Worried about Step 1 and retaining knowledge during medical school

[Scrubsy]

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I just finished paging through First Aid Step 1 and am quite overwhelmed with the amount and detail of the material you need to know! I have already taken most of the first and second year medical school courses during my grad school and this stuff still looks daunting! I'm starting medical school in the fall and have two questions:

1. During your first two years do students mainly binge and purge the material for exams or actually retain the stuff?? (I know during my accelerated masters I did quite a bit of the binge/purge method. I aced all my exams, but two weeks later probably couldn't tell ya much of what I had learned.)

2. How on earth are you supposed to memorize all of the material tested on step 1?? There is a ton of material and its very detailed. I'm going for a very competitive specialty, so it's important that I do everything I can to get an awesome score.

 

[calvnandhobbs68]

Yeah I'm looking at FA (and doing UWorld questions) as I type this and I feel the same way. Unfortunately for me my test is in a month....

Don't worry about it though for real. You'll learn most of the stuff during classes...that's why it's a review book. The most I'd crack open FA during the year is to look at the relevant sections while going through them during the school year. Don't look at it right now and freak yourself out.

 

[chronicidal]

I just finished paging through First Aid Step 1 and am quite overwhelmed with the amount and detail of the material you need to know! I have already taken most of the first and second year medical school courses during my grad school and this stuff still looks daunting! I'm starting medical school in the fall and have two questions:

1. During your first two years do students mainly binge and purge the material for exams or actually retain the stuff?? (I know during my accelerated masters I did quite a bit of the binge/purge method. I aced all my exams, but two weeks later probably couldn't tell ya much of what I had learned.)

2. How on earth are you supposed to memorize all of the material tested on step 1?? There is a ton of material and its very detailed. I'm going for a very competitive specialty, so it's important that I do everything I can to get an awesome score.

If you've already been exposed to most of it already, going through it a second time will really allow you to take the time and energy to understand and focus on retention. The best way to do this is via doing flashcards of every high-yield factoid in a spaced repetition system like Anki, in parallel with your curriculum. Once you put all of the declarative knowledge (i.e. most of what the first two years are about) into a database format, you realize that it's finite, albeit massive (there are probably 10k+ factoids in First Aid).

That said, students mainly binge and purge, and will really binge in the month prior to Step 1. But don't follow what the (average and variably performing) masses do. Some handle it better than others and you can't bank on you being above the curve in binging ability.

 

[thesauce]

We all binge and purge. Step 1 is a nightmare, but you get through it. My most valuable advice was to take notes in First Aid as you go through the first 2 years.

 

[NickNaylor]

If you've already been exposed to most of it already, going through it a second time will really allow you to take the time and energy to understand and focus on retention. The best way to do this is via doing flashcards of every high-yield factoid in a spaced repetition system like Anki, in parallel with your curriculum. Once you put all of the declarative knowledge (i.e. most of what the first two years are about) into a database format, you realize that it's finite, albeit massive (there are probably 10k+ factoids in First Aid).

That said, students mainly binge and purge, and will really binge in the month prior to Step 1. But don't follow what the (average and variably performing) masses do. Some handle it better than others and you can't bank on you being above the curve in binging ability.

No offense, but I'm a little skeptical of a MS1 saying what the "best" way to study for step 1 is. Using Anki or something similar might be a good way to study for some people, but it is hardly the best, and certainly not for everyone.

OP, for what it's worth I both suck at memorizing things and hate doing it and am actually enjoying step 1 studying to some extent. It's a massive amount of material, but if you work hard and have at least a general plan of what you want to do, you'll be fine. In med school the name of the game is repetition, and the more times you get through the material the more you're likely to retain. The standard study plan is pretty universal though: use a question bank (UWorld) to practice applying the knowledge and pick up little facts not in First Aid (the universal review book) and read First Aid as much as you can. Put in the oven, and 5+ weeks later you have a step 1 score.

IMO the key to doing well is 1) knowing what you need to study and 2) being EXTREMELY efficient with your studying (i.e., knowing how you study best). The hard thing is that #2 is different for everyone, so you really need to know how your brain works.

 

[Narmerguy]

No offense, but I'm a little skeptical of a MS1 saying what the "best" way to study for step 1 is. Using Anki or something similar might be a good way to study for some people, but it is hardly the best, and certainly not for everyone.

OP, for what it's worth I both suck at memorizing things and hate doing it and am actually enjoying step 1 studying to some extent. It's a massive amount of material, but if you work hard and have at least a general plan of what you want to do, you'll be fine. In med school the name of the game is repetition, and the more times you get through the material the more you're likely to retain. The standard study plan is pretty universal though: use a question bank (UWorld) to practice applying the knowledge and pick up little facts not in First Aid (the universal review book) and read First Aid as much as you can. Put in the oven, and 5+ weeks later you have a step 1 score.

IMO the key to doing well is 1) knowing what you need to study and 2) being EXTREMELY efficient with your studying (i.e., knowing how you study best). The hard thing is that #2 is different for everyone, so you really need to know how your brain works.

I'm pretty sure this isn't his idea, another SDN guy has been pretty outspoken about his Anki method of Step 1 study. But I get your point, a lot of people were still pretty skeptical even of that user (who has taken the Step 1 and did quite well from what I understand).

 

[NickNaylor]

I'm pretty sure this isn't his idea, another SDN guy has been pretty outspoken about his Anki method of Step 1 study. But I get your point, a lot of people were still pretty skeptical even of that user (who has taken the Step 1 and did quite well from what I understand).

If I were to take SDN's advice on step 1 then 1) seemingly everyone scores above 240 and 2) if I don't use GT (Gunner Training) and DIT (Doctors in Training) then I have absolutely no chance of doing well. 😛 There's a huge circlejerk here when it comes to GT/Firecracker and DIT (systems that work in an Anki-like way, at least with respect to GT), and while I'm sure they're excellent products, there are an infinite number of ways to skin this cat.

I think this is exactly comparable to what you see here with the MCAT. People are so desperate just to have ANY plan that they blindly follow whatever is put in front of them by people who presumably did well on the exam. Sure, there's definitely value in looking at what other people's plans look like, but following any plan without modification/personalization is likely not going to get the results you're looking for. By simply spending a little time looking at what people did AND modifying that plan to suit your needs/weaknesses, you can likely develop a study strategy that will work best for you. Apart from some very broad similarities (use FA, do questions), there is no one-size-fits-all for exam prep - step 1 or otherwise.

 

[calvnandhobbs68]

That said, students mainly binge and purge, and will really binge in the month prior to Step 1. But don't follow what the (average and variably performing) masses do. Some handle it better than others and you can't bank on you being above the curve in binging ability.

Hmm yes I tend to find the other plans entirely too shallow and pedantic.

 

[image187]

I just finished paging through First Aid Step 1 and am quite overwhelmed with the amount and detail of the material you need to know! I have already taken most of the first and second year medical school courses during my grad school and this stuff still looks daunting! I'm starting medical school in the fall and have two questions:

1. During your first two years do students mainly binge and purge the material for exams or actually retain the stuff?? (I know during my accelerated masters I did quite a bit of the binge/purge method. I aced all my exams, but two weeks later probably couldn't tell ya much of what I had learned.)

2. How on earth are you supposed to memorize all of the material tested on step 1?? There is a ton of material and its very detailed. I'm going for a very competitive specialty, so it's important that I do everything I can to get an awesome score.

Most importantly, why do you advertise yourself as a "Medical Student" if you haven't even started medical school yet? lol

 

[deleted127837]

...2) if I don't use GT (Gunner Training) and DIT (Doctors in Training) then I have absolutely no chance of doing well. ...

Half of (h)SDN probably just bookmarked those two sites. 😛

Anki can be enormously helpful for raw fact retention, which is why it's so useful in language acquisition, but as NN's said, it's a tool, not a study plan. It works for language due to the natural relationship between all the cards - use in a language - but a lot of interconnecting stuff is lost when people translate First Aid over. Very few people take the time to make a comprehensive Anki deck because that's basically a full-time job. 10,000+ cards? Let's be serious.

 

[hownowmauvecow]

however you decide to study in the feature (and there are many ways you can go about this, you just have to pick what works best for you, not just what others have done), you really shouldn't be worried about step 1 right now, save that for about 1/2 way through your second year. Its better to try and do well in your classes your first and second years, building a solid foundation will go a long way towards your eventual step 1 prep.

 

[chronicidal]

Owning med school is a full time job.

Here's another way to get a 270. I call it the 10^x strategy. Over 10 months, with 100% determination, study 1000 hours, do 10000 questions.

 

[NickNaylor]

Owning med school is a full time job.

Here's another way to get a 270. I call it the 10^x strategy. Over 10 months, with 100% determination, study 1000 hours, do 10000 questions.

That guy started out with a UWorld correct of 88%. That is what many people aim to have at the end of their prep, not as a first pass. That is highly atypical and not what anyone should expect.

Look, anyone in medical school can get a 270+ or whatever arbitrary cutoff you set. Since you're apparently a med student now at a school that is presumably a "top" school you should realize this. Everyone is capable and everyone is smart. Med school performance comes down to nothing more than time spent repeatedly going over the material; the people at the top are simply those that spend more time doing that (or, more rarely, have insane memorization skills). With that said, most people instead choose to have a more balanced life that includes time spent doing things outside of school and a self-worth that isn't defined by a score on an exam. This might come as a shock, but there are actually people who choose to forgo academic fellatio in favor of interests and pursuits outside of school specifically and medicine generally. 😱 Sure, there are people that are superstars in every aspect of life, but that isn't most people, even those at top schools. In most cases it's a balancing act, and performance simply reflects where the fulcrum lies on the spectrum of "work super hard" to "slack off."

Sent from my SAMSUNG-SGH-I717

 

[sinombre]

That guy started out with a UWorld correct of 88%. That is what many people aim to have at the end of their prep, not as a first pass. That is highly atypical and not what anyone should expect.

Look, anyone in medical school can get a 270+ or whatever arbitrary cutoff you set. Since you're apparently a med student now at a school that is presumably a "top" school you should realize this. Everyone is capable and everyone is smart. Med school performance comes down to nothing more than time spent repeatedly going over the material; the people at the top are simply those that spend more time doing that (or, more rarely, have insane memorization skills). With that said, most people instead choose to have a more balanced life that includes time spent doing things outside of school and a self-worth that isn't defined by a score on an exam. This might come as a shock, but there are actually people who choose to forgo academic fellatio in favor of interests and pursuits outside of school specifically and medicine generally. 😱 Sure, there are people that are superstars in every aspect of life, but that isn't most people, even those at top schools. In most cases it's a balancing act, and performance simply reflects where the fulcrum lies on the spectrum of "work super hard" to "slack off."

Sent from my SAMSUNG-SGH-I717

Probably the best description of this phenomenon I've heard thus far.

 

[KnuxNole]

chronicidal is just too hardcore for us 99% to handle 😛

Everyone will binge and purge on Step 1 🙂

Or at least after you take it, you'll wanna completely cool off after the intense study period!

 

[calvnandhobbs68]

Owning med school is a full time job.

Here's another way to get a 270. I call it the 10^x strategy. Over 10 months, with 100% determination, study 1000 hours, do 10000 questions.

As has been mentioned, most people NEVER hit 91% on Kaplan and aspire to hit 88% on UWorld their second pass through (especially all random timed). The dude was already a superstar before he even started hardcore studying.

 

[Mattinthehat250]

Just wondering what everyone thinks about using anki to make flashcards of information that is in first aid and also taught in class during 1st and 2nd year. So like, study the way you normally would, but look through first aid to see what material covered in class is also in first aid. Make anki cards for these things. Then study these cards, even after the exam, for long-term retention for step 1. Worth it? Overkill?

 

[Scrubsy]

Most importantly, why do you advertise yourself as a "Medical Student" if you haven't even started medical school yet? lol

It took me seven very long and very difficult years of chasing my dream AFTER graduating college to get to the point that I am at today. So after staring at my "pre-med" status for so long (I've been a member of sdn since 2006 only under a different name), I figured it was alright to change my status. Although, I don't start for another four months I am still an incoming medical student. I've worked much longer and much harder than many to get here so excuse me if I want to change my status after all these years....I earned it.

So why don't you stop wasting your time posting dumb s**t on my thread. Thanks.


Accepted to Class of 2017 MD!!!!

 

[yehhhboiii]

.

 

[sinombre]

It took me seven very long and very difficult years of chasing my dream AFTER graduating college to get to the point that I am at today. So after staring at my "pre-med" status for so long (I've been a member of sdn since 2006 only under a different name), I figured it was alright to change my status. Although, I don't start for another four months I am still an incoming medical student. I've worked much longer and much harder than many to get here so excuse me if I want to change my status after all these years....I earned it.

So why don't you stop wasting your time posting dumb s**t on my thread. Thanks.


Accepted to Class of 2017 MD!!!!

I understand your eagerness to ditch the "pre-medical" title, but you can't really blame medical students for mocking someone who hasn't matriculated sporting a "medical student" title. Just don't take it to heart... who cares what a bunch of random people on the internet think? Also, congrats on the acceptance!

 

[image187]

It took me seven very long and very difficult years of chasing my dream AFTER graduating college to get to the point that I am at today. So after staring at my "pre-med" status for so long (I've been a member of sdn since 2006 only under a different name), I figured it was alright to change my status. Although, I don't start for another four months I am still an incoming medical student. I've worked much longer and much harder than many to get here so excuse me if I want to change my status after all these years....I earned it.

So why don't you stop wasting your time posting dumb s**t on my thread. Thanks.


Accepted to Class of 2017 MD!!!!

This is a terrible excuse. Many people in my medical school class work like dogs for many hours a day without pay, and not one of them calls themselves a doctor or writes "M.D." after their name even though graduation is not that far off. Forgive me for not realizing that your hard work is worth more than others because you've been trying really really hard to get into medical school for so long.

 

[calvnandhobbs68]

It took me seven very long and very difficult years of chasing my dream AFTER graduating college to get to the point that I am at today. So after staring at my "pre-med" status for so long (I've been a member of sdn since 2006 only under a different name), I figured it was alright to change my status. Although, I don't start for another four months I am still an incoming medical student. I've worked much longer and much harder than many to get here so excuse me if I want to change my status after all these years....I earned it.

So why don't you stop wasting your time posting dumb s**t on my thread. Thanks.


Accepted to Class of 2017 MD!!!!

Yeahhh...just shouldn't have responded.

 

[NickNaylor]

Just wondering what everyone thinks about using anki to make flashcards of information that is in first aid and also taught in class during 1st and 2nd year. So like, study the way you normally would, but look through first aid to see what material covered in class is also in first aid. Make anki cards for these things. Then study these cards, even after the exam, for long-term retention for step 1. Worth it? Overkill?

This is the whole point of Gunner Training/Firecracker. It is essentially First Aid in flashcard form that uses an algorithm similar to Anki, including your perception of how difficult the card was. I haven't used GT but my understanding is that it is best used through M1-M2, so I would look into that if you're interested.

Sent from my SAMSUNG-SGH-I717

 

[prado]

It took me seven very long and very difficult years of chasing my dream AFTER graduating college to get to the point that I am at today. So after staring at my "pre-med" status for so long (I've been a member of sdn since 2006 only under a different name), I figured it was alright to change my status. Although, I don't start for another four months I am still an incoming medical student. I've worked much longer and much harder than many to get here so excuse me if I want to change my status after all these years....I earned it.

So why don't you stop wasting your time posting dumb s**t on my thread. Thanks.


Accepted to Class of 2017 MD!!!!

I think you just lost any form of support you had prior to this post...

 

[jorgediaz]

It took me seven very long and very difficult years of chasing my dream AFTER graduating college to get to the point that I am at today. So after staring at my "pre-med" status for so long (I've been a member of sdn since 2006 only under a different name), I figured it was alright to change my status. Although, I don't start for another four months I am still an incoming medical student. I've worked much longer and much harder than many to get here so excuse me if I want to change my status after all these years....I earned it.

So why don't you stop wasting your time posting dumb s**t on my thread. Thanks.


Accepted to Class of 2017 MD!!!!

Time to make another account? lol

 

[thesauce]

I understand your eagerness to ditch the "pre-medical" title, but you can't really blame medical students for mocking someone who hasn't matriculated sporting a "medical student" title. Just don't take it to heart... who cares what a bunch of random people on the internet think? Also, congrats on the acceptance!

It's more than that. SDN largely relies on those at different stages to help out those that haven't reached that point yet. Mis-representation of credentials undermines that process. You can say that these people are stupid for trusting others on the internet, but I've found most on SDN to be trustworthy and the process generally works. Aside from that, pre-meds have very few resources for information outside of SDn because med students and physicians are busy and have difficulty finding time to mentor.

 

[mcloaf]

It took me seven very long and very difficult years of chasing my dream AFTER graduating college to get to the point that I am at today. So after staring at my "pre-med" status for so long (I've been a member of sdn since 2006 only under a different name), I figured it was alright to change my status. Although, I don't start for another four months I am still an incoming medical student. I've worked much longer and much harder than many to get here so excuse me if I want to change my status after all these years....I earned it.

So why don't you stop wasting your time posting dumb s**t on my thread. Thanks.


Accepted to Class of 2017 MD!!!!

I see u mad.

 

[sinombre]

It's more than that. SDN largely relies on those at different stages to help out those that haven't reached that point yet. Mis-representation of credentials undermines that process. You can say that these people are stupid for trusting others on the internet, but I've found most on SDN to be trustworthy and the process generally works. Aside from that, pre-meds have very few resources for information outside of SDn because med students and physicians are busy and have difficulty finding time to mentor.

Good points. I can appreciate the significance of integrity on SDN.

 

[Nottinghamlace]

It took me seven very long and very difficult years of chasing my dream AFTER graduating college to get to the point that I am at today. So after staring at my "pre-med" status for so long (I've been a member of sdn since 2006 only under a different name), I figured it was alright to change my status. Although, I don't start for another four months I am still an incoming medical student. I've worked much longer and much harder than many to get here so excuse me if I want to change my status after all these years....I earned it.

So why don't you stop wasting your time posting dumb s**t on my thread. Thanks.


Accepted to Class of 2017 MD!!!!

Obligatory bandwagon insult directed at your self righteous post

 

[Scrubsy]

Let me clear some things up. First, I would like to apologize to my fellow SDNers and to image187 for my previous comment. I was out of place in saying what I did. I am not trying to misrepresent myself in any way. I was just excited about getting into medical school and eager to change my status. I am on here just trying to get information on how to best prepare myself for medical school like many others. I'll change my status back to premed to avoid any confusion for others in future posts. I am really not a self-righteous person and am well aware that everyone has worked very hard to get where they are today and many have worked even harder than I have. I do appreciate and value the advice received from all of the medical students on this site. So, again, I apologize for my immature and inappropriate comment.

 

[image187]

Let me clear some things up. First, I would like to apologize to my fellow SDNers and to image187 for my previous comment. I was out of place in saying what I did. I am not trying to misrepresent myself in any way. I was just excited about getting into medical school and eager to change my status. I am on here just trying to get information on how to best prepare myself for medical school like many others. I'll change my status back to premed to avoid any confusion for others in future posts. I am really not a self-righteous person and am well aware that everyone has worked very hard to get where they are today and many have worked even harder than I have. I do appreciate and value the advice received from all of the medical students on this site. So, again, I apologize for my immature and inappropriate comment.

Apology accepted. You are far more mature than I thought you were before you made this post. Congratulations on getting in.

 

[Scrubsy]

Apology accepted. You are far more mature than I thought you were before you made this post. Congratulations on getting in.

Thank you 🙂

 

[alpinism]

Owning med school is a full time job.

Here's another way to get a 270. I call it the 10^x strategy. Over 10 months, with 100% determination, study 1000 hours, do 10000 questions.

Good God.

He started out w/ a NBME of 258 a full 9 mos before taking the test (which is more than good enough for derm or plastics). Hell, he didn't even need to study let alone spend 9 months trying to raise his score to above a 270. Why??

That guy started out with a UWorld correct of 88%. That is what many people aim to have at the end of their prep, not as a first pass. That is highly atypical and not what anyone should expect.

Look, anyone in medical school can get a 270+ or whatever arbitrary cutoff you set. Since you're apparently a med student now at a school that is presumably a "top" school you should realize this. Everyone is capable and everyone is smart. Med school performance comes down to nothing more than time spent repeatedly going over the material; the people at the top are simply those that spend more time doing that (or, more rarely, have insane memorization skills). With that said, most people instead choose to have a more balanced life that includes time spent doing things outside of school and a self-worth that isn't defined by a score on an exam. This might come as a shock, but there are actually people who choose to forgo academic fellatio in favor of interests and pursuits outside of school specifically and medicine generally. 😱 Sure, there are people that are superstars in every aspect of life, but that isn't most people, even those at top schools. In most cases it's a balancing act, and performance simply reflects where the fulcrum lies on the spectrum of "work super hard" to "slack off."

Sent from my SAMSUNG-SGH-I717

Lol

As has been mentioned, most people NEVER hit 91% on Kaplan and aspire to hit 88% on UWorld their second pass through (especially all random timed). The dude was already a superstar before he even started hardcore studying.

Exactly. This guy is NOT representative of the average med student and it wasn't his study plan that got him that score. In all likelihood, he prob would've got a 260+ if he had just read FA and did UWorld questions for a month.

If you want to give up your entire life during 2nd year, then by all means...

 

[mmmcdowe]

sometimes being strong all round is better than being prison strong, where you have meaty arms and scrawny legs to stand on.

 

[KnuxNole]

If I spent my entire 2nd year on nothing but Step prep for hours on end, I wouldn't be alive to even sit for the exam 🙁

 

[yehhhboiii]

The pace of medical school goes so quickly that you find yourself quickly forgetting things you learned a few weeks ago. You pick up the main concepts though even if the details get hazy. It seems that the binge/purge strategy still holds true except that it takes more time to go through all the material since there's so much. For Step 1, you mostly learn from doing questions on uworld and reading first aid to see which topics you understand and which you need to review. You should get about 6 weeks of dedicated time after the end of second year to get ready for the exam. Most people manage to pass with their first try.

 

[redpanda]

Here's the deal: lots of people binge and purge in medical school. I'm not from that group, but looking at classmates who do, it's partially because they decide they need to slack off for the better part of a course and then try to cram it all in before the exam. When I see people do that, I see stupidity, because why would I want to learn all the material over again later?

Looking at First Aid and getting intimidated is a useless exercise, because you have no context for the information in it. It makes a lot more sense once you have some background, and, not to needlessly intimidate you more, FA is actually bare bones material, so you should actually know something other than being able to recite FA like catechism. I didn't look at FA in MS1 and in MS2, I looked at FA the day before the exam to see if there were any topics we didn't cover in school.

What helps you in medical school is knowing your physiology well, and then the pathology and pharmacology get easier (although idiosyncratic side effects of drugs never do). Like other users, I've used Anki, but I didn't use it until mid-MS2. I use it for pattern recognition of clinical syndromes a lot. For now, just relax. Nearly everybody who matriculates into medical school gets through it, so there's no need to worry in advance.

 

[Kaputt]

Owning med school is a full time job.

Here's another way to get a 270. I call it the 10^x strategy. Over 10 months, with 100% determination, study 1000 hours, do 10000 questions.

There is no golden method to getting a "270" or whatever other score makes you cream your pants.

Consistently getting scores in the 270-zone is not attainable for just anyone. I don't think there's a linear relationship to the time you put into Step 1 and what you get out of it. Everyone hits a ceiling. Some peoples' ceilings are higher than others'.

 

[KinasePro]

There is no practical reason to lust after a 270. If you manage a 250-ish, you're all set in the step 1 department and should be trying to get the rest of your CV swole.

Once a PD sees your score is ~250, they no longer care. They then become more interested in 3rd year grades, LORs/networking, and whether or not they can stand your presence & bad jokes.

Cut off some of that anki time, start going to grand rounds, and get a chart review started. This will help your chances of matching at MGH way more than an extra 10-15 thin air points on step 1.

IMO, any student who does above-average in M1 & M2 can hit ~250 if they get through goljan RR/audio + FA 2-3x + Uworld.

 

[chronicidal]

There is no practical reason to lust after a 270. If you manage a 250-ish, you're all set in the step 1 department and should be trying to get the rest of your CV swole.

Once a PD sees your score is ~250, they no longer care. They then become more interested in 3rd year grades, LORs/networking, and whether or not they can stand your presence & bad jokes.

Cut off some of that anki time, start going to grand rounds, and get a chart review started. This will help your chances of matching at MGH way more than an extra 10-15 thin air points on step 1.

IMO, any student who does above-average in M1 & M2 can hit ~250 if they get through goljan RR/audio + FA 2-3x + Uworld.

Your hypothesis is that match rates to top residencies plateaus ("they no longer care") with respect to Step 1 score beyond 250.

The Charting Outcomes data suggest that the marginal benefit is less, but it does not plateau completely when you're looking at the most competitive specialties. Mind you, this data is for matching at all to any program. You might make the extrapolation that at the most competitive programs within, say, medicine or surgery, you might find a trend similar to the one found across plastic surgery programs.

 

[KnuxNole]

I don't wanna sound mean, but you seem to have a major love for these kinda charts and such. A 270 can have a big impact...however it's VERY rare for anyone posting here or reading this to get a 270. If someone was to say that they will get it, I'd probably look at them and question if they are sane. The rare classmate likes to use the "I'm really hard working!" as a reason, but these are the same people that cry when they "only" get a 240 and question why nobody cares.

 

[Wordead]

I just finished paging through First Aid Step 1 and am quite overwhelmed with the amount and detail of the material you need to know! I have already taken most of the first and second year medical school courses during my grad school and this stuff still looks daunting! I'm starting medical school in the fall and have two questions:

1. During your first two years do students mainly binge and purge the material for exams or actually retain the stuff?? (I know during my accelerated masters I did quite a bit of the binge/purge method. I aced all my exams, but two weeks later probably couldn't tell ya much of what I had learned.)

2. How on earth are you supposed to memorize all of the material tested on step 1?? There is a ton of material and its very detailed. I'm going for a very competitive specialty, so it's important that I do everything I can to get an awesome score.

People do binge and purge, yes. But that only works up to a point, IMO. At some point, you do need to retain the material (basically forever). Not the small details, obviously, but the overall picture should be well cemented in your brain.

This is pretty much why I find the anki-style study habits to be poor - you're flashing on select details, often without the overall picture. This can get you a decent score on step 1 (probably not spectacular), but I personally think that going for understanding allows you to be a better clinician (which is important for the wards).

My advice is to use M1 as a testing ground - find out what method of study allows you to retain information the best. Study smart, not just hard.

 

[KinasePro]

The Charting Outcomes data suggest that the marginal benefit is less, but it does not plateau completely when you're looking at the most competitive specialties. Mind you, this data is for matching at all to any program. You might make the extrapolation that at the most competitive programs within, say, medicine or surgery, you might find a trend similar to the one found across plastic surgery programs.

If you were to discuss this topic with a few PD's, I think you'd find that we can confidently dismiss causality from the correlation you're pointing out.

Though it appears you can buy an extra 5% chance of matching with those additional 10 pts on step 1, what's more likely happening is that students who score 260+ tend to have better grades & CVs than those who score 250.

Most PDs that I've interacted with in competitive surgical specialties utilize step 1 cut-offs when granting interviews, so it's not analogous to how the MCAT is viewed in medical school admissions. No data to back this up, its purely anecdotal. Ask around though, you will find this is true.

There are plenty of people in hyper-competitive specialties at MGH/Hopkins/Mayo/UCSF with step 1 <250. Networking will pay off more than an additional 10 pts on step 1, especially in small fields. Put another way, a phone call from an influential mentor may get you ranked, while both 270 and 250 will only get you interviews.

 

[Narmerguy]

Your hypothesis is that match rates to top residencies plateaus ("they no longer care") with respect to Step 1 score beyond 250.

The Charting Outcomes data suggest that the marginal benefit is less, but it does not plateau completely when you're looking at the most competitive specialties. Mind you, this data is for matching at all to any program. You might make the extrapolation that at the most competitive programs within, say, medicine or surgery, you might find a trend similar to the one found across plastic surgery programs.

You cannot extrapolate from getting accepted anywhere to getting accepted at a particular school (or a small subset of schools, i.e. top programs), especially when there are significant differences in how they interpret and judge applications. Further, this doesn't control for anything, and thus you've likely got many students with high step scores that also have great LOR or great clinical grades or great research, etc etc. In addition, these charts do not show error bars so we have no idea what the distribution is like for each score. Finally, the sample size decreases significantly at these higher scores such that we can extract less and less meaningful information from them.

No, we cannot assume top programs in medicine and surgery show a similar distribution as that seen in plastics. Ignoring the inherent lack of any real facts to support this, even using your graphs there's no reason these trends couldn't follow dermatology, or neurosurgery, or orthopedic surgery. In fact, the shape of every single graph you've given but plastics is roughly the same (with a flattening of the curve at higher scores). That the shape of this trend varies between specialties only further suggests that this is not the full story and that one needs to drill much deeper to understand the actual benefit of achieving a Step 1 score above 250 or 260.

 

[ruiner]

Interesting thread...

 

[chronicidal]

I don't wanna sound mean, but you seem to have a major love for these kinda charts and such.

It doesn't sound mean at all. I don't understand why you think it's perjorative.

If you were to discuss this topic with a few PD's, I think you'd find that we can confidently dismiss causality from the correlation you're pointing out.

Though it appears you can buy an extra 5% chance of matching with those additional 10 pts on step 1, what's more likely happening is that students who score 260+ tend to have better grades & CVs than those who score 250.

Most PDs that I've interacted with in competitive surgical specialties utilize step 1 cut-offs when granting interviews, so it's not analogous to how the MCAT is viewed in medical school admissions. No data to back this up, its purely anecdotal. Ask around though, you will find this is true.

There are plenty of people in hyper-competitive specialties at MGH/Hopkins/Mayo/UCSF with step 1 <250. Networking will pay off more than an additional 10 pts on step 1, especially in small fields. Put another way, a phone call from an influential mentor may get you ranked, while both 270 and 250 will only get you interviews.

I do share your belief that cut-offs are used for granting interviews but ranking applicants to match is another question. The annual PD surveys suggest that many programs 1) use Step 1 cutoffs for interviews, AND 2) value Step 1 scores relatively highly (albeit not the most important) when ranking applicants to match. Are you going to tell me that they use a HIGHER cutoff to rank to match? That would not make any sense.

I also share your belief that networking and personal calls are highly influential. However, the issue really is, What is the time cost-efficacy of trying to network and finding a mentor vs. preparing for Step 1? What if becoming buds with a highly influential mentor turns out to be more difficult/less likely than getting a 270?

I also share your belief that there will be high correlation between the top Step 1 scorers and the top grades+CVs. The question is, are you going to strive to be one of those people? Or will you be content with an ordinary score and justify that with having devoted extraordinary effort onto other endeavors? If so, do you believe that the 5% boost for 260s over 250s is solely attributed to other factors (grades+CV), and that an incrementally higher Step 1 score, everything else being equal, will not have ANY positive effect on your match chances?

In addition, these charts do not show error bars so we have no idea what the distribution is like for each score. Finally, the sample size decreases significantly at these higher scores such that we can extract less and less meaningful information from them.

Good point. Here are some error bars from the Ophthalmology match (3435 students over 5 years). (I added the extra lines.)

I see that, as far as matching anywhere goes, a 270 is not statistically significantly different from a 258 or so.

So, shoot for a 260? Anything above that is just gravy? I mean, anecdotally, that'll put you squarely in the average range of a few of the most competitive programs.

 

[WorksInProgress]

So, shoot for a 260? Anything above that is just gravy? I mean, anecdotally, that'll put you squarely in the average range of a few of the most competitive programs.

And... that's... not something to aspire to be?

 

[KnuxNole]

For everyone here, getting a 258 or higher would be a miracle or a cool rare feat. Shooting for the stars is key though. Try to do the best that you can. If you actually manage to break higher than a 260, then you can talk about any of this. It's nice to aim high and to do as best as possible, but if anyone would say that they will get a 260, I won't believe it until I see it 😛

Similar to a pre-med saying they WILL get a 42 on the MCAT. Won't actually believe in them until they have proof.

 

[thesauce]

For everyone here, getting a 258 or higher would be a miracle or a cool rare feat. Shooting for the stars is key though. Try to do the best that you can. If you actually manage to break higher than a 260, then you can talk about any of this. It's nice to aim high and to do as best as possible, but if anyone would say that they will get a 260, I won't believe it until I see it 😛

Similar to a pre-med saying they WILL get a 42 on the MCAT. Won't actually believe in them until they have proof.

To me, there's only so high that you can go with your preparation alone. Some people were born to take these tests. You can prepare, but be thrown by the page long clinical vignette. While others learn to see straight through all the red-herrings and focus on what they're asking for.

I personality could never have gotten a 250 on step 1 no matter how hard I studied. I had pretty much peaked when I took it and came just short of 240. I'm sure I could have gotten in the 240s on a good day, but really not any higher than that.

 

[chronicidal]

And... that's... not something to aspire to be?

No it is! Perhaps I sounded too sarcastic. I didn't mean that.