Step 1 P/F: Decision

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efle said:
Medical school faculty do not govern the NBME. There is absolutely no way that all the admins got together and strong armed the NBME into a pass/fail change out of fear that the free market was going to replace their preclinical lecturers with superior product. Look at other cases like Step 2 CS becoming mandatory for American students and then again when they raised the failing number-having students fail is a nightmare for med school deans and yet the NBME chugged along doing what makes them money, anyways.
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AAMC were the biggest stakeholders behind the recent change!!!! The American Associate of Medical Colleges. Guess whose interests they stand for?
 
libertyyne said:
do they tho? did they have the same access to primary education as well ? lets not throw this thread into more chaos.
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I'm tellin you right now they already knew step1 hysteria would be replaced by something else. It's inevitable. They just want to increase diversity in competitive specialties because it's mostly white/asian
 
ace_inhibitor111 said:
AAMC is the biggest stakeholders behind the recent change!!!! The American Associate of Medically Colleges. Guess whose interests they stand for?
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The AAMC is a toothless organization that again, doesn't control jack, especially not the NBME. Remember when they redesigned the MCAT and pushed as hard as they could for it to be treated as Pass/Fail with everything above 500 equally predictive of success? lol!
 
thissuckslol said:
I'm tellin you right now they already knew step1 hysteria would be replaced by something else. It's inevitable. They just want to increase diversity in competitive specialties because it's mostly white/asian
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PDs are going to fall back on using step 2 ck or using the good ol boys club of t-20 candidates , or even mcat. . This does not increase diversity. Diversity issue is a pipeline issue. Just because AMSA wanted it changed and it got changed doesnt mean that AMSA was the reason it got changed.
 
workaholic007 said:
i just dont understand why they did this. honestly neither programs or students benefit - only maybe a small minority of the affected parties benefit. there must be some agenda behind this.

as a first year student at a bottom MD school, do you think this is gonna affect me? Im so confused and lost.

lastly, why would they have a DO merger if they are going to do this?
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Unfortunately it's not out of the realm of possibility - but will depend on what specialties you're interested in.

thissuckslol said:
I'm tellin you right now they already knew step1 hysteria would be replaced by something else. It's inevitable. They just want to increase diversity in competitive specialties because it's mostly white/asian
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I don't think this will help minorities. It's gonna help the prestigious schools which often are made up of privileged people anyway
 
gulli_97 said:
They should go ahead and make the SAT pass/fail too
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bro standardized tests are not the problem. The problem is people finding blame for not scoring high. At what point do you decide that someone's performance is good enough for one of the hardest and most influential fields of study possible? Where do you draw the line if you make everything a participation award?
 
UNMedGa said:
Unfortunately it's not out of the realm of possibility - but will depend on what specialties you're interested in.



I don't think this will help minorities. It's gonna help the prestigious schools which often are made up of privileged people anyway
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The idea was to help those at a disadvantage but it will help the elite. Funny, medicine will always be an ol boys club
 
Mass Effect said:
Depends on the field, but just off the top of my head -- research, clinical evaluations, class rank, shelf score in the field?
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Ok, but there aren't shelf scores for some fields. And many schools don't rank, and the ranks aren't finalized until the MPSE comes out in Oct of 4th year. Unfortunately, a better metric doesn't exist. If it did, no one would use Step 1 in the first place. The only reason some people do is because other than that, there is literally nothing to look at that is standardized across applicants/schools.

You can say that we need new standardized metrics across all schools, and sure that sounds good, but until that happens, this will be hurtful to students. Because students who would have been more competitive will decide to play it safe, and some will over-reach and apply and do their rotations in fields they have zero chance of matching in a few months later when their step 2 comes back.
 
thissuckslol said:
bro standardized tests are not the problem. The problem is people finding blame for not scoring high. At what point do you decide that someone's performance is good enough for one of the hardest and most influential fields of study possible? Where do you draw the line if you make everything a participation award?
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I totally agree with you, my comment was sarcasm
 
efle said:
The AAMC is a toothless organization that again, doesn't control jack, especially not the NBME. Remember when they redesigned the MCAT and pushed as hard as they could for it to be treated as Pass/Fail with everything above 500 equally predictive of success? lol!
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It is clear from the decision page whose opinions the NBME truly values, and the AMA and AAMC are plastered on there with pride. I would trust neither organization with the future of this profession.
 
The other people this is really going to hurt, more than it did before, is those who fail Step 1.
 
ace_inhibitor111 said:
It is clear from the decision page whose opinions the NBME truly values, and the AMA and AAMC are plastered on there with pride. I would trust neither organization with the future of this profession.
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As the above poster says, don't mistake alignment with causality. AMSA is happy over potential diversity increases, and I think we all 0% believe that was a motive for the NBME.

As dust settles maybe we get more tidbits. I am absolutely speculating here, but I'll eat my hat if it turns out that the NBME is just doing the right thing and listening to faculty because they want to please the lobbying arm or the group that couldn't even change the use of scores for the MCAT.
 
gamerEMdoc said:
Ok, but there aren't shelf scores for some fields. And many schools don't rank, and the ranks aren't finalized until the MPSE comes out in Oct of 4th year. Unfortunately, a better metric doesn't exist. If it did, no one would use Step 1 in the first place. The only reason some people do is because other than that, there is literally nothing to look at that is standardized across applicants/schools.

You can say that we need new standardized metrics across all schools, and sure that sounds good, but until that happens, this will be hurtful to students. Because students who would have been more competitive will decide to play it safe, and some will over-reach and apply and do their rotations in fields they have zero chance of matching in a few months later when their step 2 comes back.
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Ok, do you seriously think this is going to happen with 2 years notice and schools aren't going to change things around? Come on guys. This is a change, but it doesn't mean that this is the ONLY change and everything else will remain the same.

I would bet that in 2 years when it comes time to apply for clerkships, schools will have other metrics to send to programs, whether that's pre-clinical class ranks, additional shelf exams, whatever. This notion that everything will remain exactly as it is and Step 1 will just change to P/F is a fantasy.
 
Mass Effect said:
Ok, do you seriously think this is going to happen with 2 years notice and schools aren't going to change things around? Come on guys. This is a change, but it doesn't mean that this is the ONLY change and everything else will remain the same.

I would bet that in 2 years when it comes time to apply for clerkships, schools will have other metrics to send to programs, whether that's pre-clinical class ranks, additional shelf exams, whatever. This notion that everything will remain exactly as it is and Step 1 will just change to P/F is a fantasy.
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I would not be surprised at all if schools started sending NBME shelf exam results in the MSPE. They already have that data, its easy to submit and it will be relatively objective. It also provides fields with specifics like interested in a surgical sub? how did you do on surgery shelf? Interested in OBGYN, how was the shelf?
 
thissuckslol said:
bro standardized tests are not the problem. The problem is people finding blame for not scoring high. At what point do you decide that someone's performance is good enough for one of the hardest and most influential fields of study possible? Where do you draw the line if you make everything a participation award?
Click to expand...
gulli_97 said:
I totally agree with you, my comment was sarcasm
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yeah bro idk how didnt catch the sarcasm lol - i thought it was funny comment by gulli
 
Maybe they’ll just decrease the pass rate for Step 1, for example making it a 30 percent fail rate
Evens the playing field
Then, getting in won’t be the issue. STAYING in will.
 
libertyyne said:
I would not be surprised at all if schools started sending NBME shelf exam results in the MSPE. They already have that data, its easy to submit and it will be relatively objective. It also provides fields with specifics like interested in a surgical sub? how did you do on surgery shelf? Interested in OBGYN, how was the shelf?
Click to expand...
ace_inhibitor111 said:
It is clear from the decision page whose opinions the NBME truly values, and the AMA and AAMC are plastered on there with pride. I would trust neither organization with the future of this profession.
Click to expand...
Also should note that ECFMG, the group for internationals, is on the page supporting this change too, and internationals sure as hell aren't going to benefit from this. There's something else coming. Something afoot at the Circle K...

I find this sentence off their announcement page interesting:

As this future work develops, and as additional system-wide changes may unfold, including advances in reliable and holistic assessment of the training of physicians, the USMLE program will offer its resources and partnership.

Perhaps my comment earlier about an aptitude test for medical students wasn't far off. Maybe they're going to introduce something new to serve the function that PDs were trying to squeeze out of Step 1. Or, like libertyne said, maybe their win here is getting all medical schools to use and report NBME shelf exams throughout preclinical and clinical years as the new standardized metric.
 
efle said:
As the above poster says, don't mistake alignment with causality. AMSA is happy over potential diversity increases, and I think we all 0% believe that was a motive for the NBME.

As dust settles maybe we get more tidbits. I am absolutely speculating here, but I'll eat my hat if it turns out that the NBME is just doing the right thing and listening to faculty because they want to please the lobbying arm or the group that couldn't even change the use of scores for the MCAT.
Click to expand...

I’m sure the AAMC are really upset they couldn’t make the MCAT a competency test with a 500 being a pass. Although, it’s strange that they publish a snazzy bell curve every year showing in excruciating detail the percentiles for each score bracket and subsection. I wonder who the money for the MCAT goes to anyway?
 
bioboy23 said:
So do you quit zanki or keep up the grind?
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I have no clue. I’m going to keep up the grind through the end of preclerkship in December, but I’m not sure if I will be able to keep up zanki during clerkship and being to study for the rotation and shelf, plus research etc. And if it’ll be pass fail when I take it anyway, doing well in my rotations will be more important.
 
Mass Effect said:
Ok, do you seriously think this is going to happen with 2 years notice and schools aren't going to change things around? Come on guys. This is a change, but it doesn't mean that this is the ONLY change and everything else will remain the same.

I would bet that in 2 years when it comes time to apply for clerkships, schools will have other metrics to send to programs, whether that's pre-clinical class ranks, additional shelf exams, whatever. This notion that everything will remain exactly as it is and Step 1 will just change to P/F is a fantasy.
Click to expand...

I sure hope so. But I have little faith in medical schools, I read hundreds of MPSEs a year, and I can tell you many schools MPSEs are often garbage. They strictly try to make every student seem the same, they go out of their way not to stratify students in many cases.

Could this spur on schools to create ways of stratifying their students? Sure. Will it? I honestly don't know.
 
ace_inhibitor111 said:
I’m sure the AAMC are really upset they couldn’t make the MCAT a competency test with a 500 being a pass. Although, it’s strange that they publish a snazzy bell curve every year showing in excruciating detail the percentiles for each score bracket and subsection. I wonder who the money for the MCAT goes to anyway?
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I mean there's a percentile curve released for the Step 1 every year too. Are we claiming organizations keep exams scored to benefit off that, or are we claiming organizations make exams pass/fail to benefit off that?
 
Matthew9Thirtyfive said:
I have no clue. I’m going to keep up the grind through the end of preclerkship in December, but I’m not sure if I will be able to keep up zanki during clerkship and being to study for the rotation and shelf, plus research etc. And if it’ll be pass fail when I take it anyway, doing well in my rotations will be more important.
Click to expand...

I'm gonna keep it up. Who knows how long it'll actually take them to implement, what the push back will be, if the scores will retroactively be changed, etc. I have a feeling they used the specific language they did "it will be no earlier than January 2022" they don't want it to impact current students to a great extent. I think they want to try and get as many current students to take it as they can so that we go "according to plan".

Also, while step 1 info isn't ALL applicable to step 2, I think without having a good grasp of step 1 material killing step 2 would be hard.

And honestly, if you're an M1 now, you will probably take the scored version.
 
gamerEMdoc said:
I sure hope so. But I have little faith in medical schools, I read hundreds of MPSEs a year, and I can tell you many schools MPSEs are often garbage. They strictly try to make every student seem the same, they go out of their way not to stratify students in many cases.

Could this spur on schools to create ways of stratifying their students? Sure. Will it? I honestly don't know.
Click to expand...
well when your reputation rests on how well your students match it only makes sense to not try and gun down your students by saying Jimmy was better than Timmy.

I'm just so confused with how this is going to play out they should have just made step 1 into a quartile grading system that way it's still useful.

Look what happened to undergrad grades, if schools are having their classes unranked and P/F then people are really gonna DGAF it and just skate by with no repercussions. How do you discern from the pack at that point? How do you reward someone who studied hard and just missed out on AOA versus someone who got straight 70's and skated by
 
efle said:
Also should note that ECFMG, the group for internationals, is on the page supporting this change too, and internationals sure as hell aren't going to benefit from this. There's something else coming. Something afoot at the Circle K...

I find this sentence off their announcement page interesting:

As this future work develops, and as additional system-wide changes may unfold, including advances in reliable and holistic assessment of the training of physicians, the USMLE program will offer its resources and partnership.

Perhaps my comment earlier about an aptitude test for medical students wasn't far off. Maybe they're going to introduce something new to serve the function that PDs were trying to squeeze out of Step 1. Or, like libertyne said, maybe their win here is getting all medical schools to use and report NBME shelf exams throughout preclinical and clinical years as the new standardized metric.
Click to expand...

I can get on board with them trying to add another test. It would make sense perhaps if NBME were to broker some sort of deal with all the others to make Step 1 P/F in order for them to make another test that they could profit off of.
 
ooh a bean said:
I can get on board with them trying to add another test. It would make sense perhaps if NBME were to broker some sort of deal with all the others to make Step 1 P/F in order for them to make another test that they could profit off of.
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now THIS is a conspiracy theory I can get behind. It would make sense in the end considering how much they've ramped up the costs of applying and taking the tests. we're making it rain up here
 
thissuckslol said:
that'll do great for the mental health issues in the medical field.
[/QUOT

I was joking... (Sorta)
As an incoming m1 I’m already hosed anyways I think. The timing of this makes me think that they want to implement this with the incoming m1 class, my class.
As most Current m1 students currently are taking the step 1 in 2021 before p/f is implemented. I agree with the other posters who say that there’s no way that retroactive pass/fail scoring will occur. For me, I’m Just gonna have to Gun Harder!
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incoming m1 looking to match into a competitive specialty. i see this as a win... instead of studying for a stupid test i can spend more time actually doing research, volunteering, and engaging with the specialty. of course, the match will still be extremely competitive, but it seems more clinically relevant and real-world metrics will be weighted more heavily now.
 
i didnt read all 9 pages of this but did anybody come to a conclusion if class of 2023 will have a normal 2xx score and application process or nah
 
thissuckslol said:
well when your reputation rests on how well your students match it only makes sense to not try and gun down your students by saying Jimmy was better than Timmy.

I'm just so confused with how this is going to play out they should have just made step 1 into a quartile grading system that way it's still useful.

Look what happened to undergrad grades, if schools are having their classes unranked and P/F then people are really gonna DGAF it and just skate by with no repercussions. How do you discern from the pack at that point? How do you reward someone who studied hard and just missed out on AOA versus someone who got straight 70's and skated by
Click to expand...


Right. I get why schools do it. But you can also understand the skepticism of believing they will now all of a sudden start using metrics to rank their students against one another now that Step 1 scoring goes away. The whole reason standardized test scores existed were because they were... standardized. I just don't believe schools, who are motivated to get their students matched, are now all of a sudden going to try to start ranking their students again and openly providing this info in the 3rd year of medical school to residency programs.
 
giguerex35 said:
i didnt read all 9 pages of this but did anybody come to a conclusion if class of 2023 will have a normal 2xx score and application process or nah
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You should. It’s quality stuff. But conclusion was nobody knows yet, just that 2022 is the earliest it’d be implemented, so it COULD be later. But most will say continue to study your butt off for Step 1 because Step 2 material is similar enough that it correlates.
 
pianoguy123 said:
ad of studying for a stupid test i can spend more time actually doing research, volunteering, and engaging with the specialty.
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Sounds great. And what happens when you do all of that, then get a score below their application cutoff 4 months into fourth year. Wouldn't you have preferred to know by the end of 2nd year whether you were, or were not, competitive enough for your given specialty choice?
 
So i guess if you think about it having many small NBME shelves that get reported ,or they give you a cumulative shelf score at the end of preclinical and clinicals wouldnt be such a bad idea. It alleviates the issue with overreliance on one day of testing and spreads it out over 3 years. I dont think this might be such a bad idea.
 
pianoguy123 said:
incoming m1 looking to match into a competitive specialty. i see this as a win... instead of studying for a stupid test i can spend more time actually doing research, volunteering, and engaging with the specialty. of course, the match will still be extremely competitive, but it seems more clinically relevant and real-world metrics will be weighted more heavily now.
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if you are at top school i would agree with that. I don't think it will benefit people at lower tier schools since the obvious and fair assumption is "oh brand name school must mean better candidate so we will give them an away rotation invite."
 
libertyyne said:
So i guess if you think about it having many small NBME shelves that get reported ,or they give you a cumulative shelf score at the end of preclinical and clinicals wouldnt be such a bad idea. It alleviates the issue with overreliance on one day of testing and spreads it out over 3 years. I dont think this might be such a bad idea.
Click to expand...

Shelf scores would be nice if there was some way of putting that info out to programs. Some type of cumulative running shelf exam GPA if you will.
 
Possible indirect consequences? Place your bets:

More students wanting a competitive specialty start taking a year off between M2 and M3 for research. Since everyone can’t do this, med schools are forced to create a research track based on grades, grant funding, lottery, etc. This track makes med school 5 years long, costing an extra year of tuition.

More Med schools convert to the 1.5 year pre-clinical curriculum, giving students more research or clinical time.

More medical students pursue dual degrees.

First-Aid revamps the Step 2 CK book series, one book, 800 pages.

Book sales for FA Step 1 stay the same due to paranoia of not passing.

Step 2 CK starts testing more basic science content.

Students focus so much on Step 2 CK during 3rd year, they read FA and see less patients.

Residences focus more on Step 2 CK score, research, publications.

Residencies start asking for NBME scores from preclinical years.
 
thissuckslol said:
well when your reputation rests on how well your students match it only makes sense to not try and gun down your students by saying Jimmy was better than Timmy.

I'm just so confused with how this is going to play out they should have just made step 1 into a quartile grading system that way it's still useful.

Look what happened to undergrad grades, if schools are having their classes unranked and P/F then people are really gonna DGAF it and just skate by with no repercussions. How do you discern from the pack at that point? How do you reward someone who studied hard and just missed out on AOA versus someone who got straight 70's and skated by
Click to expand...

Well according to AAMC, the difference between a 70 and 100 is no longer worth distinguishing according to them.

Got a pulse? Got a pencil? Here’s your MD.
 
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