Advice for applicant with sub-200 Step 1

[theadvocate]

Hello, everyone! I am a U.S. MD reapplying to psychiatry this cycle, and I am looking for some advice on how to apply more smartly. I am aware that there is research showing how many applications students with different step scores send out before reaching the point of diminishing returns, and I think it makes sense that applying to more programs will not necessarily help-- especially because programs use the same system to screen their applicants. This was my experience last year. I have a sub-200 Step 1 score and some remediated clerkship exams due to undiagnosed ADHD (recovery was delayed for years because my ADHD symptoms were attributed to depression). While my academic record improved after I received the correct diagnosis and medication, it was very difficult to get invited to interviews with my Step 1 score and remediations. Despite casting a wide net, I received less than ten interviews and ultimately did not match. Is there a smarter way I can apply to programs, in order to avoid getting screened out? What steps can I take to get my application looked at with a sub-200 Step 1 score? Would a good Step 3 score help, or would my application get screened out due to the Step 1 score, anyway? Per multiple faculty interviewers and program directors, the rest of my application was otherwise very strong.

Thank you.

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[MacDonaldTriad]

A low step 1 score generally doesn't make us worry that you are missing needed knowledge to become a psychiatrist. It does make us worried that you will have difficulty passing step 3. Not passing step 3 is a big problem for both you and the program who has to either replace you or burden other residents with more work. Having a pass on step 3 will significantly diminish a lot of program's reservations about you. I wish you better luck this year.

 

[Central_SOULcus]

OP, you didn't mention how you did on Step 2. If your score was also low, then I would strongly consider taking Step 3. As MacDonaldTriad said, programs want people who will pass Step 3 without a hitch. I would think if you pass Step 3 (even with a low score), that could open more doors.

As for what might have prevented you from matching the first time, I have a feeling it wasn't your low Step 1. Having to remediate clerkship exams might have been more of an issue. However, maybe even those weren't a huge deal since you said the rest of your application was very strong. If you got only a couple interviews, then that's one thing. But you said you got less than 10, which I'm assuming is maybe 6 or 7? Do you feel you have strong interview skills? I know people who had red flags on their applications and still matched because they knocked the few interviews they got out of the park. (I'm not saying you don't interview well, but just something to consider.) As for how many programs you should apply to, I don't have a good answer for you. I would think you still need to apply broadly. I'd check the list of which programs are new this year and make sure you apply to those as well. Good luck this cycle!

 

[Stagg737]

If you got only a couple interviews, then that's one thing. But you said you got less than 10, which I'm assuming is maybe 6 or 7? Do you feel you have strong interview skills? I know people who had red flags on their applications and still matched because they knocked the few interviews they got out of the park.

Was about to say this. If OP managed to get almost 10 interviews and still didn't match, I'd be looking to get some feedback on interview skills as well as it sounds like programs felt there was a reason to offer them an interview but then not rank them highly.

 

[theadvocate]

OP, you didn't mention how you did on Step 2. If your score was also low, then I would strongly consider taking Step 3. As MacDonaldTriad said, programs want people who will pass Step 3 without a hitch. I would think if you pass Step 3 (even with a low score), that could open more doors.

As for what might have prevented you from matching the first time, I have a feeling it wasn't your low Step 1. Having to remediate clerkship exams might have been more of an issue. However, maybe even those weren't a huge deal since you said the rest of your application was very strong. If you got only a couple interviews, then that's one thing. But you said you got less than 10, which I'm assuming is maybe 6 or 7? Do you feel you have strong interview skills? I know people who had red flags on their applications and still matched because they knocked the few interviews they got out of the park. (I'm not saying you don't interview well, but just something to consider.) As for how many programs you should apply to, I don't have a good answer for you. I would think you still need to apply broadly. I'd check the list of which programs are new this year and make sure you apply to those as well. Good luck this cycle!

Thank you for your response. I did slightly better in Step 2, but my score was still below average. I actually already signed up for Step 3; I was just wondering exactly how much it would help me and whether schools would actually see my Step 3 score when they screen through the applications. My school had organized many mock interviews and I was told by multiple faculty members in psychiatry, medicine, and other specialties that I interviewed very well. The program directors that I talked to also said I interviewed well, with the exception of exactly one interview that I had with a medical internist. (That last bit actually scared me because I felt I couldn't allow myself to be anything less than perfect.) The PDs also said that I had strong LORs, that there were no red flags during interview day, and that I was a strong or "very competitive" candidate. My understanding is that too many candidates were just as strong in terms of interpersonal skills and extracurricular experiences, but with better board scores, so it was difficult for me to move up higher on the rank list

 

[phagocytosis41]

Thank you for your response. I did slightly better in Step 2, but my score was still below average. I actually already signed up for Step 3; I was just wondering exactly how much it would help me and whether schools would actually see my Step 3 score when they screen through the applications. My school had organized many mock interviews and I was told by multiple faculty members in psychiatry, medicine, and other specialties that I interviewed very well. The program directors that I talked to also said I interviewed well, with the exception of exactly one interview that I had with a medical internist. (That last bit actually scared me because I felt I couldn't allow myself to be anything less than perfect.) The PDs also said that I had strong LORs, that there were no red flags during interview day, and that I was a strong or "very competitive" candidate. My understanding is that too many candidates were just as strong in terms of interpersonal skills and extracurricular experiences, but with better board scores, so it was difficult for me to move up higher on the rank list

Good luck! i know what it's like to do not so great on standardized exams.. luckily the steps went okay for me. Hope all goes well for you friend.

 

[Central_SOULcus]

Thank you for your response. I did slightly better in Step 2, but my score was still below average. I actually already signed up for Step 3; I was just wondering exactly how much it would help me and whether schools would actually see my Step 3 score when they screen through the applications. My school had organized many mock interviews and I was told by multiple faculty members in psychiatry, medicine, and other specialties that I interviewed very well. The program directors that I talked to also said I interviewed well, with the exception of exactly one interview that I had with a medical internist. (That last bit actually scared me because I felt I couldn't allow myself to be anything less than perfect.) The PDs also said that I had strong LORs, that there were no red flags during interview day, and that I was a strong or "very competitive" candidate. My understanding is that too many candidates were just as strong in terms of interpersonal skills and extracurricular experiences, but with better board scores, so it was difficult for me to move up higher on the rank list

I'm not sure when you're scheduled to take Step 3 but remember that once you take it you still have to wait about a month for your score to come out. As we said above, only take Step 3 if you're sure you can pass it. If your score comes out later in the season (when programs are still giving out interviews), then you can release it to ERAS and contact certain programs specifically to let them know your score is in. As for your conjecture about other candidates being ranked higher because they have better scores, that may be the case, and if so, is another reason for you to take Step 3 (that way your scores will be less of an issue).