ERAS Filter

[thesauce]

Forgive me, but I'm not really "getting" why Step 1 needs to allow retakes in order to be used to assess performance? Can someone explain?

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[howelljolly]

Because in today's politically correct world, there can be no losers or failures. Being told "you are not good enough" is unacceptable.

/sarcasm off

oh right, silly me. I forgot that we are entitled to whatever we want. Especially if we have the money for it.

 

[NotAProgDirector]

Forgive me, but I'm not really "getting" why Step 1 needs to allow retakes in order to be used to assess performance? Can someone explain?

The argument is pretty straightforward. The USMLE is used to assess minimum competency for licensure, and is also used by residency PD's for ranking / interview decisions. In the former, once you pass there would be no need to take the exam again. In the latter, if you passed the exam but with a lowish score, it might be in your best interest to take it again to get a better score, much like taking the MCAT again if your score is low.

As to why this is unlikely to change:

1. The USMLE doesn't want the exam used for residency decisions. Hence, they are unlikely to change their policy in this direction.

2. The exam is used to assess adequacy for licensure. What happens if someone passes the first time, then fails the second? The problem with this is that each state has it's own laws regarding USMLE passage for licensure, and each state would need to address the legal problem. Even if states left it alone, if you were ever sued for medmal in the future it could (and would) be argued that you were incompetent based upon this failed exam.

3. You are assuming that PD's would believe the most recent, or highest, score. That is an assumption. There is some chance that PD's would simply look at your lowest score, or your first score. In that case, retakes would only be harmful.

Instead of arguing for a solution that is never going to happen (making the USMLE pass/fail or allowing retakes), it would be better to argue for a solution that would work. The NBME offers shelf exams to medical schools that cover the same content as the USMLE's. If they offered the shelf exams in the same secure environment as the USMLE's and would report them via an official transcript, you could take those as often as you want. There are shelf exams in each field, and I'm sure they could put together a "comprehensive" one that covers everything without much additional work. And, boy, would they make a bunch of money.

 

[thesauce]

The argument is pretty straightforward. The USMLE is used to assess minimum competency for licensure, and is also used by residency PD's for ranking / interview decisions. In the former, once you pass there would be no need to take the exam again. In the latter, if you passed the exam but with a lowish score, it might be in your best interest to take it again to get a better score, much like taking the MCAT again if your score is low.

This seems straighforward to you?

I don't see how "it may be in your best interest" to retake it equates to the exam being worthless without retakes.

Is someone saying that they took it without understanding that it would be used for evaluation of residency candidates (i.e. they took it under false pretences)?

 

[howelljolly]

This seems straighforward to you?

I don't see how "it may be in your best interest" to retake it equates to the exam being worthless without retakes.

Is someone saying that they took it without understanding that it would be used for evaluation of residency candidates (i.e. they took it under false pretences)?

you no makee sense

if you dont believe aPD, see post #37 by me

 

[Cerberus]

I don't see any need for a retake. There are ~350 questions on the exam and statistically, regardless of what version you get, your score should fall +-7 points from the score you got. So basically, if you aren't prepared to take it, you simply shouldn't take it. Allowing retakes would be unfair to other applicants who don't have the time/money to retake it over and over until they get a high score. Also, you don't have the option to retake other exams in medical school, why should you be allowed to retake the STEP exams?

As for STEP I being used as a major criteria in the selection process, why shouldn't it be? It's the most objective way of comparing applicants from different schools/regions.

 

[howelljolly]

I don't see any need for a retake. There are ~350 questions on the exam and statistically, regardless of what version you get, your score should fall +-7 points from the score you got. So basically, if you aren't prepared to take it, you simply shouldn't take it. Allowing retakes would be unfair to other applicants who don't have the time/money to retake it over and over until they get a high score. Also, you don't have the option to retake other exams in medical school, why should you be allowed to retake the STEP exams?

As for STEP I being used as a major criteria in the selection process, why shouldn't it be? It's the most objective way of comparing applicants from different schools/regions.

Thats actually a very good point. Theyve also found that of those who fail, their second attempt is not very different from their first attempt. Only half of those who do get a second attempt at the USMLE are able to elevate their score to a pass.

And as Cerberus points out, a statistically insignificant portion of students make a statistically significant change in their score. And thats a true story.

So, there IS a cohort who gets a second attempt at the USMLE, and its been shown that there is no significant difference.

Strong work Cerberus.

 

[QofQuimica]

These arguments are all beside the point. It doesn't matter whether residency programs use USMLE scores or PSes or LORs or clinical rotation grades or a crystal ball to choose which applicants they want to interview: *someone* is going to get shafted. Any time you are trying to winnow hundreds of reasonably competitive apps down to a manageable number, you run the risk of losing some perfectly good applicants no matter how you go about it.

This is now my third year serving on the adcom at my med school, and I can unequivocally tell you that choosing which applicants to interview or accept is not an exact science. There is a great deal of subjectivity at every step in the process. There is also no perfect system for going about it. Some med schools decide whom to interview according to set minimum GPAs and MCAT scores, and they get criticized for being "stats ******." My school chooses to not set minimum GPA and MCAT scores, but then we have people complaining about how we're not objective enough.

Ultimately, not everyone is going to love you in this world. That's why you don't apply to one single residency program (or med school either, unless you're applying ED). That's why you don't only attend one interview. That's why you don't only rank one hospital. Instead of complaining about how this or that system of choosing applicants isn't "fair," we'd all be better off by educating ourselves about the realities of the system, and adjusting our app strategies accordingly in order to maximize the chance of success.

 

[thesauce]

you no makee sense

if you dont believe aPD, see post #37 by me

You clearly thought I was responding to every part of apd's post that I wasn't. The first paragraph is all that I was addressing (i.e. why an exam needs to allow retakes in order to be valid). I wasn't addressing the issue of why the NBME won't allow retakes.

FYI: saying something in a funny way doesn't do much to solidify your position.

 

[RxnMan]

And for the record (to beat this dead horse again) "it wasn't designed for that!" is not a good argument...technically grades aren't designed for residency selection, they're designed for feedback and evaluation of medical school performance...Surely you don't suggest those be the only factors in residency selection.

And if you honestly believe that a 260 doesn't tell you anything helpful about a student compared to a 200, you're delusional.

Awesome post.

...I don't see how "it may be in your best interest" to retake it equates to the exam being worthless without retakes.

Is someone saying that they took it without understanding that it would be used for evaluation of residency candidates (i.e. they took it under false pretences)?

I get you. To restate, thesauce doesn't understand the stance that "Step I is not fair or useless because there are no retakes for those who pass with a low score." thesauce believes that this position could be held if the test taker wasn't informed - they didn't understand that scores would be used in the residency application process.

I also submit that if one was in denial, or immature, or for whatever reason felt that they didn't need to score well to get their program of choice ("I have connections", "I'm going into [uncompetitive specialty] and I just need to pass," etc.), you might later regret your laissez-faire attitude. I've met students who were Patch Adams-Mrk2-I'm-going-to-heal-Africa-and-live-with-natives-in-the-bush, only to realize they like ortho in MS3 and now regret not preparing for the Step I.

But we all knew the challenge of Step I was coming. We all knew what it meant. It wasn't a surprise. Similarly, if someone suffered from test anxiety, or had poor test-taking skills, they had time to prepare and make adjustments.

And how would retakes make things more just? I didn't have the time or money to prepare and take Step I again. I had to cover the same material and take the same test everyone else did. Granted, not the exact same questions, but given the huge bank of questions, my mix of difficult and easy q's where scaled to everyone else's. And I had to be ready for that one day just like everyone else.

Is there any other measure PD's have to compare applicants from different schools to each other? Everyone here has experienced how clinical grades can be random and subjective, and I doubt my HP would translate to another school's HP (and I can gripe about it, but that wouldn't be productive because the system won't change in time for my application).

 

[thesauce]

Awesome post.

I get you. To restate, thesauce doesn't understand the stance that "Step I is not fair or useless because there are no retakes for those who pass with a low score." thesauce believes that this position could be held if the test taker wasn't informed - they didn't understand that scores would be used in the residency application process.

Exactly what I was trying to say. Thanks.

 

[howelljolly]

But who isnt informed that their USMLE scores will be used for residency apps?

I cant fathom how someone can go through 2 years of med school without hearing even in passing that your step1 scores will be used for resident selection. Why would you go take the Step1 if you didnt know why? You thought it was just so you can start clinicals?

 

[Cerberus]

But who isnt informed that their USMLE scores will be used for residency apps?

I cant fathom how someone can go through 2 years of med school without hearing even in passing that your step1 scores will be used for resident selection. Why would you go take the Step1 if you didnt know why? You thought it was just so you can start clinicals?

If someone isn't aware that USMLE scores will be used in the ranking process for residency, it's because they have been willfully ignorant throughout medical school. I don't buy for a second that someone who has made it this far is unaware that their STEP I score will be used in the match process

 

[RxnMan]

But who isnt informed that their USMLE scores will be used for residency apps?

I cant fathom how someone can go through 2 years of med school without hearing even in passing that your step1 scores will be used for resident selection. Why would you go take the Step1 if you didnt know why? You thought it was just so you can start clinicals?

If someone isn't aware that USMLE scores will be used in the ranking process for residency, it's because they have been willfully ignorant throughout medical school. I don't buy for a second that someone who has made it this far is unaware that their STEP I score will be used in the match process

Exactly. This is what thesauce and I are arguing - the "usmle isn't fair because there's no re-takes" stance is pretty flawed because it relies on willful denial of reality.

In any case, I think we're in agreement.

 

[NotAProgDirector]

Exactly. This is what thesauce and I are arguing - the "usmle isn't fair because there's no re-takes" stance is pretty flawed because it relies on willful denial of reality.

The exact same thing could be said about the MCAT. You know it will be used for med school admissions. You can choose exactly when you take it. Just wondering if you think that MCAT should be limited to one take also.

(Please note I am not suggesting that retakes of the USMLE are warranted or even beneficial. I simply ask for the sake of the discussion)

 

[Man In White]

Wow, certainly became more lively in this thread - Retakes would only make it harder for selection committees to evaluate candidates, but not impossible - it's done annually for med school admissions. Take the average, take the best score, be suspicious of applicants who have taken the exam 4 times to reach 250, whatever, you're just adding more uncertainty to the equation.

If I were a program director in a perfect world I would look at each individual application and pull out of thin air the magic rank of the applicant that keeps the universe "fair" and "right."

But since we don't live in a perfect world what people who argue against cutoffs are asking is that committees should somehow review hundreds of applications and reliably be able to rank them by some other arbitrary formula that is riddled by more imperfections/randomness than simply having a cutoff. They're also asking committees to spend more of their time evaluating candidates, because they didn't perform as well as they may have been able to perform. I don't think that's very "fair" for the committees, their patients, students, and other responsibilities.

 

[winner123]

Wow, certainly became more lively in this thread - Retakes would only make it harder for selection committees to evaluate candidates, but not impossible - it's done annually for med school admissions. Take the average, take the best score, be suspicious of applicants who have taken the exam 4 times to reach 250, whatever, you're just adding more uncertainty to the equation.

If I were a program director in a perfect world I would look at each individual application and pull out of thin air the magic rank of the applicant that keeps the universe "fair" and "right."

But since we don't live in a perfect world what people who argue against cutoffs are asking is that committees should somehow review hundreds of applications and reliably be able to rank them by some other arbitrary formula that is riddled by more imperfections/randomness than simply having a cutoff. They're also asking committees to spend more of their time evaluating candidates, because they didn't perform as well as they may have been able to perform. I don't think that's very "fair" for the committees, their patients, students, and other responsibilities.

Why shud ERAS even bother to report yur previous scores?
Let bygones be bygones.U r wat u r at present.If one scores 99 after a
fail on any step,then he/she has undoubtedly reached the competence level of a 99 er.
The whole concept underlying the USMLE exams is that one can never improve him or herself.Look , wat an outdated concept in such an ultra-modern and democratic world of 21st Century and that too in the most advanced country in the world.

 

[howelljolly]

Why shud ERAS even bother to report yur previous scores?
Let bygones be bygones.U r wat u r at present.If one scores 99 after a
fail on any step,then he/she has undoubtedly reached the competence level of a 99 er.
The whole concept underlying the USMLE exams is that one can never improve him or herself.Look , wat an outdated concept in such an ultra-modern and democratic world of 21st Century and that too in the most advanced country in the world.

oh

 

[howelljolly]

The exact same thing could be said about the MCAT. You know it will be used for med school admissions. You can choose exactly when you take it. Just wondering if you think that MCAT should be limited to one take also.

(Please note I am not suggesting that retakes of the USMLE are warranted or even beneficial. I simply ask for the sake of the discussion)

No, I dont think so. Unlike the standard curriculum of med school, undergrad is not a level playing field. The American system (contrast with the British system) Allows for people to get a Bachelors in whatever they want, and do whatever they want before med school. That may involve a BS in Physics which earned you an above average, 3.2 GPA. It might involve a BA in Art Hx which got you a poor base in science, which was followed up by a PhD in Genetics, which got you a better one. The MCAT is your chance to do whatever you need to in order to prove yourself to the Admissions Committee, and historically it is used to "make up for" a low GPA.

The MCAT is an Admissions Test. It's up to you to prepare for it in whatever way you want, and in whatever mindset you want... and by that I mean ~3 years of preparation possibly while studying Art Hx, with medicine as a backup. Perhaps after working at Starbucks for 4 years with your Art degree, you might get a PhD in Genetics, and a career in medicine becomes your primary goal. In that case, you should be able to take your Art Historian - Latte maker self, and replace it with your published Geneticist self, and take the MCAT again. I think its fair that the ultra-modern democratic American system is set up to offer that. Whereas, the British decide-when-youre-16y.o. system is not set up as such.

Additionally, the physics, and especially the Org. Chem components are there for a good reason. They are assessing how you apply a novel, closed set of information. You can take a Sociology major, or Marvin the Martian, and stick them in an OrgChem class, and they will be presented every dry, complicated principle and rule which one needs to solve OrgChem problems. They will have to learn the principles, and apply them in the class itself. No basis in Gen chem, or any other class is needed. Its a cognitive test. Receive new information, and the method to apply it, then apply it. Thats what OrgChem has to do with Medicine. We dont do drug development. We present students with complex new information and force them to apply it.

However, once you're in med school, its a level playing field. You KNOW that from this point, you are in it to study medicine. You need to know Biochem whether you like it or not. It's no longer what you feel like doing - its what the WHO says you need to know. If you dont like it, get out. Point is, its the same curriculum for everyone. You can go on the USMLE website and see what is fair-game testable material; you know exactly what you are expected to know. And everyone gets the same material from the same text books forcefed down their throat.

Then after your 2nd year, you take the United States Medical Licensing Exam, with the same groundwork as everyone else. Even if you don't know that it will be used to select residents (and if you dont know that, youre so out of touch with reality that you shouln't be given a medical license), you know that it will be used by the United States to Examine if you should be granted a Medical License. Rearrange the letters if you dont see the correlation. If you take that lightly, you probably shouldnt be granted one.

 

[GmailQueen]

The exact same thing could be said about the MCAT. You know it will be used for med school admissions. You can choose exactly when you take it. Just wondering if you think that MCAT should be limited to one take also.

(Please note I am not suggesting that retakes of the USMLE are warranted or even beneficial. I simply ask for the sake of the discussion)

I think that by allowing students to retake the MCAT multiple times, we are putting those from a lower socioeconomic status at more of a disadvantage than they already are, as they are less likely to have the money and time to buy books, take the Kaplan course, pay to take the test multiple times, etc.

As far as filtering candidates based on their USMLE scores - programs want residents who aren't going to fail standardized exams. So they take candidates with higher scores because they are less likely to fail in the future. As everyone here has had to take at least the SAT or ACT and the MCAT, I find it kind of surprising that people are so upset over being judged by a test. It's not exactly the first time this has happened.

 

[Cerberus]

Why shud ERAS even bother to report yur previous scores?
Let bygones be bygones.U r wat u r at present.If one scores 99 after a
fail on any step,then he/she has undoubtedly reached the competence level of a 99 er.
The whole concept underlying the USMLE exams is that one can never improve him or herself.Look , wat an outdated concept in such an ultra-modern and democratic world of 21st Century and that too in the most advanced country in the world.

Man, it's pretty hard to take anything you say seriously when you type like a 13 year old girl sending a text message to her BFF about the Jonas Brothers.

 

[winner123]

Man, it's pretty hard to take anything you say seriously when you type like a 13 year old girl sending a text message to her BFF about the Jonas Brothers.

Oh,really!
How the hell did u think that I will take u seriously?

 

[winner123]

I think that by allowing students to retake the MCAT multiple times, we are putting those from a lower socioeconomic status at more of a disadvantage than they already are, as they are less likely to have the money and time to buy books, take the Kaplan course, pay to take the test multiple times, etc.

As far as filtering candidates based on their USMLE scores - programs want residents who aren't going to fail standardized exams. So they take candidates with higher scores because they are less likely to fail in the future. As everyone here has had to take at least the SAT or ACT and the MCAT, I find it kind of surprising that people are so upset over being judged by a test. It's not exactly the first time this has happened.

It is not a question about who has or has not taken the standardised tests.
If that is the case then wat do u say about the IMGs who do not take any standardised tests like MCAT,SAT , etc.Does it mean that there shud be a different test for the IMGs other than the standardised USMLE?

 

[winner123]

The exact same thing could be said about the MCAT. You know it will be used for med school admissions. You can choose exactly when you take it. Just wondering if you think that MCAT should be limited to one take also.

(Please note I am not suggesting that retakes of the USMLE are warranted or even beneficial. I simply ask for the sake of the discussion)

aPD's argument is really full of meaning.

 

[winner123]

No, I dont think so. Unlike the standard curriculum of med school, undergrad is not a level playing field. The American system (contrast with the British system) Allows for people to get a Bachelors in whatever they want, and do whatever they want before med school. That may involve a BS in Physics which earned you an above average, 3.2 GPA. It might involve a BA in Art Hx which got you a poor base in science, which was followed up by a PhD in Genetics, which got you a better one. The MCAT is your chance to do whatever you need to in order to prove yourself to the Admissions Committee, and historically it is used to "make up for" a low GPA.

The MCAT is an Admissions Test. It's up to you to prepare for it in whatever way you want, and in whatever mindset you want... and by that I mean ~3 years of preparation possibly while studying Art Hx, with medicine as a backup. Perhaps after working at Starbucks for 4 years with your Art degree, you might get a PhD in Genetics, and a career in medicine becomes your primary goal. In that case, you should be able to take your Art Historian - Latte maker self, and replace it with your published Geneticist self, and take the MCAT again. I think its fair that the ultra-modern democratic American system is set up to offer that. Whereas, the British decide-when-youre-16y.o. system is not set up as such.

Additionally, the physics, and especially the Org. Chem components are there for a good reason. They are assessing how you apply a novel, closed set of information. You can take a Sociology major, or Marvin the Martian, and stick them in an OrgChem class, and they will be presented every dry, complicated principle and rule which one needs to solve OrgChem problems. They will have to learn the principles, and apply them in the class itself. No basis in Gen chem, or any other class is needed. Its a cognitive test. Receive new information, and the method to apply it, then apply it. Thats what OrgChem has to do with Medicine. We dont do drug development. We present students with complex new information and force them to apply it.

However, once you're in med school, its a level playing field. You KNOW that from this point, you are in it to study medicine. You need to know Biochem whether you like it or not. It's no longer what you feel like doing - its what the WHO says you need to know. If you dont like it, get out. Point is, its the same curriculum for everyone. You can go on the USMLE website and see what is fair-game testable material; you know exactly what you are expected to know. And everyone gets the same material from the same text books forcefed down their throat.

Then after your 2nd year, you take the United States Medical Licensing Exam, with the same groundwork as everyone else. Even if you don't know that it will be used to select residents (and if you dont know that, youre so out of touch with reality that you shouln't be given a medical license), you know that it will be used by the United States to Examine if you should be granted a Medical License. Rearrange the letters if you dont see the correlation. If you take that lightly, you probably shouldnt be granted one.

U r right when u said that MCAT is an Admission Test.Then , in the same token USMLE is simply a licensing exam and nothing more than that.
I don't say this.It is what the USMLE says.

 

[diosa428]

It is not a question about who has or has not taken the standardised tests.
If that is the case then wat do u say about the IMGs who do not take any standardised tests like MCAT,SAT , etc.Does it mean that there shud be a different test for the IMGs other than the standardised USMLE?

The US system is not designed to cater to IMGs, and I don't think it should be. As far as I'm concerned, if IMGs don't want to deal with the US system, they can stay in their own country. Plenty of IMGs have managed to navagate our system successfully; if you can't cut it, perhaps you don't belong here.

 

[howelljolly]

Oh,really!
How the hell did u think that I will take u seriously?

U r right when u said that MCAT is an Admission Test.Then , in the same token USMLE is simply a licensing exam and nothing more than that.
I don't say this.It is what the USMLE says.

It is not a question about who has or has not taken the standardised tests.
If that is the case then wat do u say about the IMGs who do not take any standardised tests like MCAT,SAT , etc.Does it mean that there shud be a different test for the IMGs other than the standardised USMLE?

Are you daft?

People who type like 13 year old girls' text messages should should should not be in medical school.

Learn some semblance of grammar and spelling.

Otherwise, go away and die. you're wasting my oxygen.

 

[Cerberus]

Oh,really!
How the hell did u think that I will take u seriously?

Quite frankly, I don't give a damn what someone with the grammar of a poorly educated teenager thinks of me. I am just letting you know, that the vast majority of adults find poor grammar and spelling to be indicative of laziness and stupidity.

 

[Man In White]

roflcopter. winner wins at failing.

 

[winner123]

Are you daft?

People who type like 13 year old girls' text messages should should should not be in medical school.

Learn some semblance of grammar and spelling.

Otherwise, go away and die. you're wasting my oxygen.

Oh, but I already finished my medical school , but u r not even worth joining a kindergarten.U r just cursing me like a poor divorced wife.

 

[winner123]

Quite frankly, I don't give a damn what someone with the grammar of a poorly educated teenager thinks of me. I am just letting you know, that the vast majority of adults find poor grammar and spelling to be indicative of laziness and stupidity.

First let me know whether u r an adult or a teenager.If u r an adult then I will give an ADULT tinge to my grammar .I hope u get me.

 

[winner123]

The US system is not designed to cater to IMGs, and I don't think it should be. As far as I'm concerned, if IMGs don't want to deal with the US system, they can stay in their own country. Plenty of IMGs have managed to navagate our system successfully; if you can't cut it, perhaps you don't belong here.

This is not so. US healthcare system cannot exist without IMGs.It is the IMGs who sustain all the primary care specialties in the US.It is the IMGs who serve in the underserved areas of the US where otherwise healthcare services will be defunct.

 

[winner123]

roflcopter. winner wins at failing.

Failure is the first step towards success.

 

[howelljolly]

Oh, but I already finished my medical school , but u r not even worth joining a kindergarten.U r just cursing me like a poor divorced wife.

I already finished medical school, you twit.

 

[J1515]

Man, it's pretty hard to take anything you say seriously when you type like a 13 year old girl sending a text message to her BFF about the Jonas Brothers.

 

[LucidSplash]

This is not so. US healthcare system cannot exist without IMGs.It is the IMGs who sustain all the primary care specialties in the US.It is the IMGs who serve in the underserved areas of the US where otherwise healthcare services will be defunct.

Yes. Those IMGs who perform well enough to land those spots.

 

[howelljolly]

Yes. Those IMGs who perform well enough to land those spots.

Those IMGs can spell.

 

[winner123]

Yes. Those IMGs who perform well enough to land those spots.

No,there r hundreds of examples of those IMGs who did poorly on the steps and then proved out to be the finest doctors out there.They have proved this scoring system wrong by their mettle and determination.Scores r only one of the criteria among the ACGME six core competencies.This shows that they r not everything.Alas,they r being used as the only criterion!

 

[howelljolly]

No,there r hundreds of examples of those IMGs who did poorly on the steps and then proved out to be the finest doctors out there.They have proved this scoring system wrong by their mettle and determination.Scores r only one of the criteria among the ACGME six core competencies.This shows that they r not everything.Alas,they r being used as the only criterion!

Well, yes. In a manner of speaking. For resident selection they're used as a rule-out criteria of sorts, because they're less subjective than the prestige of the med school, LORs, or the PS.

So if your scores dont meet the cut-off, the rest of your application will not be looked at.

I'm gathering that you are an FMG and that nobody explained (in the midst of your applications for Visas and the ECFMG) that your USMLE will be used for residency selection, not just medical licensure in the US. I think that's a slightly more valid gripe to have.

If you say things clearly, people might have a bit more sympathy.

And I wish you would stop typing like a 13 year old girl on a cell phone. Your personal statement must be a horrorshow.

 

[Winged Scapula]

The childish back and forth arguing is just as immature as textspeak.

Many of us use textspeak, even from time to time, on SDN. However, we do ask that users post in a manner which enhances communication with other users. Textspeak is common not just for 13 yo girls but on foreign boards. It is not common on US medical boards and I ask, as a staff member for SDN, that everyone try to communicate as clearly as they can.

Unfortunately, winner123, the users who have complained about your efforts at posting here are correct. Your communication skills are paramount as a physician, especially if English is not your first language. And while you and others may think that the form of communication on an internet BB is not important, it does obsfuscate your intended meaning, makes it more difficult for others to communicate and as evidenced above, calls into question your maturity. Fair or not, that's the way it works.

So if we can get back to the topic at hand, I would appreciate it.

 

[winner123]

Well, yes. In a manner of speaking. For resident selection they're used as a rule-out criteria of sorts, because they're less subjective than the prestige of the med school, LORs, or the PS.

So if your scores dont meet the cut-off, the rest of your application will not be looked at.

I'm gathering that you are an FMG and that nobody explained (in the midst of your applications for Visas and the ECFMG) that your USMLE will be used for residency selection, not just medical licensure in the US. I think that's a slightly more valid gripe to have.

If you say things clearly, people might have a bit more sympathy.

And I wish you would stop typing like a 13 year old girl on a cell phone. Your personal statement must be a horrorshow.

I was admired for my personal statement at a residency interview.
I hope u stop behaving like a delinquent child.

 

[winner123]

The childish back and forth arguing is just as immature as textspeak.

Many of us use textspeak, even from time to time, on SDN. However, we do ask that users post in a manner which enhances communication with other users. Textspeak is common not just for 13 yo girls but on foreign boards. It is not common on US medical boards and I ask, as a staff member for SDN, that everyone try to communicate as clearly as they can.

Unfortunately, winner123, the users who have complained about your efforts at posting here are correct. Your communication skills are paramount as a physician, especially if English is not your first language. And while you and others may think that the form of communication on an internet BB is not important, it does obsfuscate your intended meaning, makes it more difficult for others to communicate and as evidenced above, calls into question your maturity. Fair or not, that's the way it works.

So if we can get back to the topic at hand, I would appreciate it.

It is just that I was presenting my point of view on the issue of retakes.

OK,WS,I will get back to the topic.

 

[RxnMan]

It is just that I was presenting my point of view on the issue of retakes.

OK,WS,I will get back to the topic.

You've presented your thoughts. Given the way residency selection is done right now, what do you want out of posting here? If you want to change minds, then you need to convince folks with more than anecdotes about successful FMGs with low scores and how the USMLE isn't designed for resident selection. If you want to vent, then that's ok too, and we'll cheer you on and say the situation sucks.

 

[howelljolly]

You've presented your thoughts. Given the way residency selection is done right now, what do you want out of posting here? If you want to change minds, then you need to convince folks with more than anecdotes about successful FMGs with low scores and how the USMLE isn't designed for resident selection. If you want to vent, then that's ok too, and we'll cheer you on and say the situation sucks.

Yup

The fact is, that nobody has come up with a better method for resident selection. And with the growing applicant pools, it will only become more difficult and unfair.

For me, I just leave it to the experts. People with PhDs in I/O Psychology spend their lives figuring out valid methods for personnel selection and placement. I won't be able to add any new ideas.

 

[LucidSplash]

You are arguing as though there is a dearth of IMGs/FMGs with strong test scores as well as strength in the other core competencies. This is simply not the case. If positions in some residency programs were going unfilled even after the scramble, I might agree that there is a problem with the current system. But currently there are more than enough applicants to fill spaces so programs look for people who are strong in all areas.

No,there r hundreds of examples of those IMGs who did poorly on the steps and then proved out to be the finest doctors out there.They have proved this scoring system wrong by their mettle and determination.Scores r only one of the criteria among the ACGME six core competencies.This shows that they r not everything.Alas,they r being used as the only criterion!

 

[JeffLebowski]

No,there r hundreds of examples of those IMGs who did poorly on the steps and then proved out to be the finest doctors out there.They have proved this scoring system wrong by their mettle and determination.Scores r only one of the criteria among the ACGME six core competencies.This shows that they r not everything.Alas,they r being used as the only criterion!

Huh? Finest doctors according to whom? You? "Finest" meaning better? You're saying that the finest doctors in America have low Step 1 scores? Lofty claim.

The idea of doing poorly on Step 1 and doing well in your career is not a phenomenon that is limited to IMGs, by the way, there are plenty of people out there that are good doctors in their field with poor Step 1 scores. Which, to me, suggests that the current system of stratifying doctors into specialties based on (in part) Step 1 is actually working, because they excel in the field of medicine their score landed them in.

Regarding the IMG issue - luckily, the U.S. is closing the gap between U.S. grads and U.S. residency positions that IMGs used to fill, so you won't have to worry about your claim of U.S. dependency on IMGs for much longer. It's wrong for us to steal talented physicians from their home countries with the promise of better training, compensation, and lifestyle that frankly not many countries can compete with when there's a paucity of good doctors in the country that educated them. Especially when there's a system in place for matching applicants to training programs and licensing U.S. physicians that we like but they hate (if your comments are any representation of your cohort).

 

[howelljolly]

Huh? Finest doctors according to whom? You? "Finest" meaning better? You're saying that the finest doctors in America have low Step 1 scores? Lofty claim.

The idea of doing poorly on Step 1 and doing well in your career is not a phenomenon that is limited to IMGs, by the way, there are plenty of people out there that are good doctors in their field with poor Step 1 scores. Which, to me, suggests that the current system of stratifying doctors into specialties based on (in part) Step 1 is actually working, because they excel in the field of medicine their score landed them in.

Regarding the IMG issue - luckily, the U.S. is closing the gap between U.S. grads and U.S. residency positions that IMGs used to fill, so you won't have to worry about your claim of U.S. dependency on IMGs for much longer. It's wrong for us to steal talented physicians from their home countries with the promise of better training, compensation, and lifestyle that frankly not many countries can compete with when there's a paucity of good doctors in the country that educated them. Especially when there's a system in place for matching applicants to training programs and licensing U.S. physicians that we like but they hate (if your comments are any representation of your cohort).

Ah, the much maligned Brain Drain Phenomenon.

 

[winner123]

Are you kidding me...in the 21st century, things are hopefully based on merit. merit implies that you not only get a good test score but did it the first time and with a reasonable amount of preparation. What value is the score as a tool for comparison to US grads when you take it 2-3 times and study for 6-12 months. A true comparison would be taking the test once and studying for a few weeks as most US grads do.

I think this poster is an IMG who had to take his steps a few too many times and has not gotten the residency they desire. He therefore has come here to spout delusions in a hope that someone will justify his existence.

My step-1 score is 96 and three-digit above 230 and on first attempt.
Good Luck,Buddy!

 

[JeffLebowski]

My step-1 score is 96 and three-digit above 230 and on first attempt.
Good Luck,Buddy!

You sound proud of your accomplishment, considering your whole point is that the score is meaningless.

I would congratulate you, but your score says nothing about your knowledge, work ethic, or clinical reasoning so you're out of luck.

 

[winner123]

Huh? Finest doctors according to whom? You? "Finest" meaning better? You're saying that the finest doctors in America have low Step 1 scores? Lofty claim.

The idea of doing poorly on Step 1 and doing well in your career is not a phenomenon that is limited to IMGs, by the way, there are plenty of people out there that are good doctors in their field with poor Step 1 scores. Which, to me, suggests that the current system of stratifying doctors into specialties based on (in part) Step 1 is actually working, because they excel in the field of medicine their score landed them in.

Regarding the IMG issue - luckily, the U.S. is closing the gap between U.S. grads and U.S. residency positions that IMGs used to fill, so you won't have to worry about your claim of U.S. dependency on IMGs for much longer. It's wrong for us to steal talented physicians from their home countries with the promise of better training, compensation, and lifestyle that frankly not many countries can compete with when there's a paucity of good doctors in the country that educated them. Especially when there's a system in place for matching applicants to training programs and licensing U.S. physicians that we like but they hate (if your comments are any representation of your cohort).

This statement of yurs shows that u have a problem understanding english language.
I never said that all the finest doctors in the US have low Step-1 scores.Wat I said is that there r many doctors who have done badly on steps but later proved to be very fine practicing doctors.
I hope u join some international english langauage teaching course.
Good Luck!