They correlate well because they're similarly constructed tests that are studied for with similar methods. I guarantee the correlation between shelves for an individual is high, but that's not because of the content being similar in OBGYN and Neuro shelves. Even when topic is the same (e.g. pick any from that list) the step 1 questions emphasize pathophys causing disease to arise while step 2 asks for what to order/test/treat with next.
I don't think its impossible for someone to enter the wards ready to do well on both tests, but that'd be from having picked up a lot outside of UFAPS (like from school curriculum). I do think it's impossible for someone to believe that Uworld banks and First Aid books and online lecture packages and the USMLEs themselves are spuriously divided with an 80% overlap.
That's a great way to get a look at how an applicant works, but school grading is prone to wild inconsistency and the expectations are all over the place. I'm sure folks here can attest - there are preceptors who are brutal and others who give everyone a trophy and a pat on the back for showing up. Add to that, the push to move toward P/F for everything, and objectivity is out the window.
Well, when it happened to Dental they just started accepting other standardized exams like CBSE and even GREs.
I agree. It seems the response to this decision has focused on the need for more objective criteria, for some reason. But yes definitely too much applying overall.
I don’t disagree. The value of the FITREP system is the weight applied to the rating because all evaluators are compared to one another. If you consistently fluff your evaluations, you’re not doing anyone any good. That alone can’t fix how candidates are evaluated, but something along those lines seems more attractive than P/F grades or a glowing LOR that is identical to someone else’s glowing LOR.
I very much agree. Furthermore, some are much harsher than others. I had one evaluate me “below expectations” while the other people (3 of them i think) that evaluated me all gave me “far exceeds”. That evaluation was tossed... and other students had the same issue with this person.
Yep. On the other hand, some dont care and give honors to everyone.
Are millennials killing the step 1 industry?
Lol I’m far from boomer but I see what people in my generation and few years younger and older are doing. This emphasis on “life balance” and “mental health” has resulted in docs that are too sensitive. I see them cry over scores, an attending not giving enough praise, and threatening to report their own programs to LCME/ACGME like a spoiled kid telling their parents that they’ll report them for disciplining over anything. This doesn’t help produce better docs or improve medical care IMO. Step 1 (or NBME) has been around for a very long time and has helped PDs screen people in and out on both extremes of the scores.
You might not be a boomer in age, but sure sound like one in spirit. Step 1 didnt exist in this format before 92 , yet going pass fail is the end of the world? Why wasnt the world ending before 92?
Older physicians always use these tactics to defend the current antiquated medical system. Nothing new!
This will somehow make the NBME more money. Maybe they’re planning on selling more shelf exams or something.
Reporting preclinical and clinical shelf scores in MSPEs could be a decent way forward. Much better at placing people across many thousands of test items, and highlighting strong areas. Gives people a way to stand out in their subject of interest instead of all battling it out over First Aid.
That seems like a good idea if everyone had the same third year experience. But that’s not the case. Some people do 40 hours no call no weekends on surgery while others do 80 hrs/week with a few 24 hour calls sprinkled in. Also the order of your rotations can really screw you here. For instance, the family med shelf is pretty chill if you’ve already had ob, peds, and im. It’s a monster if you haven’t.
I am honestly surprised why more people and program directors are not more interested in this. Why rely on one test day when you have dozens of data points? Its not like you couldnt import all the applicants into a spread sheet and apply custom formulas with higher weight given to certain exams. Want to do radiology? what was your path, anatomy, IM and surgery shelf score?
Yes, but people have different preclinical schedules with varied amount of time for dedicated. Schools also vary on how much they teach to the test, etc. Also even on the same service students may have a completely different experience in terms of hours. This variability is part of life, but i feel like the average of shelf exams or looking at individual shelves is not terrible considering the medians and percentiles on the shelf change over the course of the year as well.
People are already binging and purging for step. You think I legit remember the Krebs cycle. All I know is that the mitochondria is the powerhouse of the cell.
Shelf studying a couple hours daily, on material related to what I'm seeing on the wards that month, is a WAY better educational experience. My school giving me an empty block of 8-10 weeks to cram 24/7 was more binge-and-purge style, not less.
I know of the krebs cycle, I also know of nuclear fusion/fission, doesnt mean i know anything meaningful about it or i could rattle off the equations/intermediate steps of either.
obviously I am exaggerating for the sake of making a point and in jest.
Bro, if you try asking people at the end of their surgical subspecialty residency to answer questions from the peds shelf, they'll bomb them whether they took scored step exams or not. Not knowing information we don't need to use is how it works. It atrophies. See: cardiologist who did an IM residency and yet doesn't remember pancreatitis.
I have some worry that this is the "secret plan" by the NBME. Most DO students, and all IMG students, do not take the shelf exams. Ring the $$$$ bell for the NBME.
why do you worry in regards to this plan , yes the NBME makes more money, but spread out testing and more data points seems like a win for both applicants and program directors.
I think tutoring industry is going to through major changes. Step 2 CK will obviously be acting monarch until the system achieves stability again. If it goes towards shelves, now they will probably pay for shelves tutoring.
Figured there was something cooking behind the scenes. Even many MD schools do not use shelves for preclinical, only clinical. If shelves became the central metric surely they'd start buying the preclinical ones to better prep us for NBME exams.
Be careful man. These SDNers are going to burn you at the stake for saying this. I had to lock my post earlier because they all came after me.
