The Mythology of USMLE Step 1 Scores and Board Certification

There’s a persistent objection to making USMLE Step 1 pass/fail that goes something like this: Dear Sheriff, When you suggest that we should make USMLE Step 1 pass/fail, you overlook one very important thing. See, I’m a program director, and if my residents don’t pass their boards, my program will get shut down. Whatever failings […]

Symbiosis: The USMLE, ERAS, and medical education

From time to time, hunters exploring the depths of the Amazon rainforest stumble upon an eerie sight. Nestled amidst the almost-impenetrable jungle are well-circumscribed areas where the forest has been almost completely cleared out. Instead of the usual lush vegetation extending from the groundcover to the tree canopy above, these clearings contain only a single […]

The Etiology of Application Fever

I saw my first case of Application Fever three years ago. A medical student asked me to write a letter of recommendation for her internal medicine residency applications. She was a great student – easily in the top 10% from my work with her on the wards – and I was happy to do it. […]

The Intellectual Opportunity Cost of USMLE Step 1

Today, I took to Twitter to consider the opportunity cost of USMLE Step 1. How much, exactly, is Step 1 Mania costing us in terms of intellectual capital? Let’s do the math. How much time is spent on Step 1? A recent study found that the average student spends 11 hours per day over 35.3 […]

On pi and Step 1 Mania

What could an irrational number have to do with residency selection? Lately, I’ve been talking a lot about USMLE. I’ve argued that the current culture of Step 1 Mania is destroying medical education, and I’ve asserted that the test should be made pass/fail. Not everyone agrees with that. I’ve addressed some of the objections previously, […]

The new USMLE score report

Since January 15, 2019, students taking USMLE Step 1 (and Step 2 CK) have received a new score report. What changed – and why? If you’re interested in the party line, you can read it here. If you’d prefer to compare the reports yourself and come to your own conclusion, read on. (And if you’d […]

A MCQ exam on the USMLE

A few weeks ago, I got interested in financial conflict of interest at the National Board of Medical Examiners – particularly as it relates to their opposition to a pass/fail USMLE. At this point, I’ve spent more time reviewing the NBME’s Annual Reports and IRS Form 990s than any person should. I’ve learned a lot […]