USMLE Step 1: now P/F

[Ozilcr7]

The USMLE program will change score reporting for Step 1from a three-digit numeric score to reporting only a pass/fail outcome. A numeric score will continue to be reported for Step 2 Clinical Knowledge (CK) and Step 3. Step 2 Clinical Skills (CS) will continue to be reported as Pass/Fail. This policy will take effect no earlier than January 1, 2022 with further details to follow later this year.

Home | United States Medical Licensing Examination

www.usmle.org

---

Members don't see this ad.

 

[DrStephenStrange]

Well, it's gonna be more than a bloodbath for DO class of 2024.

 

[DOsoon_2Be]

I start school this summer... Just saw this shared on Facebook so I'm glad someone posted it here. Is this only going to affect competitive specialties in regards to DO grads?

Sent from my Pixel 4 using Tapatalk

 

[Ozilcr7]

I start school this summer... Just saw this shared on Facebook so I'm glad someone posted it here. Is this only going to affect competitive specialties in regards to DO grads?

No one knows, but generally speaking it will definitely hurt DOs greatly regardless of field.
Step 2 CK will now be the new Step 1.

 

[Whysoez]

I start school this summer... Just saw this shared on Facebook so I'm glad someone posted it here. Is this only going to affect competitive specialties in regards to DO grads?

Sent from my Pixel 4 using Tapatalk

Seems like DO competitiveness will drop a tier down to that of IMGs and FMGs.

 

[DOsoon_2Be]

Seems like DO competitiveness will drop a tier down to that of IMGs and FMGs.

Competitiveness in terms of matching any residency?

Sent from my Pixel 4 using Tapatalk

 

[AnatomyGrey12]

Competitiveness in terms of matching any residency?

Sent from my Pixel 4 using Tapatalk

Yes. DO's will probably be isolated in opportunity to former DO programs, regional programs, and programs they specifically audition at.

 

[Whysoez]

Competitiveness in terms of matching any residency?

Sent from my Pixel 4 using Tapatalk

It seems like it since now you are no longer associated with a numerical value to stand out and outshine your MD counterparts. For DOs class of 2024 and later, I think residencies that were competitive will now be impossible, semi-competitive will now be competitive, and safe will now be semi-competitive. FML (((((

 

[Rogue42]

Oh, look. The sky is falling again.

 

[JimBone905]

Yes. DO's will probably be isolated in opportunity to former DO programs, regional programs, and programs they specifically audition at.

So what about if youre just going for IM? will i have to worry about matching into IM now?

 

[AnatomyGrey12]

So what about if youre just going for IM? will i have to worry about matching into IM now?

Just matching? No.

 

[madiso30]

Ehh. Negligible.

DOs will still match fine at places they already had chances at.

I feel that it will be the same as the merger (though we haven't seen those results yet). DO programs that were already strong will continue that. New schools and not so great programs will take another hit.

 

[Startingover123]

No one knows, but generally speaking it will definitely hurt DOs greatly regardless of field.
Step 2 CK will now be the new Step 1.

I am applying 2021 for DO school. Would you even consider applying DO now?

 

[Whysoez]

I am applying 2021 for DO school. Would you even consider applying DO now?

Stats wise, do you think you have other choices besides DO school ?

 

[Startingover123]

Stats wise, do you think you have other choices besides DO school ?

Unfortunately no. Older non trad with a family can’t afford a SMP as well. I would like to do gas or OB not sure that’s possible now??

 

[Startingover123]

Not only possible, but probable if you are a good student and do things the right way.

Even with step one being pass/fail in the future?

 

[JimBone905]

EDIT: took out a quote i put in by accident

Even with step one being pass/fail in the future?

i think if you have at least average scores in school, do some research, get a pub, and have good rotations and a decent comlex, you should be fine.

 

[Startingover123]

EDIT: took out a quote i put in by accident

i think if you have at least average scores in school, do some research, get a pub, and have good rotations and a decent comlex, you should be fine.

I would be interested to see how this affects DO school matriculation averages moving forward. Can’t belive this &$@. First grade replacement was abolished now this....

 

[OwurayawMD]

the sky is falling

 

[MDapplicant578124]

I’m interested to see if this causes medical schools to care less about the MCAT, since I assume they selected high MCAT scores to maintain a high step 1 average. Doubt it would affect admissions committees mid cycle now but maybe next cycle. (Though we wouldn’t see that data until MSAR 2023 or something)

 

[Startingover123]

the sky is falling

You really think so?

 

[ach52]

Can anyone explain why they would do this? According to the site its to make the UME-GME transition easier? What does that even mean.

I feel like society is treading towards non-competition which is only a detriment to our future patients and a lower quality overall..

 

[Drlurker]

The sky might not fall but this is a move towards more subjective measures of competitiveness like what school you come from, who you know, what extra curriculars you choose to do. It gives more advantage to people who are already advantaged basically. As flawed and as stressful as step 1 was it was nice it was a measure that put everyone on an equal playing field.

 

[Chibucks15]

Step 2 becomes the big guy. And honestly that works out just as well because I’d rather the craziness be over a clinically useful exam rather than over biochemical pathways I forgot 3 days after taking that damn thing. It doesn’t affect us currently in school and instead of speculating I don’t see why it’ll make that huge of a difference.
Places that hate DOs will continue to do so. I don’t think it makes a difference at the majority of places that don’t have the “prestige over anything” stick up their asses

 

[BoneWizard]

Step 2 becomes the big guy. And honestly that works out just as well because I’d rather the craziness be over a clinically useful exam rather than over biochemical pathways I forgot 3 days after taking that damn thing. It doesn’t affect us currently in school and instead of speculating I don’t see why it’ll make that huge of a difference.
Places that hate DOs will continue to do so. I don’t think it makes a difference at the majority of places that don’t have the “prestige over anything” stick up their asses

But it does affect us currently in school if they report step scores as P/F when we apply for residency. I.e you take exam 2021, apply for residency 2022. Your score goes from a 3 number score to a P.

 

[Chibucks15]

But it does affect us currently in school if they report step scores as P/F when we apply for residency. I.e you take exam 2021, apply for residency 2022. Your score goes from a 3 number score to a P.

There is no way they do that. There is no logical reason for them to do that. That is prime SDN nonsense. They planned it for 2022 so places can prepare. It would make less than zero sense for them to retroactively eliminate scoring. Where did that even start?

 

[Medic741]

I start school this summer... Just saw this shared on Facebook so I'm glad someone posted it here. Is this only going to affect competitive specialties in regards to DO grads?

Sent from my Pixel 4 using Tapatalk

The negative effect will likely be spread across all specialties.

I would NOT go the do route now that there won’t be a metric to compare yourself against MD counterparts... this decision is really bad for us

 

[BorntobeDO?]

Oh, look. The sky is falling again.

Nah it’s sunshine and rainbows stop being a self hating DO.

I’m interested to see if this causes medical schools to care less about the MCAT, since I assume they selected high MCAT scores to maintain a high step 1 average. Doubt it would affect admissions committees mid cycle now but maybe next cycle. (Though we wouldn’t see that data until MSAR 2023 or something)

It will affect the OMS0 more than anyone in now, although the wording could make 2023 scores pass/fail as well. I expect there to be a drop off in candidates and the DO schools are going to go down that waitlist now. Some students this will make their day as this will be their ticket into DO instead of Carib. I suspect some will drop acceptances to reapply, but I doubt it will be more than 15% cause many premeds don’t keep up with this stuff at all.

 

[BoneWizard]

There is no way they do that. There is no logical reason for them to do that. That is prime SDN nonsense. They planned it for 2022 so places can prepare. It would make less than zero sense for them to retroactively eliminate scoring. Where did that even start?

I sincerely hope you're right. But the announcement says reporting of scores and could be taken either way. Otherwise you'd have one year of graduates where some have a step score and others (who take it MS3 as part of their curriculum) only have a pass.

 

[BorntobeDO?]

The negative effect will likely be spread across all specialties.

I would NOT go the do route now that there won’t be a metric to compare yourself against MD counterparts... this decision is really bad for us

Nonsense, people say I’m a downer. This will have no impact on FM and community IM spots. Now things that are more competitive than that, yes this will make it harder for DOs. The glass ceiling breakers are less likely now.

 

[gamerEMdoc]

Step 2 is more clinically useful. The problem is the timing of it all. The results aren't back until after you have already scheduled and done some of your AIs. It will be nearly impossible to pivot to something more/less competitive based on your scores. So if you want to do ortho, what if you are on your 3rd ortho AI and don't score above a 260? And how are fields that really stress board scores to determine who to let do an AI going to figure out who to let rotate? Sure that lets everyone get to apply for rotation, but are you doing yourself a favor rotating at a place that won't rank you once you get your step 2k back months later?

That's my biggest issue with this. Knowing your scores helps guide you to apply to fields you are competitive in, and to places you are competitive at. But by the time step 2 comes back, AIs are mostly over.

This will hurt students IMO. I'd rather have just seen them go all P/F for all exams and just de-emphasize scores all together.

 

[Chibucks15]

I sincerely hope you're right. But the announcement says reporting of scores and could be taken either way. Otherwise you'd have one year of graduates where some have a step score and others (who take it MS3 as part of their curriculum) only have a pass.

Which is exactly why it doesn’t make sense at all and they won’t do it. Don’t buy into the nonsense

 

[BoneWizard]

Which is exactly why it doesn’t make sense at all and they won’t do it. Don’t buy into the nonsense

Listen. I am a neurotic med student and I'll buy into whatever nonsense lets me put off my Anki reviews for a few more hours.

 

[BorntobeDO?]

Step 2 is more clinically useful. The problem is the timing of it all. The results aren't back until after you have already scheduled and done some of your AIs. It will be nearly impossible to pivot to something more/less competitive based on your scores. So if you want to do ortho, what if you are on your 3rd ortho AI and don't score above a 260? And how are fields that really stress board scores to determine who to let do an AI going to figure out who to let rotate? Sure that lets everyone get to apply for rotation, but are you doing yourself a favor rotating at a place that won't rank you once you get your step 2k back months later?

That's my biggest issue with this. Knowing your scores helps guide you to apply to fields you are competitive in, and to places you are competitive at. But by the time step 2 comes back, AIs are mostly over.

This will hurt students IMO. I'd rather have just seen them go all P/F for all exams and just de-emphasize scores all together.

I think they will go all pass/fail. That is what this set up.

 

[BorntobeDO?]

Unfortunately no. Older non trad with a family can’t afford a SMP as well. I would like to do gas or OB not sure that’s possible now??

I would think OB and Gas got much harder for a DO. There aren’t that many former AOA of either.

 

[gamerEMdoc]

I think they will go all pass/fail. That is what this set up.

Sure, but until they do, this was a bad decision. Because it will really screw up 4th year scheduling and knowing what fields/places you actually have a chance at. I'd rather them have just gone all P/F and eliminated scorings effect on competitiveness altogether. But now, for many fields, the most competitive piece of the application won't come back until after your AIs are done and right when interview decisions are being made. There is no time to pivot to a different field at that point. This is really going to hurt some students.

 

[Startingover123]

I would think OB and Gas got much harder for a DO. There aren’t that many former AOA of either.

Sucks what about ER?

 

[BorntobeDO?]

Sucks what about ER?

SLOE is and has always been king. I actually expect that to be similar.

 

[Drlurker]

Sure, but until they do, this was a bad decision. Because it will really screw up 4th year scheduling and knowing what fields/places you actually have a chance at. I'd rather them have just gone all P/F and eliminated scorings effect on competitiveness altogether. But now, for many fields, the most competitive piece of the application won't come back until after your AIs are done and right when interview decisions are being made. There is no time to pivot to a different field at that point. This is really going to hurt some students.

Also I’m thinking this could cause more students to play it safe and ironically make less competitive specialties more competitive

 

[BoneWizard]

Sucks what about ER?

I think ER was shifting away from Step 1 towards SLOEs anyway. So, minimal effect?

 

[madiso30]

I think ER was shifting away from Step 1 towards SLOEs anyway. So, minimal effect?

Feels like EM approached the change in Step 1 emphasis with way more rationale than NBME.

 

[PapaStill]

Gas folks are toast

 

[BorntobeDO?]

Sure, but until they do, this was a bad decision. Because it will really screw up 4th year scheduling and knowing what fields/places you actually have a chance at. I'd rather them have just gone all P/F and eliminated scorings effect on competitiveness altogether. But now, for many fields, the most competitive piece of the application won't come back until after your AIs are done and right when interview decisions are being made. There is no time to pivot to a different field at that point. This is really going to hurt some students.

what are your thoughts on what this will do for ER tho. I feel like ER with its SLOE is much more prepared than other specialties for this.

 

[madiso30]

Gas folks are toast

Why do you say that?

 

[gamerEMdoc]

what are your thoughts on what this will do for ER tho. I feel like ER with its SLOE is much more prepared than other specialties for this.

Yeah, in EM we rely heavily on SLOEs so I doubt it will change a ton about how you rank anyone. The problem will be in selecting people for rotation and having students rotate at places they are actually competitive for, which will be a bigger issue. Programs that do emphasize boards will have Step 2 back by the time interviews go out so interview/rank won't be the issue. The big change will be competitive EM programs and how they decide who to let rotate. Because many places have a board cutoff for rotation/interview. So now you may be able to get a rotation at a place, but then when your score comes back, they won't interview you. There will be no way to select out people you have no intention on ranking based on their scores because the scores won't be back until after their AIs. So that really hurts the students. It would stink wasting your AIs on places that potentially won't rank you.

 

[MDapplicant578124]

Step 2 is more clinically useful. The problem is the timing of it all. The results aren't back until after you have already scheduled and done some of your AIs. It will be nearly impossible to pivot to something more/less competitive based on your scores. So if you want to do ortho, what if you are on your 3rd ortho AI and don't score above a 260? And how are fields that really stress board scores to determine who to let do an AI going to figure out who to let rotate? Sure that lets everyone get to apply for rotation, but are you doing yourself a favor rotating at a place that won't rank you once you get your step 2k back months later?

That's my biggest issue with this. Knowing your scores helps guide you to apply to fields you are competitive in, and to places you are competitive at. But by the time step 2 comes back, AIs are mostly over.

This will hurt students IMO. I'd rather have just seen them go all P/F for all exams and just de-emphasize scores all together.

I think an entirely pass fail system has many problems of its own. The competitiveness of certain specialties will always exist, but they’d have to judge people based on school prestige, partly (or fully) subjective clinical grades, and # of pubs. I can’t see a situation where it doesn’t become a soft requirement to take year(s) after med school to crank out as many pubs as you can to match into competitive fields, especially if you’re not coming from a top program. The only way to distinguish yourself would be publications, and I doubt that would be enough. Top schools would feed top residencies, mid schools would feed mid residencies, etc. There would be hardly any room for vertical movement. Step scores allow for said movement.

 

[gamerEMdoc]

I think an entirely pass fail system has many problems of its own. The competitiveness of certain specialties will always exist, but they’d have to judge people based on school prestige, partly (or fully) subjective clinical grades, and # of pubs. I can’t see a situation where it doesn’t become a soft requirement to take year(s) after med school to crank out as many pubs as you can to match competitive fields, especially if you’re not coming from a top program. The only way to distinguish yourself would be publications, and I doubt that would be enough. Top schools would feed top residencies, mid schools would feed mid residencies, etc. There would be hardly any room for vertical movement. Board scores allow for said movement.

Correct. I'm not a fan of P/F anything. I'm just saying I'd rather they went all P/F than do this, because now the most competitive part of the app for many fields won't come back until after AIs are over. It will be too late for students to change anything.

Personally, I just think they shouldn't have changed it at all. So many schools are already P/F, with clinical grades skewed so everyone gets HP/Honors to the point where its impossible to tell anyone apart. An all P/F system would just continue that trend, and then no one will know who is or is not good anymore. At which point then specialties will just have to make their own tests I'd imagine to stratify candidates. Which defeats the whole purpose of all this entirely.

 

[gamerEMdoc]

Also I’m thinking this could cause more students to play it safe and ironically make less competitive specialties more competitive

Correct.

 

[gamerEMdoc]

I also wonder, in some way, that if COMLEX remains a scored exam, if this actually helps DOs. Like, if applying for rotations and someone has a high COMLEX score, if more competitive fields will now take that person over the P/F USMLE candidate? I just don't know otherwise how fields that put so much emphasis on Step 1 scores will choose candidates to rotate?

 

[Alkain]

Haha
Are you telling me gunner MDs are going to go through OMM in order to take the COMLEX?