Am I competitive for an anesthesia residency?

[Curlyfriez12]

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I am a 3rd year MD medical student. In terms of grades, I'd say i'm a C student, and my Step 1 score was 211. I spent the summer before medical school doing research, but I don't think it went anywhere. I have nothing to show for it, except that I did research one summer. I did a bit of volunteering during my MS1 year, but not substantial.

I am consistently getting "Passing C" grades at my school. How good are my chances of matching in Anesthesia? I think it is a good match for my personality. I work hard, but am just not as bright as my classmates.

Also, how could I make myself more competitive?

Thanks a bunch.

 

[Precedex]

No.
Try to get mostly As in your clinicals.

 

[Gern Blansten]

Not for most programs. You might find a few programs that might interview you. Getting all C's at most schools would mean you are probably last in your class. As the number of graduating MD's & DO's will probably surpass the number of overall residency spots, you should plan now for a back up that you can be competitive in.

 

[gas2014]

.

 

[gasblaster]

What will hurt him/her more? The 211 Step 1 or the straight Passes in 3rd year?

I ask because I find it funny that the clinical grades have so much importance.

1. The grades are extremely subjective. Up to 2/3rds of one's grade at some schools is based on an attending filling out a form asking whether the student is "below normal", "normal", "above normal", or "outstanding". Hence, some attendings give everyone "outstanding" while others give everyone "normal." It's just a matter of luck.

2. Different schools have different grade distributions. At some schools 60% of the class gets a B, while at others 60-65% gets a C. Some schools have grade inflation, while others have deflation.

If the OP gets above the national average for Step 2CK (235 this year, I believe), would that "make up" for the "poor" clinical grades.

This is true and I think most everyone understands how subjective clinical grades can be. However, I think schools try and off-set it when it comes time for the Dean's Letter. I know my med school provided the breakdown of grade distribution (% of class) in the MSPE. Also, straight average (pass, C, etc) grades across clerkships is a red flag. That would be a trend which is much more telling versus just one or two.

 

[Precedex]

What will hurt him/her more? The 211 Step 1 or the straight Passes in 3rd year?

I ask because I find it funny that the clinical grades have so much importance.

1. The grades are extremely subjective. Up to 2/3rds of one's grade at some schools is based on an attending filling out a form asking whether the student is "below normal", "normal", "above normal", or "outstanding". Hence, some attendings give everyone "outstanding" while others give everyone "normal." It's just a matter of luck.

The USMLE step 1 is the last exam you'll take where anyone cares about your score. After that it is all about "extremely subjective" evaluations so try to get used to it. When looking at applicants we put a lot of weight on clinicals and I bet most programs do to.

 

[Gern Blansten]

The USMLE step 1 is the last exam you'll take where anyone cares about your score.

I disagree.

A solid step II score can help you recover from a poor step I score.

A poor ITE score can result in reprimand at some residency programs. In addition, with the new system, you could be held back with the new basic science exam. In addition, a poor ITE score can hurt your chances of getting a competitive fellowship. In addition, a barely passing written board score is associated with a high fail rate for the orals for first time US grad takers.

At the very least, the person taking the exam should care about that last statistic. However, if you are saying you can do "average to slightly above average" without causing any issues, you are probably correct.

 

[Philosiraptor]

I think you're going to have to shoot for community programs, and that is if you do well on Step 2 CK early enough for it to matter. Still, you should have a back up plan in a less competitive specialty.

Step 1 is what they use to screen for interviews from what I understand/have been told, and Step 2 can affect where on the rank list you end up (but some places don't really care much about that test).

I've heard this year secretaries and PD's didn't even get through all the applications received...so if the filters cut you out because of the Step 1 score...even a 260+ on Step 2 CK won't help you "make up for the low Step 1".

Not saying it's impossible, but you should probably be realistic given the facts.

 

[Curlyfriez12]

Thank you all.

 

[tima]

I think you have a fair chance. You are a US MD student, which helps. Try to work hard on step 2 and aim for the upper 220's or 230s. Do away rotations at institutions where you think you have a good chance and impress them. Apply to a good number of programs.

 

[TeamZissou]

While we are at it, I did subpar on Step I (200sh) and I'm a DO.

Step II is scheduled July 29th, is that "early" enough?

 

[Ronin786]

While we are at it, I did subpar on Step I (200sh) and I'm a DO.

Step II is scheduled July 29th, is that "early" enough?

As long as its not in that area where they delay score reporting (usually mid-June), I think you should be fine. At most you can count 4 Wednesdays, which would have your score out by the end of August.

 

[Per4mer8]

The USMLE step 1 is the last exam you'll take where anyone cares about your score. After that it is all about "extremely subjective" evaluations so try to get used to it. When looking at applicants we put a lot of weight on clinicals and I bet most programs do to.

Respectfully disagree. I got just as many or more comments about my Step II as I did my Step I. I got the sense a lot of PDs are kind of sick of the whole "do well on Step I then coast and delay Step II until after apps" strategy. They are getting too many apps to rely on just one score for applicant stratification. I do agree that clinical grades can be frustratingly subjective but think the overall trend is noticed. Just my .02

 

[gas2014]

.

 

[Ronin786]

I agree with this a lot. In my school, we don't have any sort of curve, its all on a scale out of 100. So even though I'm in the 90th percentile, all my grades are in the 75-85 range (with one 68 where that was the 10th highest score out of 300+ students) when in reality they would look a lot higher with a curve.

I'm personally debating whether to mention something about that in my personal statement, but I don't want to come off as making excuses.

 

[Planktonmd]

Why on earth do you want to go to anesthesia?
Actually I am surprised that any one is still trying to go to anesthesia despite the very sad state of affairs and the uncertain future.
Do yourself a favor and a find something else.

 

[foley12]

To match SOMEWHERE in anesthesia is not that competitive and you are a US MD. If you apply widely enough to the low tier programs you will match. I am in the east coast so here is a starter list of programs in my area that fit these criteria and you should definitely apply to.

Downstate
Stony Brook
New Jersey Medical School
RWJ
Maimonides
Einstein
St Joseph's Reigonal Med center - NJ
NYMC
UMass
St. Elizabeth's
Case Metrohealth
U - Rochester (very strong program but in an undesirable location - program has alot of DO and IMG's)
Drexel
Temple
Penn State (also undesirable location)
St Barnabas

 

[chudat]

Why on earth do you want to go to anesthesia?
Actually I am surprised that any one is still trying to go to anesthesia despite the very sad state of affairs and the uncertain future.
Do yourself a favor and a find something else.

Anyone care to explain? Refute? Confirm?

 

[Ronin786]

Anyone care to explain? Refute? Confirm?

That same sentence can be said for a large number of medical specialties. Radiology went through the whole "sky is falling" scare, as did Path and multiple other specialties. Heck, the other day there was an Ophthalmologist saying they have too much competition and that Anesthesia is better off.

While things aren't very rosy for Anesthesia, its still one of the better specialties out there, and if you like it then I don't think things are bad enough for people not to apply.

 

[Planktonmd]

Anyone care to explain? Refute? Confirm?

This specialty unfortunately has a very uncertain future worse than any other medical specialty.
The time of independent private practice groups is over and the anesthesiologists of the future will be employed by hospitals or large management companies which means twice the work for half the money.
The future of surgical anesthesia will increasingly depend on CRNA's with loose supervision (1 anesthesiologist to 8 - 10 rooms) or no supervision at all.
The income is rapidly declining with the decline of reimbursement and with the hospitals and management groups in full control of our income.
Old anesthesiologists are staying longer and as a result decreasing the available jobs.
The numbers of new graduates produced yearly by residency programs are absolutely insane and driving the Job market for the new guys further down.
Unfortunately I don't see the residency programs changing their admission numbers anytime soon because for them residents are cheap labor and money from Medicare, and because they feel protected in their academic ivory towers.
These are just some of the issues you should consider before applying to anesthesia.
You will hear a completely different speech from the academic guys because they don't live in the real world, but this is how things look from the trenches of private practice.

 

[dotcb]

Right now you're not on track to match well, if at all, in your desired field. Turn things around, work harder, study more, and have a back up plan for not matching in anesthesia.

 

[chudat]

This specialty unfortunately has a very uncertain future worse than any other medical specialty.
The time of independent private practice groups is over and the anesthesiologists of the future will be employed by hospitals or large management companies which means twice the work for half the money.
The future of surgical anesthesia will increasingly depend on CRNA's with loose supervision (1 anesthesiologist to 8 - 10 rooms) or no supervision at all.
The income is rapidly declining with the decline of reimbursement and with the hospitals and management groups in full control of our income.
Old anesthesiologists are staying longer and as a result decreasing the available jobs.
The numbers of new graduates produced yearly by residency programs are absolutely insane and driving the Job market for the new guys further down.
Unfortunately I don't see the residency programs changing their admission numbers anytime soon because for them residents are cheap labor and money from Medicare, and because they feel protected in their academic ivory towers.
These are just some of the issues you should consider before applying to anesthesia.
You will hear a completely different speech from the academic guys because they don't live in the real world, but this is how things look from the trenches of private practice.

Dr. Plankton,
Incidentally, I'm on my month of anesthesia rotation and the attending I'm with literally said the exact same you posted. He foresees in the next 30 yrs, anesthesia will be an obsolete profession and everything that he does in the OR (maintaing BP, vent settings, gas inhalation etc) can be done remotely by someone behind a computer desk. Is this possible?

He says anesthesia was a good choice in the 90's.

 

[Noegrus]

Dr. Plankton,
Incidentally, I'm on my month of anesthesia rotation and the attending I'm with literally said the exact same you posted. He foresees in the next 30 yrs, anesthesia will be an obsolete profession and everything that he does in the OR (maintaing BP, vent settings, gas inhalation etc) can be done remotely by someone behind a computer desk. Is this possible?

He says anesthesia was a good choice in the 90's.

I know I have been a massive supporter of this and foresee this happening. That would happen, BUT, this will take a massive amount of time and would be limited.

 

[BLADEMDA]

Dr. Plankton,
Incidentally, I'm on my month of anesthesia rotation and the attending I'm with literally said the exact same you posted. He foresees in the next 30 yrs, anesthesia will be an obsolete profession and everything that he does in the OR (maintaing BP, vent settings, gas inhalation etc) can be done remotely by someone behind a computer desk. Is this possible?

He says anesthesia was a good choice in the 90's.

Anesthesia will exist in 30 years. But, it will be a very different profession in terms of income and prestige.

I understand Med Students much match into some specialty and ansthesia looks appealing right now but the future doesn't look anything like the present or the past.

Most of you won't like working for an AMC or a hospital but as long as that is acceptable then there will be a job after Residency. This is why a Fellowship MAY (and I stress may) be a good insurance policy for future employment.

 

[Planktonmd]

Dr. Plankton,
Incidentally, I'm on my month of anesthesia rotation and the attending I'm with literally said the exact same you posted. He foresees in the next 30 yrs, anesthesia will be an obsolete profession and everything that he does in the OR (maintaing BP, vent settings, gas inhalation etc) can be done remotely by someone behind a computer desk. Is this possible?

He says anesthesia was a good choice in the 90's.

He is right!
The hospital administrators and management companies (our future employers) will do everything they can to decrease or eliminate their need for us.
That would certainly include more automation and cheeper providers.