I got my step 1 score back and I was very disappointed. I got a 219 (88) when I was shooting for at least a 230. Problem is that I really want to be able to get into a good IM program (that offers cards); my dream residency would be in Boston, or to get into other competitive programs (e.g. Duke), but I have a feeling that I could just end up in NYC/Long Island (I've dreamed of going into academic medicine/clinical research in cards, but I'm not so sure about that anymore). I'm wondering if anyone could give me a realistic impression of how I stand (which so far, is not so good) in the eyes of these PD's.

Weaknesses:
-Not a single High Pass or Honors in the first 2 years of school.
-Only a 219 (88) on Step 1. Especially depressing when the people you studied with scored in the 230s, 250s, and even the 260s (and some of these guys never even got any Honors grades either!)
-No chance at being AOA.
-My "network" does not include anyone at academic IM programs .

Strengths:
-A few years of basic science research in cards mostly in gene therapy (one paper out of this).
-A summer working at BWH in Boston doing clinical research in cards (this was in undergrad; no papers out of this). I established (and do my best to maintain) connections with one of the biggest names in Vascular Medicine, the head of the cards fellowship committee, as well as one of the biggest names in interventional cards (biggest historically and academically; this guy is great, he's always telling me to let him know whenever he can "help" me out in in my career)
-A summer working (during med school; no papers) under a well-respected and well-funded person in basic science research of arrythmia (gene therapy work).
-I feel that I am above average compared to the rest of my class in terms of clinical knowledge and skills (pathophysiology, interviewing, differential dx, etc.) so I'm hoping that by breaking my butt I will be able to establish a few Honors as well as a few good LORs during 3rd and 4th years (most importantly in my IM clerkship).

Some of the things that I've opened up as ways to bolster my application include doing AIs/sub-Is at some of these programs or even taking a year off to do clinical research (hopefully back at BWH) through either Doris Duke or Howard Hughes.

Any honest comments/advice? I've wanted to do cards for a while (esp. interventional, I love the technical aspects of it) but I'm trying to do my clinicals with an open mind not only to get better grades, but most importantly to see if there is another field that I fall in love with). Thanks.

I can definitely commiserate! My Step One was 217. I did get two first-year honors but one was in embryo which doesn't count for much, and my second-year coursework wasn't stellar. My "connections" are at the Mayo Clinic but I'd definitely have to impress on an away rotation. You can give Howard Hughes a shot, just don't count on it (I didn't receive an interview when I applied this year, but not having much research experience probably hurt). I was also hoping for Boston among other places...not really hoping for MGH/BWH at this point, but maybe BID/BUMC.

Hopefully this makes you feel better considering all these 240+ scores posted on SDN. :p

threading catheters up someone's groin and watching on the fluroscope isn't very exciting.

IM isn't very competitive and a 219 with strong letters will get you into a solid program.

best of luck

thanks to those who posted so far. Lara, I really wish you the best of luck!
Does anyone else have anything they could add?

definately get try your best to honor medicine...and if possible the same at a sub i...i would consider taking step 2 early...i think your score is really good but just a few more points and you would be in contention for those better programs...

doing a sub-i at the high caliber programs will only help...and if you get connected with the right people at that time it can help...but sometimes there is only so much you can do when you are on a sub-i....

the problem is that upstate sometimes has fierce competition for IM...last year a ton of AOAs applied...and we got people into some of those lofty programs but they were all kind of competitive applicants...the thing is upstate is a second tier program (i'm quoting the deans) so it makes it harder to get to the lofty programs (like Duke, BW, MGH) unless you are AOA....

i would broaden your search and consider other strong university based im programs such as northwestern, tufts, rochester, brown, uva etc...you could still do acadmeic medicine after working at these programs...and still get a good cards fellowship...

i can't speak on how doing doris duke...not too many upstate people do those types of programs...i think it can only help but the question is help how much??

don't worry, things will work out...good luck :)

definately get try your best to honor medicine...and if possible the same at a sub i...i would consider taking step 2 early...i think your score is really good but just a few more points and you would be in contention for those better programs...

doing a sub-i at the high caliber programs will only help...and if you get connected with the right people at that time it can help...but sometimes there is only so much you can do when you are on a sub-i....

the problem is that upstate sometimes has fierce competition for IM...last year a ton of AOAs applied...and we got people into some of those lofty programs but they were all kind of competitive applicants...the thing is upstate is a second tier program (i'm quoting the deans) so it makes it harder to get to the lofty programs (like Duke, BW, MGH) unless you are AOA....

i would broaden your search and consider other strong university based im programs such as northwestern, tufts, rochester, brown, uva etc...you could still do acadmeic medicine after working at these programs...and still get a good cards fellowship...

i can't speak on how doing doris duke...not too many upstate people do those types of programs...i think it can only help but the question is help how much??

don't worry, things will work out...good luck :)

sounds like you're also at Upstate. Thanks for the excellent advice! :)

I am an R1 at a competetive UC IM program - I would agree that you have to take Step II and guarantee you will do better, everyone does. Also if you do a sub I make sure 1 of them is at a reasonable place, lots of people do harvard/hopkins sub Is and aren't guaranteed a spot, find a nice academic program and work your ass off, and make sure to meet the PD.

lots of luck

golyte

sounds like you're also at Upstate. Thanks for the excellent advice! :)

actually graduated 2004...