MD/PhD with low Step 1 score

[weirdsci1985]

It's been a while since I've posted here; first time with this shiny new profile. I'm wondering what my chances are for matching into top 10 IM or anesthesia programs as an MD/PhD with a Step 1 score of 215 (taken in 2010 when the median was lower than it now is). I am at an MSTP on the West Coast that's top 5-10 nationally and I will have 2-3 moderate-high impact 1st author pubs. I'm not currently AOA and MS1/2 are completely P/F here. If I bust my ass on clerkships and get some good letters, what do you guys think? Are the top programs even looking at Step 1 scores this low nowadays?

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[ratherbefishing]

Replied via PM with some anecdotal info from past graduates of my program

 

[gutonc]

There's no reason not to try. In contrast to med school apps, residency apps border on free, at least for the first 30. I had a similar Step 1 to you, a couple of points higher and several (OK, 11) years earlier (when the median was even lower) and a worse publication record (2 moderate impact 2nd authors, a 1st author in preparation at the time) and probably hit .500 for "top tier" IM program invites. But I had way more invites that I knew what to do with. Just go for it and see what happens. Kick ass on Step 2. Get honors (or at least high pass) in your subI or Gas rotation (if that's the way you decide to go). Blow your first 10 apps on the big names, another 15 on solid programs and 5 on relative safeties.

 

[Shifty B]

Internal medicine programs are pretty big, so you will have a pretty decent chance. Anesthesia is a little smaller and may be harder.

I'm not going to lie though, this is going to be a hurdle for you. Definitely apply to top 25 programs in areas away from the coasts (e.g. Texas, WashU, Emory, Vanderbilt, Cleveland, etc) because these programs don't have the noise of people clamoring to stay on/get back to their coast of choice that they have in California and the northeast. They may be more willing to interview you.

 

[DermViser]

It's been a while since I've posted here; first time with this shiny new profile. I'm wondering what my chances are for matching into top 10 IM or anesthesia programs as an MD/PhD with a Step 1 score of 215 (taken in 2010 when the median was lower than it now is). I am at an MSTP on the West Coast that's top 5-10 nationally and I will have 2-3 moderate-high impact 1st author pubs. I'm not currently AOA and MS1/2 are completely P/F here. If I bust my ass on clerkships and get some good letters, what do you guys think? Are the top programs even looking at Step 1 scores this low nowadays?

Just curious why Anesthesia has to be a "top 10 program". I understand for Internal Medicine, but why Anesthesia? It's virtually the same everywhere.

 

[weirdsci1985]

Just curious why Anesthesia has to be a "top 10 program". I understand for Internal Medicine, but why Anesthesia? It's virtually the same everywhere.

It doesn't have to be a top ten program per se, but being able to keep options open is nice. Ultimately, I'd prefer to train wherever I get the best fit of people in the program, quality of clinical teaching, research and quality of life (not nec. in order). That could end up being anywhere from UCSF to UNC (both excellent programs, as far as I know).

 

[Fencer]

There are a lot of quality clinical Anesthesia programs with substantial research programs away from the coasts including: Wash U, Vandy, Duke, Michigan, Colorado, Wake Forest, UAB, Iowa, MCW, Wisconsin, Illinois-Chicago, and Chicago.
see: http://www.brimr.org/NIH_Awards/2013/Anesthesiology_2013.xls

 

[sakata8242]

You will need to really step up your game in 3rd and 4th year and hit your Step 2 score out of the park to be competitive, especially for desirable salt water IM or anesthesia programs. For top programs Step 1 does matter, even for anesthesia. You will also want to take Step 2 early enough that those scores will be available by the time ERAS opens. If you can do this I think you'd be viable at may of the midwest, south, and southeastern programs like those Fencer mentioned. Having interviewed at 7 of them, they are were all excellent programs in good locations. You will not be living the "chic" life in Boston, SF, or New York though. I'd recommend applying broadly and not be geographically confined to the coasts.

You should also find a career mentor in the department(s) you're interested in to help you figure out what areas you really need to work on.