Step 1 P/F: Decision

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"The USMLE program will change score reporting for Step 1from a three-digit numeric score to reporting only a pass/fail outcome. A numeric score will continue to be reported for Step 2 Clinical Knowledge (CK) and Step 3. Step 2 Clinical Skills (CS) will continue to be reported as Pass/Fail. This policy will take effect no earlier than January 1, 2022 with further details to follow later this year"

Discuss
 
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What do we think this means for all of us applying to competitive specialties in next 1-2 years? Any differences? Do we expect a more "holistic" look? Higher emphasis on Step 2?
 
It was inevitable, not only because of the damage Step 1 Mania was causing to preclinical education, but because the theoretical and statistical validity for the use of Step 1 in this way simply wasn't there. It was built from the ground up to be a test of minimum knowledge for licensure, with good discrimination around the 65-70% pass mark, and should have been Pass/Fail to begin with like the bar exam. Treating it like an aptitude test to favor 250s over 230s for residency placement was a bastardization that sparked a pointless arms race.

I have to say though, I don't like the immediate implications here. Keeping Step 2 CK as a triple digit score is just going to lead to all residency programs requiring a Step 2 CK to apply and treating it exactly the same way.

Also going to be curious to see how people handle the relatively imminent potential implementation (January 2022). That's close enough that anyone who wanted a competitive surgical specialty, and did poorly on Step 1, could consider a couple of research years to have a brand new shot...
 
Yeah I wonder if this change will affect current Med-students in which programs started to look at other things.
 

"The USMLE program will change score reporting for Step 1from a three-digit numeric score to reporting only a pass/fail outcome. A numeric score will continue to be reported for Step 2 Clinical Knowledge (CK) and Step 3. Step 2 Clinical Skills (CS) will continue to be reported as Pass/Fail. This policy will take effect no earlier than January 1, 2022 with further details to follow later this year."

I'm glad Step 2 CS remains pass/fail. Some idiots thought making that test a scored exam was a good idea.
 
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So it seems that at least M2's will be safe. I guess the question is whether or not they will retroactively change scores to P/F after 2022. This may impact peoples decisions on whether or not to take a gap year if that is the case...
 
I actually agree with this change. Step 1 has become a dumb competition of memorizing minutiae that is long forgotten after the test. The next step needs to be reducing the number of residencies students can apply to so that programs don't become overwhelmed with apps and require some new step 1-like metric to stratify applicants and can instead focus on the bigger picture of the applicant. My $0.02.
 
It was inevitable, not only because of the damage Step 1 Mania was causing to preclinical education, but because the theoretical and statistical validity for the use of Step 1 in this way simply wasn't there. It was built from the ground up to be a test of minimum knowledge for licensure, with good discrimination around the 65-70% pass mark, and should have been Pass/Fail to begin with like the bar exam. Treating it like an aptitude test to favor 250s over 230s for residency placement was a bastardization that sparked a pointless arms race.

I have to say though, I don't like the immediate implications here. Keeping Step 2 CK as a triple digit score is just going to lead to all residency programs requiring a Step 2 CK to apply and treating it exactly the same way.

Also going to be curious to see how people handle the relatively imminent potential implementation (January 2022). That's close enough that anyone who wanted a competitive surgical specialty, and did poorly on Step 1, could consider a couple of research years to have a brand new shot...

I'm glad this was announced right after i was freaking out about that absurd NBME 18 score creep...
 
So it seems that at least M2's will be safe. I guess the question is whether or not they will retroactively change scores to P/F after 2022. This may impact peoples decisions on whether or not to take a gap year if that is the case...
I suspect they'd have to implement the change retroactively. Otherwise, there would be potential for unfair advantage of older test takers to distinguish themselves (for example, any MSTP applicant would have a Step 1 score to show while their competition could only display a Pass).

In the interest of keeping it a level playing field for the match, they'd have to hide the MSTP's score and show them both as Pass.
 
Wondering if this will change the current M22 grades to just a pass retroactively
 
Does this mean pre-clinical education is going to be weighted higher or what? I imagine nothing changes for M2s?

Probably gonna do better on boards than I did in my school's curriculum where volunteer faculty read off old slides...
 
I'm MD/PhD and wonder how reporting will work if say, I apply for the match in 2025. I guess this will incentivize me even more to work hard and publish as much as possible.

Yeah, same... MSTP with a score I'm not proud of. so will we be at a disadvantage because we still have old scores? Or do you think they may try to retroactively change our scores to pass
 
The competition during clinical rotations and the shelf exams will be even more fierce and cutthroat.

How much of a benefit will this provide to those in top 10 med schools?

What does delineating between schools with tough Honors cutoffs (Michigan) and schools with generous grade distributions (Harvard, several Florida schools) look like?

I have so many questions as a current student.
 
as a premed, should this affect how you decide which school to attend? I figure now that if one has a chance to go to Stanford/Harvard/Hopkins vs staying at the local state university for free tuition, they SHOULD choose the former? with no step1 scores, and no step2ck taken by the time you apply, how are people going to determine if you deserve to match in Neurosurg/Derm/Ortho/RadOnc?
 
Given the residency application process where hundreds or even thousands of applicants apply for a handful of spots, there will still be a need to stratify applicants for some sort of 'quick-winnow' -- What are the other options?
  1. Step 2
  2. School prestige
  3. Research
  4. Connections
  5. Away rotations
  6. Class rank
There are certainly downsides to each of these also. Curious to see how this will shake out...
 
So current M1s taking Step1 in 2021 should be safe from these changes, right?
 
How will this affect people doing PhDs/research years? These people with both scored steps will be competing against the classes after them with just a scored step 2. That has to give you an advantage automatically unless they retroactively make every class's step 1 P/F from Jan 2022 onwards.
 
I think this is good in theory but realistically, unless they modify the residency application process (limiting amount of programs people can apply to, etc) this changes nothing because PDs will still get way more apps than they can look through "holistically" and will just use another filter. I am happy this isn't affecting me..as a DO student I feel that Step is the one thing that makes me equal in the eyes of most PDs. I've busted my butt the last year and a half on Anki and although I wish we lived in a world where I didn't feel the need to do that, I'd be really pissed if it all went down the toilet.
 
It was inevitable, not only because of the damage Step 1 Mania was causing to preclinical education, but because the theoretical and statistical validity for the use of Step 1 in this way simply wasn't there. It was built from the ground up to be a test of minimum knowledge for licensure, with good discrimination around the 65-70% pass mark, and should have been Pass/Fail to begin with like the bar exam. Treating it like an aptitude test to favor 250s over 230s for residency placement was a bastardization that sparked a pointless arms race.

I have to say though, I don't like the immediate implications here. Keeping Step 2 CK as a triple digit score is just going to lead to all residency programs requiring a Step 2 CK to apply and treating it exactly the same way.

Also going to be curious to see how people handle the relatively imminent potential implementation (January 2022). That's close enough that anyone who wanted a competitive surgical specialty, and did poorly on Step 1, could consider a couple of research years to have a brand new shot...

My initial reaction was that this change is not a good thing, but for M2s, the bolded might actually work out for some of us. Want to do ortho with a poor step score? Take a year off, do research and network, then apply with a P on the transcript. Not a bad option

But overall, this thing is a complete dumpster fire
 
Gunners gonna be cracking FA step 2 CK open in MS1 now

Lmao exactly. If anyone thinks anything is going to change at all then they have another thing coming. “Step 1 mania” will now become “Step 2 mania”. Oh and add on the stress of ever more important clinical grades, which are extremely subjective, and the fact that Step 2 is taken right before residency apps and you have the recipe for a complete disaster lol.
What do we think this means for all of us applying to competitive specialties in next 1-2 years? Any differences? Do we expect a more "holistic" look? Higher emphasis on Step 2?

Probably nothing at all honestly.

I have made many statements about this and my opinion has not changed. This only benefits the top schools and completely shafts all DO and low tier MD students.

Good luck.
 
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