Which is the Hardest Test a Medical Doctor Has to Take? Is it the MCAT, USMLE Step 1, Step 2, etc.?

Discussion in 'USMLE' started by Dr.Scorpiowoman, Oct 11, 2020.

  1. Dr.Scorpiowoman

    Dr.Scorpiowoman Golden Member

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    This question was originally posted on Quora.com and was answered by Paul Bolin, M.D. (physician)

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    Step 1.

    The MCAT has a fairly limited amount of information in disciplines that are objectively easier (elementary chemistry, general biology, etc.). Admittedly, I took the MCAT prior to the changes made in 2015, so my perspective might be outdated.

    Steps 2 and 3 are limited to commonly-encountered diseases and situations. That’s not to say it’s a small amount of information, as there are many commonly-encountered diseases and situations. It is also more judgment based. In other words, there may be multiple “correct” choices on a Step 2 or 3 question, but you’re expected to choose the “best” correct choice.

    Step 1 is almost purely a memorization test. It tests molecular biology and biochemical processes and detailed microbiology that you will never encounter in real life. The unique thing about Step 1 is that you could administer the exam to 100 practicing physicians and it’s quite likely that the majority of them would fail, and fail by a lot. That’s not the case for Steps 2 and 3.

    Personally, I found that I could reason my way through Step 2 and 3 questions. I could rule out wrong answers and make an educated guess, and more often than not I’d be right. With Step 1, there are a large number of questions where you either know it or you don’t. If you know it, it’s easy. If you don’t, you’ll have to make a wild guess. That’s the nature of a memorization test. And, for me, memorization tests are harder than judgment tests.

    Does this look like something your friendly doctor would need to know? (Step 1)

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    Or rather this? (Step 3)

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    Obviously one you see — tangibly and practically. The other is pure trivia.

    An honorable mention for Step 2 CS (which tests your clinical interview and exam skills, judged by model patients and real physicians). While well over 90% of examinees pass the exam, I found it difficult because it was almost impossible to “study” for it. You also have to satisfy a checklist, which just isn’t practical in real life. That is, in real life, you’re not going to ask a patient with an obvious migraine about their sexual activity. But on Step 2 CS you may be docked points if you fail to gather a full history. You have to get used to doing things in a way that you just don’t do in real life, as it’s simply not practical or time efficient.

    The old adage for Steps 1, 2, and 3 — when it comes to what you need to prepare is “Two months, two weeks, and a number two pencil.” I think that’s pretty accurate.

    Dr. Paul

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