Step 1 keeps you safe from the dangers of fun

If students were to devote more time to activities that make them less prepared to provide quality care, such as binge-watching the most recent Netflix series or compulsively updating their Instagram account, this could negatively impact residency performance and ultimately patient safety.

That’s Peter Katsufrakis, MD, MBA, president and CEO of the National Board of Medical Examiners (NBME) and Humayun Chaudhry, DO, MS, president and CEO of the Federation of State Medical Boards, responding in Academic Medicine to a student-written article concerning how Step-prep has consumed medical education that advocated for a pass/fail Step 1.

There was a backlash, and they tried to backpedal on this comment (emphasis mine):

During the editing process of our manuscript, we added a statement about excessive use of Netflix and Instagram which was unfair and inappropriate. As leaders of the USMLE, we believe that students, medical educators, and the public deserve our respect. Our statement was inconsistent with that belief, and we are deeply sorry.

Yeah, right. Make no mistake, their glib response to actual student concerns is exactly what they meant to say. Humor is often the dull dagger of truth, seemingly softer and more palatable than direct honest communication but ultimately more damaging.

However, the disrespect is by far the lesser evil here. Students and residents are rarely respected on an intellectual level by administrators. Their perspectives are viewed as myopic and ill-informed. The real issue here is dismissal.

Students have valid concerns. Residents have valid concerns. Trainee complaints are often dismissed by their superiors as the whining of a coddled generation (whether decades ago or today), and then those graduates go on to perpetuate both the toxic culture and broken system it engenders.

The biggest problem in medical education is the uncanny ability of doctors to pay-it-forward instead of being agents of change.

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