Ortho and Step 2

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I'd like to start a more recent post for this question....
What's the consensus on needing or not needing a Step 2 score to match in Ortho specifically? Anyone with first-hand or second-hand experience on this?

I did really well on Step 1 and there's a good chance my Step 2 score would only bring me down..

Thanks guys

Originally Posted by medicine0509

I'd like to start a more recent post for this question....
What's the consensus on needing or not needing a Step 2 score to match in Ortho specifically? Anyone with first-hand or second-hand experience on this?

I did really well on Step 1 and there's a good chance my Step 2 score would only bring me down..

Thanks guys

I doubt you'll every get a solid consensus on this. It's as variable as the programs you apply to. I'm sure you can weigh out the pros and cons: if you did really well on Step 1 all you really need to do is pass Step 2 so why risk taking it early and doing poorly? On the other hand, if you didn't do so hot on Step 1, you really HAVE to take it early to prove you had a bad test day on Step 1.

With that said, from my 12 interviews last year I did get the sense that already having my score (I took it in early August of my 4th year) really helped me. I did well on Step 1 also but I wanted to show I had nothing to hide and my interviewers seemed to like the confidence.

I do think there is a trend among programs to want as much info as possible on applicants - it only makes sense considering how many highly qualified applications they receive. This is especially true of highly competitive fields like ortho.

My personal advice is to put 2-3 hard weeks of studying in, take it early, and go into your interviews confident that you've proven twice what you're made of.

I agree with GAdoc. If your step 1 is good it can only make your app more complete to have step 2 in. I think it shows that that you have nothing to hide. Also you would be surprised at how many applicants have >240 on step 1. Sometimes it's good to have something else to differentiate your app. Again it's not mandatory but I have a completely unscientific feeling that more applicants are taking it early.

Cut and paste from a previous post about the same question (on the plastics forum). I will say that not many people agreed with me, but I am still right (I wrote this as an MS3 and I am now a PGY2 in ortho):

Dude, just take it early. Don't play the game, just work hard and kill it. Residencies want applicants with balls (or ovaries) who aren't afraid to face challenges head on. Just study hard, do well, and get on with the rest of the year - thats what you want to do anyway. You'll be happy you did. Also you will never be more prepared for it than right at the end of 3rd year, the longer you wait, the more random little things you will start to forget and thus a lower score you will have. Furthermore, there are programs that want to see a passed Step 2 before they rank you, do you think they would look more or less favorably upon you if you already took it and passed well before your interview?

I am taking my step 2 CK first month of 4th year despite a great step 1. You know why? Because I'm not afraid of a test, and you shouldn't be either. Just do it man.

When I asked my program chair about this, he agreed with everything I just said.

So here I am 6 mos later, and just wanted to throw this out there..

My ortho advisor, who is really well known in the field and was himself a PD of a top residency program, said to absolutely NOT take Step 2 in time for ERAS with a strong Step 1 (>250). Furthermore, according to a 4th year I know going through interviews now at great programs (he also did not take Step 2), and some of my own research on programs, there are only a couple programs nationally that require Step 2 before they make their rank lists! That means the odds of them holding back an interview offer for no Step 2 must be pretty slim, right? It seems to me that maybe ortho is not changing as much as other competitive specialties with regards to Step 2 expectations..

So wouldn't it make sense to spend the time in July-Sept focusing on ortho sub-I's to boost one's ortho experience and get strong LORs than it would to take time off to study for Step 2?

Originally Posted by medicine0509

So here I am 6 mos later, and just wanted to throw this out there..

My ortho advisor, who is really well known in the field and was himself a PD of a top residency program, said to absolutely NOT take Step 2 in time for ERAS with a strong Step 1 (>250). Furthermore, according to a 4th year I know going through interviews now at great programs (he also did not take Step 2), and some of my own research on programs, there are only a couple programs nationally that require Step 2 before they make their rank lists! That means the odds of them holding back an interview offer for no Step 2 must be pretty slim, right? It seems to me that maybe ortho is not changing as much as other competitive specialties with regards to Step 2 expectations..

So wouldn't it make sense to spend the time in July-Sept focusing on ortho sub-I's to boost one's ortho experience and get strong LORs than it would to take time off to study for Step 2?

The opinion I gave back in July remains unchanged. As a med student it's so easy to think linearly - i.e. "if I do well on Step 1 I'll get lots of interviews, if I get lots of interviews I'm sure to match, etc". There are specialties where that probably holds pretty true - for example if you're a 260+ braniac you probably don't need to do well on Sub-Is (or even attend one) to get a spot in radiology, rad onc, etc. Ortho, however, is one of the few hold-outs that wants the ideal combo of a smart person who is also a hard worker and decent to be around. That's why sub-Is are critical.

With that said, most sub-Is will not judge you on how much ortho you know. They want to see how hard you'll work and how well you get along with them. Thus, trying to "prepare" for sub-Is is often an exercise in futility. My advice for Sub-Is could be a different thread, but to make it short - work hard, don't complain, and try to prepare for cases without being obnoxious or showing anyone up.

We make our rank list in the next couple of weeks so I've been looking at lots of applications from the people we interviewed. I can tell you that the average step 1 is probably a lot higher than you'd think (though there are some lower scores mixed in). As far as I'm concerned, when I see that someone went ahead and took Step 2, it makes me think higher of them - they were confident. They had nothing to hide. Step 1 was not a fluke - it was the real deal. They prove they have not only the intelligence to do well twice, but also the work-ethic to get it knocked out early.

I don't necessarily look down on those whose Step 2 scores are not reported and I also don't look down on someone who rocked Step 1 and had maybe a 10 point drop on Step 2.

Still, this is an individual decision and I don't blame people who did really well on Step 1 or waiting. I'm sure there are guys in other programs who who whole-heartedly agree with you. For me, it was a risk since I did well on Step 1, but I ended up doing better on Step 2 with half the study time. At one of my interviews, I was asked why I took it - I replied that I wanted programs to know I had nothing to hide. They seemed to really like that answer.

Believe me - Step 2 isn't nearly as hard as 1...three solid weeks of preparation before heading to your first Sub-I should be all you need to rock it. Then you don't have to worry about it.

Originally Posted by GAdoc

For me, it was a risk since I did well on Step 1, but I ended up doing better on Step 2 with half the study time. At one of my interviews, I was asked why I took it - I replied that I wanted programs to know I had nothing to hide. They seemed to really like that answer.

Believe me - Step 2 isn't nearly as hard as 1...three solid weeks of preparation before heading to your first Sub-I should be all you need to rock it. Then you don't have to worry about it.

It is disturbing that your assumption is that those without their Step 2 present at the date of their interview or when ranking have something to hide...what is more twisted is that someone with your thought processs is involved in the selection of future residents. There are many reasons why a candidate may not have their Step 2 score in time for the ranking process. I realize you took a risk and were able to score higher with half the time-good for you! Now you can stop trying to inject your twisted logic into expectations for other applicants. Not everyone is as 'risky' as you; perhaps risk avoidance is a good thing for a future surgeon. Also, I found it humourous how you start your post with a distinction between medical student 'linear thinking' and your newfound thinking as a resident-it's quite clear you'll full of yourself even using linear thinking.

Taking or not taking step 2 will not likely make a big difference in getting interviews or how your are ranked. However, taking step 2 early with a strong (>250) step 1 is certainly a statement of your character. It shows that you are confident in your ability to do well and you aren't going to "play the game" of matching. The ONLY way step 2 will hurt you is if you COMPLETELY BOMB IT. No one would even bat an eye if you did 10-15 points worse (and since so many people don't take step 2 seriously, you are much more likely to do as well or better with less studying).

Reasons one should take step 2 early with a strong step 1:
1. Establishing a pattern of excellence.
2. No other great time to take it - after 3-4 months of ortho sub-Is, then 2 months of interviews + mandatory rotations, it may be tough to fit it in. You WILL be burned out at the end of your sub-i's.
3. Some programs that you MAY want to go to do require it. As ortho gets more competitive, more may start requiring it. If you take it early, you don't even have to worry about it.
4. Take it early so you get it out of the way and don't have to worry about it. Piece of mind is nice.
5. You want to show people you aren't afraid of a test and you don't want to play the game. It may not count for much, but it definitely counts for something.
6. Waiting until real late with the mindset of "I just have to pass" makes you MUCH more likely to fail, which would be a huge headache that late in the year (depending on when you do it you may have to delay residency).

My advice to most applicants is to take it early. My advice to you is to wait. It probably wont' make a big difference either way. Best of luck in whatever you decide to do.

(Just a side note: Being nationally known does not necessarily make you the guru on match advice. And depending on when your mentor was a PD, things may have changed significantly. Just look how the match rate is plummeting even over the last 5 years.)

Double Post

Originally Posted by spongioform

It is disturbing that your assumption is that those without their Step 2 present at the date of their interview or when ranking have something to hide...what is more twisted is that someone with your thought processs is involved in the selection of future residents. There are many reasons why a candidate may not have their Step 2 score in time for the ranking process. I realize you took a risk and were able to score higher with half the time-good for you! Now you can stop trying to inject your twisted logic into expectations for other applicants. Not everyone is as 'risky' as you; perhaps risk avoidance is a good thing for a future surgeon. Also, I found it humourous how you start your post with a distinction between medical student 'linear thinking' and your newfound thinking as a resident-it's quite clear you'll full of yourself even using linear thinking.

Crap like this is why I post less and less on this forum.

In fairness, I guess it would be appropriate for everyone who posts advice on this site to first disclaim "I am only one person out of many and this is just my opinion" but I guess we assume people already know that. In my "twisted" way of thinking, I further assume people posting questions on this forum actually want honest responses from people who have gone through the very things they now face.

To your post - first, I am not implying that people who don't take Step 2 early have something to hide. I DO think that taking Step 2 builds the case to programs that you are confident and that your performance on Step 1 was not a fluke - sorry if that offends you. No one may look down on you for not taking it early, but I definitely think more people are impressed when you do. That's all I was saying.

Amazingly, people with my thought process ARE the ones at least partially responsible for selecting future residents. Of course, I find it hard to believe that you have any grasp on my thought process from a single post - more accurately, you disagree with one statement I made.

Next, I'd be interested in all the "good reasons" you can come up with for not taking Step 2 early. The material tested comes from your 3rd year, thus you'll never know it better than just after 3rd year. My med school did not even give us time to study for it - I took 3 weeks of vacation to prepare. The only valid reason for not taking Step 2 early is "I didn't want to" - which is fine! As other posters have said it probably won't affect whether you match. But don't get mad at me that there actually are programs out there that do want to see a Step 2 - that's not my opinion that's just the way things are.

You're right - risk avoidance is a good trait in a surgeon - but so is confidence. Choosing not to walk into Step 2 without studying is risk avoidance; walking in after solid preparation is confident and that's how programs are going to see it.

The only thing i'm "injecting" is my opinion and I've never claimed it's anything more than that. From the time I was a pre-med until now I've never had anyone who took offense to it the way you did. Well, let me take one more chance to clarify: EVERYTHING I POST ON THIS SITE IS MY OPINION - THE OPINION OF ONE GUY WITH ONE EXPERIENCE. IT IS POSSIBLE THAT EVERYTHING I SAY IS COMPLETELY WRONG.

Lastly - I'm full of myself??? You attacked me for giving a solicited opinion. Do you think I care AT ALL when you take Step 2? Do whatever you want bud and when you match (or don't) you can get on here and give YOUR personal opinion about how things worked out. And you know what - i'll respect YOUR experience.

How could you misconstrue what I said about linear thinking as being "full of myself"? Every person who has ever gotten on a forum and posted a "what are my chances" question is proof of linear thinking - and that includes ME! We all want to be comforted by the fact that a good MCAT = med school, a good Step 1 = lots of interviews, and lots of interviews = match my number 1 choice. It's not residency that has shown me the fallicy of that thinking - it's experiencing the match for myself!

I'm sorry you took such offense with my opinion - just a tip: next time you have a problem with a post, try questioning the opinions of the poster; not attacking them.

Originally Posted by GAdoc

Crap like this is why I post less and less on this forum.

Don't apologize for stating your opinion on a public forum. Plenty of people in the ortho community share your opinions on step 2.

I'm torn about this as well, ideally I'd like to match my step 2 score on step 1 early and I did very well on step 1-I have no research in medical school so it behooves me to have as much on my application as possible to "offset it"

With that beings said, it's risky

There is a time period where you can take CK, get your score back, decide on releasing the score or not, and if you did decide to release it - it will be included with your application when you send it out. I think this is mid-August, but don't quote me on this.

On the other hand, I took mine a little later and still got my scores back before interviews. I just emailed my programs and they added my score to my folder. No big deal.

When you guys mean early, what time frame do you guys refer to? June/July? Early aug? aug sept? Thanks

Early to me means that it will be included with your residency application without you having a choice.

This generally means anytime before mid-August.

The cut off date usually is somewhere in late August/early September . If you take it before then you will have it in time for interviews.

With all that said remember that for next app cycle the ERAS dates changes:https://www.aamc.org/services/eras/. Now residency programs start downloading your app on sept 15 (pushed back from sept 1) and your deans letter gets released on October 15 ( moved up from November 1st). So if you want your step 2 scores in before programs start sending out invites you will need to do it early.

As a side note this new date also means you probably won't want to be on many away rotations in November

Interesante. Welcome changes though.

I did it in November. I did well on Step 1 so I did not need to show improvement, I studied two weeks after my Sub-I ended, took Step 2 and had the score in 3 weeks. I was able to send my score out to all the programs I was interviewing at as well as programs I had not heard from. I improved 13 points on Step 2 so I thought sending out my scores would be to my advantage. If I had done worse I would have pretended Step 2 never happened and no program would have heard anything from me about it and I would not have released it on ERAS. I thought this was the best risk/reward approach. No risk in programs seeing if I had a bad day taking Step 2 and the advantage of having my Step 2 score factored into the interview and ranking process. If you are worried you may not get enough interview invites in the first place your Step 1 is probably already in the mid to low range and it is clearly to your advantage to take Step 2 early and do well. That's my linear thinking, I hope nobody thinks that I am too full of myself for saying so.

Originally Posted by bigcat9

I did it in November. I did well on Step 1 so I did not need to show improvement, I studied two weeks after my Sub-I ended, took Step 2 and had the score in 3 weeks. I was able to send my score out to all the programs I was interviewing at as well as programs I had not heard from. I improved 13 points on Step 2 so I thought sending out my scores would be to my advantage. If I had done worse I would have pretended Step 2 never happened and no program would have heard anything from me about it and I would not have released it on ERAS. I thought this was the best risk/reward approach. No risk in programs seeing if I had a bad day taking Step 2 and the advantage of having my Step 2 score factored into the interview and ranking process. If you are worried you may not get enough interview invites in the first place your Step 1 is probably already in the mid to low range and it is clearly to your advantage to take Step 2 early and do well. That's my linear thinking, I hope nobody thinks that I am too full of myself for saying so.

This was my exact approach.

Do ortho programs look to see if applicants took STEP2 CS as well? Is taking CK early and putting off CS ok? Or does CS have to be taken before programs rank the applicants?

Originally Posted by sincity college

Do ortho programs look to see if applicants took STEP2 CS as well? Is taking CK early and putting off CS ok? Or does CS have to be taken before programs rank the applicants?

No one cares about CS. Take it whenever you have some time in your schedule. I'd suggest doing it after your EM rotation.

I've heard a few programs "prefer" Step2-CK AND CS prior to offering an interview. Anyone else hear similar things from programs?

Yes when comparing to similar applicants some cali programs (ucla or usc I think) would prefer you to have your step 2 in as compared to not, but for the vast majority of programs its still not a requirement. Still though, my advice hasn't changed...if you did well on step 1, you will most likely to better on step 2 CK. Just do the test as soon as you finish 3rd year, get the score and make your application even more complete.

Originally Posted by DoctaJay

The cut off date usually is somewhere in late August/early September . If you take it before then you will have it in time for interviews.

With all that said remember that for next app cycle the ERAS dates changes:https://www.aamc.org/services/eras/. Now residency programs start downloading your app on sept 15 (pushed back from sept 1) and your deans letter gets released on October 15 ( moved up from November 1st). So if you want your step 2 scores in before programs start sending out invites you will need to do it early.

As a side note this new date also means you probably won't want to be on many away rotations in November

Forgive my lack of understanding, but why is it a bad idea to do away rotations in November? Thanks in advance.