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

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Knicks

Knicks

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(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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Good retention of FA and USMLE netted a > 99 two digit score for me. Would I do follow the same study method again? Nope. Would kick Brian Jenkin's course to the curb and supplement with Goljan RR Path and skim BRS GA.

U.S. students fail the Step 1 for a multitude of reasons, but stereotypes exist for a reason and doctors have to been sensitive to patterns. Here goes...

1. Shooting to pass...end up shooting too low
2. Burn out/fatigue
3. life getting in the way (death, illness, fiscal issues, drug abuse, etc...)
4. Relationship issues
5. Not wanting to pursue medicine (yes, there really are people who endure all this for someone else.)

To all those who are coming down the pipe. Keep on keeping on, 3rd year and being totally clueless around real life patients is absolutely worth it!
 
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1. using too many sources
2. too much annotating which is wasted time that is better spent memorizing.
3. not studying because of obsessing about a study schedule or future aspirations
4. 2nd year classes interferring with actual board studying
5. laziness
 
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evenflowcarter said:
2. too much annotating which is wasted time that is better spent memorizing.
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Actually almost every study out there on the subject suggests that "active" studying such as annotating, taking notes, making flashcards is superior than just reading and trying to memorize. But hey, to each his own.

I do agree with your points 1 and 3 though, that you can divert your efforts too much between too many resources (which is just as bad as using too few (such as FA exclusively)), and that some people are too easily distracted in too many directions rather than focusing in on a set game plan. The best first step in doing well on the boards is doing well in second year. Many schools have done internal studies on this. So I think your #4 is wrong. I can't really argue with #5, but haven't really met too many med students who haven't put in the time (whether productive or not) for this major test.
 
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Well, obviously the number one reason for failing is probably poor performance first and second year. I mean, the majority of people who struggle and it's not unexpected.

As for the "average to above average" failers, I have to say "Too many sources". People get hung up on reading "Okay I have to read this huge stack of books by this time or I'll fail" So they start racing through sources so they can "finish" them without actually learning.
 
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Ok, I honestly tried not to reply to this thread again but apparently I just can't help myself. I never thought the OP meant English schools I always assumed he was referring to the caribbean schools. Still though, I think it was unnecessary to say the especially US schools bit. Caribbean students know their school isn't as hard to get into, do you all really need to belittle them by bringing it up all the time? (I know that's what I am doing now but I am just trying to get my point across). Just because they go to a caribbean school it doesn't automatically make them unintelligent or less intelligent than you, maybe they just partied a bit too hard during undergrad. In the end they take the same USMLE you do, yes their average might be a bit lower than those of US schools but I imagine that's more to do with US schools tailoring the curriculum to the USMLE more. No wonder people at caribbean schools worry so much about residency etc when people like you lot automatically assume they aren't as clever as you without even meeting them.
 
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bambi said:
yes their average might be a bit lower than those of US schools but I imagine that's more to do with US schools tailoring the curriculum to the USMLE more.
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That makes no sense whatsoever. If anything, they have more latitude to tailor their curriculum to things other than Step 1. A Carib school has nothing if they don't have a high pass rate. I imagine that it's more likely due to the fact that they have more lax admission standards.
 
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Law2Doc said:
Actually almost every study out there on the subject suggests that "active" studying such as annotating, taking notes, making flashcards is superior than just reading and trying to memorize. But hey, to each his own.
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There's note-taking, and then there's note-taking. I know people who fill up the page with notes when the professor simply repeated, nearly verbatim, what was already written on the page. You can easily go waaay overboard. I tend to only write in the things that I didn't already know and aren't very clear in the notes. Or if I want to make a clinical correlation or something.
 
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TheProwler said:
That makes no sense whatsoever. If anything, they have more latitude to tailor their curriculum to things other than Step 1. A Carib school has nothing if they don't have a high pass rate. I imagine that it's more likely due to the fact that they have more lax admission standards.
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Well obviously I have never been to either so that was just a guess and I expect most US schools do tailor their courses quite significantly. What exactly would a US school have if they didn't have a high pass rate? Also although the average at caribbean schools might not be as good as at US schools some do well and beat those at US schools so like I said before it is unfair to just assume that none of them are as clever as you.

Anyway, like I said before we should just get back to what the thread is about. A lot of you have made it very clear you think you are better than caribbean students and I think I have made it clear that I think that is pretty nasty so we know what each other think, why not just leave it at that?
 
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when it comes to learning styles, you must figure out what works for you...for the most part, during 1st and 2nd yr, i would simply read the scribe notes, not write anything down, highlight, etc. When i studied for step 1, i did the same thing basically: would just read the review sources for comprehension and understanding and barely even annotated FA. When I mean barely, I mean just a few notes in the entire thing...the only place I decided to take notes were on the UW questions. I wanted to change up my learning style a little bit and I think that having some variation helped me keep a little focused, but in the end, I relied on what worked for me in yrs 1 and 2. its not a terrible thing to have read a bunch of really good books, but dont do it at the expense of being able to learn the things that are important. some people are better at picking up the important facts and concepts and moving on, while others dwell on the unimportant. when i would talk about some concepts to friends during the study period, it shocked me to find out what level of depth these people were trying to learn the info (and at the expense of the important things).
 
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Bambi, you'd be astonished. I actually spend more time on SDN, because I find US students to be more supportive then FMG's. When I post on valuemd, I get nothing but de-motivating comments.. like " Oh that will never happen...". Because the truth is alot of FMGS have a negative view about themselves. 99% of the students I went to school with were pretending they had all the stats to go to a US school, but then just managed to end up in a Carib school. I agree academics aren't the only reason for ending up an FMG, some people have financial issues, or didn't have the maturity and didn't achieve the grades required. We can't take away credit from students that went to US schools, they worked very hard to get there. Carib schools give people the OPPORTUNITY, and the people that ACTUALLY make it through are give or take at the level of US students. There is alot of insecurity and thats why I noticed there is alot of lying. For example, everyone that has taken the step so far has claimed to get 90+% in my school, which I think is BS and makes no sense to lie. I do agree with you , that US students shouldn't look down on Carib students, but you have to see where they are coming from, and the truth is.. carib schools are not selective! if they were.. then the pass rate would be higher, and the students you started with would be the students you ended with, but that isn't the case.. so point is, don't take offense.. we have to be realistic, facts are facts. as an IMG, according to charting outcomes, even with similar step scores, we get matched less! Its a struggle, but in the end we will all be MDS....now back on topic...

I know a person that had a very high GPA in med school, studied , but then after she/he finished basic sciences, decided to take 2 weeks off, and relax in the Caribbean, instead of getting on the material. She didn't pass any Practice NBMES ( came very close) yet still sat for the exam, and failed by a few points. In this case its just plain stupidity. You have to pass the NBME's at least before you sit, and I doubt anyone with 220's etc on NBME's went and failed, it is less likely. Although I'm not a 99er, I can tell you that passing is a combination of a FOUNDATION of basic sciences, application of concept, and ability to memorize material. The misconception is that memorizing first aid will get you a 99. Yeah sure it can, if you had a good foundation to begin with, chances are if you didn't get it while you were learning it, first aid is just a bunch of words....so my goal for rotations, is to keep up with material/texts, instead of just jumping to review books...not making the same mistake I did in step 1.....just my two cents...
 
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bambi said:
Ok, I honestly tried not to reply to this thread again but apparently I just can't help myself. I never thought the OP meant English schools I always assumed he was referring to the caribbean schools. Still though, I think it was unnecessary to say the especially US schools bit. Caribbean students know their school isn't as hard to get into, do you all really need to belittle them by bringing it up all the time? (I know that's what I am doing now but I am just trying to get my point across). Just because they go to a caribbean school it doesn't automatically make them unintelligent or less intelligent than you, maybe they just partied a bit too hard during undergrad. In the end they take the same USMLE you do, yes their average might be a bit lower than those of US schools but I imagine that's more to do with US schools tailoring the curriculum to the USMLE more. No wonder people at caribbean schools worry so much about residency etc when people like you lot automatically assume they aren't as clever as you without even meeting them.
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Ok, so you are saying they might not be less intelligent, but they are instead less dedicated and less responsible? That is much better. :rolleyes:


And you obviously know nothing about Caribbean schools. It is the exact opposite of what you think. Caribbean schools tailor their curriculum to scoring as high as possible on the USMLE, because they know their students are already at a disadvantage. This can but does not always come at a price when it comes time for clinicals.
 
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Blesbok said:
Ok, so you are saying they might not be less intelligent, but they are instead less dedicated and less responsible? That is much better. :rolleyes:


And you obviously know nothing about Caribbean schools. It is the exact opposite of what you think. Caribbean schools tailor their curriculum to scoring as high as possible on the USMLE, because they know their students are already at a disadvantage. This can but does not always come at a price when it comes time for clinicals.
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I'm not saying they are less dedicated or responsible, I was offering another perspective. Some people might just be happy with passing, then later decide on med for example so not have the grades because of that, not because they aren't capable. There are loads of reasons why people might not do that well until later, I just picked 1.

I said I didn't know about caribbean schools and that it was just a guess!

The whole reason I posted in this thread in the first place was because I thought it was nasty to constantly go on saying that caribbean students aren't as good as you. So what if they aren't? Do you need to throw it in their face all the time? How does that help you? All it does is make other people feel bad. Shouldn't you just concentrate on being the best doctors you can be, surely that is more important?
 
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PAN627 said:
Bambi, you'd be astonished. I actually spend more time on SDN, because I find US students to be more supportive then FMG's.
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Yeah most US students I have come across have been nice and supportive, that's partly why I was so shocked that some are just so pointlessly nasty.
 
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bambi said:
it is unfair to just assume that none of them are as clever as you.
...

Anyway, like I said before we should just get back to what the thread is about. A lot of you have made it very clear you think you are better than caribbean students and I think I have made it clear that I think that is pretty nasty so we know what each other think, why not just leave it at that?
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It speaks for itself that my undergrad grades/MCAT ARE better than nearly everyone in a Caribbean school, so while I don't think I'm a better or smarter person, my academic qualifications were better. There's a huge difference.
 
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Law2Doc said:
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.
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You're right that FA is a difficult learning tool if you didn't grasp most of the basics during the 1st 2 years. But in response to your point that there are plenty of people that use only FA and do poorly - that's true, but there's also many people who use supplemental sources for each subject and do badly.

Anyway, I stuck to FA, BRS path, BRS phys and UsmleWorld and did fine. UW was gold but I don't think BRS path/phys got me more than 3-4 extra answers on the real thing that were missing in FA.
 
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The major theme for people I know who "didn't pass" this time around is being under prepared or not taking the test seriously. One guy only used qbank. Couple of others only studied 2 weeks. Other's studied lazily, i.e. a few hours a day for 3 weeks with weekends off.

It's my personal opinion that at this stage in the process everyone should be a decent enough test taker to pass a standardized test if they know the material. The step might not be the best way to measure people, but it's the best one we've got right now.

I'm aware personal issues are sometimes a factor, but I think it's much more common to simply be under prepared.
 
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^^ Thanks for the relevant, on-topic contribution to the thread. :thumbup:


and yeah, you do make some good points.
 
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Knicks you really are pathetic, I wasn't the one to turn it into a whole big thing but was the only one that repeatedly said that we should get back to the topic of the thread.

As for the actual topic of the thread- everyone says you should at least learn all of first aid but does that mean you actually learn every step in the Krebs cycle and other things like that?
 
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bambi said:
Knicks you really are pathetic, I wasn't the one to turn it into a whole big thing but was the only one that repeatedly said that we should get back to the topic of the thread.

As for the actual topic of the thread- everyone says you should at least learn all of first aid but does that mean you actually learn every step in the Krebs cycle and other things like that?
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Hey Barbie, I think you misunderstood Knicks. I think he's an IMG too so he should not have any reason to speak ill of them.

In regards to your question, I don't think anyone can answer that for you. I found the mnemonic in FA to be pretty helpful though.
 
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students that had trouble with step 1, were

1) told "FA is all you need" (and believed it)
and then
2)tried to read FA like a book
(glancing at picture of heart, Oh, there's the heart. Done. What's next...)


Also, there were those bottom of the class students who believed they could reproduce the results of the top ranked person in the class before them that came back and said, "I only studied for 2 weeks and got a 240+"

I also ran into students that for some strange reason or another believed that they wanted to "save their qbank" questions.. saying such ridiculous things like, "I'll start my qbank once i finish re-drawing mosby's clinical anatomy, and memorized my p chem notes from undergrad..."
 
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bambi said:
In the end they take the same USMLE you do, yes their average might be a bit lower than those of US schools but I imagine that's more to do with US schools tailoring the curriculum to the USMLE more.
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You're trolling but I'll bite anyway.

I can only speak for one accredited allopathic US medical school but its curriculum was anything but tailored to the USMLE Step 1! Actually a good case could me made that points toward the curriculum being purposely skewed away from preparing the student body for Step 1.

US students fare better because the filter for US schools is finer than those located off shore. Better students tend to do better regardless. Understand I’m not making a statement about intelligence but students with a good academic track record, which most would agree has more to do with work ethic than intrinsic ability.
 
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chrisjohn said:
Y Understand I’m not making a statement about intelligence but students with a good academic track record, which most would agree has more to do with work ethic than intrinsic ability.
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That is perfectly fair, my problem is when people make out that they are all stupid, I just think it's nasty.
 
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