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How important/necessary is it to take the USMLE steps?


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Hi everyone, 

I'm entering 2nd year at a 4 year program and was just curious about how how important taking Step 1 is. From what I've been reading (and I could be wrong!) it's mostly important for:

  • Keeping residency programs in the states open (in that case, try to score competitively)
  • Keeping fellowship training in certain states open (score might matter, but not as much as residency?)
  • Working in certain states 

It seems that the classmates who have been considering writing it are interested in surgical specialties. The only problem is that I still don't know what type of medicine I want to do, but i'm almost certain I don't want anything surgical or highly procedural (will try to keep an open mind before clerkship though). We also aren't allowed to shadow right now which is making it a bit harder to get exposure to different areas of medicine. 

Any thoughts on this topic? I'm not completely opposed to studying/taking the test if it's important, but it does seem like a ton of additional work keeping up with Step resources alongside our curriculum this year, and then cramming it between 2nd year and 3rd year and potentially going into clerkship feeling burntout. 

Thanks :)

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I think the biggest question you have to ask yourself with this one is if you ever want to potentially work in the states! I have no interest in doing so, so I will not be writing it. If you think moving to the states is something you might consider doing, then I would write it. I wouldn't worry as much about "keeping residency programs open"- especially if you're not interested in surgery, there are many good jobs in Canada. Maybe someone who is really risk-averse would consider that as an option, but personally I'm not too concerned about finding a job in Canada. I'm sure others more knowledgeable can chime in, but for me it mostly just comes down to if you want to work in the states or not.

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I started it in second semester very very slowly. But really went into it in...May? APRIL? Writing it soon. Much rather learn the mechanism of a drug or the biochemistry of a disease now than in PGY1 when I’m learning to be a good clinician not basic scientist. going for surgical speciality so keeping options open for fellowship. If you go ham in the summer and sometime before you won’t sacrifice too much, and you’ll actually use some of your knowledge which is nice. 

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4 hours ago, IMislove said:

I started it in second semester very very slowly. But really went into it in...May? APRIL? Writing it soon. Much rather learn the mechanism of a drug or the biochemistry of a disease now than in PGY1 when I’m learning to be a good clinician not basic scientist. going for surgical speciality so keeping options open for fellowship. If you go ham in the summer and sometime before you won’t sacrifice too much, and you’ll actually use some of your knowledge which is nice. 

Conversely, I'd much rather have taken it when it's P/F rather than now when people will actually have a grade to look at if I apply for a fellowship (apparently some fellowships use step 1 as a screening tool...).

I took it after 3 weeks of post-M2 studying, and I've since pretty much forgotten everything lol. I didn't get an amazing grade, but I passed by a good margin and that's all that matters to me -- but how will that stack up against the US grads if I apply for a fellowship at Stanford?

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It's only important if you plan to work in the States or if you pursue a few certain surgical subspecialties which have exceedingly poor Canadian job prospects. The vast majority of specialties do not have any need to do USMLEs for the purpose of finding a job.

For fellowship, a few fellowships require the USMLEs but most do not. If you want to keep every possible option open, then you should write it. There are many good/prestigious ones that do not require it though.

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