The 1.5 Year Preclinical Curriculum

[ChiapetBrownie]

I believe Downstate switched to 1.5 year last year.

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[kasukabe81]

I believe Downstate switched to 1.5 year last year.

I am deciding between Stony Brook and MCW (Medical College of Wisconsin) and leaning towards MCW due to their curriculum.
Stony Brook is changing their curriculum a lot starting this year and I don't wanna be the guinea pig going through the rigorous change.
1.5 year preclinical, PBL/small group everyday, 50% of the grade from non-multiple choice questions.
I guess all the med schools are starting to change their curriculum...

 

[aspirantmed]

Seems like this is the new way to go; I wrote out certain schools from my list because they're still on a 2.0-year. I'd much rather take Step after clinical year.

 

[bakedbeans18]

Seems like this is the new way to go; I wrote out certain schools from my list because they're still on a 2.0-year. I'd much rather take Step after clinical year.

Florida International University has you take Step I after the end of 3rd year...

 

[kasukabe81]

Florida International University has you take Step I after the end of 3rd year...

Yeah, that would make sense. But for Stony Brook, you have to take step 1 in January/February right after the preclinical instead of in the 3rd year after some exposure to clinical.
I did not like that...

 

[3rdarmageddon]

UVA is also 1.5.

 

[bakedbeans18]

Yeah, that would make sense. But for Stony Brook, you have to take step 1 in January/February right after the preclinical instead of in the 3rd year after some exposure to clinical.
I did not like that...

Step I is typically a basic sciences exam...what's the issue taking it before starting clerkships?

 

[kasukabe81]

Step I is typically a basic sciences exam...what's the issue taking it before starting clerkships?

Thanks for the reply.
My concern is that I might not have enough time studying for it. Typically people take it in May/June right? I'll have to take it (if I go there) right after the compressed 1.5 year preclinical. And this is the first year they are doing it. They are also changing other things. They are going to start daily PBL/small group exercises. I'm all for PBL but I don't know if I want to do it everyday.
And their grading will be 50% multiple choice exam, another 50% from faculty/peer assessment, oral/written exam, problem solving skills, and essays according to their website.
Wha do you guys think?

 

[mvenus929]

My concern is that I might not have enough time studying for it. Typically people take it in May/June right? I'll have to take it (if I go there) right after the compressed 1.5 year preclinical. And this is the first year they are doing it. They are also changing other things. They are going to start daily PBL/small group exercises. I'm all for PBL but I don't know if I want to do it everyday.
And their grading will be 50% multiple choice exam, another 50% from faculty/peer assessment, oral/written exam, problem solving skills, and essays according to their website.

My class and all subsequent classes take Step 1 between Dec and the end of January/beginning of February. We all have plenty of time to study for it, and our scores didn't drop from previous years, where they took Step 1 in April/May. So, I don't think that should be a major concern for you, provided you're given at least 5 weeks of dedicated study time. Yes, taking it after some time during clinical rotations has some advantages and may allow you to remember more, but you also just have to memorize the basic science stuff, and not having dedicated study time to do that would suck. So, I essentially think taking it right after a shortened basic science curriculum vs. taking it sometime during clinical rotations is a wash overall.

The 50% non-multiple choice part sounds miserable, though.

 

[bakedbeans18]

Thanks for the reply.
My concern is that I might not have enough time studying for it. Typically people take it in May/June right? I'll have to take it (if I go there) right after the compressed 1.5 year preclinical. And this is the first year they are doing it. They are also changing other things. They are going to start daily PBL/small group exercises. I'm all for PBL but I don't know if I want to do it everyday.
And their grading will be 50% multiple choice exam, another 50% from faculty/peer assessment, oral/written exam, problem solving skills, and essays according to their website.
Wha do you guys think?

You won't have time to study for Step I during clerkships, in my opinion. You'll be far too busy with clinical work for basic sciences. You're better off taking Step I after you've done a basic sciences intensive (i.e., the pre-clerkship curriculum of medical school) than delaying it. You won't the fine basic science details that much by the end of clerkship year - only whats relevant in practice.

 

[TeamLeafs]

There are a few 3 year MD schools in Canada, so at least they have all 4 years here!

 

[kasukabe81]

My class and all subsequent classes take Step 1 between Dec and the end of January/beginning of February. We all have plenty of time to study for it, and our scores didn't drop from previous years, where they took Step 1 in April/May. So, I don't think that should be a major concern for you, provided you're given at least 5 weeks of dedicated study time. Yes, taking it after some time during clinical rotations has some advantages and may allow you to remember more, but you also just have to memorize the basic science stuff, and not having dedicated study time to do that would suck. So, I essentially think taking it right after a shortened basic science curriculum vs. taking it sometime during clinical rotations is a wash overall.

The 50% non-multiple choice part sounds miserable, though.

My class and all subsequent classes take Step 1 between Dec and the end of January/beginning of February. We all have plenty of time to study for it, and our scores didn't drop from previous years, where they took Step 1 in April/May. So, I don't think that should be a major concern for you, provided you're given at least 5 weeks of dedicated study time. Yes, taking it after some time during clinical rotations has some advantages and may allow you to remember more, but you also just have to memorize the basic science stuff, and not having dedicated study time to do that would suck. So, I essentially think taking it right after a shortened basic science curriculum vs. taking it sometime during clinical rotations is a wash overall.

The 50% non-multiple choice part sounds miserable, though.

Thanks for your input!!!!
I guess the compressed curriculum isn't a big deal.
But yes, the 50% from non multiple choice...

You won't have time to study for Step I during clerkships, in my opinion. You'll be far too busy with clinical work for basic sciences. You're better off taking Step I after you've done a basic sciences intensive (i.e., the pre-clerkship curriculum of medical school) than delaying it. You won't the fine basic science details that much by the end of clerkship year - only whats relevant in practice.

Thank you all for your input.
I guess the compressed curriculum isn't that big of a deal. But yes, the 50% of the grade from non multiple choice sounds rough. Don't know if I wanna spend a lot of time on presentations and essays in preclinical years. And they have PBL/small group exercise everyday. I don't mind couple times a week but everyday sounds painful. Us being the first one going through the changes scares me a little too.
Another school option I have is MCW (medical college of Wisconsin) and they incorporated PBL and small group couple years ago. Few times a week. So they sound more solid to me.
Sorry, I have only couple more days to decide so kinda freaking out. I appreciate all your help though!!

 

[mehc012]

Why all the hate for non-multiple choice? Makes for a far more useful test. Besides, it's not like tests were MC in college, why the sudden expectation of easier exam format in med?

 

[Amygdarya]

There aren't that many. Columbia, Penn, Vanderbilt, UVa, NYU, Emory, Baylor, and UVM. Duke has 1.0 years for pre-clinical coursework and Vandy will shorten it's pre-clinicals to 1.0 years starting next year or so.

Cornell is switching to 1.5 preclinical years this year, too.

You won't have time to study for Step I during clerkships, in my opinion. You'll be far too busy with clinical work for basic sciences. You're better off taking Step I after you've done a basic sciences intensive (i.e., the pre-clerkship curriculum of medical school) than delaying it. You won't the fine basic science details that much by the end of clerkship year - only whats relevant in practice.

First of all, you will get dedicated Step 1 study time regardless of when you take your test (4-8 weeks depending on the school, *not* the type of curriculum; eg., WashU that has a traditional 2 years preclinical curriculum gives its students 4 weekes of dedicated Step 1 prep time, while a condensed preclinical school like Baylor gives 6-8 weeks). Plus, you can schedule your Step 1 prep time after an "easier" rotation like FM, which may give you some time to study during the rotation. Don't forget that you'd still have to study for your MS2 classes even if you took your Step 1 after MS2 in the traditional curriculum, so it's not like you'd have all that much more time to prepare for Step 1 if you take it right after your MS2..
Second and most important, it has already been said in this thread (see @mmmcdowe posts) and elsewhere on SDN that having actual clinical experience helps with Step 1, which, by the way, is getting more clinically oriented each year.

 

[mvenus929]

Why all the hate for non-multiple choice? Makes for a far more useful test. Besides, it's not like tests were MC in college, why the sudden expectation of easier exam format in med?

Because all the exams you take for licensure and board certification, with the exception of oral boards in the few fields that still do them (mostly surgery, I think), are multiple choice. Exception might be the second part of Step 3--I'm not entirely sure how that one works. So yes, you may have more of an opportunity to explain your knowledge, but you get less practice with the question format you'll see on the tests that matter.

Second and most important, it has already been said in this thread (see @mmmcdowe posts) and elsewhere on SDN that having actual clinical experience helps with Step 1, which, by the way, is getting more clinically oriented each year.

This is really debatable. People usually only take Step 1 once. It's difficult to compare school to school, because variations in the test could be due to the caliber of students recruited, the amount of time given to study for the exam, etc (even at my school, there are variations in step scores year to year). So you don't have a straight apples to apples comparison of step 1 scores done before and after clinical years.

Yes, having some additional clinical background will help you better understand certain disease processes. But, there is so much that is on Step 1 that is not used much in clinical medicine, particularly the clinical medicine you see during third year. So, as I said, it's probably a wash in the end.

 

[mmmcdowe]

Because all the exams you take for licensure and board certification, with the exception of oral boards in the few fields that still do them (mostly surgery, I think), are multiple choice. Exception might be the second part of Step 3--I'm not entirely sure how that one works. So yes, you may have more of an opportunity to explain your knowledge, but you get less practice with the question format you'll see on the tests that matter.



This is really debatable. People usually only take Step 1 once. It's difficult to compare school to school, because variations in the test could be due to the caliber of students recruited, the amount of time given to study for the exam, etc (even at my school, there are variations in step scores year to year). So you don't have a straight apples to apples comparison of step 1 scores done before and after clinical years.

Yes, having some additional clinical background will help you better understand certain disease processes. But, there is so much that is on Step 1 that is not used much in clinical medicine, particularly the clinical medicine you see during third year. So, as I said, it's probably a wash in the end.

I have tutored dozens of students for the step 1. People who are doing it post clinical year get the disease much quicker even if they still have to struggle to remember the basic science. It isn't even so much about the idea that you are learning things on the clinical year that are on the exam, it is setting up the framework of diseases in your mind that makes studying easier. If you know myasthenia gravis solid then it is WAY easier to go back and learn the mechanism for it. It's just one less thing to worry about when tackling a problem presenting with pleuritic chest pain if you have a differential firmly in mind. It let's you focus on relearning the basic science rather than relearning the diseases and the basic science.

 

[mehc012]

Because all the exams you take for licensure and board certification, with the exception of oral boards in the few fields that still do them (mostly surgery, I think), are multiple choice. Exception might be the second part of Step 3--I'm not entirely sure how that one works. So yes, you may have more of an opportunity to explain your knowledge, but you get less practice with the question format you'll see on the tests that matter.

Sorry, I don't buy that. You learn better with non-MC tests, which makes a subsequent MC exam easier. Besides, it's not like MC is some special thing which requires its own practice (or as if there aren't qbanks which provide it anyway).
MCAT is multiple choice, and you don't see UG students going for courses with MC exams just to practice for the standardized tests. This reasoning is "well, I'll learn the material less well, but hey, at least I'll have practice filling out Scantrons, because that's REALLY the hard part of an MC exam." (Yes, I know they're on the computer now...the MC aspect still isn't going to make something harder.)

 

[Amygdarya]

This is really debatable. People usually only take Step 1 once. It's difficult to compare school to school, because variations in the test could be due to the caliber of students recruited, the amount of time given to study for the exam, etc (even at my school, there are variations in step scores year to year). So you don't have a straight apples to apples comparison of step 1 scores done before and after clinical years.

Yes, having some additional clinical background will help you better understand certain disease processes. But, there is so much that is on Step 1 that is not used much in clinical medicine, particularly the clinical medicine you see during third year. So, as I said, it's probably a wash in the end.

I see what you mean. I'm all evidence-based, too and I agree with you that there is probably not enough data to compare the two (though mmmcdove did mention some data from Columbia). Plus, self-selection may be a factor here as well.
But, in any case, even if taking Step 1 after clinical rotations does not provided a significant advantage, it doesn't seem to be a disadvantage either and is, ultimately, a matter of preference.

 

[mehc012]

I see what you mean. I'm all evidence-based, too and I agree with you that there is probably not enough data to compare the two (though mmmcdove did mention some data from Columbia). Plus, self-selection may be a factor here as well.
But, in any case, even if taking Step 1 after clinical rotations does not provided a significant advantage, it doesn't seem to be a disadvantage either and is, ultimately, a matter of preference.

Just as a question, because I truly don't know, does the school mandate when you take it, or simply when you must take it by?
If it's the latter, does this provide those who wish to take it immediately after basic sciences with the opportunity to do so, or are they simply too busy, schedule-wise, to prepare?
In general, I always side with the path of 'most flexibility' until I know enough to commit to one option or the other.

 

[Amygdarya]

Just as a question, because I truly don't know, does the school mandate when you take it, or simply when you must take it by?
If it's the latter, does this provide those who wish to take it immediately after basic sciences with the opportunity to do so, or are they simply too busy, schedule-wise, to prepare?
In general, I always side with the path of 'most flexibility' until I know enough to commit to one option or the other.

Most likely, it depends on the school. However, it's also my impression that schools that have a 1.5 preclinical curriculum are generally more flexible about individual student schedules. Eg., I know that Penn and Cornell (in its new curriculum starting this year) allow students to choose when to take Step 1 during the main clinical year (i.e. you can choose any time between 1.5 and 2.5 years of medical school to take Step 1) and Step 2 in the last 1.5 years. In other words, nobody will stop you from taking Step 1 right after your 1.5 preclinical years if you want to do so, though I've heard from faculty/administration at both schools that it is advisable that you take Step 1 after you're done with at least some of your rotations (they must believe that having clinical experience helps with Step 1). And, just like you, I appreciate the flexibility

Speaking of flexibility, one great thing that mmmcdove mentioned about condensed curriculum is that it allows you more flexibility in selecting elective rotations, away rotations, research time etc., which helps you with selecting your specialty and preparing your best residency application.

 

[tantacles]

I was thinking of things more along the lines of number of hours of lecture per day/week, mandatory attendance vs voluntary, PBL and small group learning vs. large lecture (or the relative mix of the two), block scheduling, organ system based teaching vs subject specific courses (histology, physiology, etc), timing of clinical exposures within the 4 year curriculum, research: required v. encouraged v. available. Lectures available as podcasts? other materials available for students to review?

Mandatory attendance is a drag if you are a visual learner who learns best reviewing the material on your own and drawing concept maps, and would prefer just to show up for the exams. If you are the type who learns best by teaching/tutoring as a review of the material, then you might prefer a small group model over a lecture based format.

Is everything on the test and is the test hard is not, in my opinion, the way to judge your fit for a specific medical school.

I want to underscore that even if a school does not have mandatory attendance, it might not be a good idea to bring up lack of mandatory attendance at your interview, particularly if your interviewer is >40 years old. Many of the more old school lecturers are quite touchy about the fact that medical students don't attend lecture, and implying that you don't plan to attend lecture will seriously sour them to you.

This attitude certainly frustrates me (I attended <25% of lectures at my school), but this is part of the game you have to play right now. Tread carefully.

 

[mvenus929]

Sorry, I don't buy that. You learn better with non-MC tests, which makes a subsequent MC exam easier. Besides, it's not like MC is some special thing which requires its own practice (or as if there aren't qbanks which provide it anyway).
MCAT is multiple choice, and you don't see UG students going for courses with MC exams just to practice for the standardized tests. This reasoning is "well, I'll learn the material less well, but hey, at least I'll have practice filling out Scantrons, because that's REALLY the hard part of an MC exam." (Yes, I know they're on the computer now...the MC aspect still isn't going to make something harder.)

It's not the act of filling out the scantron that's difficult, it's the type of questions they use on the Steps. Long clinical vignettes with limited time to read and figure out an answer. I suppose it's just as easy to take away the multiple choice aspect of it and still have the same question stems. But I can see why someone would be intimidated by going to a school where 50% of exams are not multiple choice when basically every other medical school has very limited short answer/essay requirements.

Just as a question, because I truly don't know, does the school mandate when you take it, or simply when you must take it by?
If it's the latter, does this provide those who wish to take it immediately after basic sciences with the opportunity to do so, or are they simply too busy, schedule-wise, to prepare?
In general, I always side with the path of 'most flexibility' until I know enough to commit to one option or the other.

Our school requires that you pass Step 1 prior to starting clinical rotations. Which means they give you a date that you have to take it by in order to get your score back to start clinical rotations on time (because it would royally suck to be there for the first 3 days of a rotation and then get pulled because you failed Step 1. Then again, it would royally suck to fail Step 1, so I guess the leaving rotation part would be fairly minor).

One of my classmates took it 1.5 weeks after class ended. The majority took it at the tail end of our dedicated study time, roughly 6-7 weeks after our classes ended. One had an accident during the break, so was permitted to take additional time to study and thus did not start clinical rotations with us.

I imagine each school has it's own policy for a 'take exam by' date.

 

[mehc012]

It's not the act of filling out the scantron that's difficult, it's the type of questions they use on the Steps. Long clinical vignettes with limited time to read and figure out an answer. I suppose it's just as easy to take away the multiple choice aspect of it and still have the same question stems. But I can see why someone would be intimidated by going to a school where 50% of exams are not multiple choice when basically every other medical school has very limited short answer/essay requirements.

Why would they feel intimidated? Everyone else is being graded the same way, and they're not being graded against students at other med schools. If anything, that would help them, because again, if you ask the same question with MC and without MC, without MC will be more difficult (and better preparation in the long run).
I can see not wanting to do it the hard way, I guess, but I think it would be very odd to suddenly be in an environment where I was graded on MC.

Our school requires that you pass Step 1 prior to starting clinical rotations. Which means they give you a date that you have to take it by in order to get your score back to start clinical rotations on time (because it would royally suck to be there for the first 3 days of a rotation and then get pulled because you failed Step 1. Then again, it would royally suck to fail Step 1, so I guess the leaving rotation part would be fairly minor).

One of my classmates took it 1.5 weeks after class ended. The majority took it at the tail end of our dedicated study time, roughly 6-7 weeks after our classes ended. One had an accident during the break, so was permitted to take additional time to study and thus did not start clinical rotations with us.

I imagine each school has it's own policy for a 'take exam by' date.

Right, my point with the 'take by' date thing was that if that is the setup, then students who are thrown off by the large gap between basic sciences and taking the Step at 1.5yr schools could, theoretically, schedule it earlier so that they feel more comfortable.
Obviously, if the school has a 'take Step I before clinicals' policy, that's not going to be an issue in the first place

 

[Carbocation1]

What about schools that have a 1.75 year preclinical?

At Brown, classes are over at the end of February. 2/25/14-4/4/14 are for STEP 1 preparation and clinical skills clerkship is 4/15/14-5/2/14. What do you guys think of this?

 

[mvenus929]

Why would they feel intimidated? Everyone else is being graded the same way, and they're not being graded against students at other med schools. If anything, that would help them, because again, if you ask the same question with MC and without MC, without MC will be more difficult (and better preparation in the long run).
I can see not wanting to do it the hard way, I guess, but I think it would be very odd to suddenly be in an environment where I was graded on MC.

I don't want to pretend to get into the heads of everyone, but I am absolutely horrible at names. It takes me several days of working with someone to remember their name, though I could tell you a lot of stuff about them. So eponyms kill me. I can remember the disease process just fine, but actually remembering the random name given to it? I always fail at those pimping questions, unless I've seen the disease multiple times in the past. So an exam where I'm asked to make a diagnosis but can't remember the name of the diagnosis, even if I know everything else about it, would be intimidating to me. Multiple choice allows me to narrow it down and I'm usually pretty good at describing the diseases if I see the name on paper rather than the other way around. So yeah, I'd probably be better prepared with a curriculum of short answer in the long run, but I'd probably also make far worse grades.

So yeah, I can see how someone would be intimidated.

What about schools that have a 1.75 year preclinical?

At Brown, classes are over at the end of February. 2/25/14-4/4/14 are for STEP 1 preparation and clinical skills clerkship is 4/15/14-5/2/14. What do you guys think of this?

You still get an extended fourth year and aren't starting with the interns in July, so it's not as good as a 1.5 year curriculum, but it's still better than the standard 2 year. IMO.

 

[Perd ulv]

After finishing 1 year on a 2 year preclin, I can say that 1.5 or even 1 year is way better. You end up learning tons of unnecessary garbage - we learned about zebra mussels in some lectures/doing required stuff that is useless on a 2 year preclin. Like full body dissecting- a whole month's worth of waste. Or our neuroscience class- graduating 4th years and alumni docs say a lot of the gross neuroanatomy images can be eliminated. Or genetics, which is well organized but overtaught. Or biochem- could eliminate/condense a couple weeks of redundant undergrad material. Even our dean of med ed wants a 1.5 yr, but the phD's running the actual curriculum resisted. Only benefit is you get a few more months of no clinical duties, but at 1.5 yr schools you could do that if you wanted to- elective time.