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Thoughts After Step 1

Hugh Dowlen  

I wait. Three weeks or more will go by before I find out my score. A number that, in some respects, is the sum total of two years of academic work. A solitary data point. A sample size of one, lending itself to little extrapolation. So much is encompassed in that three digit score, and yet it says so little.

Step 1, that USMLE metric imposed by the National Board of Medical Examiners, is yet another milestone along the winding path of medical education. Before part one of the boards, the MCAT looms large. At the time, this is the obstacle to be surmounted, the hurdle that must be cleared. All previous tests bow before it in difficulty, and surely no future exams will be legitimate competitors in scope, meaning, and its accompanying anxieties. But how shortsighted and limited an understanding that is. Instead of secured courtside seats, the Medical College Admission Test is merely a ticket into the arena, or, more accurately perhaps, an interchange with a parking attendant in securing one’s vehicle before continuing to the game on foot.

The journey towards becoming a physician is beset with numerous gauges of progress. For just as the MCAT is to medical school admissions, so is Step 1 is to progressing to the third year of medical school. And Step 2 follows during fourth year, with Step 3, falling in the midst of intern year, coming next. Other board certifying exams are sure to come afterwards, with renewing exams always in the future.

Credentialing and maintaining a standardized competency is, I am fully aware, a stalwart of the profession into which I am entering. Each must be taken with the appropriate amount of preparation and knowledge of its role in the broader picture. I must not look to each as the finish line, but merely another mark of progress along my quest.

Those tests I’ve taken and the ones to come are not roadblocks, but rather checkpoints to measure my progress and assure myself and others that I can keep going. I must always remember, though, that we are so much more than a test result, a number. Standardized tests are neither necessary evils nor absolute measures of worth, but they do have value. And of course most tests will not come in computer-based format of open-and-shut one hour blocks of 46 multiple choice questions.

 Hugh Dowlen 

Hugh Dowlen
Year in Medical School: MS4, Class of 2015
College Attended: Davidson College
Hometown: Chattanooga, TN
Favorite Quote: “This life therefore is not righteousness, but growth in righteousness, not health, but healing, not being but becoming, not rest but exercise. We are not yet what we shall be, but we are growing toward it, the process is not yet finished, but it is going on, this is not the end, but it is the road. All does not yet gleam in glory, but all is being purified.”
- Martin Luther
Fun Fact: I love to run and water ski. 



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Last Updated: 05-19-2015
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