Best route for plastics after underwhelming step 1 score?

[point542]

---

Members don't see this ad.

Hey all,

Like many before me, I had a **** test day and scored well below my average. Real score was in low 230s. I was/am quite interested in plastics so I have some research in it.

I'm thinking what's the best route if I just want to sack up and keep pursuing it?

1) take a research year and apply integrated plastics
2) go gen surg then fellowship
3) give up on the plastics dream 🙁

any experience or advice here?

 

[Kkshake]

If you truly want plastics, go to one of those medical conferences and network, that's your best bet with a lower score

 

[Kkshake]

Also, with LORs, get them to call rather than just write a letter

 

[AnatomyGrey12]

Hey all,

Like many before me, I had a **** test day and scored well below my average. Real score was in low 230s. I was/am quite interested in plastics so I have some research in it.

I'm thinking what's the best route if I just want to sack up and keep pursuing it?

1) take a research year and apply integrated plastics
2) go gen surg then fellowship
3) give up on the plastics dream 🙁

any experience or advice here?

Why not do a research year, and then dual apply I-Plastics and GS? It's my understanding this is pretty common for plastics applicants.

 

[point542]

Why not do a research year, and then dual apply I-Plastics and GS? It's my understanding this is pretty common for plastics applicants.

This is a viable route as well. I'm mostly worried that I'll put in all this work but just be auto-screened because of my step score.

 

[AnatomyGrey12]

This is a viable route as well. I'm mostly worried that I'll put in all this work but just be auto-screened because of my step score.

Within the last two years I know a DO candidate that matched plastics with a score in that range. So if they can do it... it's definitely possible for you. Now not to say it will be any sort of easy, but the worst case scenario is you dual apply and end up matching GS and go for a plastics fellowship.

Only you can decide if the work is worth it.

 

[7331poas]

Within the last two years I know a DO candidate that matched plastics with a score in that range. So if they can do it... it's definitely possible for you. Now not to say it will be any sort of easy, but the worst case scenario is you dual apply and end up matching GS and go for a plastics fellowship.

Only you can decide if the work is worth it.

ACGME residency? Not a home program?

 

[Dr. Death]

ACGME residency? Not a home program?

ACGME, University program

 

[mistafab]

Gonna be honest dude, that is a low score for plastics.

I know you know that, but you gotta be realistic. Plastics are full of highly competitive applicants that also research and network well. I’d go talk to a plastics advisor at your school and figure out what is possible for you looking at your CV. A meeting now and after step 2 ck + 3rd year grades makes sense. It might make more sense to go the GS -> plastics route since integrated is such an uphill battle for you. 1 research year to dual apply GS + integrated may just delay you a year when GS -> integrated is the only hope.

Again, I’m not expert. I would go talk to your plastics advisor and get their opinion just so you know what you can expect.

 

[7331poas]

How competitive is plastics to get into from general surgery?

 

[GoSpursGo]

Hey all,

Like many before me, I had a **** test day and scored well below my average. Real score was in low 230s. I was/am quite interested in plastics so I have some research in it.

I'm thinking what's the best route if I just want to sack up and keep pursuing it?

1) take a research year and apply integrated plastics
2) go gen surg then fellowship
3) give up on the plastics dream 🙁

any experience or advice here?

~75% of applicants in the 230s matched, but that's out of only 30 applicants and there likely was some selection for people who knew that they had other strengths in their applications that would make them attractive applicants in spite of the step 1 score. Only you can know whether you have the kind of research projects and networking to make going straight to integrated plastics realistic.

Agree that speaking with the PD of your home plastics program would give you better direction and perspective.

 

[7331poas]

~75% of applicants in the 230s matched, but that's out of only 30 applicants and there likely was some selection for people who knew that they had other strengths in their applications that would make them attractive applicants in spite of the step 1 score. Only you can know whether you have the kind of research projects and networking to make going straight to integrated plastics realistic.

Agree that speaking with the PD of your home plastics program would give you better direction and perspective.

How many of those took a research year?

 

[GoSpursGo]

How many of those took a research year?

Impossible to know; Charting Outcomes doesn't really break information down into such granular detail. But the mean USMLE step 1 score was 249, and the mean number of abstracts/publications/presentations was 14.2. If the step 1 score is so far below the mean, I would imagine the research productivity would have to be above the mean, meaning a research year likely would have helped. Or they otherwise have strong networking that is impossible to quantify.

 

[AnatomyGrey12]

ACGME residency? Not a home program?

There are no DO plastics residencies. It was to a large university program that, from my understanding, is very solid. It was a great match.

How competitive is plastics to get into from general surgery?

Again from my understanding, talking with residents etc, is that it’s competitive but not to the level of peds or surg onc and can vary depending on the year. With the advent of the integrated programs GS residents as a whole have less of the plastic surgery type personalities in them than they did.

So not a walk in the park like trauma or transplant but not insane like peds either. Somewhere in the middle.

 

[LoGo]

The GenSx + plastics +/- fellowship route is just so damn long

 

[7331poas]

Again from my understanding, talking with residents etc, is that it’s competitive but not to the level of peds or surg onc and can vary depending on the year. With the advent of the integrated programs GS residents as a whole have less of the plastic surgery type personalities in them than they did.

So not a walk in the park like trauma or transplant but not insane like peds either. Somewhere in the middle.

Do you have a good grasp on what makes a competitive fellowship applicant? For residency its step that is king. What is the equivalent for fellowship out of STEP/LORs/residency caliber/research output?

 

[AnatomyGrey12]

Do you have a good grasp on what makes a competitive fellowship applicant? For residency its step that is king. What is the equivalent for fellowship out of STEP/LORs/residency caliber/research output?

Networking, LORs, and research is what I've been told.

 

[point542]

Gonna be honest dude, that is a low score for plastics.

I know you know that, but you gotta be realistic. Plastics are full of highly competitive applicants that also research and network well. I’d go talk to a plastics advisor at your school and figure out what is possible for you looking at your CV. A meeting now and after step 2 ck + 3rd year grades makes sense. It might make more sense to go the GS -> plastics route since integrated is such an uphill battle for you. 1 research year to dual apply GS + integrated may just delay you a year when GS -> integrated is the only hope.

Again, I’m not expert. I would go talk to your plastics advisor and get their opinion just so you know what you can expect.

That's what I figured. If there is a reasonable chance that I could take a research year and match integrated, I'd be shaving off a year total versus gen surg + plastics fellowship. But if my step score is truly too low, maybe I should only consider gen surg + plastics fellowship.

Still pissed about step lol, was getting high 240s and low 250s on practice exams, but here we are.

 

[AnatomyGrey12]

That's what I figured. If there is a reasonable chance that I could take a research year and match integrated, I'd be shaving off a year total versus gen surg + plastics fellowship. But if my step score is truly too low, maybe I should only consider gen surg + plastics fellowship.

Still pissed about step lol, was getting high 240s and low 250s on practice exams, but here we are.

You already have research in plastics, why not just dual apply as is? At the end of the day it's just money, and dual applying plastics and GS is common, it's not like trying to dual apply to ortho or something. I wouldn't abandon applying to the integrated spots simply because of your Step score.. I mean the match rate to plastics for people in your score bracket in the last 6 years is 78%.

 

[libertyyne]

Dual apply, not to the same institutions. Dont tell anyone. And if you match plastics you match if not , there is always the fellowship.

 

[libertyyne]

Do you have a good grasp on what makes a competitive fellowship applicant? For residency its step that is king. What is the equivalent for fellowship out of STEP/LORs/residency caliber/research output?

I have heard that for IM fellowships step is still considered.

 

[LateNightChef]

Within the last two years I know a DO candidate that matched plastics with a score in that range. So if they can do it... it's definitely possible for you. Now not to say it will be any sort of easy, but the worst case scenario is you dual apply and end up matching GS and go for a plastics fellowship.

Only you can decide if the work is worth it.

Where did that DO student match? As a DO student myself, I've talked to a couple of the DOs in the integrated programs currently but never asked about specific scores. Also, wondering if anyone knows or has heard of the exact Step 1 scores certain programs have as a cut-off for integrated PRS interviews. Thanks!

 

[doyouhaveaflag]

No programs really advertise their step 1 cutoff for screening, but based on word of mouth only a few have the cutoff above 240.

Your chances of matching to an integrated program will be much lower if you do not take a research year. Your med school will also make a big difference in whether or not you will match to an integrated program. If you're currently at a school with a top plastics program and you do well enough on your rotation/with research for someone to make some calls on your behalf, your chances of matching are much better. I personally think it's worth taking the year now to do research and go to a bunch of meetings to network. Put everything you have into trying to get an integrated spot, then if you don't match at least you'll never wonder if you could have done something more.

I'm not sure how competitive it is to match to a plastics fellowship, but the independent programs seem to be increasingly opening integrated programs. Many of the plastics fellows I talked to on the interview trail had done significant research during residency in order to match to fellowship. I did not apply GS backup and the majority of plastics residents (maybe roughly 2/3?) I've talked to about it also did not apply backup. If you're putting 100% effort into matching plastics and you're trying to do 15-20 interviews like most people I met on the trail, it's extremely difficult to put together a decent GS application. You have to do gen surg rotations to get gen surg letters and you have to write a different personal statement. Programs can tell you're applying plastics if you have a bunch of plastics research and plastics letters and no one wants to think they're your backup plan.

Sorry for the meandering post. In summary, I think you should take a research year, network, and do your best to match integrated plastics. You may also want to apply for gen surg, but be very careful about not making it look like your plan B. Have a frank discussion with your PD about your chances of matching.