Step P/F for psychiatry residency apps?

[meowmixmeowmix]

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Hello! I am class of 2023 and as of now I am very interested in psychiatry. The way my school's curriculum is structured we get to pick (sort of) when we take STEP. My class is in the unique position of being able to pick whether to take STEP p/f or for a grade. I was wondering what residencies may think of an applicant knowing they chose to take STEP p/f?

 

[nexus73]

I don't think they'd know you were able to choose. I can't imagine they've got that kind of time.

 

[meowmixmeowmix]

Another thing, is I was considering taking a research year between years 2 and 3 because I need to undergo surgery (not something super emergent but something I would like done soon since it causes me chronic pain and I'd rather not deal with that while on my rotations standing up all day). Will residencies see this as potentially evading graded step 1?

 

[aim-agm]

Another thing, is I was considering taking a research year between years 2 and 3 because I need to undergo surgery (not something super emergent but something I would like done soon since it causes me chronic pain and I'd rather not deal with that while on my rotations standing up all day). Will residencies see this as potentially evading graded step 1?

To echo the above poster, residencies won't see it because they won't look (ain't nobody got time for that).

I think get your health taken care of.

 

[Sushirolls]

I still can't believe steps are transitioning to Pass / Fail.

American (undergrad) universities have already regressed by coddling students, and pushing graduation rates at the expense of institutional/degree/course integrity. This academic cancer has now metastasized into the graduate level of Medicine. I can't help but view this in a negative light and lament it's impact on Medicine in the future.

 

[Techmed07]

Getting 270 vs. 220 doesn’t make you a better doctor. The data is clear man

 

[ERK123]

I still can't believe steps are transitioning to Pass / Fail.

American (undergrad) universities have already regressed by coddling students, and pushing graduation rates at the expense of institutional/degree/course integrity. This academic cancer has now metastasized into the graduate level of Medicine. I can't help but view this in a negative light and lament it's impact on Medicine in the future.

Step 1 obsession was destroying medical education. The test was designed to be a minimal competency test just like the Bar exam. 20-30 years ago it was treated as such, but people became more and more obsessed with this single objective measures and it spiraled out of control. Students are spending all of their time on Anki decks memorizing trivia, getting burned out and resentful, instead of learning medicine.

 

[psych_0]

Step 1 obsession was destroying medical education. The test was designed to be a minimal competency test just like the Bar exam. 20-30 years ago it was treated as such, but people became more and more obsessed with this single objective measures and it spiraled out of control. Students are spending all of their time on Anki decks memorizing trivia, getting burned out and resentful, instead of learning medicine.

So now, instead of two tests to stand out amongst your peers, you only get one (Step 2CK). I'm sorry but I just don't understand your logic at all. Pass/fail steps make sense when you look at it from the narrow angle of easier to match specialties, but when you're trying to match more competitive fields the focus will now be all on Step 2CK. A poor Step 2CK score means your dreams of that field are likely done. I would hate that if I was trying to match now.

I guess you could argue that programs shouldn't care so much about a test score that "doesn’t make you a better doctor" as the other poster suggested, but how else do you propose these programs filter applicants during the application process? I doubt anyone has the time (or desire) to sift through 500+ personal statements and letters of rec..

 

[ERK123]

So now, instead of two tests to stand out amongst your peers, you only get one (Step 2CK). I'm sorry but I just don't understand your logic at all. Pass/fail steps make sense when you look at it from the narrow angle of easier to match specialties, but when you're trying to match more competitive fields the focus will now be all on Step 2CK. A poor Step 2CK score means your dreams of that field are likely done. I would hate that if I was trying to match now.

I guess you could argue that programs shouldn't care so much about a test score that "doesn’t make you a better doctor" as the other poster suggested, but how else do you propose these programs filter applicants during the application process? I doubt anyone has the time (or desire) to sift through 500+ personal statements and letters of rec..

I anticipate that Step 2 CK will become P/F in the next several years as well. However, I do think it is a more clinically relevant exam. A lot of the most competitive specialties only care about Step 1 so many of those applicants have only had one exam to determine their path to begin with. Residency programs found ways to evaluate applicants before Step 1 was such a big deal, and they will need to again make adjustments. I am not sure how they are going to do this, but I am sure they will adapt. Specialties are free to develop their own exam to filter applicants if they wish.

Also, the whole “narrow angle of easier to match specialties” is actually a pretty wide angle as the vast majority of applicants end up in internal medicine, family medicine, pediatrics, and psychiatry compared to derm, ortho, and ENT. Some of the more competitive programs in easier to match specialties specialties do care about Step scores quite a bit. They will just need to adjust.

Many of my classmates who scored extremely well on Step 1 were extremely burned out and resentful by the time Clinical’s began. They felt as though their purpose as a medical student started and ended with their performance on Step 1. This had consequences for their personal career satisfaction the rest of their education, and likely the rest of their career. think this is a very toxic mindset to force upon medical students. Medicine is never never going to be an easy career. This is ok. However, we should try to create an environment where medical students don’t lose a part of their soul before they first ever step onto the wards.

 

[motuza]

I guess you could argue that programs shouldn't care so much about a test score that "doesn’t make you a better doctor" as the other poster suggested, but how else do you propose these programs filter applicants during the application process? I doubt anyone has the time (or desire) to sift through 500+ personal statements and letters of rec..

The best solution would be limit the number of programs one can apply to on ERAS and restrict interviews to 10 programs total. Nobody should be applying to 60+ programs each cycle or going on 15+ interviews. We should discourage students from taking a shotgun approach and focus on more deliberate selection of programs. PDs would have fewer applications to sift through, applicants spend far less time/money, and there would be a net benefit for all involved. Whether the AAMC would allow one of their biggest cash cows to be restricted is another story...

 

[psych_0]

The best solution would be limit the number of programs one can apply to on ERAS and restrict interviews to 10 programs total. Nobody should be applying to 60+ programs each cycle or going on 15+ interviews. We should discourage students from taking a shotgun approach and focus on more deliberate selection of programs. PDs would have fewer applications to sift through, applicants spend far less time/money, and there would be a net benefit for all involved. Whether the AAMC would allow one of their biggest cash cows to be restricted is another story...

I agree with this. Although, I wouldn't limit the number of applications as much as I would limit the number of interviews you're allowed to accept. If we had one universal interview acceptance system we could track it easier. Now how many interviews you're "allowed" to accept is kinda arbitrary in my opinion, but would ultimately need to be decided upon.

They will just need to adjust.

This seems to be a common theme here, but what do you tell the applicants while this is happening?

 

[MacDonaldTriad]

Getting a good score will always be better than a pass and getting a bad score will be worse than a pass. I agree no one will track if you have a choice. PSs and LORs are fairly useless except for the few that tell the truth. Dean's letters are only a little better. There isn't much left to be honest. The true choke point on this whole hydraulic system is getting into medical school. If that levee breaks, (name your deity) help us all.

 

[ERK123]

This seems to be a common theme here, but what do you tell the applicants while this is happening?

Step 1 is not all that important for many psych programs. I don’t generally give advice to none psych applicants so my advice is not likely to change. I tell people to do some audition rotations, and to put a lot of thought into answering questions, both to themselves and to interviewers, about what they want out of a career in psychiatry. Developing confidence in your passion for psychiatry goes a very long way in shining as an applicant both on rotations and on the interview trail.