Taking Step I after 3rd year?

[mryoshi13]

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I've heard that at a few schools (UPenn maybe?) it is the norm to take Step I after 3rd year. What are your thoughts on this? Does it hurt you or help you to have a year of clinical medicine under your belt? We have the option of taking it after 3rd year as well (although most take it after 2nd year) and I am seriously considering taking that option due to my less than stellar performance on QBank. I was thinking maybe a year in the hospital will help solidify many of the concepts. Any advice would be greatly appreciated especially from those who have taken it after 3rd year. 🙂

 

[Law2Doc]

I've heard that at a few schools (UPenn maybe?) it is the norm to take Step I after 3rd year. What are your thoughts on this? Does it hurt you or help you to have a year of clinical medicine under your belt? We have the option of taking it after 3rd year as well (although most take it after 2nd year) and I am seriously considering taking that option due to my less than stellar performance on QBank. I was thinking maybe a year in the hospital will help solidify many of the concepts. Any advice would be greatly appreciated especially from those who have taken it after 3rd year. 🙂

First, the test is really on the material covered in the basic science years (i.e. the foundation), so spending a year in the hospital probably would not help you solidify as much as you are going to forget. But I would guess the biggest drawback of doing that would be that you won't really know which specialties you actually have a shot at until it's almost time to apply for residencies. So to the extent you wanted to do away rotations, check out certain electives etc, at the beginning of 4th year, I don't see how you would have time to set that up.

 

[SOUNDMAN]

I thought you had to pass step I before even starting rotations? That this is a basic requirement of many hospitals even in order to have privileges there? Now obviously step 2 and 3 are a different story.

 

[bkflaneur]

I'm pretty sure you're right about Penn - they start clinicals early and don't take boards until later. I've heard mixed reports on how this works for or against people. I think for some, a year of clinical rotations helps to tie things together. But I think law2doc's right that the bulk of the material is focused on what's covered in years 1 and 2.

I don't think there's any national requirement for passing step 1 before clinical rotations. Some schools require it, and others don't.

 

[Law2Doc]

I don't think there's any national requirement for passing step 1 before clinical rotations. Some schools require it, and others don't.

I'm pretty sure a handful of places simply require it as a condition of graduation but not necessarilly before rotations. But most places have you do it the summer after 2d year.

 

[blz]

upenn's step 1 average is like a 235 so it obviously isn't negatively affecting those kids.

also, my school doesn't require us to have passed step 1 before rotations.

 

[doctorp82]

upenn's step 1 average is like a 235 so it obviously isn't negatively affecting those kids.

There's always selection bias to consider as well with that sort of stat.

 

[blz]

There's always selection bias to consider as well with that sort of stat.

i was waiting for one of these types of responses. i expected it sooner.

anyways, the point i was trying to make was that taking it after 3rd year shouldn't affect your ability to score high if you're capable of it. i wasn't saying it was gonna get you a higher score by doing it that way.

 

[mryoshi13]

Yeah I was looking at some of the 3rd year shelf exams and it obviously is more clinical but it still has a lot of overlap w/ step I material. I'm guessing the clinical experience may benefit some students...it just depends on your learning style. As for me, I find it almost impossible to learn out of a book and I'm hoping the clinical year will help cement a little more of the clinical scenarios on Step 1. Where will I learn all the esoteric Step 1 material though?? Who knows! I was hoping someone who has taken Step 1 after 3rd year might have something to say about it!

 

[doctorp82]

i was waiting for one of these types of responses. i expected it sooner.

anyways, the point i was trying to make was that taking it after 3rd year shouldn't affect your ability to score high if you're capable of it. i wasn't saying it was gonna get you a higher score by doing it that way.

Exactly, I only meant to imply UPenn is a good school with good students.

I have a classmate who is doing a year between now and clinicals to do a path internship; basically she'll be working alongside the pathology interns in sort of an M-3 year-long rotation kind of deal. She's taking step 1 after that. No doubt that'll be a definite help.

 

[domer621]

Taking it after 3rd year probably makes it easier. Both UPenn and Baylor do this and their Step averages are fairly high (although they have top students, too).

 

[Taus]

if I still had to study details of biochem and DNA junk during clinical rotations I might just slit my throat....

 

[diosa428]

I go to Duke, and we cram the first two basic science years into one year and then do clinical rotations our second year. We don't take Step I until after our rotations, either before, during, or at the end of third year, which is a year devoted to research. Our school has actually done a study in which we all take a practice Step I at the end of first year (without studying) and then take another at the end of our clinical rotations (without studying) and the grades do go up significantly. With studying (ie, the actual Step I) grades go up even more. I realize the study isn't perfect, since no one actually knows if we'd end up with the same scores after year 1 if we actually studied for the test, but it's interesting.

Also, some people at my school have been known to take Step 2 immediatelly after second year, and then go back and take Step 1 later on, when they have more time to devote to studying all the little things we forgot. Again, this works for us because we're doing research during all of third year, so our schedule is a little more flexible. If I went somewhere with a more standard curriculum, I'm not sure I'd want to risk waiting to take Step 1 until the end of third year because I'd just like to know what I got far in advance for residency applications, etc.

 

[mryoshi13]

Ah finally some first hand experience! Thanks for the insight. So do you and your classmates feel like it works for them or do they wish they had taken Step 1 after basic sciences?

 

[diosa428]

Ah finally some first hand experience! Thanks for the insight. So do you and your classmates feel like it works for them or do they wish they had taken Step 1 after basic sciences?

I can't answer this, unfortunately, because I'm only a first year, so I won't take the boards for another year. My personal feeling is that I'd prefer to wait until after rotations, because I don't feel like I have retained all that I need from this past year, and I think a lot of concepts will be solidified for me on the wards. I realize that I'm going to have to relearn a lot of minutia when I do take the boards, but it's minutia I've probably already forgotten anyway. But, again, our third year is pretty flexible (we can do 10 or 12 months of research) so we can fit in a good chunk of study time. I've heard our grads like the system b/c the questions on the boards are presented as clinical cases, and they've already been taught to look at things from a clinical perspective, but I don't know how accurate that is.

 

[missmod]

I'm from Penn and took my boards after my clinical years. I think it definitely helped me during Step 1. I did have to spend a lot of time reviewing biochemistry, genetics, embryology, and those first year subjects that never get touched on during the clinical years. However, I would argue that even as a 2nd year taking this exam after basic sciences, you've probably forgotten a lot of that info. I actually didn't have to spend a lot of time on physiology and path and even pharm. When you have a basic familiarity of certain diseases, processes, and drugs to use (that you will develop over the course of your core clerkship year), it's much easier to memorize minutiae afterwards.

However, I think not taking the boards before my clerkships hurt me on the shelf exams and on every day round pimping. I remember going into peds not knowing that staph was gram positive. It was pretty atrocious, but the learning curve is steep and I would say that by my 2nd rotation, it wasn't as bad.

As a caveat, most of the schools that take their boards after clerkships have some sort of accelerated basic science schedule. We took our Step 1 2.5 years after we started med school so that still gave us plenty of time to retake it if we failed and also figure out what we wanted to go into. If you take yours in July of your 3rd year, that leaves you with basically 2 months with your score before you apply to residency and its very hard to plan what specialty to go into, what places to apply for, and whether to do away rotations or not when you don't know how competitive of a candidate you are.