P/F step 1 is a lot more appropriate considering CK is more based on the knowledge required for residency. I don't think memorizing glycogen storage genes or biochem is necessarily relevant for being a good doctor.
I thought so as well but now that I am studying for CK I have seen how so much of these questions are vague and the answers are very debatable. One thing that was nice was that if you did bad on step 1 you could make up for it with CK, now that isn’t an option
A video talking about how the match was when you were trying it would be nice! Like, explaining what back then was the big deal in your application and comparing it to now
Preparing for Step 2 now and honestly, If I didn't grind my ass off to get the score I got on Step 1, I don't think I would be nearly as comfortable with the concepts being tested on Step 2. Step 1 is just laying the foundation for Step 2. If you barely pass step 1, you're probably barely going to pass step 2 unless you crank up the studying in your 3rd year and let me tell you from experience, studying during 3rd year is TOUGH. Coming home after working and studying all night is NOT easy. The lack of motivation is the hardest part tbh. Just don't feel like this was the right move.
Really hate how step 2 will now be our deciding factor especially given how we take it right before we apply to residency. Thus for people going for competitive residencies, a big part of their application rides on a grade they won’t have for a while
STEP 2 CS isn't a thing anymore! My experience as an M2 that has taken STEP 1 P/F is that it is not a very stressful period if you have been preparing for the test throughout pre-clinicals. However, besides just loading all the stress on STEP 2, you also have to consider the amount of extracurricular activities that might be required to stand out, which are sometimes not entirely tied to medicine (imo this would increase burnout even more). I think it'll devolve into how the pre-med journey of box checking for "interesting experiences" and research.
Super random, but I would be very grateful if you took the time to answer. I’m a freshmen pre-med. I’m currently trying to figure out what I want my plan to be for extracurricular (work, research, etc). I’m currently working as a phlebotomist at a plasma donation clinic. I am planning on getting my EMT certs this weekend with the intention of working as a physician-substitute at my current clinic where I’ll give physicals to new donors to assess their ability to donate. I also have my CNA. Do you have any advice on moving forward with my extracurriculars? Research is essentially required, so do you have any advice on what I should pursue for work? Rec letters are important, which I am currently planning on getting from scribing. Would also like to volunteer as an emt. This was super disorganized, but any advice would be appreciated. TLDR: Pre-med. Don’t want to waste time with extracurriculars that won’t help. What are the best jobs/experience/volunteer opportunists for med applications?
@@semajo.9514 First, I think it's important to gauge what types of schools you want to end up at. Do you want to be at a top 30 school which likely requires a lot of research? Research isn't necessarily required, it is encouraged, especially for certain schools. Reach out to your undergraduate professors if research interests you, that's what I did. Extracurriculars: You seem to be building up solid clinical extracurriculars and getting your EMT cert would add even more valuable experience! Besides clinical experience, you should look for some sort of leadership position either in a club, or a position you could get in your local community (i.e. anything non-clinical). I volunteered in several leadership positions in my local church which was more than an enough, I'm hot sure if you have that option as well. EDIT: Strongly recommend checking out reddit on the r/premed for advice from many premeds, admitted, students, medical students, residents, and attendings. It got me through the whole process.
I took Step 1 last week as a pass fail exam. Honestly I think it puts more pressure on me as a student because instead of being able to partially make up for a lower step 1 score with a really good step 2 score we now only have one shot to get a good score. I know step 1 was always weighted more heavily but it still gave some opportunity to improve and make up for a lower score. Also I think we all are super stressed trying to figure out how to stand out. From what I have seen the step 2 scores are less stratified and typically higher overall so honestly the only way to stand out is research + extracurriculars + going to a competitive med school + clerkship grades. Also most of us won't be getting a step 2 score until after finishing 3rd year so it is going to be really difficult to plan to apply for specialties that may or may not be more competitive without having any idea of what step 2 score we are going to get. I feel like in the past having a step 1 score helped people to narrow down their options more and what they had a chance of matching. Anyways thanks for speaking on this topic!
all this is going to do really (in my opinion) is be helpful to Ivy League MD students and students in "prestigious" universities. So it reduces the USMLEs score importance and basically just helps already privileged students. It's so dumb in my opinion. But hey, if you get a ridiculous step 2 score like 278 or so, I'd say any program would want to interview you. But still; it just puts more emphasis on your medical schools status which is wrong on so many levels as it has less to do with merit anymore.
The funny thing is.. specialities that require the highest scores in these exams are not necessarily the hardest as to require the “brainiest” of applicants.. in fact, they’re actually the easiest specialties, they just are the specialties that make the most MONEY with the least amount of effort possible. Oh yes.. it all boils down to money. I’m happy step 1 is a pass/fail now because those easy specialties will be partially stripped off the power to take only the supposedly “smartest applicants” although I’m sure they’ll find some other artificial barrier for their “prestigious” money-making specialty.
I really love how blunt your videos are. So many people beat around the bush to keep up this facade about improvement in the medical industry, but I’m glad you address these topics head on and don’t feed into the faux changes made to make medicine more accessible. Your perspective is so refreshing!
They should make more dermatology residencies so their competitiveness goes down. Just ask the old dermatologists that are retiring now and if they are honest they will tell you this was one of the easiest residencies to get into back in the day. This whole "$kin is my Pa$$ion" crap came later when students found out how much money they could make basically looking at zits and rashes. Oh yeah, and Mohs surgery helped alot too. You basically have the "best students" in all of medicine clamoring over each other to prescribe zit cream. It's nonsense and crazy. I can understand competitiveness in surgery residencies but not in dermatology, it shouldn't take 3 months to see a zit doctor.
You are exactly right. The one positive aspect to the step 1 score being reduced to pass/fail is that it will be an absolute headache for the smartest students to land a derm residency which is easier than family medicine but pays an eventual salary orders of magnitude higher. Almost no one is passionate about the skin and many of the derm applicants are in the field of medicine for the entirely wrong reasons.
I have a cousin who never studied much, we studied together but she gives most of her time to her phone than her studies after writing the STEP 1 last month she passed and i failed😢, i asked her how she did it, just found out she got help from Mr Richard
I think this P/F change might still negatively affect students who are not good test-takers. Before, you already know what specialties you're aiming for after 2nd year based on step 1 score. But now with a barely pass on step 1, students, especially undecided ones, would still aim for more competitive specialties during their clinical years until reality hits when their Step 2 scores aren't good enough. I'd be so panicked trying to switch specialties at the last minutes
I think this can be negated somewhat by studying your hardest (which most of us are doing anyways especially if you’re historically not a great test taker) then taking practice tests to approximate your actual performance on step (some tests offer the three digit score still, but you can approximate your score based on the EPC). Then base your speciality ambitions on that. Barring a disastrous actual test day performance this would allow you to see where you stand on the competitiveness scale test wise.
Taking Step 2 on Wednesday! I’m taking a research year so took Step 1 for a score but will be graduating 2024, when most of the other students will be P/F. Will be very interesting to see if my experience with ERAS differs from theirs based solely on the fact that I’ve got a number for Step 1!
I want to give my take. I took step 1 pass fail, I completely revamped my form of studying during dedicated. My classmates and I were very collaborative and helpful to one another. Because of these changes I made in my studying, I believe I am better prepared to face the beast that will be step 2. Step 1 was sort of a primer for me, it showed me the errors I was making in my study habits, that I should have started earlier, used picture mnemonics and even made my own, etc. In summary, the first test has helped me learn HOW TO study for boards exams. Which will set me up for success going into step 2 prep. So yes, the stress has shifted onto a new exam, but I certainly feel MUCH better prepared for how I will approach this stress You only really find what works for you when youve actually applied it and seen success with it.
@@thefocusedlife497 practice tests were part of my preparation, along with all of U world. I see your point, however the definitive confirmation for me that what I was doing worked was obviously seeing my test result. I have great confidence applying what I learned during dedicated early in step 2 ck prep will get me a great score
But then what will they use to asses residency applicants if the most important factors are being secluded from scrutiny? The step 1 was a test we could use to differentiate applicants. Now it will be even more difficult to set us apart from others. What do we do ugh?
Thanks for such a wonderful video that gives me a perspective. I’m going into my first year of med school (DO), and fingers crossed we won’t be negatively impacted
Personally I prefer Step 2 to be graded and Step 1 to be P/F. Our School has professors who teach the most low yield information and has in house exams, so it makes it extremely difficult to study for boards to be competitive (If you try you will fail the courses ex. we are basically memorizing Robbins) Step 2 is what you make of it. You don't have professors holding you back.
I agree! Though thank God I am doing well on practice exams, I am glad it's pass fail and I do prefer more weight being on Step 2 and extracurriculars.
I don't even care about Step 1 being P/F. My issue is that now people may get screwed if they do badly on Step 2 CK. If you planned on going into Ortho and end up with a 220 on CK, you now have to start thinking about an alternate career and at this point you're already close to graduation. I understand the reasoning for Step 1 p/f but now everything just shifted onto Step 2 CK and people having to take an extra year or people having to switch plans later in the process towards graduation. Also, now I would place higher priority in attending a big name medschool if I were premed because letter of rec would be more important. A Pass on Step 1 from UCSF student is seen better than a Pass from a student from Texas Tech University trying to go into neurosurgery.
The fact that students couldn't retake the USMLE Step 1 once they passed it was problematic. E.g., one's average score could fall within a range of 244 - 250. If that person got a relatively bad pool of questions and were also unlucky in guessing, they could easily score a 244. If the opposite happened, they could easily score a 250. This sort of difference was enough to determine whether or not one could get into a highly competitive residency/specialty. Randomness was too impactful! I like that USMLE Step 1 is now truly P/F; however, other changes need to be made. We must determine the most important factors that can be used to divide students into residencies based on estimated future success while eliminating arbitrariness and randomness. I feel that a potentially good remedy to the issue of matching into residency could be one that utilizes analyses and evaluations specific to each specialty; extensive research would need to be performed to determine what unique evaluations and analyzes would be the most effective, efficient, and realistic indicators of success for each specialty. If you are reading this and would like to answer: What do you think could be potential solutions to the current problems faced when determining how students match into residencies? What are your opinions on my views?
another disadvantage is for students that study abroad.. some places already make it more difficult for them to get into residency and the grade of usmle1 sometimes helped them "prove" that they are not less than instate/country applicant.
I feel like pass fail step 1 will only make CK more important and make things more difficult for DO and IMG students for matching in more competitive residency spots
It definitely is scary thinking about how STEP 2 is now the big deciding factor especially when considering that the exam is taken at the end of M3. Personally, I’m shooting for ENT and it’s scary thinking that my STEP 2 score could potentially be not good enough and I’d then have to scramble and figure out what other specialty I’d be interested in. That would just make the match process a lot more stressful.
If the idea from the USMLE was for both exams not to be used to ranking, then they should also make step 2 P/F to be consistent. No use to have one scored and one P/F because its only logical that people will only care about the scored test. I suspect they'll move step 2 to P/F within a few years depending how this goes.
Thanks so much for doing this great video. It is really really sad that one exam decides your future and every effort done in the past to be doctor has been destroyed. There are others things that I do not agree. The salary for residents is so lowwwww and they work as slaves at our hospitals. With the new salary raise, our janitors make more money than medical residents who work 80 hrs sometime weekly. Does anyone know why the resident salary is so low compared with the volume of work and level of responsibilities they have?
Step 1 going P/F has me super stressed about deciding on a specialty. I am finishing up my 2nd year now, taking step in June, and am still not sure what specialty I want. Not having a score for step 1 means we don’t have the guidance from that on what is still realistic to pursue. I just don’t want to go after a competitive specialty only to have my step 2 score come back after applying and not be enough.
They should get rid of all the exams!! We had enough during medical school itself!! It is not right to stop doctors from practicing medicine once we have already gotten our degrees!! The exams stress me out !! I don’t want my whole life hanging on exams. 😥
I totally agree with you….the fact that you know everything is on these exams it’s enough anxiety to make you not do well…..i feel like they should focus more on preceptor evaluations and extracurricular activities if anything.
I feel like the change was made in good faith, but ultimately as you said doesn't change anything. It's kicking the bucket down the line to something else. The main problem is that residency spots can be incredibly competitive to get despite us being in the middle of a doctor shortage, and how residency slots want the "best" students. So they'll always use metrics that could suggest that a student is the "best". If it isn't board exam scores, it'll be what medical school you went to. It may even be MCAT scores if all of medical school becomes p/f. There really isn't a way to win here unfortunately, which feels awful since this change seems to be a shift to help make the process better for up and coming doctors.
Step 2 CS was basically an English exam for IMGs with the extra kick of getting money from US graduates LOL. Now they have some other different ways to collect money from IMGs instead of Step 2 CS.
Because of this medical schools have added a bunch of new things to their curricula, mostly just "mandatory activity" so it defeated the original purpose of easing the stress for getting a numerically high score on USMLE 1. Why does our system value form over substance and activity over actual learning?
Read the title. Don't worry. We all said the same thing. In fact, they did a whole survey in the NEJM and most directors basically made the same points you did. However, the competition aspect didn't exist between myself and other medical students. We were all more concerned about beating the exam than each other. Simply "hiding notes" didn't make a difference when everyone use the same resources.
Yeah this is bad IMO. This will just give students who have a plethora of research opportunities better chances of matching at better programs (ie. students at top schools will have easier times matching, especially to competitive specialities). Third year students will even be less interested in clinical medicine because they'll be more focused on clerkship grades (shelves) and studying for Step 2. This will all lead to students being less prepared and more burnt out (as they aren't spending enough time in the hospital to know what specialities are really like). Not saying Step 1 scores is the answer, but doing this will make things worse. We will see how things are in 10 years. EDIT: I think your comments about Step 1 competition is over the top. My experience is obviously different than yours, but I never once saw or experienced somebody not helping/trying to sabotage somebody on Step 1. I mean alot specialities have hundreds/thousands of spots, helping your classmate won't really effect anything. You would think a med student could understand that math. Just sounds like your school selected shitty candidates or my school did an amazing job. Who knows.
@@HA-vm9ph Meh, I use step 1 material everyday. And I thought Step 2 wasn't really that clinical but it has been awhile since I have taken it. Still have to know nearly all that crap from Step 1. Step 3 is a clinical exam though.
What do you think would be the best way to go about this situation? How would they be able to compare in a fair and standardized manner while taking off some more of the stress in your opinion? I feel like so many people say that this decision didn’t solve the problem and while that’s true, I can’t think of a way that they can currently solve it.
I would've seen if some sort of application score could be added for the STEP exams alone. Where STEP 1 has a lower multiplier score while STEP 2 has a higher multiplier. That way, both scores matter but STEP 2 is more heavily emphasized due to relevance.
Of greater concern to me is this new methodology in residency application where you essentially super like certain programs where they know you’re highly considering them. The fear is that you apply to 50 programs, star 30 of them, then never hear back from the other 20-all of which you would have interviewed at previously and considered. Now you may not hear back because you didn’t favorite them? It’s more stress to a stressful process. It’s annoying. Also, very important is the fact that step 1 was a major source of depression and caused many unfortunate med students to end their lives. It’s sad but true. Luckily, the rates of medical student self-harm goes down.
I hope I can pass USMLE I Don't haves a job,I am 36 years old all my dreams related to USMLE,if I can choose between my life and USMLE I would choose USMLE
If only we had a place where students could be evaluated individually and holistically over the course of four years in order to determine the best placement for them for residency and when they are ready to move on to that step. Maybe some sort of…school…for medicine.
*thr is nothing wrong, necessarily, as long as thr are unlimited re-sits.* tho it still needs work. you could not match str8 into a fellowship, & get to it later. that may leave too many hospitalists. education is a problem, any time it is not about the education. -JC
Why would this affect us IMGs negatively please can u further elaborate ? And how can we compensate this disadvantage in order to be able to match into highly competitive speciality
Same problems with the MCAT. I will talk to nurses, patients, and other hospital staff and they ask me why doctors are so competitive and hard to work with. I honestly think these exams that pit students against each other is a large reason doctors are non-team players sometimes. This is sad to me because we should be collaborative and we are trained to be so.
Lemme tell u as a 2Nd year med student I’m loving the pass fail. I’m vibing this semester whereas if it wasn’t pass fail I think I would be stressing much more
Pass/Fail is good. Step 1 has never been a great indicator of one's ability to be an actual doctor. It was only setup in it's former form because of the chaos that was the residency-position offer process prior to the NRMP match. It's obvious that directors needed a way to delineate candidates when it was more common to give offers ~2 years prior to a student's graduation. The whole time they knew that a good score in basic sciences doesn't mean someone would be a good doctor. Step1 finally changing is a classic example of the lag/latency for systemic change in medicine, and what is actually dumb, is how long it took for the old guard to get out of the way. Step 1 should've been pass/fail right after the Match process/algorithm was solidified and "perfected," to the ability that it can be. So, at least 10 years ago. CK should've always been the lowest level metric used by residency programs. The application of science in a clinical setting is what it is to be a doctor... so yeah. Pass/Fail is good.
Super interesting. In Canada all med schools are P/F so your residency apps are 100% considered on your evaluations in med school (preceptors, electives, extracurricular, references, etc.). Even the MCCQE exam isn’t written until your graduating year and you write it AFTER you match traditionally. Means that you have a chance at matching regardless of your med school & grades and focus on your actual qualities
How will this be detrimental to imgs?? Like i am from india. And from 2024 by new ecfmg accredetions rules all medicsl schools will be removed from the world directory of med schools . so american board or usmle will not recognize our med schools as authorized ones. Please throw a loght on this dr cellini. How will it affect imgs after 2024 from our country?? Cant we give usmle anymore?
The things about STEP 1 being pass/fail is that, it's not like medical Students are going to study THAT MUCH LESS for it just because it is pass/fail. Because if you happen to fail it then...you really won't get into a decent residency. So basically you will be studying almost as hard, but with none of the pay off.
As others have mentioned, turning USMLE Step 1 pass/fail has the intended or unintended consequences of hurting DO and IMG students in the match. If you are a DO or IMG student begin studying for Step 2 from day one and try to take Step 2 before the match to show you are "worthy". If you are not competitive for competitive specialties such as Derm, consider completing 2-3 years of internal medicine. The ability to take care of very sick patients is a desired commodity in specialties where those skills may be lacking.
Mysteriously, once beyond the highly competitive college and medical school environments, physicians are generally collegial and cooperative. Docs have come to realization that the only people really looking out for their health and welfare are other docs.
Sounds like you had a lame med school class. My classmates and I always helped each other out studying for exams including USMLE. Yes people were competitive and tried to get top scores but you can still be good natured and help others while doing it.
I'm not a med student. A former nurse. I find your channel very educational. I hear alot about these step exams. How stressed the already stressed student is. What's interesting is I've found just because they do so well on these exams doesn't mean there a great doctor. It's not cool that if your scores make it so u don't match in the field they want ? I think pass failed is best. So what now step 2 is the hardest? I just don't understand how these med schools work?
In my situation, my dad counseled me to get the best undergraduate degree possible. It didn’t matter what type of undergrad degree you got as long as you did good on your MCATs. Heck, you could get a four year degree in basket weaving and end up in medical school. I chose mechanical engineering as my undergraduate degree. Graduated with a 4.0. The reason why I chose mechanical engineering is because if something happened during medical school I could always fall back on my BSME. I can support a family with a BSME. Most doctors have degrees in the basic sciences. They drop out of medical school and they serve fries at McDonald’s. When I graduated medical school, step one and step two were very important. I put all my eggs in one basket and I knew that I would end up in the program of my choice in Europe which allowed me a double board certification in trauma and cardiothoracic medicine.
MDs aren't collaborative. About the only difference between the MDs and DOs. We have legit the exact same curriculum just have to learn some extra voodoo BS.
I hope I can pass USMLE I Don't haves a job,I am 36 years old all my dreams related to USMLE,if I can choose between my life and USMLE I would choose USMLE
I failed my USMLE exam 2 times first was 2020 second was 2021 and I lost money on review questions and also wasted a lot of time studying which never helped me .
P/F step 1 is a lot more appropriate considering CK is more based on the knowledge required for residency. I don't think memorizing glycogen storage genes or biochem is necessarily relevant for being a good doctor.
I thought so as well but now that I am studying for CK I have seen how so much of these questions are vague and the answers are very debatable. One thing that was nice was that if you did bad on step 1 you could make up for it with CK, now that isn’t an option
It is and anyway that is potential step 2 material anyway
yes but i think because step 2 is more clinically oriented it should be weighted more.
A video talking about how the match was when you were trying it would be nice! Like, explaining what back then was the big deal in your application and comparing it to now
Preparing for Step 2 now and honestly, If I didn't grind my ass off to get the score I got on Step 1, I don't think I would be nearly as comfortable with the concepts being tested on Step 2. Step 1 is just laying the foundation for Step 2. If you barely pass step 1, you're probably barely going to pass step 2 unless you crank up the studying in your 3rd year and let me tell you from experience, studying during 3rd year is TOUGH. Coming home after working and studying all night is NOT easy. The lack of motivation is the hardest part tbh. Just don't feel like this was the right move.
Keep it up
Yeah dude, keep pushing.
But I think this is the right move.
Really hate how step 2 will now be our deciding factor especially given how we take it right before we apply to residency. Thus for people going for competitive residencies, a big part of their application rides on a grade they won’t have for a while
STEP 2 CS isn't a thing anymore! My experience as an M2 that has taken STEP 1 P/F is that it is not a very stressful period if you have been preparing for the test throughout pre-clinicals. However, besides just loading all the stress on STEP 2, you also have to consider the amount of extracurricular activities that might be required to stand out, which are sometimes not entirely tied to medicine (imo this would increase burnout even more). I think it'll devolve into how the pre-med journey of box checking for "interesting experiences" and research.
Super random, but I would be very grateful if you took the time to answer. I’m a freshmen pre-med. I’m currently trying to figure out what I want my plan to be for extracurricular (work, research, etc). I’m currently working as a phlebotomist at a plasma donation clinic. I am planning on getting my EMT certs this weekend with the intention of working as a physician-substitute at my current clinic where I’ll give physicals to new donors to assess their ability to donate. I also have my CNA. Do you have any advice on moving forward with my extracurriculars? Research is essentially required, so do you have any advice on what I should pursue for work? Rec letters are important, which I am currently planning on getting from scribing. Would also like to volunteer as an emt. This was super disorganized, but any advice would be appreciated.
TLDR:
Pre-med. Don’t want to waste time with extracurriculars that won’t help. What are the best jobs/experience/volunteer opportunists for med applications?
@@semajo.9514 First, I think it's important to gauge what types of schools you want to end up at. Do you want to be at a top 30 school which likely requires a lot of research? Research isn't necessarily required, it is encouraged, especially for certain schools. Reach out to your undergraduate professors if research interests you, that's what I did.
Extracurriculars: You seem to be building up solid clinical extracurriculars and getting your EMT cert would add even more valuable experience! Besides clinical experience, you should look for some sort of leadership position either in a club, or a position you could get in your local community (i.e. anything non-clinical). I volunteered in several leadership positions in my local church which was more than an enough, I'm hot sure if you have that option as well.
EDIT: Strongly recommend checking out reddit on the r/premed for advice from many premeds, admitted, students, medical students, residents, and attendings. It got me through the whole process.
I took Step 1 last week as a pass fail exam. Honestly I think it puts more pressure on me as a student because instead of being able to partially make up for a lower step 1 score with a really good step 2 score we now only have one shot to get a good score. I know step 1 was always weighted more heavily but it still gave some opportunity to improve and make up for a lower score. Also I think we all are super stressed trying to figure out how to stand out. From what I have seen the step 2 scores are less stratified and typically higher overall so honestly the only way to stand out is research + extracurriculars + going to a competitive med school + clerkship grades. Also most of us won't be getting a step 2 score until after finishing 3rd year so it is going to be really difficult to plan to apply for specialties that may or may not be more competitive without having any idea of what step 2 score we are going to get. I feel like in the past having a step 1 score helped people to narrow down their options more and what they had a chance of matching. Anyways thanks for speaking on this topic!
all this is going to do really (in my opinion) is be helpful to Ivy League MD students and students in "prestigious" universities. So it reduces the USMLEs score importance and basically just helps already privileged students. It's so dumb in my opinion. But hey, if you get a ridiculous step 2 score like 278 or so, I'd say any program would want to interview you. But still; it just puts more emphasis on your medical schools status which is wrong on so many levels as it has less to do with merit anymore.
This hits hard as I'm studying for Step 2 now.... 😭
Same bruh 😭😭
The funny thing is.. specialities that require the highest scores in these exams are not necessarily the hardest as to require the “brainiest” of applicants.. in fact, they’re actually the easiest specialties, they just are the specialties that make the most MONEY with the least amount of effort possible.
Oh yes.. it all boils down to money.
I’m happy step 1 is a pass/fail now because those easy specialties will be partially stripped off the power to take only the supposedly “smartest applicants” although I’m sure they’ll find some other artificial barrier for their “prestigious” money-making specialty.
I really love how blunt your videos are. So many people beat around the bush to keep up this facade about improvement in the medical industry, but I’m glad you address these topics head on and don’t feed into the faux changes made to make medicine more accessible. Your perspective is so refreshing!
They should make more dermatology residencies so their competitiveness goes down. Just ask the old dermatologists that are retiring now and if they are honest they will tell you this was one of the easiest residencies to get into back in the day. This whole "$kin is my Pa$$ion" crap came later when students found out how much money they could make basically looking at zits and rashes. Oh yeah, and Mohs surgery helped alot too. You basically have the "best students" in all of medicine clamoring over each other to prescribe zit cream. It's nonsense and crazy. I can understand competitiveness in surgery residencies but not in dermatology, it shouldn't take 3 months to see a zit doctor.
You are exactly right. The one positive aspect to the step 1 score being reduced to pass/fail is that it will be an absolute headache for the smartest students to land a derm residency which is easier than family medicine but pays an eventual salary orders of magnitude higher. Almost no one is passionate about the skin and many of the derm applicants are in the field of medicine for the entirely wrong reasons.
The USMLE exam is very difficult to pass, I can't believe i failed step 1after studying with so many materials😞
Sometimes it doesn't matter how hard you study, you also need to pray to God for success
@ very correct
I have a cousin who never studied much, we studied together but she gives most of her time to her phone than her studies after writing the STEP 1 last month she passed and i failed😢, i asked her how she did it, just found out she got help from Mr Richard
Please does anyone know who this Mr Richard is? I really need to speak with him I'm frustrated
Yes you're correct
I think this P/F change might still negatively affect students who are not good test-takers. Before, you already know what specialties you're aiming for after 2nd year based on step 1 score. But now with a barely pass on step 1, students, especially undecided ones, would still aim for more competitive specialties during their clinical years until reality hits when their Step 2 scores aren't good enough. I'd be so panicked trying to switch specialties at the last minutes
I think this can be negated somewhat by studying your hardest (which most of us are doing anyways especially if you’re historically not a great test taker) then taking practice tests to approximate your actual performance on step (some tests offer the three digit score still, but you can approximate your score based on the EPC). Then base your speciality ambitions on that. Barring a disastrous actual test day performance this would allow you to see where you stand on the competitiveness scale test wise.
Taking Step 2 on Wednesday! I’m taking a research year so took Step 1 for a score but will be graduating 2024, when most of the other students will be P/F. Will be very interesting to see if my experience with ERAS differs from theirs based solely on the fact that I’ve got a number for Step 1!
Good luck! I took my first CCSSA on Saturday with a friend of mine. Very glad I did.
Best of luck !
Are there plans to make Step 2 pass/fail as well?
I want to give my take. I took step 1 pass fail, I completely revamped my form of studying during dedicated. My classmates and I were very collaborative and helpful to one another. Because of these changes I made in my studying, I believe I am better prepared to face the beast that will be step 2. Step 1 was sort of a primer for me, it showed me the errors I was making in my study habits, that I should have started earlier, used picture mnemonics and even made my own, etc.
In summary, the first test has helped me learn HOW TO study for boards exams. Which will set me up for success going into step 2 prep. So yes, the stress has shifted onto a new exam, but I certainly feel MUCH better prepared for how I will approach this stress
You only really find what works for you when youve actually applied it and seen success with it.
Different personalities for diff people but most people find step 1 alot harder than step 2
@@inchyokk If thats true, I suppose Il be that much more prepared to study for step 2 then
It could be argued that practice exams would have given u the same results
@@thefocusedlife497 practice tests were part of my preparation, along with all of U world. I see your point, however the definitive confirmation for me that what I was doing worked was obviously seeing my test result. I have great confidence applying what I learned during dedicated early in step 2 ck prep will get me a great score
But then what will they use to asses residency applicants if the most important factors are being secluded from scrutiny? The step 1 was a test we could use to differentiate applicants. Now it will be even more difficult to set us apart from others. What do we do ugh?
Thanks for such a wonderful video that gives me a perspective. I’m going into my first year of med school (DO), and fingers crossed we won’t be negatively impacted
Personally I prefer Step 2 to be graded and Step 1 to be P/F. Our School has professors who teach the most low yield information and has in house exams, so it makes it extremely difficult to study for boards to be competitive (If you try you will fail the courses ex. we are basically memorizing Robbins) Step 2 is what you make of it. You don't have professors holding you back.
I agree! Though thank God I am doing well on practice exams, I am glad it's pass fail and I do prefer more weight being on Step 2 and extracurriculars.
I don't even care about Step 1 being P/F. My issue is that now people may get screwed if they do badly on Step 2 CK. If you planned on going into Ortho and end up with a 220 on CK, you now have to start thinking about an alternate career and at this point you're already close to graduation. I understand the reasoning for Step 1 p/f but now everything just shifted onto Step 2 CK and people having to take an extra year or people having to switch plans later in the process towards graduation. Also, now I would place higher priority in attending a big name medschool if I were premed because letter of rec would be more important. A Pass on Step 1 from UCSF student is seen better than a Pass from a student from Texas Tech University trying to go into neurosurgery.
The fact that students couldn't retake the USMLE Step 1 once they passed it was problematic. E.g., one's average score could fall within a range of 244 - 250. If that person got a relatively bad pool of questions and were also unlucky in guessing, they could easily score a 244. If the opposite happened, they could easily score a 250. This sort of difference was enough to determine whether or not one could get into a highly competitive residency/specialty. Randomness was too impactful!
I like that USMLE Step 1 is now truly P/F; however, other changes need to be made. We must determine the most important factors that can be used to divide students into residencies based on estimated future success while eliminating arbitrariness and randomness. I feel that a potentially good remedy to the issue of matching into residency could be one that utilizes analyses and evaluations specific to each specialty; extensive research would need to be performed to determine what unique evaluations and analyzes would be the most effective, efficient, and realistic indicators of success for each specialty.
If you are reading this and would like to answer:
What do you think could be potential solutions to the current problems faced when determining how students match into residencies? What are your opinions on my views?
another disadvantage is for students that study abroad.. some places already make it more difficult for them to get into residency and the grade of usmle1 sometimes helped them "prove" that they are not less than instate/country applicant.
I feel like pass fail step 1 will only make CK more important and make things more difficult for DO and IMG students for matching in more competitive residency spots
It definitely is scary thinking about how STEP 2 is now the big deciding factor especially when considering that the exam is taken at the end of M3. Personally, I’m shooting for ENT and it’s scary thinking that my STEP 2 score could potentially be not good enough and I’d then have to scramble and figure out what other specialty I’d be interested in. That would just make the match process a lot more stressful.
I agree with what you are saying. USMLE is overwhelmingly important in the road to getting into your medical specialty of your choice.
Now that its pass fail, how can one who goes to a “lower tier” med school stand out/ become competitive for specialty residencies ?
Gotta focus on other things in your application
Step 2, research, extracurriculars
If the idea from the USMLE was for both exams not to be used to ranking, then they should also make step 2 P/F to be consistent. No use to have one scored and one P/F because its only logical that people will only care about the scored test. I suspect they'll move step 2 to P/F within a few years depending how this goes.
Thanks so much for doing this great video. It is really really sad that one exam decides your future and every effort done in the past to be doctor has been destroyed. There are others things that I do not agree. The salary for residents is so lowwwww and they work as slaves at our hospitals. With the new salary raise, our janitors make more money than medical residents who work 80 hrs sometime weekly. Does anyone know why the resident salary is so low compared with the volume of work and level of responsibilities they have?
Step 1 going P/F has me super stressed about deciding on a specialty. I am finishing up my 2nd year now, taking step in June, and am still not sure what specialty I want. Not having a score for step 1 means we don’t have the guidance from that on what is still realistic to pursue. I just don’t want to go after a competitive specialty only to have my step 2 score come back after applying and not be enough.
of note step 2 CS Is no longer offered...it was replaced with oet
Yeah I knew that. Don’t know why I mentioned it haha
They should get rid of all the exams!! We had enough during medical school itself!! It is not right to stop doctors from practicing medicine once we have already gotten our degrees!! The exams stress me out !! I don’t want my whole life hanging on exams. 😥
I totally agree with you….the fact that you know everything is on these exams it’s enough anxiety to make you not do well…..i feel like they should focus more on preceptor evaluations and extracurricular activities if anything.
I feel like the change was made in good faith, but ultimately as you said doesn't change anything. It's kicking the bucket down the line to something else. The main problem is that residency spots can be incredibly competitive to get despite us being in the middle of a doctor shortage, and how residency slots want the "best" students. So they'll always use metrics that could suggest that a student is the "best". If it isn't board exam scores, it'll be what medical school you went to. It may even be MCAT scores if all of medical school becomes p/f. There really isn't a way to win here unfortunately, which feels awful since this change seems to be a shift to help make the process better for up and coming doctors.
Step 2 CS was basically an English exam for IMGs with the extra kick of getting money from US graduates LOL. Now they have some other different ways to collect money from IMGs instead of Step 2 CS.
Because of this medical schools have added a bunch of new things to their curricula, mostly just "mandatory activity" so it defeated the original purpose of easing the stress for getting a numerically high score on USMLE 1. Why does our system value form over substance and activity over actual learning?
Interesting ! STAY SAFE ALL ! ER doc here !
Read the title. Don't worry. We all said the same thing. In fact, they did a whole survey in the NEJM and most directors basically made the same points you did. However, the competition aspect didn't exist between myself and other medical students. We were all more concerned about beating the exam than each other. Simply "hiding notes" didn't make a difference when everyone use the same resources.
Step 2 is more fun to study or at least more relevant I don’t care abt how to differentiate valine from aspartic acid so yea it’s a really nice move.
Now it make sense because step 2 is more important in saving life’s!!
Yeah this is bad IMO. This will just give students who have a plethora of research opportunities better chances of matching at better programs (ie. students at top schools will have easier times matching, especially to competitive specialities). Third year students will even be less interested in clinical medicine because they'll be more focused on clerkship grades (shelves) and studying for Step 2. This will all lead to students being less prepared and more burnt out (as they aren't spending enough time in the hospital to know what specialities are really like).
Not saying Step 1 scores is the answer, but doing this will make things worse. We will see how things are in 10 years.
EDIT: I think your comments about Step 1 competition is over the top. My experience is obviously different than yours, but I never once saw or experienced somebody not helping/trying to sabotage somebody on Step 1. I mean alot specialities have hundreds/thousands of spots, helping your classmate won't really effect anything. You would think a med student could understand that math. Just sounds like your school selected shitty candidates or my school did an amazing job. Who knows.
Yeah I don’t think it’s going to do as much as they anticipated
Imo i’d rather be tested and evaluated on clinical knowledge that i’m gonna need in my career than useless facts which constitutes the bulk of step 1
@@HA-vm9ph Meh, I use step 1 material everyday. And I thought Step 2 wasn't really that clinical but it has been awhile since I have taken it. Still have to know nearly all that crap from Step 1. Step 3 is a clinical exam though.
@@drewmartin9148 my fiancee took step 2 last year, she also said it didnt feel as clinical compared to step 1
What do you think would be the best way to go about this situation? How would they be able to compare in a fair and standardized manner while taking off some more of the stress in your opinion? I feel like so many people say that this decision didn’t solve the problem and while that’s true, I can’t think of a way that they can currently solve it.
I would've seen if some sort of application score could be added for the STEP exams alone. Where STEP 1 has a lower multiplier score while STEP 2 has a higher multiplier. That way, both scores matter but STEP 2 is more heavily emphasized due to relevance.
Of greater concern to me is this new methodology in residency application where you essentially super like certain programs where they know you’re highly considering them. The fear is that you apply to 50 programs, star 30 of them, then never hear back from the other 20-all of which you would have interviewed at previously and considered. Now you may not hear back because you didn’t favorite them? It’s more stress to a stressful process. It’s annoying.
Also, very important is the fact that step 1 was a major source of depression and caused many unfortunate med students to end their lives. It’s sad but true. Luckily, the rates of medical student self-harm goes down.
Never studied for any of them…but was 34 years ago…so slipped through…
What is the criteria of deciding pass/fail for step 1 ? On what basis they decide if this student is pass or fail ?
I hope I can pass USMLE I Don't haves a job,I am 36 years old all my dreams related to USMLE,if I can choose between my life and USMLE I would choose USMLE
What makes it more fun is that many Med Schools still operate under the STEP 1 emphasis with STEP 2 as an afterthought.
@@BrocKelley 9:15
If only we had a place where students could be evaluated individually and holistically over the course of four years in order to determine the best placement for them for residency and when they are ready to move on to that step. Maybe some sort of…school…for medicine.
That is okay. At last these tests show who works harder and more prepared to recall the medicine when the time comes.
Exactly! Not the basic science bullshit we're expected to stuff into our brains MS1-2.
I wish blessings to the future doctors who are reading this.
*thr is nothing wrong, necessarily, as long as thr are unlimited re-sits.* tho it still needs work. you could not match str8 into a fellowship, & get to it later. that may leave too many hospitalists. education is a problem, any time it is not about the education. -JC
Step 1 though tests a lot of esoteric clinically less relevant material. Step 2 is more relevant to clinical medicine.
I mean it is filled with a lot of details but there is absolute correlation between STEP 1 and STEP 2 success which suggests it isn't all useless.
Why would this affect us IMGs negatively please can u further elaborate ? And how can we compensate this disadvantage in order to be able to match into highly competitive speciality
what do you think about canadian LCME accreddted schools with stuents applying to competitive specialties? would we be viewed as every other IMG?
Just an FYI that Step 2 CS (clinical skills) is no longer a thing since COVID.
Why don’t they just have one test that is Pass/Fail?
CS is over! Thank goodness!
Can you make a video about Interventional radiology matching for IMG s!
Just make it so that students can retake step 2 up to 3 times
I want to ask if I was matching for internal medicine, would it be difficult to get it or it is somehow possible ?
step 2 CS is no longer there
I’m wondering if they’re testing the waters to eventually make step 2 pass/fail as well
That would absolutely destroy the chances of a DO or IMG student matching into any remotely competitive specialty
Same problems with the MCAT. I will talk to nurses, patients, and other hospital staff and they ask me why doctors are so competitive and hard to work with. I honestly think these exams that pit students against each other is a large reason doctors are non-team players sometimes. This is sad to me because we should be collaborative and we are trained to be so.
Lemme tell u as a 2Nd year med student I’m loving the pass fail. I’m vibing this semester whereas if it wasn’t pass fail I think I would be stressing much more
I suggested that you should watch and react on Nair Karma.
Step 2 is a better indicator than step 1 . I don’t agree with his opinion.
Pass/Fail is good. Step 1 has never been a great indicator of one's ability to be an actual doctor. It was only setup in it's former form because of the chaos that was the residency-position offer process prior to the NRMP match. It's obvious that directors needed a way to delineate candidates when it was more common to give offers ~2 years prior to a student's graduation.
The whole time they knew that a good score in basic sciences doesn't mean someone would be a good doctor.
Step1 finally changing is a classic example of the lag/latency for systemic change in medicine, and what is actually dumb, is how long it took for the old guard to get out of the way. Step 1 should've been pass/fail right after the Match process/algorithm was solidified and "perfected," to the ability that it can be. So, at least 10 years ago.
CK should've always been the lowest level metric used by residency programs. The application of science in a clinical setting is what it is to be a doctor... so yeah. Pass/Fail is good.
Super interesting. In Canada all med schools are P/F so your residency apps are 100% considered on your evaluations in med school (preceptors, electives, extracurricular, references, etc.). Even the MCCQE exam isn’t written until your graduating year and you write it AFTER you match traditionally. Means that you have a chance at matching regardless of your med school & grades and focus on your actual qualities
I heard step 2 is mad easy compared to step 1 tho
How will this be detrimental to imgs?? Like i am from india. And from 2024 by new ecfmg accredetions rules all medicsl schools will be removed from the world directory of med schools . so american board or usmle will not recognize our med schools as authorized ones. Please throw a loght on this dr cellini.
How will it affect imgs after 2024 from our country?? Cant we give usmle anymore?
Apply for step exam and fill form 183 before 2024 . You will be good .
@@AD70003 i will be in 2nd year in that year. How will i give step 1?
@@aritrachatterjee9090 you can apply in advance
The things about STEP 1 being pass/fail is that, it's not like medical Students are going to study THAT MUCH LESS for it just because it is pass/fail. Because if you happen to fail it then...you really won't get into a decent residency. So basically you will be studying almost as hard, but with none of the pay off.
Lol yet another reason why becoming a physician is easily the hardest career out there.. most people out there don’t realize what it takes
As others have mentioned, turning USMLE Step 1 pass/fail has the intended or unintended consequences of hurting DO and IMG students in the match. If you are a DO or IMG student begin studying for Step 2 from day one and try to take Step 2 before the match to show you are "worthy". If you are not competitive for competitive specialties such as Derm, consider completing 2-3 years of internal medicine. The ability to take care of very sick patients is a desired commodity in specialties where those skills may be lacking.
Thank you
CS doesn’t not exist anymore . Stopped during pandemic and USMLE decided to not ever bring it back 😀😀
Are all specialties of medicine really a team sport?
Mysteriously, once beyond the highly competitive college and medical school environments, physicians are generally collegial and cooperative. Docs have come to realization that the only people really looking out for their health and welfare are other docs.
Step 2 is going to be pass fail too. In process now
I'm working on USMLE I
I like this type of content
Your med school’s ranking and prestige are now the main deciding factor in your residency decisions.
All those texts suck....some people just don't test well!
Sounds like you had a lame med school class. My classmates and I always helped each other out studying for exams including USMLE. Yes people were competitive and tried to get top scores but you can still be good natured and help others while doing it.
Stoggles is still best sponsor :)
I'm not a med student. A former nurse. I find your channel very educational. I hear alot about these step exams. How stressed the already stressed student is. What's interesting is I've found just because they do so well on these exams doesn't mean there a great doctor. It's not cool that if your scores make it so u don't match in the field they want ? I think pass failed is best. So what now step 2 is the hardest? I just don't understand how these med schools work?
I love how pessimistic everyone is!!
Can I take the USMLE exam even if I haven't studied medicine in the US? Kind of important cause I think it has a higher value than my country's exam.
You have to be ECFMG certified, check in the WDOMS if your school is listed. If it is, then you can take the USMLE.
Is this guy really a physician
Na
@@DrCellini Only because Georgia really isn't part of the United States
Thoughts on real estate possibly crashing
In my situation, my dad counseled me to get the best undergraduate degree possible. It didn’t matter what type of undergrad degree you got as long as you did good on your MCATs. Heck, you could get a four year degree in basket weaving and end up in medical school. I chose mechanical engineering as my undergraduate degree. Graduated with a 4.0. The reason why I chose mechanical engineering is because if something happened during medical school I could always fall back on my BSME. I can support a family with a BSME. Most doctors have degrees in the basic sciences. They drop out of medical school and they serve fries at McDonald’s. When I graduated medical school, step one and step two were very important. I put all my eggs in one basket and I knew that I would end up in the program of my choice in Europe which allowed me a double board certification in trauma and cardiothoracic medicine.
MDs aren't collaborative. About the only difference between the MDs and DOs. We have legit the exact same curriculum just have to learn some extra voodoo BS.
You lost me at step 1. Lol
me too lol
Where is your wife !!!!!!!!! jk ;D
.
No one cares about usmle anymore
Quite the blanket statement
I hope I can pass USMLE I Don't haves a job,I am 36 years old all my dreams related to USMLE,if I can choose between my life and USMLE I would choose USMLE
I've always believed USMLE is not all about studying, you need God's grace to pass
So sorry about that am still looking forward too take my USMLE exam on April just studying hard and praying to God I know I can make it.
USMLE exam is so difficult & I don't know the reason why it should be?
After, 3-4 years of studying we are being challenged be the ultimate exam "USMLE" many students face difficulties in acquiring their license
I failed my USMLE exam 2 times first was 2020 second was 2021 and I lost money on review questions and also wasted a lot of time studying which never helped me .