Am I overreaching by applying to a top psych. residency with a low Step 1 score?

[blackberry13]

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I got a 208 on my Step 1 test. If I honor my psych rotation and get a 235+ on Step 2 will this be enough to offset my terrible Step 1 score? I also expect to get good letters of rec from my school in psych (which has a good psych program) and also from another psychiatrist who is a big name in the field who I am doing a 2 week elective with. I also plan on doing a one-month externship at a school like Harvard or Columbia and hope to do well during this externship. Basically, I will cover all my bases except my poor Step 1 score...is it still a good idea for me to reach for schools like Columbia or Harvard for psychiatry? I don't want to do the externship if I know that even if I do good there they won't consider me. Please let me know what you guys think. Any ideas are much appreciated! Thanks!

 

[DebDynamite]

You don't even need to spank step 2. Just do as well as your step 1, or better, and I think you'll be fine. My score were far from tremendous & I received big-name invites. Granted, I have 2 publications, had stellar letters, lots of leadership, honored psych, etc...

Who really knows the magic formula? I had friends in med school with less leadership (than I) and zero publications- I never asked their scores, but I know Harvard & Mt Sinai, Dartmouth, Brown - all invited them. Not Penn or UCLA- they seems to issue less invites (UCLA regionally dependent). I don't think their (my friends) scores were outstanding, I actually kind of doubt it. You will be A-okay.

 

[Still Kickin]

I got a 208 on my Step 1 test. If I honor my psych rotation and get a 235+ on Step 2 will this be enough to offset my terrible Step 1 score? I also expect to get good letters of rec from my school in psych (which has a good psych program) and also from another psychiatrist who is a big name in the field who I am doing a 2 week elective with. I also plan on doing a one-month externship at a school like Harvard or Columbia and hope to do well during this externship. Basically, I will cover all my bases except my poor Step 1 score...is it still a good idea for me to reach for schools like Columbia or Harvard for psychiatry? I don't want to do the externship if I know that even if I do good there they won't consider me. Please let me know what you guys think. Any ideas are much appreciated! Thanks!

Aim high, but have a "backup" plan, too.
(Not to imply your stats require a backup - I'm no expert on that subject one way or another. I'm just talking from a cheerleader/practicality standpoint here.)

It would be stupid to self-select to NOT apply to those programs when perhaps they would have had you. (I mean, worst thing that can happen is you apply & they reject you - you're really not out of much other than whatever the application cost you in ERAS). But if you don't even apply, well, then you're guaranteed not to get in.

I think your externship plan sounds like a good one, too. I don't know about those particular programs but in general I would think this should highly up your chances of getting an interview at the program where you do your externship. PLUS - if you get a good letter of rec from a big name place like that - that should help your entire application, even at other schools.

Just my 2-cents worth. Again, I'm just a student, too, so really don't know the specifics of what these programs might be looking for.

Also, you can aim high with your Step II, but don't freak out if you don't get the 235+ you're aiming for. I mean, that would be an amazingly stellar score.

Check out this document:
http://www.nrmp.org/data/chartingoutcomes2007.pdf
Page 110 of the report shows that the avg. USMLE for someone who matched in Psychiatry (during the 2007 match) was 210, with 25% having a 194 or below...
(Additional Match Statistics can be found at this page):
http://www.nrmp.org/data/index.html

 

[billypilgrim37]

First off, why did u get a low step 1 score? If you're thinking you can get a 235 on Step 2, that suggests that the step 1 score is an anomaly for you, and if that's true, and the rest of your app is that strong, then it might just be a blip. A few places might blow you off, but there are a lot of good psychiatry programs. Heck, in the top 10, there are at least ten of them.

If you're at a good psych program, and have connections to a name, well, that can mean A LOT.

So don't fret. Apply and see what happens. Externship, eh, that's a harder question, and will probably require more details than you should be disclosing on a public forum like this. The programs that would blow you off because of a low step 1 score would probably find other excuses to blow you off as well regardless of an externship. But I'm biased against externships for any purpose other than you getting to know a program you're interested in.