LOVE Neuro, but just got step 1 score back and it's low 200's...advice?

[f0xforcefive]

Hello! Not sure if I'm posting in the right place, if not, please direct me elsewhere!

To preface: I go to a US MD school.
I don't want to discount the fact that I'm grateful just to PASS step 1, really. However I got my score back a few weeks ago and for anonymity's sake let's just say it was between 202-205. I've looked at charting the outcomes for 2014 and it looks like a fair number of people with my score did end up matching into Neuro. I was just wondering if anyone older and wiser than myself has any experience with what those folks might have had that could make up for this lackluster score?

I already have multiple publications in pretty good Neuro journals from a prestigious university that I did research at during my gap years, I'm just not sure if that really counts as something I can say on my residency app. I also have letter writers from said university that have said they will absolutely write me letters when the time comes. I'm just a little embarrassed by how low this score is compared to how much time and effort I put into this test. Do you guys think I have a shot?

My plan to make up for said score is
#1: seriously improve on step 2 and take it early (but how??)
#2: clinical rotations for 3rd year start soon so I want to do REALLY well in those, (although I'm not sure how to even do that yet),
#3 talk to my home institutions Neuro residency director to see what he'd advise,
#4 more research??
#5 set up good away rotations
#6 apply really broadly?

I have always wanted to do Neurology. I have had so much Neuro exposure throughout my life with family members with MS, TBI, Stroke, along with multiple psych problems. It just has always seemed that this is what I was called to do which is why I did so much research and shadowing in it. I'm just so mad at myself for not being a better test taker.

If any of you have any advice, I would love to hear it!

Thanks to all in advance!

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[TUGM]

1). Shake it off. Step 1 can mean a lot, but I promise you, it is not the end-all-be-all, especially in neurology. The big thing, honestly, is that you passed on your first attempt.

2). Neurology remains wide open as a future career for you. Do all the things you are planning on doing. Keys to doing well on your clinicals: show up, work hard, take interest. Some clinical rotations have shelf exams at the end, so try to study a bit for them, and try to do well. Do a neurology rotation, and try to honor it. Do some away audition rotations and charm the pants off the faculty (not literally...) and get excellent LORs.

3). When it comes to applying, be broad in your applications. Don't limit yourself to Chicago, SF, LA, and NYC.

4). Your publications absolutely count.

Keep your passion alive, and work hard. You will find yourself a bow-tie wearing eccentric with extensive knowledge of corticospinal tract lesions and their effects on motor functions soon enough.

Good luck!

 

[f0xforcefive]

Thank you so much for motivating me! Really appreciate the pep talk. That makes me feel a lot better

 

[artsydoc]

I recently matched into my top choice residency in a competitive program/location with a below average Step 1 score. I had been very concerned about my prospects while applying based on that Step 1. Honestly, once I got to interviews, it didn't seem to be much of an issue. I think a few things helped mitigate the poor score, the first being that despite its increasing popularity (at least at my school) it still isn't a terribly number centric field. Having said that I'm sure it none the less helped that I made up for Step 1 on Step 2, in a dramatic, different league score kind of way. Only one program director at any of my neuro interviews even brought up the step 1 score and that was just to say hey, good job bringing your score up, what happened the first time around? (I think clinical information is just a lot easier to learn, yes there's memorization but it's integrated into clinical scenarios, more critical thinking, less brute memorization of minutia; I went through the uworld qbank once over the course of third year for shelf exams, and then again in its entirety right before taking step 2 as well.) Also, I really pushed hard to excel in my neuro rotation. Lots of outside reading, lots of participation and enthusiasm, and tons of shelf studying to make sure I could get honors. This leads to another thing that will help you, namely, a really good letter of recommendation. I think neuro seems to value references very highly, it was mentioned in nearly all the interviews as a positive. (Actually excelling clinically in general is just taken seriously, and appreciated. Try to ace all your rotations. It takes a very different skill set to do this and in my experience some people just start to flourish third year. Your passion for the field suggests you will.) That's good that you have the research letters, the clinical ones will be even more important, so do your best to impress on rotations. Finally, a personal statement that's really well crafted, articulate, and compelling will give you a voice that can speak loudly enough to at least partly overshadow that one black mark on your application. Apply broadly still. It will give you peace of mind. Go on as many interviews as you can afford for the same reason. And don't hold back from applying to all your dream programs, each program will have different ideas about what they're looking for and some of them are bound to be impressed by really exciting research, the neuro ppl I met with love candidates who love the field, and have a thirst for knowledge and discovery. I know this post has a lot of me, me, me in it, but I think what helped in my situation will also help you; I wrote a very similar post a couple years ago. Hang in there and be optimistic!

 

[f0xforcefive]

Sorry for not responding sooner - Thanks so much for your reply! You guys have really helped me get motivated for third year, I greatly appreciate the responses!
Hopefully I can pay it forward in a couple years.

 

[W19]

1). Shake it off. Step 1 can mean a lot, but I promise you, it is not the end-all-be-all, especially in neurology. The big thing, honestly, is that you passed on your first attempt.

Keep your passion alive, and work hard. You will find yourself a bow-tie wearing eccentric with extensive knowledge of corticospinal tract lesions and their effects on motor functions soon enough.

Good luck!

Lol... Why some of these guys wear bow-tie? I was interested neurology but after getting thru a difficult neuroscience block, I am kind of reevaluating my interest... Neurology seems to be an extremely complicated field...

 

[TUGM]

The bowtie is a historic stereotype. And neurology can be complicated. There are many tracts and pathways to learn, allowing localization from a physical exam. But this complication is why most of us chose the field in the first place.

 

[AlbinoHawk DO]

The bowtie is a historic stereotype. And neurology can be complicated. There are many tracts and pathways to learn, allowing localization from a physical exam. But this complication is why most of us chose the field in the first place.

God, so true. My neuroscience block consumed my life, and I loved every second of it.

 

[soulofmpatel]

However I got my score back a few weeks ago and for anonymity's sake let's just say it was between 202-205.

Don't worry. No one cares. I have been at my current institution for >5 years, and not once has someone asked me what my step I score was. In fact, 95% of people I work with don't even know where I went to medical school. It honestly is a stupid test. If I took it now, I would probably score 150. You can be a great neurologist. You can be better than 95% of neurologists by working or studying only one extra hour each day. Unfortunately, program directors are dumb and will be slightly biased against you. Just strengthen the rest of your application and apply broadly

 

[typhoonegator]

Don't be embarrassed. Ask them to mention it in their letter, meet it head-on. Your ability to be a good protege for your mentor has nothing to do with your step score, and if they like you they could mention their surprise with your score and note that your working medical knowledge far outstrips that suggested by your score.

A 218 isn't atrocious, but a lot of people applying to Columbia/Partners are going to have better scores than you. An improvement in step 2 helps, but only if you're already on their radar. It's uphill, but I'd still encourage you to apply. Most importantly, loving neurology and getting fantastic training and mentorship in neurology does not require passing through an old-school East coast bastion of late greats. I'm not saying you can't get in, but don't feel like you have to either. You could always try to swing back around for fellowship anyway.

 

[StartingLine3]

I am starting the process of applying to neurology residency. I noticed that some of the programs (usually more competitive programs) under their FAQ state that they want people with 220 score minimum. I do not know how much weight they put into that but it is something worth looking into.