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I've heard rumors that there are potential plans to change the USMLE to a pass/fail test. If so, is this likely to affect those in the entering class of 2007 or later?
Where did you hear this? I doubt very much it will happen. The Step 1 is pretty much like the MCAT: it's the only equalizer that residency directors can use to quantitatively compare an applicant from one school to an applicant from another. I wouldn't sweat it moving to P/F any time soon.I've heard rumors that there are potential plans to change the USMLE to a pass/fail test. If so, is this likely to affect those in the entering class of 2007 or later?
Where did you hear this? I doubt very much it will happen. The Step 1 is pretty much like the MCAT: it's the only equalizer that residency directors can use to quantitatively compare an applicant from one school to an applicant from another. I wouldn't sweat it moving to P/F any time soon.
I've heard rumors that there are potential plans to change the USMLE to a pass/fail test. If so, is this likely to affect those in the entering class of 2007 or later?
I've heard rumors that there are potential plans to change the USMLE to a pass/fail test. If so, is this likely to affect those in the entering class of 2007 or later?
this could be very good.
No, it would be disasterous. As it stands, like it or not, the USMLE Step1 is a number that every applicant has on his application for comparison. If this test becomes meaningless then residency application is going to get alot more stressful.
I agree. PDs will find a yardstick to compare applicants. If not the USMLE, where you are in competition with faceless students at other schools, then your grades, where you are in direct competition with your classmates.No, it would be disasterous. As it stands, like it or not, the USMLE Step1 is a number that every applicant has on his application for comparison. If this test becomes meaningless then residency application is going to get alot more stressful.
Med school grades will become MUCH more important, gunners will probably come out of the woodwork...
If students shut themselves out of specialties by not doing as well as they can on step 1 its nobody's fault but their own.I think that we are more likely to see a combining of steps than a conversion to p/f. As it stands right now, the structure of the steps make it impractical for students to get real clinical skills until after their choice of specialty may be already limited.
I think that we are more likely to see a combining of steps than a conversion to p/f. As it stands right now, the structure of the steps make it impractical for students to get real clinical skills until after their choice of specialty may be already limited.
I personally am of the opinion that there is seldom a huge gap between clinical ability and USMLE score (either step). The myth of the kid who gets 250 and is a bonehead around patients is just that - a myth. I know probably 10 people who scored in the 250s and 9//10 of them are superstars.
Also, saying that people will be forced to do better in class ... is not necessarily a bad thing. .
In a perfect world, these courses would follow the Step and also go pass/fail.I think you weaken your argument here. You make a good point about the Step not testing the right things, but elimination of the Step simply results in focusing on coursework on those same things -- only even less targeted. Putting more weight on pre-clinical course grades (things like biochem, embryo, histo...) is the logical conclusion of eliminating a preclinical step score, and simply isn't going to be more relevant to a field like derm or plastics, which will still demand high scorers in whatever they can get scores on.
In a perfect world, these courses would follow the Step and also go pass/fail....
Medical school has continued to remain 4 years for more than 70 years despite the extensive growth in medical information during this time period. It's not feasible nor necesssary to have intimate knowledge of medical science that we will: 1) never use in practice 2) never remember past the test/boards
4. If the USMLE goes P/F, expect the NBME shelf exams to be used instead. This isn't a terrible idea -- everyone could take whatever shelf they wanted (i.e. Medicine, Surgery, OB, etc), the NBME would provide a transcript of these results. Students could choose the shelfs that made the most sense for their careers. Specialty sociaties could then have more input into their shelf exams -- i.e. plastics could have some sort of physical aspect to their test (i.e. tie these knots, or draw how you would change this face, etc).
A system for IMG's to take shelfs would be needed. Of note, one bonus to this system is that you would be able to retake a shelf should you want to try to improve your score, unlike the USMLE.
We don't live in a perfect world. And in case you missed it, much of education is not meant to be focused on what you can use. This isn't vocational school. Most of us are used to a long history of learning things that are not immediately applicable to our career goals. The prereqs for med school are not useful for med school. In fact, more and more nonsci majors are attending medical school because it has been made clear that the strict science majors are actually not all that useful background for physicians, who are better served by being well rounded. Then in med school, the basic science years material is somewhat more relevant, in that there are actually folks out there with these particular diseases, but sure, they will be more useful in some specialties than others. Schools train you to be a generalist first, to have a core base of medical knowledge. Then you go on to residency where you learn a specialty, but still generally have to study for boards and recertification on things that may not be directly related to your sub-practice. Such is life. And it's actually a system that has served us well for quite a while. The notion of broad rounded education rather than learning a finite skillset is ingrained in American education and will outlast you. And considering folks may change specialties at times, it probably isn't a bad idea for folks to come from a generalist background. But you can take heart in the fact that, a few years back the concept of internship - where you do a year of medicine (even if you are going into derm, path, etc) was largely eliminated from many residency tracks. So that's a bit less general knowledge you can avoid.
The rest of the world has realized that learning a bunch of extraneous information is not necessary to become a great physician. Maybe someday we will follow suit.
And I totally disagree with making the USMLE P/F unless there is another objective way to compare applicants.
Considering it won't affect any of us who are already in med school, I don't feel that strongly one way or another. They can muck up the entry to the profession as much as they want as long as I (and present company are) allowed through beforehand.