Hey — first off, thank you for your honesty. You’re not alone in feeling the pressure here, and I want to say upfront: navigating this stuff doesn’t make you weak or behind. It makes you human. And the fact that you’re still thinking strategically while carrying that weight? That speaks volumes.
You’re right to pause and reflect. Barely passing Level 1 plus lower-than-desired Step 2 practice scores would make anyone reconsider. And there’s no one-size-fits-all here — but a few reframes might help:
First, not taking Step 2 won’t automatically tank your chances — especially if you’re applying broadly to DO-friendly IM programs. There are many PDs who understand the COMLEX pathway and evaluate it fairly. That said, there are some programs that do still prefer or quietly expect a Step 2 score, even if Step 1 is pass/fail. If you skip it, just know that you’re potentially narrowing your list — not eliminating your chances.
Second, if you're thinking about Endo, remember that fellowship applications will lean heavily on what you do during residency — performance, LORs, research, how you show up. A weak or absent Step 2 won’t close the door, but you’ll want to be intentional about what strengths you're bringing into focus elsewhere.
So here’s the deeper question:
Are you avoiding Step 2 because you know it wouldn’t help your story right now?
Or are you avoiding it because of fear — and the thought that a less-than-perfect score would confirm the doubts you're carrying?
Because there’s no shame in deferring a test that doesn’t help your narrative. But there’s also something powerful in choosing to take it, even knowing it might not be perfect — and using it to show resilience, growth, and commitment.
Either way, make sure it’s a decision you can own in an interview. If you skip it, own it with calm, strategic clarity. If you take it and underperform, own that too — and be ready to tell the story of how you kept moving forward anyway.
You’re not behind. You’re in-process.
And many strong physicians have walked this exact path — bumps and all — and still ended up exactly where they were meant to be.
Rooting for you to choose the version of this path that aligns with your values — and gives future-you something to be proud of.
