Step 1 to be abolished?????

[pauljack]

has anyone got any news on this C R A Z Y rumor that i just heard?

Apparently Step 1 is being taken offline sometime in the next year or two. Students going into M1 or M2 next year will be the last ones to take this exam.

i'm starting med school this year so this would be great for me if true.
does it mean that Step 2 scores will start to be important for matching? Willl Step 2 become the new Step 1. kinda makes sense that clinical knowledge will be more important than basic science in some ways.

what other news on this is out there?

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[Law2Doc]

has anyone got any news on this C R A Z Y rumor that i just heard?

Apparently Step 1 is being taken offline sometime in the next year or two. Students going into M1 or M2 next year will be the last ones to take this exam.

i'm starting med school this year so this would be great for me if true.
does it mean that Step 2 scores will start to be important for matching? Willl Step 2 become the new Step 1. kinda makes sense that clinical knowledge will be more important than basic science in some ways.

what other news on this is out there?

It is crazy, a rumor (you perhaps made up) and not very likely. Step 1 has become a huge money making cottage industry and too many livelihoods are at stake to get rid of it. Even aside from the board review companies, if the testing organization had to forego the almost $500 registration fee from each of the 20,000+ people who take Step 1 each year, they would be walking away from $10 mill in revenues. Does that still sound likely? In fact, not only will Step 1 continue, but as of this year they are reportedly expanding it to include audio and video. Expect Step 1 to be more involved, not gone by the time you take it. Sorry.

 

[Fin-Nor]

if there was ever a stupid post award of the day... this would win the award.

 

[diosa428]

Actually, there was a thread on SDN a couple of weeks ago saying the exact same thing. Apparently (according to that thread), Step I is eventually going to be combined with Step 2 to make a giant (and more expensive) test. It was confirmed by some people at some posters schools. Yes, I realize that's vague, but I don't think the OP made up that rumor.

 

[fakin' the funk]

How about a slightly more legitimate rumor:

Is Step 2 CS going to be d/c'd anytime soon?

 

[flumazenil]

hahah, this is fun. Ya, speaking of rumors, I also heard a rumor, can't remember where laugh, that in a few years, you can take Step 1 In groups of 5, and you get to use one professor of your choice and you also have an extra 8 hours to take the exam. anyone hear of this rumor?

 

[Just Applied]

This is not a rumor. My school made and announcement about a month ago, that the incoming class of 2007 will probably not be taking the USMLE step 1 due to a change in the way that they are going to be testing the information. So this is not a rumor and is an actual possibility at this point

 

[lord_jeebus]

I thought this was just a rumor but I've heard it indirectly from my school administration as well.

I don't think the plan is firm at this point, and the change is projected to take place around 2012. I think the general idea is to combine the content of Steps I and II into a single test taken after 3rd year. I doubt the people considering such a change have reached a consensus about anything.

 

[flumazenil]

okay just based on what i know about step 1..combining those two exams ..i cant even imagine. This is a very interesting thread

 

[lord_jeebus]

I should add that there are some who want to make the test Pass/Fail (!)

 

[71263]

I should add that there are some who want to make the test Pass/Fail (!)

Well, technically, the test is already pass/fail.

But yeah, I get your point. If they made it so it didnt matter how well we actually did, wed all be stressing alot less, thats for sure!

 

[marr]

Yep, heard about this rumor too from a school higher up. I don't think that this would help students from less prestigious school applying to high power residency though. Plus, if they combine the current step I into step II, I can't even imagine how students are going to review basic sciences and clinical. IMHO, I still like the current format, there has to be an objective way of measuring a student for residency which is Step I.

 

[FrogE7]

Yep, heard about this rumor too from a school higher up. I don't think that this would help students from less prestigious school applying to high power residency though. Plus, if they combine the current step I into step II, I can't even imagine how students are going to review basic sciences and clinical. IMHO, I still like the current format, there has to be an objective way of measuring a student for residency which is Step I.

exactly my worry

 

[Roy7]

I'm on my schools curriculum committee and step one will be changed to being after 3rd year and more integrative for all incoming freshman this year.

The goal is to make the exam more of a licensure exam as opposed to a "start third year exam".

That being said, according to my school nothing is set in stone yet although is it very very likely that this is what will be happening, as we're rearranging our first year curriculum to accommodate the upcoming changes.

Dont believe me consider it a rumor, eh, I dont care, it doesnt relate to me or matter much at all. Even if it changes, the new step 1 will be just as difficult and no easier or more relaxing.

 

[marr]

I'm on my schools curriculum committee and step one will be changed to being after 3rd year and more integrative for all incoming freshman this year.

The goal is to make the exam more of a licensure exam as opposed to a "start third year exam".

That being said, according to my school nothing is set in stone yet although is it very very likely that this is what will be happening, as we're rearranging our first year curriculum to accommodate the upcoming changes.

Dont believe me consider it a rumor, eh, I dont care, it doesnt relate to me or matter much at all. Even if it changes, the new step 1 will be just as difficult and no easier or more relaxing.

Wow!! What happens to student input in deciding whether step I goes or stays????

 

[Plead the Fifth]

Somewhere, a Kaplan rep cries......

 

[flumazenil]

or....that is what you may think..but somewhere many kaplan reps could be smiling

 

[KNightInBlue]

I should add that there are some who want to make the test Pass/Fail (!)

lol so for someone coming from a pass/fail school, his would mean that by the time they apply for residency, they'll have a transcript full of Ps for EVERYTHING..........how can the programs differentiate b/w applicants from that school?

 

[hucm2009]

Yes, I have also heard this rumor, from school administration and also from of all people a Kaplan representative, so I'm pretty sure the rumor has some truth behind it.

 

[doctorp82]

I'm on my schools curriculum committee and step one will be changed to being after 3rd year and more integrative for all incoming freshman this year.

The goal is to make the exam more of a licensure exam as opposed to a "start third year exam".

That being said, according to my school nothing is set in stone yet although is it very very likely that this is what will be happening, as we're rearranging our first year curriculum to accommodate the upcoming changes.

Dont believe me consider it a rumor, eh, I dont care, it doesnt relate to me or matter much at all. Even if it changes, the new step 1 will be just as difficult and no easier or more relaxing.

There are some schools (that have even been mentioned in other threads i.e. - UPenn) that do their boards post 3rd year already. I don't think it's required to do it before starting third year. In fact, some classmates of mine who for some academic reasons deferred their first rotation are going to take theirs during the timeframe the rest of us will be starting. According to blz UPenn's average step score is around 235.

If anyone has downloaded the 2007 practice items, you'll remember the three interactive questions at the end, with the video clip, and the auscultation. Eventually you'll have to know what the difference is between fixed split S2 and wide splitting of S2 simply by hearing it

 

[Law2Doc]

Yes, I have also heard this rumor, from school administration and also from of all people a Kaplan representative, so I'm pretty sure the rumor has some truth behind it.

I'll believe it when I see it. I'm not buying it -- Far too much money at stake for it to just be changed willy nilly. Because it is a big money maker, as well as providing across-school objective modes of comparison of students, the incentive is probably to have more, not fewer standardized tests. Even if there is discussion of such, we are probably talking about many many many years of figuring out how to work out all the kinks (it affects not only residency determinations, but timing of rotations at schools, transfers, etc), so it will be of no help for the OP or others just starting or already in school. I'd chalk it up to hollow rumor until there's a more realistic plan being talked about.

 

[Law2Doc]

Actually, there was a thread on SDN a couple of weeks ago saying the exact same thing.

If you are referring to what I think you are, one of the advisors floated a teaser for the test prep review week bearing this title. It was a joke header meant to get people to open the thread.

 

[Freshnstylin]

I don't think it's required to do it before starting third year. In fact, some classmates of mine who for some academic reasons deferred their first rotation are going to take theirs during the timeframe the rest of us will be starting.

wow that's pretty cool. our school will pull us out of rotations and make us take the test until we pass if our scores come back saying we failed

 

[Law2Doc]

wow that's pretty cool. our school will pull us out of rotations and make us take the test until we pass if our scores come back saying we failed

Ditto. It's like this at the majority of med schools from what I've heard.

 

[diosa428]

If you are referring to what I think you are, one of the advisors floated a teaser for the test prep review week bearing this title. It was a joke header meant to get people to open the thread.

I have no idea what thread you're talking about, but the one that I'm talking about had a very similar to the discussion that's going on right now. And it was several weeks before test prep week.

Edit: There was a brief discussion of it in this thread: http://forums.studentdoctor.net/showthread.php?t=398401

 

[foreverLaur]

There are some schools (that have even been mentioned in other threads i.e. - UPenn) that do their boards post 3rd year already.

?? I have a friend at UPenn who just finished her second year and is studying like mad for her boards. Do UPenn students have the option or is that false information ??

 

[G0S2]

One of my deans told me that he just returned from a national conference and the NBME and LCME "floated" the idea of combining Step 1 and 2. He also said that they don't "float" any idea unless it has already been decided upon. So it is true.

 

[Law2Doc]

I have no idea what thread you're talking about, but the one that I'm talking about had a very similar to the discussion that's going on right now. And it was several weeks before test prep week.

Edit: There was a brief discussion of it in this thread: http://forums.studentdoctor.net/showthread.php?t=398401

Hadn't seen that one -- That thread also came to a consensus identical to mine above that it will never happen because of financial reasons. Too much money out the window by eliminating this test.

 

[Law2Doc]

One of my deans told me that he just returned from a national conference and the NBME and LCME "floated" the idea of combining Step 1 and 2. He also said that they don't "float" any idea unless it has already been decided upon. So it is true.

What national conference? -- these things get memorialized and could provide actual info rather than rumor (if it's not just wishful talk).
From my prior career I would suggest that your post indicates a lack of organizational decision making understanding -- The whole point of "floating" an idea is to see how it will be received. If it's already decided upon then you never want to float it because you don't care how it will be recieved, you just announce. (To do otherwise risks waffling, is an invitation to comments that undermine your decision etc). Since your dean indicated it's a float (if true) it hasn't gotten to that decided upon stage. I'd still bank against it. Too much money at stake.

 

[MDPhoDollas]

lol so for someone coming from a pass/fail school, his would mean that by the time they apply for residency, they'll have a transcript full of Ps for EVERYTHING..........how can the programs differentiate b/w applicants from that school?

First, step1 isn't going anywhere--it works. All standardize tests evolve over years. But regarding the all P transcript: duh. Does the thought intimidate some students because they'll actually have to get up and DO something to show they aren't worthless rather than simply sit and read all day, every day? God forbid people actually build a cv. that's how you differentiate the coat-tail riders from the real deal.

 

[Law2Doc]

Does the thought intimidate some students because they'll actually have to get up and DO something to show they aren't worthless rather than simply sit and read all day, every day? God forbid people actually build a cv.

I still think the competitive residencies would rather know what kind of a student you were in the first two years than that you participated in X, Y and Z club and did some research (like everyone else will have also done if such were the only determinants). As you suggested in your initial sentence Step 1 serves a big purpose. (Even aside from being a huge money maker which is probably more important to NBME).

 

[diosa428]

What national conference? -- these things get memorialized and could provide actual info rather than rumor (if it's not just wishful talk).
From my prior career I would suggest that your post indicates a lack of organizational decision making understanding -- The whole point of "floating" an idea is to see how it will be received. If it's already decided upon then you never want to float it because you don't care how it will be recieved, you just announce. (To do otherwise risks waffling, is an invitation to comments that undermine your decision etc). Since your dean indicated it's a float (if true) it hasn't gotten to that decided upon stage. I'd still bank against it. Too much money at stake.

Is there a reason you feel the need to personally criticize EVERY post on this thread? You've stated your opionion (several times), but since it's not based on any data anymore than anyone else's posts are, I don't see the point of you repeatedly reintereting it.

BTW, if they are simply combining the Steps 1 and 2 (which I honestly don't see the point of - does anyone even know WHY they want to do this?), they could just charge twice as much for the test. And the score you get on the combined test could still be used for residency decisions, it would just have to be taken very close to the end of third year, rather than during fourth year. Soooo what's the big deal?

 

[MDPhoDollas]

I still think the competitive residencies would rather know what kind of a student you were in the first two years than that you participated in X, Y and Z club and did some research (like everyone else will have also done if such were the only determinants). As you suggested in your initial sentence Step 1 serves a big purpose. (Even aside from being a huge money maker which is probably more important to NBME).

This is my point. people that think joining x y and z club and "some research" are items for a cv are exactly who will be weeded out. again: the real deal performers will be easy to pick out of the application pool.

 

[Medical123]

Yep, heard about this rumor too from a school higher up. I don't think that this would help students from less prestigious school applying to high power residency though. Plus, if they combine the current step I into step II, I can't even imagine how students are going to review basic sciences and clinical. IMHO, I still like the current format, there has to be an objective way of measuring a student for residency which is Step I.

I also actually heard this from a Dean. She said that she was afraid that if they do combine Steps 1 and 2 and make it a Pass/Fail exam, that there will be much more emphasis on grades during the first two years and that schools will almost be forced to return to the old A,B,C,D,F grading system.

I don't know. Sometimes, I think too much emphasis is put on Step 1. A person, who would otherwise make a great clinician, is often barred from certain specialties because their board scores aren't high enough and it just may because they had a "bad day" for whatever reason (like getting a case of raging diarrhea in the middle of the test!). On the other hand, there has to be an adequate way for programs to weed through hundreds of applicants and decide who they want to interview. I think that if a student wants to shell out the money to do so, they should be allowed to take a Step exam more than once to improve their scores. The programs should see that there was more than one attempt and should see all scores and then make their decision from there.

 

[pauljack]

so i guess so far the consenus is "not confirmed but not denied".

Thanks, Law2Doc, for your apology after clearly seeing that I did not make this up. Oh....


Since this is a compulsory exam TPTB can charge what they like. Lost $$$ due to wiping out Step 1 can easily be clawed back from increased fees for whatever replaces it. The NBME care nothing for other businesses involved in this industry and neither should they. I guess Kaplan etc will just have to try to anticipate/keep up with changes.

Looks like I'll be taking Step 1 after all... or maybe not.

Thanks for your input everyone.

 

[leorl]

Man, if that turns out to be true...i'd like to march to the NBME head office and create some smackdown for all the frickin stress and anxiety they put as through...for potentially nothing? Not to mention the money. Maybe I should become a postal worker for a few years so i can go in postally disgruntled.

 

[Shangal]

why will they even want to abolish step 1? I thought administrators are out there to make our lives miserable! why didn't they abolish it last year?

Those bastards, damn them, damn them all!

 

[Law2Doc]

Thanks, Law2Doc, for your apology after clearly seeing that I did not make this up. Oh....

Well, in all fairness s/he didn't direct to the source of the rumor, just to another thread on SDN discussing it as a rumor. But ok, I apologize for suggesting you "perhaps" made it up. My bad.

 

[dowiattp]

How about a slightly more legitimate rumor:

Is Step 2 CS going to be d/c'd anytime soon?

This is actually a worthwhile point- I've heard from some deans that there is a fair amount of discussion about this with the possibility of CS going bye bye in the next 3-5 years...

 

[Law2Doc]

Is there a reason you feel the need to personally criticize EVERY post on this thread? You've stated your opionion (several times), but since it's not based on any data anymore than anyone else's posts are, I don't see the point of you repeatedly reintereting it.

On SDN if something is left unchallenged it's going to reappear a month from now as an "I heard someplace that..."

My posts on this thread span several days and I'm not rereading stuff to see what I already said a day ago. Didn't mean to be redundant or offend.

 

[Pepsy]

according to FA --> even though residencies do look at step scores (esp. the competitive ones), NBME keeps stressing that they dont want that to happen. ie, thats not what they intend step score to be. maybe they're thinking that its time they do something about it instead of complaining about PD's. Its not that unusual for it to happen.. but surely take some time.

lol.. that was funny about kaplan rep crying.. maybe they could attempt to sue?

 

[postbacker]

Several posters have pointed out the apparent misuse of absolute Step I scores for ranking of applicants by residency directors...seems to me a more logical approach would be to keep the test and make it pass/fail since it is intended for licensure purposes...

 

[foreverLaur]

Several posters have pointed out the apparent misuse of absolute Step I scores for ranking of applicants by residency directors...seems to me a more logical approach would be to keep the test and make it pass/fail since it is intended for licensure purposes...

Then how do you differentiate between residency applicants? Most schools as pass/fail as well. Residencies would have no grounds to compare and evaluate applicants. You'd never know that person A rocked step 1 and had straight A's while person B was iffy and average all around. They both passed.

 

[pragusa]

Hi y'all -

My name is Peter Ragusa. I am a third year student at the University of Minnesota. I am the consensus national student representative on the Committee to Evaluate the USMLE Program (CEUP). I'm also on the Step One Committee.

I don't have the time to address all of your questions or concerns, but I did want to clear up some things:

• The CEUP is still meeting and addressing all of your issues - nothing is final at this point. The next meeting is June 15th. I have been impressed with the thoughtfulness of the CEUP members. I once was very cynical about the USMLE, but now I am more confident in the motives and intents of those who run the program. We are continuing to solicit input from focus groups and discussion groups, but we also are inviting input from anyone wishing to give it. If you would like to provide us with your thoughts, please email me at: [email protected].
• It is true; there might not be a Step One in the future, although that is still a pending question and no one should understand it as a final reality. If your deans do, please inform them that it has not been decided as yet.
• The implementation timeframe depends on our recommendations. The general time horizon we are working on is 5-7 years, but that is subject to change based on our recommendations.

Please either post here or email me if you have any other questions or would like to provide the CEUP with feedback.

Thanks,

pr

 

[SoCuteMD]

Hi y'all -

My name is Peter Ragusa. I am a third year student at the University of Minnesota. I am the consensus national student representative on the Committee to Evaluate the USMLE Program (CEUP). I'm also on the Step One Committee.

I don't have the time to address all of your questions or concerns, but I did want to clear up some things:

• The CEUP is still meeting and addressing all of your issues - nothing is final at this point. The next meeting is June 15th. I have been impressed with the thoughtfulness of the CEUP members. I once was very cynical about the USMLE, but now I am more confident in the motives and intents of those who run the program. We are continuing to solicit input from focus groups and discussion groups, but we also are inviting input from anyone wishing to give it. If you would like to provide us with your thoughts, please email me at: [email protected].
• It is true; there might not be a Step One in the future, although that is still a pending question and no one should understand it as a final reality. If your deans do, please inform them that it has not been decided as yet.
• The implementation timeframe depends on our recommendations. The general time horizon we are working on is 5-7 years, but that is subject to change based on our recommendations.

Please either post here or email me if you have any other questions or would like to provide the CEUP with feedback.

Thanks,

pr

Thanks so much for posting - despite the fact that I won't be affected by this change I was very curious!

 

[MDPhoDollas]

Please either post here or email me if you have any other questions or would like to provide the CEUP with feedback.

Thanks,

pr

do you have any idea how this will affect a mudphud that starts with a class that takes the as-is step one and then returns from grad years to clinics with a class subject to the new system? also, does not affect me at all, but curious. if i started this year, took step one, and then had to take the "new" step1+2 after MS3 year...well, it might say QUEENS backwards across a few foreheads

 

[FrogE7]

Eliminating the Step 1 will make it harder for people who go to non-brand-name med schools, to get into competitive residencies. This is a one way of standardizing anything and proving a kid in an average medical school can potentially be just as good as some one from harvard med.

Judging by grades not only makes the process un-standardized, but also puts undue stress on people for two years. It will make the entire environment in medical school a lot more hostile by making already competitive medical students, even more cut throat. Medical students just do not need any more stresses of this sort.

I hope people realize the consequences before any real action is taken.

 

[marr]

Eliminating the Step 1 will make it harder for people who go to non-brand-name med schools, to get into competitive residencies. This is a one way of standardizing anything and proving a kid in an average medical school can potentially be just as good as some one from harvard med.

Judging by grades not only makes the process un-standardized, but also puts undue stress on people for two years. It will make the entire environment in medical school a lot more hostile by making already competitive medical students, even more cut throat. Medical students just do not need any more stresses of this sort.

I hope people realize the consequences before any real action is taken.

Totally agreed with this statement. Oh well, you better hope that you like the area your med school is in. With step I out of the way, residencies will most likely pick their own students and those coming from band name schools only. Joe Schmoe from podunk school will have no chance. If pre-meds are reading this, better get a 38, go to brand name school, chill for four years and still end up in a competitive residencies.

 

[pragusa]

do you have any idea how this will affect a mudphud that starts with a class that takes the as-is step one and then returns from grad years to clinics with a class subject to the new system? also, does not affect me at all, but curious. if i started this year, took step one, and then had to take the "new" step1+2 after MS3 year...well, it might say QUEENS backwards across a few foreheads

There almost certainly will be a phase-in period that will address the specifics of the 'in between' classes, those that start under the old system and transition to the new system during their time in school.

Thanks,

pr

 

[abhin]

Mr. Ragusa:

Thanks for posting here. I have (more than a) few questions:

1. What is the rationale for changing the current system? IOW, what's broken and needs fixing, in the views of the CEUP?

2. Will Step I be replaced by a combined Step I and Step II exam?

3. Also, is it likely that any new test will be strictly P/F, with no additional means of ranking relative performance on the exam?

On balance, I think the latter move would be a mistake--residency programs must rank applicants in some manner (given the sheer numbers of applicants per position). Eliminating a relatively objective standard will only promote far more subjective markers of competence, including the 'prestige' of a school as well as GPA. All this is likely (all else being equal) to increase the competitive advantage of 'prestige' medical school grads for the most sought after residency spots.

Regards,
Abhin