Hello guys. I haven’t posted here in a while. Primarily since I’m already done with my steps. However I noticed the recent “explosion” of news and your opinions on the proposed changes to the scoring system. So let me give you my point of view:
First off, there is an important legend and false information being spread about the average scores of IMGs vs AMGs (I’m a non-US IMG myself). So let me address that. All the information I place here is from “Charting Outcomes in the Match 2018”, this pertains to the actual MATCHED physicians, you can look it up yourselves on nrmp website.
The false info: “IMGs score lower on Step 1 than AMGs, but they score higher on Step 2 CK”.
THIS is fundamentally INCORRECT. According to the data and I quote " Overall, matched U.S. IMGs had mean USMLE Step 1 scores of 222.5 (s.d. = 16.1) and matched non-U.S. IMGs had mean USMLE Step 1 scores of 234.1 (s.d. = 16.4)" WHILE “Overall, U.S. allopathic seniors who matched to their preferred specialty have mean USMLE Step 1 scores of 232.8 (s.d. = 17.5)”
So basically the confounding factor is whether or not the person has residency or citizenship in the US. Non-US IMGs constitute 58% of the total IMG population, and these graduates on AVERAGE have a step 1 score 1.3 points higher than AMGs. So whereas on AVERAGE IMGs have lower step 1 scores, this completely ignores the LARGE discrepancy between US and non-US IMGS.
The other half of this legend is also not true. AMGS have an average Step 2 CK score of 245, whereas for IMGS it’s 232 and 239 (US and non-US respectively).
So putting aside all of that data, and the false info being fed by a few people on this page. Here’s what I think! It is fundamentally UNFAIR to IMGs (Especially Non-US IMGs) to move to a pass/fail system. Simply due to the fact that these incrementally higher step 1 scores may have a significant effect on them matching or not. The other factors that may replace and assist with matching are scientific papers (finance dependent, and sadly I’m from a rather poor country), US medical experience (3500$ for a single 4-week rotation in Yale, in places where clinical rotations are free, the application costs range around 400$, and there is no guarantee of acceptance) and contacts (purely dependent on luck and completely nepotistic).
Yes, I am sympathetic to the old graduate, or the graduate who didn’t get a high score on Step 1. But changing the system is not a way to get them residency positions.
An alternative (in my limited experience, so do not judge too harshly) would simply be to prohibit “Filtering” systems based on Step 1 scores somehow, so the graduates with skills other than their Step 1 score would be able to shine. However disadvantaging such a HUGE portion of the IMG population is unfair and wrong to an extreme degree. Please, feel free to post your ideas as well. Sorry if this is a long post. Best wishes!