Step 1 P/F: Decision

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Govols22 said:
So for the class of 2022, will this not make a difference considering that they will start applying to programs by fall of 2021?
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I like where your head is at. But I think we may get the shaft. I don't like the idea of competing for a fellowship with someone who may be viewed as having a higher P than my actual score, or who was allowed more adequate time to prepare for step 2. Unless they retroactively change scores.
 
Now people will actually have to care about their preclinical grades at the non P/F schools, and school name will matter even more.

It is nice in that there’s less stress about this one test. You at least have until the end of your third year to figure this out
 
Lawper said:
Also i have a sinking feeling that med admins will use the opportunity to spam more useless wellness lectures...
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Complete with notecards with lollipops taped to the back at each chair (I wish I was kidding)

Kill....meeee.....I can barely handle the wellness BS now. I feel sorry for you kids.
 
Step 1 is a stupid largely irrelevant test. If you had me sit down and take it right now I might pass but who knows.

I could pass step 2 ck and step 3 with ease. They are much more relevant to medicine and being a physician. So long as these two keep their score, this will be a good move in the long run.
 
Tenk said:
Step 1 is a stupid largely irrelevant test. If you had me sit down and take it right now I might pass but who knows.

I could pass step 2 ck and step 3 with ease. They are much more relevant to medicine and being a physician. So long as these two keep their score, this will be a good move in the long run.
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Why is Step 3 useful?
 
What do you think this means for EM/gas for DO grads?
 
Lawper said:
Yeah but Step 2 is taken right after clinical years with little time to prepare for something competitive. The only way to fix this is to drastically reduce preclinical to 1 year and have 3 years for clinical.
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Are you mad??? I literally got goosebumps at the thought lol. I literally cannot imagine compressing those 2 years any more than the barebones they already do.

I mean, not really...everyone’s been managing to study for the thing until now. With it being at least a consideration in the process, too. School’s would just give more dedicated if they want any hopes of sending their products to competitive residencies.
 
DO here, so Class of 2022 is okay though? We'll be taking Step either this year or next year, before the change. By the time the change happens (earliest January 2022), we'd have already applied and be doing residency interviews?
 
alkaidius said:
Are you mad??? I literally got goosebumps at the thought lol. I literally cannot imagine compressing those 2 years any more than the barebones they already do.

I mean, not really...everyone’s been managing to study for the thing until now. With it being at least a consideration in the process, too. School’s would just give more dedicated if they want any hopes of sending their products to competitive residencies.
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I mean it's already being done at few schools so they can extend this easily to everywhere. I don't see the point of spending 2 years studying preclinical stuff when i can use one of the years preparing more clinically, Step 2 and taking electives, aways etc.
 
Actinium24 said:
Not just that, but this person also assumes he/she is already getting into Harvard, Stanford, and Hopkins and is actually worried that this change alone will desecrate his chances at a ROAD specialty. Like seriously.......
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holy ****...relax people. That's not what I'm saying. I was just in another thread where a person was trying to decide which school to go to. So that's how I got the idea to ask the question. I never claimed I was going to get accepted into any one of those schools or that I would want to be doing a ROAD specialty. Can a person just not ask a question? I'll be happy to get into any medical school. It's like nobody can ask a question in here anymore without walking on eggshells. Relax. Take a chill pill.
 
This thread right now

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9blade said:
holy ****...relax people. That's not what I'm saying. I was just in another thread where a person was trying to decide which school to go to. So that's how I got the idea to ask the question. I never claimed I was going to get accepted into any one of those schools or that I would want to be doing a ROAD specialty. Can a person just not ask a question? I'll be happy to get into any medical school. It's like nobody can ask a question in here anymore without walking on eggshells. Relax. Take a chill pill.
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Sorry if I offended you
 
CheGuevaraMD said:
Technically this change could reduce stress at the med school level, since many students will be resigned to their fate (i.e. no sense in trying for certain specialties if you're at rank<X). High schoolers and undergrads may be more stressed though.

This is how they do it in Europe -- you're tracked very early on in your life, so you have very little hope of a high outcome if you're on a low track. Low stress but highly depressing. Also increases inequality and classism.
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Name checks out.
 
Tenk said:
Step 1 is a stupid largely irrelevant test. If you had me sit down and take it right now I might pass but who knows.

I could pass step 2 ck and step 3 with ease. They are much more relevant to medicine and being a physician. So long as these two keep their score, this will be a good move in the long run.
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Not disagreeing, but a high Step 1 did provide a gateway for students from low-mid-tier schools entry into the highly-competitive specialties early enough for them to seek relevant clinical experience and burnish/tailor their qualifications. Delaying that validation a year changes the equation substantially and increases the risk of focusing on the 'wrong' specialty.
 
Preclinicals need to be 1.5 years or even 1 year. I'm pretty sure if you give Uworld, Pathoma, Sketchy, First Aid, and Anki to M1 day 1 and tell them go study for step 1, you have 1-1.5 year to take it. They will all PASS. If motivation is an issue class grades still need to be met and passed or else they can't move onto the next course let alone Step 1. So much of M1 and M2 curriculum is wasted on poorly executed powerpoint lectures. Dr. Sattar on pathoma can teach me a concept a million times better than school lecturers rambling on and on about low-yield stuff. This will ultimately force med schools to change the timeline of the preclinical years.
 
Yeaboi09 said:
Preclinicals need to be 1.5 years or even 1 year. I'm pretty sure if you give Uworld, Pathoma, Sketchy, First Aid, and Anki to M1 day 1 and tell them go study for step 1, you have 1-1.5 year to take it. They will all PASS. If motivation is an issue class grades still need to be met and passed or else they can't move onto the next course let alone Step 1. So much of M1 and M2 curriculum is wasted on poorly executed powerpoint lectures. Dr. Sattar on pathoma can teach me a concept a million times better than school lecturers rambling on and on about low-yield stuff. This will ultimately force med schools to change the timeline of the preclinical years.
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I feel UFAPS is overkill for Step 1 now but i'm not sure
 
Yeaboi09 said:
Preclinicals need to be 1.5 years or even 1 year. I'm pretty sure if you give Uworld, Pathoma, Sketchy, First Aid, and Anki to M1 day 1 and tell them go study for step 1, you have 1-1.5 year to take it. They will all PASS. If motivation is an issue class grades still need to be met and passed or else they can't move onto the next course let alone Step 1. So much of M1 and M2 curriculum is wasted on poorly executed powerpoint lectures. Dr. Sattar on pathoma can teach me a concept a million times better than school lecturers rambling on and on about low-yield stuff. This will ultimately force med schools to change the timeline of the preclinical years.
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You’re making the mistake in thinking that our current preclinical system is good. Yeah give anyone a year to study exclusively FIRST AID and anyone can pass it. But the current curriculum was tailored TO Step 1 rather than the other way around. I cannot tell you how many times I’ve heard “don’t worry about why, just memorize”.
 
Lawper said:
No. Keep it 4 years with 1 + 3 model. Having more clinical time is critical.
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Clinical time has been watered down somewhat... One learn a lot more in their first 6 months of residency than they learn in clinical year

Being responsible for patients yourself accelerate your learning... Residency is what make physicians
 
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alkaidius said:
Or keep it two years, but tailor the curriculum so that it covers both exams. There’s a decent bit of overlap that this is viable.
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Why would 2 years preclinical be necessary if most of the critical learning is done at the wards? With now a bigger emphasis placed on Step 2 that attendings argue is clinically relevant, having more clinical time is absolutely valuable if not necessary
 
tulip81 said:
Well said and I completely agree.

This needed to happen. But this is in no way removing the 'burden' or 'stress' from students shoulders. They are simply moving the problem to a different location. There needs to be a complete reform if there is going to be any reform, and this just seems premature and not well thought out.

I think limiting the # of residency apps a person can place (minus couples match perhaps) would have been more beneficial to the immediate future than a non-strategic step 1 change. That way, LSU-Shreveport Peds or whatever isn't getting 260+ apps from 1000K students.
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Alternatively, they may be a step ahead of us (pun intended). The logic that this will turn Step 2 CK into the new Step 1 must have also occured to them. If their goal was to have Step 1, Step 2 CK and Step 2 CS all become pass/fail like other licensure exams, they'd need to ease everyone into it exactly like this. Would not be surprised at all if in ~5 years Step 2 CK is up for a similar change.
 
Where you went to medical school will now matter a lot more to residency programs since the pre-clinical years are already pass/fail at most schools anyway. It makes it hard to distinguish performance in the early years of medical school.
 
Splenda88 said:
Clinical time has been watered down somewhat... One learn a lot more in their first 6 months of residency than they learn in clinical year

Being responsible for patients yourself accelerate your learning... Residency what make physicians
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Yeah but if the core rotations are done in 2nd year, i have 2 more years to learn to practice working like an acting intern and be well prepared for residency
 
efle said:
Alternatively, they may be a step ahead of us (pun intended). The logic that this will turn Step 2 CK into the new Step 1 must have also occured to them. If their goal was to have Step 1, Step 2 CK and Step 2 CS all become pass/fail like other licensure exams, they'd need to ease everyone into it exactly like this. Would not be surprised at all if in ~5 years Step 2 CK is up for a similar change.
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Smh at the bold.

Also this is why the current changes are absolutely idiotic. If Step 1 is changed, so should Step 2. You don't just shift the mania and panic to another exam
 
Lawper said:
Why would 2 years preclinical be necessary if most of the critical learning is done at the wards? With now a bigger emphasis placed on Step 2 that attendings argue is clinically relevant, having more clinical time is absolutely valuable if not necessary
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It’s easier to setup. Theres no real need for most schools to complicate their curriculum. Legally it also keeps things simpler with having to coordinate between rotation sites. Probably a whole mess of internal stuff. I totally agree with having more clinical, though, I think it’s too drastic a change. Maybe in the long term.
 
alkaidius said:
It’s easier to setup. Theres no real need for most schools to complicate their curriculum. Legally it also keeps things simpler with having to coordinate between rotation sites. Probably a whole mess of internal stuff. I totally agree with having more clinical, though, I think it’s too drastic a change. Maybe in the long term.
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I think the schools should discuss changes immediately and gradually reduce preclinical time yearly. From 2 yr to 1.5 yr to 1 yr.
 
Lawper said:
Yeah but if the core rotations are done in 2nd year, i have 2 more years to learn to practice working like an acting intern and be well prepared for residency
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You aren't going to work like intern if you are NOT ultimately responsible for patients... aka making the difficult calls. Trust me! It's a different mindset.
 
Lawper said:
I think the schools should discuss changes immediately and gradually reduce preclinical time yearly. From 2 yr to 1.5 yr to 1 yr.
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As if schools are fast about doing ANYTHING. My school has been arguing about the best way to coordinate between clinical skills lab and OMM lab for 5 years now. I have zero faith they can do this lol.
 
Shotapp said:
How is this going to affect DO students?
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Trying to discern NBOME's reaction is a fool's errand. All I can tell you is that they don't give a damn about your career goals.

I suspect that Step 2 will be the screen now, but as I understand what's on Step 2, it will make more of an even playing field, given that the knowledge base being assessed is more on clinical thinking and less on scientific knowledge. But make sure you know your best practices and epidemiology, for starters!!!
 
Lawper said:
Smh at the bold.

Also this is why the current changes are absolutely idiotic. If Step 1 is changed, so should Step 2. You don't just shift the mania and panic to another exam
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True but I'd prefer the mania on step 2, which felt much easier to study for and more clinical relevant than step 1. I remember having a question on my step 1 about diencephalon... like come on... embryo is useless for clinical medicine. Step 1 was just too much memorization of stuff I ultimately forgot going into clinicals.

Someone also said it here, tell me to take to take step 1 now and I'd probably fail. I'd still pass Step 2 because those algorithms for clinical management is something I'd be able to recall and is actually more applicable to the practice of medicine.

50% of Step 1 is based on pathology but barely anyone goes into pathology. There is barely any derm on Step 1 yet Step 1 is a huge metric for derm residency because of supply and demand. Step 1 to me just shows how capable you are at memorizing minutiae whereas Step 2 cares more about clinical reasoning. Sure, memorizing that minutiae from uptodate and other resources is important down the road for making clinical decisions but it's something a lot of physicians can easily look up if they forget. But, that clinical life-saving decision is what should be tested the most. Can you distinguish life-threatening diagnosis from a vignette? Do you know the next steps in management for a life-threatening condition. Step 1 doesn't accomplish those things. It can be argued whether how well Step 2 assess those skills but it definitely does it more than Step 1.
 
Sorry if this has already been discussed, but what happens to Class of 2023 when we apply with a mix of both P/F and numerical scores? The 2-year preclinical students would take Step 1 in 2021 and get a numerical score, while the students with an accelerated preclinical who take Step 1 after clerkships would be taking it in 2022 when it’s P/F. Would everyone’s scores be converted to P/F for the 2023 app cycle?

this whole announcement was so vague and poorly thought-out.
 
Is there anyone I can message about this? I am an incoming MS1 and am deciding medical schools. I am hoping to see how this would factor in.
 
Natural Killer Cell said:
DO here, so Class of 2022 is okay though? We'll be taking Step either this year or next year, before the change. By the time the change happens (earliest January 2022), we'd have already applied and be doing residency interviews?
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It shouldn't impact 2022. Like you said, it's worded that the earliest possible change would be in January 2022. We'd be submitting our rank list a month later.
 
Tenk said:
I mean maybe if we went back in time 40 years where students actually did stuff independently. I don’t think students get enough exposure to do well on step 3 nowadays.
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Darn. What i was hoping for was a 1 yr preclinical and 3 yr clinical, where last 2 years give full opportunities for students to practice independently and be well prepared. But idk if it can happen
 
Assuming everything else remains the same, the most obvious ramifications are:
-anytime you remove an objective metric, the process becomes more subjective. Now LORs from big names, aways, clinical evals and school prestige become more important.
-the most important board exam will now be taken the year you apply to residency, giving the applicant who does poorly no time to prepare their app for a different field.
-M1 and M2 will become less standardized and more school specific. Now schools can teach what they want in whatever detail they choose.
-step 2 is the new step 1. Stress will simply move from summer of M2 to summer of M3...but now you get one shot to do well with no shot at redemption.
-DOs and IMGs will get shafted. Some residencies explicitly write that competitive DOs and IMGs should have steps >250...now one of those board exams are gone, and should step 2 become p/f, options will become very limited for these applicants.
-the MCAT becomes more important. Board exams are a tool low tier MDs, DOs and IMGs use to open doors to highly competitive places...now it becomes even more important to attend a top medical school by doing very well on the MCAT.

Just a few thoughts.
 
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