 Hey everybody welcome back to my channel thank you so much for watching don't forget to like and subscribe. Wow so I'm reading this on the USMLE website. USMLE United States Medical Licensing Examination Board is saying that the USMLE program will change score reporting for step one from a three-digit score to reporting only a pass-fail outcome. A numeric score will continue to be reported for step two clinical knowledge CK and step three. Step two clinical skills CS will continue to be reported as pass-fail which has always been the case. This policy will take effect no earlier than January 1st 2022 with further details to follow later this year. Okay wow Pacific consideration was placed on supporting the educational engagement and overall experience of medical students and on increasing the dialogue about how multiple assessments of competency could best be utilized by the stakeholders in medical regulation and in medical education. So I heard about this decision coming to light you know in the last week or so and actually saw some other response videos to this on YouTube and I decided to make my own because I have just recently sent email to one of my mentees about you know what she should be doing as far as getting ready for applying to residency next year. So you know we talked about the step one score which was the issue it wasn't you know in her opinion a really good score so she was worried. So now you know this situation is going to be totally upended in 2022 when it becomes a pass-fail system. It's a crazy concept to think about because the step one usmally step one score has been the number that most residencies looked at to determine you know whether or not a candidate was even to be interviewed and then even going forward from there should that candidate be ranked. I'm very closely involved in this process in my particular anesthesiology residency program and so we look at these things and it's a part of our decision-making process. So now that it's going from a numeric score to a pass-fail system that is going to really change things for the stakeholders which would be you as a medical student everyone who is involved in the residency application process everyone is affected by this. So now that this is going to be the thing like what else are we going to be looking for to make sure that we are selecting candidates that will be successful. So a lot of people out there have been saying oh this is horrible this is not a good thing like you know step one you know it's really important to have this number but I actually I'm a proponent of the other end of things. I feel that the clinical skills and clinical knowledge part of the assessment from the USMLE I think those are actually very much more effective predictors of how well someone is going to do in a residency. Now you may wonder why you know why you're supposed to know a lot of knowledge as a doctor this is true you're supposed to have a very strong basis in the basic sciences this is true but does it always translate to you being a great clinician or even a competent clinician and how you interact with patients does that always translate you know the knowledge that you have does that always translate to someone being a good clinician or someone who is able to connect with patients figure out diagnoses and treat them maybe not I think you know those who haven't actually taken this step to clinical skills portion of the three step exams that test really is great because you're physically going in you're presented with clinical scenarios and then you're going in to see patients you know they have people who are sitting there as actors they're prepared for you know presenting and describing their symptoms and you go in and you see these patients after reading a clinical scenario and you have to formulate your decision making process as far as what are you going to do in your history questioning so how are you going to ask them about their symptoms and based on those questions how are you going to perform or what types of exams are you going to perform for physical assessment so are you going to listen to the lungs are you going to listen to the heart probably always but what else will you examine what other signs are you looking for and it really tests your conglomeration of knowledge the way that you put together I should say your clinical knowledge with your physical exam skills and clinical assessment skills so those are all the things that a resident physician needs to be doing every day and that's why I think it is a better test to look at again there's a past fail component but then the other numeric score for the clinical knowledge is the one that we're going to be looking at in another vein this is going to propose a lot of challenge for I would say people who are more medical students who are doing the USM lead to you know enter a US residency which we all know the spaces are limited to begin with you know there's such a high demand and low supply but knowing all that that being said this clinical skills test is really a test of your communication skills and most of the time in residency that is like the key that you need to have mastered so that you can actually present information examine your patients well and figure out what's going on so the communication aspect and you know especially if someone has the barrier of having English as a second language that may also you know make it a more challenging test and an assessment point for them so that's something that again it's a tough thing I think you know when there's so much emphasis on this portion of the test so that might make it even harder it's going to be very interesting to see you know just there are the pros and the cons it's very it's going to be very interesting to see how all of this affects the residency so all of this came to be as a result of a vote that involved the AMA or American Medical Association there were residents medical students and physicians that voted so once again voting matters some final thoughts right there are a lot of questions how is this all going to affect everything most specifically like the timing of these tests how is it going to be restructured is it going to be restructured to allow for people to have time to take step two and get those scores back before they're applying for residency because currently you didn't really have to have that all submitted to submit your application for residency the competitiveness of residencies what other criteria they're going to be putting at the forefront addition to step two what this means for the spots that we have available as far as you know different programs that are considered more competitive are they going to be more spot are they going to be any changes to the number of you know spaces that are allowed for training with the ACGME we don't know there are a lot of questions a lot of possibilities that will come up only time will tell if this is going to be a change for the better i know that there's a lot of stress and a lot of emphasis on the step one with medical students and this is actually probably the most distressing part of their training and that was mentioned by the statement that was put out by the AMA that you know it's going to relieve this really really tough burden off of medical students that actually improve their education yeah potentially that could be so and if that is the case and if that is so i think that that's excellent and great and will hopefully make for you know a better generation of doctors to come but you know it really does affect many many people who are pursuing medicine it affects you definitely you know those that are on their road to medical school and those that are currently just starting medical school are in there that will end up needing to apply after 2023 we'll see how it goes if not done right things could go either way so like i i keep thinking like my whole process and getting into residency when i was in medical school like my focus going in through the door was okay got to do well on your step one that's it you got to make sure that from the day that you start your basic sciences that you're thinking about studying for step one as a matter of fact the moment i started you know started taking exams in medical school i bought a book to review for step one and as i went through each topic i went to that topic in the review book to make sure that i was able to see the links to the standardized tests what they were going to ask me and the like so you know going in with that focus i knew like i wanted to get into anesthesia and it was very competitive so my goal was like you need to score in the 99 percentile you have to do it and so that was my goal i went in and that's basically what i had to do and because of that i was able to get into my first choice residency program and so i think that that one test the step one really like set my destiny so what is going to happen now i mean like all of the really competitive specialties look at step one you know you're wanting to go into radiology ophthalmology all of these specialties of surgery ortho like you need to have a really high step one and that's how it's been so what are we going to be looking at now we don't know you know they may switch up the timing where step one and step two are very like closely timed so you're gonna have a step one and then you're gonna have a step two maybe less than six months later you they may reverse it who knows they may call it something totally different so it's not step one it's just part of the test so it's usm only test you know we don't know what they're gonna call it maybe they may take away the numbers who knows step two may become step one whatever they may change it all together what i really want to emphasize is that all of these tests they're there for a reason we want to make sure that everyone has a standardized base of medical knowledge and also everyone is trained to take care of patients that's the most important part so i feel that if whatever way the test needs to be structured to make sure that the physicians that are coming through that are going into residency and that are in the community treating patients are the excellent and best they can be that i feel would be the most ideal outcome so however we can accomplish that let's do it guys leave your questions in the comments below people you know have varied opinions on this topic i want to hear what yours are yeah and don't forget to like and subscribe and i'll see you guys in the next video take care