How do PDs view a vastly improved (40+ point increase) 2nd Step 2 CK attempt? (206 - 252)

[Morpheses]

Hello everyone,

Long time lurker, first time poster but as the title goes, I failed step 2 ck a month ago (206) but then passed with my score today (252) on my second try. I felt a lot of nerves going into the first one and let that get to me during the exam. This time around I wanted to crush the exam kind of mentality and attacked every question to make up for my piss poor first score. I was angry and that was my main motivation.

Will PDs see the first score and be like "wtf happened there? The jump is so huge, 1st exam must be a fluke." Or will they not even look at my application?

Not sure if this is the correct place to ask, but any chances I can still match IM as a US-IMG? Aside from being img, this is the only other red flag I have on my application. I will be applying extremely broadly to IMG friendly programs only for the most part because of this setback and will be happy to match anywhere that will even take me.

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[wysdoc]

Hello everyone,

Long time lurker, first time poster but as the title goes, I failed step 2 ck a month ago (206) but then passed with my score today (252) on my second try. I felt a lot of nerves going into the first one and let that get to me during the exam. This time around I wanted to crush the exam kind of mentality and attacked every question to make up for my piss poor first score. I was angry and that was my main motivation.

Will PDs see the first score and be like "wtf happened there? The jump is so huge, 1st exam must be a fluke." Or will they not even look at my application?

Not sure if this is the correct place to ask, but any chances I can still match IM as a US-IMG? Aside from being img, this is the only other red flag I have on my application. I will be applying extremely broadly to IMG friendly programs only for the most part because of this setback and will be happy to match anywhere that will even take me.

Great job and it will mainly look like you were able to study more effectively for your retake and did well

 

[Morpheses]

Great job and it will mainly look like you were able to study more effectively for your retake and did well

Thank you! I know PDs take a more holistic approach to applications but will the jump make up for much in their viewpoint as most people pass on a first attempt?

 

[Morpheses]

Hey all,

Like the title suggests, there was a month between the two scores and I think I just let the anxiety get the better of my my first attempt. I kinda zoned out every later block and got into a routine that almost felt passive when I was answering questions as exhaustion had hit me. Almost mentally checked out as I let my anxiety fester and passed on from one block to the other.

Second time around I went in with a killer attitude and attitude and just wanted revenge. I wanted to destroy it and the anger from failing fueled me those 4 weeks.

To be clear, I will be applying as a US-IMG and to mainly img friendly programs. Anyone care to chime in if this second attempt makes a difference at all as most people pass on their first attempts?

 

[NotAProgDirector]

It's impossible to say for certain, and each program will be different. Certainly much better that you scored so well on the second take. Would have been better if you hadn't failed the first time. Impossible to say whether it would have been better to get a just-passing score the first time, or this situation.

 

[Morpheses]

It's impossible to say for certain, and each program will be different. Certainly much better that you scored so well on the second take. Would have been better if you hadn't failed the first time. Impossible to say whether it would have been better to get a just-passing score the first time, or this situation.

Yeah I can see that viewpoint for sure. I guess I will have to just apply and see. Only red flag here aside from applying as US-IMG so I'm hoping that PDs will take a chance. According to this table below, 152 people matched in IM-categorical in 2022 having passed step 1 and failed 1st attempt step 2 ck, so I'm hoping to be someone like those that matched. Is that a reasonable data point to look at for my situation?

Table B2. First-Attempt Pass Rates on USMLE and COMLEX Examinations for First-Year Residents by Specialty

Experiences of First-Year Residents by Specialty

www.aamc.org

EDIT: NVM that table doesn't apply as Step 1 back then was a numerical score. Ignore that point.

 

[HemeOncHopeful19]

I think you should be able to match in IM and even possibly a lower tier University program if you interview well and have an otherwise good application.

 

[Morpheses]

I think you should be able to match in IM and even possibly a lower tier University program if you interview well and have an otherwise good application.

Oh wow! I didn't know that was even in the realm of possibilities. I thought I'd be relegated to only applying FM with a failed 1st attempt. Thanks for the words of encouragement.

 

[mszzeta]

It depends on how programs filter their applications. Most programs receive thousands of applications each year and would filter it first with certain criteria. Many use score cutoffs. If they filter based on the number of attempts, your application might not be reviewed.

For US-IMG, FM is often much more friendly to match than IM. I agree that you may consider this as a back up

 

[hotsaws]

You will probably need feedback from some PDs to get specifics. My two cents is that as long as someone sees quick improvement, they are probably going to consider the failure a fluke. This depends on how the rest of the application looks. If you're an otherwise good student, an outlier shouldn't be a major deal. However, as many have mentioned, PDs use filters to sort out the numerous applications they get. Plenty of community programs desperate to match people and also quite a few fakeademic and low tier university programs out there. The key for you is getting past auto filters. I would recommend you personally email the PDs of programs you are interested in and be candid about the fact that you had a big score jump after a failure and are worried you will get auto filtered out. Assuming the rest of your application is decent and you can explain yourself well in person, this strategy might be quite effective.

I may be a bit out of touch but are you in the first class where step 1 is now pass/fail? (pass/fail step 1 is huge mistake IMO and probably hurts IMGs and DOs more than anything)

 

[voxveritatisetlucis]

Some PDs will screen for step failure in itself

 

[Morpheses]

It depends on how programs filter their applications. Most programs receive thousands of applications each year and would filter it first with certain criteria. Many use score cutoffs. If they filter based on the number of attempts, your application might not be reviewed.

For US-IMG, FM is often much more friendly to match than IM. I agree that you may consider this as a back up

Yeah It really will me trying for IMG friendly IM programs. I already know that some will filter me out automatically but I'm hoping for those ones that wont. There's lists floating out there that show certain IMG-friendly programs requiring or preferring a "first attempt pass" for step 2 ck and other programs that don't have that requirement. I have my research cut out for me for sure.

May have to apply for FM as backup for sure.

 

[Morpheses]

I may be a bit out of touch but are you in the first class where step 1 is now pass/fail? (pass/fail step 1 is huge mistake IMO and probably hurts IMGs and DOs more than anything)

I am the first class, so it may be worse for me, as step 2 is now the gold standard. Have to apply and see.

as long as someone sees quick improvement, they are probably going to consider the failure a fluke.

I'm hoping for this! I will definitely also email the PDs and see what comes of that when that time arises.

 

[Morpheses]

Some PDs will screen for step failure in itself

Yeah definitely have to apply extremely broadly because of that fact.

 

[deleted1139416]

Would you mind letting us know what you did to improve so much???

 

[Morpheses]

Would you mind letting us know what you did to improve so much???

Honestly, my practice scores were kinda close to that ball park. UWSA 2 prior to the exam was 244 and free 120 was 79%. NBMEs were 220s range but I didn't do all of them (just 10,11, 12). I felt I had imposter syndrome leading to it because I didn't know if my UWSA2 was a fluke or not. Maybe I was testing correctly that day only? I'm not too sure. I let that affect me even on test day when I should've been more confident in myself. I also got hit with severe exhaustion middle of exam and what I thought was still being in the "zone" was just me answering passively. Let my anxiety from previous blocks kinda cloud me for future blocks if that makes sense. Felt like I wasn't attacking the questions as hard anymore and was approaching from a place of fear which is not the attitude you want at all especially on the big test day. Everything compounded on each other and definitely felt like I failed. Thought this was normal as everyone feels that way? Boy was I wrong.

I never finished all my second pass uworld questions so I went back and did whatever ~850 or so I had left and all the incorrects and marked. I approached the exam a whole lot differently. Like I wanted all the revenge in the world and would make the exam my b****. It was all really a mental game to be honest. It took a few days for my averages to shoot back up again in uworld as I had forgotten a bit (who would've thought you'd forget so much in 2 weeks). I did 3-4 blocks back to back in the morning (5 mins in between) to help boost my endurance. There's a divine podcast on this method of studying and I focused on it to a T. If you study the same way you would take the exam, the day of the exam is no different from any other day you've had before for about 4 weeks. I reviewed everything in the evening after lunch. If I had time, I did a block of one of the CMS forms of IM/Surgery/Peds after dinner. I never looked at CMS forms before so this was kinda neat to check out as I didn't really remember them from my shelf days.

Problem I ran into was the only exams I had left to practice were UWSA1, NBME 9, and 13, all 3 of which aren't really indicative of the exam. Uwsa1 and nbme 9 at 2/3 week marks scoring 241 and 238 respectively. 13 came out a few days before my exam and I took it that day and got a 248. It was a huge confident boost as many people were having trouble with it that I thought if I can do this well, the real thing shouldn't be bad at all. I thought about retaking 10-12, but the inflated scores wouldn't mean much so I just reviewed the concepts from them again.

I think I was just in an overall much better mental state this time around. Attacked each block of the test with the same intensity and was so used to the whole 9-10 hour days of how I studied that I felt alright even exiting the exam. It was just like any other day. I never once thought that this is my last shot or I have to quit medicine or anything like that. After a day or two of grieving my failed attempt, I said my 1st exam was in the past and I had to do whatever it took to destroy my next try within as short of time as possible so that anyone reviewing my app this cycle would see that my 1st try was a complete utter fluke. That's what kept me going.

Hope it helps! Sorry for the wall of text!

 

[chilly_md]

Threads were merged for consolidation.

 

[AlbinoHawk DO]

Hello everyone,

Long time lurker, first time poster but as the title goes, I failed step 2 ck a month ago (206) but then passed with my score today (252) on my second try. I felt a lot of nerves going into the first one and let that get to me during the exam. This time around I wanted to crush the exam kind of mentality and attacked every question to make up for my piss poor first score. I was angry and that was my main motivation.

Will PDs see the first score and be like "wtf happened there? The jump is so huge, 1st exam must be a fluke." Or will they not even look at my application?

Not sure if this is the correct place to ask, but any chances I can still match IM as a US-IMG? Aside from being img, this is the only other red flag I have on my application. I will be applying extremely broadly to IMG friendly programs only for the most part because of this setback and will be happy to match anywhere that will even take me.

They might think the second score was the fluke. That's the problem. You can't come up with a single interpretation by everyone

The truth is that this will still hurt you. Being IMG means you'll already be screened out by some programs. Having a failure will mean that you will be screened again by another substantial amount of programs. Lastly, even if you interview, you will likely be placed toward the bottom of every rank list. My own residency and fellowship would do that. Everyone that has a fail is ranked below everyone else, so even a minimum pass is worth more. All the programs want to avoid anyone that may fail their board exam

 

[Morpheses]

They might think the second score was the fluke. That's the problem. You can't come up with a single interpretation by everyone

The truth is that this will still hurt you. Being IMG means you'll already be screened out by some programs. Having a failure will mean that you will be screened again by another substantial amount of programs. Lastly, even if you interview, you will likely be placed toward the bottom of every rank list. My own residency and fellowship would do that. Everyone that has a fail is ranked below everyone else, so even a minimum pass is worth more. All the programs want to avoid anyone that may fail their board exam

Oh I have no doubt it'll hurt me. The fail doesn't change that. I know most programs will filter me out and I'm aware of that. Just wanted to know if I'd even get the foot in the door at some spots. I can try and interview well there and let the rest of my application shine a little better aside from the failed score.

 

[collegestud2013]

Yeah I can see that viewpoint for sure. I guess I will have to just apply and see. Only red flag here aside from applying as US-IMG so I'm hoping that PDs will take a chance. According to this table below, 152 people matched in IM-categorical in 2022 having passed step 1 and failed 1st attempt step 2 ck, so I'm hoping to be someone like those that matched. Is that a reasonable data point to look at for my situation?

Table B2. First-Attempt Pass Rates on USMLE and COMLEX Examinations for First-Year Residents by Specialty

Experiences of First-Year Residents by Specialty

www.aamc.org

EDIT: NVM that table doesn't apply as Step 1 back then was a numerical score. Ignore that point.

Still have a decent chance of matching lower tier community IM programs if your apply broadly and interview well. Be careful, because a good portion of these programs are malignant and really exploit residents to the max. However, the combination of having failed any Step exam on the first attempt + IMG will get your app screened out at many programs unless you have connections there.