USMLE Remote Proctoring in 3-6 Months

[AnatomyGrey12]

But here's the kicker - they're already supposed to be preventing stuff like wandering eyes or unsupervised bathroom use for our NBMEs. And they aren't, at all. So you can understand my skepticism that they'll run a secure Step.

Did you have supervised bathroom visits for your Step? Because I didn't... once you left the testing room you could go do whatever you wanted, include pull out First Aid and look stuff up

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[Matthew9Thirtyfive]

Did you have supervised bathroom visits for your Step? Because I didn't... once you left the testing room you could go do whatever you wanted, include pull out First Aid and look stuff up

Haven’t taken step yet but we have supervised bathroom visits for our nbme exams. They walk into the bathroom with us.

 

[altblue]

not disagreeing with you, but if someone cant get a 240 on step 1 without cheating, they definitely should not operating on people's brains

I think you mean a 200...

 

[TheIllusionist]

school prestige will just matter more and more with these tests going this way. Do well on your mcat kiddos. I did but chose the cheap route like a dumb ass.

 

[Pepe18]

I could have cheated on any of my school-proctored shelves. Easily. But there's no reason to, because we don't even have Honors cutoffs, and they're a tiny part of the overall grade.

Step 1, on the other hand? Suppose my lifelong goal has been to follow my father's footsteps in neurosurgery, but my practice scores are in the 220s? Or how about if all I really want to do is Pass the damn thing but my practice scores are in the danger zone? Or maybe I'm just an amoral bastard that wants a cushy life and knows I'll never get a Derm spot with my practice scores.

I'm sure plenty of people's fears and aspirations could beat their conscience into submission.

I don't think they would allow at home testing.

I can see them setting up at schools in a room with proctors, similar to how it's done in prometric sites. Shelf exams are all one block, so you can look ahead at questions before going to the bathroom. In step, you only take breaks in between blocks.

The only way to cheat if you are in a school proctored setting using the NBME software (especially if they use remote monitoring as well) that is different than whatever cheating you could get away with at prometric, is to fake an ID and have someone take the test for you. A school could carry out all the normal empty your pockets, lift up the legs of your pants, record break times, etc and watch a group of 13 people taking a test in the same way prometric does

One way to counteract the fake ID situation is to require sites to upload a photo of each testtaker and these photos will be used (in addition to IDs/fingerprinting) to identify the testtaker at future licensing exams. If their photo doesn't match the photo of the person who took the remote exam, their exams can be nullified and their diploma/residency revoked. Schools could probably even fingerprint with ink pads in case there is any question of who is in the photo

 

[Thesimplelifeofamyloid]

Everyone is worried about something that they're not comitting to. The only way this option would work, and the only way they'd consider it, is if the highest score you could get on it in this setting is a pass. I think there's plenty of people that would want to just pass the thing. Yes, you would have a mix between P/F and scored BUT:

1) We're likely to have that anyway for class of 2024.
2) People would elect to take this option.


Other than that, I think they'll find quickly that technology just isn't there.

 

[efle]

I love that you guys think my examples are ridiculous! I wish a wireless mouse and spare laptop was outlandish, but it really isn't. People do crazy **** like hire similar looking people to test in their place, or straight up raiding the teachers office to get after the answer sheet and risk expulsion. I think an earpiece or second screen are on the tame side.

I would agree this makes the most sense if they switch it to Pass/Fail for remote exams, but they seem unwilling to consider it until 2022

 

[Thesimplelifeofamyloid]

I love that you guys think my examples are ridiculous! I wish a wireless mouse and spare laptop was outlandish, but it really isn't. People do crazy **** like hire similar looking people to test in their place, or straight up raiding the teachers office to get after the answer sheet and risk expulsion. I think an earpiece or second screen are on the tame side.

I would agree this makes the most sense if they switch it to Pass/Fail for remote exams, but they seem unwilling to consider it until 2022

If people elect to take it P/F, that's on them, and they personally can't be held accountable for that. Relieves them of any responsibility, more or less, and keeps all parties involved happy. That WOULD make sense for some people. Also, timing is critical too. If they can swing this well enough during the summer, they can get a bit a breathing room during the winter, and might not ever need to implement that.

 

[Matthew9Thirtyfive]

I love that you guys think my examples are ridiculous! I wish a wireless mouse and spare laptop was outlandish, but it really isn't. People do crazy **** like hire similar looking people to test in their place, or straight up raiding the teachers office to get after the answer sheet and risk expulsion. I think an earpiece or second screen are on the tame side.

I would agree this makes the most sense if they switch it to Pass/Fail for remote exams, but they seem unwilling to consider it until 2022

Oh no I’m sure it happens. I think it’s ridiculous that people try that ****.

 

[<L>]

I did but chose the cheap route like a dumb ass.

You'll feel A LOT better about that decision when you're my age and calculating how much mortgage you can afford.

 

[Pepe18]

I love that you guys think my examples are ridiculous! I wish a wireless mouse and spare laptop was outlandish, but it really isn't. People do crazy **** like hire similar looking people to test in their place, or straight up raiding the teachers office to get after the answer sheet and risk expulsion. I think an earpiece or second screen are on the tame side.

I would agree this makes the most sense if they switch it to Pass/Fail for remote exams, but they seem unwilling to consider it until 2022

But what makes prometric different that could not be replicated outside prometric centers?

 

[throwaway1000000]

school prestige will just matter more and more with these tests going this way. Do well on your mcat kiddos. I did but chose the cheap route like a dumb ass.

Didn't you match at a pretty good IM program, think I remember reading that?
Honestly, you can do pretty much any fellowship you want from a solid IM program.
Don't think you are a dumb ass, would consider it pretty smart actually. A 100k difference in debt is huge which will make sense later.

 

[CaliAtenza]

Its happening this year for the LSATS: Introducing LSAT-Flex | The Law School Admission Council

 

[Pepe18]

You'll feel A LOT better about that decision when you're my age and calculating how much mortgage you can afford.

And when your salary and job opportunities are the same as 90% of your colleagues who went to top tier residencies. The other 10% are working high-ranked academic jobs that pay less and require research time

 

[Lawpy]

I love that you guys think my examples are ridiculous! I wish a wireless mouse and spare laptop was outlandish, but it really isn't. People do crazy **** like hire similar looking people to test in their place, or straight up raiding the teachers office to get after the answer sheet and risk expulsion. I think an earpiece or second screen are on the tame side.

I would agree this makes the most sense if they switch it to Pass/Fail for remote exams, but they seem unwilling to consider it until 2022

That's why i was getting confused because i thought the only way a remote Step is possible is if it's P/F. Btw this also means remote Step 2 CK and Step 3 should also be P/F

 

[TheIllusionist]

Didn't you match at a pretty good IM program, think I remember reading that?
Honestly, you can do pretty much any fellowship you want from a solid IM program.
Don't think you are a dumb ass, would consider it pretty smart actually. A 100k difference in debt is huge which will make sense later.

I did. But I'm being a salty little bitch because I wanted a T10 type one and those with my stats from my school who happened to also be AOA, often with less research and leadership ECs, got that or very close to it.

 

[efle]

But what makes prometric different that could not be replicated outside prometric centers?

Well I def can't do anything with an earpiece, second camera or second screen at a Prometric. At my prometric, the bathroom was directly attached to the shared locker space and I couldn't hide anything in it the night before or easily get a laptop into or out of it without a bunch of other people seeing.

At my school, it's just raise your hand and walk over to the bathroom around the corner that we all have 24/7 access to. Much easier

 

[efle]

Its happening this year for the LSATS: Introducing LSAT-Flex | The Law School Admission Council

Fantastic find, and this is downright ridiculous imho. They are indeed letting people take it at their home/apartment using their own equipment. It would just be so, so easy to pay someone to take it for me / feed me answers into an earpiece.

But, if the LSAT is doing it, I bet the MCAT, GRE and eventually USMLE can't be that far behind. We need something to let us keep providing law students, med students, lawyers and doctors. But, as devil's advocate, this nonsense is the only thing that works anytime soon and won't be affected by a second wave. Or at least, I can't think of anything else that would work in another complete shutdown.

 

[Pepe18]

Well I def can't do anything with an earpiece, second camera or second screen at a Prometric. At my prometric, the bathroom was directly attached to the shared locker space and I couldn't hide anything in it the night before or easily get a laptop into or out of it without a bunch of other people seeing.

At my school, it's just raise your hand and walk over to the bathroom around the corner that we all have 24/7 access to. Much easier

Correct me if I'm wrong, but you can't take a bathroom break in the middle of a block during step (Edit: I confirmed on the USMLE website that you cannot take a break during a block except for an emergency and all those events must be reported to the NBME). Even at prometric, you are permitted to use your phone and review during breaks. You could take out First Aid and read in the middle of your break if you wanted to. Hiding answers in the bathroom is pointless because you won't be in the bathroom until you submit your answers for the block

A proctor at your school could easily look at your ear as you go in and out the room and ask you to turn out your pockets in the same way they do at prometric.

 

[throwaway1000000]

I did. But I'm being a salty little bitch because I wanted a T10 type one and those with my stats from my school who happened to also be AOA, often with less research and leadership ECs, got that or very close to it.

I was in a pretty similar situation, matched into a top 30 program with pretty competitive stats (90th percentile + steps, research, etc). Mainly lacked AOA, which I agree did hurt me.
It is what it is. Your career from this point whether that's the money you earn, academic prestige, productivity, clinical acumen or whatever other goals you have will be determined by your work ethic and attitude.
Honestly the difference in career opportunities between a top 30 and top 10 program is minimal (definitely not worth 100k). More of an ego thing.

 

[efle]

Correct me if I'm wrong, but you can't take a bathroom break in the middle of a block during step (Edit: I confirmed on the USMLE website that you cannot take a break during a block except for an emergency and all those events must be reported to the NBME). Even at prometric, you are permitted to use your phone and review during breaks. You could take out First Aid and read in the middle of your break if you wanted to. Hiding answers in the bathroom is pointless because you won't be in the bathroom until you submit your answers for the block

A proctor at your school could easily look at your ear as you go in and out the room and ask you to turn out your pockets in the same way they do at prometric.

That's big! I didn't realize Step forbids bathroom breaks during questions, I thought it was like the NBMEs where you can do what you want but the timer keeps running. If schools are setting up with prometric equipment and proctoring well, I'm fine with that solution. It's the at-home testing that I think is a lot more concerning

 

[throwaway1000000]

That's big! I didn't realize Step forbids bathroom breaks during questions, I thought it was like the NBMEs where you can do what you want but the timer keeps running. If schools are setting up with prometric equipment and proctoring well, I'm fine with that solution. It's the at-home testing that I think is a lot more concerning

It is definitely the at-home testing that you should concerned about.

Honestly, using prometric protocols and equipment and implenting the tests at schools is not hard.

The bathroom thing that you are talking about is considered extremely suspicious activity by prometric if you take a break during a block. They are not going to stop you but if you take a break during a block, that will be flagged.
Between blocks, you can do whatever you want at a prometric center and even take your first aid to the bathroom.

They do at that my school too where they check our pockets before and after going to the bathroom during a NBME shelf exam.

Since there are no natural breaks for an NBME shelf exam like the USMLE step exam, some people have to go the bathroom during the NBME shelf. Easy solution would be breaking up the NBME shelf into 2 blocks, so people can have a bathroom break in between without the risk of cheating. But I am pretty sure my schools checks the bathrooms before each NBME exam to make sure people are not hiding any materials inside and there is someone right outside the bathroom checking your pockets before and after you go the bathroom.

 

[ExplodingUlcers]

Fantastic find, and this is downright ridiculous imho. They are indeed letting people take it at their home/apartment using their own equipment. It would just be so, so easy to pay someone to take it for me / feed me answers into an earpiece.

But, if the LSAT is doing it, I bet the MCAT, GRE and eventually USMLE can't be that far behind. We need something to let us keep providing law students, med students, lawyers and doctors. But, as devil's advocate, this nonsense is the only thing that works anytime soon and won't be affected by a second wave. Or at least, I can't think of anything else that would work in another complete shutdown.

The LSAT is basically a lengthy and more beefed up CARS section of the MCAT. With that in mind, it's difficult to cheat effectively on it despite potentially having access to outside resources given the time constraints and the nature of the exam itself not assessing knowledge. Not sure if this is setting as much of a precedent for the nbme to follow as you're suggesting.

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[sharkbyte]

Did you have supervised bathroom visits for your Step? Because I didn't... once you left the testing room you could go do whatever you wanted, include pull out First Aid and look stuff up

Right but you can't do this in the middle of a section right? I think Step exams are unrestricted for breaks so you can leave the test center/use your phone/read things but only during breaks in between sections, so you would have to just be lucky that something you read showed up on a future section.

 

[Matthew9Thirtyfive]

The LSAT is basically a lengthy and more beefed up CARS section of the MCAT. With that in mind, it's difficult to cheat effectively on it despite potentially having access to outside resources given the time constraints and the nature of the exam itself not assessing knowledge. Not sure if this is setting as much of a precedent for the nbme to follow as you're suggesting.

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I dunno if you had a list of the different types of logic games and how to solve them that could be an effective cheating strategy. It would be hard to cheat on the CARS like sections though.

 

[ace_inhibitor111]

The LSAT is basically a lengthy and more beefed up CARS section of the MCAT. With that in mind, it's difficult to cheat effectively on it despite potentially having access to outside resources given the time constraints and the nature of the exam itself not assessing knowledge. Not sure if this is setting as much of a precedent for the nbme to follow as you're suggesting.

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Agreed, the LSAT would be extremely difficult to cheat on short of having someone take it for you. It also has a huge emphasis on speed so looking anything up (not like anything helps) will actually put you at a disadvantage.

EDIT: I took a bunch of practice LSATs back when I was thinking about law school. The answers are all in the passage so it’s not like there is anything to look up lol. The real challenge is finding them and doing so quickly.

 

[efle]

Huh, I thought people spent many weeks / 100+ hours preparing for the LSAT much like the MCAT. Surprised to see the LSAT is just three 35 minute MCQ passage based blocks.

 

[CaptainZeki]

I was in a pretty similar situation, matched into a top 30 program with pretty competitive stats (90th percentile + steps, research, etc). Mainly lacked AOA, which I agree did hurt me.
It is what it is. Your career from this point whether that's the money you earn, academic prestige, productivity, clinical acumen or whatever other goals you have will be determined by your work ethic and attitude.
Honestly the difference in career opportunities between a top 30 and top 10 program is minimal (definitely not worth 100k). More of an ego thing.

Sorry what is meant by AOA?


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[Crassus]

school prestige will just matter more and more with these tests going this way. Do well on your mcat kiddos. I did but chose the cheap route like a dumb ass.

@TheIllusionist At what point does prestige matter vs cost? I know NYU isn't considered a "real" T10 by many, but would you have taken the free tuition at NYU vs. full cost at an established T5 (like Harvard/Hopkins/UCSF etc.)?

 

[ciestar]

Sorry what is meant by AOA?


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Honors society

 

[throwaway1000000]

Right but you can't do this in the middle of a section right? I think Step exams are unrestricted for breaks so you can leave the test center/use your phone/read things but only during breaks in between sections, so you would have to just be lucky that something you read showed up on a future section.

This is their intention. Once you start a block, you are not supposed to take a break. Those are called unauthorized breaks and they will flag you for suspicious activity and might even cancel your test if you do it multiple times.
Between blocks, they don't care. Which makes sense because you don't know what questions will be on the next block.

 

[throwaway1000000]

@TheIllusionist At what point does prestige matter vs cost? I know NYU isn't considered a "real" T10 by many, but would you have taken the free tuition at NYU vs. full cost at an established T5 (like Harvard/Hopkins/UCSF etc.)?

NYU vs Harvard is really not something that should be even debated about. Anyone who forgoes full tuition at NYU to go to harvard is financially stupid.
I believe what he is referring to is more of NYU vs a low-tier MD school where you will get a distinct advantage by going to the well known school. But this can also be negligible depending on how you do at the low-tier school. If the difference is over 100k, you will be OK going to an MD school as long as they are putting out graduates that match in all residencies. Your path might be harder but worth 100k or over.
When I say you will be OK, I mean you have to do well at the low-tier school. You can't afford to make as many mistakes as you would at a top school.

 

[Crassus]

NYU vs Harvard is really not something that should be even debated about. Anyway who forgoes full tuition at NYU to go to harvard is financially stupid.
I believe what he is referring to is more of NYU vs a low-tier MD school where you will get a distinct advantage by going to the well known school. But this can also be negligible depending on how you do at the low-tier school. If the difference is over 100k, you will be OK going to an MD school as long as they are putting out graduates that match in all residencies. Your path might be harder but worth 100k or over.
When I say you will be OK, I mean you have to do well at the low-tier school. You can't afford to make as many mistakes as you would at a top school.

Thanks for clarifying, that makes a lot of sense.

 

[Mass Effect]

NYU vs Harvard is really not something that should be even debated about. Anyone who forgoes full tuition at NYU to go to harvard is financially stupid.

Many would still choose Harvard, particularly in the P/F Step 1 era.

 

[efle]

Many would still choose Harvard, particularly in the P/F Step 1 era.

I dunno, 30% of Harvard admits turn it down every year for something else. It's even higher (~50%) at Stanford and Hopkins. Surely a >250k price differential should move almost anybody into that big group of defectors

 

[Crassus]

Many would still choose Harvard, particularly in the P/F Step 1 era.

I can see why Harvard may still be the best choice for some (perhaps they're dead-set on top-tier academia or want to engage in consulting/certain private practices, etc.) despite the COA difference. I think the general consensus here, from what I've gathered, is that Harvard (or Hopkins/Stanford/UCSF, etc.) may be worth the full price if you know you want to devote your career to academia/consulting/etc. Otherwise, I personally think it might not be worth it if you go to one of those schools and end up in the same position as others did (with little to no debt on their end).

It's all highly dependent on the person though, and I guess if one just wanted to have the prestige of going to HMS or the other established T5s (at full price) I can't really fault them for wanting that.

 

[throwaway1000000]

Many would still choose Harvard, particularly in the P/F Step 1 era.

I agree many probably will but in my narrow experience of what worked out for IM, it is financially stupid.
And, also I work pretty hard, so I am confident I will match at a similar place from NYU or Harvard if step 2 still exists.
Might not apply to everyone though.

 

[Matthew9Thirtyfive]

Huh, I thought people spent many weeks / 100+ hours preparing for the LSAT much like the MCAT. Surprised to see the LSAT is just three 35 minute MCQ passage based blocks.

Most people do. It’s very important for law school admissions. There are no interviews so your application has to be as perfect as it can be since you don’t get any other chance to sell yourself.

And it’s actually 2 parts. The first part is multiple choice and is five 35-minute MCQ sections. Four of them count toward your score and one is used to evaluate new questions. You aren’t told which one doesn’t count. But of the ones that do count, one is reading comprehension, one is analytical reasoning (the games section), and two are logical reasoning. The second part of the exam is an unscored written essay kind of like the essay part of the GRE.

 

[Steve_Zissou]

And that’s why remote proctoring is a terrible idea. Because there are unscrupulous people who would do this ****.

I agree. I have at least a couple classmates I can think of that would definitely jump on the cheating train.

That being said, I agree with one of the earlier posts in this thread. The people who think the nbme is going to let people test at home must be smoking something.