Is the USMLE Step 1 useless?

Dr. Centor thinks so:

Medical students spend the first 2 years with step 1 anxiety. This is a difficult test, which – in my opinion – adversely influences the teaching of basic science. Medical school leaders design the first 2 years of medical school so that their students have a good chance to pass the test.
We need to know basic basic science to be excellent physicians. But ask most clinicians, and they use little of their basic science education.

Update:
DB with a follow-up post.

Comments

The Independent Urologist
I disagree. My understanding of basic science influences my understanding of clinical medicine.
Anonymous
I disagree too.
How the heck are you supposed to rate a student from medical A vs. B? Some schools have a pass fail system… and some have an A-C grading system. You tell me what looks better… C or P (both mean the same thing theoretically)?
Basic science… blah blah blahh…
Robert
please reread my entire rant. I am not advocating getting rid of basic sciences, rather I want students to learn the basics and not get overwhelmed with minutia.
Anonymous
I’m still confused. I’d like to think understanding of basic science is one of the things that distinguishes us from the paramedical people nibbling at physician scope of practice.
And more to the point, is it important or not? If not worth knowing, why bother teaching it in the first place?
If it’s not worth testing, aren’t you saying it’s not worth knowing? Why bother having standards? Pass the test, fail the test, you’re a doctor anyway.
Where the basic sciences becomes most useful can be interpreting tests. I’ve run into many occasions where a test shows a certain result, nurses say this result = certain action to follow. Without getting into details in a forum like this, it is clear the people involved don’t know the purpose of the test, what precisely it’s measuring, the limitations of the test, etc.
I’m thinking of one instance in particular where a child was about to be led onto a wild goose chase of invasive testing, ICU stays, etc., because of a false-positive test. I had to spend a lot of time explaining pharmacology and biochemistry to various nursing administrative types who stuck their noses into the particular matter. Yes, I was right in the end……
I know it, because I learned the basic science. That’s what’s supposed to be one of the things distinguishing us from the NP’s, etc.
Whether it’s minutia or otherwise, without testing, how do you know if the student learned anything at all in basic science?
KoKo
As a PhD biochemist and professor, I’d say that most MDs do use their basic sciences in their daily practice, whether they realize it or not.
Personally, I’d like to see more emphasis placed on biochemisty, physiology and pharmacology and less emphasis on molecular biology in the medical school curriculum.
Greg P
One of the things I have tried to explain to my son about undergraduate college is that the significance of a college education is that you were given the task of meeting a number of criteria to learn various areas, some of which you may have been interested in, some not. You end up showing that you can succeed in that task, which is similar to life in the real world, and this makes the college degree valuable, not so much what you learn.
Similarly, medical school is the same thing at a higher level, teaching you how to teach yourself, how to reformulate ideas as new concepts develop in medicine. How to recognize that something isn’t what it looked like at first. It’s basic science that helps us do this. Like any part of a medical education there has to be some rigor in the method, some measure of learning. Otherwise, you may as well just be part of an audience watching basic science documentaries in a passive way.
Mike
What specifically would you like to cut out? Your post was awfully vague and seemed relevant only to YOUR education, i.e one or two profs you had that taught you stuff they were researching, etc.
I can’t think of one thing I was taught in basic sciences that didn’t help my practice of medicine. True, I dont remember 90% of it, but so what?
Seriously Bob, what should be trimmed, specifically! And since testing promotes memorization, and rote memorization is the only way to remember 1000 anatomic names and drug side effects, what slternative is there?
Anonymous
How about that clinical skills exam they do these days?
Seems awfully expensive.
I really don’t know, so put away the flamethrowers. The clinical skills exam was before my time.
My concern is not that clinical skills are not useful, of course you need clinical skills. But does the exam really measure this?
Or are our new doctors spending a lot of money for a useless exercise?
Anonymous
ahem….rereading….the clinical skills exam requirement started long after I took the Boards…..

Is the USMLE Step 1 useless?

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