MCAT vs. Step 1 - Step 1 = more "studyable?"

[rocketbooster]

I know there are some very old threads on this but I wanted to hear from some ppl who have recently taken the Step 1. My test is coming up in June so I'm starting to prep for this beast.

I was just curious if you would more or less agree with this....from what I've heard/read, the Step 1 is nothing like the MCAT. Going into the MCAT, I thought it was mainly knowledge-based so the more content you studied the better you would do. After taking the real test, I realized the test was more like 2/3rds reading comprehension and 1/3rd content/knowledge-based with some critical thinking skills mixed in there. Yes you had to know the science content well, but if your reading comprehension was not excellent then you would not be getting a very high score. I tried comparing it back to the SAT and realized the SAT is mainly half reading comprehension and half critical thinking. So the MCAT was more "study-able" than the SAT but still very reading comprehension based.

For the Step 1, based on reading some practice questions, all my school tests which only have vignettes, and reading others' commentaries on the Step 1, this test definitely seems the most "study-able." I keep hearing it is a "thinker's test" and just memorizing things will enable you to pass but not score super high. Thinker's test = critical thinking which is much different than reading comprehension. So it sounds like this test is more like half content-based and half critical thinking. The critical thinking = understanding the mechanisms, processes, reasoning of the memorization that is required. A vignette only has a few sentences and one question associated with it. It's a much different format than passage-based tests (long passage + 7 questions over the passage) like the SAT and MCAT. Because of this difference, reading comprehension is less important on the Step 1. Being able to read fast and retain lots of what you just read in a long passage doesn't really help as much on this test. Most ppl can probably retain most of what they read in a few sentences and read fast enough that having to read a short paragraph will not cause them time problems overall.

So for those who have taken the Step 1, would you agree with this, part of this, or not at all? Why or why not?

---

Members don't see this ad.

 

[quique2]

Hi. You point out something I find pretty interesting. I'm an IMG and therefore have not taken neither the MCAT nor the SAT, so I can't compare Step 1 to those. However, I did take my exam recently, and now feel like I can actually offer an opinion about the test's content. You probably already know this, but maybe some people could benefit from this.

- What most people associate with Step 1 are questions on drug mechanisms of action and specific side effects (and why they occur), specific properties of pathogens, disease pathophysiology, straight up diagnoses, biochem, anatomy/histology/neuroanatomy - you get the drill. All this is pretty much straight recall, although actually understanding what's going on will help you remember a lot more easily and even tricky wording won't confuse you if you truly understand. Question banks prepare you for this because while most of the questions test relatively straightforward concepts, the question is usually designed to make you think in order to get to the answer. Also, proper critical thinking will help you rule out the incorrect answers. (random fact: I found that on my real test, questions were a lot more straightforward than those on question banks)

- Like you say, it seems that just memorizing will enable you to just pass the test. I know a bunch of people who just go through First Aid and end up passing (usually low average scores). This is because being able to put together all that knowledge is just as important as remembering it.

- There's another kind of question which is the non-recall type, or however you'd want to call it. It's the question that can be answered with basic clinical reasoning or just general understanding. Let me cite a few examples.
a. A test on a normal patient has a 5% chance of getting a false positive each time you test a patient. What's the probability that the patient will get three consecutive false positives on the test. This is high school math, and so many people get this wrong because it's not in most review books that I have seen. This is easily answerable, and even if you haven't seen this kind of math years, proper critical thinking will get you the right answer... (also, good reading comprehension is needed in cases when the question is not worded so directly)

b. Physiology questions and some biochem - sometimes physio questions will be straight recall, but in my experience they will usually test whether you know what's going on inside a cell or in a patient's body as a whole. These are the questions that throw in a bunch of different parameters, let's say cardiac output, total peripheral resistance and something else, let's say plasma potassium or something (or in biochem, some elements of a cycle, like acetyl-CoA, F2,6-BP, glucagon). The answer choices are all the different combinations of arrows that you could imagine - pointing up, down, etc. These questions really require you to understand the clinical case as well as the process they're asking you about. You could spend a long time just thinking, but if you understand the mechanism you can rule out the obvious incorrect answers and focus on the 2-3 remaining ones. They will try and ask you about things that you don't normally think about (intermediate products in a cycle for example) but that are logical, easy answers if you understand the underlying process.

c. Miscellaneous questions like graph interpretation. Example - multiple graphs showing the amount of beta-lactamase producing bacteria in a cell culture at baseline, when exposed to just penicillin, when exposed to just clavulanate (clavulinic acid) and when exposed to both together. Logically, clavulanate by itself does nothing, and both together would have the best bactericidal effect. You'd be surprised how many people go into mental block when exposed to 5-7 similar-looking graphs. Similar questions along this line: anything that includes graphs, charts or tables, or questions that give you more information than you need but deep down are really simple.

d. Again with the math: a question that looks complicated but is essentially asking you to calculate oxygen consumption, given cardiac output and arterial-venous oxygen gradient. This is Fick's principle, but what could confuse many people is the fact that the "typical" question asks you cardiac output, while this one is asking something different. The people I know who memorize First Aid would go blank when given this question (plus, imagine it doesn't say cardiac output but "heart rate x stroke volume" which is the same thing. Added confusion for those who memorize, same thing for those who understand)

So this post was a random collection of ideas I've had over the past few days. I just wanted to point out that a big part of it is straight recall (especially on my real test and NBMEs!), the other part of the exam really requires underlying comprehension, especially if you want to do well.

 

[rocketbooster]

So this post was a random collection of ideas I've had over the past few days. I just wanted to point out that a big part of it is straight recall (especially on my real test and NBMEs!), the other part of the exam really requires underlying comprehension, especially if you want to do well.

Right. You're basically saying exactly what I was hinting at. Except what you're calling "comprehension/reading comprehension," I'm calling critical thinking skills. The way I defined it, reading comprehension is reading a long passage, retaining and understanding it well in one read-through, and then answering 7 questions based on that passage. The questions are mainly based on what it is found in the passage, while not much background content is needed. This would be a passage-based format test, like the MCAT and SAT. The MCAT definitely requires more background knowledge than the SAT, but the MCAT is still majorly reading comprehension. The Step 1 is formatted completely different. You read a few sentences and then answer one question. You are only going to know most of the answers using your own science knowledge and critical thinking skills over that knowledge. Straight memorization will make you diagnose the disease, while true understanding/critical thinking on that topic will allow you to answer the 2nd and 3rd order magnitude questions, i.e. "what lab test would identify this disease, what treatment should be used, etc."

For native English speakers, I think most ppl have more than enough reading comprehension skills to not have an issue with understanding the actual vignette. This may be different for IMGs, though, if English is your 2nd language. However, I honestly doubt IMGs would struggle much either since it is only a few sentences per question and half of the vignette is lab values/pictures.

I posted this on the main allopathic boards, too. It got a lot of replies there. Check it out.

 

[vicinihil]

yes.

 

[ucsfstudents]

Being able to memorize, understand basic concepts, recall, and apply are all key to doing well on the exam.

 

[HeyThere13]

Being able to memorize, understand basic concepts, recall, and apply are all key to doing well on the exam.

 

[MedPR]

.

 

[lolpremed]

bump