THE UNCERTAINTY OF STEP 1 AMID COVID-19

Med students across the nation are uncertain when they will be able to take their USMLE boards like Step 1 because of COVID-19 restrictions and closures.

6:15 am. Alarm goes off. It keeps going off. I quietly yell at my husband… “Blade! Your alarm!” He snoozes it. Our two-year-old daughter is sleeping in the room right next to us, so I don’t want it to wake her up. Plus, let’s be honest, I want to keep sleeping… 6:25 am the alarm goes off again. “Blaaade!” He turns it off.

6:30 am he rolls out of bed. Another day begins of Step 1 studying during COVID-19.

*Update on our current Step 1 status at the end of this post.

To Step or Not to Step

We have officially completed four weeks of dedicated study with two weeks to go. It has been a complete roller coaster because of the ripple effect of COVID-19. We have had a constant barrage of questions and worries…

Where should he study? Do we stay in Minnesota or go to Arkansas with family? Should he reschedule and move his test? Should he even study if we reschedule? Will the testing sites open up? Will he be able to take Step 1 on his original date? What will we do if Prometric or USMLE cancel his test and he is one of the 50 percent to be cut to meet COVID-19 regulations?

Even a few days ago (as I was about to publish this post), everything was turned upside down and our plans ruined when he received an email from Prometric saying his test was cancelled.

We were devastated and scrambling to reschedule.

Prometric’s website was down so he was unable to reschedule. We both anxiously had the site pulled up on our computers waiting to get in. The site finally popped up at 5 pm.

But to make things worse, we soon discovered he would not be able to reschedule like the other medical students who had received cancellation emails. Since he has accommodations as a Type 1 diabetic, he had to do it over the phone. BUT, he would have to wait til the next day to call and reschedule because phone lines were now closed.

Least to say we were angry, worried, and I definitely shed a few tears.

Fast-forward to early this morning. Here’s what we found out after talking to someone at Prometric on the phone.

The email was an error…for some.

You read that right. The cancellation email we received was an error. He is still scheduled to take it May 11 in Rochester, MN. They sent him his permit and he called again to verify a second time.

Prometric somehow sent out a cancellation email and then failed to send a follow up saying it was an error. Hundreds of students had probably already rescheduled! We later found out that among his classmates some did receive a real cancellation email while others received the error email.

I am finding the silver lining in that he had accommodations and couldn’t reschedule his Step 1 exam yesterday. There’s a reason for everything and God definitely has a plan for the way things happen. We had strongly felt he shouldn’t change his date before all this craziness and have been praying consistently that his date would go through.

I am finding the silver lining in that he had accommodations and couldn’t reschedule his Step 1 exam yesterday. There’s a reason for everything and God definitely has a plan for the way things happen. We had strongly felt he shouldn’t change his date before all this craziness and have been praying consistently that his date would go through.

Then this happened. Somehow he still has his original date. This was definitely a test of our faith. God is good and we are praying he is still able to take it on May 11. Things are looking up, and we remain hopeful during this crazy time.

With two weeks to go, I had to write down what has been happening. If not to help others feel some solidarity in similar situations, at least it would be recorded for our kids.

But first a bit of background.

What is Dedicated Study and Step 1?

If you are not involved in the medical community, I think it’s important to understand a few basic things about dedicate and Step 1 to fully appreciate what medical students are preparing for.

Dedicated study is a time set aside for medical students to completely focus on preparing for the USMLE Step 1 without worrying about classes or other obligations that medical school brings. How long dedicated lasts is dependent on the school. What, how, and when students study is all on the individual. Most students will study pretty much all day and often late into the evenings with a few breaks.

My husband’s dedicated study time looks very different from what he planned back in November because of the pandemic with COVID-19.

Here are a few facts to understand the gravity of Step 1:

“Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning.” USMLE.org
Content covers systems, physician tasks, discipline specifications, and even communications skills. To learn more about the actual content of the exam, click here.
Students must take the exam in one day.
It is made up of seven 60-minute blocks and administered in one 8-hour testing session.
Generally there is 280 questions.
The highest score is 300. However, most students score between 140 to 260.
Currently a medical student’s Step 1 score plays an important role in what residency programs they can apply for. (This may change when Step 1 goes to pass/fail in 2022, but that’s another story.)
In short, Step 1 is one of the most important tests a med student will take in their medical career.

Uncertainty with Prometric and USMLE

Uncertainty has continued to build for medical students as there is little communication or direction from USMLE and Prometric.

On April 23, 2020, Prometric announced the following:

“In accordance with the changing local and federal governance and advice from the CDC and WHO, we have determined it is necessary to further extend the closure of test centers in the U.S. and Canada through May 31^st. This applies to all testing programs, with the exception of a limited set of essential services programs.”
https://www.prometric.com/corona-virus-update

About 30 minutes later, USMLE tweeted the following:

“Prometric does consider USMLE an essential examination & will resume testing on May 1. Continue to follow us on social media and http://USMLE.org for updates. You can find the Prometric announcement regarding essential testing here https://bit.ly/35adnVL“

Now medical students are in a panic as Prometric has begun to send out cancellation emails without warning. And you’ve seen how some of that has panned out. Some students that we know are rescheduling in different locations for as soon as end of May or as late as November.

I don’t think I am the only one who is frustrated and disappointed by the lack of communication and transparency with these two organizations.

Our Uncertainty Brought On By COVID-19

Medical students across the nation are uncertain when, or even IF, they will be able to take their USMLE exams (Step 1, Step 2, etc.) because of restrictions and closures caused by COVID-19. In an already stressful time for medical students, COVID-19 has brought on extra and unwelcome stress and uncertainty.

Where to Study?

When Minnesota was put on stay-at-home orders, we scrambled to figure out what our next move should be. Blade was finishing up his last organ block (GI) and approaching a six-week period of dedicated study for Step 1. The school officially told the students that they would not be allowed to study at the school because it wouldn’t be considered essential travel. Plus, the library and every other place he could have possibly used to study was closed.

The idea of Blade trying to have focused, quiet study at home with a busy and needy toddler and a socially isolated wife…well let’s be honest…it wouldn’t have worked very well for any of us.

The idea of Blade trying to have focused, quiet study at home with a busy and needy toddler and a socially isolated wife…well let’s be honest…it wouldn’t have worked very well for any of us.

So, after carefully weighing our options, pros, cons, and risks we decided to make a 10-hour drive to Arkansas to stay with Blade’s family at the end of March. We recognize this isn’t an option for everyone, but it was definitely the right choice for our family to have some extra support during this time.

Our daughter has loved spending time with her grandparents, aunts, and uncles. Tucker, our dog, is in heaven with all the open space he has to run around. There is obviously some challenges with 11 people living in the same house, but overall we have loved staying with family during this time and feel extremely blessed.

Our plan was to stay in Arkansas for the two-week stay-at-home order in Minnesota, but that has since changed.

What’s our back up plan if his test is cancelled?

As far as his test date on May 11, we felt it best to just sit on it and wait. Many of his classmates decided to be proactive and move their April and May dates back to June or even July.

When the governor of Minnesota extended the stay-at-home order to May 4, we reevaluated our plans and decided to stay in Arkansas longer. For how much longer, we didn’t know. We continued to move our going home date back further and further because of so much uncertainty regarding testing sites being open for the big day. Eventually, we just decided it would all have to be a last minute decision once we knew more.

The biggest worry? His test would be cancelled.

We tried to make various plans to address different situations. In fact, as of today, our tentative plan is still unsure.

Oh, and did I mention that I’m almost 28 weeks pregnant? All my appointments from 28 weeks on have to be in person. So that just adds in one more factor to consider and plan around.

Oh, and did I mention that I’m almost 28 weeks pregnant? All my appointments from 28 weeks on have to be in person. So that just adds in one more factor to consider and plan around.

Plan A: Head back to Minnesota on the first weekend of May so he can finish studying and take the exam on May 11 and I can go in for my glucose screening test. This plan is contingent on the Prometric testing site in Rochester being open and that he would be one of the 50 percent selected that could still take the exam on their scheduled date.

Plan B: Our least favorite option. If he is unable to take it for some reason in Rochester, we would move his test to a different location close by and pray for an open date in May. Arkansas, Missouri, Iowa, and Texas were top on our list because he could stay with family or friends.

With the cancellation email that came in, we scratched Plan A and waffled between Plan B, C, D, Z… However, after the “error” we are now back to Plan A.

What will we do to celebrate after Step?

At this point, we have cancelled two post-step trips that we had scheduled to celebrate and relax.

Our first trip was unrelated to COVID-19, but would have been cancelled either way. We had scheduled a cruise back in November 2019, but we had to cancel because I got pregnant and would be too far along to be allowed on board. Thankfully they actually gave us a full refund after spending hours on the phone and explaining our situation. A trip credit wouldn’t work with third-year clinicals, fourth-year interviews and residency applications, and possibly moving for residency who knows when.

Our second trip we planned to replace our cruise was to Charleston, SC. We sadly had to cancel that last week due to COVID-19 closures and our Airbnb host having to cancel on us.

So, what do you do when everything is falling through and nothing is open or taking reservations?

You rent an RV.

We decided rented an RV and a KOA site. I’m not going to lie, we actually are really excited. We’ll drop our daughter off with grandma, take our dog, and go enjoy five days of relaxation by a lake kid-free. It does mean a third and a fourth 10-hour drive, but I think it will be worth it.

Hopefully the third time is the charm and won’t have to be cancelled!

Moving Forward

With so much uncertainty surrounding Step 1, it can be easy to lose hope, slack off with studying, or want to throw in the towel and quit. My husband was definitely at that point before we found out his test was actually “not” cancelled.

But if there is anything we have learned, it’s absolutely important that you bend not break. We are often required to bend and be very flexible with every aspect of life at times. From vacations to locations, almost every aspect of our life as been uncertain since COVID-19 showed up.

Among all the uncertainty, I have found peace in a few certainties. This is crazy time is temporary. Things will work out. God is good and this too shall pass.

Among all the uncertainty, I have found peace in a few certainties. This is crazy time is temporary. Things will work out. God is good and this too shall pass.

What has been your experience with preparing for Step 1? I’d love to hear! Share in the comments below!

Update | May 2

Y’all this is such an emotional rollercoaster. My eyes hurt from crying so much yesterday…

Are you ready to hear the most ridiculous and frustrating situation when it comes to Step 1?

One day after I posted about the scare with the error email, Blade’s test date was cancelled because of the MN governor’s mandate/stay-at-home extension. Blade was able to reschedule and snag a May 12 date for Bedford, TX because he would be able to stay with his aunt.

The following day we tried to get a hold of the actual testing site in Texas without luck. After 3 hours on hold and talking with a gal at Prometric, we were told that testing site would likely not be open. She looked for open seats in May and said the only one in the nation that she could see was in Pittsburgh, PA for May 22. We said we’d take it for now. She put us on hold and after 30 mins of waiting…she hung up.

We called back and after an hour in line on hold, the guy we spoke to said we were still good to go for the Texas location and still scheduled for it. He saw no reason Blade’s test would be cancelled. We confirmed several times and even got his permit sent to us.

Something wasn’t right as we still couldn’t get a hold of the testing site in TX. So, we called the restaurant right next to the testing site. They said there had been no activity. We got connected with the manager of the building. Turns out…THEY HAD A FIRE 3 WEEKS AGO.

He will not be able to test May 12. But Prometric is STILL somehow scheduling people there…Why? I don’t know.

We found this out after Prometric closed their phone lines so we couldn’t call to change his date (he can’t change it online since he has accommodations). An hour later, probably about 50 plus new seats opened up across various states, including Minnesota where his original location was for testing. But we couldn’t snag any of them because phone lines were closed.

We are a bit worried Prometric overbooked these sites or the seats aren’t actually available and might be the ones that were cancelled to meet COVID regulations. But we remain hopeful that they opened more seats and days up to help students.

Essentially there is nothing we can do until Monday.

To be honest, I have about ZERO confidence and trust in Prometric at this point. We don’t even know what to believe now. There is a lot of talk among the medical community that USMLE needs to break their contract with Prometric. Only time will tell what will happen, but I definitely think things will not stay the same when it comes to the future of licensing medical students.

I have faith that it will all work out. But it is so hard when we have little to no control over something that will greatly affect potential residencies and specialties. I’ve spoken with many of you who are in similar situations and my heart and prayers go out to each of you! I’m sure I’m not the only one when I say that I can’t wait for this rollercoaster to be over…

All my love,

Kristi

Update | May 14

STEP 1 COMPLETED! After 6.5 weeks of essentially studying 12 hours a day, almost 3 cancellations, a lot of stress and frustration, HE DID IT! I couldn’t be more proud of my husband!

Long story short, we were able to reschedule his exam for a site in Minnesota on May 14th, close to the original site of his first scheduled test. We continued to check with Prometric and the testing site that all would go through. The day before he took Step 1, he received a call confirming his appointment to take the test.

Big sigh of relief.

We didn’t relax fully until he walked out of the testing center later the next day. He officially finished his first board on the medical journey, face mask and all. Thanks COVID.

Now, we wait for results…