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slopes23

Parlors & Poop Shoots
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I think Step scores matter less at fellowship level. Though it's possible you will get filtered out at some places based on Step cut offs, I think your chances are excellent based on residency reputation assuming good LOR and that some of that research is in GI.

As for specific programs, it sounds like you are looking regionally, so if your residency is in the region that'll help a lot. If not, I would write to the PD to let them know you are really interested in training in the region for reasons X, Y and Z.

I'm curious, though, for residency, was there anything else to help your application: med school highly ranked? AoA? PhD or other advanced degree? Because that will help too.
 
My residency research is all in GI, my medical school research was not. My residency program is not in that region, but I do have significant ties to the area that draw me to it (versus staying at my home institution which I like overall or going back to my medical school where I was also very happy).

My medical school was a top 30 school and is well known for churning out clinically strong residents. Otherwise, I didn't have any awards as such to separate me specifically no AoA, Gold Humanism Award, or PhD.

My biggest concern is really just making sure I match GI first and foremost, as I have found that its where my passion truly lies (as much as I like medicine overall otherwise), and secondly being able to have some geographic preference in where I match. I know that my best shot is my home institution, and it has a good reputation for GI, biggest thing is its not my geographic preference long term (although I would happily make it work for an extra 3 years). My worry is, if I express to my home GI PD that I would be interested in going somewhere else, say as mentioned above to a Duke or UNC as an example, that I would then have lower chances at my home institution and therefore less chances overall at matching I would imagine. Versus, not mentioning that I have that preference, but then my PD wouldn't know to make a call on my behalf? Sounds like your suggestion is to just message the PD myself, which I was planning to do anyways when the time is right. I guess its not a zero sum game, like to think that people understand you can have multiple places you would be happy.

I just know that programs like to hear they are the apple of your eye, and I am not the type to tell multiple programs they are my number one (even if they are number 2 for example). If my step scores weren't where they were I wouldn't even be asking, but given that reality, I want to make sure I don't make any strategic errors that could cost me my career choice, perhaps I am overthinking the variables though.
I think youre having a classic case of pre-applicant anxiety. totally normal. besides low step scores your application sounds excellent. however i wouldnt worry too much about it. it is looked at, but if the rest of your application is exemplary, i think most programs will not care. for example, if youre coming from Harvard residency, do you really think Duke GI is gonna care you scored 210? you're a Harvard resident! that's all they care about.

one thing, you mentioned 10+ abstracts/pubs. what exactly is the breakdown and how many of these are publications? I see a lot of ppl on these forum combining abstracts/pubs as if they are one thing that can be mixed together. so, be specific, how many 1st author GI publications do you have?

as far as the PD making a call, your internal medicine PD can make a call out to duke or UNC. you do not need to have your home institution's GI program director make this call. your IM PD, likely will not tell the GI PD that he/she is making such a call. it is possible, but overall unlikely. i had no trouble asking my internal medicine PD to make a call at another institution.

and of course, in no situation should you tell mult programs you are ranking them #1, but you already know that.
 
Have 3 first author GI pubs, 4 first author pubs total, a GI first author book chapter. Additionally have 10 abstracts (many from med school) all first author of which 3 are GI (all GI abstracts were first author), others are med ed original work and a couple of case reports, otherwise have several QI projects too that were from medical school that are mainly first author, although one was second author.

And I appreciate the reassurance/kind words from both of you from whatever its worth.
to be honest, what I would do is this:

1. Except for your non-GI 1st author publication, I personally would exclude ALL other non-GI abstracts
that would leave you with 4 publications (3 of which are gI), 1 book chapter (excellent!), and your 3 GI first other abstracts.
2. the reason for #1 above, is you do not want to flood the application reviewer with abstracts, trust me I have reviewed many applications. it is hard to keep track of everything when you have a mix of GI and non-gi. I really dont think some 1st author med school abstracts are gonna help you much. If you have 3 GI pub +1 non-GI pub +1 GI chapter + 3 GI first author abstracts, that is plenty and i think a strong application. last think you want is to risk a reviewer 'missing' these for the sea of other, non-GI abstracts.

3. for what it's worth, there were a few abstracts i myself left out of my GI app for the above-stated reasons
 
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