Distressed DO in Dire Need of Guidance

[doQuestions2]

resolved

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[AlteredScale]

Depending on how poorly you scored I would stick with just comlex, apply to IM community programs that are friendly to DO's AKA ones with "osteopathic recognition" on FRIEDA and previously AOA programs that still continue to essentially take only DO's and IMG's.

If you didn't score that poorly, you could probably take Steps, maybe in your elective time or something.

You need to check FRIEDA to see if you meet the cutoffs for these programs. If there are programs that have scores above your cutoff and you really want to go there, email the coordinator and explain what's going on and ask if they would consider you.

 

[JustPass]

As a person who doesn't have stellar scores, i mean not even average scores as far as USMLE, but matched into an IM program, Step 1 would help. HOWEVER, since you've been out of the step 1 phase of your life for a while now, you'd probably be better just focusing on step 2/level 2.

Also, I know this might sound harsh (but believe me, I mean it in the kindest way possible) but you gotta lower your expectations now.
Not that you can't apply to big city programs but you gotta get real with yourself and be able to accept wherever you end up.
You prefer big city? PDs don't give a hoot if you don't have the scores or other things on your resume.
I am being completely honest here. Because I was in your shoes and I lowered my expectations.
I ended up matching to a good program (in my opinion) and I can live with it.

Dream big but don't aim way too high when it comes to applications.

 

[doQuestions2]

resolved

 

[AlteredScale]

So do you mean COMLEX cutoff and not worry about Step exams? I was thinking if I were to take Step 1 and/or Step 2 and do at least average that they wouldn't even care about my COMLEX scores?

Yes that is what I mean.

If you take Step and pass, it will only open more doors for you to apply to, especially programs that require Step scores (many mid and top tier university programs and also a good amount of community programs).

If you take to programs that are DO friendly they will probably still look at your comlex scores since majority of those applicants will be DO's.

Did you honor your IM shelf?

 

[JustPass]

So do you mean COMLEX cutoff and not worry about Step exams? I was thinking if I were to take Step 1 and/or Step 2 and do at least average that they wouldn't even care about my COMLEX scores?



Yea thanks, I realize this but also need to know what would be the best path going forward so I can plan. Like do I go all or nothing and put all my effort into Step 1, or spread myself and try to do Step 1 and 2, or just focus on Step 2 (but then I saw some posts here saying on interviews PDs appreciated their Step 2 and wished they had taken Step 1).

Ultimately your call (obviously).
I believe every one on here thinks doing well in Step 1 will essentially erase your bad comlex 1 score. But you'll have tough time trying to study for Step 1 while shelf/comat exams while studying for level 2 and step 2. AND, if you happen to not score well on Step 1, which is likely based on low Level 1 (not always correlated but can be), you have wasted precious time for studying Level 2/step 2.
Pick your battles, listen to other responses on here for a few days, make up your mind and go for it.

 

[deleted480308]

I would never go back to step/level one. You passed. Move on with with life and take comlex 2 and score better

 

[camng11]

whats a bad comlex score? 550 could mean bad for some delusional med students

 

[hallowmann]

Like 400s comlex, like I said I was hitting upper 230s by the Uworld/NBME correlation charts but nerves really got me. Did not honor IM, one of my 1st rotations (know that's not an excuse) - notoriously difficult at our school since it requires damn near perfect on the subjective portion, but doing increasingly decent throughout the year and got a good eval by the IM doc.

Does this sound somewhat reasonable for trying to match IM: go for broke on Step 1, don't take Step 2, and just pass COMLEX 2 and PE

Or would I be better off not taking Step 1, focusing on COMLEX 2/Level 2? That's basically my main question right now.
Thanks to everyone so far for the replies.

Based on your posts, you seem to think that the only way to take Step 2 CK is if you also take Step 1. That is not the case. You can only take Step 2 CK if you want. Personally, I would only take it if you are doing very well on the clinical NBMEs, and even then I would aim to take it at the end of August/beginning of Sept, so you could submit your app before getting a USMLE score and releasing the score report (in case you do poorly on it).

I agree with others that it will be very difficult for you to get back into studying Step 1 material, especially because it does not sound like you've studied extensively throughout 3rd year. I also agree that you need to be very honest with yourself, your ability to do well on board exams, and your ability to match IM in a big city. You need to be lowering expectations to some degree, and you will need to apply to less competitive programs. That doesn't necessarily mean that fellowships are out of the question (competitive fellowships probably are), because many low-tier or less competitive community programs also have a handful of in-house fellowships, which often take from within.

Step 1 will certainly open more doors to you, especially for the programs that require it, but Step 2 CK will also help (just not as much) for some programs. Its honestly a personal decision, and it truly is up to you how you will go about doing this, but being honest with yourself, your motivation, and your abilities is very important now and in the future.

 

[doQuestions2]

Thanks, I guess then the question becomes which is "worth more" to residency programs that would open more doors, Step 1 or Step 2 CK, if I just had to take one. I think I could get back into the swing of things regarding Step 1 because if I do end up scheduling it, by just passing COMLEX 2 and putting my effort into Step 1 I would be able to set aside 3-5 wks of dedicated, and then have at least a month prior of regular studying.

 

[BorntobeDO?]

In a bad spot and don't have many people to talk to, need some advice please.

Situation: 3rd year. Bad COMLEX Level 1, no Step 1. Throughout second year was keeping up with Anki, during dedicated UWorld and practice exams had me high-230s. Before my COMLEX I started to panic and couldn't sleep or concentrate with all the anxiety, actually dozed off a few times during my COMLEX and got a very low score. Didn't help my confidence so I canceled Step 1 and just continued on through third year. Haven't kept up with my Step 1 material at all, a majority of it I find isn't relevant in clinical practice. i.e. biochem, genetics, all those pathology details, etc.,

Rotations have been okay, but being by myself at a remote site hasn't helped with motivation. Have been working through the sleep/anxiety/depression issues and it's getting better day by day.

I want to match IM, and preferably to a program in a major city (which look to be mostly academic). I'm from the south, but have no geographic ties otherwise and don't mind which region I end up in. I'm guessing at this point academic IM/future fellowships are out of the question, I just really want to match with the upcoming merger.

My questions: We have 2 rotations left and I'm wondering what exams I should take to match IM in/near a major city. Should I take Step 2CK? I was thinking maybe I take COMLEX 2 but put all my energy into relearning Step 1 material, and take that exam after COMLEX 2 (after which sometime I would have COMLEX PE). Do I need a Step 2 CK at all? That would mean I need to take 4 exams and that sounds daunting while trying to relearn Step 1 material. I'm planning to redo my anki deck, Uworld, Pathoma, and Sketchy. A lot of diagnosing/next-step is easy now that I've been through clinicals and I remember Step 1 Qs were transitioning to that style so that's in my favor, then I would just need to focus on the minutiae/details. Using fourth year vacation time I could maybe take 4 weeks off for a dedicated.

tldr - low COMLEX 1, No Step 1 hoping to match IM near a city, should I just focus on Step 1 or also take Step 2, and if so when?

Thoughts? Thanks!

Easiest path to redemption is level 2/step 2. Best thing for your app would be to takeoff time and take step 1 with an average score. Not sure how much drop off there is for someone with step 2 only vs step 1 only. I think you could meet your goal without step 1, but it would definitely address your biggest weakness if you did decently (220+).

 

[doQuestions2]

resolved

 

[Goro]

In a bad spot and don't have many people to talk to, need some advice please.

Situation: 3rd year. Bad COMLEX Level 1, no Step 1. Throughout second year was keeping up with Anki, during dedicated UWorld and practice exams had me high-230s. Before my COMLEX I started to panic and couldn't sleep or concentrate with all the anxiety, actually dozed off a few times during my COMLEX and got a very low score. Didn't help my confidence so I canceled Step 1 and just continued on through third year. Haven't kept up with my Step 1 material at all, a majority of it I find isn't relevant in clinical practice. i.e. biochem, genetics, all those pathology details, etc.,

Rotations have been okay, but being by myself at a remote site hasn't helped with motivation. Have been working through the sleep/anxiety/depression issues and it's getting better day by day.

I want to match IM, and preferably to a program in a major city (which look to be mostly academic). I'm from the south, but have no geographic ties otherwise and don't mind which region I end up in. I'm guessing at this point academic IM/future fellowships are out of the question, I just really want to match with the upcoming merger.

My questions: We have 2 rotations left and I'm wondering what exams I should take to match IM in/near a major city. Should I take Step 2CK? I was thinking maybe I take COMLEX 2 but put all my energy into relearning Step 1 material, and take that exam after COMLEX 2 (after which sometime I would have COMLEX PE). Do I need a Step 2 CK at all? That would mean I need to take 4 exams and that sounds daunting while trying to relearn Step 1 material. I'm planning to redo my anki deck, Uworld, Pathoma, and Sketchy. A lot of diagnosing/next-step is easy now that I've been through clinicals and I remember Step 1 Qs were transitioning to that style so that's in my favor, then I would just need to focus on the minutiae/details. Using fourth year vacation time I could maybe take 4 weeks off for a dedicated.

tldr - low COMLEX 1, No Step 1 hoping to match IM near a city, should I just focus on Step 1 or also take Step 2, and if so when?

Thoughts? Thanks!

A low COMLEX doesn't instill within me any confidence that you will magically do better on Step I, especially if you were a weak pre-clinical student.

Hence, stick with COMLEX, do well on Level II, and target programs historically friendly to DOs and especially to your school's grads.

 

[Wjldenver]

You need to minimize your risk here. Forget the USMLE, and work to maximize your performance on all remaining COMLEX exams. Also, as Goro and others have stated, you should adjust your expectations. With a sub-500 Level 1 score, you will need to focus on community programs, particularly ones which have hired grads from your school in the past. And yes, there will be a good chance that your residency will not be in a large, or by a large, city.

 

[ortnakas]

If it were me, I wouldn’t take Step 1. The material isn’t fresh anymore, and going back to studying for it would be difficult, and it sounds like your pre-clinical knowledge base wasn’t quite where you thought it was anyway.

Step 2 has a lot of overlap with Level 2, which you have to take anyway. There’s less reward with Step 2 than Step 1 if you’re comparing head to head, but also way less risk.

 

[doQuestions2]

resolved

 

[hallowmann]

Thanks, I guess then the question becomes which is "worth more" to residency programs that would open more doors, Step 1 or Step 2 CK, if I just had to take one. I think I could get back into the swing of things regarding Step 1 because if I do end up scheduling it, by just passing COMLEX 2 and putting my effort into Step 1 I would be able to set aside 3-5 wks of dedicated, and then have at least a month prior of regular studying.

If we're talking strictly from a which would open more doors standpoint assuming average or slightly below average in both, Step 1 will. That said, you also have to keep in mind the likelihood that you will do equally well in both.

You will require additional time preparing for Step 1, whereas Step 2 CK will overlap with Level 2 material, which you have to study for to graduate and apply anyways. You just "passing" Level 2 is a risky endeavor, because barely passing is dangerously close to failing, something that will hurt your application much more than adding an average USMLE score.

In addition, you barely passed Level 1, and while you feel its a fluke due to stress/anxiety, who's to say you won't feel that way again, given that stakes are potentially even higher?

It's honestly a personal decision. You need to truly assess your own skills, realistically evaluate the time and effort needed, and assess whether you really have time to re-study all the Step 1 material to do well. No one here can give you a definitive answer, we can only give you advice, only you can make that decision, because only you will be living with the consequences either way.

OP, Im going through the same dillemma.. Others please correct me if Im wrong about any of this or if you have anything to add. Lets break it down..

Taking step 1:
Advantages- opens more doors (helps with screening and also when being ranked by programs), shorter question stems, only 7 blocks
Disadvantages- have to learn biochem/genetics details, takes time away from level 2 studying

Taking step 2:
Advantages- goes along with level 2 studying, you can avoid all the biochem minutiae
Disadvantages-mostly helps during rankings (not so much with being screened in other words doesnt really open more doors), 8 blocks, longer stems

The bolded is not accurate. It will open doors with getting interviews, just not as many as Step 1 will. All board scores available at application time play a role in interview invites.

If it were me, I wouldn’t take Step 1. The material isn’t fresh anymore, and going back to studying for it would be difficult, and it sounds like your pre-clinical knowledge base wasn’t quite where you thought it was anyway.

Step 2 has a lot of overlap with Level 2, which you have to take anyway. There’s less reward with Step 2 than Step 1 if you’re comparing head to head, but also way less risk.

This essentially summarizes it well.

 

[recycledpaper]

Crush Level 2 and forget about Step 1. You likely won’t do well given your Level 1 performance and how long it’s been since you studied Step 1 material.

Good Level 2 will help your app.