#but more importantly the result of this shaming is less honest community engagement and a game that's not made for its players
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juniperjelly · 2 months ago
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i think people who argue about minecraft saying shit like "the devs are lazy and bad!" or "these updates are free and you should be grateful!" need to understand that these are both equally stupid takes devoid of nuance or critical thought
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kristinsimmons · 5 years ago
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#USMLEPassFail: A Brave New Day
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By BRYAN CARMODY, MD
Well, it happened.
Beginning as soon as 2022, USMLE Step 1 scores will be reported pass/fail.
I’m shocked. Starting around two weeks ago, I began hearing rumors from some well-connected people that this might happen… but I still didn’t believe it.
I was wrong.
The response thus far has been enormous – I haven’t been able to clear my Twitter mentions since the news broke. And unsurprisingly, the reaction has been mixed.
In the future, I’ll post more detailed responses on where we go from here – but for now, I’d like to emphasize these five things.
1. By itself, making USMLE Step 1 pass/fail doesn’t fix much.
Simply getting rid of three digit scores doesn’t improve medical education. And it doesn’t make residency selection any better, either.
It does give us the opportunity to make changes. And the importance of that should not be understated.
Put simply, this is the greatest opportunity for medical education reform since Flexner, and the greatest opportunity to re-design residency selection since… ever.
Tumblr media
“WHAT WILL REPLACE STEP 1?” IS A HARD QUESTION. AND MAKE NO MISTAKE, THE FACT THAT IT’S A HARD QUESTION IS ONE OF THE VERY REASONS MANY CLUNG TO STEP 1 SCORES SO DOGGEDLY.
2. The path of least resistance does not take us where we want to go.
Most of the commentary on social media thus far has taken the following form:
Now only Ivy League medical students will get into competitive specialties.
Don’t worry! USMLE Step 2 CK will just be the new Step 1.
I guess DOs and IMGs can forget about getting into top residency programs.
And you know what? Most of these concerns are justified.
If we do nothing, Step 2 Mania is the natural result of a pass/fail Step 1. And unless we give program directors more useful information – and the time to thoughtfully review all the applications they receive – they’ll gravitate to another convenience metric out of necessity.
But that does not mean it’s inevitable.
3. We all have a say in what comes next.
If the rise and fall of a scored Step 1 teaches us nothing else, it should clearly demonstrate these two things.
First, advocacy works. There is no way that the NBME’s entrenched, out-of-touch bureaucracy would have ever voluntarily changed Step 1 to pass/fail – unless their feet had been repeatedly been held to the fire by the public over the past year. Change is possible – but you have to speak up.
Students, I’m looking at you – especially those from “non-elite” or international medical schools. You have a say in what comes next. How should residency programs evaluate you? Surely, answering multiple choice questions with peripheral relevance to real patient care is neither the best nor the only way to identify your talent. It’s time to dream bigger – and demand more meaningful evaluation.
Second, medical students will rise to whatever bar we set for them.
Ask them to memorize an 800 page review book so they can excel on a multiple choice question test of basic science esoterica? Done and done. Students knew most of what they were learning was pointless – but they worked tirelessly because we told them it mattered.
So program directors, now I’m looking at you.��Whatever you tell students to do, they’ll do. You want high Step scores? Students will give them to you. But what really matters to you? Do you want residents who will serve the underserved? Contribute to research? Arrive on July 1 with specialty-specific knowledge? Whatever you say, goes. If you choose to grump about the loss of the bad old days, you’re abdicating your authority to set the standards you want.
Tumblr media
YOU WON’T FIND ME SHEDDING ANY TEARS OVER THE DEMISE OF A SCORED STEP 1.
4. No one should mourn the loss of a scored Step 1.
Look around my Twitter mentions, and you can find touching testimonials mourning the demise of Step 1 scores. There are tales of useful factoids brought to bear on patient care decades later; of students inspired to consume as much (mostly useless) scientific knowledge as possible; of doors opened and careers launched because of one shining moment on test day years ago.
Give me a break.
The Step 1 score was the biggest false god in medical education, and no one should be too sad that it’s going away.
Was it objective? Sure. But the ability of three-digit scores to discriminate between applicants was actually fairly imprecise.
Did it test some useful concepts? Of course. But scoring highly required memorizing esoteric information that would never benefit an actual human patient.
Did some students benefit from scoring highly? Absolutely. But did Step 1 scores really “level the playing field” for students from international or non-prestigious medical schools overall? I doubt it.
Did it give program directors an easy way to screen applications? Yup. But was that way meaningful? Probably not. The main value of Step 1 was that it gave you a number. But if the content of the test doesn’t matter, why not just have medical students throw darts, or race go karts, or memorize digits of pi?
And of course, our idol worship of Step 1 came at a significant opportunity cost. The fact that most of us turned out okay doesn’t prove that Step 1 was the best way, or that that we wouldn’t have been better off under another system.
Here’s the thing:
Whether you liked a scored Step 1 or not, the current system is not what any of us would have designed if we were building something from the ground up.
In the scored Step 1 era, we sat back and watched as preclinical medical education turned into a glorified USMLE prep course with a five-figure/year tuition bill attached. We did nothing as residency applications spiraled out of control and program directors’ outsourced their most important decision-making to the NBME.
We shouldn’t be proud of any of this. And we shouldn’t mourn the loss of the three-digit score that enabled us to neglect the need for reform for so long.
More importantly, there is no turning back now.
If you opposed #USMLEPassFail, do your grieving for the scored USMLE – and then get to work. Saying “I told you not to make Step 1 pass/fail!” is a hollow victory. There is an opportunity here to engage our students in tasks that could actually lead them to be better physicians – but we have to seize it.
And if you supported #USMLEPassFail, now is not the time to dance on the three-digit score’s grave. We need to get to work, too – or this hard-won victory will go for naught.
5. The way forward… my opinion
Expect more from me on these topics in the future, but for now, let me put these three thoughts in your head.
WE NEED MEANINGFUL EVALUATIONS.
My 5th grader’s report card provides more useful information than any medical school transcript I’ve ever seen. He doesn’t get an “A” in math – I get to see a lengthy list of math skills and an assessment of where he’s at with all of them. Maybe he’s comfortable dividing fractions, but still developing proficiency with using variables to set up algebraic equations.
Letter grades are nice – but they don’t tell me what he knows and what he doesn’t. (I don’t get a histogram of other students’ performance and where he falls – because how other students performed is kind of irrelevant if my goal is to help him become better in math.)
The fact that elementary schools provide more information-rich evaluations than medical schools is shameful. In the past, we’ve justified this because of Step 1. Starting in 2022, that excuse will ring hollow.
Let’s be honest: there should never be a medical school evaluation in which a students is exceptional in every area. (If there is, it tells you more about the school than the student.)
Our goal should be to make medical school formative, not performative; to help learners maximize their potential without fearing failure; to provide and communicate honest feedback that leads to improvement and growth along the spectrum of medical education. (For their part, program directors need to focus less on relative accomplishment and more on potential to grow and thrive in that program/field.)
We don’t need another arms race. We do need more thoughtful evaluation. We should require students to engage in tasks that leave them – and their future patients – better off. And schools that refuse to participate in this process should be penalized by program directors and medical school applicants alike.
WE NEED HOLISTIC REVIEW.
I don’t think we need a one-size-fits-all metric to tell us who are the “best” applicants. Honestly, we don’t.
Certain talents and traits get you a lot farther in certain disciplines than others. Even within the same discipline, different programs have different needs and serve different missions. What makes a good doctor? It’s complicated. And trying to reduce that complexity down to a single three digit number is silly.
Holistic review is possible. It’s what we do at the residency program at which I’m an associate program director. But it’s labor intensive – and it requires human judgment. That last part makes some people uncomfortable, and I understand why. Holistic review has the potential to devolve into bias and cronyism. But that’s not a reason to not do it – it’s a reason to strive to do it well, to make decisions deliberately, and to build some checks and balances to make sure you stay aligned with your values.
WE ALSO NEED APPLICATION CAPS.
The only way to get away from screening metrics and treat every applicant as an individual is to limit the pile of applications that program directors receive.
Tumblr media
THE EXISTENCE OF A SCORED STEP 1 ALLOWED US TO PRETEND THAT THIS WASN’T HAPPENING.
Look, I’ve preached this sermon before. But you’d better believe I’m gonna be carrying this particular gospel to the people again in the near future.
Afraid of application caps? Worried that they’ll disadvantage students from non-elite schools? Stay tuned for a data-driven expose of the misinformation surrounding caps coming soon.
Dr. Carmody is a pediatric nephrologist and medical educator at Eastern Virginia Medical School. This article originally appeared on The Sheriff of Sodium here.
The post #USMLEPassFail: A Brave New Day appeared first on The Health Care Blog.
#USMLEPassFail: A Brave New Day published first on https://wittooth.tumblr.com/
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lauramalchowblog · 5 years ago
Text
#USMLEPassFail: A Brave New Day
Tumblr media
By BRYAN CARMODY, MD
Well, it happened.
Beginning as soon as 2022, USMLE Step 1 scores will be reported pass/fail.
I’m shocked. Starting around two weeks ago, I began hearing rumors from some well-connected people that this might happen… but I still didn’t believe it.
I was wrong.
The response thus far has been enormous – I haven’t been able to clear my Twitter mentions since the news broke. And unsurprisingly, the reaction has been mixed.
In the future, I’ll post more detailed responses on where we go from here – but for now, I’d like to emphasize these five things.
1. By itself, making USMLE Step 1 pass/fail doesn’t fix much.
Simply getting rid of three digit scores doesn’t improve medical education. And it doesn’t make residency selection any better, either.
It does give us the opportunity to make changes. And the importance of that should not be understated.
Put simply, this is the greatest opportunity for medical education reform since Flexner, and the greatest opportunity to re-design residency selection since… ever.
Tumblr media
“WHAT WILL REPLACE STEP 1?” IS A HARD QUESTION. AND MAKE NO MISTAKE, THE FACT THAT IT’S A HARD QUESTION IS ONE OF THE VERY REASONS MANY CLUNG TO STEP 1 SCORES SO DOGGEDLY.
2. The path of least resistance does not take us where we want to go.
Most of the commentary on social media thus far has taken the following form:
Now only Ivy League medical students will get into competitive specialties.
Don’t worry! USMLE Step 2 CK will just be the new Step 1.
I guess DOs and IMGs can forget about getting into top residency programs.
And you know what? Most of these concerns are justified.
If we do nothing, Step 2 Mania is the natural result of a pass/fail Step 1. And unless we give program directors more useful information – and the time to thoughtfully review all the applications they receive – they’ll gravitate to another convenience metric out of necessity.
But that does not mean it’s inevitable.
3. We all have a say in what comes next.
If the rise and fall of a scored Step 1 teaches us nothing else, it should clearly demonstrate these two things.
First, advocacy works. There is no way that the NBME’s entrenched, out-of-touch bureaucracy would have ever voluntarily changed Step 1 to pass/fail – unless their feet had been repeatedly been held to the fire by the public over the past year. Change is possible – but you have to speak up.
Students, I’m looking at you – especially those from “non-elite” or international medical schools. You have a say in what comes next. How should residency programs evaluate you? Surely, answering multiple choice questions with peripheral relevance to real patient care is neither the best nor the only way to identify your talent. It’s time to dream bigger – and demand more meaningful evaluation.
Second, medical students will rise to whatever bar we set for them.
Ask them to memorize an 800 page review book so they can excel on a multiple choice question test of basic science esoterica? Done and done. Students knew most of what they were learning was pointless – but they worked tirelessly because we told them it mattered.
So program directors, now I’m looking at you. Whatever you tell students to do, they’ll do. You want high Step scores? Students will give them to you. But what really matters to you? Do you want residents who will serve the underserved? Contribute to research? Arrive on July 1 with specialty-specific knowledge? Whatever you say, goes. If you choose to grump about the loss of the bad old days, you’re abdicating your authority to set the standards you want.
Tumblr media
YOU WON’T FIND ME SHEDDING ANY TEARS OVER THE DEMISE OF A SCORED STEP 1.
4. No one should mourn the loss of a scored Step 1.
Look around my Twitter mentions, and you can find touching testimonials mourning the demise of Step 1 scores. There are tales of useful factoids brought to bear on patient care decades later; of students inspired to consume as much (mostly useless) scientific knowledge as possible; of doors opened and careers launched because of one shining moment on test day years ago.
Give me a break.
The Step 1 score was the biggest false god in medical education, and no one should be too sad that it’s going away.
Was it objective? Sure. But the ability of three-digit scores to discriminate between applicants was actually fairly imprecise.
Did it test some useful concepts? Of course. But scoring highly required memorizing esoteric information that would never benefit an actual human patient.
Did some students benefit from scoring highly? Absolutely. But did Step 1 scores really “level the playing field” for students from international or non-prestigious medical schools overall? I doubt it.
Did it give program directors an easy way to screen applications? Yup. But was that way meaningful? Probably not. The main value of Step 1 was that it gave you a number. But if the content of the test doesn’t matter, why not just have medical students throw darts, or race go karts, or memorize digits of pi?
And of course, our idol worship of Step 1 came at a significant opportunity cost. The fact that most of us turned out okay doesn’t prove that Step 1 was the best way, or that that we wouldn’t have been better off under another system.
Here’s the thing:
Whether you liked a scored Step 1 or not, the current system is not what any of us would have designed if we were building something from the ground up.
In the scored Step 1 era, we sat back and watched as preclinical medical education turned into a glorified USMLE prep course with a five-figure/year tuition bill attached. We did nothing as residency applications spiraled out of control and program directors’ outsourced their most important decision-making to the NBME.
We shouldn’t be proud of any of this. And we shouldn’t mourn the loss of the three-digit score that enabled us to neglect the need for reform for so long.
More importantly, there is no turning back now.
If you opposed #USMLEPassFail, do your grieving for the scored USMLE – and then get to work. Saying “I told you not to make Step 1 pass/fail!” is a hollow victory. There is an opportunity here to engage our students in tasks that could actually lead them to be better physicians – but we have to seize it.
And if you supported #USMLEPassFail, now is not the time to dance on the three-digit score’s grave. We need to get to work, too – or this hard-won victory will go for naught.
5. The way forward… my opinion
Expect more from me on these topics in the future, but for now, let me put these three thoughts in your head.
WE NEED MEANINGFUL EVALUATIONS.
My 5th grader’s report card provides more useful information than any medical school transcript I’ve ever seen. He doesn’t get an “A” in math – I get to see a lengthy list of math skills and an assessment of where he’s at with all of them. Maybe he’s comfortable dividing fractions, but still developing proficiency with using variables to set up algebraic equations.
Letter grades are nice – but they don’t tell me what he knows and what he doesn’t. (I don’t get a histogram of other students’ performance and where he falls – because how other students performed is kind of irrelevant if my goal is to help him become better in math.)
The fact that elementary schools provide more information-rich evaluations than medical schools is shameful. In the past, we’ve justified this because of Step 1. Starting in 2022, that excuse will ring hollow.
Let’s be honest: there should never be a medical school evaluation in which a students is exceptional in every area. (If there is, it tells you more about the school than the student.)
Our goal should be to make medical school formative, not performative; to help learners maximize their potential without fearing failure; to provide and communicate honest feedback that leads to improvement and growth along the spectrum of medical education. (For their part, program directors need to focus less on relative accomplishment and more on potential to grow and thrive in that program/field.)
We don’t need another arms race. We do need more thoughtful evaluation. We should require students to engage in tasks that leave them – and their future patients – better off. And schools that refuse to participate in this process should be penalized by program directors and medical school applicants alike.
WE NEED HOLISTIC REVIEW.
I don’t think we need a one-size-fits-all metric to tell us who are the “best” applicants. Honestly, we don’t.
Certain talents and traits get you a lot farther in certain disciplines than others. Even within the same discipline, different programs have different needs and serve different missions. What makes a good doctor? It’s complicated. And trying to reduce that complexity down to a single three digit number is silly.
Holistic review is possible. It’s what we do at the residency program at which I’m an associate program director. But it’s labor intensive – and it requires human judgment. That last part makes some people uncomfortable, and I understand why. Holistic review has the potential to devolve into bias and cronyism. But that’s not a reason to not do it – it’s a reason to strive to do it well, to make decisions deliberately, and to build some checks and balances to make sure you stay aligned with your values.
WE ALSO NEED APPLICATION CAPS.
The only way to get away from screening metrics and treat every applicant as an individual is to limit the pile of applications that program directors receive.
Tumblr media
THE EXISTENCE OF A SCORED STEP 1 ALLOWED US TO PRETEND THAT THIS WASN’T HAPPENING.
Look, I’ve preached this sermon before. But you’d better believe I’m gonna be carrying this particular gospel to the people again in the near future.
Afraid of application caps? Worried that they’ll disadvantage students from non-elite schools? Stay tuned for a data-driven expose of the misinformation surrounding caps coming soon.
Dr. Carmody is a pediatric nephrologist and medical educator at Eastern Virginia Medical School. This article originally appeared on The Sheriff of Sodium here.
The post #USMLEPassFail: A Brave New Day appeared first on The Health Care Blog.
#USMLEPassFail: A Brave New Day published first on https://venabeahan.tumblr.com
0 notes
pinkcatsy · 8 years ago
Text
i fucking hate fair game
tl;dr There are too many words – a majority of the words in this story build up to obnoxious and redundant/otherwise unnecessary sentences, paragraphs and thoughts.
Fair Game by Monica Murphy is a New Adult Romance that is largely about how badly cliche insecure lead Jade Frost and cliche rich playboy Shepard Prescott want to fuck each other and, occasionally, how much Jade Frost and Shepard Prescott enjoy fucking each other. There’s some hubbub at the begin about Shepard “winning” Jade in a bet but it’s largely of little importance to the plot besides being one of the many little bits of misogyny.
Fair Game currently has largely positive reviews – it’s not very many reviews, I doubt I’ve seen more than 10 either Goodreads or Google Play, but they’re not just positive, it’s 4.4/5s. This is initially confusing to me and anyone else who’s had to listen to me talk about how much I hate this book and its characters (especially Jade, seriously fuck her). But it makes some sense once you consider fanfiction.
This is not a knock on fanfiction, I’ve read many incredibly good fanfiction. Some of the best pieces of writing I’ve ever read were fanfiction. I wrote fanfiction from the age of 12 to about 16/17 – I wasn’t mega popular but I had reviews blowing up my inbox at my peak. From experience, I can tell you that it’s not really difficult to write enjoyable fanfictions. It’s not hard to write fanfics that people will like. Because someone else has already done most of the heavy lifting for you – it’s not necessary to work especially hard to establish characters or develop relationships, most of your readers are already know all of it and, most importantly, most of them are already emotionally invested in them. I got by writing romances by just hitting a few beats; I didn’t need to know why Inuyasha and Kagome would fall for each other or think especially hard about what they like about each other, Rumiko Takahashi sorted that shit out and it’s just safe to assume it carried over somehow.
I don’t think this covers all of the positive reviews or all fans of Fair Game but, personally, I assume some of the emotional investment people have in Fair Game, its core “romance” and its characters are not a result of anything that’s actually in Fair Game. I’ll admit to you right now that there’s tons of manga, anime, books etc. that I have read and enjoyed because the characters hit on archetypes I was already invested in or because they reminded me of my characters, not because of the writing of the material itself because sometimes it was kind of garbage.
Another thing I will talk about is yaoi – I’ve recently gotten particularly into yaoi, especially reading it off the ebookrenta site. Most of them are pretty trashy – some of them are honestly, kind of garbage, some of them know what they are and know that engaging characters and romantic developments are absolutely not necessary. I can tell you I’ve read a lot of garbage, although I’ve read some really interesting, emotional and complex stories, most of it is just finding a way to get two hot guys to fuck each other. And, to be completely honest, that’s all I’m reading it for anyways. So it’s not particularly important that their relationship seems fairly shallow or contrived; that if I really thought about it, I couldn’t tell you what the characters like about each other or even much about them at all – the art is cute and the sex scenes are decently drawn. And maybe I would’ve felt that way about Fair Game if they’d spent less time talking about fucking and more time actually fucking and if they also spend less time thinking stupid, obnoxious and redundant stuff during the sex scenes so that I could focus on what they were doing and not how much I fucking hate Jade, how douche-y Shep is and what a misogynist Monica Murphy almost certainly is.
There’s also the likely fact that the other readers probably have a higher tolerance for all of the absolutely hokey sounding shit that’s in the book, a lack of well developed anything and MISOGYNY.
Let’s talk about the misogyny for a bit, actually. There’s nothing that’s out and out women are dumb stuff, there’s just little things like:
·       all the obnoxious, unnecessary moments of slut-shaming like:
o   Jade describing her roommate jumping from relationship to relationship while stressing that she wasn’t a slut
o   Shep remarking that the revealing top Jade wore to a party is revealing but not trashy
o   Shep lifting Jade about as a natural beauty by putting down all of his previous sexual partners as being fake or deceitful by wearing heavy makeup and dying their fucking hair
o   Jade’s use of the word skank
o   Jade’s roommate (Kelli) use of the word whore (which could be a sort of friendship thing if not for the rest of the fucking book)
o   the fact that Jade is adamant on not having sex with Shep purely because she seems to think she’ll lose something by just having a one-night stand with a guy she finds sexually attractive - up until they actually get to having sex, then she’s scared to catch feels
o   and the following aren’t centered around women but it’s actually slut-shaming all the same:
§  the use of the word man-whore to describe Shep
§  the pervasive idea that there’s anything inherently wrong with Shep being uninterested in pursuing romantic relationships – he’s hooking up with girls who are also only interested in hooking up, that doesn’t make him a fucking asshole or even a playboy so you fucked up your archetype here Monica
·       the way all the other girls interested in Shep are treated (which is probably also slut-shaming) and, in fact, the way any girl that is not Jade or Kelli is described in this story
·       the PMS stuff on both Jade and Shep’s part
·       the way Shep sexually objectifies Jade every time he talks about her and I mean literally every time
·       the way Shep just plain objectifies Jade and how the story doesn’t seem to think of it as problematic – he suggests that she be thrown into the pot during a poker game, he tries to use “winning” her in the bet as a way to get close to her at least twice which is two times too many, he calls her a fucking prize near the end
·       the fact that Shep “changing” just means he’ll tone down the misogyny and douchebaggery when it concerns Jade and only Jade
·       the fact that Jade suggests Shep should go and hook up with a drunk girl instead of with her
·       the fact that Shep thinks Jade being on her period is a test from God and this is allowed to continue without any hint whatsoever that it’s a disgustingly self-centred notion or douche-y thing to say
Additionally, there’s little bits of actual misandry because Jade is the fucking worst:
·       she says something to the affect of “you’re a man, of course all you think about is sex”
·       she literally says “men are so pathetic”
·       she’s disgusted by a toilet purely by thinking of all the specifically male butts that have been on it
And just as a bonus, here’s things I hate about Jade:
·       she’s not strong or defiant – she’s just rude for no reason and blatantly dishonest about her feelings throughout the whole story for also no reason really; it’s treated not like a major character flaw but it’s actually something Shepard likes about her
·       the way she thinks – just the way she phrases things sometimes just piss me off
·       she says repeatedly that “[Shep] confuses me” but Shepard is actually pretty straight-forward and honest about his feelings the entire story – he’s not confusing, you’re just insecure and projecting that onto him which is something you should be at least a little aware of, given that you’re a fucking psychology major
·       her insecurity feels like it’s there because of the clichés anyways
o   she’s had 2 boyfriends – 1 was pretty long-term and they only broke up because they didn’t want to do long distance once they picked different schools and the other one tries to get back together with her but apparently neither of them ever said she was beautiful
o   even though her performance anxiety is driven pretty hard before she has sexual intercourse with Shep, it’s barely there immediately before she has sex with Shepard, it’s almost as if she only has performance anxiety so that sex with Shepard is that much more special and unique
·       the story tries to act like she’s a strong character but she just does whatever she’s told after saying no maybe once or twice – and despite Shep saying “she doesn’t fall for my shit” every thing she does in the story, with few exception, is motivated by him in some part and she’d been taken with him since chapter one
·       even though she’s only had 2 boyfriends, she later talks as if she’s very experienced
·       it’s later strongly implied that the only reason she’s never successfully orgasmed during intercourse before is because she wasn’t willing to communicate her needs or wants with her previous sexual partners yet somehow it’s their fault – Shep doesn’t have “magic” fingers, he just asked what you liked and you actually fucking told him, it’s not hard you fucking dolt
·       Jade: "Has he been keeping tabs on me? I hope not, I'm infinitely boring, especially by Shep standards."
Jade, literally on the next page: "Not that I care what this man thinks of me anymore."
·       "I'm supposed to hate it when he calls me baby, but I don't." – who told you that Jade? Why are you supposed to hate it, JADE???
Things that annoy me about Shep (besides the stuff under the misogyny list):
·       every time he says or thinks something and then goes BOY AM I DOUCHEY or WOW EVEN I THINK I SOUND LIKE A RICH ASSHAT
·       the fact that he thought Jade being on her period was a test from G O  D
·       the fact that he didn’t immediately follow the “maybe she’s on her period because God is trying to make me fail to hook up with her” with one of those BOY AM I DOUCHEY moments
·       every time outside of a sex scene that he told us his dick was twitching
·       he’s not really funny
Yeah so this book is terrible. If I’d paid money for it, I would be furious. If I could give it negative stars, I actually would. Monica Murphy seems like she doesn’t know how to convey things subtly so whenever she can, she makes sure to spell it explicitly in some of the most obnoxious cases of telling instead of showing that I’ve seen in my entire life. Every time something about the characters, their feelings or their relationships are referenced, it is like it is the first time it’s ever been mentioned.
Also, there’s a superfluous “plot” point tacked on at the end about Jade’s mom selling their home and Jade needing a place to stay. It serves no real point and is wholly unnecessary as what little it does do could be done in literally any other way. In fact, Jade’s relationship with her mom is talked about a few times but it adds nothing to her character or the story so it’s also totally unnecessary.
I didn’t buy their romance – I don’t think these characters know much of anything about each other because I don’t know much of anything about either them besides what establishes their archetypes and their physical appearances. When they do start to learn about each other, aside from one scene, it’s all basically “off-camera” and we’re told about it after the fact. These are not two people falling in love with each other, these are two people who wanna fuck each other and love fucking each other. It was also extra annoying whenever the story acknowledged that these are two character who barely know each other falling for each other for apparently no reason.
Also stuff like this was actually written and (self-)published:
·       Guys like to watch. They're visual beings. Hello, porn.
·       I come face to penis within a few shocking seconds.
·       Damn he's so strong. I'd really like to see him naked.
·       God, look at me. Yes, me. Straight-laced, good girl Jade Frost is hanging out with a billionaire spoiled sexy brat who runs an illegal freaking casino in a house just off campus. What have I done? Who am I, for God's sake?
·       I need to be able to handle all of her moods. Is this some sort of test? Is God upstairs laughing at me, throwing me one obstacle after another in the hopes that I'd fail? (this is the PERIOD thing and no I’m not over it)
·       She slowly shakes her head, all those wayward strands of hair tickling her cheeks. Her hair is like fire. Vibrant and bright, wild and free - I sound like a fucking poet in my head. Jesus.
·       "Five minutes," I tell her, leaning in so I can press a quick kiss to her surprised lips. Who knew lips could be surprised? And they would taste so damn good?
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crosbysierra95 · 4 years ago
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How To Cure Premature Ejaculation Stupefying Cool Tips
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minnievirizarry · 7 years ago
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Facebook Automation: What Your Brand Doesn’t Know
Juggling multiple social presences has become an expectation for modern brands. Facebook. Twitter. Instagram. The list goes on and on.
As a result, marketers are scrambling for shortcuts to streamline their social presences and save time in the process. Given the rapid rise of social media automation, more and more brands are experimenting with the idea of putting their social channels on autopilot.
With Facebook standing tall as the most popular social network by far with over 2 billion monthly active users,, Facebook automation, in particular, is drawing a ton of attention. The concept of letting a service or software do the legwork for you when it comes to Facebook sounds enticing, but is it realistic? Is there more to the emerging trend of automation than meets the eye?
Below we’ve combed through the fine details of Facebook automation and what it could potentially mean for your brand and marketing efforts.
What Is Facebook Automation &Amp; How Does It Work?
While the concept of automation tends to freak some people out, you don’t need to worry about a robot takeover quite yet.
Automation simply refers to software or tools which rely on scripts or bots to take care of various marketing tasks, well, automatically. If you’ve ever received an email autoresponder, you’ve seen automation in action firsthand.
In the case of Facebook automation, we’re talking about tools that automate tasks such as:
Leaving comments on statuses, images or pages
Liking and sharing statuses, images or pages across your account(s)
Inviting friends to specific pages or events en masse
Accepting or rejecting all pending friend requests
These features of Facebook automation features might seem like game-changers at a glance. That said, there’s much more to automation than meets the eye.
As soon as you put your Facebook presence in the hands of a bot, you instantly give up the human element of your social marketing.
Sure, not having to focus on seemingly menial tasks such as “liking” posts might be a nice bonus. But is it worth having to play damage control when your bot accidentally “likes” an inappropriate image or starts spamming comments at random? Even when you’re dealing with bots and automation, there’s always some room for error.
The Benefits of Facebook Automation
So why are some marketers relying on Facebook automation, anyway? What’s the appeal? The desire for automated tools is totally understandable given the potential benefits detailed below:
1. You Save Time
Perhaps the most obvious benefit of automation is that marketers can focus less on the “small stuff” and more on the big picture of their social marketing. Although tasks such as liking posts or leaving relevant comments are pieces of a well-oiled social presence, they don’t always represent your most prudent marketing tasks.
Through Facebook automation, marketers can focus more on promoting that killer piece of content or conducting outreach versus breaking their backs leaving comment after comment that may never actually be seen.
2. Your Brand Never Sleeps
Brands should respond to questions, comments and inquiries in a timely manner, regardless of industry or time zone. If you can’t get back to your commenters or critiques within a matter of hours, such inaction could translate to a lost customer or sales opportunity. The idea of automated responses is appealing to marketers who want their business to be “on” 24/7.
Our research found that consumers expect brands to reply within four hours on social, yet most brands take significantly longer.
You can see this sort of “mass reply” approach work for big brands like Domino’s who primarily deal with customer concerns around the clock (note the timestamps):
3. You Can Grow Your Follower Count
While there are many moving pieces of growing your Facebook presence, finding opportunities to engage your followers is an absolute must. Beyond sharing and replying to content to make a Facebook page more visible, automation helps create the illusion of a more active presence. Brands that post regularly and appear to connect with their followers are obviously poised for bigger numbers than a page gathering cobwebs.
However, Facebook automation isn’t all it’s cracked up to be when you take a step back and examine the pitfalls.
The Drawbacks of Facebook Automation
Here’s the deal: Facebook automation, alongside most other services that put your social presence on autopilot, are still in their infant stages. They’re buggy. They don’t particularly align with Facebook’s best practices in their crusade against bots and spam, either.
Most importantly, automation tools cannot truly imitate the tone of a real-life social media manager, nor can they craft unique responses that actually cater to the unique needs of your followers. There’s a huge difference between redirecting your followers to a specific FAQ page versus spamming “Nice comment!” or “Thanks!” on every other post.
In fact, automation can oftentimes backfire on brands who are trying to cover too much ground with serial “likes” and comments. According to our Research, this sort of behavior bugs your fans and encourages them to unfollow you.
Part of the beauty of social media is you can get in the trenches with your followers, pick their brains and listen to their concerns. When you leave these tasks to an automation service, you’re losing out on crucial conversions and gambling with how followers perceive your brand.
Meaningful customer interactions like this one from Loot Crate simply can’t be imitated by a bot or automation service:
And let’s be honest: it’s not difficult to tell a personally tailored comment from a copy-and-pasted one. When you rely on the latter, your followers might see you as little more than a spammer.
Simply put, the risk of damaging your brand or tuning out your followers isn’t worth the potential time saved or followers gained. That’s why Facebook automation tools are generally frowned upon by the platform and its users alike.
How to Use Facebook Automation the Right Way
Rather than attempt to put your Facebook presence on autopilot, marketers should try to find a balance between automation and real-time interaction with their followers. The following alternatives to Facebook automation provide marketers the best of both worlds: saved time and increased engagement without sacrificing your brands’ reputation.
Schedule Your  Facebook Posts
You don’t need to be glued to your keyboard 24/7 to boast a powerful Facebook presence. Scheduling your Facebook posts in advance is a brilliant strategy for busy brands looking to knock out the time-consuming task of posting content while also optimizing the timing of their posts.
Facebook scheduling is a key component of creating a more efficient social strategy. With the ability to spread content across multiple platforms and see firsthand which posts receive the most love, the can focus on the types of content that matter most to your followers.
Hire a Helping Hand
If managing the moving pieces of Facebook is taking a toll on your schedule, there’s no shame in hiring a virtual assistant to pick up the slack on your behalf. With the help of a social media scheduling tool, you have peace of mind knowing your essential content is being posted while your for-hire social manager handles your customer service.
Invest in Smarter Bots
Not all bots are bad news.
Facebook Messenger bots are booming in popularity as brands look to streamline communication between themselves and their followers. With the help of bots, brands can respond to queries in real-time or even help potential customers make purchasing decisions.
By setting up specific responses and suggestions, brands are able to engage with followers off-the-clock. Unlike Facebook automation tools that rely on generic, one-size-fits-all comments and responses, Sprout’s own Facebook bot is totally customizable and allows your followers to guide the conversation.
Oh, keep in mind that your followers are the one initiating the conversation. In other words, you don’t run the risk of unnecessarily bugging your followers with spam. Messenger bots effectively address customer concerns and queries minus worrying about going rogue on you.
These strategies allow you to show genuine interest and keep the human element of your social presence and filling in the gaps in terms of your schedule. While we’re nowhere near the point of fully-automated social marketing, these tools tick the boxes of making the lives of marketers so much easier.
Run Your Own Ads
Sometimes the best way to increase your Facebook reach is by opening up your pocketbook. Fortunately, Facebook’s ad platform is known for its customization and hyper-specific targeting, guaranteeing that you get the most bang for your buck when it comes time to run an ad.
What Does Facebook Automation Mean to Your Brand?
Modern marketers have a distinct choice to make in regard to how they manage their social channels. Removing the personal touch of your Facebook presence could be a perilous decision for brands who strive for legitimate engagement.
On the flip side, proven strategies such as scheduling and messenger bots serve as smart alternatives to full-blown automation that saves brands time. These sorts of tools not only streamline your social presence but also allow you to spend more time focusing on getting to know your followers.
So, what are you doing to cut down your time spent managing your Facebook presence? What are you feelings on the ever-changing trend of Facebook automation? Let us know in the comments below!
This post Facebook Automation: What Your Brand Doesn’t Know originally appeared on Sprout Social.
from SM Tips By Minnie https://sproutsocial.com/insights/facebook-automation/
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garynsmith · 8 years ago
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Can’t Buy My Love – 5 Reasons To STOP Buying Likes NOW [And What To Do Instead]
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Your real estate page is setup and it’s time to get more likes on Facebook.
So…
You’ve committed to a consistent post schedule.
And invited your friends, family and network to Like your page.
The only problem is you’re still looking at something like this every morning when you check your numbers.
Does the number of people who Like your page actually matter? OF COURSE IT DOES! The more people who choose to interact with you on Facebook, the greater your audience will be. A sizeable audience means more website traffic and can ultimately get you more leads.
After all, that’s the point of staying active and engaging your community on social media. Right?
Why put all this time and energy into Facebook marketing if no one is seeing your content?
There’s no question that you’ve got to focus some attention on growing your page in order to ensure your continual success and relevance on Facebook. So, what’s a realistic solution to get more Likes on Facebook?
Buying Them?
WRONG!!!
Whatever you’ve heard about the benefits of buying Facebook Likes, I want you to forget it. Right now. For every fake Like you add to your page, one real person will see less and less of your content. So, if you spend X amount of dollars purchasing 100 fake likes, you can kiss 100 potential leads goodbye.
Today we’re going to go through the top 5 reasons you should never buy Facebook likes again and what you can do instead to grow your page organically and connect with real leads.
Let’s go!
Here are the top 5 reason why fake likes are TERRIBLE for your business.
#1) Kill Engagement
If you think your content is aimlessly floating in cyberspace now…just wait until you start raking in those false fans. Getting people to Like your page is only the beginning. Your fake likes will never engage with you. I mean, sure you can pay extra for that, but then you’ll never hear from them again. So really, you’ll be in the same predicament you’re in now, only instead of trying to push your content to a few hundred real people, you’ll have to comes to terms with the fact that your page has thousands of Likes, but none of them are interacting with your content.
#2) Diminish Credibility
Your audience is smart. And if you think you’re going to get away with adding a bunch of bots to your network without them noticing, then shame on you. I’m sure part of your motivation to buy Likes in the first place is actually to try and boost credibility. And it makes sense, in theory. When a new lead comes on your page and sees that you have 1 million fans, they’re bound to be impressed. A large numbers of followers is an indirect referral, really. Gaining likes can totally help you to appear more trustworthy and knowledgeable, but only if they’re quality Likes. And all I mean by quality, in this case, is that they are real people. Imagine what a prospect would think when they first see that you’ve got 100K likes but zero interaction on your last 3 posts. Would you do business with someone like that?
#3) Destroy Relationships
You can’t  buy relationships. Period. And by trying to pull a fast one on your real customers, you’re going to end up harming your current and future relationships. If you’re buying likes to try and show that you’re a more popular or qualified agent, what else are you faking? Are your testimonials real? Are you accurately representing the properties you’re selling or homes you’re showing? These are just a few examples of the first questions returning clients or future prospects might ask themselves before moving on to the next agent. You need to be authentic in order to build relationships in your area.
#4) Drain Your Budget
No matter how little you’re paying per like, there are literally dozens of better places for you to sink your marketing dollars (and cents) into. But the more you rely on bought fans, the more all of these other, more effective actions are going to cost you. You will never get more likes on Facebook or get to know your target audience better if the majority of your Likes aren’t even in the same country. And if you’re buying Likes, I guarantee you this is the case.
#5) And Most Importantly…
Fake Likes Will NEVER Do Business With You
You shouldn’t need any further convincing than this. These fake Likes will never turn into leads or convert to sales. So why are you bothering with this at all? You’re much better off continuing to speak directly to your audience (however small) and invest in advertising to reach more people who could benefit from your services. Building a solid community on Facebook takes time and is worth investing in.
Now it’s time to take action and start advertising to get more likes on Facebook. Here’s the one activity you can do today to make sure that your page and content get directly shown to your audience.
Take these 5 steps to complete 1 activity that you can repeat as many times as you want. This 1 thing is going to keep your audience engaged and keep you from ever having to buy likes again.
#1) The Meat And Potatoes
The first thing you need to do to get more likes on Facebook is choose a recent blog post you’ve written to share with your audience. Your content is the fundamental piece of this strategy and should really be at the core of all of your ad and marketing tactics.
For this post, you want something that will appeal to a lot of people and is more general and not related to a specific real estate topic. Remember, the goal here is to get more likes on Facebook and build a quality community on your page.
Minnesota-based Leadsite user Chase Binnie posted this awesome blog last year and it’s a perfect example of the kind of content you’d want to share to get more likes on Facebook.
It’s specific enough that folks in his area will know that he is talking directly to them, yet doesn’t focus on a single topic that is relevant to only buyers or sellers. Everyone loves Christmas lights!
It’s almost February 2017 so this exact post obviously wouldn’t be the most timely piece of content to share, but there’s a ton of ways to reframe this.
You could talk about:
The Best Romantic Places To Spend Valentine’s Day
Top 10 Pubs To Crawl For St. Patrick’s Day
Best Parks To Host An Easter Egg Hunt
There are a bunch of holidays coming up and you can easily take the same approach as Chase.
Now, if you do already know your audience pretty well on Facebook, or at least who your ideal audience would be, you can share a more specific post. This one that Chase recently published is a good example.
You’re narrowing your audience by only talking to those who have a garden on their property and are interested in gardening.
We’re going to use the first blog as our sample Facebook post. Make sure that your blog has a high-quality image like either of the ones above so it’s easily shareable on Facebook. When you’re ready, copy the URL and go to your Facebook page.
#2) Don’t Fake It
Now you’re going to share your blog to get more likes on Facebook. Don’t try to dress it up into something it isn’t or make false promises. Give your readers a true sense of what they’re getting and what value you are providing.
Open a post and paste in your blog URL. It should look something like this.
At the bottom, Facebook will show you all of your options for usable images. If you don’t like your options, you can click the + sign in the square next to the picture and upload another one. Once you are feeling good about the image or graphic, go ahead and delete the link. The preview will still stay so all folks will have to do is click the image and they’ll be taken to your blog.
Now you can write your post. Keep it simple and honest. Use the first sentence to tell your audience what you’re talking about. And then end with a question or call to action. A question will encourage your fans to start talking on the post itself. Here’s what we wrote.
When you’re done, click the blue Publish button and get ready to get some views!
#3) Give It A Boost
Right after you publish your post, boost it. Just click the Boost Post button.
The first thing you’ll need to do is choose who you want to see your post. You’ll either want to create an audience of People you choose through targeting or select the option “People who like your Page and their friends.” If you’re really unsure who to target, go ahead and pick the second option. Otherwise, click Create New Audience.
We’re going to name this audience “Christmas Lights” based on the post content. That way, after the boost is done running, we can see how well it performed. For now, keep it simple. Target both men and women from ages 25-65 who live in and around your area.
If you’ve run a Facebook Ad or two already, you can get a bit more specific with your targeting, but we’re only trying to get more likes on Facebook and up our engagement with this post.
You can see exactly what your post will look like. This is not going to run like an ad. It will show just like any other post you’ve published on your page, only it will say “Sponsored” beneath your name.
Before you complete the boost, you need to decide on your budget and timeframe. Let’s say you want to run the boost for one week and spend $20 total. You’ll be spending just under $3 per day and you can pause your promotion at any time if you’re not getting the results you want. That said, you may have to try this a few different times to determine what your audience best responds to.
Finally, select your payment method and click Boost. Your promo will then go into review and Facebook will notify you as soon as it’s approved. There’s always a small chance it could be rejected. This can be something as simple as having too much text on your featured photo or graphic. Whatever the case, Facebook will let you know so you can edit it and resubmit the post.
#4) Take Your Relationship To The Next Level
Keep an eye on your post. Whenever someone Likes, Comments or Shares it, open up your Messenger App and send them a message. This is not a sales pitch. You’re simply starting a conversation. The best part? You’ve already got something to talk about.
  From this conversation, you can see that I asked open-ended questions about my blog. Even if folks don’t respond right away, chances are a friendly message will get people talking. Do this each day for every new person who engages with your post during the promotion. This is how you will begin to truly create a connected and interactive community online.
#5) Rinse, Repeat, Convert
It’s entirely possible that the people who engage with you on social media aren’t ready to buy or sell…yet. Keeping in touching via Messenger in an excellent way to make sure you’re their first call the second they or someone they know are ready to make a real estate transaction. You can repeat this action as often as you want. Every time someone new interacts with you, send them a personal greeting via Messenger. If you continue to take action on this, you’ll soon have an entire new log of contacts and potential leads. Plus, you’ll get more likes on Facebook.
Sure, this activity isn’t as easy as buying Likes, but the results will real and trackable. Try it out.
Not convinced about the power of Facebook Messenger? Check out these 5 amazing stats!
With 1 billion unique users, Messenger is the most popular iOs app of all time, after Facebook itself of course. (Source)
And now powers 10% of all VoIP calls. (Source)
68% of Facebook users in the U.S. access it via mobile. (Source)
Each month 17 billion photos are sent through Messenger and 22 million GIFS are exchanged daily. (Source)
Messenger’s new platform now has 18,000 bots, and 23,000 developers have signed up for Facebook’s Wit.ai Bot Engine. (Source)
Read More On The Blog
Can’t Buy My Love – 5 Reasons To STOP Buying Likes NOW [And What To Do Instead]
Easy Agent Pro’s 2016 Year In Review (What to expect in 2017)
Steal These 4 Facebook Ads That Are Getting Real Estate Leads Right Now
The Inman Teaser, Juggling Different Facebook Pages and Chris Turns Bitter.
The post Can’t Buy My Love – 5 Reasons To STOP Buying Likes NOW [And What To Do Instead] appeared first on Easy Agent Pro.
from Easy Agent Pro http://ift.tt/2jFo4XG via IFTTT
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kristinsimmons · 5 years ago
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#USMLEPassFail: A Brave New Day
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By BRYAN CARMODY, MD
Well, it happened.
Beginning as soon as 2022, USMLE Step 1 scores will be reported pass/fail.
I’m shocked. Starting around two weeks ago, I began hearing rumors from some well-connected people that this might happen… but I still didn’t believe it.
I was wrong.
The response thus far has been enormous – I haven’t been able to clear my Twitter mentions since the news broke. And unsurprisingly, the reaction has been mixed.
In the future, I’ll post more detailed responses on where we go from here – but for now, I’d like to emphasize these five things.
1. By itself, making USMLE Step 1 pass/fail doesn’t fix much.
Simply getting rid of three digit scores doesn’t improve medical education. And it doesn’t make residency selection any better, either.
It does give us the opportunity to make changes. And the importance of that should not be understated.
Put simply, this is the greatest opportunity for medical education reform since Flexner, and the greatest opportunity to re-design residency selection since… ever.
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“WHAT WILL REPLACE STEP 1?” IS A HARD QUESTION. AND MAKE NO MISTAKE, THE FACT THAT IT’S A HARD QUESTION IS ONE OF THE VERY REASONS MANY CLUNG TO STEP 1 SCORES SO DOGGEDLY.
2. The path of least resistance does not take us where we want to go.
Most of the commentary on social media thus far has taken the following form:
Now only Ivy League medical students will get into competitive specialties.
Don’t worry! USMLE Step 2 CK will just be the new Step 1.
I guess DOs and IMGs can forget about getting into top residency programs.
And you know what? Most of these concerns are justified.
If we do nothing, Step 2 Mania is the natural result of a pass/fail Step 1. And unless we give program directors more useful information – and the time to thoughtfully review all the applications they receive – they’ll gravitate to another convenience metric out of necessity.
But that does not mean it’s inevitable.
3. We all have a say in what comes next.
If the rise and fall of a scored Step 1 teaches us nothing else, it should clearly demonstrate these two things.
First, advocacy works. There is no way that the NBME’s entrenched, out-of-touch bureaucracy would have ever voluntarily changed Step 1 to pass/fail – unless their feet had been repeatedly been held to the fire by the public over the past year. Change is possible – but you have to speak up.
Students, I’m looking at you – especially those from “non-elite” or international medical schools. You have a say in what comes next. How should residency programs evaluate you? Surely, answering multiple choice questions with peripheral relevance to real patient care is neither the best nor the only way to identify your talent. It’s time to dream bigger – and demand more meaningful evaluation.
Second, medical students will rise to whatever bar we set for them.
Ask them to memorize an 800 page review book so they can excel on a multiple choice question test of basic science esoterica? Done and done. Students knew most of what they were learning was pointless – but they worked tirelessly because we told them it mattered.
So program directors, now I’m looking at you. Whatever you tell students to do, they’ll do. You want high Step scores? Students will give them to you. But what really matters to you? Do you want residents who will serve the underserved? Contribute to research? Arrive on July 1 with specialty-specific knowledge? Whatever you say, goes. If you choose to grump about the loss of the bad old days, you’re abdicating your authority to set the standards you want.
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YOU WON’T FIND ME SHEDDING ANY TEARS OVER THE DEMISE OF A SCORED STEP 1.
4. No one should mourn the loss of a scored Step 1.
Look around my Twitter mentions, and you can find touching testimonials mourning the demise of Step 1 scores. There are tales of useful factoids brought to bear on patient care decades later; of students inspired to consume as much (mostly useless) scientific knowledge as possible; of doors opened and careers launched because of one shining moment on test day years ago.
Give me a break.
The Step 1 score was the biggest false god in medical education, and no one should be too sad that it’s going away.
Was it objective? Sure. But the ability of three-digit scores to discriminate between applicants was actually fairly imprecise.
Did it test some useful concepts? Of course. But scoring highly required memorizing esoteric information that would never benefit an actual human patient.
Did some students benefit from scoring highly? Absolutely. But did Step 1 scores really “level the playing field” for students from international or non-prestigious medical schools overall? I doubt it.
Did it give program directors an easy way to screen applications? Yup. But was that way meaningful? Probably not. The main value of Step 1 was that it gave you a number. But if the content of the test doesn’t matter, why not just have medical students throw darts, or race go karts, or memorize digits of pi?
And of course, our idol worship of Step 1 came at a significant opportunity cost. The fact that most of us turned out okay doesn’t prove that Step 1 was the best way, or that that we wouldn’t have been better off under another system.
Here’s the thing:
Whether you liked a scored Step 1 or not, the current system is not what any of us would have designed if we were building something from the ground up.
In the scored Step 1 era, we sat back and watched as preclinical medical education turned into a glorified USMLE prep course with a five-figure/year tuition bill attached. We did nothing as residency applications spiraled out of control and program directors’ outsourced their most important decision-making to the NBME.
We shouldn’t be proud of any of this. And we shouldn’t mourn the loss of the three-digit score that enabled us to neglect the need for reform for so long.
More importantly, there is no turning back now.
If you opposed #USMLEPassFail, do your grieving for the scored USMLE – and then get to work. Saying “I told you not to make Step 1 pass/fail!” is a hollow victory. There is an opportunity here to engage our students in tasks that could actually lead them to be better physicians – but we have to seize it.
And if you supported #USMLEPassFail, now is not the time to dance on the three-digit score’s grave. We need to get to work, too – or this hard-won victory will go for naught.
5. The way forward… my opinion
Expect more from me on these topics in the future, but for now, let me put these three thoughts in your head.
WE NEED MEANINGFUL EVALUATIONS.
My 5th grader’s report card provides more useful information than any medical school transcript I’ve ever seen. He doesn’t get an “A” in math – I get to see a lengthy list of math skills and an assessment of where he’s at with all of them. Maybe he’s comfortable dividing fractions, but still developing proficiency with using variables to set up algebraic equations.
Letter grades are nice – but they don’t tell me what he knows and what he doesn’t. (I don’t get a histogram of other students’ performance and where he falls – because how other students performed is kind of irrelevant if my goal is to help him become better in math.)
The fact that elementary schools provide more information-rich evaluations than medical schools is shameful. In the past, we’ve justified this because of Step 1. Starting in 2022, that excuse will ring hollow.
Let’s be honest: there should never be a medical school evaluation in which a students is exceptional in every area. (If there is, it tells you more about the school than the student.)
Our goal should be to make medical school formative, not performative; to help learners maximize their potential without fearing failure; to provide and communicate honest feedback that leads to improvement and growth along the spectrum of medical education. (For their part, program directors need to focus less on relative accomplishment and more on potential to grow and thrive in that program/field.)
We don’t need another arms race. We do need more thoughtful evaluation. We should require students to engage in tasks that leave them – and their future patients – better off. And schools that refuse to participate in this process should be penalized by program directors and medical school applicants alike.
WE NEED HOLISTIC REVIEW.
I don’t think we need a one-size-fits-all metric to tell us who are the “best” applicants. Honestly, we don’t.
Certain talents and traits get you a lot farther in certain disciplines than others. Even within the same discipline, different programs have different needs and serve different missions. What makes a good doctor? It’s complicated. And trying to reduce that complexity down to a single three digit number is silly.
Holistic review is possible. It’s what we do at the residency program at which I’m an associate program director. But it’s labor intensive – and it requires human judgment. That last part makes some people uncomfortable, and I understand why. Holistic review has the potential to devolve into bias and cronyism. But that’s not a reason to not do it – it’s a reason to strive to do it well, to make decisions deliberately, and to build some checks and balances to make sure you stay aligned with your values.
WE ALSO NEED APPLICATION CAPS.
The only way to get away from screening metrics and treat every applicant as an individual is to limit the pile of applications that program directors receive.
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THE EXISTENCE OF A SCORED STEP 1 ALLOWED US TO PRETEND THAT THIS WASN’T HAPPENING.
Look, I’ve preached this sermon before. But you’d better believe I’m gonna be carrying this particular gospel to the people again in the near future.
Afraid of application caps? Worried that they’ll disadvantage students from non-elite schools? Stay tuned for a data-driven expose of the misinformation surrounding caps coming soon.
Dr. Carmody is a pediatric nephrologist and medical educator at Eastern Virginia Medical School. This article originally appeared on The Sheriff of Sodium here.
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