Pass/ Fail Step 1

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By capping the # of apps people can send out? I don't think capping the # of caps hurt DO students anymore than it does MD students. I think it hurts applicants who don't apply with a strategy
Is the match like MED school applications where a well designed list of 15 programs is about as effective as just throwing your app to see where it sticks?

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Is the match like MED school applications where a well designed list of 15 programs is about as effective as just throwing your app to see where it sticks?

I'm a measly third year, but it seems to be more of a probability game, honestly. More apps = more chances at interviews = bigger rank list = higher chances. Even the top students who apply to a small amount of programs run the risk of being unsuccessful.
 
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By capping the # of apps people can send out? I don't think capping the # of caps hurt DO students anymore than it does MD students. I think it hurts applicants who don't apply with a strategy

Absolutely. Do you think DOs would match high quality MD programs at the rate they do if apps were capped? Can’t apply broadly to mid-tier IM anymore to get enough interviews to match so in order to get enough interviews now you have to apply to low tier and community programs because it’s simply too risky to send apps to programs that aren’t “high yield.”

Someone matched plastics this year from my school, if apps we’re capped they wouldn’t have even applied in order to maximize their interview yield.

For MDs, oh you come from State U so now to maximize your chances of matching you are limited to the programs that take your schools grads every year, gotta increase the yield. No more trying to push the envelope.

Caps seem fine on the surface but the truth is if there were caps a significant number of people wouldn’t be matching the places they are matching. Once again bringing your match potential even more closely related to the medical school you attend.
 
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Let me summarize a few points of crystallization for this thread and provide an argument that I think many of us, who have been through the process, can buy

Points in favor of making STEP1 pass/fail
1. Minorities and low SES people do worse on STEP1
2. STEP1 is not a good measure of clinical ability
3. Making STEP1 pass/fail would incentivize using better markers for clinical ability
You forgot the major reasons, which Med Ed has alluded to time and again in these threads:
Step I score anxiety/obsession is lead to medical student stress and burnout.
STEP I was never meant to be a convenient screening tool for lazy or overworked PDs.
StepI was meant to be a medical knowledge competency exam, period.
 
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You forgot the major reasons, which Med Ed has alluded to time and again in these threads:
Step I score anxiety/obsession is lead to medical student stress and burnout.
STEP I was never meant to be a convenient screening tool for lazy or overworked PDs.
StepI was meant to be a medical knowledge competency exam, period.
1. less burnout with more standardized shelves M1-M3 since more data points for PDs and quintiles means people won't go that extra burnout hard as much for that last little point if they are comfortably above on practice tests
2.STEP1 STEP2 and all major preclinical and clinical shelf exams should be mandated prior to ERAS much fuller picture. Some med school write competent questions. Many don't but politics rules so they continue. In the end, NBME shelves, while flawed, are superior and should be mandated.
3. It was meant to be a minimum competency exam. However, an even better function, one that levels the playing field between different tiers of schools, makes it a good general competency stratification tool. The issue is what is and isn't emphasized and how it is the sole tool. CK and shelves must also be used.
 
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Step I score anxiety/obsession is lead to medical student stress and burnout.

Changing to to P/F literally won’t change this. If anything it will make it worse. Medical school is hard, period.
STEP I was never meant to be a convenient screening tool for lazy or overworked PDs.

Doesn’t matter, just because something is used for a purpose other than what it was originally intended for doesn’t mean the new purpose is invalid. It is literally the ONLY standardized thing that is on every single app they see.
 
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Congratulations, you just proposed another way to screw over DOs and low tier MD students.

Is it though? I might be missing something but it's not obvious to me that it should disproportionately affect anyone. I wont reiterate the points about Avg number of apps discussed early on in this thread, but the main reason applicants feel they need to apply to an ever increasing number of programs is to increase their chances of receiving enough interviews to feel confident in their ability to match their preferred specialty and the competition for interviews is itself driven by the number of apps received / interview slot at any given residency program.

More importantly, from a big-picture view it doesnt seem to me that you can leave the problem of app proliferation untouched. Switching to quintiles would still give applicants from any medical school an opportunity to differentiate themselves and therefore understand their level of competitiveness for X specialty or Y program within X. But if you leave app proliferation as is then, in some very competitive or small specialties (like Derm), you would make it much harder for PDs to make meaningful decisions about who to interview or not -- e.g. if every single Q1 applicant is applying to every single program in the country regardless of whether or not they are likely to actually rank the program highly if interviewed, you stall the disbursement of interviews to candidates most likely to accept/need them and therefore increase the probability that otherwise desirable applicants may fall through the cracks. Who is most likely to fall through the cracks? Precisely the types of students you and many others are concerned about.
 
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Absolutely. Do you think DOs would match high quality MD programs at the rate they do if apps were capped? Can’t apply broadly to mid-tier IM anymore to get enough interviews to match so in order to get enough interviews now you have to apply to low tier and community programs because it’s simply too risky to send apps to programs that aren’t “high yield.”

Someone matched plastics this year from my school, if apps we’re capped they wouldn’t have even applied in order to maximize their interview yield.

For MDs, oh you come from State U so now to maximize your chances of matching you are limited to the programs that take your schools grads every year, gotta increase the yield. No more trying to push the envelope.

Caps seem fine on the surface but the truth is if there were caps a significant number of people wouldn’t be matching the places they are matching. Once again bringing your match potential even more closely related to the medical school you attend.

I don't think you're right about capped applications being to DO students disadvantage. With capped number of apps, programs will actually be able to look at applications more closely, instead of using heuristics like step 1 cutoffs or MD only. DO students will have to apply smartly and do better program research ahead of time, but I think those students who distinguished themselves during medical school will actually have a better shot at matching with capped applications and a more thorough review of their app than the current apply everywhere approach.
 
How would P/F or quintiles increase stress?

The stress will never disappear, it just gets kicked down the road to something else. I don’t know about you but I’d rather stress about something 2 years away from residency applications where if I don’t perform as well as I need to for my specialty of choice rather than find out last second that I’m not competitive for it and be completely SOL.

Or would you rather have class grades become the determiner of your competitiveness? Where every school has different lecturers, different emphasis, etc? That sounds terrible to me. Or a specialty specific exam taken right before applications? Yay, more money in the NBMEs pocket.

I cannot reiterate this enough, the stress will literally never disappear. Anyone saying P/F will decrease stress is either straight up lying, or simply delusional.

Is it though? I might be missing something but it's not obvious to me that it should disproportionately affect anyone. I wont reiterate the points about Avg number of apps discussed early on in this thread, but the main reason applicants feel they need to apply to an ever increasing number of programs is to increase their chances of receiving enough interviews to feel confident in their ability to match their preferred specialty and the competition for interviews is itself driven by the number of apps received / interview slot at any given residency program.

More importantly, from a big-picture view it doesnt seem to me that you can leave the problem of app proliferation untouched. Switching to quintiles would still give applicants from any medical school an opportunity to differentiate themselves and therefore understand their level of competitiveness for X specialty or Y program within X. But if you leave app proliferation as is then, in some very competitive or small specialties (like Derm), you would make it much harder for PDs to make meaningful decisions about who to interview or not -- e.g. if every single Q1 applicant is applying to every single program in the country regardless of whether or not they are likely to actually rank the program highly if interviewed, you stall the disbursement of interviews to candidates most likely to accept/need them and therefore increase the probability that otherwise desirable applicants may fall through the cracks. Who is most likely to fall through the cracks? Precisely the types of students you and many others are concerned about.

I already addressed this. I don’t care if it’s not obvious to someone at an elite MSTP, this would harm a lot of applicants.
 
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I don't think you're right about capped applications being to DO students disadvantage. With capped number of apps, programs will actually be able to look at applications more closely, instead of using heuristics like step 1 cutoffs or MD only. DO students will have to apply smartly and do better program research ahead of time, but I think those students who distinguished themselves during medical school will actually have a better shot at matching with capped applications and a more thorough review of their app than the current apply everywhere approach.

Perhaps, but I doubt it. Does the DO match UPenn ENT if applications are capped? How about Mayo ortho? UW plastics? I would be willing to bet that no they don’t, because with applications capped they can’t afford to have those those places taking up an application slot that could have gone to a program considered more “high yield.”
 
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I don't think making STEP 1 pass/fail will hurt DO students; COMLEX is scored on percentiles and PDs can see which ones did better on COMLEX whereas on the MD side, they don't have a score. COMLEX becomes the test DOs focus on.
 
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Perhaps, but I doubt it. Does the DO match UPenn ENT if applications are capped? How about Mayo ortho? UW plastics? I would be willing to bet that no they don’t, because with applications capped they can’t afford to have those those places taking up an application slot that could have gone to a program considered more “high yield.”

Unless they do an away there and get really positive feedback. That’s the only thing that I think might reduce some of the screwing, but you can only do so many of those.
 
I don't think making STEP 1 pass/fail will hurt DO students; COMLEX is scored on percentiles and PDs can see which ones did better on COMLEX whereas on the MD side, they don't have a score. COMLEX becomes the test DOs focus on.

COMLEX is one of the stupidest tests known to man. PDs won’t give two craps about it whether or not Step goes to P/F. PDs still wouldn’t be able to compare DOs to MDs because the testing pool is very different.
but you can only do so many of those.

Exactly.
 
Perhaps, but I doubt it. Does the DO match UPenn ENT if applications are capped? How about Mayo ortho? UW plastics? I would be willing to bet that no they don’t, because with applications capped they can’t afford to have those those places taking up an application slot that could have gone to a program considered more “high yield.”

There is 1/24 DO at UPenn ENT. None in UW plastics. I really, truly believe that capping applications would make matching in competitive residencies easier for DO students.

This isn't a perfect analogy, but it's kinda the same problem with online dating for guys who are medium attractiveness. When women have the option of all the men, they gravitate to basically the top 20%. In a setting with less apparent abundance, such as a bar, it is a much more even playing field. That's what capping applications would do for DO students.
 
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There is 1/24 DO at UPenn ENT. None in UW plastics. I really, truly believe that capping applications would make matching in competitive residencies easier for DO students.

This isn't a perfect analogy, but it's kinda the same problem with online dating for guys who are medium attractiveness. When women have the option of all the men, they gravitate to basically the top 20%. In a setting with less apparent abundance, such as a bar, it is a much more even playing field. That's what capping applications would do for DO students.

Fair enough. I kinda suspect an application cap will be in the pipeline before a change in Step scoring so we'll find out I guess. UW Plastics has a DO intern. UW has DOs in GS, Plastics, and Ortho.
 
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There is 1/24 DO at UPenn ENT. None in UW plastics. I really, truly believe that capping applications would make matching in competitive residencies easier for DO students.

This isn't a perfect analogy, but it's kinda the same problem with online dating for guys who are medium attractiveness. When women have the option of all the men, they gravitate to basically the top 20%. In a setting with less apparent abundance, such as a bar, it is a much more even playing field. That's what capping applications would do for DO students.

I'm pretty sure the math just does not support that thought. If you cap applications there will just end up being lots of unmatched applicants and the programs will find the MDs in the scramble
 
I'm pretty sure the math just does not support that thought. If you cap applications there will just end up being lots of unmatched applicants and the programs will find the MDs in the scramble
Would you rather be in a pool of 400 applicants or 700?

For everyone: do applicants actually take into consideration the “point of diminishing returns” coined by AAMC? Because their data suggests after x amount of applications submitted the likelihood of matching doesn’t increase as a function of submitted application. Reason I say this is because for example aamc says for applicants with step 1 greater or equal to 235 the point of diminishing returns was 34 applications for Urology (confidence 25-44 applications). However, per AUA match data sheet the average application submitted per applicant was 71. (I realize this # is for every applicant not just in that step 1 range but it’s safe to assume that most had atleast a 235 score.)

If submitting 40 applications will get you roughly the same interviews as 70+ maybe capping it wouldn’t be a bad idea.
 
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Would you rather be in a pool of 400 applicants or 700?

For everyone: do applicants actually take into consideration the “point of diminishing returns” coined by AAMC? Because their data suggests after x amount of applications submitted the likelihood of matching doesn’t increase as a function of submitted application. Reason I say this is because for example aamc says for applicants with step 1 greater or equal to 235 the point of diminishing returns was 34 applications for Urology (confidence 25-44 applications). However, per AUA match data sheet the average application submitted per applicant was 71. (I realize this # is for every applicant not just in that step 1 range but it’s safe to assume that most had atleast a 235 score.)

If submitting 40 applications will get you roughly the same interviews as 70+ maybe capping it wouldn’t be a bad idea.

okay, how does that make it easier for DO applicants to match?
 
Would you rather be in a pool of 400 applicants or 700?

For everyone: do applicants actually take into consideration the “point of diminishing returns” coined by AAMC? Because their data suggests after x amount of applications submitted the likelihood of matching doesn’t increase as a function of submitted application. Reason I say this is because for example aamc says for applicants with step 1 greater or equal to 235 the point of diminishing returns was 34 applications for Urology (confidence 25-44 applications). However, per AUA match data sheet the average application submitted per applicant was 71. (I realize this # is for every applicant not just in that step 1 range but it’s safe to assume that most had atleast a 235 score.)

If submitting 40 applications will get you roughly the same interviews as 70+ maybe capping it wouldn’t be a bad idea.

70+ apps gets you the same number of interviews, but the percentage matched for US graduates is significantly higher with a higher average number of apps. It's significantly higher with US seniors too. As a DO, would you rather apply to 40 programs where the percentage matched was 30% or apply to 71 programs where it's 78%? Even for US seniors, when they were applying to 53 programs (and that number includes DOs and IMG/FMGs, so it may not be representative), only 69% matched versus 91%. There doesn't seem to be much incentive to apply to fewer programs.
 
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If submitting 40 applications will get you roughly the same interviews as 70+ maybe capping it wouldn’t be a bad idea.
70+ apps gets you the same number of interviews,

That data is poor and misleading. 70 apps gets you more interviews, their info doesn’t say that it doesn’t. What it doesn’t increase is your chances of matching somewhere, but I don’t know anyone whose goal is to simply match.

The more apps = more interviews = greater control over where you go for residency.

It’s also a well known fact that DO students have to apply to many more programs in order to get the same amount of interviews.
 
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I'm pretty sure the math just does not support that thought. If you cap applications there will just end up being lots of unmatched applicants and the programs will find the MDs in the scramble

I think the problem with the current system is that if you send more apps, you can safely assume everybody else is sending more apps too. It's a prisoner's dilemma situation. By forcing cooperation (capping number of applications), all parties are helped out.
 
I think the problem with the current system is that if you send more apps, you can safely assume everybody else is sending more apps too. It's a prisoner's dilemma situation. By forcing cooperation (capping number of applications), all parties are helped out.

Sure,

but that doesn't necessarily help my match rate, nor does it solve the problem of medical school rank = competitiveness of the applicant.
 
Sure,

but that doesn't necessarily help my match rate, nor does it solve the problem of medical school rank = competitiveness of the applicant.
But wouldn’t it take less emphasis off of step 1 tho? Which is like the goal it seems like. PDs wouldn’t have to use as a way to just filter out applications.
 
Sure,

but that doesn't necessarily help my match rate, nor does it solve the problem of medical school rank = competitiveness of the applicant.

The whole point is that, overall, it would neither help nor harm your match rate, but it would make applicants and programs better able to select one another through mutual interest.
 
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The whole point is that, overall, it would neither help nor harm your match rate, but it would make applicants and programs better able to select one another through mutual interest.

It would likely help or hurt your match rate depending on if you chose 15 programs that just so happened to have no interest in ranking you. Sub-Is would become a de facto requirement.
 
Just **** the 249 guys? lol

I'm above a 250. A few questions wrong and I could have gotten a 249.

Terrible idea.
Okay but you’re totally fine with residencies with cutoffs though? There is no difference between the scores as you mention which is why it should be P/F.
 
Okay but you’re totally fine with residencies with cutoffs though? There is no difference between the scores as you mention which is why it should be P/F.
Not quite sure how that is relevant. There are only so many interview spots available. If a competitive program gets 1000 applicants and only has 400 interview spots, then they can make their interview cutoff whatever they want as long as they fill the interview spots and fill their complement on match day. A less competitive program may not require a cutoff or use a very low one. If two otherwise similar applicants have a 250 and a 220, guess who is more likely to get the interview spot.

Additionally, many specialties (excepting highly competitive specialties) will have programs accepting a broad range of scores. If your scores are 2 standard deviations below what a specialty typically matches, then you should find a different specialty to apply to.
 
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Not quite sure how that is relevant. There are only so many interview spots available. If a competitive program gets 1000 applicants and only has 400 interview spots, then they can make their interview cutoff whatever they want as long as they fill the interview spots and fill their complement on match day. A less competitive program may not require a cutoff or use a very low one. If two otherwise similar applicants have a 250 and a 220, guess who is more likely to get the interview spot.

Additionally, many specialties (excepting highly competitive specialties) will have programs accepting a broad range of scores. If your scores are 2 standard deviations below what a specialty typically matches, then you should find a different specialty to apply to.
I don’t understand your point then. The person with 249 would be ****** in both scenarios if the cut off was 250. If you could have gotten below a 250 on a different day then don’t you think the over emphasis on step 1 is too much? If it was changed to P/F and a cap was put on the amount of apps you can submit then PDs wouldn’t need to use step1 like how they do now. That helps everyone. From the PDs that I know, they say that step 1 is used only as a way for you app to get reviewed the higher the score the more likely your entire file is reviewed. It doesn’t guarantee an interview. If pass fail, The full body of an applicant’s app (grades,clerkships, etc) would then be considered thoroughly and fairly.
 
Pass is 200, high pass 203+. Unless you’re a DO. Then pass is 249 and high pass is 250+.
If I’m a pre med you damn sure are one too lmao because we are both starting this fall plus I actually might remember you from an interview I attended w you
 
If I’m a pre med you damn sure are one too lmao because we are both starting this fall plus I actually might remember you from an interview I attended w you

I didn’t call you a premed lol. Where do you think we interviewed together? Feel free to PM lol.
 
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I don’t understand your point then. The person with 249 would be ****** in both scenarios if the cut off was 250. If you could have gotten below a 250 on a different day then don’t you think the over emphasis on step 1 is too much? If it was changed to P/F and a cap was put on the amount of apps you can submit then PDs wouldn’t need to use step1 like how they do now. That helps everyone. From the PDs that I know, they say that step 1 is used only as a way for you app to get reviewed the higher the score the more likely your entire file is reviewed. It doesn’t guarantee an interview. If pass fail, The full body of an applicant’s app (grades,clerkships, etc) would then be considered thoroughly and fairly.

I agree that there is not a difference between a 249 and a 250. But again, there will be a broad range of scores that different programs accept within each specialty. Unless you are significantly below average for that specialty, 1 point probably won't make or break you.

There is, however, a difference between a 200, 230, 260 etc.

Pass/fail will just put the stress from step 1 elsewhere (research, etc.).

If step 1 is pass/fail, then specialties can just design their own exams for objective comparisons, effectively replacing step 1.

Programs want an objective way to differentiate similar students. It is difficult to compare grades between schools.

I am not necessarily opposed to capping the amount of applications so that fewer applications can be considered more carefully.
 
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Lmao I’m in medical school. But since you’re a year or two ahead you gotta have the superiority complex
I’m sure it’s been a super enlightening week or two for you and thus your opinion should be just as heavily considered as those of us who’ve been through the process this entire thread is about.:rolleyes:

Also:

From the PDs that I know...

Lol, yeah ok sure
 
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The stakeholder meeting was on the 26th right? When do you believe word on what transpired or was discussed will reach us
 
I’m sure it’s been a super enlightening week or two for you and thus your opinion should be just as heavily considered as those of us who’ve been through the process this entire thread is about.:rolleyes:

Also:



Lol, yeah ok sure
Look I recognize the reasons why people would want step to stay the same, I see your side. I just have a different opinion. This notion of you have to have studied for step to have opinion is ridiculous lmaooo. I’m pretty sure it is exactly my class that should have the biggest say since it will most likely affect us, but okay haha. Many posters here are premeds or first years but the reason you haven’t called them out is bc they are in favor of keeping step the same. Just bc someone has a different opinion doesn’t mean you should try to delegitimize people. And yes you would be surprised who I know considering a President (MD) at a top univ. wrote one of my LORs ....LOL

But I’m just a premed tho
 
Look I recognize the reasons why people would want step to stay the same, I see your side. I just have a different opinion. This notion of you have to have studied for step to have opinion is ridiculous lmaooo. I’m pretty sure it is exactly my class that should have the biggest say since it will most likely affect us, but okay haha. Many posters here are premeds or first years but the reason you haven’t called them out is bc they are in favor of keeping step the same. Just bc someone has a different opinion doesn’t mean you should try to delegitimize people. And yes you would be surprised who I know considering a President (MD) at a top univ. wrote one of my LORs ....LOL

But I’m just a premed tho
You’re absolutely allowed to have an opinion on the matter. But it’s not as important as those who’ve actually experienced what we’re talking about. You wouldn’t seriously consider the opinions of someone in freshman year of college about how to study for the mcat or any advice about applying to med school. I’m not trying to delegitimize you. I don’t have to. Your opinions aren’t legitimate. I respect the opinion of other posters who actually know what this is about, even if I don’t agree with them. But you don’t. A couple years ago I probably would have agreed with you. That shows the disconnect.

And yes you would be surprised who I know considering a President (MD) at a top univ. wrote one of my LORs ....LOL
I mean maybe. But you sound like that annoying premed type that somehow knows 50 doctors. Yeah right. Maybe that’s not the case, tho.
But I’m just a premed tho

Nice clincher. I bet your personal statement was sick:thumbup:
 
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I know this is a topic people feel strongly about one way or the other, but let's try to keep it professional. There's no need to take pot shots at each other. That does nothing to refute the argument.

If you want to debate whether an appeal to authority is appropriate here, feel free. But let's leave the passive aggressiveness out of it (not directed at any individual--it's just starting to pick up so I want to head it off before it gets out of hand).
 
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I know this is a topic people feel strongly about one way or the other, but let's try to keep it professional. There's no need to take pot shots at each other. That does nothing to refute the argument.

If you want to debate whether an appeal to authority is appropriate here, feel free. But let's leave the passive aggressiveness out of it (not directed at any individual--it's just starting to pick up so I want to head it off before it gets out of hand).
Might as well close the thread. I was pm'd about a post that was neither inaccurate or inflammatory recently in this thread because SDN apparently put the kid gloves on to revamp the forum reputation. It essentially amounts to defacto censorship. A discussion cannot be had when you aren't allowed to refute an argument in which the only response is "you are awful at arguing your point and don't make sense."
 
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Might as well close the thread. I was pm'd about a post that was neither inaccurate or inflammatory recently in this thread because SDN apparently put the kid gloves on to revamp the forum reputation. It essentially amounts to defacto censorship. A discussion cannot be had when you aren't allowed to refute an argument in which the only response is "you are awful at arguing your point and don't make sense."

Encouraging people to not be jerks to each other on a professional forum is not censorship. I'm not going to close the thread unless it turns into a dumpster fire, which it hasn't. Just be professionals. It's not that hard.
 
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