Step 1 P/F: Decision

[slowthai]

I disagree. I think it carries a net benefit despite whatever flaws come with clinical grades and election criteria. If we accept that merit-based competition between peers exists for certain specialties and for certain programs within all specialties, we should accept that students should have ways to demonstrate merit compared to their peers.

As more and more schools move to P/F everything, P/F Step 1, not even putting full comments on MSPEs, there's almost nothing left for a student to point to that constitutes credible evidence of excellent performance in med school.

Not everyone is the same, and there's nothing wrong with acknowledging that. Med school performance is not a reflection of someone's worth as a person. But in a competitive field like medicine, I think it's wrong to legislate for equality of outcomes among a given class at a school when there is nearly true equality of opportunities at matriculation, probably more than in any other profession. And I think it's flatly wrong to abolish recognition of excellent performance in med school because others' feelings may be hurt or they may suffer emotional stress during a critical time like the start of M4. That is BS.

The problem is that AOA nomination isn't standardized, much like clinical grades. At some schools, being part of a certain demographic or knowing certain people automatically puts you in the running. At other schools, it's purely objective, based on preclinical grades and/or step 1.

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[sw99]

I disagree. I think it carries a net benefit despite whatever flaws come with clinical grades and election criteria. If we accept that merit-based competition between peers exists for certain specialties and for certain programs within all specialties, we should accept that students should have ways to demonstrate merit compared to their peers.

As more and more schools move to P/F everything, P/F Step 1, not even putting full comments on MSPEs, there's almost nothing left for a student to point to that constitutes credible evidence of excellent performance in med school.

Not everyone is the same, and there's nothing wrong with acknowledging that. Med school performance is not a reflection of someone's worth as a person. But in a competitive field like medicine, I think it's wrong to legislate for equality of outcomes among a given class at a school when there is nearly true equality of opportunities at matriculation, probably more than in any other profession. And I think it's flatly wrong to abolish recognition of excellent performance in med school because others' feelings may be hurt or they may suffer emotional stress during a critical time like the start of M4. That is BS.

FTLOG

 

[sw99]

credible evidence of excellent performance in med school

 

[sw99]

And I think it's flatly wrong to abolish recognition of excellent performance in med school because others' feelings may be hurt or they may suffer emotional stress during a critical time like the start of M4. That is BS.

I can believe this crap

 

[NeuResurgens]

I disagree. I think it carries a net benefit despite whatever flaws come with clinical grades and election criteria. If we accept that merit-based competition between peers exists for certain specialties and for certain programs within all specialties, we should accept that students should have ways to demonstrate merit compared to their peers.

As more and more schools move to P/F everything, P/F Step 1, not even putting full comments on MSPEs, there's almost nothing left for a student to point to that constitutes credible evidence of excellent performance in med school.

Not everyone is the same, and there's nothing wrong with acknowledging that. Med school performance is not a reflection of someone's worth as a person. But in a competitive field like medicine, I think it's wrong to legislate for equality of outcomes among a given class at a school when there is nearly true equality of opportunities at matriculation, probably more than in any other profession. And I think it's flatly wrong to abolish recognition of excellent performance in med school because others' feelings may be hurt or they may suffer emotional stress during a critical time like the start of M4. That is BS.

Your latter two paragraphs are correct, but the problem is that AOA is really not all that merit based at many places as @slowthai said. Some schools use a peer vote and I've known people who were extremely smart and likely towards the top of their class by preclinical grades, who didn't get AOA because they were introverted. One of the nicest guys I've ever met was actually known to be in the top 5% but he's extremely soft spoken and didn't get it. Dude was deserving. That's really not a demonstration of merit. And while some will argue that the social adeptness indicated by being voted by peers is "merit," it's not hard to see that the same intrinsic traits, which are often not in the control of the individual person, are prevalent in those who get voted by peers.

The points you make are why I think going away from grades on step 1 so quickly without something to fill the void and address the real problem of increasing residency competitiveness was a bad idea. More and more weight is going to be placed on things that applicants are less able to control, like clinical grades, med school pedigree, and variable things like AOA.

 

[longhaul3]

The problem is that AOA nomination isn't standardized, much like clinical grades. At some schools, being part of a certain demographic or knowing certain people automatically puts you in the running. At other schools, it's purely objective, based on preclinical grades and/or step 1.

Your latter two paragraphs are correct, but the problem is that AOA is really not all that merit based at many places as @slowthai said. Some schools use a peer vote and I've known people who were extremely smart and likely towards the top of their class by preclinical grades, who didn't get AOA because they were introverted. One of the nicest guys I've ever met was actually known to be in the top 5% but he's extremely soft spoken and didn't get it. Dude was deserving. That's really not a demonstration of merit. And while some will argue that the social adeptness indicated by being voted by peers is "merit," it's not hard to see that the same intrinsic traits, which are often not in the control of the individual person, are prevalent in those who get voted by peers

The points you make are why I think going away from grades on step 1 so quickly without something to fill the void and address the real problem of increasing residency competitiveness was a bad idea. More and more weight is going to be placed on things that applicants are less able to control, like clinical grades, med school pedigree, and variable things like AOA.

This is a fair argument, and I sympathize with people who get screwed by the process. I've never heard of peer review for AOA; that is horrendous. My point is just that, on balance, I think having it still outweighs not having it, exactly because of the bolded. It's worse to have nothing at all than just to have AOA, in my opinion.

 

[efle]

People wrote op-eds in opposition to pass/fail preclinical too, guys. Ten years later its ubiquitous at the top programs and slowly becoming the norm everywhere. Now those same schools are experimenting with delayed or absent AOA, and pass/fail clerkships, which is already how it works in Canada.

In 10+ years people will look back at all this as archaic and stupid too.

 

[altblue]

People wrote op-eds in opposition to pass/fail preclinical too, guys. Ten years later its ubiquitous at the top programs and slowly becoming the norm everywhere. Now those same schools are experimenting with delayed or absent AOA, and pass/fail clerkships, which is already how it works in Canada.

In 10+ years people will look back at all this as archaic and stupid too.

Unless you're at a low-tier program and have an interest in orthopedic surgery, or whatever is competitive in the future, and would've wanted the extra boosts to stand out

The fewer the factors like AOA, clinical grades and step 1/2 to evaluate, the more weight applied to existing factors like pedigree almost by default, unless programs explicitly exclude this as a factor which won't happen

Forgive me for belaboring the point, but I disagree that all would look back at this as archaic, because your final perspective would really depend on where you ended up in terms of ranking. If it's for the best that med school be like law school where anything sub-rank X is bad for competitive specialties or you're set from the start, almost regardless of how much effort you put forth in school, then so be it. But that's not how I'd want it

 

[Matthew9Thirtyfive]

Unless you're at a low-tier program and have an interest in orthopedic surgery, or whatever is competitive in the future, and would've wanted the extra boosts to stand out

The fewer the factors like AOA, clinical grades and step 1/2 to evaluate, the more weight is applied to existing factors like pedigree almost by default, unless programs explicitly exclude this as a factor which won't happen

Forgive me for belaboring the point, but I disagree that all would look back at this as archaic, because your final perspective would really depend on where you ended up in terms of ranking. If it's for the best that med school be like law school where anything sub-rank X is bad for competitive specialties or you're set from the start, almost regardless of how much effort you put forth in school, then so be it. But that's not how I'd want it

Or research. Maybe more specialties could adopt SLOEs. They’re already more important than step in EM anyway.

 

[altblue]

Or research. Maybe more specialties could adopt SLOEs. They’re already more important than step in EM anyway.

That leaves research and pedigree, an odd way to select for residents lol.

Yeah, it'd take quite a while for those to come to fruition, though I'm fully supportive

 

[NotAProgDirector]

With DO takers on track to equal or outperform MD takers

What data are you referencing for this statement?

People wrote op-eds in opposition to pass/fail preclinical too, guys. Ten years later its ubiquitous at the top programs and slowly becoming the norm everywhere. Now those same schools are experimenting with delayed or absent AOA, and pass/fail clerkships, which is already how it works in Canada.

In 10+ years people will look back at all this as archaic and stupid too.

Or, we'll look back and wonder why we made a change like this. As already mentioned, this just shuffles the deck of winners and losers. If you end up with a "better" spot (however you want to define that), then you'll think the new system is better. If you end up with a worse spot, you'll think the new system is crap. The only way it's really an improvement across the board is if everyone gets the same spot, but the process is just better.

Maybe more specialties could adopt SLOEs. They’re already more important than step in EM anyway.

This runs into problems. How do all DO and IMG students get SLOE's? That's almost impossible. Then, how does each dept decide who gets "honors" vs "high pass" vs "pass" on a SLOE? We end up with the same complaints of subjective grading. People will try to game the system to work with people who give them all 5's, rather than the 3-bombers.

 

[Matthew9Thirtyfive]

This runs into problems. How do all DO and IMG students get SLOE's? That's almost impossible. Then, how does each dept decide who gets "honors" vs "high pass" vs "pass" on a SLOE? We end up with the same complaints of subjective grading. People will try to game the system to work with people who give them all 5's, rather than the 3-bombers.

How do they do it now in EM?

 

[ace_inhibitor111]

People wrote op-eds in opposition to pass/fail preclinical too, guys. Ten years later its ubiquitous at the top programs and slowly becoming the norm everywhere. Now those same schools are experimenting with delayed or absent AOA, and pass/fail clerkships, which is already how it works in Canada.

In 10+ years people will look back at all this as archaic and stupid too.

I mean you could use this to defend everything the T10 does. Their decisions are not all beneficial. 10 years later and people are still questioning a need for 4 year EM residencies.

 

[efle]

What data are you referencing for this statement?



Or, we'll look back and wonder why we made a change like this. As already mentioned, this just shuffles the deck of winners and losers. If you end up with a "better" spot (however you want to define that), then you'll think the new system is better. If you end up with a worse spot, you'll think the new system is crap. The only way it's really an improvement across the board is if everyone gets the same spot, but the process is just better.



This runs into problems. How do all DO and IMG students get SLOE's? That's almost impossible. Then, how does each dept decide who gets "honors" vs "high pass" vs "pass" on a SLOE? We end up with the same complaints of subjective grading. People will try to game the system to work with people who give them all 5's, rather than the 3-bombers.

The data from the USMLE site on pass rates for USMD, USDO and international.

I don't find it compelling to keep using metrics we know are inaccurate or worthless, just because we're running out of metrics. If AOA isn't standardized or fairly awarded at many schools, and if grading is an inflated mess of gaming-the-system at many schools, then we shouldn't be using them. Full stop. Deluding ourselves because it's hard to acknowledge the real problem - a lack of good metrics - isn't a valid response.

A SLOE is at least as meaningfully close as we can get to a valid comparison tool on the wards. The language of it and comparisons it asks you to make are miles better than what's in post-clerkship surveys at my school, at least. As far as DO or IMG students having difficulty, it seems the same to me as having difficulty in other specialized departments that aren't available at a "home" institution. My answer is again that if you're interested in neurosurgery or ortho or EM or whatever other specialization, then don't matriculate to a school that lacks specialists. If there's a problem here, it's a problem with allowing these kinds of setups to exist, not a problem with PDs asking to see SLOEs.

 

[efle]

I mean you could use this to defend everything the T10 does. Their decisions are not all beneficial. 10 years later and people are still questioning a need for 4 year EM residencies.

I've got no grounds to comment on academia favoring fellowships or other extended training paths. I'm sure they screw up. But medical curriculum innovations like shortened preclinical, flexibility of Step after clerkships, Pass/Fail preclinical grading, removing or delaying AOA, optional recorded lectures and replacing many lectures with small groups or PBLs instead, are all winners in my book.

Bump this thread in 20 years so we can laugh at how old we've gotten. I feel pretty confident that when I explain to a Class of 2040 student about what Zanki was, or how clerkship evals worked, or what got people elected to AOA (friggin preclinical professor's exams at some schools? Are you kidding me??), they're going to laugh about it, not feel envious of us.

 

[slowthai]

Bump this thread in 20 years so we can laugh at how old we've gotten. I feel pretty confident that when I explain to a Class of 2040 student about what Zanki was, or how clerkship evals worked, or what got people elected to AOA (friggin preclinical professor's exams at some schools? Are you kidding me??), they're going to laugh about it, not feel envious of us.

RemindMe! 20 years

Oh wait, that doesn't work on here...

 

[altblue]

Bump this thread in 20 years so we can laugh at how old we've gotten. I feel pretty confident that when I explain to a Class of 2040 student about what Zanki was, or how clerkship evals worked, or what got people elected to AOA (friggin preclinical professor's exams at some schools? Are you kidding me??), they're going to laugh about it, not feel envious of us.

Probably not

 

[efle]

Probably not

Do you envy the people who had to gun against the curve throughout MS1-MS2 because their MSPE gave a literal class rank?

Miss me with that noise. Despite it being harder to single yourself out as the best memorizer of slide decks in all the land, I doubt many others regret seeing that all go the way of the dodo.

 

[altblue]

Do you envy the people who had to gun against the curve throughout MS1-MS2 because their MSPE gave a literal class rank?

Miss me with that noise. Despite it being harder to single yourself out as the best memorizer of slide decks in all the land, I doubt many others regret seeing that all go the way of the dodo.

I'm sure Step, AOA, and clinical grades are all imperfect metrics that are sometimes interpreted unfairly. Yet they're all reasonable measures of ability or soft-skills in some fashion that allow people without pedigree to differentiate themselves. I'm aware I'm still in the pre-clinical years and that my perspective is more limited than yours, but as someone with pretty good stats who decided to go to a cheaper, lesser-known school because he felt it was a good fit, the nature of pass-fail Step in particular could affect my matching ability if it hits the class of 2023.... So it does concern me.

In other conversations, I believe you've suggested that selection prior to the med school level is sufficient, since HMS grads will end up as beast clinicians relative to people from Drexel or NYMC.... That assumes undergrad GPA, MCAT, or EC's are good enough of a proxy. But I don't think undergraduate organic chemistry and some bygone exam with passages about 18th-century art dealers are the most accurate reflection of a future clinician's ability.

Instead, I feel that imperfect clinical metrics are superior. Even if on a population level HMS grads are better, that doesn't mean there isn't overlap within the populations for which med school metrics would be useful for demarcating. I only bring up your points in the IM thread because I feel they tied in well to this conversation of the utility of graded Step 1 and other metrics.

What I'm trying to hammer home though, and what I'm not sure you're sympathizing with, is that these changes do not benefit most med students. They benefit those who attend the most prestigious programs. Sure preclinicals (for class rank)/clinical grades/Step etc. suck and are incredibly emotionally taxing but they offer a key way to elevate one's application and make themselves seen. To be frank, I have no explicit interest in anything competitive yet, but many of my classmates do and some are concerned, so it's frustrating to see this marketed as a benefit when for many it is not.

 

[peachrings]

Agreed, tbh I think it is hard for someone from a top-tier school to empathize with those from lower schools. It is natural for someone from HMS to want to do away with stratifying variables because the final stratifier to fall back on would always be school prestige.

We shouldn't be getting rid of these "imperfect" metrics; instead we should be improving them so that they measure or predict something meaningful. Or just take into account more variables, e.g. required Step 2, reporting of Shelf scores, Apgars etc.

 

[Scrubb]

P/F Step 1 will do a great job of placing more emphasis on the MCAT. Med school name will become that much more important, thus the MCAT will become more important. And do we really think the MCAT (and subsequent school prestige granted by a high MCAT score) is that much better a predictor of student outcomes than Step 1? I doubt that it is.

And before anyone argues that there are other variables that go into the med school selection process...yes, there are. But do you also really think undergrad volunteering, club involvement, and grades are going to be better predictors than Step 1? But this is where we are headed unfortunately.

 

[NeuResurgens]

People wrote op-eds in opposition to pass/fail preclinical too, guys. Ten years later its ubiquitous at the top programs and slowly becoming the norm everywhere. Now those same schools are experimenting with delayed or absent AOA, and pass/fail clerkships, which is already how it works in Canada.

In 10+ years people will look back at all this as archaic and stupid too.

I'll be honest, I'd take a swap of graded preclinical for p/f clinicals

 

[NeuResurgens]

Unless you're at a low-tier program and have an interest in orthopedic surgery, or whatever is competitive in the future, and would've wanted the extra boosts to stand out

The fewer the factors like AOA, clinical grades and step 1/2 to evaluate, the more weight applied to existing factors like pedigree almost by default, unless programs explicitly exclude this as a factor which won't happen

Forgive me for belaboring the point, but I disagree that all would look back at this as archaic, because your final perspective would really depend on where you ended up in terms of ranking. If it's for the best that med school be like law school where anything sub-rank X is bad for competitive specialties or you're set from the start, almost regardless of how much effort you put forth in school, then so be it. But that's not how I'd want it

Law school is a pretty good analogy - ranking hugely matters for those careers. If you want to work in corporate law or in desirable areas you better get into a T14, otherwise your options are more limited to smaller markets and forms of law seen as "lower" on the totem pole (personal injury/those guys on billboards, etc.)

 

[efle]

I'll just reiterate once again that the prestigious school grads taking your competitive surgical seats isn't real. The percentage of spots in Ortho, ENT etc going to top 40 NIH grads is no different than their percentage of the overall pool. There always have been and always will be plenty of U of State med students matching and being trained to replace joints. Maybe institutions will rely on auditions and home matches more, sure. Pretending the P/F change or removing AOA means the brand-name boogeyman is gonna steal your spot, not so much.

 

[TedCruz]

I'll just reiterate once again that the prestigious school grads taking your competitive surgical seats isn't real. The percentage of spots in Ortho, ENT etc going to top 40 NIH grads is no different than their percentage of the overall pool. There always have been and always will be plenty of U of State med students matching and being trained to replace joints. Maybe institutions will rely on auditions and home matches more, sure. Pretending the P/F change or removing AOA means the brand-name boogeyman is gonna steal your spot, not so much.

Not sure how this proves anything. There always have been state school students matching well because they alway had Step 1 to prove themselves. There's no way to know for sure if that will continue to be the case.

 

[Ho0v-man]

I'll just reiterate once again that the prestigious school grads taking your competitive surgical seats isn't real. The percentage of spots in Ortho, ENT etc going to top 40 NIH grads is no different than their percentage of the overall pool. There always have been and always will be plenty of U of State med students matching and being trained to replace joints. Maybe institutions will rely on auditions and home matches more, sure. Pretending the P/F change or removing AOA means the brand-name boogeyman is gonna steal your spot, not so much.

Is there a way to know if those from top schools didn’t apply because of below average scores for the field? I think we all know some ortho or bust folks who had a change of heart that shows up around the same time they got their step1 score back.

 

[Matthew9Thirtyfive]

Is there a way to know if those from top schools didn’t apply because of below average scores for the field? I think we all know some ortho or bust folks who had a change of heart that shows up around the same time they got their step1 score back.

I can’t wait to suddenly discover my passion for primary care after my step score comes back.

 

[detritus]

Not sure how this proves anything. There always have been state school students matching well because they alway had Step 1 to prove themselves. There's no way to know for sure if that will continue to be the case.

Isn’t there still Step 2 CK? I would think people would just now have 1 chance instead of 2 to show that they are “competitive” for a particular field. Schools w/o home programs may be at a disadvantage (devil you know vs. devil you don’t) but the majority of students will be fine after P/F Step 1. If you want to match in a particular field, go to a school with a home program in your chosen specialty so you can likely match at home or get those in the department to put in a good word at other programs.

 

[Kracin]

Man, I keep checking in on this thread to see if there are any updates. Instead, I see people asking dumb questions like what is AOA and rehashing the same surface level anecdotal analysis over and over.

The circle of dumb conversation continues, removing this from my watch list. Rant over

 

[efle]

Not sure how this proves anything. There always have been state school students matching well because they alway had Step 1 to prove themselves. There's no way to know for sure if that will continue to be the case.

1) It's a zero sum game. When there are only a few dozen people from the top schools applying ortho and 700 ortho slots, no, it wasn't because of Step 1 that state schoolers were matching ortho. It's because top school applicants are a small minority of the applicant pool and always have been and always will be.
2) The charting outcomes documents go back for more than a decade. When you look back at the 2005-2006 data when nobody gave a crap about Step 1, guess what? The fraction of Ortho matches from the NIH top 40 is, again, no different than expected for the population (1% more than IM).

This is about as conclusive as it gets. There is no apparent over-representation of top schools. There wasn't any over-representation before step mattered either, and there still isn't any now. So it makes zero sense to me when people talk about how Pass/Fail means your med school brand name is all that matters now. That just isn't true. If someone fails to match Ortho in 2023 it will be because they didn't play the audition game as well as their peers, not because the HMS students gobbled up all the spots.

 

[efle]

Man, I keep checking in on this thread to see if there are any updates. Instead, I see people asking dumb questions like what is AOA and rehashing the same surface level anecdotal analysis over and over.

The circle of dumb conversation continues, removing this from my watch list. Rant over

What update are you refreshing SDN for? The USMLE has shifted to making weekly updates on their home page

Recent Announcements | USMLE

www.usmle.org

 

[efle]

Is there a way to know if those from top schools didn’t apply because of below average scores for the field? I think we all know some ortho or bust folks who had a change of heart that shows up around the same time they got their step1 score back.

I actually don't know a single person who wanted Ortho and failed to hit 250+, with Zanki it was just a sort of checklist thing they all did. In fact the score range for Ortho people here I know (about half a dozen) all ranges from 257-270.

This may have been a bigger contributing factor a few years back, but now that we have widespread Zanki and a 248 school average, I don't really think it's acting like much of a filter. It's a timesuck but not a real threat like that. All the other schools I believe have been converging on step averages in the mid to high 240s too, we were actually catching up from way behind.

 

[ace_inhibitor111]

1) It's a zero sum game. When there are only a few dozen people from the top schools applying ortho and 700 ortho slots, no, it wasn't because of Step 1 that state schoolers were matching ortho. It's because top school applicants are a small minority of the applicant pool and always have been and always will be.
2) The charting outcomes documents go back for more than a decade. When you look back at the 2005-2006 data when nobody gave a crap about Step 1, guess what? The fraction of Ortho matches from the NIH top 40 is, again, no different than expected for the population (1% more than IM).

This is about as conclusive as it gets. There is no apparent over-representation of top schools. There wasn't any over-representation before step mattered either, and there still isn't any now. So it makes zero sense to me when people talk about how Pass/Fail means your med school brand name is all that matters now. That just isn't true. If someone fails to match Ortho in 2023 it will be because they didn't play the audition game as well as their peers, not because the HMS students gobbled up all the spots.

Why is this discussion resting around ortho again? That’s probably one of the more meritocratic of the competitive specialties. There’s no reason Akron General or UMKC would prefer Harvard students over local candidates, and are probably more likely to reject them honestly unless they did an away rotation there. Derm and IM on the other hand have historically favored students from top schools, and with the scoring change I can definitely see this getting worse.

 

[efle]

Why is this discussion resting around ortho again? That’s probably one of the more meritocratic of the competitive specialties. There’s no reason Akron General or UMKC would prefer Harvard students over local candidates, and are probably more likely to reject them honestly unless they did an away rotation there. Derm and IM on the other hand have historically favored students from top schools, and with the scoring change I can definitely see this getting worse.

It's just the biggest surgical subspecialty, so I used it as an example. Same pattern is seen in the others like ENT and neurosurg. There's never a big top 40 over-representation, whether looking at mid 2000s or now.

 

[CognitiveNeuro]

So for someone that does step 1 in 2021, gets a 270 but applies in 2023....will their score now be evaluated as a pass only?

Does anyone know if they gave an answer to anyone concerning this yet?

 

[slowthai]

Does anyone know if they gave an answer to anyone concerning this yet?

Nope, they still don't know if they're going to retroactively screw us over yet

 

[Yellow345]

Does anyone know if they gave an answer to anyone concerning this yet?

I wish they would let us know As I would like to know if I can do a research year and keep my step score

 

[efle]

I wish they would let us know As I would like to know if I can do a research year and keep my step score

These are the folks who need two months to tell us how they're going to administer board exams to everyone. I'd be shocked if they clarify the retroactive score problem before 2022.

 

[TwistedTea]

Better get to keep my steps for fellowship applications ! Dang you Nbme succumbing to the scum that benefit most to this (high tier places that can name their price now)

 

[TwistedTea]

P/F Step 1 will do a great job of placing more emphasis on the MCAT. Med school name will become that much more important, thus the MCAT will become more important. And do we really think the MCAT (and subsequent school prestige granted by a high MCAT score) is that much better a predictor of student outcomes than Step 1? I doubt that it is.

And before anyone argues that there are other variables that go into the med school selection process...yes, there are. But do you also really think undergrad volunteering, club involvement, and grades are going to be better predictors than Step 1? But this is where we are headed unfortunately.

It was short sighted change and I can believe people think otherwise. Sad!

 

[BeLikeH2O]

The data from the USMLE site on pass rates for USMD, USDO and international.

Only 50 to 60 percent of DO's take Steps. LOL, if all DO's take steps, especially the lower end DOs, the curve would not look like that. dont kid your self, there would be a gap that would be propostional to the MCAT gap for MD vs DO.

 

[efle]

Only 50 to 60 percent of DO's take Steps. LOL, if all DO's take steps, especially the lower end DOs, the curve would not look like that. dont kid your self, there would be a gap that would be propostional to the MCAT gap for MD vs DO.

Are the 60% taking it really that different than the other 40%?

 

[7331poas]

Are the 60% taking it really that different than the other 40%?

Probably I think. The only people taking it are those who thought they could compete in the MD match.

 

[throwaway1000000]

Used to be a strong advocate for step 1 and I still am.

But with the midlevel creep and anyone thinking they can practice medicine, going to med school must mean something that other professions don't have access to.

This online education is going to make it worse and worse. If I am just going to be studying from home using boards and beyond, the first 2 years should change to primarily online with decreased tuition, which is not going to happen.

Making step 1 pass/fail to bring students back to the classroom is not a bad idea when I think about it. OK with this change if it will bring back students to classrooms so medical schools have their own curriculum unique to physicians.

The curriculum should also be appropriately changed now that Step 1 is pass or fail. Would really like to see experienced clinicians teaching majority of these courses. I think a foundational lecture like boards and beyond that you watch at home followed by applying those concepts to real life cases in the classroom can be an excellent way to make someone a better clinician and more prepared for M3/M4. Also much more hands-on learning should be happening now that step 1 is changed to p/f.

When I listen to podcasts like the clinical problem solvers, curbsiders, etc, I am amazed how well teaching can be done that is clinically relevant. None of this dry powerpoint BS by both phds and clinicians. Every classroom session in M1/M2 years should be interactive and relevant to M3/M4 and residency.

 

[efle]

I think a foundational lecture like boards and beyond that you watch at home followed by applying those concepts to real life cases in the classroom can be an excellent way to make someone a better clinician and more prepared for M3/M4.

This is exactly what I did, and I was really bummed when I'd get to the small group led by an experienced clinician to work through example patients, and all my friends would just be banging away at flashcards ignoring the smallgroup as best they could.

I felt like I was prepared for MS3 at the end of preclinical, but my CBSE told me I was in the 210s. After cramming tons of rote minutiae into my head during dedicated and scoring well, I dumped all that knowledge in the next few weeks.

We're going to collectively look back in 10 years and see this as a good move

 

[AnatomyGrey12]

Are the 60% taking it really that different than the other 40%?

Yes. The bottom 26% of entering DO students have an MCAT below 500.

My personal suspicion is if USMLE were required of all DO's the pass rate would likely be in the range of 88%. However, I will say that on a school to school basis there are definitely certain DO schools that would easily perform equal to a low tier/State MD school level, and others that would have atrocious numbers.

 

[medschoolwoo]

Do we know for sure Step will be pass/fail for the class of 2024?

 

[Matthew9Thirtyfive]

Do we know for sure Step will be pass/fail for the class of 2024?

AFAIK, all that is certain is that the change will happen no sooner than Jan 2022.

 

[7331poas]

This is exactly what I did, and I was really bummed when I'd get to the small group led by an experienced clinician to work through example patients, and all my friends would just be banging away at flashcards ignoring the smallgroup as best they could.

I felt like I was prepared for MS3 at the end of preclinical, but my CBSE told me I was in the 210s. After cramming tons of rote minutiae into my head during dedicated and scoring well, I dumped all that knowledge in the next few weeks.

We're going to collectively look back in 10 years and see this as a good move

You only hold that position because you experience none of the negative consequences of this decision. Your opinion is moot.

 

[Mass Effect]

You only hold that position because you experience none of the negative consequences of this decision. Your opinion is moot.

A person's opinion does not become moot just because they're not personally impacted by it. If that was the case, then the only people allowed to make policy decisions would be only those people currently in it.