Twitter is buzz with USMLE Step 1 changes.
Here’s my summary of Tweets
Change - good or bad?
according to one Twitter survey, 40% of the respondents believed it was change for good; 40% believed change was bad and balance 20% were not sure
according to another Twitter survey, the impact of change would be negative according to 68% of respondents; 11% said positive and rest unsure
Student stress
Most felt while stress for Step 1 may have been reduced, it has shifted the stress to other parts of the process - Step 2CK, ECs and research
Some felt students will feel more stressed about having to do research (to show on their resume) even tough they may have zero interest in it
ECs - especially volunteering - will gain in importance and students may be forced to increase volunteer hours to the detriment of actual learning
Privilege vs diversity
even though the stated aim is to increase diversity in specialties, most folks on Twitter felt this change would have the opposite effect and benefit “privilege” - both T20 schools and whites. Some felt mediocre students from T20 will benefit.
Many felt the process will become more subjective and more subject to bias and will impact negatively minority students, students from lesser known programs and
Some felt this was a way for wealthier colleges/ folks to retain control over who gets into specialty residency
DOs/ International graduates (IMGs)
almost all felt it will negatively impact DOs and international graduates
someone also asked if COMLEX will also change
Many were of the view this is the start of many changes coming to Med education
Year 2021/ 2022 applicants
some folks were of the view a lot of students in the ERAS applying batch of 2021 may take a gap year - to give the new Step 1 exam - potentially reducing the pool of applicants for 2022 residency admits. This may benefit the reduced applicant pool as well as DOs and IMGs.
by the same token, the applicant pool for the subsequent year may be larger impacting all applicants - potentially benefiting the gap year students (with more Ecs/ research) and negatively impacting other applicants; this may also reduce the number of seats for DOs/ IMGs
Program directors (PDs)
most felt this change alone will make life difficult for program directors in selecting the right candidate
some indicated specialty branches may come up with their own tests
some felt PDs will be subject to increase pressures and may play safe benefiting T20 colleges
From what I can gather, there was intense lobbying done to bring this change.
I saw some twitter handles congratulating each other for their lobbying success.
Also, now they have tasted success, they were talking about the next item on their agenda and initiate lobbying for that. Could not figure out what that item is.
Also, USMLE InCus press release mentions work by “Coalition of Physician Accountability” - which involves “broader system-wise review”.
At present, except for this announcement of change of USMLE Step 1 scores, nothing changes.
2022 - Step 1 scores reports will change to Pass/Fail
Between now and 2022 - there will be more discussions on how to make the residency process more “holistic” and that may trigger some changes.
Personally, not sure if exams for specialty residencies are the way forward.
Currently, your STEP 1 score gave you an idea which residencies you will be competitive. With pass/fail, you may prepare for 1 residency and find out later that is out of reach, you are stuck. More time wasted to re-tool your experience for another residency.
I think this is a much needed change. All for it. A study in Arizona showed that the final outcome for residents with and without Step 1 - was statistically insignificant. I understand this study helped AAMC to recommend doing away with the Step 1 scores. However, I am concerned that without a score, the PDs of residency programs will start relying on the reputation of the medical college. Currently, a high STEP 1 score can open many doors for students even from lower ranked programs. Does anybody else here worry about that?
Certainly it is a valid concern. At the same time PDs have misused Step 1 score for their own benefits, USMLE has clearly stated Step 1 is not meant for residency evaluation. Now PDs will be forced to come up with their own solution. How it affects on various aspects is to be seen as more and more info start trickling.
I see people applying to more programs with the change just like people are applying to more and more UG and medical schools with each cycle.
I want to hear from senior members whose kids are in BSMD programs. Do they have to work hard in medical school without strong ECs in UG to build up on?
Agree partially. I am concerned about “Holistic” word used to remove the accountability and objectivity. Lack of objective measures for PDs to rank their applicants will force them to use other aspects such as school brand name, MCAT score etc. In my opinion, will hurt BS/MD applicants, barring a few like NU, WUSTL, Case, Brown, BU. Do you see that way?
Actually it’s more common than you think. Medical schools (whose USN ranking is affected by STEP 1 scores) often purchase institution-wide access for prep resources like QBank or UWorld. On top of that student themselves purchase additional prep materials–often immediate after receiving their first acceptance to med school. At the med school one of my daughter’s attended, student are required to take a Step 1 Kaplan practice test and depending on the score from that exam are either allowed to continue to prep on their own, or required (non-optional) attend a Kaplan Step 1 prep course for 6 weeks.
I know both my daughter purchases multiple resources to help with STEP 1 prep. Currently STEP 1 prep involved -8 weeks release time from all other medical school responsibilities. It’s very common for student to spend a solid 8-12 hours day studying for it . You need multiple different resources to do that much prep over that long of a period.