STEP 1 Score Rate of Increase?

[Vesh]

---

Members do not see this ad.

Hello all,

I was recently speaking to a cousin of mine who has just started residency and we were discussing how competitive residencies were getting. In particular he mentioned that it seemed like everybody was doing increasingly well on STEP 1 every year. I was looking at the NRMP charting outcomes, and the mean score has jumped nine points (from 221 to 230) in just five short years (2009 to 2014). Considering I will be starting MSTP this fall, this especially piqued my interest. I would think this sort of jump would affect MD/PhD students in particular because in the time that it takes to earn a PhD, an above average score can slowly diminish in value. Obviously, earning a superstar score (255+) will probably buffer this increase, but that is easier said than done. I would think that this gradual increase in STEP scores cannot be indefinitely sustainable, but I was just wondering if others had thoughts about this.

I am aiming for a particularly competitive specialty (RadOnc) with fewer spots and I have to imagine that a ~240 may have been more adequate just a few years ago. Regardless I think that getting a good score on STEP 1 is probably the most important thing I can do in the first two years of medical school; this has just had me thinking for the past few days.

P.S. I apologize if this has already been discussed before, I was having trouble searching for similar threads

 

[Neuronix]

http://www.neuronix.org/2012/06/effects-of-score-creep-trends-in.html

You are correct, and the residency programs don't care when you took step 1. They only care how you compare to the other applicants when you apply. Step 1 is just another obstacle for MD/PhD students.

In the future I suspect this trend will continue with the increasing ratio of US+Caribbean grads to residency positions.

 

[URHere]

This has been a major issue for some of the students in my program. The consensus is that you do as well as you possibly can on Step 1. If your score isn't good enough for your intended specialty by the time MS3 year rolls around, you have the option of taking Step 2 CK early and knocking it out of the park. It won't replace a poor-mediocre Step 1 score, but it is a way to show that you are a competent test taker.

The downside to this plan is that (if you're anything like me), you'll seem to magically lose a lot of your standardized test taking skills during the PhD, and you'll probably have to put far more time and effort into Step 2 than your peers if you want to avoid bombing it.

If all of that fails, for the love of god make strong connections with people in your chosen field.

 

[Neuronix]

If all of that fails, for the love of god make strong connections with people in your chosen field.

My experience has been that if all that fails, find a less competitive specialty you can learn to love instead.

 

[mercaptovizadeh]

The best you can do is the best you can do on Step 1. Don't count on the PhD bailing you out. You are paddling upriver, since in 5 years the curve inflation will take your 260 and make it a 250. So shoot for 300 and take what comes!

 

[Vesh]

http://www.neuronix.org/2012/06/effects-of-score-creep-trends-in.html

You are correct, and the residency programs don't care when you took step 1. They only care how you compare to the other applicants when you apply. Step 1 is just another obstacle for MD/PhD students.

In the future I suspect this trend will continue with the increasing ratio of US+Caribbean grads to residency positions.

Incredibly interesting, if not a little worrying. It's crazy how the increase in the number of medical schools, the variety of study materials, and the increased emphasis on STEP 1 scores at the residency level have pushed the mean score so fast. A percentile score would be seemingly more valuable, but I have no idea if that is coming in the future or not. I have to imagine that this steady increase will have to plateau at some point though. I suppose we will just have to wait and see.

The best you can do is the best you can do on Step 1. Don't count on the PhD bailing you out. You are paddling upriver, since in 5 years the curve inflation will take your 260 and make it a 250. So shoot for 300 and take what comes!

That is the plan. On the interview trail, I heard similar sentiments echoed (although sometimes it took a little prying). In addition, MD/PhD's would be served best by matching into top academic residencies so it seems that with the creep each year, there is smaller and smaller margin for error on STEP 1. I was hoping that since my PhD will be directly applicable to the residency that I am interested in (MedPhys > RadOnc), it would be a significant boost, but I am quickly realizing that there are diminishing returns.

 

[Chansey]

Pritzker offers the 1-4-3 program for MSTP. This allows dual degree students to take Step 1 in their M2 year, AFTER four years of PhD and alongside their match classmates. Do you guys think this is a viable solution to the problem? Or would you guys still recommend the traditional 2-4-2 route? Do you guys know of any other programs that offer 1-4-3? I'm very interested in taking the 1-4-3 route.

 

[StIGMA]

Pritzker offers the 1-4-3 program for MSTP. This allows dual degree students to take Step 1 in their M2 year, AFTER four years of PhD and alongside their match classmates. Do you guys think this is a viable solution to the problem? Or would you guys still recommend the traditional 2-4-2 route? Do you guys know of any other programs that offer 1-4-3? I'm very interested in taking the 1-4-3 route.

Why not just do the PhD first? It's foolish to let 1 test dictate how MD/PhD programs are run. If you just go through M1, you may have to take more PhD classes for the degree (versus waiving PhD classes due to completing preclinicals). The current model works fine, and you need a better reason to choose otherwise (talk to students at Chicago who have/havent done it for program-specific advice). The best explanation I've heard about the score increase is that the studying resources are much better/tailored to the exam; step 1 may change during your PhD and the average score could go back down (along with your score)(I don't think so- but for argument).

Could a 5-8 point score creep on step 1 impact where you match? Maybe in some score ranges in the more competitive fields. It's not like you can procure any data to make a definitive statement about this. It sucks that it happens, but I'd argue that the overall impact isn't as great as we'd like to think. Yeah there is some impact of a score creep- but it's not keeping us out of good programs. As Neuronix and others mention frequently, you need to be a very strong medical student, and that is more than just a good Step 1 score (necessary but not sufficient). At any rate, it's not some big secret that Step 1 is important, so if you're an MD/PhD student who didn't work hard at it (eg: made very little effort to prepare, NOT most people)- you should have made the effort! Almost everyone scores within ~10 points of their practice tests, so you should know what score range to expect going in.

FYI, when I took step 1 the average was 221; I'll be applying with applicants who took the test when the average was 228. I knew the average would go up (thanks forum), but that was more than I expected! Do your best in order to leave the most doors open. (Program-wide, I'd bet that the most common attitude is to have students "just deal with it" without making any effort to change things. And I agree b/c there's no easy fix).

 

[URHere]

My school used to offer students the option of a 1-4-3, 2-4-2, or (gasp) 3-4-1 MD/PhD model.

What I have heard from students choosing the 1-4-3 route is that the biggest downside is the absolute lack of flexibility concerning when you can return to medical school. MS2 classes start on a specific day, and students finishing their PhDs had that as a hard deadline. In contrast, those going back to MS3 year could go back during rotation 1, 2, or 3, which bought them some flexibility. The other downside that people mentioned were having less time to do rotations before starting the PhD, and therefore ending up extending the degree. As Stigma said, starting the PhD earlier may also mean that you are exempt from fewer of the PhD courses (I can't personally attest to this because my school used to be stubborn and require all MD/PhD students to take all PhD classes, regardless). If you want to go back into research, your papers would also be one year older by the time you hit fellowship. It doesn't seem like a long time, but with funding every year counts.

In terms of benefits, students here mostly described them as social (i.e. it was nice to get to know 100% of your new classmates). It's hard to say if the Step 1 thing made a huge difference to anyone, and there certainly didn't seem to be any difference in terms of performance once students got back to MS3 year.

 

[plumazul]

Hello all,

I was recently speaking to a cousin of mine who has just started residency and we were discussing how competitive residencies were getting. In particular he mentioned that it seemed like everybody was doing increasingly well on STEP 1 every year. I was looking at the NRMP charting outcomes, and the mean score has jumped nine points (from 221 to 230) in just five short years (2009 to 2014). Considering I will be starting MSTP this fall, this especially piqued my interest. I would think this sort of jump would affect MD/PhD students in particular because in the time that it takes to earn a PhD, an above average score can slowly diminish in value. Obviously, earning a superstar score (255+) will probably buffer this increase, but that is easier said than done. I would think that this gradual increase in STEP scores cannot be indefinitely sustainable, but I was just wondering if others had thoughts about this.

I am aiming for a particularly competitive specialty (RadOnc) with fewer spots and I have to imagine that a ~240 may have been more adequate just a few years ago. Regardless I think that getting a good score on STEP 1 is probably the most important thing I can do in the first two years of medical school; this has just had me thinking for the past few days.

This reminded me of the standard disclaimer in the world of finance whenever a broker advertises their history of returns.

past performance is not necessarily indicative of future results

America's economy has been through a lot since 2009 and the effect this has had on decisions made by people entering the workforce is hard to quantify. However, one thing is certain, the dynamics driving these decisions are always changing, and if these same dynamics have been driving who takes the STEP 1, then predicting any trend becomes impossible. Instead of the continuation of rising scores, we could very well see a reversion to the mean (whatever that is).