Step 1 Pass/Fail thoughts

[VampsMed]

Hi guys! I’ve been thinking about this. What is your honest prediction on the step 1 pass/fail when it comes to residency? Do you think they’ll heavily weigh step 2 CK given step 1 isn’t graded anymore? Also, do you think certain specialties will now be more competitive? Ie EM and OB. Any thoughts would be much appreciated!

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[slowthai]

100% yes. Step 2 will be the de facto step 1. The most competitive specialties will be even more competitive because people won't self-select out secondary to a sub-par step anymore. They'll keep going and going until step 2 (a lot of people take it towards the end of 3rd year, close to ERAS), and just keep going because they're 3 years deep building an app for that specialty. Some say that the shelves correlate with step 2, so maybe people will self-select earlier. I doubt it though, lol

Interestingly, with this lack of self-selection going on, in the fields that require aways, we may see a glut of applicants, even more than there are now. Apparently most aways are first come first serve, with some having step cutoffs. Without those cutoffs because of p/f, coupled with an insane amount of people applying, people will be selling their firstborns to secure aways, lol. With that, people that weren't quick enough will be effectively barred from a specialty even if they end up having the app for it when their step 2 score comes out.

 

[VampsMed]

100% yes. Step 2 will be the de facto step 1. The most competitive specialties will be even more competitive because people won't self-select out secondary to a sub-par step anymore. They'll keep going and going until step 2 (a lot of people take it towards the end of 3rd year, close to ERAS), and just keep going because they're 3 years deep building an app for that specialty. Some say that the shelves correlate with step 2, so maybe people will self-select earlier. I doubt it though, lol

Interestingly, with this lack of self-selection going on, in the fields that require aways, we may see a glut of applicants, even more than there are now. Apparently most aways are first come first serve, with some having step cutoffs. Without those cutoffs because of p/f, coupled with an insane amount of people applying, people will be selling their firstborns to secure aways, lol. With that, people that weren't quick enough will be effectively barred from a specialty even if they end up having the app for it when their step 2 score comes out.

This is what I thought too lol. With that said though, do you think they’ll make Step 2 harder or maybe grade it differently since it’s essentially now the defining factor?

That scares me... I’m particularly interested in EM and I know most (if not all) programs require an away rotation. Do you think the level of competitiveness for EM would reach that of let’s say rads? I mean I hope not but there’s so many unknown with the changes. Not to mention the MD/DO merger

 

[slowthai]

This is what I thought too lol. With that said though, do you think they’ll make Step 2 harder or maybe grade it differently since it’s essentially now the defining factor?

That scares me... I’m particularly interested in EM and I know most (if not all) programs require an away rotation. Do you think the level of competitiveness for EM would reach that of let’s say rads? I mean I hope not but there’s so many unknown with the changes. Not to mention the MD/DO merger

Nah, I have no reason to believe that the NBME will make step 2 harder or change up the grading. The issue is that since it's an "easier" test (people usually score 10 points higher without too much trouble), I feel like it'll become harder and harder to separate the higher scores. But that's just my guess. I don't really know how the NBME scores these exams.

I mean, they're both around middle of the road in competitiveness. I don't know how much EM would be affected because they already focus on step 2 and SLOEs anyway. But I will say that EM programs are expanding at an alarming rate, so I don't know how long it'll stay at this level of competitiveness.

 

[efle]

The NBME is much more likely to switch Step 2 to P/F than to try and revamp it to fill the role of an aptitude test. If they just needed a harder-to-hack test, they would've done it with Step 1. They're here to make sure we have the minimum knowledge to get licensed, not help derm PDs thin the herd.

Won't change field competitiveness much, except maybe spiking up the competition a bit for tiny fields that previously used Step 1 as a major self selector after MS2.

You can read exactly how a bunch of PDs voted on questions like this here!

 

[Goro]

Hi guys! I’ve been thinking about this. What is your honest prediction on the step 1 pass/fail when it comes to residency? Do you think they’ll heavily weigh step 2 CK given step 1 isn’t graded anymore? Also, do you think certain specialties will now be more competitive? Ie EM and OB. Any thoughts would be much appreciated!

This has been done to death. Use the search function

 

[VampsMed]

The NBME is much more likely to switch Step 2 to P/F than to try and revamp it to fill the role of an aptitude test. If they just needed a harder-to-hack test, they would've done it with Step 1. They're here to make sure we have the minimum knowledge to get licensed, not help derm PDs thin the herd.

Won't change field competitiveness much, except maybe spiking up the competition a bit for tiny fields that previously used Step 1 as a major self selector after MS2.

You can read exactly how a bunch of PDs voted on questions like this here!

Amazing, thank you for the link!

 

[VampsMed]

This has been done to death. Use the search function

Lol sorry

 

[AnatomyGrey12]

Nah, I have no reason to believe that the NBME will make step 2 harder

According to Divine from the Divine Intervention podcasts the NBME has already made Step 2 harder and that it isn't the same test that people took a few years ago.

Just ask anyone who has taken it. It's absolutely brutal and much more difficult than Step 1.

 

[Matthew9Thirtyfive]

According to Divine from the Divine Intervention podcasts the NBME has already made Step 2 harder and that it isn't the same test that people took a few years ago.

Just ask anyone who has taken it. It's absolutely brutal and much more difficult than Step 1.

When did that happen? Cause even just last year the mean was 13 points higher than for step 1.

 

[Lawpy]

According to Divine from the Divine Intervention podcasts the NBME has already made Step 2 harder and that it isn't the same test that people took a few years ago.

Just ask anyone who has taken it. It's absolutely brutal and much more difficult than Step 1.

Good opportunity for Step 2 to go P/F

 

[slowthai]

According to Divine from the Divine Intervention podcasts the NBME has already made Step 2 harder and that it isn't the same test that people took a few years ago.

Just ask anyone who has taken it. It's absolutely brutal and much more difficult than Step 1.

Wait, what?? How?? Lol

 

[AnatomyGrey12]

When did that happen? Cause even just last year the mean was 13 points higher than for step 1.

Wait, what?? How?? Lol

It's not really a change in mean, but a change in the exam itself. I think we like to compare the bell curves of Step 1 to Step 2 because of similarity in numbers, but I really don't think they are actually related. We hear "Oh average for Step 2 is a 244" and think that it must be easier. From what I have been told by numerous people that have taken it already I do not think the percentage correct for a 244 on Step 2 is remotely similar to what it is for Step 1. People walk out if this test completely rocked and say it is nothing like Step 1.

Divine says that the NBME over the last few years has slowly changed the exam from what was once an easier "associations" exam, to a much more difficult pathophysiology based test that requires you to have that Step 1 knowledge in order to even answer the "next best step" questions on it.

Even for the test itself it's a longer exam, with many more convoluted ethics and biostats questions.

Obviously this is purely from other sources and not myself, I'll report back in August if the reports are true.

 

[Matthew9Thirtyfive]

It's not really a change in mean, but a change in the exam itself. I think we like to compare the bell curves of Step 1 to Step 2 because of similarity in numbers, but I really don't think they are actually related. We hear "Oh average for Step 2 is a 244" and think that it must be easier. From what I have been told by numerous people that have taken it already I do not think the percentage correct for a 244 on Step 2 is remotely similar to what it is for Step 1. People walk out if this test completely rocked and say it is nothing like Step 1.

Divine says that the NBME over the last few years has slowly changed the exam from what was once an easier "associations" exam, to a much more difficult pathophysiology based test that requires you to have that Step 1 knowledge in order to even answer the "next best step" questions on it.

Even for the test itself it's a longer exam, with many more convoluted ethics and biostats questions.

Obviously this is purely from other sources and not myself, I'll report back in August if the reports are true.

Isn’t it also possible that the type of questions just makes you feel like it rocked you? Even if it’s easier to do better on the exam, if you are putting in significantly more mental energy then it’s not really an easier exam despite what the score distributions say.

FWIW my friend just took it and said it was hard as ****.

 

[AnatomyGrey12]

Isn’t it also possible that the type of questions just makes you feel like it rocked you? Even if it’s easier to do better on the exam, if you are putting in significantly more mental energy then it’s not really an easier exam despite what the score distributions say.

FWIW my friend just took it and said it was hard as ****.

I mean it's definitely possible, but that doesn't make is "easier" though. And that's assuming the score distributions are actually related.

 

[libertyyne]

Isn’t it also possible that the type of questions just makes you feel like it rocked you? Even if it’s easier to do better on the exam, if you are putting in significantly more mental energy then it’s not really an easier exam despite what the score distributions say.

FWIW my friend just took it and said it was hard as ****.

The exam has a different mean and median, im not sure if they intentionally set it 10 points above step 1 so people think they are improving or it was serendipitous.

It's not really a change in mean, but a change in the exam itself. I think we like to compare the bell curves of Step 1 to Step 2 because of similarity in numbers, but I really don't think they are actually related. We hear "Oh average for Step 2 is a 244" and think that it must be easier. From what I have been told by numerous people that have taken it already I do not think the percentage correct for a 244 on Step 2 is remotely similar to what it is for Step 1. People walk out if this test completely rocked and say it is nothing like Step 1.

Divine says that the NBME over the last few years has slowly changed the exam from what was once an easier "associations" exam, to a much more difficult pathophysiology based test that requires you to have that Step 1 knowledge in order to even answer the "next best step" questions on it.

Even for the test itself it's a longer exam, with many more convoluted ethics and biostats questions.

Obviously this is purely from other sources and not myself, I'll report back in August if the reports are true.

You know step 1 felt like they had read all the practice material and intentionally selected stuff that was one degree of knowledge greater than what was in the practice material. Its like they selected experimental data that may be out there in the literature but not actually well known and it required test taking/reasoning skills to get to the answer.

 

[Matthew9Thirtyfive]

The exam has a different mean and median, im not sure if they intentionally set it 10 points above step 1 so people think they are improving or it was serendipitous.

Yeah not sure. My friend said it was hard though and she’s smart as ****. So I dunno.

 

[piii]

You can do all of zanki, UFAPS, and feel like you don’t know 10% of the info on your step 1. You can do all that work for step 2 and feel like you don’t know HALF of what you see on your test. Gonna be rough

 

[slowthai]

You know step 1 felt like they had read all the practice material and intentionally selected stuff that was one degree of knowledge greater than what was in the practice material. Its like they selected experimental data that may be out there in the literature but not actually well known and it required test taking/reasoning skills to get to the answer.

I won't lie, this is somewhat alarming, lol. Hoping that they keep this mainly to the experimental qs cuz my test taking skills SUCK.

 

[Matthew9Thirtyfive]

I won't lie, this is somewhat alarming, lol. Hoping that they keep this mainly to the experimental qs cuz my test taking skills SUCK.

Opposite here. My memorization sucks but my test taking skills pay the bills.

 

[slowthai]

You can do all of zanki, UFAPS, and feel like you don’t know 10% of the info on your step 1. You can do all that work for step 2 and feel like you don’t know HALF of what you see on your test. Gonna be rough

God, just demoralizing me the more loool

 

[slowthai]

Opposite here. My memorization sucks but my test taking skills pay the bills.

I would give anything to trade places with you, lol. You can just pound the crap out of FA/Zanki/LY to ensure a good knowledge base. Me? I have to do multiple qbanks and hope I'm not effing it up as I go along trying to develop these skills that I may never develop, lol

 

[Matthew9Thirtyfive]

I would give anything to trade places with you, lol. You can just pound the crap out of FA/Zanki/LY to ensure a good knowledge base. Me? I have to do multiple qbanks and hope I'm not effing it up as I go along trying to develop these skills that I may never develop, lol

Yeah I really have to pound the crap out of it though. Like I will literally get the same card wrong like 8 times in a row before I finally get it haha. I’m really good at memorizing pictures though. Anatomy and our rads stuff were a breeze.

 

[libertyyne]

I won't lie, this is somewhat alarming, lol. Hoping that they keep this mainly to the experimental qs cuz my test taking skills SUCK.

What is even weirder is the nbme practice exams seemed like they were straight rote memorization of a little detail. So the way it works in my head is that if you have those details memorized you can actually reason through step 1 questions. But you need that information to be able to do so.