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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[pragusa]

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.

I think y'all are making quite a few assumptions here. Eliminating Step One does almost nothing to prevent 'Joe Schmoe' from going to a world-class institution. If you eliminate Step One, but keep the new 'Gateway A' exam scored, there's nothing to say that Residency Directors won't simply use the new exam - which, by design, would be much, much more appropriate than the current system of using a basic sciences exam for clinical positions.

 

[pragusa]

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

Good questions, and ones on which the CEUP spent a great deal of time and, in some cases, continues to spend considerable time on...

1.) Because this type of review hasn't been done since ~1985 and much has changed since then - in medicine, in basic sciences, in practice, in the broader social context, etc...

2.) It's not clear yet. It seems to be moving in that direction somewhat, but I wouldn't even say I'm 'confident' that there won't be a Step One when all is said and done.

3.) Unlikely, exactly for the reasons you mentioned.

Take care,

pr

 

[FrogE7]

Let me get this straight Mr. Pregusa:

If a certain grading system still exists for whatever exam that results, nothing really changes. Students still go buck wild to study for board scores. The only thing that HAS changed is the format of the test, and maybe the timing of when it is taken. All of this won't occur for several years, if at all. So all of us reading this board can just relax and focus on getting through the current system?

 

[pragusa]

Let me get this straight Mr. Pregusa:

If a certain grading system still exists for whatever exam that results, nothing really changes. Students still go buck wild to study for board scores. The only thing that HAS changed is the format of the test, and maybe the timing of when it is taken. All of this won't occur for several years, if at all. So all of us reading this board can just relax and focus on getting through the current system?

I disagree with your understanding. 'Nothing really changes'? No, a lot changes, and most of the changes will likely occur in content, format and structure, and possibly timing. 'Students still go buck wild to study for board scores'? Sure, because by and large, medical students are competitive. The idea is that it won't be necessary to 'go buck wild' because the exam will reflect the actual practice of medicine, which we are supposed to be learning in school. And yes, no doubt there will be a certain percentage of students who continue to 'go buck wild.'

But you are right about two things: 1.) It will likely be years before the test changes, and 2.) Yes, you can just relax because if it affects you at all, it will most likely be during Step 3 if you are already a medical student or will be matriculating this fall.

And by the way, Ragusa is spelled with two 'A's; no 'E'.

Take care,

pr

 

[Psycho Doctor]

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.

I was thinking the same thing...I guess it's the fact that he has "advisor" next to his name, he feels he has the right to...

 

[FrogE7]

I disagree with your understanding. 'Nothing really changes'? No, a lot changes, and most of the changes will likely occur in content, format and structure, and possibly timing. 'Students still go buck wild to study for board scores'? Sure, because by and large, medical students are competitive. The idea is that it won't be necessary to 'go buck wild' because the exam will reflect the actual practice of medicine, which we are supposed to be learning in school. And yes, no doubt there will be a certain percentage of students who continue to 'go buck wild.'

You missunderstand me: I believe that as long as there exists a test that is graded in a non-pass-fail manner, most medical students WILL freak out and take it to another level. In that aspect, things do not change.

 

[Hallm_7]

Hopefully this is part of the larger push to revamp medical education completely, which is being discussed I believe. After going through the first two years I think most of us agree there was a lot of needless information covered, and a lot of very pertinent information left out regarding clinical practice. It seems as medical science has gone forward, new information and subjects have been added but outdated information and methodologies haven't been purged. Going to a combined test would still allow for program directors to make judgements, and it would shift the testing criteria from basic science to clinical science. The shift in focus of the "judgement test" would result in a corresponding shift in focus of medical school.

I personally think we should move to a one-year preclinical period and a three-year clnical period. As it stands now, we are principally judged for residency by our understanding of basic science concepts with little regard for clinical decision making or skills. We also often choose a specialty before we even rotate through it in many instances, which has always baffled me.

I wouldn't be surprised if the Step II CS goes away before long. I haven't heard a single good thing about it, and at every national AMA event I go to there are always questionaires and focus groups discussing its merits or lack thereof. It's a waste of money, and in an environment where medical student debt is ballooning out of control it's hard to justify spending $1200 on a useless test.

 

[Law2Doc]

I personally think we should move to a one-year preclinical period and a three-year clnical period. As it stands now, we are principally judged for residency by our understanding of basic science concepts with little regard for clinical decision making or skills. We also often choose a specialty before we even rotate through it in many instances, which has always baffled me.

Well, I think there's still a majority of people who still feel that the basic science years provide useful foundation, even though it's not immediately clinically relevant, so I'd be surprised if that goes by the wayside. Most of the stuff you get "pimped" on will come from information studied in these years. You just don't know that it's relevant until you see how it all gets put together -- sort of like a Karate Kid "sand the floor/paint the fence" revelation. Probably is even more relevant each year because the percentage of non-science major students admitted to med school each year is increasing, so fewer people are showing up each year already having had a lot of courses besides the prereqs.

But I have certainly heard of frustration from department heads of specialties people don't get exposure to until 4th year at best, so I wouldn't be surprised if something was eventually done to accellerate exposure to an additional elective or two - a move which would appease these specialties and the students interested in them.