AMG US Citizen, Low Step 1

[shao]

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Hey:

I'm new here. I am an AMG third year med student US citizen. I am interested in path. Step 1 is 79/195 (yeah i know...). Done one elective so far in clinical path, got high pass not honors... No research yet.

Plans:

1. Improve Step 2 before interviews
2. I only have one month available to take an elective between now and interview time because of the scheduling. Will try Surgical path in whatever program i find the most suitable.
3. Try to do get started on some research while subsequently in core rotations.

Any other ideas? Don't know much about individual programs other than what their websites say, so don't know what is a good possibility vs. remote possibility.

Thanks

 

[gbwillner]

Hey:

I'm new here. I am an AMG third year med student US citizen. I am interested in path. Step 1 is 79/195 (yeah i know...). Done one elective so far in clinical path, got high pass not honors... No research yet.

Plans:

1. Improve Step 2 before interviews
2. I only have one month available to take an elective between now and interview time because of the scheduling. Will try Surgical path in whatever program i find the most suitable.
3. Try to do get started on some research while subsequently in core rotations.

Any other ideas? Don't know much about individual programs other than what their websites say, so don't know what is a good possibility vs. remote possibility.

Thanks

You're going to have to apply broadly because I know many programs set their screening net at a step 1 score of 200. You might even want to call a few places to reconsider if you get a rejection for interview.
Away electives are not necessarily helpful. They should be used only to see if ia program is a "good fit" for you. In other specialties it's probably a good idea, but in path it really isn't because it will be hard to impress residents/faculty when you really don't know anything.
Best bet would be to get incriminating photos of your program director with a hooker and blackmail them.

/I keed

 

[KeratinPearls]

Hey:

I'm new here. I am an AMG third year med student US citizen. I am interested in path. Step 1 is 79/195 (yeah i know...). Done one elective so far in clinical path, got high pass not honors... No research yet.

Plans:

1. Improve Step 2 before interviews
2. I only have one month available to take an elective between now and interview time because of the scheduling. Will try Surgical path in whatever program i find the most suitable.
3. Try to do get started on some research while subsequently in core rotations.

Any other ideas? Don't know much about individual programs other than what their websites say, so don't know what is a good possibility vs. remote possibility.

Thanks

Yeah everything you mentioned sounds good. Letters of recommendation are key especially from well known faculty. If not, then any faculty in an academic position is fine.

Make sure to show interest, enthusiasm during your rotations which will hopefully be reflected in your recs.

I don't know if research will help much...it def will not hurt though. Research is a lot of work (esp if you are doing a full fledged project)...if you are going to do it most likely you will just be someone's biatch..if you enjoy research, then do pathology related research with well known faculty and get a letter out of that. Please don't do research on the TCA cycle in rats or something really off the wall.

If I were you I would schedule that surg path month at a place that will give you some hands on experience and get a letter out of that. Study for step 2 and bring up that score.

Good luck.

 

[shao]

Thanks for the above replies.

Is there any added benefit of being an AMG, especially since there seems to be a high IMG applicant pool for this field?

In other words, would an AMG with not as good of a stats still be as competitive as an IMG who has better stats?

Because my impression would be that AMGs would be favored.

 

[biotin]

Thanks for the above replies.

Is there any added benefit of being an AMG, especially since there seems to be a high IMG applicant pool for this field?

In other words, would an AMG with not as good of a stats still be as competitive as an IMG who has better stats?

Because my impression would be that AMGs would be favored.

I think being an AMG gives you an advantage over the IMGs who have similar or slightly better scores. At least this is what some PDs have told me on interviews this year.

Some person last year from my school (unknown US medical school) had a similar Step 1 score to yours and pretty bad grades. He applied fairly broadly and got about 10 interviews.

 

[KCShaw]

Actually, I think spending as much time as possible in path rotations could be a significant plus. In my experience, PD's are more sensitive to the problem of people trying to get into a path residency because spots are considered less competitive and not because they are interested in path or have any idea what they're getting into (those are people who tend to drop out, fail, or switch to another specialty). I've seen individuals with much better numbers be frowned upon because they gave that impression, whether it was in interviews, recommendations (which mentioned how they would make a great surgeon or cardiologist, but nothing about path), or personal statements. I've also seen individuals with worse numbers but who evidently interviewed well, had a pathology plan and understanding, and were otherwise well-rounded go-getters match -- not at generally accepted "top tier" programs, but still.

And, yes.. other things being equal, being an AMG U.S. citizen with an American accent is very likely to put you in a better position than an IMG &/or individual with a non-American accent or doesn't speak English as a first language. Eventually the selection process becomes so subjective that, unfortunately, little things like that can separate applicants for the last couple of rank spots.

Know what you're getting into, be aggressive, persistent, and involved but not annoying (a sometimes difficult thing to judge), and don't let rejections get you down. Don't be afraid to still aim high, but be realistic and cast a wide net at the non-big-name programs, and hit the interview trail as hard as you can. It can still be done, but you'll have that much more to prove if you match -- use this as motivation.

 

[Entgegen]

I agree with what KC said about doing rotations. I happened to do 3 path rotations before starting interviews (1st in a community private practice setting at the end of 3rd year to decide if path was what I wanted to do, then the other 2 at residency programs I wanted to take a look at and get a good feel for), and on every interview I've been on so far, I've been asked at least once about what path rotations I've done. Each inquiry seemed to be asked in order to gauge my true interest in path and to see if I knew what I was getting myself into, and not that I'm simply choosing it because of a dislike for everything else.

As for what to do on rotations, I was actually able to help out a lot on a hemepath rotation by gathering histories for and presenting the peripheral smears that the techs had flagged to the attending while the residents were diffing marrows. On the other surgpath rotation, I went with the residents on as many frozen sections as I could (they actually went to the OR to pick up the frozen and then to give the diagnosis as opposed to just calling the OR), helped with grossing (not much I could do there except mash colon fat looking for lymph nodes), and sat in on as many sign-outs as possible and tried to ask intelligent questions to show interest. Just show up, be interested and enthusiastic.

 

[shao]

Thank you again for the above replies. I had a few more thoughts/questions:

1. What criterion distinguishes a "top-tier" program from others and in terms of competitiveness, and how will I recognize it? Is it something actually tangible for a resident like staff support and work hours or is it more just external stats like research funding, etc?

2. This is more general, but what criterion should I look for in a program if I decide to do an external rotation in it, since essentially this will become on the top of my rank list, where my letters will come from, etc.

3. The NRMP data is a litte scary. I see the average score as at least 220+ for matched candidates over the past few years. How do you guys interpret this data?

 

[KeratinPearls]

Thank you again for the above replies. I had a few more thoughts/questions:

1. What criterion distinguishes a "top-tier" program from others and in terms of competitiveness, and how will I recognize it? Is it something actually tangible for a resident like staff support and work hours or is it more just external stats like research funding, etc?

2. This is more general, but what criterion should I look for in a program if I decide to do an external rotation in it, since essentially this will become on the top of my rank list, where my letters will come from, etc.

3. The NRMP data is a litte scary. I see the average score as at least 220+ for matched candidates over the past few years. How do you guys interpret this data?

As an American grad, you should be able to match somewhere. I don
t know if you can get into a top tier program with those stats unfortunately, but it's worth a try.

 

[KCShaw]

"Top tier" is somewhat subjective, based on some combination of institution recognition, path attending recognition which generally includes significant publication, historical success of previous residents, and size of program to include number and variety of common and uncommon specimens. Everyone has a slightly different mental list of what they consider "top tier" vs very respectable vs just another accredited program, etc., though a very few would make most people's list.

Generally "good" programs are at least moderately large, able to accomodate > 12 residents, affiliated with a large medical school, and have subspecialty trained attendings in most of the major AP categories. Most programs have limited bone and pediatric specimens. But, one would probably prefer to go somewhere with solid numbers of GI, cytology, breast, prostate, kidney specimens, or other common/bread-and-butter type material, and at least a couple of MD attendings (NOT just PhD's) in CP to include transfusion/blood bank.

Haven't seen that NRMP data, nor the trend over the last 5-10 years. Numbers are numbers. If that's a consistent upward trend, good for the specialty. But it still means there could be 9 candidates with a 225 and one with a 190 and the average is above 220. There are a lot of residency positions out there, and "enough" programs willing to take a warm body or two even just to help them cover service work. Probably not good for the future of the specialty, looking at the big picture, but good for a few individuals who might make the best of it.

 

[Dawn1980]

Hey:

I'm new here. I am an AMG third year med student US citizen. I am interested in path. Step 1 is 79/195 (yeah i know...). Done one elective so far in clinical path, got high pass not honors... No research yet.

Plans:

1. Improve Step 2 before interviews
2. I only have one month available to take an elective between now and interview time because of the scheduling. Will try Surgical path in whatever program i find the most suitable.
3. Try to do get started on some research while subsequently in core rotations.

Any other ideas? Don't know much about individual programs other than what their websites say, so don't know what is a good possibility vs. remote possibility.

Thanks

Shao,

I was in your shoes.

I picked 2 places I really wanted to go and did away rotations there. By the end of the rotation, I received interviews at both places. During the interviews, I was told I by both that I was their top choice.

Must be true b/c I ended up at my first choice (of the two).

I can't recommend doing away rotations enough. Unless you'll be detrimental to yourself. Hopefully this isn't the case.

 

[shao]

Shao,

I was in your shoes.

I picked 2 places I really wanted to go and did away rotations there. By the end of the rotation, I received interviews at both places. During the interviews, I was told I by both that I was their top choice.

Must be true b/c I ended up at my first choice (of the two).

I can't recommend doing away rotations enough. Unless you'll be detrimental to yourself. Hopefully this isn't the case.

So your stats were similar to mine, if I may ask? And did Step 2 go along well for you?

Also, it seems like I will really only have chance to do one out of town rotation between now and when ERAS is open to programs because my schedule is packed with cores. So it looks like I'll only have the benefit of getting involved in one program. Is there anyway to supplement for extending to other places other than doing an out of town elective? It seems like there isn't much that can be done there....

 

[Dawn1980]

So your stats were similar to mine, if I may ask? And did Step 2 go along well for you?

Also, it seems like I will really only have chance to do one out of town rotation between now and when ERAS is open to programs because my schedule is packed with cores. So it looks like I'll only have the benefit of getting involved in one program. Is there anyway to supplement for extending to other places other than doing an out of town elective? It seems like there isn't much that can be done there....

You can do second-looks which usually take only a day. I never did this, but I know others who have and have been successful. However, I've seen more that have been unsuccessful, mostly because they were socially awkward or some other personality quirk. Plus, it's hard to get to know someone well in just one day. I still think a strong away rotatation (one month) is much more solid than a second-look.

 

[the alchemist]

Shao,

I was in your shoes.

I picked 2 places I really wanted to go and did away rotations there. By the end of the rotation, I received interviews at both places. During the interviews, I was told I by both that I was their top choice.

Must be true b/c I ended up at my first choice (of the two).

I can't recommend doing away rotations enough. Unless you'll be detrimental to yourself. Hopefully this isn't the case.

any advice on what made you stand out on those away rotations that they offered you interviews by the end of the rotation? that is, advice on how to "shine" on path elective rotations?

 

[KeratinPearls]

any advice on what made you stand out on those away rotations that they offered you interviews by the end of the rotation? that is, advice on how to "shine" on path elective rotations?

If you are a medical student, my advice would be to help out the resident when the opportunity arises, be willing to learn and not be annoying. I've seen many medical students come thru our department. You aren't expected to know anything (maybe basic histology). Just be enthusiastic and be yourself. Those that made a good impression were those that had a good personality on top of the traits listed above.

Of course make sure you learn as much you can during the rotation. Go to tumor boards, ask to gross specimens (if allowed), sit at the scope during signout, follow your cases from the time you gross the specimen until it's been signed out, go to morning conferences and just be nice to people.

 

[KCShaw]

There is a thread or two around about this, too.

Personally, I don't think it's hard to stand out in a positive way as a med student on a pathology rotation. If you actually show up every day and don't whine about leaving by lunchtime when you do manage to show up, you're already well ahead of the curve in my experience. I shudder to recall the number of times I was asked as the chief resident, by the attending who was supposed to sign off on the student, how X did on their month long path rotation and I could only say "...who?" And there weren't very many students who signed up for a path rotation in the first place. Unfortunately many who did, did so because they wanted an off rotation at the end of their year. Even less fortunately, it wasn't clear the faculty much cared either.

Honestly, as has been said.. show up, interact, offer to do things or ask if you can be shown how to do things (paper shuffling or looking up medical records in certain cases will earn you bonus points and save residents time to teach/show you other things later), but pay attention and try to recognize when it's too busy to get in the mix right then (don't be annoying). It's sometimes a fine line. Ultimately, try to show that you learned something by the end, but don't feel like you have to become a sudden star or that you'll never make it in pathology if you aren't an immediate gun. Medical school doesn't even remotely ground one for a career in anatomic pathology.. clinical pathology, only slightly better.

 

[Dawn1980]

any advice on what made you stand out on those away rotations that they offered you interviews by the end of the rotation? that is, advice on how to "shine" on path elective rotations?

I ditto the advice from KeratinPearls and KCShaw.

I was also required to give a talk. I made sure it was kickass. I also had a resident and an attending (particularly one who is persuasive in the resident selection process) look it over and give advice to make it better.

Yes, I had to use politics (having an influential attending look the talk over). I hated that. Unfortunately, when you have low board scores, this may be the only hand you have. If you play it well, it can help you.

 

[shao]

Does anybody here know how many programs use the screening process? Anybody here recall if their place has a limit?

 

[KCShaw]

We had some people give talks at the end of their rotations - seemed like a good idea.

Politics -- Yeah. Don't have to like it, but do have to play the game (if only to keep from getting run over sometimes). Unless you're the X-Games type, I'd stay away from the risky backstabbing crap, but everyone has to figure out who wields the power and connections in the department and probably go a little out of their way to stay on their good side. That's life. Deal and move on.

How many programs screen -- what do you mean? Just that some programs don't particularly look at people below X score, etc.? Every program screens to some extent or other, because they simply can't interview every single applicant. Even troubled programs get large numbers of applicants, though they may be foreigners who don't have any appropriate documentation or test results, or poorly qualified individuals applying primarily to other specialties. USMLE scores are, fortunately or not, simply very easy marks by which to screen, but are not the only thing. And even programs that claim to have a cutoff generally don't, though they may avoid dipping below that mark for interview offers until later in the process, depending on what they already think they have.

 

[the alchemist]

thanks for the advice. my step 1 and grades are pretty good. just a little worried since i haven't done a path rotation yet and don't know what to expect since the daily day of a pathologist is diff than what i saw during 3rd year rotations or 4th year where i've mostly been on in-pt consult services. interested more in CP and was in research b4 med school (i'm a non-trad). i just want to make sure i can best help the team in the little that i can actually contribute and not get in the way (ie - be annoying) and it took me a while to figure out how to do that during 3rd yr and on c/s services.

btw, i'm horrible at giving presentations. i usually run too long and have a quiet voice for them (though usually i'm a pretty loud person) so ppl ask me to speak up and then i feel like i'm shouting. organizing what to put in ppt is ok but making it engaging/interactive is harder for me.

Shao,

I was in your shoes.

I picked 2 places I really wanted to go and did away rotations there. By the end of the rotation, I received interviews at both places. During the interviews, I was told I by both that I was their top choice.

Must be true b/c I ended up at my first choice (of the two).

I can't recommend doing away rotations enough. Unless you'll be detrimental to yourself. Hopefully this isn't the case.