Step 1 P/F: Decision

[efle]

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Link me to where he cites research on Step 1. His blog from what I saw consists of rehashed NRMP Statistics and that one post where he cherry-picked Step 1 questions to show how ridiculous it was but IMO were still quite valid.

The new NBMEs consistently show 60% correct as passing, and they’re not generally as hard as the real exam.

Reddit.com/r/step1/comments/bjmd91

You can check the Step 1 research yourself. I’ll post random links but a literature search would probably do more good.

The Predictive Value of General Surgery Application Data for Future Resident Performance

The predictive value of application data for future general surgery resident performance and attrition are poorly understood. We sought to determine w…

www.sciencedirect.com

What predicts surgical internship performance?

Variables associated with postgraduate year 1 (PGY-l) performance in surgical training have not been fully defined.Mean composite PGY-l evaluation sco…

www.sciencedirect.com

United States Medical Licensing Examination Step 1 Scores Directly Correlate with American Board of Neurological Surgery Scores: A Single-Institution Experience

Neurosurgery residency is becoming an increasingly competitive match. The process of screening and ranking applicants is a multifactorial process that…

www.sciencedirect.com

Correlation of USMLE Step 1 scores with performance on dermatology in-training examinations

Although United States Medical Licensing Examination (USMLE) Step 1 was not designed to predict resident performance, scores are used to compare resid…

www.sciencedirect.com

https://www.researchgate.net/publication/266205167_Usmle_Step_1_Score_a_Valid_predictor_of_Success_in_Surgical_Residency

Here's an example

The Mythology of USMLE Step 1 Scores and Board Certification

There’s a persistent objection to making USMLE Step 1 pass/fail that goes something like this: Dear Sheriff, When you suggest that we should make USMLE Step 1 pass/fail, you overlook one very…

thesheriffofsodium.com

The new NBMEs were rolled out because the old ones were losing their validity due to creep. I would absolutely expect a brand new set of rescaled ones to be down at the other end of the range. They certainly didn't feel easier to me! They were brutal.

Just glancing at the first few of these examples:
Paper #1 showing moderate r=0.4 ABSITE correlation...for a cohort with an average score centered around 214. That makes a lot of sense to me, that chunk of people down in what's currently bottom ~20% are where Step is meant to be functionally useful.

Paper #2 I think you made a mistake including this one, it actually shows there is not significant correlation to Step 1

Paper #3 shows a significant correlation to neursurg written board score but mentions >95% pass rate by 220.

Giving up there for now but I think we both understand where the research sits. Good MCQ exam takers tend to remain that way, but actual outcome differences? The practice of screening and heavily favoring high scores isn't evidence based at all. Find me something that shows a 230 is at risk compared to a 250 and I'll eat my shoes

 

[Lucca]

Rehashing the arguments pro and con P/F is pointless. The arguments been had and the decision is fait accompli.

The more interesting argument to have is what next? and the meaningful discussion of that won't happen on SDN or reddit (thank god) but the conversation should definitely be had between students and Med Ed folks at individual medical schools and in the literature / on social media.

I think something to keep in mind is that all US medical students are essentially highly trained academic fox terriers. Whatever bar you set, they will zoom past it. You want them to memorize 30,000 flashcards? Done. You want to base resident selection on bench + squat? Everyone hitting the gym. You want it to be digits of pi? Done. Fastest time solving a Rubiks cube? Solving logic puzzles? Mastery of multiple languages? Name your bar, medical students will devote night and day to it to get what they want. What we are living now is an opportunity to think about what we actually want medical students to be spending their time on (indeed, three or more years of it) and dictate it, rationally, as opposed to letting the bar be set by default because of a lousy UME to GME pipeline unequipped for modern med ed or the realities of the current resident workforce.

 

[subdermallight]

I would've also made it Pass/Fail haha

You wouldn’t have left Step 2 like that though, at least improved the error

 

[Medsthetic]

What do i do if im gonna go to low rank MD and want to do gas? SOL?

 

[Dantrolene FC]

What do i do if im gonna go to low rank MD and want to do gas? SOL?

I’m not sure if gastroenterology ever cared that much about step 1. I’d just focus on getting into a good IM residency and doing well on the ITE.

 

[efle]

I’m not sure if gastroenterology ever cared that much about step 1. I’d just focus on getting into a good IM residency and doing well on the ITE.

I think he means anesthesia but there's still no reason to worry
Anesthesia has a 96% match rate even in the 210s
Step wasn't going to be a make or break thing anyways

Tableau Public

public.tableau.com

 

[Dantrolene FC]

I think he means anesthesia but there's still no reason to worry
Anesthesia has a 96% match rate even in the 210s
Step wasn't going to be a make or break thing anyways

Tableau Public

public.tableau.com

Ohh... I guess one could see the confusion here.

 

[after p3]

The more interesting argument to have is what next? and the meaningful discussion of that won't happen on SDN or reddit (thank god) but the conversation should definitely be had between students and Med Ed folks at individual medical schools and in the literature / on social media.

Hopefully medical school curriculum prepares itself more for the imminent health issues posed by climate change. I also think that areas like art, creative photography, and dance can also have clinical significance as well as the many esoteric topics related to the lecturing professors specialty. This also opens up time for more mandatory wellness lectures, diversity & combating implicit bias, and becoming a professional through classes of professionalism. Perhaps more problem based learning scenarios and more forced interaction via small groups. The future holds so many possibilities.

 

[ginsengreset]

So I asked a PD in one of the 245+ step average specialties about this, and this is what they said, in order:

1) "You don't think they're actually changing it to pass/fail, are you? As you can tell, I'm still sort of denial about this"
2) Now they will need to make Step 2 CK mandatory for applying
3) They will also end up needing to look more closely at research (which they already value) and clerkship grades. I'm not sure if it was particular to this PD, but apparently 3rd year grades weren't hugely important before, as long as you got honors in the relevant clerkship, notwithstanding 3rd year grades' impact on AOA.

Seems like I'll need to spend the first two years just amassing research, and then M3 year is full drive on Step 2 and shelf exams.

 

[Dantrolene FC]

Hopefully medical school curriculum prepares itself more for the imminent health issues posed by climate change. I also think that areas like art, creative photography, and dance can also have clinical significance as well as the many esoteric topics related to the lecturing professors specialty. This also opens up time for more mandatory wellness lectures, diversity & combating implicit bias, and becoming a professional through classes of professionalism. Perhaps more problem based learning scenarios and more forced interaction via small groups. The future holds so many possibilities.

Please tell me this is sarcasm.

 

[slowthai]

Where's @failedatlife when you need him? Oh yeah, he died secondary to a failed ENT match. He must be rolling in his grave right now

 

[efle]

@failedatlife when you need him? Oh yeah, he died secondary to a failed ENT match. He must be rolling in his grave right now
[/QUOTE]
Gonna be wild seeing that 50% surgical subspecialty match rate in 2022

 

[Mass Effect]

For some, it is the “i had to deal with it (suffer) so you have to, too” mentality.

That mentality has nothing to do with this. In fact, this is exactly the opposite. We had to deal with it and now we know better and we don't want you to have to deal with it when it truly is completely irrelevant to clinical practice.

 

[ciestar]

That mentality has nothing to do with this. In fact, this is exactly the opposite. We had to deal with it and now we know better and we don't want you to have to deal with it when it truly is completely irrelevant to clinical practice.

I mean.. i took step 1. I know what you’re saying

 

[Ho0v-man]

Uggh.. I have no doubt a good portion of NPs can pass this test. The threshold is more like 60% correct, not 69%. They should just get rid of Step 1 entirely. Passing it doesn’t have any value, it doesn’t tell you if you’re able to understand basic science or are a safe physician. Now it’s just there to make money like CS.

Lol no chance. I know it seems crazy, but the average NP hasn’t studied the volume of material in one semester of med school over the course of their entire education including undergrad pre reqs.

I could actually see PAs doing it with like 6 months of dedicated. They use a lot of the same stuff for school we use like sketchy.

Anywho, now that the midlevel bashing has begun, it’s time to prepare for maximum thread toxicity.

 

[Lucca]

Lol no chance. I know it seems crazy, but the average NP hasn’t studied the volume of material in one semester of med school over the course of their entire education including undergrad pre reqs.

I could actually see PAs doing it with like 6 months of dedicated. They use a lot of the same stuff for school we use like sketchy.

Anywho, now that the midlevel bashing has begun, it’s time to prepare for maximum thread toxicity.

Online NP programs are going to use AI trained for Step 1 to get their grads to pass it and they are going to be able to staff all surgical subs and Derm for 15$/hr. The DO degree will be merged into NP. MDs will all be forced at gunpoint to practice FM in North Dakota by the government.

 

[ace_inhibitor111]

Lol no chance. I know it seems crazy, but the average NP hasn’t studied the volume of material in one semester of med school over the course of their entire education including undergrad pre reqs.

I could actually see PAs doing it with like 6 months of dedicated. They use a lot of the same stuff for school we use like sketchy.

Anywho, now that the midlevel bashing has begun, it’s time to prepare for maximum thread toxicity.

I disagree. My sister is an NP and I looked through the material she uses several times before. It mimics the first two years of medical school albeit imperfectly. If every NP just studied using UWorld I would put their average around the 15-20th percentile on the Step 1, which is passing with good margins. I mean Caribbean grads have an average Step 1 of 220. So there’s that.

 

[Splenda88]

I disagree. My sister is an NP and I looked through the material she uses several times before. It mimics the first two years of medical school albeit imperfectly. If every NP just studied using UWorld I would put their average around the 20-25th percentile on the Step 1, which is passing with good margins.

Does your sister study biochem, histology, cell and molecular bio, Genetics, biostats, immunology, embryology etc...?

I guess my experience is different...

 

[efle]

I disagree. My sister is an NP and I looked through the material she uses several times before. It mimics the first two years of medical school albeit imperfectly. If every NP just studied using UWorld I would put their average around the 15-20th percentile on the Step 1, which is passing with good margins. I mean Caribbean grads have an average Step 1 of 220. So there’s that.

I think the cohort of Carib MDs that survive to ERAS are significantly stronger, there's no similar filtering process for midlevel

 

[libertyyne]

I disagree. My sister is an NP and I looked through the material she uses several times before. It mimics the first two years of medical school albeit imperfectly. If every NP just studied using UWorld I would put their average around the 15-20th percentile on the Step 1, which is passing with good margins. I mean Caribbean grads have an average Step 1 of 220. So there’s that.

their failure rate of their exams in 19-25% . There exams do not seem anywhere close to step questions in complexity. I would sincerely doubt that when they are unable to pass an easier exam they are going to be able to pass step 1.

 

[Ho0v-man]

I disagree. My sister is an NP and I looked through the material she uses several times before. It mimics the first two years of medical school albeit imperfectly. If every NP just studied using UWorld I would put their average around the 15-20th percentile on the Step 1, which is passing with good margins. I mean Caribbean grads have an average Step 1 of 220. So there’s that.

Different experience from me. Entirely. Open book, open notes, open google, untimed. Who cares what’s in the book if you’re never responsible for knowing it? Their textbook could be Harrison’s, but if they’re just searching an iBook of it for every question, I’m not impressed.

Also, the material does occasionally have science in it, but it’s undergrad pre req depth at best.

 

[ace_inhibitor111]

Different experience from me. Entirely. Open book, open notes, open google, untimed. Who cares what’s in the book if you’re never responsible for knowing it? Their textbook could be Harrison’s, but if they’re just searching an iBook of it for every question, I’m not impressed.

Also, the material does occasionally have science in it, but it’s undergrad pre req depth at best.

Curious, what is your experience? My sister went to a local university part-time while working and her tests were your standard closed book exams like you’d have in university. Also had genetics and histology, and from what I recall going in depth about the pathophysiology of PNH up to the molecular level. Not much biochem though, but that would probably be deemed a good thing by medical students nowadays.

 

[Ho0v-man]

Curious, what is your experience? My sister went to a local university part-time while working and her tests were your standard closed book exams like you’d have in university. Also had genetics and histology, and from what I recall going in depth about the pathophysiology of PNH up to the molecular level. Not much biochem though, but that would probably be deemed a good thing by medical students nowadays.

Like I said in my previous post. Entirely online with unproctored, untimed, open everything tests. What you’re describing is the most rigorous thing I’ve ever heard of an NP curriculum.

 

[Matthew9Thirtyfive]

There are about a billion threads discussing NP education versus physician education. This thread is about step and how it affects med students. Keep it on topic.

 

[GastriqueGraffin]

Millennials did this. They complain hard and now they/we have a lot of influence in these matters. We have put institutions (schools and residencies) in trouble with complaining, strictly enforce training hours and other things for “mental health” reasons. Now we got rid of the only standardized way to test someone basic medical knowledge. We replace it with some nonsense. Then when a med student or even a resident who felt no need to study during the first half of school doesn’t know anything during clinical rotations or residency and someone call them out who will be in trouble, the student or the one calling them out? This is so wrong.

 

[slowthai]

Millennials did this. They complain hard and now they/we have a lot of influence in these matters.

If we had a lot of influence, CS wouldn't exist. I promise you, the majority of med students didn't want this. If anything, it was faculty and administrators. Why? Because for some reason they think we'll start giving them the time of day now that step 1 is p/f. They're totally lacking in insight, because students will continue to ignore them and just gun for a high step 2 score.

Now we got rid of the only standardized way to test someone basic medical knowledge. We replace it with some nonsense.

There's still step 2. Definitely wouldn't call it nonsense.

Then when a med student or even a resident who felt no need to study during the first half of school doesn’t know anything during clinical rotations or residency and someone call them out who will be in trouble, the student or the one calling them out? This is so wrong.

You still have to study enough to pass step 1. Furthermore, step 2 will be the same exact thing as step 1 in terms of the intensity put towards studying for it. There are still shelves as well.

In regards to the students being called out thing, by and large, this isn't the case, but I have heard some absolutely insanely ridiculous stories in regards to students reporting attendings for even mild pimping.

 

[Prehealth1011]

Millennials did this. They complain hard and now they/we have a lot of influence in these matters. We have put institutions (schools and residencies) in trouble with complaining, strictly enforce training hours and other things for “mental health” reasons. Now we got rid of the only standardized way to test someone basic medical knowledge. We replace it with some nonsense. Then when a med student or even a resident who felt no need to study during the first half of school doesn’t know anything during clinical rotations or residency and someone call them out who will be in trouble, the student or the one calling them out? This is so wrong.

This makes us do more “work” in the form of research, giving a crap about class rank, making connections etc. I think most of us would opt for a simpler one-and-done deal like it was.

 

[efle]

Millennials did this. They complain hard and now they/we have a lot of influence in these matters. We have put institutions (schools and residencies) in trouble with complaining, strictly enforce training hours and other things for “mental health” reasons. Now we got rid of the only standardized way to test someone basic medical knowledge. We replace it with some nonsense. Then when a med student or even a resident who felt no need to study during the first half of school doesn’t know anything during clinical rotations or residency and someone call them out who will be in trouble, the student or the one calling them out? This is so wrong.

Bruh, the attendings doing the pimping and teaching out there in the real world either 1) didnt take step or 2) scored on average near the current failing threshold

The sky isnt crashing down like that

 

[GastriqueGraffin]

This makes us do more “work” in the form of research, giving a crap about class rank, making connections etc. I think most of us would opt for a simpler one-and-done deal like it was.

Research is totally useless unless you’re planning on being a researcher. Trust me, I’m in GI and to get into it we had to do “research”. The vast majority of people want to be clinicians and their research is completely useless and a waste of time. Many of them were bad residents who had high scores and a lot of “research”.
Class rank has many problems. How do you compare schools? What happens in schools that don’t even grade for the first 2 years? And if it’s based on clinical rotations it can vary widely based on who you’re working with and the personality of student. In other words, the really friendly outgoing student who happens to have a friendly attending will get higher .
Having connections... don’t even get me started...

 

[efle]

Research is totally useless unless you’re planning on being a researcher. Trust me, I’m in GI and to get into it we had to do “research”. The vast majority of people want to be clinicians and their research is completely useless and a waste of time. Many of them were bad residents who had high scores and a lot of “research”.
Class rank has many problems. How do you compare schools? What happens in schools that don’t even grade for the first 2 years? And if it’s based on clinical rotations it can vary widely based on who you’re working with and the personality of student. In other words, the really friendly outgoing student who happens to have a friendly attending will get higher .
Having connections... don’t even get me started...

If both are going to be equally likely to pass boards and practice, I'd rather spend 80 hours/week with a coworker with a fantastic personality and a 230, than a jerk with a 250.

Nobody seems to bitch and moan about the importance of interview impressions...that's the #1 ranked item for actually securing your match spot.

 

[FindersFee5]

If both are going to be equally likely to pass boards and practice, I'd rather spend 80 hours/week with a coworker with a fantastic personality and a 230, than a jerk with a 250.

Nobody seems to bitch and moan about the importance of interview impressions...that's the #1 ranked item for actually securing your match spot.

Ooooo I'll absolutely bitch and moan about interview impressions. I've done a lot of mock and real interviews for my school and have been doing them long enough that I've actually met a good number of my interviewees in real life afterwards. Let me tell you, other than the bottom 10% of interviews, they tell you NOTHING. I had some incredible experiences where I was super impressed with the applicants, both on paper and as people, and then I hung out with them at class events and they were - well, terrible people might be strong, but they were definitely not people that I would want as my physician or classmate, and especially not given that I had been a person who initially vouched for them. Similarly, a lot of people are more of a slow burn. It takes some time to warm up to them and understand them, but they turn out to be amazing folks.

Anybody can put on an act for a day. All interviews screen for is people who don't know how to play the game.

 

[Chad12]

What does everyone think about extracurriculars now that step 1 is P/F. Are they going to matter more? I'm Class of 2023 and have the opportunity to be on the EXEC board for a club but I'm wondering if it's worth the time commitment given my other responsibillities.

 

[efle]

Ooooo I'll absolutely bitch and moan about interview impressions. I've done a lot of mock and real interviews for my school and have been doing them long enough that I've actually met a good number of my interviewees in real life afterwards. Let me tell you, other than the bottom 10% of interviews, they tell you NOTHING. I had some incredible experiences where I was super impressed with the applicants, both on paper and as people, and then I hung out with them at class events and they were - well, terrible people might be strong, but they were definitely not people that I would want as my physician or classmate, and especially not given that I had been a person who initially vouched for them. Similarly, a lot of people are more of a slow burn. It takes some time to warm up to them and understand them, but they turn out to be amazing folks.

Anybody can put on an act for a day. All interviews screen for is people who don't know how to play the game.

Interesting, I had the opposite experience and felt like the people I clicked with after chatting with for an hour at second look dinner/parties were exactly who I ended up being room mates and good friends with

What does everyone think about extracurriculars now that step 1 is P/F. Are they going to matter more? I'm Class of 2023 and have the opportunity to be on the EXEC board for a club but I'm wondering if it's worth the time commitment given my other responsibillities.

Which clubs you were in is always going to be way, way down at the bottom of the list

 

[FindersFee5]

Interesting, I had the opposite experience and felt like the people I clicked with after chatting with for an hour at second look dinner/parties were exactly who I ended up being room mates and good friends with


Which clubs you were in is always going to be way, way down at the bottom of the list

Second look is a very different format from interviews. People are likely to be more casual and more real. How well somebody does in interviews, to me, feels like it's mostly about how well you deal with the stress of that artificial situation rather than saying anything about you as a candidate or a colleague.

 

[efle]

Second look is a very different format from interviews. People are likely to be more casual and more real. How well somebody does in interviews, to me, feels like it's mostly about how well you deal with the stress of that artificial situation rather than saying anything about you as a candidate or a colleague.

True, I guess the role of the brief interview is more to filter out the psychos. But they also get LORs to work with. Someone who worked with you for weeks or months and is willing to vouch for you should be treated as more important than step percentile for the ranking stage. Only reason step was so important was for interview invitations, and that was only out of necessity from people applying to 80+ programs each.

 

[FindersFee5]

True, I guess the role of the brief interview is more to filter out the psychos. But they also get LORs to work with. Someone who worked with you for weeks or months and is willing to vouch for you should be treated as more important than step percentile for the ranking stage. Only reason step was so important was for interview invitations, and that was only out of necessity from people applying to 80+ programs each.

Letters are better, although you still have to filter out the people who are super enthusiastic about everybody vs those who are more honest as well as those who write basically the same form letter for everyone, something you can't really know from the applicant side prior to requesting the letter.

I do think LOR from people you did away rotations with (assuming you actually got the chance to work with your letter writer a good amount, which is not a given for aways) can be a good, reliable, unbiased source of information. The away rotation itself is probably the best test, but obviously applicants can't do an infinite number of aways.

 

[efle]

Letters are better, although you still have to filter out the people who are super enthusiastic about everybody vs those who are more honest as well as those who write basically the same form letter for everyone, something you can't really know from the applicant side prior to requesting the letter.

I do think LOR from people you did away rotations with (assuming you actually got the chance to work with your letter writer a good amount, which is not a given for aways) can be a good, reliable, unbiased source of information. The away rotation itself is probably the best test, but obviously applicants can't do an infinite number of aways.

Hahah you'd be surprised, my Plastics elective had 5 away students plus 2 home students for a total of 7 on their small service. Another of the legitimate criticisms for this Pass/Fail change, is that the audition rotation game is about to become insane.

 

[Mass Effect]

Millennials did this. They complain hard and now they/we have a lot of influence in these matters. We have put institutions (schools and residencies) in trouble with complaining, strictly enforce training hours and other things for “mental health” reasons. Now we got rid of the only standardized way to test someone basic medical knowledge. We replace it with some nonsense. Then when a med student or even a resident who felt no need to study during the first half of school doesn’t know anything during clinical rotations or residency and someone call them out who will be in trouble, the student or the one calling them out? This is so wrong.

Page 23 and the hysteria continues...

Step 2 is hardly nonsense. And FYI, Step 1 does tests very little of the information one needs during "clinical rotations or residency."

Also, no reason for "mental health" to be in quotes.

 

[ace_inhibitor111]

Page 23 and the hysteria continues...

Step 2 is hardly nonsense. And FYI, Step 1 does tests very little of the information one needs during "clinical rotations or residency."

Also, no reason for "mental health" to be in quotes.

Try downloading the Step 2 Zanki deck and see for yourself. 70-80% of the content overlaps with First Aid and Step 1 (except for the OB/GYN stuff)

 

[Mass Effect]

Try downloading the Step 2 Zanki deck and see for yourself. 70-80% of the content overlaps with First Aid and Step 1 (except for the OB/GYN stuff)

Step 1, the exam, has very little relevance to clinical rotations.

 

[efle]

Try downloading the Step 2 Zanki deck and see for yourself. 70-80% of the content overlaps with First Aid and Step 1 (except for the OB/GYN stuff)

No way. Step 2 uworld and medicine shelf were NOT blocks you could score 75% on just by being fresh out of dedicated. Learned that myself the hard way.

 

[ace_inhibitor111]

Step 1, the exam, has very little relevance to clinical rotations.

Most people in my class just dive into clinical rotations after taking Step 1 and do pretty well. Many don’t have time to study for shelves until the last few weeks. The background is enough to recognize common problems, and the pharm knowledge is definitely useful. Most of what I learned in rotations IMO comes from figuring out the work-flow and being efficient rather than relearning clinical medicine from the ground up.

No way. Step 2 uworld and medicine shelf were NOT blocks you could score 75% on just by being fresh out of dedicated. Learned that myself the hard way.

It’s not easy, but people definitely can and have done so.

 

[AnatomyGrey12]

Hahah you'd be surprised, my Plastics elective had 5 away students plus 2 home students for a total of 7 on their small service. Another of the legitimate criticisms for this Pass/Fail change, is that the audition rotation game is about to become insane.

Welcome to the DO world, where the audition is king. I will say this, it is kind of Interesting to see who can hold it together for a whole month and who caves under the pressure.

 

[GastriqueGraffin]

Step 1, the exam, has very little relevance to clinical rotations.

You’ll have the rest of your career to be mindless follower of algorithms and/or procedures. The preclinical knowledge is your best chance to learn the science to make you a better doctor. God forbid you understand the mechanism of a disease or how a drug works or the relevance of pathology.

Put it this way, your undergrad GPA has nothing to do with medical school. Neither does the MCAT. But neither does your volunteering or research or whatever extracurricular activity you do to pretend like you’re some sort of unique individual. But I’ll tell you that eliminating the grades and test would not turn out better students.

 

[efle]

It’s not easy, but people definitely can and have done so.

No, dude, no. There's a reason they are entirely separated Qbanks and First Aid books and why everyone watches OnlineMedEd instead of Boards and Beyond to review. They are different. Not 20% different. Different.

 

[ace_inhibitor111]

No, dude, no. There's a reason they are entirely separated Qbanks and First Aid books and why everyone watches OnlineMedEd instead of Boards and Beyond to review. They are different. Not 20% different. Different.

Not been my experience bro, sorry. I didn’t watch a lot of OME, but what I did watch (secondary causes of hypertension, causes of RUQ pain) was information in First Aid just organized in a different way. Also, there is information in the Step 2 CK Qbank that showed up on my Step 1 (auto*** ***reflexia) but weren’t in any other sources. Everyone seems hung-up on the biochem stuff but don’t realize the whole entire rest of Step 1 studying/First Aid that is very relevant to clinical work.

 

[efle]

Not been my experience bro, sorry. I didn’t watch a lot of OME, but what I did watch (secondary causes of hypertension, causes of RUQ pain) was information in First Aid just organized in a different way. Also, there is information in the Step 2 CK Qbank that showed up on my Step 1 (auto*** ***reflexia) but weren’t in any other sources. Everyone seems hung-up on the biochem stuff but don’t realize the whole entire rest of Step 1 studying/First Aid that is very relevant to clinical work.

I don't even know what to say to this. They're two separate exams with two separate sets of materials and two fundamentally different areas assessed as described by their authors. I might as well argue with you about whether the neuro and OBGYN shelves tested 80% of the same stuff because they're both medical topics.

 

[Mass Effect]

Most people in my class just dive into clinical rotations after taking Step 1 and do pretty well. Many don’t have time to study for shelves until the last few weeks. The background is enough to recognize common problems, and the pharm knowledge is definitely useful. Most of what I learned in rotations IMO comes from figuring out the work-flow and being efficient rather than relearning clinical medicine from the ground up

You didn't re-learn clinical medicine because you didn't learn it in the first place. Step 1 has little to do with clinical medicine. And if you truly believe none of your MS-3 classmates are studying clinical medicine and are just coasting through rotations based on Step 1 knowledge, well, I don't know what to say.

You’ll have the rest of your career to be mindless follower of algorithms and/or procedures. The preclinical knowledge is your best chance to learn the science to make you a better doctor. God forbid you understand the mechanism of a disease or how a drug works or the relevance of pathology.

Really? You think Step 1 reflects all that stuff better than Step 2?

 

[GastriqueGraffin]

You didn't re-learn clinical medicine because you didn't learn it in the first place. Step 1 has little to do with clinical medicine. And if you truly believe none of your MS-3 classmates are studying clinical medicine and are just coasting through rotations based on Step 1 knowledge, well, I don't know what to say.



Really? You think Step 1 reflects all that stuff better than Step 2?

I am not against making Step 2 more relevant. But I’m against making Step 1 irrelevant. Clerkship shelf exams do a fine job testing clinical knowledge, which is part of the reason I’m not excited about Step 2. Nothing makes up to standardize basic medical science without step 1.

 

[efle]

I am not against making Step 2 more relevant. But I’m against making Step 1 irrelevant. Clerkship shelf exams do a fine job testing clinical knowledge, which is part of the reason I’m not excited about Step 2. Nothing makes up to standardize basic medical science without step 1.

Thoughts on the whole historical aspect? Do you have zero respect for your clinical mentors because you know they probably all got a ~200?