October 2020 USMLE Step 1 Updates: Everything You Need to Know
- Nov 03, 2020
OMG, they are changing USMLE Step 1 again! Why now, during your medical school tenure, do all of these changes have to happen? The two things you thought you could bank on when starting medical school were:
1. Step 1 has been and will remain unchanged for years and years, and 2. A good Step 1 score equals the residency of your choice. These two assumptions have totally gone out the window. What does it all mean?
First, we will pull a general lesson from these changes. Then, we will discuss how post-October 20 Step 1 will be different from the pre-October 20 Step 1.
You’ve heard it before. Life is full of changes. If there is any arena where things are constantly changing, and you are forced to adapt, it is in medicine.
As much as we like to have total control over all aspects of life, many of these things will be completely out of our hands. The whims of the monopolistic governing body of medical school and residency admissions tests, the USMLE, fall into the category of being out of our hands. We must simply let it go, and do our best to stay flexible and adapt.
This constant change and need for adaptability doesn’t end with your board exams. You will have to constantly adapt to new procedures, new lab tests, new methodologies, and perhaps most importantly for your career, new people.
An important mentor told me that my career as an anesthesiologist would go from learning how to manage patients to learning how to manage people. And while my career is still in its infancy, nothing could be more true. Adaptability and being able to “play nice in the sandbox” with colleagues of so many different backgrounds and levels of training is an essential career skill.
“Enough of this career-related hooey, give me the Step 1 details!” you demand.
What Changed in the October 2020 USMLE Step 1 Practice Materials Update?
Well, before you get too worked up and start dissecting the old content description and comparing it to the new content description, rest assured, we have done this for you. And what did we discover?
The relative focus on each subject is almost exactly the same.
After comparing each and every individual discipline on the pre-October 20 and post-October 20 handouts, we learned that most categories differ by only 1-2 percentage points, and ranges nearly identically overlap.
As an example,
Musculoskeletal, Skin & Subcutaneous Tissue
Pre-October 20: 6–10%
Post-October 20: 6-10%
Multisystem Processes & Disorders
Pre-October 20: 7-11%
Post-October 20: 6-10%
This means no discernible difference in the number of questions you will see in individual disciplines.
There will be one “sweeping” change that the USMLE endorses. This verbiage comes directly from the USMLE’s Step 1 FAQs:
No new content will be assessed in Step 1 exams administered after the exam is updated in October 2020. Examinees who test after the October 2020 update will see an increase in the number of items that assess knowledge of Communication and Interpersonal Skills; this content has been included on the Step 1 exam for many years.
As far as raw data, here are your numbers for the “Social Sciences: Communication and Interpersonal Skills” category:
Pre-October 20: 3-5%
Post-October 20: 6-9%
They add the caveat that drug mechanisms (and not drug names) will continue to be the keystone of pharmacology, just as it had been in the past.
There is nearly an artistic beauty that a blog post on adaptability and working well with colleagues demonstrates only one real change as far as your Step 1 test goes: that the skills of communication and interpersonal skills will be more heavily tested.
If there was ever a time to make sure you are addressing your patients and colleagues in an upright and professional manner, upholding the tenets of autonomy, beneficence, non-malfeasance, and justice, and staying awake in your ethics and doctoring classes, that time is now.
Sublimate any anxiety about the changing test into assurance that the more things change, the more they stay the same. You are gonna do fine.