USMLE Step 1 -- Pass / Fail Starting Jan 2022

[Lure Kerr]

No one studies for Comlex that is obviously doing well on step 1 prep. Taking the two tests is only a pain due to money, frustration at the fact that comlex shouldn't exist, a waste of a whole day, and studying OMM for a few days. Day one study for USMLE and Comlex will fall into place unless you need to 700+ Comlex for AOA Ortho/ENT. You WILL 600+ even if you don't study if you are a 240+ USMLE scorer...

I don't think you're quite understanding what I'm saying... if you aren't studying for step 1 anymore, because no one is (well, at least not to the same degree), and all the MDs are just putting their effort into step 2 CK only, will DOs still need to keep studying for level 1 at the same rate as before while also trying to keep up with the increased competitiveness around step 2? Because that would mean that while the attention/work is only shifted for MD students, the attention/work is actually DOUBLED for DO students.

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[INeedAdmission2415]

I don't think you're quite understanding what I'm saying... if you aren't studying for step 1 anymore, because no one is (well, at least not to the same degree), and all the MDs are just putting their effort into step 2 CK only, will DOs still need to keep studying for level 1 at the same rate as before while also trying to keep up with the increased competitiveness around step 2? Because that would mean that while the attention/work is only shifted for MD students, the attention/work is actually DOUBLED for DO students.

The work has always been doubled for DO students in my opinion. I have a lot of respect for the amount of work they have to do in order to be competitive just for it to be an uphill battle at the end of the day.

 

[Lure Kerr]

The work has always been doubled for DO students in my opinion. I have a lot of respect for the amount of work they have to do in order to be competitive just for it to be an uphill battle at the end of the day.

Understandable... but this definitely seems like it will make it worse if COMLEX is still paid attention to. Plus the more time spent studying, the less that can be dedicated to all the other important things mentioned here, like awards and ECs and publications etc etc.

 

[Neopolymath]

I don't think you're quite understanding what I'm saying... if you aren't studying for step 1 anymore, because no one is (well, at least not to the same degree), and all the MDs are just putting their effort into step 2 CK only, will DOs still need to keep studying for level 1 at the same rate as before while also trying to keep up with the increased competitiveness around step 2? Because that would mean that while the attention/work is only shifted for MD students, the attention/work is actually DOUBLED for DO students.

Eh not really. No one cares or knows what your Comlex score is given it changes greatly year to year and is a **** exam. It doesn't mean you have double the work because it's doesn't really matter what you get. Try hard the first two years and you will be fine. MD students are NOT going to suddenly be doing Dorian deck beginning of second year while you are still studying for part 1.

 

[PikminOC]

Many Caribbean grads will be in trouble with this. They prep so hard for these tests, now the scores won't save them. With more grads and relatively stagnant residency slots, preference may be given to US grads.

 

[BoneWizard]

What's stopping carib grads from gunning for a high Step 2 score like the rest of us?

 

[JimBone905]

What's stopping carib grads from gunning for a high Step 2 score like the rest of us?

Not gonna be as important as step 1 was/is.

 

[PC89]

Since when did DOs really compete with Caribbean grads. TBH its even harder for them than it is for us to get competitive residency programs. Also, everyone was gunning for step 1 so literally nothing changes except now its Step 2 CK and VSAS is going to be very questionable on how to get rotations.

 

[PikminOC]

Correction: With more grads and relatively stagnant residency slots, preference should be given to US grads.

Was it not beforehand? Will this step 1 change make a difference in that?

 

[popopopop]

I don't think you're quite understanding what I'm saying... if you aren't studying for step 1 anymore, because no one is (well, at least not to the same degree), and all the MDs are just putting their effort into step 2 CK only, will DOs still need to keep studying for level 1 at the same rate as before while also trying to keep up with the increased competitiveness around step 2? Because that would mean that while the attention/work is only shifted for MD students, the attention/work is actually DOUBLED for DO students.

Unless they change requirements for COMLEX to p/f, programs still require minimum scores to do away rotations and for interview considerations.

 

[PikminOC]

It’s bad business for the NBME to make this decision. They did it because it was the right thing to do. They will lose money by making it pass/fail.


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How will they make less money? Price of the test is decreasing?

 

[PikminOC]

So if born in US, better to go to US DO school or Caribbean MD school given this usmle switch?

 

[Epilepsy365]

So if born in US, better to go to US DO school or Caribbean MD school given this usmle switch?

US DO bc of the low attrition rate

But residency PDs don’t give a damn if it’s DO FMG IMG or Carribean during application time.

 

[PikminOC]

That’s interesting. Another cottage industry that will be killed. Go NBME for choosing students over all these side business that make money off of licensing exams.

It never ends. Wait until you get to MOC, MOL.

 

[PikminOC]

US DO bc of the low attrition rate

But residency PDs don’t give a damn if it’s DO FMG IMG or Carribean during application time.

With this change in testing, how will this be effected?

 

[pathomapeds]

How will they make less money? Price of the test is decreasing?

Less people buying practice NBME exams and maybe less people buying UWorld. But how could they make more money off of this? Are they banking on more students failing because they don’t take the test seriously? I’ve never met a med student who hasn’t risen to the task of an exam, even a pass/fail one. There is no financial incentive and it’s clear to anyone paying attention that this is not at all what the NBME wanted to do.


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[AnatomyGrey12]

Theyre saying if u take step 1 in 2021 its gonna stay 3 digit?

No one knows, not even the NBME. They released a statement saying as much.

Less people buying practice NBME exams and maybe less people buying UWorld. But how could they make more money off of this? Are they banking on more students failing because they don’t take the test seriously? I’ve never met a med student who hasn’t risen to the task of an exam, even a pass/fail one. There is no financial incentive and it’s clear to anyone paying attention that this is not at all what the NBME wanted to do.


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You haven't been paying attention to the history of the NBME if you think there isn't an expectation of them making money off of this. They will start making more pre-clinical exams, more specialty specific shelves, more Step 2 practice tests, hell maybe even an entire new "aptitude test". I can guarantee you they will end up making money off of this. Everyone will still buy UWorld and practice tests lol.

 

[pathomapeds]

No one knows, not even the NBME. They released a statement saying as much.

You haven't been paying attention to the history of the NBME if you think there isn't an expectation of them making money off of this. They will start making more pre-clinical exams, more specialty specific shelves, more Step 2 practice tests, hell maybe even an entire new "aptitude test". I can guarantee you they will end up making money off of this. Everyone will still buy UWorld and practice tests lol.

They’re already doing these things (idk about any aptitude tests), I’m not sure shifting the emphasis from two important exams to one helps much. They will make money regardless.


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[Khan123567]

As someone who was recently admitted to a DO school for 2024, does this affect our chances/ability to get jobs. (I understand that specialty will be difficult, but I mean will we still have good opportunity for IM, ER, etc?)

 

[FutureDoctor5000]

With this change in testing, how will this be effected?

No just NO, STOP that nonsense talk bruh, DO’s still have thier residencies across all specialties that are biased for DO even after the merger or the step 1 P/F. You realize there are close to 100 former aoa IM program and like 50 former aoa general surgery programs and 40 former aoa ortho programs these are going to fill primarily with DO’s and I doubt they will start taking IMG’s.. this USMLE change hurts IMG’s way way more, it screws them completely, at least as DO’s there are programs in competitive specialties that are friendly for DO’s and can be viewed as a backup where a DO has a fair shot of matching, for an img there’s no such option , the charting outcomes are clear about this

 

[sab3156]

Thats the thing, they may change the scoring system as well in terms of what a passing rate is(This was also discussed). That is, they may increase the score in order to pass since its going to be a pass/fail.(So like a 210 may be needed to pass instead of a 194)[This was floated around my buddies school with their residency director- take as a grain of salt]

That sounds insane. Cut offs are unlikely to change very much at all. A 210 cut off means that ~18% of examinees will fail this exam...

And changing the cut off does nothing to address the problem here, which is that all examinees are shown as a "Pass" or "Fail" with a huge variability within the "Pass" cohort.

Also the old and the new MCAT were completely different exams lol. They had huge differences in topics(the new MCAT for example had almost no physics and massive emphasis on psych) and they could not be transferred. You couldn't say a 30 = This other score(Though you are correct, percentiles could be compared).

Like you said, percentiles are comparable. P/F cannot be compared to a numerically graded exam. So it doesn't matter if the MCAT was changed. Percentiles still demonstrate to admissions committees how well that person was able to prepare for a standardized exam relative to the rest of the applicant pool. So my point about it being a completely different situation still stands.

Not to mention you would need to focus on other factors to strengthen your application since step 1 is irrelevant. You could use all that board time on something more important.

Remember if step 1 is irrelevant and step 2 follows, you will need other things to strengthen your application. If you are just studying for a pass, you don't need to commit as much time to boards, rather other topics to make you stronger(Esepcially if you are a DO). It would pull the rug from under peoples legs who took it before 2022.

People applying to competitive programs/specialties have strong, well-rounded applications. They're not sitting there with nothing but Zanki open on their laptops 24/7. There's not really more you can do after you've generated strong research and a great Step 1 score. I hardly think this will change anything for competitive specialties and programs other than screw lower tier schools. Competitive programs/specialties also care a lot about your school name, and this is just going to emphasize this part of the app even more. It's not like you can change that.

On a side note, even if Step 2 CK becomes the next "big equalizer", it doesn't do anything for getting away rotations, and some specialties barely care about Step 2 CK - who knows if they ever will. This is potentially disastrous for DOs trying to match into Ophthalmology, for example, which matches in January, and they really don't care about Step 2 CK. Most of the MD students from good schools are at a huge advantage compared to lower tier schools. Things were bad before, and now they're just insanely bad. It's really just wishful thinking to believe that Step 2 CK is going to be a huge deal now - there are programs and specialties that might just as well be happy stratifying their applicants solely by school name, research, and quality of letters/connections.

I have already heard from faculty that have stated that it's going to be very difficult for them to figure out who to bring on away rotations based on just a "Pass" on Step 1, so school name and research is going to play a big role there. Guess who is going to luck out? It's not going to be the students at Bumblef*** Rural College of Osteopathic Medicine.

 

[PikminOC]

Less people buying practice NBME exams and maybe less people buying UWorld. But how could they make more money off of this? Are they banking on more students failing because they don’t take the test seriously? I’ve never met a med student who hasn’t risen to the task of an exam, even a pass/fail one. There is no financial incentive and it’s clear to anyone paying attention that this is not at all what the NBME wanted to do.


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I've known people who failed, one who committed suicide, left medicine over this test

 

[pathomapeds]

I've known people who failed, one who committed suicide, left medicine over this test

This is a huge opportunity to improve medical student wellness.


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[Whysoez]

This is a huge opportunity to improve medical student wellness.


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Idk, I feel my stress level has been increasing in the past 4 days and I am not even in my 1st year yet

 

[You-Are-My-Only-Hope]

That sounds insane. Cut offs are unlikely to change very much at all. A 210 cut off means that ~18% of examinees will fail this exam...

And changing the cut off does nothing to address the problem here, which is that all examinees are shown as a "Pass" or "Fail" with a huge variability within the "Pass" cohort.

Thats my point, a score change would mean that people on the old system would fail on the new one.

So my point about it being a completely different situation still stands.

I know, my point was simply they are different exams and you couldn't translate them at all to eachother.

People applying to competitive programs/specialties have strong, well-rounded applications. They're not sitting there with nothing but Zanki open on their laptops 24/7. There's not really more you can do after you've generated strong research and a great Step 1 score. I hardly think this will change anything for competitive specialties and programs other than screw lower tier schools. Competitive programs/specialties also care a lot about your school name, and this is just going to emphasize this part of the app even more. It's not like you can change that.

This is simply not true. While it is true that people have more than just their score. It is without a doubt that people spend hundreds of hours before dedicated studying for step doing Anki, questions, videos aside from school. You are talking about a possible 200+-hour increase you could do in other things, not counting dedicated.

Hell I could have passed step 8 weeks out from my test date(Was getting around a 230) before I even started dedicated. And I spent 100's of hours prepping for the exam outside of class due to Anki/Questions/Videos and 100's more during dedicated. Would I have done other things(Aside from the masters/volunteer/working) to strengthen my app? Of course

Furthermore, that is my point. DO's, international students and low tier MD schools are being kind of screwed.

Anyways we have gotten off track, as of now, we can only wait. Again I doubt they will make a person 250 July 20th come out Jan 2022 as a pass/fail. Its likely going to stay numerical until they change it according to most sources.

But we shall see.

All I can say is I am out and will match WAY before this. Thank the lord

Cheers

 

[DrStephenStrange]

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Another one lol

 

[PikminOC]

I know students who choose Caribbean MD over us DO. Will this effect that?

 

[Whysoez]

I know students who choose Caribbean MD over us DO. Will this affect that?

They will be in much worse shape than DOs comes 2024 match.

 

[PikminOC]

They will be in much worse shape than DOs comes 2024 match.

How so?

 

[Whysoez]

How so?

This x10 in 2024

 

[DrStephenStrange]

How so?

They are currently worse off than DO already, and their main hope was to do exceptional on the Step 1. I would imagine it's gonna get even harder for them especially with the greatest increase in DO grads happening in 2024.

 

[FutureDoctor5000]

How so?

Is this a joke? Get of the Kool aid... IMG's have a tough go at it already, theres no comparison between DO vs caribbean MD.. there are DO schools that have their own teaching/academic hospitals and/or a large network of hospitals where students rotate and have residencies, DO students have the upper hand, also the DO bias is nothing compared to the IMG bias, show me the last time a Caribbean IMG matched UWash IM or Ohio State/Brown Optho or Interventional Rads anywhere.

 

[NurWollen]

I know it's easy for me to say this, as someone who's already made it through the gauntlet, but my overall feeling is this has the potential to really change some things for the good. But its it'ss going to be tough for the people going through school during the transition, for sure.

Step I is, IMHO, a terrible metric for predicting future success in residency. I've met people with 260's on Step I who can't keep up a normal conversation to save their lives, and I've met people who got
To me, this change being beneficial is going to hinge of a few key things happening.

1. Step II doesn't also go pass fail. This will push the emphasis to Step/level II* which is a good thing. Studying for rocking this test will actually help you be a better clinical student and resident.

2. Schools really need to update their curriculum to adjust to a P/F Step I. Shorten summer break in between MS1 and MS2 to 1-2 weeks. Finish preclinicals by Dec of MS2. Take Step I beginning of February. Start clerkships in February, and take Step II the following March after a month or two of dedicated. Scheduling of aways and Sub-Is can be adjusted accordingly.

This is the Way.

*I'm absolutely positive NBOME will make Level II P/F. It's what they've always done, emulate the NBME in everything they do, but claim they do it better.

My biggest concern is that DO schools will do DO school things and stubbornly stick to he old calendar and not make any of the adjustments above, for the same reasons they make it hard to have enough dedicated time for Steps, tell you not to take the Steps, etc. Whatever those reasons are.

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[Khan123567]

Is it possible that this change will be postponed, since the announcement says Jan 2022 earliest? ( being very optimistic but still)

 

[Butterfly23]

As an attending perspective(devil's perspective), this is what I will do if I happen to administrative duties for picking residents. In order to make profits from applicants, I will design specialty specific exams after usmle step 2. So for people applying to ortho or Pm&R, I will make separate exams focusing on MSK conditions and charge applicants with huge money something like that.

 

[dohopeful13]

Is it possible that this change will be postponed, since the announcement says Jan 2022 earliest? ( being very optimistic but still)

Of course it's possible! Time will tell.

 

[harrislakers123]

There will be new objective metrics created over next 1-2 years that will allow students from mid/low tier MD and DO schools to demonstrate excellence and attain any residency. I feel terrible for premeds and newly accepted students reading these threads. I am seeing some very horrible advice, and extreme negativity. I am extremely anti Step 1 P/F and have also made theatrical statements but what is being portrayed here is over the top and we (me first) have to be more responsible with what we say on these forums. DOs can and will match in every specialty. There is uncertainty now but there is a two year window here to adjust curriculums to Step 2 CK and create/reestablish objective metrics

 

[PikminOC]

Is this a joke? Get of the Kool aid... IMG's have a tough go at it already, theres no comparison between DO vs caribbean MD.. there are DO schools that have their own teaching/academic hospitals and/or a large network of hospitals where students rotate and have residencies, DO students have the upper hand, also the DO bias is nothing compared to the IMG bias, show me the last time a Caribbean IMG matched UWash IM or Ohio State/Brown Optho or Interventional Rads anywhere.

I'm not joking nor am I biasing one for another. I'm just asking questions. This is a very interesting threads.

 

[Dr.Bruh]

US DO bc of the low attrition rate

But residency PDs don’t give a damn if it’s DO FMG IMG or Carribean during application time.

Huh? That’s just wildly inaccurate. Check the PD survey. Many many more programs willing to rank and interview DOs than IMG. Also I’m applying through VSAS now and I haven’t come across a single program that’s not accepted DO (I’m sure there’s a few out there) but the vast majority I’ve been applying to say no IMG allowed. So a lot of program won’t even let them do a Sub-I which is immensely important to matching in many specialties.

 

[Epilepsy365]

Huh? That’s just wildly inaccurate. Check the PD survey. Many many more programs willing to rank and interview DOs than IMG. Also I’m applying through VSAS now and I haven’t come across a single program that’s not accepted DO (I’m sure there’s a few out there) but the vast majority I’ve been applying to say no IMG allowed. So a lot of program won’t even let them do a Sub-I which is immensely important to matching in many specialties.

That is false. Your DO status limit your VSAS screen to only programs that are fine with DOs for aways.

Meanwhile, your IMG friend with their MD status has unlimited access to all aways. Also, there isn’t a single VSAS away that says no IMG. Screen shot me an ACCME program on VSAS that says no IMG and I’ll believe you.

The IMGs that I’ve met on the interview trail do all of their 4th yr rotations at academic centers via VSAS. It’s a common thing. They’re not doing their rotations at some AOA podunk clinics.

 

[Dr.Bruh]

I'm not joking nor am I biasing one for another. I'm just asking questions. This is a very interesting threads.

Maybe you’re just out of the loop which is fine. But basically bias against IMGs has been far greater then DO bias for a long time now. DO will places 98-99% of graduates where Carrib schools will place 60%ish. Many programs won’t even consider them for interviews.

 

[Dr.Bruh]

That is false. Your DO status limit your VSAS screen to only programs that are fine with DOs for aways.

Meanwhile, your IMG friend with their MD status has unlimited access to all aways. Also, there isn’t a single VSAS away that says no IMG. Screen shot me an ACCME program on VSAS that says no IMG and I’ll believe you.

The IMGs that I’ve met on the interview trail do all of their 4th yr rotations at academic centers via VSAS. It’s a common thing. They’re not doing their rotations at some AOA podunk clinics.

Lol the delusion is real. I’ll send them when I’m off work. I’ve seen countless programs that state verbatim on their website “we do not consider international medical students for auditions”. Also my friend is at SGU and doing his rotations in the middle of nowhere in a clinic basically ran out of a dude’s house lol.

 

[Dr.Bruh]

That is false. Your DO status limit your VSAS screen to only programs that are fine with DOs for aways.

Meanwhile, your IMG friend with their MD status has unlimited access to all aways. Also, there isn’t a single VSAS away that says no IMG. Screen shot me an ACCME program on VSAS that says no IMG and I’ll believe you.

The IMGs that I’ve met on the interview trail do all of their 4th yr rotations at academic centers via VSAS. It’s a common thing. They’re not doing their rotations at some AOA podunk clinics.

And also are you saying the PD surgery is false?? Bc according to that’s only 32% of PDs often rank US IMGs (only 20% for non us IMGs), 52 % seldom rank us IMGs (45% for non us), and 16% never rank IMGs (34% for non us IMGs). So combining never or seldom rank IMGs that’s 68% of programs and 79% for non us IMG.

57% of PD often rank DOs (nearly double US and triple non us IMG rate). 31% will seldom rank and 12% never rank. sorry to break it to you but PDs defeo care if you’re DO vs Carrib. And they will most often pick the DO

 

[pathomapeds]

Students will be buying more NBME exams for Step 2 and less NBME exams for Step 1. No significant net difference in revenue.

I agree. If this was financially motivated it would have happened long ago....


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[Dr.Bruh]

That is false. Your DO status limit your VSAS screen to only programs that are fine with DOs for aways.

Meanwhile, your IMG friend with their MD status has unlimited access to all aways. Also, there isn’t a single VSAS away that says no IMG. Screen shot me an ACCME program on VSAS that says no IMG and I’ll believe you.

The IMGs that I’ve met on the interview trail do all of their 4th yr rotations at academic centers via VSAS. It’s a common thing. They’re not doing their rotations at some AOA podunk clinics.

of the first 10 places I googled for EM away rotations most do not accept IMGs: Rush, UMKC, New York Medical College, Loyola (charges imgs 1500 bucks for an away), UT Nashville (multiple specialties), University of Missouri, medical college of Georgia. All accept DOs and currently have DOs as residents in these programs. The idea that IMGs have unlimited access to all seats is seriously wrong. You have dramatically less.

 

[PikminOC]

of the first 10 places I googled for EM away rotations most do not accept IMGs: Rush, UMKC, New York Medical College, Loyola (charges imgs 1500 bucks for an away), UT Nashville (multiple specialties), University of Missouri, medical college of Georgia. All accept DOs and currently have DOs as residents in these programs. The idea that IMGs have unlimited access to all seats is seriously wrong. You have dramatically less.
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Xenophobic. I wonder if the people there are for or against illegal immigration

 

[PikminOC]

of the first 10 places I googled for EM away rotations most do not accept IMGs: Rush, UMKC, New York Medical College, Loyola (charges imgs 1500 bucks for an away), UT Nashville (multiple specialties), University of Missouri, medical college of Georgia. All accept DOs and currently have DOs as residents in these programs. The idea that IMGs have unlimited access to all seats is seriously wrong. You have dramatically less.
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At least Loyola just wants money. Carribean grads have lots of

 

[Dr.Bruh]

At least Loyola just wants money. Carribean grads have lots of

That’s a criminal amount of money to charge. Also they don’t have any IMGs in the program but do have 2 DOs. It’s a money grab

 

[Dr.Bruh]

Xenophobic. I wonder if the people there are for or against illegal immigration

No...many IMGs are US citizens.

 

[PikminOC]

No...many IMGs are US citizens.

Still discrimination. These liberal bastions are discriminating.