Failed Step 2CK – What are my options?

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aspen14

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Hoping for any insight and opinions, or if anyone has been through this before and hopefully had a positive outcome.

I am a 4th year medical student at a foreign med school, and have done very well up until now. In clinical rotations I have received half A's and the other half B's. I received a 228 on my Step 1. I am looking to do general surgery only, and have completed 2 audition rotations which also went very well. I have great LORs all from department heads, positive feedback, and have made some great connections. Everything was going great, until to my shock, I found out yesterday that I failed Step 2 CK...by one point.

I registered to re-take, and so far only have the date range from Oct 1st – Dec 31st.

I have so many questions. What is the reality? Is there ANY chance of getting matched into a General Surgery Residency? What are my options? Again, I would appreciate any input whatsoever as I try to get through this. Thank you for the help.

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Hoping for any insight and opinions, or if anyone has been through this before and hopefully had a positive outcome.

I am a 4th year medical student at a foreign med school, and have done very well up until now. In clinical rotations I have received half A's and the other half B's. I received a 228 on my Step 1. I am looking to do general surgery only, and have completed 2 audition rotations which also went very well. I have great LORs all from department heads, positive feedback, and have made some great connections. Everything was going great, until to my shock, I found out yesterday that I failed Step 2 CK...by one point.

I registered to re-take, and so far only have the date range from Oct 1st – Dec 31st.

I have so many questions. What is the reality? Is there ANY chance of getting matched into a General Surgery Residency? What are my options? Again, I would appreciate any input whatsoever as I try to get through this. Thank you for the help.

You'll have to give up on General Surgery. Look at Charting Outcomes. Even with a 228 Step 1 score, your chances weren't great as an IMG because while it's a good score, it's not an outstanding score. Apply to IM and Family and ace Step 2 CK the next time.

Also did you take NBME's and UWSA before taking the exam? What were your scores on that?
 
Gen surg categorical as a FMG is out of the question. Your only hope for that is to get a surgical prelim spot, blow everyone away, and use the connections made there to land yourself a categorical spot the next year.

But before that, you need to focus on not only passing, but doing well on step 2 prior to anything else.
 
Gen surg categorical as a FMG is out of the question.

You know this how, exactly? OP, if general surgery is what you want, then go for it. You will probably have some more leg work to do to get there now, but in the real world, people's paths through lives aren't flawless and they all get there eventually.
 
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You know this how, exactly? OP, if general surgery is what you want, then go for it. You will probably have some more leg work to do to get there now, but in the real world, people's paths through lives aren't flawless and they all get there eventually.

According to Charting Outcomes, 24/107 (22%) of independent applicants with Step 1 scores like OPs matched to GS. Now, considering that pretty much everybody jumps 20 points on Step 2 CK, OP has a pretty giant red flag in addition to the others (FMG, mediocre Step 1). I wouldn't put him in the group that beats the odds.

In the real world, things don't always turn out well, and OP could be one of those FMGs on the general residency board that is several years out of clinical practice and applying to 300 family med programs for the third straight time. He should be realistic about his career prospects.
 
You know this how, exactly? OP, if general surgery is what you want, then go for it. You will probably have some more leg work to do to get there now, but in the real world, people's paths through lives aren't flawless and they all get there eventually.

p. 88 of Charting Outcomes: only 22% of independent applicants with a Step 1 in the 220's matched

p. 55 of the program director survey: 50% of PDs will never accept an applicant who failed CK, and only 48% 'seldom' consider an applicant who has failed CK

I don't think anyone is trying to be a jerk, rather, I think we're trying to help the OP be realistic. Not being an AMG hurts their chances of getting a GS spot, and when you throw in the mediocre step 1 and failing CK, things don't look too hot. However, that's not to say that the OP cannot match, but it's unlikely to be in GS.

To the OP: good luck, and I hope you rock the exam next time :luck:
Are there any specialties you can see yourself doing other than GS?
 
You know this how, exactly? OP, if general surgery is what you want, then go for it. You will probably have some more leg work to do to get there now, but in the real world, people's paths through lives aren't flawless and they all get there eventually.

Encouraging false hopes isn't helping the OP. Yes, SOME people somehow manage to still make it but those cases are few and far in between. There are statistical reports for a reason. No need to attack ppl who are basing their advice on facts.
 
Come back down to the real world. 228 is not mediocre. Avg step 1 is 222 which means a 228 is better than what most amg get on step 1. The reality is that the real world step 1 avg is no way near the so called student doc avg.Thank u
 
Come back down to the real world. 228 is not mediocre. Avg step 1 is 222 which means a 228 is better than what most amg get on step 1. The reality is that the real world step 1 avg is no way near the so called student doc avg.Thank u

But a 228 is not what most FMG gen surg applicants who matched got. So, for OP's purposes, it is mediocre.

Thank u
 
Come back down to the real world. 228 is not mediocre. Avg step 1 is 222 which means a 228 is better than what most amg get on step 1. The reality is that the real world step 1 avg is no way near the so called student doc avg.Thank u

You're missing the point. He/she is an FMG which means for competitive residencies like surgery, you have to blow it out of the water, not be 4 points above average. (Average for my exam which was in 2011 was 224, average for 2013 is 227). If OP was an AMG, that would be different. He/she would still stand a chance. As an FMG, you need to have everything be perfect if you want to match into a competitive specialty.
 
dude looking at this chart avg step 1 for independent is 230 with a range between 215 to 240. Exactly my point - how is 228 mediocre?
 
dude looking at this chart avg step 1 for independent is 230 with a range between 215 to 240. Exactly my point - how is 228 mediocre?

Go to page 89. For a step score of around 228, probability of matching is less than 0.30. What part of that suggests that 228 is good enough for an IMG?

Anyway, not commenting further on this. If you would like to be delusional and continue to believe that for General Surgery, an IMG can get 228 and have a good chance of matching, be my guest. Also, how good a score is, is relative to the specialty. 228 is excellent for Family and right around the average for IM as well and considering that IM is not as competitive as surgery, chances are higher of getting IM with a 228. Look at all the data carefully. Nobody's trying to be a jerk here but you have to face facts.
 
dude an img can match into general surgery with 228. it might not get u into yale or upenn but they are many community hospitals ready to take u. Don't forget general surgery is not ortho, rad or ENT. Thank you.
 
dude an img can match into general surgery with 228. it might not get u into yale or upenn but they are many community hospitals ready to take u. Don't forget general surgery is not ortho, rad or ENT. Thank you.

I'm sorry, what does less than 30% mean to you? Does it mean less than 30% matched to Hopkins? It means that >70% of applicants were turned down even by community hospitals.
 
dude an img can match into general surgery with 228. it might not get u into yale or upenn but they are many community hospitals ready to take u. Don't forget general surgery is not ortho, rad or ENT. Thank you.

30% of FMGs that applied with a score that 228 falls into matched. Not good odds IMO. On top of that, the OP (which is what the focus is) failed Step 2CK, therefore his/her shot at a CATEGORICAL surgery residency is all but 0%. Regardless of who you are, you have to be realistic with your statistics about residency options. The data is there that even if OP had not failed Step 2CK, he would've had a 30% chance of matching.

Yes, an IMG CAN match with a 228 (and likely no red flags). A failed Step 2CK is a red flag, unfortunately.
 
Of those that matched, I guarantee almost all of them did better on step 2 than on step 1. So yeah OP will be lucky to match FM.
 
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Going into match on September 15, 2014

Step 1 231 1st attempt
Step 2ck 222 2nd attempt
Step 2cs Passed 1st attempt
Visa status J2 Visa with EAD (Not needing visa sponsorship)
Graduated in February 2011 in India
Clinical Work Experience in India for 3 years
Research Experience in Internship in India
I am Residing in Brooklyn New York

I do not have USCE but will working as Research Volunteer at the Downstate Medical Center in Neurology from October 2014.
Wife working in DMC Brooklyn in peds

LOR's from India

I want to know which programs I should apply to? which states? and what programs are there outside the match?
 
Just so you know, doing a transitional or prelim year before going categorical can be a really GOOD thing. It lets you spend a year living in a place you probably never would have lived in, and it lets you gain a diversity of experience and perspective before committing to anything lifelong. Even if you think you really want surgery, give it another year, seriously. The surgery lifestyle sucks.

I'm an IMG, scored 262 on Step1, and will be applying for transitionals/prelims ahead of anything categorical for those reasons. My take is that people generally rush for categorical spots because they're so caught up with making money as soon as possible. If you look at the physicians report (http://www.medscape.com/features/slideshow/compensation/2014/public/overview), many people tend to be unhappy with their choices in the long-term. Be happy a prelim/transitional year is a good option for you. And bear in mind that some specialties actually require one first.
 
Phloston, I agree with you at some level, but the match is only becoming more and more difficult, doing a prelim helps out a little but if one has mediocre Stats that prelim is not really amount to many categorical interviews the next year there are exceptions, but someone mentioned that in 2018 thrs a 30% Inc in. Amgs and it's going to be very though as trends show
And a lot of places abuse prelim residents it's important whr you go, I want to go into surgery as well but will be very careful where I go, BTW if you know of any good prelim Gen surg programs do let me know as well.
 
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