Mailbag: Questions about the USMLE
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- čas přidán 8. 09. 2024
- Time to answer more of your questions - this time, about the United States Medical Licensing Examination.
We’ll cover…
1. What to do if you have a problem at a Prometric test center (0:51)
-USMLE policy on “unanticipated test conditions” (see page 15)
www.usmle.org/...
2. Should you request a USMLE score recheck? (5:50)
-“To date, the score recheck process has not resulted in a score change.”
www.usmle.org/...
3. I failed the USMLE - can I appeal that it was a statistical fluke?
-Sheriff of Sodium: A brief update on USMLE score creep
• A Brief Update on USML...
-USMLE score interpretation guidelines
www.usmle.org/...
-Rubright JD, et al. Acad Med 2022; 97(8): 1219-1225.
pubmed.ncbi.nl...
4. Do USMLE Step 3 scores matter for residency selection?
-NRMP Program Director Survey (2021)
www.nrmp.org/w...
5. Why did the USMLE Step 1 pass rate drop after pass/fail?
-USMLE performance data:
www.usmle.org/...
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MUSIC: “Clutch,” by Nicolas Major.
Prominent IM Program Director who is active on X and recruits IMGs: like no one knows who he is!
Great video and excellent presentation of Data. Thank you for all the hardwork and time you put in these videos.
Thank you for watching.
Important stuff
Thanks
23:21 the accuracy 😂
One advantage for IMGs is the possibility of obtaining an H1-B visa which is a dual intent visa without the 2 year home country residency rule and hence eliminating the need for a CONDRAD 30 waiver. Another thing to think about is would having a passing score would give you an edge during ranking? We see the data on PD survey on choosing applicants to interview, what about factors used during ranking, does having a passing score help you move up the rank order list? I imagine 2 very similar applicants with comparable interviews and profile, is it likely the one with the passing score gets ranked higher as they don't need to dedicate time during intern year to study for the exam? Probably the extra time helps them adjust better to a new system? Specialties like surgery which have in service exams ( ABSITE ) would surgery PDs choosing IMGs consider step 3 as more important compared to say PDs in IM ?
These are good points. To answer your question, yes, the NRMP PD survey also evaluates factors involved in ranking. An even lower proportion of program directors indicated that they use Step 3 scores in ranking (8.4%, vs. 12.6% for assigning interviews), and the mean importance was 3.5, which was again the third lowest factor of all the factors evaluated.
IM (and other specialties) have in training exams, too - but I think most PDs believe that Step 2 CK scores are an adequate measure of an applicant’s ability to succeed on that type of test (and later specialty boards).
Personally, I just don’t think many program directors care much about Step 3… but certainly, there are some who do. And as you suggested, and it’s certainly possible that a strong USMLE Step 3 score could tip the scales in an applicant’s favor (especially at an IMG-centered program).
If you’re confident you’ll score highly on Step 3, there’s little reason not to take it. At the very least, like you pointed out, it frees up your intern year somewhat to have that test out of the way. And it’s possible that, on the margins, it could help you.
On the other hand, if you’re not confident you’ll excel on Step 3, it may be better NOT to take the exam, since a low score or worse, a failure, could seriously hurt your chances.
@@sheriffofsodium Thank you for the reply. Maybe it's time for a post P/F Step 1 era PD survey. As an IMG embarking on a research year, applying General surgery next year( hopefully), I want to get the exam out of the way and honestly be done with the steps. I would anyway have time during my research year ( much more than I would during intern year) to dedicate for it. But I will keep aiming for a good score. Who knows I end up on the margin and it could help me out.
This data is pre P/F, isn't that unreliable honestly, Maybe Step 3 has a lot more importance now.
Could be. I think Step 3 will become more important… but its value is still going to be limited by the fact that it can only be used to distinguish among IMGs, not between IMGs and graduating US MD/DOs.
Is it worth doing step 1 anymore with it being P/F. Or is level 1 plus step and level 2 enough?
This is from the perspective of a DO student
Great question - and no, I would not take USMLE Step 1, for several reasons. First, it doesn’t matter that much to residency programs. Sure, there may be some programs that will screen applicants by having passed USMLE Step 1… but this should really be taken more as a sign that they aren’t crazy about having DOs. Even if you bypass the filter, I’m not sure how likely it is that you’ll overcome the underlying bias. Plus, my perception is that this is a small number of programs. Second, there are a small number of students who will pass COMLEX-USA Level 1 but fail USMLE Step 1. (I’ve discussed this before, or take a look at the NBOME’s own concordance tables to see what I mean.) A USMLE Step 1 failure harms an application way more than a Step 1 “pass” helps it - so unless you think your chance of failure is near zero, it’s probably not worth the risk. Third, it’s expensive - not just in terms of the actual registration fee, but also the time to travel to and take the exam, etc. There are opportunity costs that are probably best directed elsewhere.
@@sheriffofsodium thank you! there seems to be a disconnect between what I read on places like reddit/SDN, where people predominantly say to take step 1, and hearing from folks like you and at my school, who recommend not doing it. It makes the decision a little confusing lol.
@@jns6320 Well, if you wanted to make a case for taking Step 1, I think you could. As you know, COMLEX-USA question stems are a little less ‘clean’ than those on USMLE. It’s certainly possible that having some real-world experience with the USMLE *before* you take Step 2 CK might improve your score on that exam. It’s also true that a good portion of USMLE Step 1 prep is foundational to Step 2 CK prep, so taking Step 1 could also benefit you in that way. But it’s an expensive, and not risk-free, way of achieving those benefits (vs. simply spending that time/money/effort in deliberate Step 2 CK prep).
Please do away with the annoying music 😢
But that’s the Sheriff of Sodium music.
@@sheriffofsodium I can understand that Doc, but perhaps a bit softer music?
Maybe if the music were the same volume as your talking it would help!
For real? That’s a sick riff man-keep the Fender Sheriff!