Why is Step 1 so important?

[Nucleus Accumbens]

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Hey,

I'm really confused at how things work in the eyes of a PD. Why do they have to place such a large emphasis on the score of 1 exam out of the 3 potential board exams we will take during med school? I mean, this test has little clinically centered management techniques, and from what attending physicians have told me, 80% of the stuff on step 1 is not even discussed in clinical setting. I mean, let's be real, how many prion diseases will I see in residency? I get that it's supposed to make us more knowledgeable, but what gives with the extra baggage placed on this exam solely?!? (Spare me the, oh the score on step 1 is only half of the app, try 98%)


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[.hematoma.]

It's the only standardized way to compare the kid from Harvard vs the kid from Howard (not insulting the schools, I just like how similar the names are haha). It sucks and I don't agree with it, but I think that's the perspective of the PD.

 

[Nucleus Accumbens]

It's the only standardized way to compare the kid from Harvard vs the kid from Howard (not insulting the schools, I just like how similar the names are haha). It sucks and I don't agree with it, but I think that's the perspective of the PD.

Ya, but why not step 2? I feel like if there ever was a more inclusive exam it's Step 2 CK/CS combination


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[.hematoma.]

I think it's cuz many people don't take step 2 before applying, but everyone has to take step 1 before rotations/applying.

 

[.hematoma.]

via Imgflip Meme Generator

 

[Brorthopedic]

My good friend @failedatlife may be able to shed some light on this topic

 

[hunterjumper14]

I have to think it's indicates how hard students are willing to work for something (and that something is standardized). People can complain about the merit of using it to differentiate candidates, but at the end of the day it's still an easy way to sort through >10x the number of apps for 60 interview slots.

 

[Nucleus Accumbens]

Thanks everyone who commented! All of your comments make total sense and I can see why it's so heavily relied upon


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[MrChance2]

There is literally no other possible way to determine who will and won't be a successful ENT resident and attending, anything in the 220s shows the applicant must be minded for primary care.

 

[Nucleus Accumbens]

There is literally no other possible way to determine who will and won't be a successful ENT resident and attending, anything in the 220s shows the applicant must be minded for primary care.

How so? It's just a number... The difference between 220 and 240 is often not many more incorrect questions. 210 vs 240 on the other hand is a different story.


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[bashwell]

Tradition. We could get rid of Step 1 tomorrow and instead use only Step 2, or design a new test that combines the best of Step 1 and 2, or otherwise design an altogether new test that better reflects the physician today, such as by not having a full day of MCQs but instead say half MCQs and half vivas or whatever is best if we don't think these are good ideas, but we won't, because tradition. Related to all this is it's probably expensive and takes a lot of effort to revise and disseminate a completely new national test, train or hire new question writers if we're no longer doing MCQs, etc.

 

[Gorne]

Because it's the easiest way to separate the big dawgs from the lil pups.

 

[Womb Raider]

I always figured step1 > all other steps because it is the most difficult of the three. Your score is basically innate intelligence + effort, and both are needed for success in residency. A deficiency in one can be overcome by an excess in the other, but only to a certain extent.

 

[darklabel]

Step 2 is being considered more now. I've been seeing a lot more students (including myself and my class) taking Step 2 earlier to get their scores in and taking it seriously. It's no longer "2 weeks to study" but people are using dedicated vacation days to really prepare for it. Even the recent program director survey (which didn't get a lot of responses, but still something) showed that Step 2 is becoming pretty important. It will never top Step 1, but I can see it being almost a requirement to take it early in the future.

 

[Azete]

I always figured step1 > all other steps because it is the most difficult of the three. Your score is basically innate intelligence + effort, and both are needed for success in residency. A deficiency in one can be overcome by an excess in the other, but only to a certain extent.

I actually think intelligence has surprisingly little to do with it. I scored 255-260, and I would consider myself very middle-of-the-pack at my DO school. I started studying during summer after M1 and my initial UWorld percentages were in the 40s. I just put my head down and worked, not much else to it than that.

 

[Womb Raider]

I actually think intelligence has surprisingly little to do with it. I scored 255-260, and I would consider myself very middle-of-the-pack at my DO school. I started studying during summer after M1 and my initial UWorld percentages were in the 40s. I just put my head down and worked, not much else to it than that.

I disagree, intelligence is very relevant. It's hard for any one person to understand this since we are incapable of experiencing anything different.

 

[Nucleus Accumbens]

I disagree, intelligence is very relevant. It's hard for any one person to understand this since we are incapable of experiencing anything different.

We can say to a great degree of certainty that medical students are pretty intelligent to arrive at M2 having passed all courses...


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[kb0275]

I actually think intelligence has surprisingly little to do with it. I scored 255-260, and I would consider myself very middle-of-the-pack at my DO school. I started studying during summer after M1 and my initial UWorld percentages were in the 40s. I just put my head down and worked, not much else to it than that.

Resources for step 1? 🙂

 

[sliceofbread136]

I disagree, intelligence is very relevant. It's hard for any one person to understand this since we are incapable of experiencing anything different.

This, tired of seeing that crap. I think it's also due to our demographic being mostly limited to the highly educated. Go talk to a morbidly obese blue collar red neck and tell me that guy could do well on step 1 just by working hard

 

[Azete]

This, tired of seeing that crap. I think it's also due to our demographic being mostly limited to the highly educated. Go talk to a morbidly obese blue collar red neck and tell me that guy could do well on step 1 just by working hard

I literally don't even think one person on this entire forum has ever suggested that, don't sensationalize for no reason.

We're obviously talking about beyond a basic level of intelligence that every single person that's been accepted to medical school has.

 

[Womb Raider]

We can say to a great degree of certainty that medical students are pretty intelligent to arrive at M2 having passed all courses...

Yes no doubt that medical students, on average, are more intelligent than the general population. However, there still exists a large variation of intelligence between medical students. These differences might seem small in a relative sense (like comparing in-group differences to the general population) but small differences can lead to substantial differences in performance. I think step1 is very effective at segregating medical students in this way (along with effort, as I said earlier).

 

[Azete]

Resources for step 1? 🙂

Nothing special. Started a FA Anki deck (similar to Bros) after M1, did a full pass of UWorld before dedicated, and drilled Micro/Pharm very early and reviewed it every single weekend. During dedicated I did another pass of UWorld, focused heavily on physio concepts (watched a lot of Najeeb), did Pathoma twice, and reviewed all the bugs & drugs every night for 2 hours. Outside of my Anki deck, I never really opened FA and definitely never annotated it.

I also made a 10 page review sheet of all the "**** I always forget" -- which ended up being my savior because I basically memorized it the last few days before my test and it scored me at least 20 questions I otherwise may have missed.

 

[Stagg737]

Yes no doubt that medical students, on average, are more intelligent than the general population. However, there still exists a large variation of intelligence between medical students. These differences might seem small in a relative sense (like comparing in-group differences to the general population) but small differences can lead to substantial differences in performance. I think step1 is very effective at segregating medical students in this way (along with effort, as I said earlier).

Disagree. I think that other than the very few people at the top and bottom .5% of the bell curve, intelligence plays an insignificant role compared with work ethic and more importantly work efficiency. The people I know who crushed boards were all people who worked really hard and were insanely efficient at studying. Some of them were top of our class in terms of intelligence, many of them were pretty average there imo. Some of the most brilliant people I know also just don't have the drive to learn all the material required for boards or are too disorganized to learn that much material in such a short time. Unless you're one of those people who are so good at memorizing that you only need 1-2 passive glances at the material, or you're at the bottom end of med school intelligence it's not going to have a significant impact on board scores.

I'll also point out that learning styles and curriculum plays an impact on this also. I didn't do fantastic first 2 years or on Step 1, but did significantly better on all the shelf exams throughout 3rd year and crushed practice exams for step 2. I also know people that did really well in first 2 years that struggled significantly 3rd year, and I highly doubt their intelligence level changed. I'm not saying intelligence doesn't matter or doesn't have some impact. However, I don't think boards do a very good job of sorting people based on their intelligence, and they're not meant to.

 

[Anicetus]

Hey,

I'm really confused at how things work in the eyes of a PD. Why do they have to place such a large emphasis on the score of 1 exam out of the 3 potential board exams we will take during med school? I mean, this test has little clinically centered management techniques, and from what attending physicians have told me, 80% of the stuff on step 1 is not even discussed in clinical setting. I mean, let's be real, how many prion diseases will I see in residency? I get that it's supposed to make us more knowledgeable, but what gives with the extra baggage placed on this exam solely?!? (Spare me the, oh the score on step 1 is only half of the app, try 98%)


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The real reason is because we need to have some reason to throw residents into undesirable cities so the cow town folks can get their medical care as well.

Therefore people that bomb it or fail it get exiled to the cornfields.

 

[Anicetus]

I actually think intelligence has surprisingly little to do with it. I scored 255-260, and I would consider myself very middle-of-the-pack at my DO school. I started studying during summer after M1 and my initial UWorld percentages were in the 40s. I just put my head down and worked, not much else to it than that.

This is so common where someone with a 255+ walks on into the convo stating they think they are middle of the pack intelligence. It's like if a Bill Gates gave a motivational talk spewing crap like "I'm not special guys! I'm just your ordinary guy!" as if someone could then walk out realizing they can do it too.

Well guess what, I consider myself very middle of the pack at my MD school and I worked my *** off for 7 weeks of dedicated studying, worked with learning specialists throughout my MS1-2 as well to develop the most efficient study strategies for myself and I never once broke 240 on a practice test and certainly didn't for my actual step 1. Not to mention I also study more than most of my classmates (10 hours a day on average) during the year for MS1-2). Talking as if a 250 (80-85percentile) is attainable for almost everyone if they "try hard enough" is BS and only stated if someone got a 250+ themselves or they slacked off and got just under it and now realize they could've attained the 250 HAD they tried.

For some reason people downplay overall intelligence and memory capabilities on this forum and most of the smartest folks don't ever admit that they are actually more intelligent than most of their med school peers. Maybe they don't even know it, but it's quite fascinating if you ask me.

 

[Azete]

This is so common where someone with a 255+ walks on into the convo stating they think they are middle of the pack intelligence. It's like if a Bill Gates gave a motivational talk spewing crap like "I'm not special guys! I'm just your ordinary guy!" as if someone could then walk out realizing they can do it too.

Well guess what, I consider myself very middle of the pack at my MD school and I worked my *** off for 7 weeks of dedicated studying, worked with learning specialists throughout my MS1-2 as well to develop the most efficient study strategies for myself and I never once broke 240 on a practice test and certainly didn't for my actual step 1. Not to mention I also study more than most of my classmates (10 hours a day on average) during the year for MS1-2). Talking as if a 250 (80-85percentile) is attainable for almost everyone if they "try hard enough" is BS and only stated if someone got a 250+ themselves or they slacked off and got just under it and now realize they could've attained the 250 HAD they tried.

For some reason people downplay overall intelligence and memory capabilities on this forum and most of the smartest folks don't ever admit that they are actually more intelligent than most of their med school peers. Maybe they don't even know it, but it's quite fascinating if you ask me.

Certainly some truth in there, but USMLE isn't an IQ test -- you either know the stuff or you don't. Had I only studied during our schools dedicated period, I know for certain I would have scored much lower (likely below the national average). But I committed a full year to it. The day before a path test, while all my classmates were cramming path, I was still putting in 2 hours of board studying on top of my already full day. The day after the path test, while all my classmates were napping/relaxing, I was putting in 8 hours of board studying. Every single day with the exception of Christmas day and my daughter's birthday I was doing at least 2-3 hours of Anki that had nothing to do with my current class material.

Before dedicated even started I had put in 700 hours of studying. I didn't use special study techniques, I didn't use special resources, and my history of standardized test taking certainly doesn't suggest I excel in that regard. Maybe I'm smarter than I give myself credit for, but I attend a low tier DO school and still I often felt dwarfed by my classmate's learning capabilities. I just saw something I really wanted, challenged myself, and did it.

 

[jw3600]

Certainly some truth in there, but USMLE isn't an IQ test -- you either know the stuff or you don't. Had I only studied during our schools dedicated period, I know for certain I would have scored much lower (likely below the national average). But I committed a full year to it. The day before a path test, while all my classmates were cramming path, I was still putting in 2 hours of board studying on top of my already full day. The day after the path test, while all my classmates were napping/relaxing, I was putting in 8 hours of board studying. Every single day with the exception of Christmas day and my daughter's birthday I was doing at least 2-3 hours of Anki that had nothing to do with my current class material.

Before dedicated even started I had put in 700 hours of studying. I didn't use special study techniques, I didn't use special resources, and my history of standardized test taking certainly doesn't suggest I excel in that regard. Maybe I'm smarter than I give myself credit for, but I attend a low tier DO school and still I often felt dwarfed by my classmate's learning capabilities. I just saw something I really wanted, challenged myself, and did it.

....what do you think an IQ test measures?

 

[Azete]

....what do you think an IQ test measures?

You're right, I forgot that standard with all IQ tests is recognizing homer-wright rosettes.

 

[kb0275]

Certainly some truth in there, but USMLE isn't an IQ test -- you either know the stuff or you don't. Had I only studied during our schools dedicated period, I know for certain I would have scored much lower (likely below the national average). But I committed a full year to it. The day before a path test, while all my classmates were cramming path, I was still putting in 2 hours of board studying on top of my already full day. The day after the path test, while all my classmates were napping/relaxing, I was putting in 8 hours of board studying. Every single day with the exception of Christmas day and my daughter's birthday I was doing at least 2-3 hours of Anki that had nothing to do with my current class material.

Before dedicated even started I had put in 700 hours of studying. I didn't use special study techniques, I didn't use special resources, and my history of standardized test taking certainly doesn't suggest I excel in that regard. Maybe I'm smarter than I give myself credit for, but I attend a low tier DO school and still I often felt dwarfed by my classmate's learning capabilities. I just saw something I really wanted, challenged myself, and did it.

What was your mcat and gpa?

 

[Merely]

Azete is correct. Step 1 is not a thinking or intelligence test, it is a content/memorization test.

*this is assuming you are reasonably intelligent/capable of basic critical thinking

/thread

 

[Stagg737]

This is so common where someone with a 255+ walks on into the convo stating they think they are middle of the pack intelligence. It's like if a Bill Gates gave a motivational talk spewing crap like "I'm not special guys! I'm just your ordinary guy!" as if someone could then walk out realizing they can do it too.

Well guess what, I consider myself very middle of the pack at my MD school and I worked my *** off for 7 weeks of dedicated studying, worked with learning specialists throughout my MS1-2 as well to develop the most efficient study strategies for myself and I never once broke 240 on a practice test and certainly didn't for my actual step 1. Not to mention I also study more than most of my classmates (10 hours a day on average) during the year for MS1-2). Talking as if a 250 (80-85percentile) is attainable for almost everyone if they "try hard enough" is BS and only stated if someone got a 250+ themselves or they slacked off and got just under it and now realize they could've attained the 250 HAD they tried.

For some reason people downplay overall intelligence and memory capabilities on this forum and most of the smartest folks don't ever admit that they are actually more intelligent than most of their med school peers. Maybe they don't even know it, but it's quite fascinating if you ask me.

The problem is that working hard =/= efficient studying. Second year I put in 3x the amount of time I did first year and did worse because we no longer had lectures and I struggled to organize my notes/figure out what was high yield and what to actually study. I had classmates who would finish their first pass on the material in 3 days and easily make 7-8 passes before a given test. I was lucky if I got 2 solid passes in. This had nothing to do with differences in the amount of time we put in (some of them put in less time than me!), but they were just so efficient and creating notes/outlines that they had all of their materials written/typed out in the first 2-3 days and could just keep making multiple passes. The one test I was able to make 4 solid passes on that year I scored almost perfect, which was about 20% higher than I averaged everywhere else.

....what do you think an IQ test measures?

Have you ever taken an actual IQ test? They certainly do not measure memorization ability or ability to differentiate between two random factoids like boards. They measure logic, spatial, color, and shape awareness, language, and general perception with abstract thinking. None of that (other than very basic logic) is tested on the USMLE or COMLEX because it's not pertinent to being a physician beyond an elementary level of ability.

 

[Anicetus]

Azete is correct. Step 1 is not a thinking or intelligence test, it is a content/memorization test.

*this is assuming you are reasonably intelligent/capable of basic critical thinking

/thread

Your asterisk is an opinion.

Azete is wrong in that if any "middle of the pack" student did what he did they could do just as well on step 1.

The problem is that working hard =/= efficient studying. Second year I put in 3x the amount of time I did first year and did worse because we no longer had lectures and I struggled to organize my notes/figure out what was high yield and what to actually study. I had classmates who would finish their first pass on the material in 3 days and easily make 7-8 passes before a given test. I was lucky if I got 2 solid passes in. This had nothing to do with differences in the amount of time we put in (some of them put in less time than me!), but they were just so efficient and creating notes/outlines that they had all of their materials written/typed out in the first 2-3 days and could just keep making multiple passes. The one test I was able to make 4 solid passes on that year I scored almost perfect, which was about 20% higher than I averaged everywhere else.



Have you ever taken an actual IQ test? They certainly do not measure memorization ability or ability to differentiate between two random factoids like boards. They measure logic, spatial, color, and shape awareness, language, and general perception with abstract thinking. None of that (other than very basic logic) is tested on the USMLE or COMLEX because it's not pertinent to being a physician beyond an elementary level of ability.

As I mention in the post you quoted, I worked with learning specialists since 1 month into MS1. I experimented with different strategies to see what would work. None of it could net me a 240+ on step 1. I wasn't just banging my head against the book in sheer force.

 

[sliceofbread136]

I literally don't even think one person on this entire forum has ever suggested that, don't sensationalize for no reason.

We're obviously talking about beyond a basic level of intelligence that every single person that's been accepted to medical school has.

So you're suggesting that the benefit of intelligence is entirely binary? You either aren't smart enough to do it at all or you meet some minimum level of intelligence at which point it is all hard work?

 

[Azete]

So you're suggesting that the benefit of intelligence is entirely binary? You either aren't smart enough to do it at all or you meet some minimum level of intelligence at which point it is all hard work?

I'd say it's more sigmoidal, but yeah, I think that's a good summation of my views. Obviously it's all meaningless conjecture that can't be proven one way or the other.

 

[sliceofbread136]

I'd say it's more sigmoidal, but yeah, I think that's a good summation of my views. Obviously it's all meaningless conjecture that can't be proven one way or the other.

Fair enough I guess.

 

[Anicetus]

I'd say it's more sigmoidal, but yeah, I think that's a good summation of my views. Obviously it's all meaningless conjecture that can't be proven one way or the other.

So in the world that exists in your eyes, I'm lazy, have been doing everything wrong for years despite reaching out or experimenting with study methods, or am simply in the <1% of med students who are stupid.

Meanwhile, you're just your average medical student who worked harder than his low tier DO classmates (you labeled your school, not me) and happened to fall on a score in the top 10% of medical school test takers.

Without an ounce of hostility, I'm legitimately curious now. For those of you who believe this stuff, have you called people on welfare lazy or do your views only apply to med students as if med students are already a higher echelon of natural intelligence so that you could blame someone's average score on "not working hard enough" for it?

 

[Stagg737]

Your asterisk is an opinion.

Azete is wrong in that if any "middle of the pack" student did what he did they could do just as well on step 1.



As I mention in the post you quoted, I worked with learning specialists since 1 month into MS1. I experimented with different strategies to see what would work. None of it could net me a 240+ on step 1. I wasn't just banging my head against the book in sheer force.

I didn't say that any middle of the pack student could score as well as Azete if they do exactly what he did. I'm saying that intelligence is a poor way to measure how successful a med student would be. Maybe you did work hard and seek out help from learning specialists, but that doesn't mean your study methods were efficient (which Imo is the most important part of being highly successful). There are also many forms of intelligence, maybe you really are in the bottom of the med school pack when it comes to ability to memorize (I know that's a big problem for me), idk. Another thing is that maybe whatever curriculum you're in doesn't match your learning style. I know if I started in a PBL-based curriculum I may not have gotten through first year, but in the curriculum we had I did decently first year with minimal effort. Second year when we switched to a curriculum that was much more like PBL, I struggled a lot. So maybe that played some factor as well.

Again, I'm not saying "intelligence" doesn't matter, but there are different kinds of intelligence and pre-clinical grades and boards seem to mainly measure only 1 or 2 of them heavily. At the same time, I really do believe that efficiency and amount of work is far more important to success than intelligence as I know plenty of people that are brilliant (even compared to med classmates) who are just average in med school and I also know people that aren't all that bright who dominate. The only difference I really see is how much work they put in or how efficiently they get through stuff.

 

[Mad Jack]

I disagree, intelligence is very relevant. It's hard for any one person to understand this since we are incapable of experiencing anything different.

Eh, the people who did the best in my class weren't the most intelligent, but the ones with a decent baseline intelligence that worked the hardest. Intelligence does note necessarily correlate to memory nor effort. Step 1 requires all of these things, so a deficit in any of the three can hurt you.

 

[sliceofbread136]

So in the world that exists in your eyes, I'm lazy, have been doing everything wrong for years despite reaching out or experimenting with study methods, or am simply in the <1% of med students who are stupid.

Meanwhile, you're just your average medical student who worked harder than his low tier DO classmates (you labeled your school, not me) and happened to fall on a score in the top 10% of medical school test takers.

Without an ounce of hostility, I'm legitimately curious now. For those of you who believe this stuff, have you called people on welfare lazy or do your views only apply to med students as if med students are already a higher echelon of natural intelligence so that you could blame someone's average score on "not working hard enough" for it?

I believe their argument is specifically referring to step 1 and not extrapolating to anything. Their argument is that since step 1 has a large component of memorization that if you just work hard enough you will do well. I think this completely ignores quite a few other factors and frankly common sense, but as was pointed out I don't really have any data to back it up

 

[IslandStyle808]

The problem is that working hard =/= efficient studying. Second year I put in 3x the amount of time I did first year and did worse because we no longer had lectures and I struggled to organize my notes/figure out what was high yield and what to actually study. I had classmates who would finish their first pass on the material in 3 days and easily make 7-8 passes before a given test. I was lucky if I got 2 solid passes in. This had nothing to do with differences in the amount of time we put in (some of them put in less time than me!), but they were just so efficient and creating notes/outlines that they had all of their materials written/typed out in the first 2-3 days and could just keep making multiple passes. The one test I was able to make 4 solid passes on that year I scored almost perfect, which was about 20% higher than I averaged everywhere else.

If you have a good ability to memorize and understand, your first pass will be much quicker, your second pass will be even more quicker. Its an additive effect and yes talent can definitely play a role, even if the hours have nothing to do with it. Here I'll give you an example

Person 1: understand superficial amount (1 pass: 1 hour per lecture), deeper amount (2nd pass: 45 minutes per lecture), even deeper (3rd pass: 20-30 minutes per lecture) --> completes 7 passes before test day
Person 2: understand superficial amount and struggles (1 pass: 2 hours per lecture), deeper amount but still struggling (2nd pass: 1 hour 30 minutes), even deeper (3rd pass: 45 minutes-1 hour) --> complete 4 passes before test day

The first person combines his hardworking with talent and this gets him a greater amount of passes --> thus leading to a higher scores. I've literally studied with dudes like this and yes talent totally plays a role. However, it still doesn't negate efficiency or hardworking. But the top dudes have all three in spades.

 

[Anicetus]

I believe their argument is specifically referring to step 1 and not extrapolating to anything. Their argument is that since step 1 has a large component of memorization that if you just work hard enough you will do well. I think this completely ignores quite a few other factors and frankly common sense, but as was pointed out I don't really have any data to back it up

Oh I'm sure. However to me, personally when I hear a 250+ scorer make assumptions and judgements such as "oh they got a 215? Should've tried harder." I equate that attitude to fiscally hyperconservatisms who say "straight Cs in high school and now working at macdonalds? Should've tried harder." Although what I said was extreme, I wouldn't believe they would make that extrapolation, but it sounds ridiculous to me when they dedicate their step 1 score to "pulling themselves up by their bootstraps" methods in medical school and downplaying their other innate abikities.

 

[sliceofbread136]

Oh I'm sure. However to me, personally when I hear a 250+ scorer make assumptions and judgements such as "oh they got a 215? Should've tried harder." I equate that attitude to fiscally hyperconservatisms who say "straight Cs in high school and now working at macdonalds? Should've tried harder." Although what I said was extreme, I wouldn't believe they would make that extrapolation, but it sounds ridiculous to me when they dedicate their step 1 score to "pulling themselves up by their bootstraps" methods in medical school and downplaying their other innate abikities.

I agree it's silly and usually comes down to a type of humble brag

 

[Womb Raider]

I've literally studied with dudes like this and yes talent totally plays a role. However, it still doesn't negate efficiency or hardworking. But the top dudes have all three in spades.

There's a guy in my class who absorbs more asleep in lecture than I do while paying attention.

 

[Nucleus Accumbens]

Eh, the people who did the best in my class weren't the most intelligent, but the ones with a decent baseline intelligence that worked the hardest. Intelligence does note necessarily correlate to memory nor effort. Step 1 requires all of these things, so a deficit in any of the three can hurt you.

I believe their argument is specifically referring to step 1 and not extrapolating to anything. Their argument is that since step 1 has a large component of memorization that if you just work hard enough you will do well. I think this completely ignores quite a few other factors and frankly common sense, but as was pointed out I don't really have any data to back it up

Well how can we explain the FMG students who study for 2 years and get 260s like it's nothin'!? I'm assuming the "effort" component of that equation may overshadow the other two over time.


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[Nucleus Accumbens]

There's a guy in my class who absorbs more asleep in lecture than I do while paying attention.

R.E.M. Sleep FTW


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[Mad Jack]

Well how can we explain the FMG students who study for 2 years and get 260s like it's nothin'!? I'm assuming the "effort" component of that equation may overshadow the other two over time.


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There's plenty of foreign students that study for two years and fail. Far, FAR more FMGs take the exam than do well on it (28% fail outright, many, many more barely pass). I stand by the "intelligence+memorization+effort" equation. More time lets you focus on the latter two, but you still need the first one to succeed.

 

[Drrrrrr. Celty]

There's plenty of foreign students that study for two years and fail. Far, FAR more FMGs take the exam than do well on it (28% fail outright, many, many more barely pass). I stand by the "intelligence+memorization+effort" equation. More time lets you focus on the latter two, but you still need the first one to succeed.

I mean you can't memorize the experimental questions can you?

 

[Nucleus Accumbens]

There's plenty of foreign students that study for two years and fail. Far, FAR more FMGs take the exam than do well on it (28% fail outright, many, many more barely pass). I stand by the "intelligence+memorization+effort" equation. More time lets you focus on the latter two, but you still need the first one to succeed.

Well that's why I said MAY overshadow the other two lol... it's definitely not gonna help you if you shouldn't have been in med school to begin with


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[NWwildcat2013]

IMHO a big part of it is not just that the test is standardized, but that the effort is standardized.

What I mean by that is - everyone puts their nose to the grindstone and busts their a** studying for step 1.

Step 2 has far more variable levels of preparation. As noted above a number of people don't even take it before they apply for residency (I didn't). The old joke of 2 months, 2 weeks, #2 pencil (the relative amounts of preparation for Steps 1, 2, and 3 respectively) still somewhat holds true.

So as a PD you use Step 1 since you know that's the test that best demonstrates maximum performance.

That is good to know because I prepared way less for Step 2. I just took it and am pretty sure Im not going to impress anyone with my score.

 

[Stagg737]

If you have a good ability to memorize and understand, your first pass will be much quicker, your second pass will be even more quicker. Its an additive effect and yes talent can definitely play a role, even if the hours have nothing to do with it. Here I'll give you an example

Person 1: understand superficial amount (1 pass: 1 hour per lecture), deeper amount (2nd pass: 45 minutes per lecture), even deeper (3rd pass: 20-30 minutes per lecture) --> completes 7 passes before test day
Person 2: understand superficial amount and struggles (1 pass: 2 hours per lecture), deeper amount but still struggling (2nd pass: 1 hour 30 minutes), even deeper (3rd pass: 45 minutes-1 hour) --> complete 4 passes before test day

The first person combines his hardworking with talent and this gets him a greater amount of passes --> thus leading to a higher scores. I've literally studied with dudes like this and yes talent totally plays a role. However, it still doesn't negate efficiency or hardworking. But the top dudes have all three in spades.

I think that's a pretty solid summary. I know in my case, the organizational and 1st pass issue is largely because I'd be the posterboy for ADHD. I can literally only study in 10-15 minute blocks, sometimes less, before I need to let my mind wander to something else for a couple minutes. For me, 12 hours of actual studying (not including breaks) only equates to around 5 or 6 actual productive study hours, so my first pass was always took way too long because making study materials took twice as long as everyone else (it also didn't help that I'm a complete idiot with technology). After that I could get through passes pretty quick, but second year I often wouldn't finish my first pass until a day or two before the test.

I do think that being successful in med school has 3 points (intelligence, work ethic, and organization/efficiency). If you're strong in 2 out of 3 or exceptional in one of the 3, you'll be fine so long as you at least meet some minimal criteria for the third category. The people I know who do really well are the ones who are exceptional in 2 of the 3, and the people that have the resumes of medical gods are exceptional in all 3 categories. Of the 3, I think intelligence is the least important, as everyone in med school had to prove they had the baseline to get accepted. Once in med school, it really comes down to the other two unless you're so brilliant you can just read the text/notes once and remember everything (I've met a total of 2 people that I think meet that criteria, and they're both entering very competitive fields). That's just based off of my observations and completely opinion, but it seems to fit well with those I know and have talked to.