Purpose
Curricular revisions, including the use of open-ended questions as assessments, and the move of USMLE Step 1 to after core clerkships, required redesigning our academic support programs. Here we describe a longitudinal support program, called PILLAR (Program In Learning with Lifelong Approach to Review) consisting of 1) PILLAR Summer for MS1s and 2) PILLAR winter for MS3s focused on Step 1.

Methods
Summer and winter programs are announced to class each year. Candidates are selected from applicants based on academic/personal need. Faculty designed and implemented early iterations and improved based on feedback. MS4 teach & design their own summer session within in a provided framework. Since AY20/21 MS4s role was expanded to serve as Step 1 study mentors. Evaluation data were collected and descriptive stats calculated across AY 20-21/ AY 23-24. Deidentified Step 1 performance data are being collected. Summer: The 8-week summer program included: A) MS4-led small groups, B) individual faculty mentoring, C) resources (U-world), D) exit exam. Winter: A) Faculty-led small groups on high-yield topics, B) individual mentoring on learning plan (Faculty/MS4 mentors).

Results
Enrollment ranged from 5 - 20 students/cohort. Summer: Program well received overall (eval 4.23 std dev 0.5 n=20): “Great way to synthesize first year topics with thoughtful and experienced MS4s and clinicians. It is good blend of first-year medical knowledge, and Step 1 oriented learning”. Winter: Program well-received (eval 4.02 std dev 0.5 n=22). Most valuable: Peer support and accountability. “The pillar program gave me a community during a stressful period of studying when we often feel isolated. I wished there was a similar program for Step 2.”

Conclusions
MS4 are superb near peer teachers and Step 1 study mentors Peer support and accountability are key.

Next Steps
Expand to Step 2.