USMLE Step 1 -- Pass / Fail Starting Jan 2022

[BorntobeDO?]

Psych is still not that competitive, according to the 2019 match list. I hope I get in though. I'll apply to community programs when the time comes.

The scores are not that high, but there is a pretty big difference in the scores from internal vs external applicants where I rotated.

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[BorntobeDO?]

Wow, psych isn't even feasible anymore? That's depressing

I wouldn’t go that far, but I do think this makes it more difficult. Psych has had lots of DOs in it for years, so they won’t shut us out completely IMO. Having a higher score clearly helped people match in the past, so without that, I think MDs become the default ‘safer’ candidate.

 

[specialk_97]

I perused through these forums, but couldn't find a definite answer, so I'm class of 2023. Is this going to affect me? Assuming I don't fail, and I take step 1 on time next year, will I still have my numerical score value be reported as whatever it is instead of a "P"? I'd be applying to residencies in 2022.

 

[Chibucks15]

So if you're a DO, your options are basically family medicine, internal medicine or pediatrics now?

No they aren’t. Christ people just chill out

 

[BorntobeDO?]

I perused through these forums, but couldn't find a definite answer, so I'm class of 2023. Is this going to affect me? Assuming I don't fail, and I take step 1 on time next year, will I still have my numerical score value be reported as whatever it is instead of a "P"? I'd be applying to residencies in 2022.

No one is sure. The language looks like that could happen. I would bet no, but if I was a 2023er I would not be feeling good right now.

 

[BorntobeDO?]

No they aren’t. Christ people just chill out

I would argue for most that statement is true. But that same thought could apply right now. The difference between now and 2024 is the quality of matches will almost certainly go down for 2024 with this change.

 

[Chibucks15]

I would argue for most that statement is true. But that same thought could apply right now. The difference between now and 2024 is the quality of matches will almost certainly go down for 2024 with this change.

There is literally zero data or proof of how this will shake out. It’s all neurotic SDN BS that drives me nuts and freaks out incoming students that don’t know better yet. I remember my anxiety peaking when I used to take the words here as gospel.
There are DOs in every damn specialty and not everyone is a prestige ***** so it doesn’t explicitly come down to credentials.

Things will work out, bust it as hard as you can even if Step is P/F. Emphasis will shift to Step 2 and other factors, which I would argue isn’t a bad thing because half the crap on Step 1 I’ve already forgotten halfway through 3rd year.

If anything this will give more weight to aways, regional ties, and networking. Again, (besides the last part) not bad things because you don’t have people throwing apps to 120 programs because they’re extra paranoid. And for the networking part? That’s how the world works outside of medicine too. Time for many sheltered students to get exposed to it, life ain’t fair just work your hardest to get somewhere.

this isn’t all to you more to give people just reading a differing opinion from a DO who is one of the majority of people who aren’t on this damn thing

 

[DrStephenStrange]

Sent from my SM-G973U using SDN mobile

 

[Scrubb]

Personal statement
Volunteering
Extra curricular activities
Letters of recommendation
Dean's letter
Awards
Research
Presentations
Patient experience
Audition rotations/Sub I's

Out of 15+ interviews, I was asked one time about my board scores. The list above is what I was asked about. I tailored my application specifically to the field I applied to, and received numerous positive comments about my application package.

First off, congratulation, in all seriousness.

To comment though: of course they're not going to ask about board scores much at interviews, it's just a number listed on your application. There's not much else to know. But you can bet they used that number to decide whether you should even get that interview or not. So it got your foot in the door. The rest shows you had the time and made the effort to have well-rounded experiences.

However, not everyone is in the position to do all these things. Some people need more time to attend to family, or take longer to study, or aren't really as keen on the research/academic side of the profession, or aren't provided with quality opportunities by their school/area. Many of these activities are linked to privilege as well. Also, from experience at my own school and from other peoples' attestations, lots of the "volunteering", "research", and "extra-curriculars" people do have very little true value and are done as resume fillers. I'm not at all saying that's true of you, or of everyone, but it's definitely highly prevalent. It's just like all the filler stuff people list on their MCAT from undergrad. In summary, these are great things to have on top of test scores to talk about in interviews and add personality to the application, but in and of themselves should not be the basis for screening for residency interviews; that should be left to scores (like Step 1 and 2) in the context of the rest of the app.

Cramming lots of minutiae isn't ideal nor is it predictive of the type of physician one will make; however, it is indicative of the effort and ability someone put into learning the material and foundational knowledge (i.e. the type of student one is and could potentially be in a residency program). That's primarily why we go to school: to acquire knowledge of the subject matter and learn the skills that we will use in our field. Not to volunteer, do research, or participate in some club, which is all great but is secondary stuff to actually learning the foundational knowledge.

In summary, Step 1 wasn't the best way to stratify people, but it was an important way (in combination with Step 2) and a much better way than subjective (and often embellished) volunteering/research/etc. experiences. No, Step 1 doesn't predict how one will be as a physician, but it shouldn't have to. It works to signify to residencies how much time and effort one was willing to put into being a student of the profession and a life-long learner.

 

[BorntobeDO?]

There is literally zero data or proof of how this will shake out. It’s all neurotic SDN BS that drives me nuts and freaks out incoming students that don’t know better yet. I remember my anxiety peaking when I used to take the words here as gospel.
There are DOs in every damn specialty and not everyone is a prestige ***** so it doesn’t explicitly come down to credentials.

Things will work out, bust it as hard as you can even if Step is P/F. Emphasis will shift to Step 2 and other factors, which I would argue isn’t a bad thing because half the crap on Step 1 I’ve already forgotten halfway through 3rd year.

If anything this will give more weight to aways, regional ties, and networking. Again, (besides the last part) not bad things because you don’t have people throwing apps to 120 programs because they’re extra paranoid. And for the networking part? That’s how the world works outside of medicine too. Time for many sheltered students to get exposed to it, life ain’t fair just work your hardest to get somewhere.

this isn’t all to you more to give people just reading a differing opinion from a DO who is one of the majority of people who aren’t on this damn thing

No data or proof? Tell me is there no difference in scores between matches and unmatched applicants? Because if there’s a difference and that difference is taken away, how do I sort now? The answer is pretty obvious.

 

[Chibucks15]

No data or proof? Tell me is there no difference in scores between matches and unmatched applicants? Because if there’s a difference and that difference is taken away, how do I sort now? The answer is pretty obvious.

There is no current direct evidence of what will take the place of this apparent step 1 score importance that’s irreplaceable, except when residencies choose a new thing to focus on. Like I said, I feel step 2 will obviously increase in importance, but so will regional ties, aways, and the interview in general not being an idiot.

if you can’t handle step2, that’s the most clinically relevant exam we take in med school. That speaks a lot more to your ability to practice medicine than step 1.

the big picture here is, not everyone is as special as they were when they grew up. You don’t get to just become a cardiologist or whatever else because you want to. This doesn’t end the game, it just changes it. Nobody knows the full effect of the merger yet much less this. And it won’t even take effect for at LEAST 2 years

 

[BorntobeDO?]

There is no current direct evidence of what will take the place of this apparent step 1 score importance that’s irreplaceable, except when residencies choose a new thing to focus on. Like I said, I feel step 2 will obviously increase in importance, but so will regional ties, aways, and the interview in general not being an idiot.

if you can’t handle step2, that’s the most clinically relevant exam we take in med school. That speaks a lot more to your ability to practice medicine than step 1.

the big picture here is, not everyone is as special as they were when they grew up. You don’t get to just become a cardiologist or whatever else because you want to. This doesn’t end the game, it just changes it. Nobody knows the full effect of the merger yet much less this. And it won’t even take effect for at LEAST 2 years

22.5 months. But I agree it will take time to see the full picture, but you don’t have to be Nostradamus to see where this looks like it’s headed.

 

[Chibucks15]

22.5 months. But I agree it will take time to see the full picture, but you don’t have to be Nostradamus to see where this looks like it’s headed.

True, but declining an acceptance to med school to chase a VASTLY limited resource in MD seats, or overly freaking out right now is the opposite of a mature, well thought out decision.

 

[BorntobeDO?]

True, but declining an acceptance to med school to chase a VASTLY limited resource in MD seats, or overly freaking out right now is the opposite of a mature, well thought out decision.

We are gonna disagree on this one, with the amount of time and effort that went into applying to med school for me, I would not take what the DO schools are currently offering unless I knew I had no shot at MD.

 

[Chibucks15]

We are gonna disagree on this one, with the amount of time and effort that went into applying to med school for me, I would not take what the DO schools are currently offering unless I knew I had no shot at MD.

Oh I agree with that take. What I always go back to is if you knew you wanted to be something competitive, to become a better applicant and go MD. Once you sign up, you know the risks and need to be okay with them.

I appreciate the measured actual discussion, so many times it gets out of hand and nothing actually gets conveyed. We’ll see how this all plays out

 

[Whysoez]

Oh I agree with that take. What I always go back to is if you knew you wanted to be something competitive, to become a better applicant and go MD. Once you sign up, you know the risks and need to be okay with them.

I appreciate the measured actual discussion, so many times it gets out of hand and nothing actually gets conveyed. We’ll see how this all plays out

This risk was just announced today, We did not know.

 

[Chibucks15]

This risk was just announced today, We did not know.

No it wasn’t. You already should have known you would most likely be some sort of primary care. Like I’ve said, this changes the game. It doesn’t end it. There will be new things emphasized so go kill those things

 

[Whysoez]

No it wasn’t. You already should have known you would most likely be some sort of primary care. Like I’ve said, this changes the game. It doesn’t end it. There will be new things emphasized so go kill those things

Up until today, the resources available for me to kill those emphasized things (ie Step 1) were available to me as a DO student. Now the resources for the new emphasized things (good rotations, research, connections, etc.) are not there for me as a DO student.

 

[Chibucks15]

Up until today, the resources available for me to kill those emphasized things (ie Step 1) were available to me as a DO student. Now the resources for the new emphasized things (good rotations, research, connections, etc.) are not there for me as a DO student.

Again, you have zero idea how this will play out. What if it comes more down to regional ties? Aways? Or step 2? Those are attainable as a DO. You can get connections as a DO by going to conferences, reaching out during aways, research, etc. sure it’s harder but it’s the same way for lower MD schools. It’s not like brand new MD schools suddenly have incredible connections. Also, you really have no idea what you want to do or what you enjoy until you get into med school (unless you have significant exposure prior).

if you want to risk torching any chance at being a physician by dropping out, there are 10 applicants dying for your seat. Feel free to do what you want I don’t really care

 

[Whysoez]

Again, you have zero idea how this will play out. What if it comes more down to regional ties? Aways? Or step 2? Those are attainable as a DO. You can get connections as a DO by going to conferences, reaching out during aways, research, etc. sure it’s harder but it’s the same way for lower MD schools. It’s not like brand new MD schools suddenly have incredible connections. Also, you really have no idea what you want to do or what you enjoy until you get into med school (unless you have significant exposure prior).

if you want to risk torching any chance at being a physician by dropping out, there are 10 applicants dying for your seat. Feel free to do what you want I don’t really care

I fully get your points and they are all valid concerns. I am just paranoid and feeling like I was shot in the back for no obvious reason as an upcoming DO student. Imagine sitting down on a blackjack table, placed in your chips and was told that the rules have just been changed and your chances of winning is now much slimmer, would you be compelled to just stand up and leave or continue to play? I definitely think declining DO acceptance is the worst possible idea, but god damn it, I feel like I will be carrying the scar of today's betrayal for the rest of my career.

 

[Chibucks15]

I fully get your points and they are all valid concerns. I am just paranoid and feeling like I was shot in the back for no obvious reason as an upcoming DO student. Imagine sitting down on a blackjack table, placed in your chips and was told that the rules have just been changed and your chances of winning is now much slimmer, would you be compelled to just stand up and leave or continue to play? I definitely think declining DO acceptance is the worst possible idea, but god damn it, I feel like I will be carrying the scar of today's betrayal for the rest of my career.

First off, nice imagery if a bit dramatic haha

Second, I get that it’s a shock. Hell I’d be in the same boat as you if I was in that situation. I’m just saying people change what specialties and what areas of the county they want all the time. 4 years is a looong time, especially when you’re in a part of life where a lot of major decisions get made and change.

there isn’t a way to know how this will play out. Same with the recent merger. Everyone has speculations

 

[FrechToastFries]

Kinda off topic, but why do I feel like DOs absolutely despise primary care (IM, FM, peds, etc)? I have many MD friends who willingly go in primary care even with great board scores. I feel there's this innate ideology among med students, but especially among DO students, that if you're primary care you're a failure. If you don't LIKE primary care I can understand that. But many times in these threads people just talk as if primary care = failure, worst life style ever, loser. Is this just some sort of inferiority complex or something? There's an insanely smart kid in our class (this kid will definitely score in the 260s on step 1), and he recently mentioned he wanted to go into family medicine because he likes it and the amount of hate he got was ridiculous. Again, off topic but just this thread was giving off those vibes.

 

[Startingover123]

Kinda off topic, but why do I feel like DOs absolutely despise primary care (IM, FM, peds, etc)? I have many MD friends who willingly go in primary care even with great board scores. I feel there's this innate ideology among med students, but especially among DO students, that if you're primary care you're a failure. If you don't LIKE primary care I can understand that. But many times in these threads people just talk as if primary care = failure, worst life style ever, loser. Is this just some sort of inferiority complex or something? There's an insanely smart kid in our class (this kid will definitely score in the 260s on step 1), and he recently mentioned he wanted to go into family medicine because he likes it and the amount of hate he got was ridiculous. Again, off topic but just this thread was giving off those vibes.

No they aren’t. Christ people just chill out

It’s always a $$$$$ thing. If FM paid 400k it would be Uber competitive.

 

[BorntobeDO?]

Kinda off topic, but why do I feel like DOs absolutely despise primary care (IM, FM, peds, etc)? I have many MD friends who willingly go in primary care even with great board scores. I feel there's this innate ideology among med students, but especially among DO students, that if you're primary care you're a failure. If you don't LIKE primary care I can understand that. But many times in these threads people just talk as if primary care = failure, worst life style ever, loser. Is this just some sort of inferiority complex or something? There's an insanely smart kid in our class (this kid will definitely score in the 260s on step 1), and he recently mentioned he wanted to go into family medicine because he likes it and the amount of hate he got was ridiculous. Again, off topic but just this thread was giving off those vibes.

I think most people don’t like the idea of being ‘forced’ into primary care. I could easily see a third (without academic IM) to over half my class choosing primary care (if you include academic IM) without any problem. Now the IM people mostly plan to specialize but even then I would bet a large number of students end up choosing primary care. But the problem is that 80% of my class will end up in IM, FM, Peds and a good amount of them would have preferred something else. That’s not cool.

There’s a huge difference between choosing a specialty cause of fit, and getting forced into residency cause you just have no option. The latter is what most DO students are worried about.

 

[DNC127]

Kinda off topic, but why do I feel like DOs absolutely despise primary care (IM, FM, peds, etc)? I have many MD friends who willingly go in primary care even with great board scores. I feel there's this innate ideology among med students, but especially among DO students, that if you're primary care you're a failure. If you don't LIKE primary care I can understand that. But many times in these threads people just talk as if primary care = failure, worst life style ever, loser. Is this just some sort of inferiority complex or something? There's an insanely smart kid in our class (this kid will definitely score in the 260s on step 1), and he recently mentioned he wanted to go into family medicine because he likes it and the amount of hate he got was ridiculous. Again, off topic but just this thread was giving off those vibes.

Because people are stupid.

Primary care is the literal dream.

9-5, 4 days a week, no super sick patients, can be a town doc and be loved by your patients.... and you make 250k? (300+k in oklahoma)

People just need their ego stoked with more than their left hand.

If I wasn't doing ortho it would be FM, psych, or ER.

 

[BorntobeDO?]

Lol an ortho bro calling FM the dream. Tell you what, if I fall to my backups and you get ortho, we can trade so you can have the dream...

Edit: dang it, I am gonna prove your point I totally wouldn’t trade FM for ortho.

 

[FrechToastFries]

It’s always a $$$$$ thing. If FM paid 400k it would be Uber competitive.

You can make 400k as a FM doc if you play your cards right. I have multiple relatives who are FM docs who make 500K per year with private practice.

 

[Whysoez]

Kinda off topic, but why do I feel like DOs absolutely despise primary care (IM, FM, peds, etc)? I have many MD friends who willingly go in primary care even with great board scores. I feel there's this innate ideology among med students, but especially among DO students, that if you're primary care you're a failure. If you don't LIKE primary care I can understand that. But many times in these threads people just talk as if primary care = failure, worst life style ever, loser. Is this just some sort of inferiority complex or something? There's an insanely smart kid in our class (this kid will definitely score in the 260s on step 1), and he recently mentioned he wanted to go into family medicine because he likes it and the amount of hate he got was ridiculous. Again, off topic but just this thread was giving off those vibes.

We all like coitus, but forced coitus, fudge no.

 

[FrechToastFries]

I think most people don’t like the idea of being ‘forced’ into primary care. I could easily see a third (without academic IM) to over half my class choosing primary care (if you include academic IM) without any problem. Now the IM people mostly plan to specialize but even then I would bet a large number of students end up choosing primary care. But the problem is that 80% of my class will end up in IM, FM, Peds and a good amount of them would have preferred something else. That’s not cool.

There’s a huge difference between choosing a specialty cause of fit, and getting forced into residency cause you just have no option. The latter is what most DO students are worried about.

I get that. But why hate on primary care in general? DO med students especially (you can see it all over this forum) talk about primary care doctors like it's the worst thing that could happen to you. You routinely see sarcastic comments on here like "Well I hope you're happy being a PC doc" and "have fun with IM/FM". I can understand someone not wanting to be forced into it, but the hate for it is puzzling.

 

[BorntobeDO?]

It’s always a $$$$$ thing. If FM paid 400k it would be Uber competitive.

I don’t think so, FM is hard to do well and you are responsible for so much stuff. There’s so much social aspect of medicine too, that FM is way involved with. It’s easy to see why people would rather be a specialist and when someone tries to go off on a tangent about their back you can just be like ‘well I’m the heart doc, I don’t know a lot about backs, gonna have to ask primary about that.’

 

[BorntobeDO?]

I get that. But why hate on primary care in general? DO med students especially (you can see it all over this forum) talk about primary care doctors like it's the worst thing that could happen to you. You routinely see sarcastic comments on here like "Well I hope you're happy being a PC doc" and "have fun with IM/FM". I can understand someone not wanting to be forced into it, but the hate for it is puzzling.

I think most of us are just having fun when you see those sorts of comments. The reality is that FM is kind of hard compared to being a specialist, and we all know that. We also know it’s the least competitive specialty, so of course it gets dumped on.

 

[FrechToastFries]

I think most of us are just having fun when you see those sorts of comments. The reality is that FM is kind of hard compared to being a specialist, and we all know that. We also know it’s the least competitive specialty, so of course it gets dumped on.

Makes sense. I always thought it was just messing around. But when I saw people hating on that poor kid in my class it made it seem a lot more real. There's definitely a lot of DO students who act like that, in a serious way. The culture of it is toxic and it impacts incoming students too.

 

[deleted831695]

I don’t think so, FM is hard to do well and you are responsible for so much stuff. There’s so much social aspect of medicine too, that FM is way involved with. It’s easy to see why people would rather be a specialist and when someone tries to go off on a tangent about their back you can just be like ‘well I’m the heart doc, I don’t know a lot about backs, gonna have to ask primary about that.’

Lol not like specialists don't have it tough too. And primary care can always refer to specialists.

 

[BorntobeDO?]

Makes sense. I always thought it was just messing around. But when I saw people hating on that poor kid in my class it made it seem a lot more real. There's definitely a lot of DO students who act like that, in a serious way. The culture of it is toxic and it impacts incoming students too.

Yeah many wanna be a surgeons/specialists are jerks. It’s always funny when some of those guys end up in the very FM residency they pee on.

 

[Khan123567]

Would I be able to do Cardiology with this change? (As a DO)

 

[BorntobeDO?]

Lol not like specialists don't have it tough too. And primary care can always refer to specialists.

Yeah, but then it just bounces back to you when the specialist rules out their stuff. You will see, primary is very important and has a lot more variance day to day but it’s hard. What’s funny is that PAs and NPs feel like they can do primary care well. They really don’t have a clue what they talk about in that regard.

 

[BorntobeDO?]

Would I be able to do Cardiology with this change? (As a DO)

Less likely, still possible. Would probably require step 1 and 2 along with aways. You won’t know if your actually competitive till summer of third going into 4th year.

 

[JimBone905]

Less likely, still possible. Would probably require step 1 and 2 along with aways. You won’t know if your actually competitive till summer of third going into 4th year.

I think hes fine. Lots of community IM have in house cardio fellows and community IM as a DO should still be "easy" enough

 

[Startingover123]

I think hes fine. Lots of community IM have in house cardio fellows and community IM as a DO should still be "easy" enough

This is good to hear. One does not need academic IM for cardiology?

 

[BorntobeDO?]

I think hes fine. Lots of community IM have in house cardio fellows and community IM as a DO should still be "easy" enough

The problem with community in house fellowships is that there are many more applcants for cards than spots, so just because a program has a fellowship does not mean they will take their own residents over a university program resident. This has actually been discussed other places.

 

[Whysoez]

At this point I will take a hospitalist job, 7 on 7 off and a little scribe minion like my current attending and I will be happy.

 

[BorntobeDO?]

At this point I will take a hospitalist job, 7 on 7 off and a little scribe minion like my current attending and I will be happy.

There are worse things, and if your totally okay with that outcome DO is still fine.

 

[JimBone905]

This is good to hear. One does not need academic IM for cardiology?

No but it helps as stated above me. If they like u then u r good

 

[Khan123567]

Ok would it also make IM difficult for DOs?

 

[GoodNotGreat]

Ok would it also make IM difficult for DOs?

IM is easy to match, hard to match well. Nobody on earth right now can tell you with certainty how this effects your odds of matching an IM prog that sets you up for a Cards fellowship.

 

[BorntobeDO?]

Ok would it also make IM difficult for DOs?

Academic -yes; community - no

 

[Khan123567]

What do you mean by academic?

 

[Startingover123]

What do you mean by academic?

Anything affiliated with a university

 

[Khan123567]

ah I see.
So what I have gathered is that working at a small community hospital as an IM won’t be affected and specializing in an IM specialty should still be doable ??

 

[Epilepsy365]

ah I see.
So what I have gathered is that working at a small community hospital as an IM won’t be affected and specializing in an IM specialty should still be doable ??

Nobody says that you can’t stop dreaming.