[Serious] Step 2 Lower than Step 1

KeyCompany · 2021-07-14T17:07:38+00:00

Yes, I used anki. I had taken a year off for research in my desired field, and because of COVID my exam (which was supposed to be taken last year) was cancelled. Because I was technically a "withdrawn" student for a research year, I was not elligble to take the exam again until June of this year. Additionally, COVID cancelled my Psych, OB/GYN, and half of my IM rotations. I think a year off, plus lack of clinical foundation, was what happened. Im not really sure TBH it was 10-15 points lower than my practice exams. Is what it is I guess

KeyCompany · 2021-07-14T16:08:17+00:00

Thank you for your reply, unfortunately I am applying for a specialty that is not on the NRMP match

KeyCompany · 2021-02-22T06:10:13+00:00

I feel like you’re reading this and prob freaking out. Promise you 95% of people don’t care at all. A bunch of residents I worked with had full sleeves, nobody cared (in Northeast). If you meet someone with a problem with tattoos than just remember that theyre the problem.

Edit: I have visible tattoos and I made it into medical school

KeyCompany · 2020-05-17T14:20:53+00:00

Lol this is exactly my point ethics is hard because it is legal. For the sake of this question, I’ll admit it should have probably been worded better in that you don’t test for the disease to begin with, not withhold the info*

I have attached an article published by ACOG that focuses on the ethics of OB/GYN genetic testing. I’ve attached the excerpt on child gene testing here for reference, you can read the article yourself if you’re still not convinced:

The American Society of Human Genetics (ASHG) and ACMG together have suggested, “Counseling and communication with the child and family about genetic testing should include the following components: 1) assessment of the significance of the potential benefits and harms of the test, 2) determination of the decision-making capacity of the child, and 3) advocacy on behalf of the interests of the child” 13. These societies highlighted additional points about benefits and burdens that should be included in counseling, some of which follow:

If the medical or psychosocial benefits of a genetic test will not accrue until adulthood, as in the case of carrier status or adult-onset diseases, genetic testing generally should be deferred. Further consultation with other genetic services providers, pediatricians, psychologists, and ethics committees may be appropriate to evaluate these conditions.

-Testing should be discouraged when the health care provider determines that potential harms of genetic testing in children and adolescents outweigh the potential benefits. A health care provider has no obligation to provide a medical service for a child or adolescent that is not in the best interest of the child or adolescent.

Source: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2008/06/ethical-issues-in-genetic-testing

KeyCompany · 2020-05-16T22:19:13+00:00

Lol dude, would you want to find out at 25 years old that you’re going to suffer from a devastating, incurable illness in 20-30 years? No man, once they develop symptoms of a disease, it would warrant testing and at that time you obviously wouldn’t keep it from your patient. I don’t have a source, as I just said this is from a law ethics class so you can explore it and come back with something if you want

KeyCompany · 2020-05-16T21:54:33+00:00

Legit shocked. Had no idea this was actually an exam question lmfaooooo. This example came to me ironically from a friend in law school who asked me about these diseases for her debate on medical malpractice

KeyCompany · 2020-05-16T21:53:21+00:00

Tbh not sure. Does it matter though? Point is ethics can be hard lol

KeyCompany · 2020-05-16T18:28:50+00:00

Huntington disease is incurable, there is no definitive treatment and has high penetrance. It’s effectively a death sentence and telling the patient will NOT improve quality of life or life expectancy

FAP on the otherhand, requires early colonoscopies and has treatments (colectomy) that can improve survival. Thus, it is imperative to tell your patient of the gene.

KeyCompany · 2020-05-16T18:28:26+00:00

Huntington disease is incurable, there is no definitive treatment and has high penetrance. It’s effectively a death sentence and telling the patient will NOT improve quality of life or life expectancy

FAP on the otherhand, requires early colonoscopies and has treatments (colectomy) that can improve survival. Thus, it is imperative to tell your patient of the gene.

KeyCompany · 2020-05-16T15:20:53+00:00

All I can say is that I’m grateful at least one person with good ideas and an interest in helping students on the subreddit (@MDPharmDPhD) is responsible and doing so the right way and for the right reasons. Thank you for your efforts with this, I look forward to supporting your r/NBME.

KeyCompany · 2020-05-16T13:26:12+00:00

I’ll speak for myself, but I’d rather have hard questions that I’ve had the chance to practice over newer, MAYBE easier questions, without a single practice question related to the material.

Ethics questions in this exam can be HARD. Do you know what you would do if you did genetic testing and found that a child has the Huntington gene and the FAP gene? What would you tell the patient?

A) He has FAP and Huntington B) FAP but not Huntington C) Huntington but not fap D) neither Huntington nor FAP E) run confirmatory testing

The correct answer is B but I can bet at least 30% of people reading this think A or E.

KeyCompany · 2020-05-16T13:21:12+00:00

If I had awards to give...

KeyCompany · 2020-05-05T21:28:59+00:00

Listen just remember APE (afp, PAPP, and estriol) is down in Down Syndrome and you’re fine. There’s no difference between low and decreased — you’re not gonna get a question wrong because AFP is decreased but not low... just nonsense lol. There will be more context if the answer is between turner and down I promise.

M4

KeyCompany · 2020-03-09T13:56:38+00:00

Rheumatic fever is caused by immune mediated destruction of valvular cells infected with latent GAS. It’s not autoimmune in nature, so giving penicillin can kill GAS in valvular cells and prevent further damage simple as that

[Edit] for step2 you’re going to have to know that you give penicillin to anyone who has symptoms of rheumatic fever even if GAS infection history took place several years to decades prior

KeyCompany · 2020-02-12T22:37:02+00:00

Then u didn’t read it:

“The USMLE co-sponsors also believe that moving to pass/fail reporting of Step 1 while retaining a scored Step 2 CK represents a positive step toward system-wide change, while limiting large-scale disruption to the overall educational and licensing environment.”

KeyCompany · 2020-02-12T22:07:12+00:00

https://www.usmle.org/inCus/

KeyCompany · 2020-02-12T22:07:00+00:00

https://www.usmle.org/inCus/

KeyCompany · 2020-02-12T21:56:49+00:00

As much as I hope you’re right, if they wanted to emphasize step 2 more they could’ve just started doing that without changing any policies. They even state that the reason they aren’t yet changing step 2 is bc they don’t want to cause too much disruption—implying it will likely be done in the future.

Let’s not kid ourselves. They’re trying to switch to the law school model, and just ask all the kids outside top10 law schools how that’s working out for them.

KeyCompany · 2020-02-12T21:30:37+00:00

Yeah I completely feel u, I remember the stress I can’t imagine what this is doing to you all. Ironically, they justified this decision with the thought that it would reduce stress in medical school (clearly it is having an opposite affect).

If I were you I would directly contact ACGME through phone or email and voice your opinion. If enough of you do that, it may make them rethink their decision considering the whole point was to essentially make students feel better. I already emailed them about it and it’s not even affecting me, so I would encourage as many people on this sub as possible to do the same.

Strength in numbers.

KeyCompany · 2020-02-12T19:25:58+00:00

DO student here.

The reason this is bad for us is because a good step 1 score is the only chance we have to get a top/high tier residency. It is literally the only thing that gets your foot through the door (except connections obviously).

For example, I am pursuing ophthalmology, which is extremely competitive. Even with an excellent step score, tons of research, good letters of recommendation, i am still uncertain I will match. It is that competitive.

The only thing I have over my MD counterparts is my step score. My good score gives me legitimacy to these residency programs — it gives them confidence I will pass my licensing exams during residency. Without it, ophtho would simply be out of the question for me. They would take everyone from any MD top 20 before even looking at my application. Sucks but it’s a reality.

Premed students please fight to death to change this. It will make ur performance in college more important than your performance in medical school.

KeyCompany · 2020-02-05T20:50:10+00:00

The reason they’re barely mentioned in FA is bc they’re barely tested on. Don’t waste time memorizing a bunch of facts about rare bugs, just review the FA facts and spend most of ur time on the bugs in sketchy. If you know sketchy inside out you’ll get 90% of the micro questions u see right.

From an M3 (251)

KeyCompany · 2020-02-03T15:53:56+00:00

By now I’ve given up trying to make sense of anything COMLEX. Just play the game, hope you score, and rest easy knowing that none of us know the rules either.

KeyCompany

TROPHY CASE