What's the MAIN reason behind people not passing the Step 1?

[Knicks]

(I purposely chose the phrase, "not passing" as opposed to,,,,, well, the F-word)


Anyway, hear me out:

People who get into med school got there because obviously they are bright individuals with a solid work ethic.

Presumably these people (we, med students) are going to be just as diligent once IN med school, perhaps even MORE.

So why do people occasionaly not pass, especially students who were average or above average in their med schools? Surely, it can't be due to lack of knowledge.


Is it just being nervous? Being a poor standardized test-taker?

Other than not studying enough (which probably is unlikely among med students preparing for Step 1), and barring any personal life problems, how/why do people not pass?

This is not a mocking thread or anything of the sort,,,,,, just stressed out as usual while studying for this damned thing and I guess I'm venting.

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[Law2Doc]

(I purposely chose the phrase, "not passing" as opposed to,,,,, well, the F-word)


Anyway, hear me out:

People who get into med school (especially U.S. med schools) got there because obviously they are bright individuals with a solid work ethic.

Presumably these people (we, med students) are going to be just as diligent once IN med school, perhaps even MORE.

So why do people occasionaly not pass, especially students who were average or above average in their med schools? Surely, it can't be due to lack of knowledge.


Is it just being nervous? Being a poor standardized test-taker? If it's the latter, isn't it a shame that someone's future could be decided by this OBJECTIVELY insignficant "short-coming"? (actually both would be silly reasons to determine someone's future).

Some "fair" test this is, huh?


Other than not studying enough (which probably is a rare thing among med students preparing for Step 1), and barring any personal life problems, how/why do people not pass?

This is not a mocking thread or anything of the sort,,,,,, just stressed out as usual about this damned thing and I guess I'm venting.

I suspect test anxiety and poor test taking skills are the biggies. Inadequate preparation is probably much further down on the list because most people who take it passed their school courses and have been studying hard for over a month, however there are certainly folks who put too much reliance on certain resources (eg First Aid) that only get you part of the way to the finish line, and so unless you really delve into multiple resources and use FA etc just as a backbone, not the primary learning tool, I could see how you might be SOL.

 

[bambi]

People who get into med school (especially U.S. med schools) got there because obviously they are bright individuals with a solid work ethic.

Especially U.S. med schools????????

 

[Taus]

I don't doubt that test-taking skills and anxiety play a role.....but IMO the key problem is not realizing the big difference b/w studying "enough" and studying "efficiently/smart".

 

[LadyWolverine]

Spending too much time on SDN.

 

[Knicks]

Especially U.S. med schools????????

*sighhhhh* I didn't mean anything bad/offensive by it,,,,, you did this in my other thread too. Please stop.


Anyway, what's "SOL"?

I don't doubt that test-taking skills and anxiety play a role.....but IMO the key problem is not realizing the big difference b/w studying "enough" and studying "efficiently/smart".

hmmmm, interesting take on it. In your opinion, what IS the difference between those two?

Thanks.

 

[Law2Doc]

Anyway, what's "SOL"?

An acronym we can't spell out on SDN. Check out an urban dictionary online.

 

[tfom08]

(I purposely chose the phrase, "not passing" as opposed to,,,,, well, the F-word)


Anyway, hear me out:

People who get into med school (especially U.S. med schools) got there because obviously they are bright individuals with a solid work ethic.

Presumably these people (we, med students) are going to be just as diligent once IN med school, perhaps even MORE.

So why do people occasionaly not pass, especially students who were average or above average in their med schools? Surely, it can't be due to lack of knowledge.


Is it just being nervous? Being a poor standardized test-taker? If it's the latter, isn't it a shame that someone's future could be decided by this OBJECTIVELY insignficant "short-coming"? (actually both would be silly reasons to determine someone's future).

Some "fair" test this is, huh?


Other than not studying enough (which probably is unlikely among med students preparing for Step 1), and barring any personal life problems, how/why do people not pass?

This is not a mocking thread or anything of the sort,,,,,, just stressed out as usual about this damned thing and I guess I'm venting.

Creating too many threads on SDN instead of studying.

 

[alpha06]

Lack of discipline.

 

[highyield]

what i observed from one person who didn't do well:


worrying more about highlighting/color coding with tabs than actually reading/memorizing

worrying more about organizing study time that actually studying

telling others how much they are studying rather than studying.



i also bet that some people just get unbalanced tests that are really heavy in their weaker areas.

 

[JeffLebowski]

Is it just being nervous? Being a poor standardized test-taker? If it's the latter, isn't it a shame that someone's future could be decided by this OBJECTIVELY insignficant "short-coming"? (actually both would be silly reasons to determine someone's future).

Let me just preface by saying I did well and am very thankful for that, and realize that a poor performance can probably happen to anyone - I'm not trying to be judgmental here.

That said, why is a standardized test such a silly "reason to determine someone's future"? This isn't 6th grade PE class where everyone gets to play quarterback and everyone gets a trophy at the end of the season. This is medical school and an academic profession, if you can't perform on objective measurements of your medical knowledge, you can't expect to have access to the same opportunities as someone who did. What's the difference between someone who doesn't have the knowledge/work ethic/reasoning skill and someone who's just a "bad test-taker"? More importantly, how would you suggest differentiating between the two? I don't mean to be harsh, but I've heard this before in various forms ("I have test anxiety", "I'm a bad standardized test-taker", etc.) at various stages of pre-medical & medical training and I've never been clear on what exactly they were claiming or implying.

 

[JeffLebowski]

what i observed from one person who didn't do well:


worrying more about highlighting/color coding with tabs than actually reading/memorizing

worrying more about organizing study time that actually studying

telling others how much they are studying rather than studying.



i also bet that some people just get unbalanced tests that are really heavy in their weaker areas.

While I agree with you when you say that these can be harmful if overdone or done without the studying to back it up, I just want to interject that in my opinion being organized in your highlighting, underlining, tabs, & with your study time is crucial, there's far too much material, far too much reading, and far too little time to be unorganized in your studying. Being organized is the best way to make an overwhelming task whelming.

 

[Knicks]

.........why is a standardized test such a silly "reason to determine someone's future"?..........

Why? Because of the two possible reasons you quoted from me. A person can have the highest knowledge of the material but they just got nervous, or they're simply poor test-takers (aka it has nothing to do with not being bright or knowing the material).

This isn't 6th grade PE class where everyone gets to play quarterback and everyone gets a trophy at the end of the season.

Of course this isn't, I never implied that it was.

This is medical school and an academic profession, if you can't perform on objective measurements of your medical knowledge, you can't expect to have access to the same opportunities as someone who did.

Of course you can't expect that, noone in their right mind would expect that. What I was trying to say was that there are/could be other factors that could hinder the objectivity of the exam that go over-looked in the final selection process.

What's the difference between someone who doesn't have the knowledge/work ethic/reasoning skill and someone who's just a "bad test-taker"?

What's the difference???? I'm glad you asked. Well someone may NOT have the "knowledge/work ethic/reasoning skill" and fail the test; no surprise/remorse here. However another person WILL have the "knowledge/work ethic/reasoning skill" but simply be a poor test-taker, and therefore, fail; and this is wherein lies the tragedy, because this person may have been a great doctor in their desired field, but alas! he/she turned out to be a poor test-taker. What's the difference???? There's a WORLD's difference. And anyone in the latter category in this example who might fail this test because of that reason has the right to say "unfair test", or rather "unfair selection process". Because failing it had NOTHING to do with lack of "knowledge/work ethic/reasoning skill".

More importantly, how would you suggest differentiating between the two?

That's not my problem. My problem is discussing the way it's CURRENTLY [not] being differentiated.

I don't mean to be harsh, but I've heard this before in various forms ("I have test anxiety", "I'm a bad standardized test-taker", etc.) at various stages of pre-medical & medical training and I've never been clear on what exactly they were claiming or implying.

Well, I hoped to have cleared up any confusion for you.



Anyway, this thread isn't about me thinking the test is unfair (although it may be a part of it), so let's get back on track here (as we were before your post).

While I agree with you when you say that these can be harmful if overdone or done without the studying to back it up, I just want to interject that in my opinion being organized in your highlighting, underlining, tabs, & with your study time is crucial, there's far too much material, far too much reading, and far too little time to be unorganized in your studying. Being organized is the best way to make an overwhelming task whelming.

Agreed.

 

[GMDMD]

There is no main reason. For every person it is different. Some people just aren't book smart. Others just aren't that smart period. Others are bad test takers (although I believe with decent brains a sufficient amount of hard work should negate any test-taking deficits, at least to prevent failing). Some were lazy during test prep. Others were lazy during pre-clinical years (hard to review stuff you never learned). I'm sure a very significant portion fail due to personal or family issues.

Take your pick. Any one of these can sink you. Any combo and you are screwed.

 

[tfom08]

What's the difference???? Well someone may NOT have the "knowledge/work ethic/reasoning skill" and fail the test; no surprise/remorse here. However another person WILL have the "knowledge/work ethic/reasoning skill" but simply be a poor test-taker, and therefore, fail; and this is wherein lies the tragedy, this person may have been a great doctor in their desired field, but alas! he/she turned out to be a poor test-taker. What's the difference???? There's a WORLD's difference. And anyone in the latter category in this example who might fail this test because of that reason has the right to say "unfair test", or rather "unfair selection process". Because failing it had NOTHING to do with lack of "knowledge/work ethic/reasoning skill".

This is an honest question, not to antagonize you. Can you give an example in which someone who has the knowledge to answer the question, along with the reasoning ability to understand what the question is trying to ask, but can't answer the question because they are a "poor test taker". I truly do not understand what the term means. Does it mean that a person gets very nervous and loses the ability to think logically and retrieve information from their memory as they are able most of the time when they are not nervous? I hear people throw the term "poor test taker" around, but does it actually mean something or is it just a term for people who have a history of poor performances on tests?

 

[JeffLebowski]

First let me just say that I understand your point and agree that Step 1 may not be the most ideal measurement of medical knowledge/reasoning and that it may be over-utilized for residency selection. I'll try to address your responses.

Why? Because of the two possible reasons you quoted from me. A person can have the highest knowledge of the material but they just got nervous, or they're simply poor test-takers (aka it has nothing to do with not being bright or knowing the material).;

Yes, nerves are definitely a factor, and it may not be a fair factor if we're saying Step 1 should solely assess a student's knowledge/reasoning. I would argue that "anxiety" or nerves are something reasonable to require people to overcome, however. And as I mentioned, I don't know how to differentiate between a person who's a bad test-taker and a person who can't answer questions well because of lack of knowledge/reasoning. Pretty gray area.

What's the difference???? Well someone can NOT have the "knowledge/work ethic/reasoning skill" and fail the test. But another person WILL have the "knowledge/work ethic/reasoning skill" but simply be a poor test-taker, and therefore, fail. What's the difference???? There's a WORLD's difference. And anyone in the latter category in this example who might fail this test because of that reason has the right to say "unfair test". Because failing it had NOTHING to do with lack of "knowledge/work ethic/reasoning skill".

Yet the vast majority of medical students pass it. I think therefore the exam is reasonably suited to "allow" medical students to continue toward practicing medicine. And I believe the NBME makes accommodations for people with learning disabilities (such as ADD & dyslexia, I believe?), I just don't buy the idea that being a bad test-taker is a disability of some sort, though I may be wrong.

But I think your main point was that too much emphasis is put on an exam that can be heavily influenced by some pretty significant factors that have little to do with a person's ability to practice medicine, which you may be right about. While I empathize with people unfortunate in these factors, I disagree that nerves & being a bad test-taker are insignificant.

That's not my problem. My problem is discussing the way it's CURRENTLY [not] being differentiated.

Lacking a better option, I think Step 1 does a reasonable job of assessing medical students' knowledge, reasoning, and work studying. This is coming from a person who came out of the test feeling like crap and believed right up until I got my score that it's possible I failed and very possible my score wouldn't reflect my grades, work, studying, and knowledge. I do understand. I just don't think the right way to approach the issue is to place all the blame on the test.

 

[Knicks]

This is an honest question, not to antagonize you. Can you give an example in which someone who has the knowledge to answer the question, along with the reasoning ability to understand what the question is trying to ask, but can't answer the question because they are a "poor test taker". I truly do not understand what the term means. Does it mean that a person gets very nervous and loses the ability to think logically and retrieve information from their memory as they are able most of the time when they are not nervous? I hear people throw the term "poor test taker" around, but does it actually mean something or is it just a term for people who have a history of poor performances on tests?

Yeah, I guess it could mean that.


But whatever, fine, the test IS fair. whateverrrr. LoL.


back on topic.

First let me just say that I understand your point and agree that Step 1 may not be the most ideal measurement of medical knowledge/reasoning and that it may be over-utilized for residency selection. I'll try to address your responses.



Yes, nerves are definitely a factor, and it may not be a fair factor if we're saying Step 1 should solely assess a student's knowledge/reasoning. I would argue that "anxiety" or nerves are something reasonable to require people to overcome, however. And as I mentioned, I don't know how to differentiate between a person who's a bad test-taker and a person who can't answer questions well because of lack of knowledge/reasoning. Pretty gray area.



Yet the vast majority of medical students pass it. I think therefore the exam is reasonably suited to "allow" medical students to continue toward practicing medicine. And I believe the NBME makes accommodations for people with learning disabilities (such as ADD & dyslexia, I believe?), I just don't buy the idea that being a bad test-taker is a disability of some sort, though I may be wrong.

But I think your main point was that too much emphasis is put on an exam that can be heavily influenced by some pretty significant factors that have little to do with a person's ability to practice medicine, which you may be right about. While I empathize with people unfortunate in these factors, I disagree that nerves & being a bad test-taker are insignificant.



Lacking a better option, I think Step 1 does a reasonable job of assessing medical students' knowledge, reasoning, and work studying. This is coming from a person who came out of the test feeling like crap and believed right up until I got my score that it's possible I failed and very possible my score wouldn't reflect my grades, work, studying, and knowledge. I do understand. I just don't think the right way to approach the issue is to place all the blame on the test.

Actually, I agree with everything you just said.

(not being sarcastic either)

 

[JeffLebowski]

Yeah, I guess it could mean that.


But whatever, fine, the test IS fair. whateverrrr. LoL.


back on topic.

Fair enough, there's probably a better place to discuss it.

As for the topic, I think language difficulty is a significant reason for failing.

 

[GMDMD]

What's the difference???? Well someone may NOT have the "knowledge/work ethic/reasoning skill" and fail the test; no surprise/remorse here. However another person WILL have the "knowledge/work ethic/reasoning skill" but simply be a poor test-taker, and therefore, fail. What's the difference???? There's a WORLD's difference. And anyone in the latter category in this example who might fail this test because of that reason has the right to say "unfair test". Because failing it had NOTHING to do with lack of "knowledge/work ethic/reasoning skill".

I really don't think it's too much to ask to have people who are in charge of other people's lives be required to score a 186 on Step1. Let's stop pretending this bar is like performing rocket-surgery.

Your statement is a pretty much a contradiction. If you have knowledge, work ethic and reasoning skill unless you have personal/family problems there is absolutely no excuse for failing the test. With knowledge and reasoning skill, a reasonable work ethic can overcome any test taking disabilities to the point of PASSING. So we're either talking someone who is lazy, someone who lacks knowledge or someone without reasoning skills. To be frank, I wouldn't want someone who can't clear 185 making dynamic decisions with my life or those of my family members on the line.

 

[ZonaRidicularis]

z

 

[Knicks]

I really don't think it's too much to ask to have people who are in charge of other people's lives be required to score a 186 on Step1. Let's stop pretending this bar is like performing rocket-surgery.

Your statement is a pretty much a contradiction. If you have knowledge, work ethic and reasoning skill unless you have personal/family problems there is absolutely no excuse for failing the test. With knowledge and reasoning skill, a reasonable work ethic can overcome any test taking disabilities to the point of PASSING. So we're either talking someone who is lazy, someone who lacks knowledge or someone without reasoning skills. To be frank, I wouldn't want someone who can't clear 185 making dynamic decisions with my life or those of my family members on the line.

yeah, I wouldn't either, and I agree with you too.


Man, I regret including that little "unfair" tid-bit in the OP. That wasn't supposed to be the point of the thread.

In fact, I'm gonna go edit the OP.

 

[tfom08]

I think language difficulty is a significant reason for failing.

That's got to be the #1 reason. I mean, if you can't comprehend written english as quickly as 95% of other test takers, obviously your knowledge needs to be that much superior to the average test taker just to get a reasonable score. Especially with the seemingly longer question stems lately, perhaps this is becoming even more important of a factor.

 

[veenut]

I suspect test anxiety and poor test taking skills are the biggies. Inadequate preparation is probably much further down on the list because most people who take it passed their school courses and have been studying hard for over a month, however there are certainly folks who put too much reliance on certain resources (eg First Aid) that only get you part of the way to the finish line, and so unless you really delve into multiple resources and use FA etc just as a backbone, not the primary learning tool, I could see how you might be SOL.

I could see this being the difference between pulling a 220 and a 250, but if you only used FA and failed the test - you didn't really learn FA too well. I think a complete understanding of FA should get most people a 220-230 at least...

 

[tfom08]

those who go into the exam with barely passing NBME scores (or any other form of performance predictor) yet go and take the exam anyways and pray afterwards that they get a 240. When they don't pass they chalk it up to things that are seemingly out of their control (test-anxiety, bad standardized test takers) but don't truly look at what their own fault was.

Sounds like a behavioral science stem. Denial or rationalization?

 

[QuikClot]

This is an honest question, not to antagonize you. Can you give an example in which someone who has the knowledge to answer the question, along with the reasoning ability to understand what the question is trying to ask, but can't answer the question because they are a "poor test taker". I truly do not understand what the term means. Does it mean that a person gets very nervous and loses the ability to think logically and retrieve information from their memory as they are able most of the time when they are not nervous? I hear people throw the term "poor test taker" around, but does it actually mean something or is it just a term for people who have a history of poor performances on tests?

A multiple choice test is a very different animal compared to, say, clinical practice. You have to know how to chose an answer based on hints in wording of the question, how to chose an answer by eliminating the other choices, and some pretty sophisticated reading comprehension skills to quickly grasp where the question is leading you.

Basically, taking the test is a skill in itself. As with any skill, some people are talented, most people learn with practice, and some people always struggle.

Obviously knowledge plays a big role in the score you get. But many other things come into play. Intuitive, quick, book-loving people tend to kill standardized tests. In my experience, minds that are systematic and methodical -- ICU/path types -- sometimes struggle with the shortcuts and hints that many people pick up without ever being aware of it.

 

[mom2four]

This is a very good thread. I am glad that you posted it KNICKS because I think you make some very good points and they are very often dismissed by those who feel that they as future doctors are superior based on these scores. Something that has not been brought up is the fact that people learn in different ways and that in turn demonstrate their retention of concepts ability to process them etc.... in different ways too. Standardized tests cater to a certain type of learner. I believe that these are the people who really blow the top off. I do not believe that their knowledge is superior than many or that they have worked harder (obviously there are exceptions) than many just that the have a "knack" for excelling at these type of assessments. People of all ages suffer from performing poorly on these and sometimes they are even categorized as learning disabled or some other degrading label. I mean it has turned many school teachers into inefficient educators because they have to focus on "teaching to the test". They spend more time training children how to take tests than helping them learn. God forbid they lose their funding. Some schools have gotten creative and do not test this way but it will eventually happen. Granted there needs to be a way to measure students against each other to bad no one has come up with a better way. If taking these type of tests is not your strong point one can only pray that the people who will end up deciding your fate will look at your application as a whole where hopefully your true knowledge and skill will be conveyed. Maybe some sort of point system that allowed all of the components of your application to have certain weight could work. This could in turn help students who felt they were not given a fair evaluation in the clinical areas of medical school. Of course I think that these are much more important that what the exams say. There is difficulty with this too because as you all know these evaluations can be totally subjective.
Oh and even people who do great on the test still have to look up stuff I have seen many doctors do it right in front of me.

I agree with Overfiend too discipline is key it just sucks that some have use some much more than others but hey that's life. We all have to deal with our "shortcomings" ,because we all have them, at one time or another and look at our whole life to measure our success. i have more to say but think that was enough.

 

[mom2four]

A multiple choice test is a very different animal compared to, say, clinical practice. You have to know how to chose an answer based on hints in wording of the question, how to chose an answer by eliminating the other choices, and some pretty sophisticated reading comprehension skills to quickly grasp where the question is leading you.

Basically, taking the test is a skill in itself. As with any skill, some people are talented, most people learn with practice, and some people always struggle.

Obviously knowledge plays a big role in the score you get. But many other things come into play. Intuitive, quick, book-loving people tend to kill standardized tests. In my experience, minds that are systematic and methodical -- ICU/path types -- sometimes struggle with the shortcuts and hints that many people pick up without ever being aware of it.

This is part of what I am talking about. I totally agree.

 

[ZonaRidicularis]

z

 

[mom2four]

That's got to be the #1 reason. I mean, if you can't comprehend written english as quickly as 95% of other test takers, obviously your knowledge needs to be that much superior to the average test taker just to get a reasonable score. Especially with the seemingly longer question stems lately, perhaps this is becoming even more important of a factor.

This is true but that is problem that really cannot be remedied as easily as taking an oath to the country in your native language.

 

[Knicks]

A multiple choice test is a very different animal compared to, say, clinical practice. You have to know how to chose an answer based on hints in wording of the question, how to chose an answer by eliminating the other choices, and some pretty sophisticated reading comprehension skills to quickly grasp where the question is leading you.

Basically, taking the test is a skill in itself. As with any skill, some people are talented, most people learn with practice, and some people always struggle.

Obviously knowledge plays a big role in the score you get. But many other things come into play. Intuitive, quick, book-loving people tend to kill standardized tests. In my experience, minds that are systematic and methodical -- ICU/path types -- sometimes struggle with the shortcuts and hints that many people pick up without ever being aware of it.

This is a very good thread. I am glad that you posted it KNICKS because I think you make some very good points and they are very often dismissed by those who feel that they as future doctors are superior based on these scores. Something that has not been brought up is the fact that people learn in different ways and that in turn demonstrate their retention of concepts ability to process them etc.... in different ways too. Standardized tests cater to a certain type of learner. I believe that these are the people who really blow the top off. I do not believe that their knowledge is superior than many or that they have worked harder (obviously there are exceptions) than many just that the have a "knack" for excelling at these type of assessments. People of all ages suffer from performing poorly on these and sometimes they are even categorized as learning disabled or some other degrading label. I mean it has turned many school teachers into inefficient educators because they have to focus on "teaching to the test". They spend more time training children how to take tests than helping them learn. God forbid they lose their funding. Some schools have gotten creative and do not test this way but it will eventually happen. Granted there needs to be a way to measure students against each other to bad no one has come up with a better way. If taking these type of tests is not your strong point one can only pray that the people who will end up deciding your fate will look at your application as a whole where hopefully your true knowledge and skill will be conveyed. Maybe some sort of point system that allowed all of the components of your application to have certain weight could work. This could in turn help students who felt they were not given a fair evaluation in the clinical areas of medical school. Of course I think that these are much more important that what the exams say. There is difficulty with this too because as you all know these evaluations can be totally subjective.
Oh and even people who do great on the test still have to look up stuff I have seen many doctors do it right in front of me.

I agree with Overfiend too discipline is key it just sucks that some have use some much more than others but hey that's life. We all have to deal with our "shortcomings" ,because we all have them, at one time or another and look at our whole life to measure our success. i have more to say but think that was enough.

Yes, thank you guys.

I knew there had to be some people out there who could understand where I was coming from.

 

[bambi]

*sighhhhh* I didn't mean anything bad/offensive by it,,,,, you did this in my other thread too. Please stop.


Anyway, what's "SOL"?




hmmmm, interesting take on it. In your opinion, what IS the difference between those two?

Thanks.

The other one was more me being fussy but this is just rude, you are out of your mind if you think the U.S. is the hardest place to get into med school.

 

[bambi]

This is an honest question, not to antagonize you. Can you give an example in which someone who has the knowledge to answer the question, along with the reasoning ability to understand what the question is trying to ask, but can't answer the question because they are a "poor test taker". I truly do not understand what the term means. Does it mean that a person gets very nervous and loses the ability to think logically and retrieve information from their memory as they are able most of the time when they are not nervous? I hear people throw the term "poor test taker" around, but does it actually mean something or is it just a term for people who have a history of poor performances on tests?

Yeah, I don't really get this either, surely if you know and understand the information properly you do well? Yeah nerves might lose you a few points but you aren't going to sit there all day really nervous, you relax after a while. Allow another few marks for silly mistakes but you should still pass. I don't think I have even heard the term "poor standardized test taker" anywhere but on here, I really don't get it.

 

[Law2Doc]

I could see this being the difference between pulling a 220 and a 250, but if you only used FA and failed the test - you didn't really learn FA too well. I think a complete understanding of FA should get most people a 220-230 at least...

Two responses to that: First, FA is a horrible resource to "learn" (or "understand") from, but adequate as a refresher. If you sat down and tried to learn from that without having a strong grasp of the underlying material, you really wouldn't get much out of it. It is truly meant to be a backbone on which to supplement knowledge, not your end all be all resource, and not enough to get you to an above average scores as you suggest. Second, it likely depends on the test questions you got, but I'd say more than the 30 "point" difference you describe on many people's tests constituted things not found in FA. You really do need to supplement, in almost every high yield subject. There are multiple threads on here each year of folks who tried to just use FA and a question bank and didn't do decently, and I kind of doubt all of them were folks who didn't get a "complete understanding" of FA. Truth of the matter is this probably got them to passing, but didn't get them around the bases as you describe. You have to keep in mind that FA, although useful, is a resource compiled by students and former students of what they have seen on tests. It is a guestimate, and a well broadcasted one at that. The test-makers see this and often choose to create questions not easily answered with this resource. This is why FA needs to be revised year after year -- things change, new stuff gets added to the test all the time.

You can rely on whatever you want, but I'd sure not expect to be above average using that one resource. And so I'd continue to put use of inadequate resources (such as this one) on this list of why folks don't pass.

 

[hj0517]

I hope this helps the OP. I think there are two ways in which you can approach this set of exams:

1. Research, be organized gather information from places like SDN, look at charting outcomes AND feel sorry for yourself and your circumstance - IMG right? Feel its unfair to take standardized tests that were tailored for a specific cohort of graduates and theorize that being good at Step 1 doesn't make you a good doctor, much like passing your driving test...

2. Research, be organized gather information from places like SDN, look at charting outcomes AND get your head down, work damned hard because the odds are frankly stacked against you (but hey, you chose to play the game) and you know what it takes. Like others said, work hard but also work smart and do the best you can.

This is what I am doing and I hope it works, standardized tests are necessary. After all, isn't this a selection process? Also like Bambi said, don't be fooled that its just the US that does this. The PGY training for UK specialties are SO SO competitive (even family practice) and thats the same in OZ.

If your test taking skills are poor do 7 blocks of UW timed unused, or do an NBME with nothing but yourself and the computer. I have never failed a standardized test but if this is where I start I will not be blaming it on my test taking skills. If you got into med school you should be smart enough to realize where you are going wrong and what you can do to correct it.

 

[Lany]

quite an interesting thread. IMO, Step1 is not written to just to test knowledge but also checks:
- whether we can perform under anxiety, stress
- know where to focus
- have understanding of concepts than rote memorization
- language skills
- quick thinking
- be able to avoid distractors (that are right in front of you) .. etc.

After step1 questions are written (testing knowledge) by docs, and its molded by psychologists (testing other criteria).. so i've heard.

While people claim that they're bad test takers.. its def. a part but only a small part and there are ways one can attempt to fix it. If one has knowledge yet dont know how to apply it or get too nervous and freak out (for various reasons), it might not be safe to put other people's lives on their hand in near future. We are ALL bit nervous walking into the exam but that shouldnt extensively damage performance.

Also as time progresses, we are expected to perform better and better and being able to enter med school takes bit of effort yet being able to pass each step requires more and more. We are basically pushing our limits further and further and one day shall reap the rewards.

conclusion: dont try to be better than someone else but be better than how you were yesterday and keep at it.

 

[mom2four]

quite an interesting thread. IMO, Step1 is not written to just to test knowledge but also checks:
- whether we can perform under anxiety, stress
- know where to focus
- have understanding of concepts than rote memorization
- language skills
- quick thinking
- be able to avoid distractors (that are right in front of you) .. etc.

After step1 questions are written (testing knowledge) by docs, and its molded by psychologists (testing other criteria).. so i've heard.


Well I think that this is part of the point that being said I think that we can agree that studying FA and listening to Goljan is not going to fix the things mentioned. So to anyone who implies that you just don't know enough to pass its just not that simple. These are skills are not specific to the medical field no doubt that somone taking the BAR would have either the same difficulty or ease depending on these factors. The real question is what can you to remedy these problem now? I don't think there many Med Schools out there that are addressing this issue because it really has nothing to do with medicine. I suppose that the people lacking in these particular skills have made up for it ins different way but it gets to point where their "coping" skills are no longer effective. Sort of like the child that graduates high school without learning to read. Maybe it would help these particular students if they (so that they could prepare accordingly)were informed of what the true objectives of these tests are after all should not the diploma from your accredited school suffice for proof that you know the material . The fact that the majority of people pass is why these guys are left out to dry but is it fair since the reason the may not be passing has little to do with what they are learning in Med school?
So if you think you fall into this category don't sell yourself short by not seeking help.

And of course I am only talking about the written exam if a person can not perform on this this test and performs poorly during clinicals too than that is another issue entirely.

 

[Tiger26]

For everybody whining about step 1, we've all got to realize that every pt we see is like a new test in and of itself. Some have problems easier to answer than others, but you're still presented w/a problem and forced to reach an answer. The only thing is that in real life everything has a lot more gray areas and their aren't any multiple choice answers.

 

[Law2Doc]

For everybody whining about step 1, we've all got to realize that every pt we see is like a new test in and of itself. Some have problems easier to answer than others, but you're still presented w/a problem and forced to reach an answer. The only thing is that in real life everything has a lot more gray areas and their aren't any multiple choice answers.

But in real life you get to look things up and can consult specialists if you need to. If they let us do that on the boards I suspect scores would be a lot higher.

 

[Blesbok]

The main reason people don't pass is poor study skills or poor study commitment. People don't go from getting 250s on the NBME to not passing because they are anxious unless their anxiety literally cripples them to the point of not being able to click a mouse. And if that is the case, then you probably shouldn't be in medicine in the first place, because what is going to happen when you have to make a life and death decision for a patient in the next 10 seconds. Poor standardized test taker might have something to do with it also, but again, if you can't get a 50% on a standardized test with multiple choice answers, what is going to happen when you have an atypical presentation of a disease in a clinic?

I am not trying to say that there aren't people that have both of the problems that you describe, but there are also hundreds of other students that have these problems that end up doing just fine on the test.

If you have the knowledge and you worked hard in first and second year, neither of these problems is going to prevent you from at least passing the test.

 

[Knicks]

...........If you have the knowledge and you worked hard in first and second year, neither of these problems is going to prevent you from at least passing the test.

I agree.

Those were ONLY 2 possible examples I thought of when making the thread, and I made the thread to get people's opinions about what other reasons could be.

Maybe I shouldn't have included specific examples in the OP, as this led to side-discussions here.

 

[45408]

The other one was more me being fussy but this is just rude, you are out of your mind if you think the U.S. is the hardest place to get into med school.

You're out of your mind if you think you have been reading these posts appropriately. Try it again.

 

[Knicks]

^^

 

[bambi]

I can read just fine thanks but what he said in this post was rude, he basically said that you have to be intelligent to get into med school in the U.S. and implied that the same might not be true or as true in other countries, how do you not see that that sounds bad? The other post I was more curious as to why he would say what he said. Anyway, this thread isn't about that, I only replied in the first place because I was stunned that he had worded it the way he had. Why not just get on with talking about what the thread is really about?

 

[Knicks]

I can read just fine thanks but what he said in this post was rude,

No it wasn't. You took it that way.

he basically said that you have to be intelligent to get into med school in the U.S.

Yes you DO have to be intelligent to get into a U.S. med school. PLUS, considering that this is a USMLE forum, expect posts to be relating to the US.

and implied that the same might not be true or as true in other countries,

No I didn't imply that. You took it that way, again.


Do I have to worry about you policing my malicious-free posts everytime I make one?

Just for you, I'm going to edit my OP. happy?

If you don't like the way I worded something, send me a PM instead of whining about it in front of everyone.

Why not just get on with talking about what the thread is really about?

Good idea.

 

[sexyman]

Bambi I will assist you in what I think the OP meant. The OP meant students in the US getting into US schools (as opposed to off shore schools). I dont think the OP is talking about someone who lives in England and gets into medical school in England etc...

 

[Knicks]

^^ yet ANOTHER person who gets me ,,,,,, anyone see a trend here?

 

[highyield]

^^ yet ANOTHER person who gets me,,,,,, anyone see a trend here?

sexy men really understand you?

 

[Instatewaiter]

sexy men really understand you?

^^ yet ANOTHER person who gets me,,,,,, anyone see a trend here?

I think we're all starting to see a trend.

 

[Instatewaiter]

Bambi I will assist you in what I think the OP meant. The OP meant students in the US getting into US schools (as opposed to off shore schools). I dont think the OP is talking about someone who lives in England and gets into medical school in England etc...

I took it the same way. Since about >90% of the regulars on here are either in US/canadian schools or off shore that is who he was directing that comment to. The folks in the carribean were the people he was referring to for various reasons. Stop being so hypersensitive.

 

[45408]

I can read just fine thanks but what he said in this post was rude, he basically said that you have to be intelligent to get into med school in the U.S.

Which is true.

and implied that the same might not be true or as true in other countries, how do you not see that that sounds bad?

I hate it when people read into something so as to make it mean something insulting.