Why is condensed preclinical curriculum better?

[AAAmeds]

I have heard from quite a few people on SDN that a condensed pre-clinical curriculum (1.5 years instead of 2) is better, and I know that top schools like Harvard tend to have a condensed curriculum. But I was wondering why it is necessarily "better"? Would it not be better to spend half a year more on the material so that you can memorize/understand the concepts and ace Step 1? How does this work?

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[Jalby]

It really depends on what they do with the extra 6 months. Frankly, you don't need that long for pre-clinical stuff. If they give you the extra 6 months to do with what you want, it will help you get a better USMLE score. I'm a bit out, but back in the day some schools would only give 2-3 weeks to study for Step one. My school finished new clinical stuff in Feb and then had about 3 months of half time classes that was essentially board review. It was the second year that they did that and our scores were the highest in history. Part of that might be better students, but I know I personally benefitted from the extra study time.

 

[darkjedi]

Exactly what Jalby said, but with the addition that having 1 year of clinics under your belt puts you in a pretty good spot when taking Step 1. The experience of being in the wards is invaluable as you are able to correlate what you see in the hospital with the pathophysiology of what you studied. It makes studying for Step 1 much easier as I could remember why certain drugs were given for certain conditions and how they worked, etc. My school also allowed us to self schedule Step 1 so we could take practically as much time as we wanted to study. Most of us took an average of 6 weeks, but one of my class makes took like 3 months to study. He wound up absolutely dominating Step 1.

 

[Jalby]

I had enough time to read Robbins pathology. It got me two questions on Step one that I wouldn't have gotten otherwise.

 

[libertyyne]

What about schools that schedule step I in m3? How do those compare?

 

[mcloaf]

What about schools that schedule step I in m3? How do those compare?

I think most schools that do a condensed preclinical schedule take Step 1 after their core rotations (I could be wrong, I've done no research and this is just my impression).

There are merits to both systems IMO. My school has changed to a condensed curriculum since I went through preclinicals and while I'm glad I went through the old system, in some ways I'm envious of those doing the condensed version. My not particularly insightful thoughts on the pros/cons would be:

Traditional:
Pros: more time for the material, being closer to the basic science courses when you take step 1, having a step score can help you target your research/rotation efforts accordingly based on your competitiveness
Cons: 2 years is a long time to spend in glorified undergrad trudging through 300 ppt slides a day, limited time for exposure/rotations in non core fields

Condensed:
Pros: significantly more opportunity to seek out exposure to fields you might not otherwise have time for, more time spent doing what you want, less of your life wasted on ppt slides, possible step 1 advantages (as an aside I'm not sold on the overall boost schools have in step 1 scores after switching to taking step 1 after rotations, my suspicion is that most top students would do well either way and it's the low end of the curve who were going to phone it in either way but score better simply because you have to have learned something after spending 60+ hours a week in the hospital for a year)
Cons: preclinical info is a lot to get through in two years let alone 1.5, you delay knowledge of the most significant factor in your residency competitiveness

Either way it seems that the Med Ed community has determined condensed is the way of the future.

 

[kegar99]

I've also heard students say that with the condensed pre-clinical, it's nice because it gives you more time to do rotations and figure out what field you want to go into before you have to start putting together your residency application.

 

[Gurby]

To quote a friend of mine who is a resident at a Boston hospital:
"1.5 year curriculum is straight up **** IMO, but that's a long discussion... The issue I have with the 1.5yr curriculum is that students are super under-prepared. Harvard rolled it out earlier this year and it has been rough... I have heard that scores go up but it seems to be at the expense of being competent on the wards."

I guess it's to be expected that performance will be worse during those core rotations as a result of shorter prep time beforehand. What sort of impact does that have on LoR's, and readiness for residency in general I wonder? Do people come out further ahead at the end, and residents/attendings just need to adjust their expectations for students at given points in the process?

 

[libertyyne]

To quote a friend of mine who is a resident at a Boston hospital:
"1.5 year curriculum is straight up **** IMO, but that's a long discussion... The issue I have with the 1.5yr curriculum is that students are super under-prepared. Harvard rolled it out earlier this year and it has been rough... I have heard that scores go up but it seems to be at the expense of being competent on the wards."

I guess it's to be expected that performance will be worse during those core rotations as a result of shorter prep time beforehand. What sort of impact does that have on LoR's, and readiness for residency in general I wonder? Do people come out further ahead at the end, and residents/attendings just need to adjust their expectations for students at given points in the process?

I feel like Step scores are a rate limiting factor in residency application prep, if you dont have them its hard to figure out what else you need to do. You could be prepping for NSG for 2 years and end up with a 220 on step, what do you even do to salvage your app at that point considering you are not in M4.

 

[Astra]

Found this post very interesting: Abbreviated pre-clinical curriculum.

Also, that thread is great regarding condensed curriculums

 

[AAAmeds]

Well for the two schools that I am basically comparing in terms of curriculum:
School X has 1.5 years of pre-clinical, takes Step 1 in March of 2nd year and has 1.5 year of core rotations (Starts in April).
School Y has 2 years of pre-clinical, takes Step 1 in July of 2nd year and has 1 year of core rotations (Starts in August).
Is there an advantage one way or the other considering that neither of the schools takes Step 1 after core rotations?

 

[Astra]

Well for the two schools that I am basically comparing in terms of curriculum:
School X has 1.5 years of pre-clinical, takes Step 1 in March of 2nd year and has 1.5 year of core rotations (Starts in April).
School Y has 2 years of pre-clinical, takes Step 1 in July of 2nd year and has 1 year of core rotations (Starts in August).
Is there an advantage one way or the other considering that neither of the schools takes Step 1 after core rotations?

How many weeks of dedicated step time do you get at each school?

 

[Pepe18]

I love the 1.5 yr curriculum. Even with it condensed, every unit repeats stuff from the previous unit and builds on each other in a way that makes sense. I also think I would be bored if I had to do a year of normal physio and then a year with pathology. I already learned the normal physio in college.

Having the condensed program also lets me do outside reading in journals, so I can reinforce what I learn. My school also heavily hammers physical exam skills, so I don't think we will be lacking there.

We take Step before rotations, which most of the 1.5 yr schools I know of do as well

 

[AAAmeds]

How many weeks of dedicated step time do you get at each school?

8 weeks with School X and 5 weeks with School Y

 

[Astra]

8 weeks with School X and 5 weeks with School Y

I'd prefer School X. More clinical experience and more step study time is a win win

 

[premed1234567891011]

To quote a friend of mine who is a resident at a Boston hospital:
"1.5 year curriculum is straight up **** IMO, but that's a long discussion... The issue I have with the 1.5yr curriculum is that students are super under-prepared. Harvard rolled it out earlier this year and it has been rough... I have heard that scores go up but it seems to be at the expense of being competent on the wards."

I guess it's to be expected that performance will be worse during those core rotations as a result of shorter prep time beforehand. What sort of impact does that have on LoR's, and readiness for residency in general I wonder? Do people come out further ahead at the end, and residents/attendings just need to adjust their expectations for students at given points in the process?

Baylor has been doing 1.5 preclinical since 2009 I think? First school to do it. And they consistently score super high on step 1 (taken after MS3) and I've never heard anyone say that Baylor students are underprepared on the wards.

 

[aldol16]

I've heard from friends that a condensed curriculum feels like you're blazing through a lot of material - especially anatomy - and it's unclear how much you'll remember before going into clinical rotations. But then again, you really re-learn everything during your rotations so it might not be a big deal anyway. The schools who have the condensed curricula cite having clinical rotations under your belt prior to taking Step 1 as a benefit because while you can certainly memorize a ton of information from a book, people learn better by applying concepts. You also get extra time to explore the specialties before you have to decide what you want to do, if you don't want to take an extra year.

 

[getdown]

Trust me. After 5 weeks of non-stop studying for STEP1 that last thing you want to do is study more. You actually start forgetting information you learned earlier. More time to study doesn't mean you'll do better, the curve plateaus off.

 

[Pepe18]

1.5 yr curriculum =/= taking Step after 3rd year. There are condensed curriculums that do both varieties.

I love the 1.5 yr curriculum, but I would not like taking step after rotations. You'd start to forget the stuff you don't use and I 100% do not want to wait until after 3rd yr to know which I can reasonably match into. I don't want to spend all of 3rd yr building a uro CV for example and then get 215 on step.