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And you’ll have the entire family with you after the exam??? Fantastic!!!!

I don’t look good in white, by the way.

I used to. Now it makes ME look gray…….

Another way of looking at it is this: Step 1 will ask, given all the lab data, some aspect of the disease, requiring you to diagnose what the real problem is (it will never ask, “What does this patient have,”–it assumes you’ve reached that point and will continue to ask something more “hidden”) in arriving at the problem. But you have all the lab/exam/pt data you need to answer the question.

Step 2 will ask, “What is the next step in the management of this patient?” The lab data is often not given; it’s your job not only to know what the dx/ddx is, but which lab tests are pertinent and what the expected results will/won’t be for each to rule out/confirm each ddx. That is when the true “clincal” questions are asked. To retain this information PLUS all the crap from Step 1 is, again, asking for trouble IMO.

At our school (in the UK), we had a couple of girls who took the Falcon Review course in Texas. They sat the exam, and both failed. They came back, saying how ‘clinical’ the exam was, and recommended to the entire school that they wait until their clinical years are over to sit the Step 1. The fact is that they were on an older, medical science-based curriculum, and everyone at the school is now on a integrated, systems-based curriculum (where we have lectures as well as patient-centered PBL style sessions). Our exam questions were presented in a clinical fashion, and theirs weren’t. So essentially, they just weren’t used to it. But now everyone at my school has it in their mind that the Step 1 is some huge clinical exam, where they’re going to have to know everything about every single lab test and clinical outcome and treatment ever (which we actually DO learn, on our new curriculum, and the old system didn’t). No matter how hard I try, I just can’t seem to convince them that maybe they should actually look at some practice questions first without taking these girls’ lecture blindly. Granted, it was a good intro for them all, but it just sort of bothers me when they try and convince me that I should wait a few more years….(so that, y’know, I can forget all the biochemistry and things you don’t actually use in clinical practice).

sorry, bit of a comment rant, but oh well. maybe one day i’ll write a post about it…