This general trend is a good thing in my opinion. If we want to have legitimacy in saying we’re better than midlevels, for example, this is one way we demonstrate that to normies. There’s a discussion to be had about how rigorous things ought to be, but having higher standards is a good and necessary thing. As previously stated, even an isolated Step failure isn’t a career-ender, so it’s not like we’re dooming our students.
I guess we will keep thumping our chest saying "we are better" until we are replaced by midlevels.
Agree. Us saying we are better doesn’t mean anything to the general public. Residency is the thing that sets us apart. If residencies had an exit exam and then you were lifetime board certified then this would accomplish that goal. We all do CME for state medical license anyway so this whole continuing education for BC is bull****
wow, this was beautifully said. I'm coming to accept that I will be ok, no matter what. I'll be a doctor with a good salary compared to the everyday person. I hope you are active in academics or at least active on SDN, because I think alot of students need to hear you. Thank you
I mean, how true is the 'not career ender' tho? on this thread I was told to basically give up obgyn by everyone (except one person). I was also told that I have other options besides "FM in rural Montana" but then everyone basically told me my only option is FM in rural Montana lol
Remember what I said about SDN being a hive of uninformed catastrophizers (not saying that EthylMethylMan is, just contributers in general)? I think it might be useful for you to stop seeking opinions from SDN and start looking at data. Because honestly, what you need is not more people telling you what you can't do and more evidence showing you what you can do.
You should be ok for FM, peds, path and community IM programs if you are a US student.
this wasn't my question. that has been beaten into me already throughout this thread- that my only options are FM/IM/peds. I get it
my question is, yeah I failed but pass 6 weeks later showing I was close. Someone at my school has taken 4 years to study for it. Will they be viewed better than me?
Ok so unless that person had some huge life event that explains it I would see them as the bigger red flag, but they also don't really fit into a clear box. For your situation, the programs have some type of history with seeing applications like that, but for this other person they might not have ever seen someone take so long.
Yes in my opinion. There were a couple of people with issues like that in my class. These people usually massage the truth. They bring up family issues and/or they were doing research in their personal statement.
Someone in the class above mine took an “academic year” to study for step 1 too. Did above average and had no problems matching.
That was my experience. Again, most of these people don't come out straight and say 'I needed time to study for step1.' They usually do a little bit of research during that year and/or use the 'family issues' in their interviews and personal statement. Gotta play the game, I guess.
thats fair
Do well on step 2 and in your clinical rotations, work closely with your advisor, and get to know the program director for the home program in your desired specialty. Your chances for matching will depend on your performance in all areas, not just step 1.
Can't sugar coat this, it will hurt.
No. Knowledge decay is a real thing .
wait i'm confused, first you said I would be viewed worse than her and then here you said 'no, knowledge decay'. With the time limit question, i'm not sure I just know my school is really pushing her to take it soon. I also heard a rumor that for some residency programs they limit you to six years of med school, and if she takes it now she will be talking almost 7 years from start to graduating.
Dude I think you need to go back and read my comment above. Stop comparing yourself to this singular outlier. None of us knows who she is or what her situation is. Just focus on you and not how someone else is going to be viewed.
As people got better at taking step 1, they kept increasing the step 1 passing score, like you said. They were trying to maintain a discriminatory function. Sounds like they didn't step down the passing score when they removed the incentive to overprepare (or in some cases just adequately prepare) by making it pass/fail, leading to overdiscriminating. It was basically a tacit agreement that the bottom 2% of med students should probably not be doctors. 10% is definitely too high.
But the bottom 2% of NP/PA should practice medicine. What a system we have!
I think it's a real shame that NP's have won independent practice in most states. It's nonsensical.
I don’t think anyone is arguing that the PA/NP education and practice system doesn’t have serious flaws.
One can argue that the standards are already low given that PA/NP have the same privilege (especially in primary care) with us in many states. It does not matter to me they have different degrees. They are practicing MEDICINE just like me.
I had to correct my post. I intended to say that no one is arguing that the PA/NP system *doesn’t have* serious flaws. Obvious big typo error on my part. Significantly changes the intent of my post. My apologies.
Not sure why you posted this in response to my correction.
Absolutely not uh wut
The issue now is that at least you knew you were going to FM in the Dakotas in 2nd year. Now you have no idea what you're competitive for pretty much until a few months before app season.
Again, *shrug*, but I think it helps make my point. This was what a lot of students wanted back before the switch, same with all the P/F grading for low stress until the “Oh Deity” moment of now having far fewer data points to offset a bad one. I thought it would lead to problems but now all I see is pre-meds prioritizing P/F, no AOA, etc.
P/F school grading + no AOA makes for a better educational experience in terms of collaborative classmates that know that the rising tide lifts all ships, but I think that P/F Step 1 makes for an incentive system that the average patient would find patently insane. I have classmates grinding meaningless research and EC's 25/30 days of the block and cramming for a quiz / test the other 5 days since Step is no longer graded and they are smart enough to get the ≥70 on the test. This seems very backwards for folks that want to become doctors and treat patients, at least to me.
Agreed on the research aspect. Frankly, I don't know why doing research beyond case reports is relevant at all unless you're doing a research career by choice. It's important to know how to read literature but beyond that? I'd guess that the vast vast majority of fully trained docs never write any research item again. It's a game to get into the training program you want, for some reason. And imo, it clogs academia with a bunch of low effort bullsh** "research" that means nothing.
I don't know where bronchs are on the "mind-numbingly-boring-and-I-would-rather-be-doing-anything else to if-I'm-not-the-one-that-does-this-then-no-one-else-should-touch-the-patient" scale to a Pulmonologist or CT Surgeon but if they're able to train their own APP to do a bronch the same way the attending would do it 50 out of 50 times and the attending is present in the hospital to manage any complication and they tell the APP what samples to take based on imaging and/or clinical picture, I don't really see that big of an issue with this? Unless this person is suggesting that APPs unilaterally make the decision that a patient needs a bronch and do it without attending sign off, in which case big no.
I am going to make an argument here that they are not trained to be capable of doing the bronch the way a doctor would. Can they go through the same outline of the procedure as we do yes. Can they check the anatomy and grab samples in the same order of us, yes. What they can't do is truly think critically about everything else going on around the procedure. They have a watered down knowledge of medicine and they can get decently knowledgeable about their specific field (after years of doing only that one field), but they lack the ability to fully grasp all the moving parts outside of what they are doing and because they are confident that they know what they are doing they may not report a small complication until it becomes a true complication that need intervention.
As someone who bronchs, no. The dynamic portion of the exam is just as important if not more than cultures. It is a vital portion of the physical exam. And the dynamic exam is certainly more valuable than pictures. I could teach my child how to bronch, especially in this era of video game skills but they wouldn’t be qualified either. APP simply don’t know enough respiratory physiology to think through what can be at play and why the exam looks the way it does in realtime. And that doesn’t account for complications. Playing doctor just to play doctor is dangerous and them doing a procedure unsupervised makes zero sense because I lose 1/2 exam by not being present in the room. If I’m in the room to witness a dynamic exam then I might as well be doing it myself
this. I have nothing to really say about the midlevel fight in these comments because as a med student I feel I have no perspective on it. But this is something I saw in real life. One guy at my school wanted an uber competitive speciality, had a pass on step 1, and got a 236 on step 2. Another guy at my school failed step his first attempt, retook, passed, then got a 266 on step 2- he always wanted EM but switched out after the step 1 fail, but then with his step 2 he was like "maybe I have a chance". Both of these people had to scramble in like a month to figure out what they wanted to do and redo their whole application. Idk what the perfect solution is, but here's a data point of what's happening in medical schools currently (shrug)
Yeah I can definitely see this as a downside that I hadn’t considered. I don’t have a solution, and there is no perfect solution available, as some population will be upset no matter what happens.
I would be in favor of going back to a scored step 1. It was a stressful time but I think it really built my foundation and how to study for boards. Especially with my specialty having about ~80% first time pass rate
Most current students would agree with you. At least at my institution
I had no problem with it being scored when I was in the position. And I was always going into a non-competitive specialty as a DO so I didn’t need the information to dictate if I would be competitive but it is quite important for those applicants hoping to go into competitive specialties to know early on. I think it’s imperative can plan their strategy with realistic understanding of their chances. Hopefully they will change it back for you guys
You can easily match EM with a step 1 fail now. Your story would be more realistic if you used something like OB/GYN.
as I have stated before, our PhD dean isn't the most encouraging to his step 1 failing students so he told this person EM was dead in the water and this guy took his word for it. Now he is realizing this isn't the case. It is very pushed in med schools that if you have a step 1 fail you'd be lucky to even get a brand new FM program
Some schools have done this in concert with earlier clinicals. Finish clinicals at end of year two then they basically get two blocks for studying for step 1 and step 2 mid year 3. Sub Is late year 3 early year 4.
They don’t want their match rate to go down.
So the dean is incompetent and the student was a fool. That's hardly a systems-level issue.
That may be true at your institution. My own experience has been quite different.
