USMLE Step 1 Pass/Fail: How Did We Get Here?

This week, I gave a brief talk at a meeting for academic physicians and program directors considering what to do in a post-Step 1 world.

My job was to set up the other speakers by explaining how we got here. How did a multiple choice question test of basic science with only peripheral relevance to actual patient care become the king of medical education and residency selection – and then collapse under the force of its own weight? I try to answer this question – and provide a brief rant on the rising wave of Step 1 Nostalgia that’s crept up in the wake of the pass/fail announcement.