The Short Coat

How residency programs misuse STEP 1 scores

01.23.2020 - By Dave Etler and the Students of the University of Iowa Carver College of MedicinePlay

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When listener Celebi Jigglypuff (yes, that's a pseudonym) reached out to ask whether we felt taking Step 1 after a year of clinical rotations (as some schools require) was a good idea or not, we were prepared to sink our teeth into that and have a normal show, too. But then, University of Iowa College of Education PhD student Andrea Ash happened to reach out to us because she's been looking at Step 1 as a class project and was surprised about what she was finding. Everything from residency programs using scores for an unintended purpose to a cut score far below the averages that students were obtaining to officials snarking about students who should be studying rather than having lives outside of med school. And thus, Dave's plans for the show were subverted for the greater good--a discussion on much of what's wrong with this important exam that can affect a medical student's dream specialty choice.

Is all hope lost if you score less than average for a given specialty? Certainly not! These are averages. But it's a source of anxiety that to many seems unnecessary--maybe it's long past time, they say, to make Step 1 pass/fail. Of course, then residency programs would grasp for some other metric to use as a way to weed out their long lists of candidates, but we'd be happy to deal with that in a future show.

We Want to Hear From You: Did you catch what started us talking about this week's topic? Celebi Jigglypuff's question! See why we love listener questions? Call us at 347-SHORTCT anytime or email [email protected] and tell us what you want us to discuss on next week's show!

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