231 Step: Options

[sharkbyte]

---

Members do not see this ad.

I scored a 231 on Step 1. I've looked at charting the outcomes and I assume I'm probably out of range of a lot of surgical subspecialties and all the other really competitive ones like derm, IR, etc. which I have not been interested in. Looks like I'm hovering around the average for IM, ANES, Peds, Neuro, and some others. I just started 3rd year so I don't know what I want to do just yet but I was thinking as of now maybe an IM subspecialty or ANES. What type of programs within these two fields could be within reach for me? I'm from California and go to med school out of state and was leaning toward going back to CA or at least somewhere closer to home, although I'd probably be fine anywhere. I did decently well during 1st and 2nd years, got H and HP on all courses 2nd year (I know this is not that important but seeing as how I don't have anything to report on 3rd year grades or LOR, thought I'd just mention it) . I've done research in a surgical field and am about to get published as first author on my project, which I've presented at 3 national conferences and one local conference. I have a second research project that is in the early stages but I'm not sure if I'll able to get it published or present it anywhere by the time I apply for the match next year. Other than that I've done some free clinic volunteering, was treasurer of a school org M2 year, and worked as an ANES resident assistant for M2 year. Thanks for any help.

 

[DubbiDoctor]

Sounds like general surgery would be a good choice for you, considering your interest in surgery. Eyeballing graph GS-2 of 2018 charting outcomes, someone with a 230 has a 86-87% chance of matching. The only specialties a 230 would close doors for are the surgical subspecialties, derm and maybe IR and rad-onc. You would obviously be fine for anesthesiology or IM.

 

[evilbooyaa]

A 230 means most doors are technically still open for you in terms of what specialty you want to go into. Some of them are more open than others. First off, find what you're interested in to practice as an attending. I found process of elimination was very helpful in this regard.

230 doesn't close doors in RadOnc, as long as you can show significant research interest to "make up" for it. I've heard the ability to do that in other fields is not as prevalent.

 

[Milotic]

I scored a 231 on Step 1. I've looked at charting the outcomes and I assume I'm probably out of range of a lot of surgical subspecialties and all the other really competitive ones like derm, IR, etc. which I have not been interested in. Looks like I'm hovering around the average for IM, ANES, Peds, Neuro, and some others. I just started 3rd year so I don't know what I want to do just yet but I was thinking as of now maybe an IM subspecialty or ANES. What type of programs within these two fields could be within reach for me? I'm from California and go to med school out of state and was leaning toward going back to CA or at least somewhere closer to home, although I'd probably be fine anywhere. I did decently well during 1st and 2nd years, got H and HP on all courses 2nd year (I know this is not that important but seeing as how I don't have anything to report on 3rd year grades or LOR, thought I'd just mention it) . I've done research in a surgical field and am about to get published as first author on my project, which I've presented at 3 national conferences and one local conference. I have a second research project that is in the early stages but I'm not sure if I'll able to get it published or present it anywhere by the time I apply for the match next year. Other than that I've done some free clinic volunteering, was treasurer of a school org M2 year, and worked as an ANES resident assistant for M2 year. Thanks for any help.

You can definitely match back at home in Cali with your Step 1 for Peds, Neuro, Anes. Even some of the mid tier IM programs will take you in Cali with that score.

As far as Surgery, you will match most likely, but will have to sacrifice location for 5+ more years. I knew some Cali-lovers in med school who tried to get back to Cali with Step 1 scores in the upper 230's and couldn't do it, although they came to terms with choosing career over lifestyle anyway so why not extend that to location haha.

 

[Snoopy2006]

Agree with above. The bigger issue is to figure out what you enjoy and want to do over the course of your M3 year. A true surgical field vs non surgical is a big branch point decision you'll figure out at some point this year.

After you figure that out you can worry about location. Also realize that you might have to sacrifice tier of program (for whatever that's worth) if you're dead set on going back to Cali. As example, I had friends in your score range who could have gotten into well known IM and EM programs elsewhere but chose to rank CA community hybrid programs higher on their list to get back home. Maybe it was worth it to most of them, but in my mind residency is a short 3-4 years. Take the best opportunity. You have the rest of your life to find a job wherever you want.

 

[IMreshopeful]

You can definitely match back at home in Cali with your Step 1 for Peds, Neuro, Anes. Even some of the mid tier IM programs will take you in Cali with that score.

As far as Surgery, you will match most likely, but will have to sacrifice location for 5+ more years. I knew some Cali-lovers in med school who tried to get back to Cali with Step 1 scores in the upper 230's and couldn't do it, although they came to terms with choosing career over lifestyle anyway so why not extend that to location haha.

Unrelated but I find it interesting that there’s always a few posts per week about “help I really wanna match back in Cali!!!1!” And some variation of it for NYC. I don’t see it for ANY other geographic location as often. Maybe it’s me, but I personally just don’t get it - Cali has nice weather I guess but I like being able to afford an apartment and certainly in my field I ain’t getting a job out there near any large city

 

[sharkbyte]

Agree with above. The bigger issue is to figure out what you enjoy and want to do over the course of your M3 year. A true surgical field vs non surgical is a big branch point decision you'll figure out at some point this year.

After you figure that out you can worry about location. Also realize that you might have to sacrifice tier of program (for whatever that's worth) if you're dead set on going back to Cali. As example, I had friends in your score range who could have gotten into well known IM and EM programs elsewhere but chose to rank CA community hybrid programs higher on their list to get back home. Maybe it was worth it to most of them, but in my mind residency is a short 3-4 years. Take the best opportunity. You have the rest of your life to find a job wherever you want.

Unrelated but I find it interesting that there’s always a few posts per week about “help I really wanna match back in Cali!!!1!” And some variation of it for NYC. I don’t see it for ANY other geographic location as often. Maybe it’s me, but I personally just don’t get it - Cali has nice weather I guess but I like being able to afford an apartment and certainly in my field I ain’t getting a job out there near any large city

Thank you all for the advice. I would like to clarify, I don't get where you got the desperate to go back to Cali vibe from, I simply said that I am leaning toward it if it's feasible. I'm in a bit of a unique situation where one of my parents suddenly died a few years ago so it would be nice if I could match either in the same state as or in pretty close proximity to my other parent and family in general. Was just trying to get an early gauge of my competitiveness for California IM or anesthesia programs just in case I end up going into one of those two fields, but overall I still do not know 100% what I want to do and obviously I will wait until interviews and seeing how the programs are like before ranking.

 

[CharlieBillings]

.

 

[sharkbyte]

How many other states are people desperate to return to?

I just meant that I said in my original post it's something I'm considering, not something that's all or nothing for me. I think I kind of misread the post and thought they were talking just about me when it was about other people.

 

[username456789]

Unrelated but I find it interesting that there’s always a few posts per week about “help I really wanna match back in Cali!!!1!” And some variation of it for NYC. I don’t see it for ANY other geographic location as often. Maybe it’s me, but I personally just don’t get it - Cali has nice weather I guess but I like being able to afford an apartment and certainly in my field I ain’t getting a job out there near any large city

If you’ve ever spent time in either place ( or significant time with people from these places ) you will realize there is a prevailing ideology that NYC/Cali are quite literally the only places worthy of habitation in the world (and in some instances, that they are essentially the center of the known universe).

Different strokes for different folks. I absolutely could not stand living in either of these locations, so I’m glad plenty of other people are willing to take one for the team.

 

[IMreshopeful]

If you’ve ever spent time in either place ( or significant time with people from these places ) you will realize there is a prevailing ideology that NYC/Cali are quite literally the only places worthy of habitation in the world (and in some instances, that they are essentially the center of the known universe).

Different strokes for different folks. I absolutely could not stand living in either of these locations, so I’m glad plenty of other people are willing to take one for the team.

I did most of my higher education in the greater NYC area so yes I know exactly what you mean. Don’t get me wrong - it’s a nice city to live in if you have the money and has a great cultural scene (perhaps less enticing for some if you aren’t into bars and clubbing), very diverse and has good food etc. it’s also unfortunately got some of the lowest pay for physicians across the board especially adjusted for COL (not to mention pretty bad job market in my area of subspecialty)