Step 1 Timing

[Dr.Cut.em.up]

I am wondering if schools can make you take step 1 earlier than you want. My school makes us take it in April but I really want to take it in June. Is this common practice? This was not mentioned during interviews nor was it said during first year. we just found out a week ago.

---

Members don't see this ad.

 

[libertyyne]

I am wondering if schools can make you take step 1 earlier than you want. My school makes us take it in April but I really want to take it in June. Is this common practice? This was not mentioned during interviews nor was it said during first year. we just found out a week ago.

Schools can do what ever they want. If you don't take it according to their time be prepared to repeat a year. Or get reamed on your rotation schedule.

 

[rukia013]

Schools can make their curriculum however they want as long as they meet accreditation requirements. Some programs will make everyone take the exam around the same time while others give students more flexibility based on their personal preference/readiness to take Step 1 (at my school, M2 year ended in mid-April and you were allowed to take Step 1 at any time as long as it was before M3 year started on July 1).

 

[Dr.Cut.em.up]

Schools can do what ever they want. If you don't take it according to their time be prepared to repeat a year. Or get reamed on your rotation schedule.

I'd rather take a year off and get a 250+ than get a sub 230.

I have some ortho pubs pending so i could just take that year to beef that up.

But you say repeat? Wouldnt it just be taking a year off?

 

[Naruhodo]

At my school you have to ask the deans if you want to take it after a certain date. Apparently a ton of people asked for a step 1 deferral last year, so they deans are supposedly going to be stricter this year. As in, you or a close family member are seriously ill or evidence that you are going to fail if forced to take step 1 on schedule.
In their defense though, I have heard that in general pushing back the date doesn't often lead to much (if any) of a score increase.

 

[redsox93]

I'd rather take a year off and get a 250+ than get a sub 230.

I have some ortho pubs pending so i could just take that year to beef that up.

But you say repeat? Wouldnt it just be taking a year off?

Time off in med school is also a red flag. Programs are gonna want to know why you took a year off and I really doubt saying you wanted to study for step for a year will be a good reason

 

[Dr.Cut.em.up]

Time off in med school is also a red flag. Programs are gonna want to know why you took a year off and I really doubt saying you wanted to study for step for a year will be a good reason

Wouldn't be taking a year off to study. Wanting to take it in June so I can have time to finish zanki and Uworld. Our school makes is test in April which I think is absurd since I am paying them for my education.

 

[libertyyne]

Wouldn't be taking a year off to study. Wanting to take it in June so I can have time to finish zanki and Uworld. Our school makes is test in April which I think is absurd since I am paying them for my education.

You take a year off because you don't controll rotation scheduling. I would talk to upperclassman etc to figure out what you can do.
That being said taking time off is a red flag as mentioned above. And there is no guarantee that you will get a 250 after taking the time off either.

 

[softball2344]

Wouldn't be taking a year off to study. Wanting to take it in June so I can have time to finish zanki and Uworld. Our school makes is test in April which I think is absurd since I am paying them for my education.

How much time do you get for dedicated? Lots of schools take it in April

 

[TakotsuboOkazaki]

I am wondering if schools can make you take step 1 earlier than you want. My school makes us take it in April but I really want to take it in June. Is this common practice? This was not mentioned during interviews nor was it said during first year. we just found out a week ago.

My school is having us take our Step 1 by April 13th. I feel like if you have been a strong preclinical student and studying for STEP along with classes, then 5.5 weeks of dedicated should be plenty of time.

Have you taken an NBME yet? Our curriculum (and a few other schools) have us take a few baseline NBMEs. If you are passing those then you will be in good shape.

 

[Dr.Cut.em.up]

You take a year off because you don't controll rotation scheduling. I would talk to upperclassman etc to figure out what you can do.
That being said taking time off is a red flag as mentioned above. And there is no guarantee that you will get a 250 after taking the time off either.

It is a new thing they decided to do effective immediately due to a study that said the earlier boards, the better the results.

Im not saying I will get a 250+ but i want to complete zanki and Uworld first To have a shot. I have a good chance I think since I'm consistently 10 points above average on exams. We didnt know till last week that our school changed the deadline from july 1st to April.

 

[Dr.Cut.em.up]

How much time do you get for dedicated? Lots of schools take it in April

Our school changed their policy this year. We get 6 weeks.

My school is having us take our Step 1 by April 13th. I feel like if you have been a strong preclinical student and studying for STEP along with classes, then 5.5 weeks of dedicated should be plenty of time.

Have you taken an NBME yet? Our curriculum (and a few other schools) have us take a few baseline NBMEs. If you are passing those then you will be in good shape.

I would have been studying along side of classes if I would have known they would change the deadline halfway through the year. They told us to "focus on class as class performance is the greatest predictor"

 

[libertyyne]

It is a new thing they decided to do effective immediately due to a study that said the earlier boards, the better the results.

Im not saying I will get a 250+ but i want to complete zanki and Uworld first To have a shot. I have a good chance I think since I'm consistently 10 points above average on exams. We didnt know till last week that our school changed the deadline from july 1st to April.

This is a difficult situation with the school changing it's policy. You can delay taking step but your school could force you to not graduate on time as a result , or they could rescind your step scheduling permit. So this is not like the MCAT.
I would start studying for your exam since you have 6 months left.
Or you could foment an uprising with other class members.
Class exams don't mean much for step performance and most people who do well on step don't sandbag studying for it till dedicated.good luck.

 

[aldol16]

You still have a ton of time left between now and April. A few months of studying during school plus 4-5 weeks of dedicated is plenty enough. Your score won't get better - and likely would get worse - if you just spent 6 months of dedicated time studying. That's overkill. More than 2 months is overkill, in my opinion. Zanki is a huge deck and many people don't get through. Prioritize getting through UWorld and really learning the concepts.

 

[Med Ed]

Our school changed their policy this year. We get 6 weeks.

This happened because there was a pandemic of delaying Step 1 this year, which has wreaked havoc on clerkship scheduling. That would be fine if the delays were actually correlated with higher Step scores, but they are not. In fact the opposite seems to be true.

 

[Chelsea FC]

Your school own your a*s the sooner you accept it the better. This whole I'm paying them for education wont get you far you're a cog in this system.

 

[libertyyne]

This happened because there was a pandemic of delaying Step 1 this year, which has wreaked havoc on clerkship scheduling. That would be fine if the delays were actually correlated with higher Step scores, but they are not. In fact the opposite seems to be true.

I do have a question regarding this. I am sure this is a common problem at many schools. Why do schools go out of their way to obfuscate that people took more than the allotted time for prep? nearly 1/3rd of my class delayed taking step within the 6 weeks that the school. A large chunk of these people were gaming the system to obtain more time.
It seems like there are zero repercussions for our delayers, with evidence of this delay not being clear in MSPE or even their transcript.
The lesson seems to be that gaming the system to get more time has little negative impact with only a risk of scoring better than your peers who were rule abiding.

 

[Med Ed]

I do have a question regarding this. I am sure this is a common problem at many schools. Why do schools go out of their way to obfuscate that people took more than the allotted time for prep? nearly 1/3rd of my class delayed taking step within the 6 weeks that the school. A large chunk of these people were gaming the system to obtain more time.
It seems like there are zero repercussions for our delayers, with evidence of this delay not being clear in MSPE or even their transcript.
The lesson seems to be that gaming the system to get more time has little negative impact with only a risk of scoring better than your peers who were rule abiding.

Historically there have only been a handful of people in each class who delayed, and usually for legitimate reasons. The mass delays just happened this year and caught everyone off guard. I think schools are reluctant to really punish these folks because they don't want to kneecap such a large proportion of their students in the match. The approach has instead been to change policies and prevent a recurrence in 2020.

Also, we have abundant data that those who tried to game the system collectively under-performed relative to their rule-abiding peers, so there is certainly a downside to that strategy. If we found that more weeks of dedicated correlated with higher scores then we would carve out time in the curriculum for more weeks of dedicated.

 

[Chelsea FC]

I do have a question regarding this. I am sure this is a common problem at many schools. Why do schools go out of their way to obfuscate that people took more than the allotted time for prep? nearly 1/3rd of my class delayed taking step within the 6 weeks that the school. A large chunk of these people were gaming the system to obtain more time.
It seems like there are zero repercussions for our delayers, with evidence of this delay not being clear in MSPE or even their transcript.
The lesson seems to be that gaming the system to get more time has little negative impact with only a risk of scoring better than your peers who were rule abiding.

Why should there be a negative impact on people recognizing that they need more time to study? Alot of times school has data of students who need the extra time and suggest that they take more time.

 

[Chelsea FC]

Historically there have only been a handful of people in each class who delayed, and usually for legitimate reasons. The mass delays just happened this year and caught everyone off guard. I think schools are reluctant to really punish these folks because they don't want to kneecap such a large proportion of their students in the match. The approach has instead been to change policies and prevent a recurrence in 2020.

Also, we have abundant data that those who tried to game the system collectively under-performed relative to their rule-abiding peers, so there is certainly a downside to that strategy. If we found that more weeks of dedicated correlated with higher scores then we would carve out time in the curriculum for more weeks of dedicated.

Could it be that the people who take more time are just the people who are more at risk for not doing well.

 

[Med Ed]

Could it be that the people who take more time are just the people who are more at risk for not doing well.

We account for that with our statistical models.

 

[Lawpy]

This happened because there was a pandemic of delaying Step 1 this year, which has wreaked havoc on clerkship scheduling. That would be fine if the delays were actually correlated with higher Step scores, but they are not. In fact the opposite seems to be true.

Step 1 mania is getting out of control.

Is a similar problem seen for Step 2 (both CK and CS)?

 

[Med Ed]

Step 1 mania is getting out of control.

Is a similar problem seen for Step 2 (both CK and CS)?

Not yet, but it's coming.

 

[Lawpy]

Not yet, but it's coming.

I'm hoping measures are taken to prevent that especially if delays are (surprisingly) associated with lower Step scores.

 

[libertyyne]

Why should there be a negative impact on people recognizing that they need more time to study? Alot of times school has data of students who need the extra time and suggest that they take more time.

If you school says you have six weeks to study for step and you are to take it. Then you should take it after those six weeks. We are not talking about students who are struggling to pass as those students should obviously receive remedial /step prep course so they can pass. We are talking about the students have been doing extremely well in preclincals and now suddenly they decide that 230 that they are trending at is not sufficient so they bomb the assessment on purpose to buy more time. There are many other students who took the exam on time with similar preclinical scores and in similar positions in terms of prep. So allowing these students to game the system essentially puts their rule following peers at a disadvantage.

 

[Chelsea FC]

If you school says you have six weeks to study for step and you are to take it. Then you should take it after those six weeks. We are not talking about students who are struggling to pass as those students should obviously receive remedial /step prep course so they can pass. We are talking about the students have been doing extremely well in preclincals and now suddenly they decide that 230 that they are trending at is not sufficient so they bomb the assessment on purpose to buy more time. There are many other students who took the exam on time with similar preclinical scores and in similar positions in terms of prep. So allowing these students to game the system essentially puts their rule following peers at a disadvantage.

Lifes not fair. If they want to work the system for more peace of mind then more power to them. They will have a shorter break for clinicals. I think this falls into the category of worrying about other people business.

 

[libertyyne]

Lifes not fair. If they want to work the system for more peace of mind then more power to them. They will have a shorter break for clinicals. I think this falls into the category of worrying about other people business.

I'm compared to these people on my mspe. We are supposed to be on a level playing field.
So I get penalized for busting my behind since day one, and someone else just freely gets more time. Yeah sounds about right.

 

[softball2344]

I'm compared to these people on my mspe. We are supposed to be on a level playing field.
So I get penalized for busting my behind since day one, and someone else just freely gets more time. Yeah sounds about right.

Not sure why you are jealous of people who had to delay? I felt sorry for all the people in my class who pushed step back, they are behind in clerkships and don't get nearly as much time off for 4th year now. And likely didn't do as well...

 

[Chelsea FC]

I'm compared to these people on my mspe. We are supposed to be on a level playing field.
So I get penalized for busting my behind since day one, and someone else just freely gets more time. Yeah sounds about right.

Life is no fair so I would say get over it. Some schools give people 8 weeks off mine gives us 6. We will be compared as the same should I be crying over this as well?? Some schools use nbme exams pre-clinicals so their students can focus more on board material do you see me crying over this as well?

 

[Ho0v-man]

If you school says you have six weeks to study for step and you are to take it. Then you should take it after those six weeks. We are not talking about students who are struggling to pass as those students should obviously receive remedial /step prep course so they can pass. We are talking about the students have been doing extremely well in preclincals and now suddenly they decide that 230 that they are trending at is not sufficient so they bomb the assessment on purpose to buy more time. There are many other students who took the exam on time with similar preclinical scores and in similar positions in terms of prep. So allowing these students to game the system essentially puts their rule following peers at a disadvantage.

The folks at my school who do this are forced into a board prep course for like 8 hrs/day which is much worse imo than just taking it with less time. I’d assumed it served to prevent this behavior while actually helping those who need it.

 

[libertyyne]

Life is no fair so I would say get over it. Some schools give people 8 weeks off mine gives us 6. We will be compared as the same should I be crying over this as well?? Some schools use nbme exams pre-clinicals so their students can focus more on board material do you see me crying over this as well?

Mspe are not national. Mspe quartiles are based on you compared to your school. I am compared to my peers .aoa eligibility is also determined locally. I have every right to be irked by these people gaming the system. If anything these people also make it worse for people who actually need the time to pass.

 

[Dr.Cut.em.up]

I agree that putting off step 1 can result in burn out and downtrend in scores over time for students. However, I feel the data reported that shows that students that take the exams earlier may be more biased towards better-prepared students. I am confident in my education and ability to do well, but I don't want to be in the situation where I have sub-optimal scores 3 weeks out and could have taken around June 1st and gotten a score good enough for my specialty of choice. while it is true that more time doesn't equal a higher score, I feel it may benefit some students to have a few weeks extra. It seems that several schools have made this switch recently. I guess I should trust the process, however, the anxiety and implications associated with this exam have me second-guessing my preparation so far.

 

[aldol16]

This happened because there was a pandemic of delaying Step 1 this year, which has wreaked havoc on clerkship scheduling. That would be fine if the delays were actually correlated with higher Step scores, but they are not. In fact the opposite seems to be true.

If you don't learn the material well the first time, you end up having to cram and you can only hold so much in your brain for so long before the rate of information loss is greater than the rate of knowledge gain.

However, there is an easier fix to the problem of delaying - at a lot of schools now, students can choose to take Step 1 either before clinical rotations or after or anywhere in between. So why not let students start clerkships if they want to delay Step 1 until later? They can take it on the back end and that way, if they need more time and end up delaying graduation/taking an extra year because they need to pass Step 1 and CK and take CS, it's on them and doesn't mess up scheduling for everyone else?

I do have a question regarding this. I am sure this is a common problem at many schools. Why do schools go out of their way to obfuscate that people took more than the allotted time for prep? nearly 1/3rd of my class delayed taking step within the 6 weeks that the school. A large chunk of these people were gaming the system to obtain more time.

It seems from the data that 6 weeks is the sweet spot for Step 1 studying. You kind of max out at the best score you personally can achieve at that point. You don't get a higher score from taking more time and in fact, you might even score lower due to increasing risk of burnout, forgetting information from the beginning of dedicated, etc. So if that's how people are "gaming the system," I think that's a terrible way to go about it because it doesn't really put them at an advantage.

 

[libertyyne]

If you don't learn the material well the first time, you end up having to cram and you can only hold so much in your brain for so long before the rate of information loss is greater than the rate of knowledge gain.

However, there is an easier fix to the problem of delaying - at a lot of schools now, students can choose to take Step 1 either before clinical rotations or after or anywhere in between. So why not let students start clerkships if they want to delay Step 1 until later? They can take it on the back end and that way, if they need more time and end up delaying graduation/taking an extra year because they need to pass Step 1 and CK and take CS, it's on them and doesn't mess up scheduling for everyone else?



It seems from the data that 6 weeks is the sweet spot for Step 1 studying. You kind of max out at the best score you personally can achieve at that point. You don't get a higher score from taking more time and in fact, you might even score lower due to increasing risk of burnout, forgetting information from the beginning of dedicated, etc. So if that's how people are "gaming the system," I think that's a terrible way to go about it because it doesn't really put them at an advantage.

Do you have this data. I feel like 7-8 weeks would have been the sweet spot for me personally. Also there is a big difference between learning new things and just reviewing. If you didn't learn something or understand something correctly taking some additional time to go over it multiple times might be beneficial.

 

[Chelsea FC]

We account for that with our statistical models.

How do you do that?? Alot of students blow off preclinical grades to study boards material and then cram class stuff couple days before making them score way below their max ability

 

[bobjonesbob]

I am wondering if schools can make you take step 1 earlier than you want. My school makes us take it in April but I really want to take it in June. Is this common practice? This was not mentioned during interviews nor was it said during first year. we just found out a week ago.

What is the actual change in your curriculum? Are you saying that your school used to have >10 weeks of dedicated study time that has been shortened to 6, or does you school curriculum now just end earlier in the year and 6 weeks is the normal length of dedicated all along? There's a big difference between those two scenarios.

 

[Med Ed]

So why not let students start clerkships if they want to delay Step 1 until later?

There are some good arguments for this approach, but also some against. In some schools the clinical sites stipulate they won't take clerkship students who have not passed Step 1. Students with severe academic problems may find themselves deeper in school (and debt) before they fail out. The clinical faculty may not relish trying to teach students who are in the clerkships and have Step 1, Step 2 CK, Step 2 CS, and shelf exams hanging over their heads.

I recently asked a colleague at a school with flexible Step 1 scheduling (as you suggest) if they had delay problems, and the answer was yes. They manifested in a large cohort of students taking an extra year between M3 and M4.

 

[Med Ed]

How do you do that?? Alot of students blow off preclinical grades to study boards material and then cram class stuff couple days before making them score way below their max ability

I cannot comment on the details of our in-house analysis, but we have a very high correlation between performance in our curriculum and Step 1 scores. We always have students who seriously over-perform relative to our predictions, but not many. More importantly, they aren't they ones who take additional time.

 

[Dr.Cut.em.up]

What is the actual change in your curriculum? Are you saying that your school used to have >10 weeks of dedicated study time that has been shortened to 6, or does you school curriculum now just end earlier in the year and 6 weeks is the normal length of dedicated all along? There's a big difference between those two scenarios.

dedicated was reduced. In other words, the deadline to take step 1 was moved up

 

[Dr.Cut.em.up]

The biggest thing I'm concerned with is how taking it earlier affected the right end of the bell curve... I just don't feel I will have the time to review/learn the gaps to make that jump from average to above average. I do not fear to fail step 1, I fear that my hard work with research and extra-circulars may be in vain by having a sub-par step 1

 

[Chelsea FC]

The biggest thing I'm concerned with is how taking it earlier affected the right end of the bell curve... I just don't feel I will have the time to review/learn the gaps to make that jump from average to above average. I do not fear to fail step 1, I fear that my hard work with research and extra-circulars may be in vain by having a sub-par step 1

How much time are they giving you now?

 

[softball2344]

dedicated was reduced. In other words, the deadline to take step 1 was moved up

Okay yea that’s not cool

 

[Med Ed]

The biggest thing I'm concerned with is how taking it earlier affected the right end of the bell curve... I just don't feel I will have the time to review/learn the gaps to make that jump from average to above average. I do not fear to fail step 1, I fear that my hard work with research and extra-circulars may be in vain by having a sub-par step 1

I now have PTSD from spending my entire summer dealing with students who voiced the same feelings. Here is what you have to accept: studying beyond 4-6 weeks will not increase your score. If it did then we would have quickly and easily picked up a positive correlation between score and length of dedicated. Alas, no such correlation exists.

There are several reasons for this, but the most prominent is that if you study for 4-6 weeks with appropriate intensity the thought of going beyond that becomes laughable, because you simply have nothing left to give. Second, Step 1 is a maximum of 280 questions drawn from a pool of information so vast that "yield" reaches the point of diminishing returns quite rapidly. Third, people who study past 6 weeks forget the first material they covered. So 9 weeks of dedicated really only nets you what was in weeks 4-9, at best. Fourth, everyone walks into dedicated with gaps, including people who score 250+. Assuming a reasonable amount of review is done, the biggest variable on test day will be your level of mental acuity and stamina, not how many weeks you spent cramming. Finally, longer periods of study present a greater window of opportunity to descend into a panic spiral, which can result in pushing the test back even further, which can incite more panic. It becomes a feedback loop of personal hell that you do not want to find yourself in.

 

[Goro]

I now have PTSD from spending my entire summer dealing with students who voiced the same feelings. Here is what you have to accept: studying beyond 4-6 weeks will not increase your score. If it did then we would have quickly and easily picked up a positive correlation between score and length of dedicated. Alas, no such correlation exists.

There are several reasons for this, but the most prominent is that if you study for 4-6 weeks with appropriate intensity the thought of going beyond that becomes laughable, because you simply have nothing left to give. Second, Step 1 is a maximum of 280 questions drawn from a pool of information so vast that "yield" reaches the point of diminishing returns quite rapidly. Third, people who study past 6 weeks forget the first material they covered. So 9 weeks of dedicated really only nets you what was in weeks 4-9, at best. Fourth, everyone walks into dedicated with gaps, including people who score 250+. Assuming a reasonable amount of review is done, the biggest variable on test day will be your level of mental acuity and stamina, not how many weeks you spent cramming. Finally, longer periods of study present a greater window of opportunity to descend into a panic spiral, which can result in pushing the test back even further, which can incite more panic. It becomes a feedback loop of personal hell that you do not want to find yourself in.

Moderators, please sticky this!!!!

In my school's experience, and I haven't seen all the data, because it's limited, having an extra 4-6 weeks prevents the weakest students from failing COMLEX.

The median student who gets the extra time scores at median....which their pre-clinical grades already predicted. So, there's no profit from the investment if you're already a good student.

 

[Espressso]

I just don't understand the idea that more time = higher scores. I never understood my classmates who kept saying it. IMO that idea comes from a bit of anxiety about taking the exam. Which makes complete sense. But I had about 7-8 weeks and I was fried come week 7. The stamina issue is real and people just think if they have just one more week they will unlock all the answers but I don't see it.

Now if you've always struggled during preclin house exams/courses, different story. But for that group of students it's the schools responsibility to find them and put them in a dedicated prep course that can boost their scores and prevent failing. But for everyone else, just schedule the exam, book a trip afterwards, and take the thing.

To the OP... It might sound crazy now. But all you have to do is adjust your board prep schedule starting now, and tailor it for the new exam window. When you've made it to the other side you will be so grateful you took it that early. I regret not taking my exam earlier tbh. Plus, You won't have to wait forever to get your scores which is huge (as well as not taking the new set of questions half way through May).

 

[aldol16]

Do you have this data. I feel like 7-8 weeks would have been the sweet spot for me personally. Also there is a big difference between learning new things and just reviewing. If you didn't learn something or understand something correctly taking some additional time to go over it multiple times might be beneficial.

Preparing to take the USMLE Step 1: a survey on medical students’ self-reported study habits | Postgraduate Medical Journal

A Predictive Model for USMLE Step 1 Scores - PMC

The United States Medical Licensing Examination (USMLE) Step 1 plays a pivotal role in one’s residency application. While prior literature has investigated which factors influence performance on the examination, the authors sought to include factors ...

www.ncbi.nlm.nih.gov