattern shift puzzles don't have any connection to propofol doses would be entertaining.

If I ran the USMLE, I would totally put logic puzzles on it.
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Let me surprise you: in the US, IQ tests are illegal for most job selection purposes. That's populism/socialism/woke for you. You cannot discriminate against stupid people unless you PROVE that stupidity will interfere with their performance. The onus is on you as employer.

And that's why I support introducing serious Math or Physics PROBLEMS in medical school admission tests. Also why smart employers will hire graduates with a degree in exact sciences (STEM). Of course, since most people are mediocre or worse (the average IQ person is STUPID), so are most employers. 😉

The world does not really belong to (book)smart people, it belongs to selfish manipulative ones (aka the emotionally "intelligent" or street "smart"), who are usually just average mediocrities good at manipulating the masses. Hence socialism, hence populism, hence "wokism", hence social "sciences". None of those are supporters of merit or personal achievement, and none of them have contributed to American greatness along our history.

Now we can add USMLE and NBME to the long list of American non-values, which has also begun to include big names such as Ivy-League universities. One cannot build a meritocracy if one doesn't even MEASURE merit, to begin with.
 
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FFP said:
One cannot build a meritocracy if one doesn't even MEASURE merit, to begin with.
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I agree with this sentiment. First, medical school removed ranking. Then, they changed medical school to pass/fail. And now, they are changing Step 1 to pass/fail. How do you differentiate candidate A that passed everything in medical school from candidate B that also passed everything?

This will eventually continue downwards to undergraduate, MCATs, highschool, and SAT, all in the name of "being politically correct" as to not hurt anyone's feeling. "Hey, nobody loses. Everyone wins." This system that was started to create no losers will create no winners, and ironically will turn everyone into losers.
 
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FFP said:
Let me surprise you: in the US, IQ tests are illegal for most job selection purposes. That's populism/socialism/woke for you. You cannot discriminate against stupid people unless you PROVE that stupidity will interfere with their performance. The onus is on you as employer.

And that's why I support introducing serious Math or Physics PROBLEMS in medical school admission tests. Also why smart employers will hire graduates with a degree in exact sciences (STEM). Of course, since most people are mediocre or worse (the average IQ person is STUPID), so are most employers. 😉

The world does not really belong to (book)smart people, it belongs to selfish manipulative ones (aka the emotionally "intelligent" or street "smart"), who are usually just average mediocrities good at manipulating the masses. Hence socialism, hence populism, hence "wokism", hence social "sciences". None of those are supporters of merit or personal achievement, and none of them have contributed to American greatness along our history.

Now we can add USMLE and NBME to the long list of American non-values, which has also begun to include big names such as Ivy-League universities. One cannot build a meritocracy if one doesn't even MEASURE merit, to begin with.
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The healthcare market doesn’t value book smarts. Our healthcare system is run by some of the biggest corporations in the world. It is a capitalist system at the moment. That system doesn’t value book smarts. You can’t champion a free market and then cry when that market doesn’t share your values. Like it or not, the end game for 99% of medical students is to be inputs into the market. Nobody cares if you can describe human biochemistry in detail. They only care that you can follow the protocols set forth by your future employer in order to maximize employer profits. Productivity and efficiency is valued, not knowledge.
 
FFP said:
Let me surprise you: in the US, IQ tests are illegal for most job selection purposes. That's populism/socialism/woke for you. You cannot discriminate against stupid people unless you PROVE that stupidity will interfere with their performance. The onus is on you as employer.

And that's why I support introducing serious Math or Physics PROBLEMS in medical school admission tests. Also why smart employers will hire graduates with a degree in exact sciences (STEM). Of course, since most people are mediocre or worse (the average IQ person is STUPID), so are most employers. 😉

The world does not really belong to (book)smart people, it belongs to selfish manipulative ones (aka the emotionally "intelligent" or street "smart"), who are usually just average mediocrities good at manipulating the masses. Hence socialism, hence populism, hence "wokism", hence social "sciences". None of those are supporters of merit or personal achievement, and none of them have contributed to American greatness along our history.

Now we can add USMLE and NBME to the long list of American non-values, which has also begun to include big names such as Ivy-League universities. One cannot build a meritocracy if one doesn't even MEASURE merit, to begin with.
Click to expand...

My engineering application to Proctor and Gamble way back in 2014 had a mini-IQ test with Raven’s progressive matrices, if that means anything.
 
FFP said:
Let me surprise you: in the US, IQ tests are illegal for most job selection purposes. That's populism/socialism/woke for you. You cannot discriminate against stupid people unless you PROVE that stupidity will interfere with their performance. The onus is on you as employer.

And that's why I support introducing serious Math or Physics PROBLEMS in medical school admission tests. Also why smart employers will hire graduates with a degree in exact sciences (STEM). Of course, since most people are mediocre or worse (the average IQ person is STUPID), so are most employers. 😉

The world does not really belong to (book)smart people, it belongs to selfish manipulative ones (aka the emotionally "intelligent" or street "smart"), who are usually just average mediocrities good at manipulating the masses. Hence socialism, hence populism, hence "wokism", hence social "sciences". None of those are supporters of merit or personal achievement, and none of them have contributed to American greatness along our history.

Now we can add USMLE and NBME to the long list of American non-values, which has also begun to include big names such as Ivy-League universities. One cannot build a meritocracy if one doesn't even MEASURE merit, to begin with.
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Where's the hard line between an "IQ test" and other demonstrations of aptitude? Of course technical questions directly related to the job are fair game. But I'm also thinking of the famous Microsoft and Google thought questions, e.g. why are manhole covers round? That's apparently OK, even though they're not hiring storm sewer maintenance workers.
 
mbMD said:
That’s what makes us a physician and them a nurse. A physician is more than medical facts.


Sent from my iPhone using SDN mobile
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GravelRider said:
It is a stupid test requiring you to memorize inane facts that you forget the day after you take it because you never use that information ever again. How many countless hours of energy and productivity have been wasted on that dumb exam? The nursing schools are running laps around us in making education more efficient and we’re sequestering ourselves in a library for 6 straight weeks memorizing the Krebs Cycle. It’s old world thinking. It’s time to move on.
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I'm a nurse matriculating to medical school and can say that nursing education is not on par with medicine. Nursing school teaches you the most common/serious side effects of drugs and pathophys that you need to know when you must call the physician and then how to chart that you did that in order to protect yourself in a court of law. Nursing is very valuable in its own way and a good nurse is an asset to a physician, but is not comparable to the liability/knowledge base needed to practice medicine. It wasn't designed to be.
 
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What a stupid decision. Tests are literally the only objective thing we have — and even if some of the content is not relevant long-term, it measures general drive to acquire/retain knowledge and general intellectual capacity - both important traits in a physician.

Other countries use objective data like tests earlier and earlier to divide up intellectual capacity and provide populations targeted education/skills, thus maximizing their citizens ability to contribute to society.

Meanwhile, our country continues to promote the “everyone is an equal snowflake” policy. This is seen from birth to death— from elementary schools lumping all the kids together with “integrated classes” to the “healthcare team member/provider ” to the dumbing-down of medicine from work-hours to pass/fail tests.


This is part of a larger trend that is why our country is inevitably going to decline over the next 50 years.
 
doctalaughs said:
What a stupid decision. Tests are literally the only objective thing we have — and even if some of the content is not relevant long-term, it measures general drive to acquire/retain knowledge and general intellectual capacity - both important traits in a physician.

Other countries use objective data like tests earlier and earlier to divide up intellectual capacity and provide populations targeted education/skills, thus maximizing their citizens ability to contribute to society.

Meanwhile, our country continues to promote the “everyone is an equal snowflake” policy. This is seen from birth to death— from elementary schools lumping all the kids together with “integrated classes” to the “healthcare team member/provider ” to the dumbing-down of medicine from work-hours to pass/fail tests.


This is part of a larger trend that is why our country is inevitably going to decline over the next 50 years.
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Two sides to that coin. I think we all know doctors who struggled earlier in life but got their **** together and went on to be very good at whatever field they went in to. That sort of thing, to my understanding, is very rare in the countries that stratify early.
 
VA Hopeful Dr said:
Two sides to that coin. I think we all know doctors who struggled earlier in life but got their **** together and went on to be very good at whatever field they went in to. That sort of thing, to my understanding, is very rare in the countries that stratify early.
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And we’ve all had those students who didn’t care about high school hold back the progression of the rest of the class.

Not that I necessarily disagree with you about giving people second chances, but that’s the equivalent of saying we should teach self-breast exams because some people will find a breast cancer that way. Or we should do a colonoscopy to everyone.

When making policy for the masses, you have to make your policy for the average person. So yes, in those countries, you don’t get second chances. But overall, they do the best education for the most people.
 
Dantrolene FC said:
And we’ve all had those students who didn’t care about high school hold back the progression of the rest of the class.

Not that I necessarily disagree with you about giving people second chances, but that’s the equivalent of saying we should teach self-breast exams because some people will find a breast cancer that way. Or we should do a colonoscopy to everyone.

When making policy for the masses, you have to make your policy for the average person. So yes, in those countries, you don’t get second chances. But overall, they do the best education for the most people.
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Umm, we do colonoscopies on everyone, at a certain age. There's even talk of lowering that age with the increasing rate of colon cancer in younger people.

But I digress: there are myriad issues with our education system, but I don't think lack of early placement in certain career tracks is one of them. Or rather, that's not why our education system isn't of universally good quality.
 
Dantrolene FC said:
And we’ve all had those students who didn’t care about high school hold back the progression of the rest of the class.

Not that I necessarily disagree with you about giving people second chances, but that’s the equivalent of saying we should teach self-breast exams because some people will find a breast cancer that way. Or we should do a colonoscopy to everyone.

When making policy for the masses, you have to make your policy for the average person. So yes, in those countries, you don’t get second chances. But overall, they do the best education for the most people.
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VA Hopeful Dr said:
Two sides to that coin. I think we all know doctors who struggled earlier in life but got their **** together and went on to be very good at whatever field they went in to. That sort of thing, to my understanding, is very rare in the countries that stratify early.
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sucks for the docs that needed a second chance — but for society as a whole there’s no evidence it’s beneficial (and likely is a waste of resources when someone else would likely be perfectly suitable from early on).
 
doctalaughs said:
sucks for the docs that needed a second chance — but for society as a whole there’s no evidence it’s beneficial (and likely is a waste of resources when someone else would likely be perfectly suitable from early on).
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I'd like to see that evidence
 
The reality is........all of the Step exams are basically just a money-grab. Have you ever received medical care in Germany? Austria? Switzerland? Well, if you ever should, you will probably be pretty satisfied with the results. Their healthcare systems are good and the doctors and nurses are well trained. Guess what? No knowledge exams. That's right. If you graduated medical school in the European Union, all you have to do is have proof of language proficiency and you can perform medical residency training there. ( If you did not attend school in the EU or Switzerland, you have to take a knowledge test). So, why, exactly are we forced to take these tests? Do you think it has anything to do with the fees? I do. Some countries in Europe do require knowledge based tests. France, & Italy, for example. They usually cost about $100.00. How is it that the USMLE exams cost about ten times that amount? It's just a money grab.....that's it. Just like the actual match process. You literally have to pay to apply for a job. Again, in Germany, you send your resume to a hospital and are interviewed like everyone else. Why would there ever be a need to have "matching program"? Please. Utter thievery. Plain and simple.
 
Dirk Diggler said:
The reality is........all of the Step exams are basically just a money-grab. Have you ever received medical care in Germany? Austria? Switzerland? Well, if you ever should, you will probably be pretty satisfied with the results. Their healthcare systems are good and the doctors and nurses are well trained. Guess what? No knowledge exams. That's right. If you graduated medical school in the European Union, all you have to do is have proof of language proficiency and you can perform medical residency training there. ( If you did not attend school in the EU or Switzerland, you have to take a knowledge test). So, why, exactly are we forced to take these tests? Do you think it has anything to do with the fees? I do. Some countries in Europe do require knowledge based tests. France, & Italy, for example. They usually cost about $100.00. How is it that the USMLE exams cost about ten times that amount? It's just a money grab.....that's it. Just like the actual match process. You literally have to pay to apply for a job. Again, in Germany, you send your resume to a hospital and are interviewed like everyone else. Why would there ever be a need to have "matching program"? Please. Utter thievery. Plain and simple.
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The match is a good system. The residency application process was a mess before the match came out in the ‘50s.
 
Dirk Diggler said:
The reality is........all of the Step exams are basically just a money-grab. Have you ever received medical care in Germany? Austria? Switzerland? Well, if you ever should, you will probably be pretty satisfied with the results. Their healthcare systems are good and the doctors and nurses are well trained. Guess what? No knowledge exams. That's right. If you graduated medical school in the European Union, all you have to do is have proof of language proficiency and you can perform medical residency training there. ( If you did not attend school in the EU or Switzerland, you have to take a knowledge test). So, why, exactly are we forced to take these tests? Do you think it has anything to do with the fees? I do. Some countries in Europe do require knowledge based tests. France, & Italy, for example. They usually cost about $100.00. How is it that the USMLE exams cost about ten times that amount? It's just a money grab.....that's it. Just like the actual match process. You literally have to pay to apply for a job. Again, in Germany, you send your resume to a hospital and are interviewed like everyone else. Why would there ever be a need to have "matching program"? Please. Utter thievery. Plain and simple.
Click to expand...

While you are at it please post the cost of TUITION in those countries vs your average private DO school in the USA. So, while I respect every penny the real thievery is the high tuition costs.
 
BLADEMDA said:
While you are at it please post the cost of TUITION in those countries vs your average private DO school in the USA. So, while I respect every penny the real thievery is the high tuition costs.
Click to expand...

They charge what the market will bear. All these institutions are being good capitalists. Go ‘murica!!
 
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