board scores

Another thing you must consider is, California is really two places.

What I mean by this is that coastal programs (i.e. close to the ocean in LA, SF or SD) are going to be much more competitive than desert programs.

Thus, if you apply to Fresno or Bakersfield, two very HOT places, you'll have less competition than if you apply to, say, UCSF.

If you really want to go to California, and if you really want to be close to the coast, look at the Kaiser programs. (I think there are three locations for Kaiser hospitals). These programs do NOT have a good reputations, and consequently, they are less competetive. No offense to those who may already be in these programs.

 

There are also alot of community hospital programs in CA, which are on average less difficult to get into, although there still are some pretty competitive community programs (Santa Clara Valley Hospital is coming to mind). The academic programs are on average much more difficult to get into, especially since there's not very many of them, but their level of competitiveness is still highly variable. There are a lot of Kaiser programs, which are less competitive to get into -- there are 3 in NorCal alone (SF, Santa Clara, Oakland), and there are some more I think in SoCal. I would suggest looking into the community hospital programs and Kaiser programs -- while some are very competitive, others are easier to get into, especially in the specialties that you mentioned. Also, still look into some of the university-affiliated hospitals, especially in Southern California (there are more there).

The good thing is that the specialties that you mentioned you have an interest in are not as competitive. As Kimberli said, they look at the rest of your application as well -- from outside activities to letters of rec to how you did in your clerkships. If the rest of your application is good, you shouldn't have too much of a problem getting into a CA residency.

 

As a graduate MD with USMLE scores of 246 on Step 1 and 248 on Step 2, and class standing in the top 5% in a highly esteemed medical school, I can tell you that high scores and ranks CAN mean very little and that low scores and ranks WON'T EXCLUDE you as long as you PASS!

I know bottom of the class MD's who barely passed both Step 1 and 2, who also took 5 or 6 years to finish a 4 year program, that have prestigious residencies (opthalmology, dermatology, surgery, orthopedics) because they were ultimate scutmasters with great personalities and attractive features. They did well only in 3rd year, because they played the game.

Conversely, the serious medical intellectual like myself and many others I've known may be held back without such scutmaster and personality skills. You won't know what happens until you try it, so my advice is to play the game, be likeable, just PASS your exams and boards, and work hard as hell while in the hospital. I'd trade my grades and scores anyday for the ability to be able to endure long hours and call while maintaining fast manual skills such as drawing blood, inserting NG tubes, spinal taps, intubations, and the like.

This is not to say that high grades and board scores are not good--it is to say that they won't carry you by themselves, and won't exclude you if you have the other qualities. Of course, I can remember one of the residency directors interviewing me and telling me that his program had found that the only correlation between board scores and success as a resident was that lower board scores meant better resident performance and that higher board scores meant lower resident performance. I wish I had been tape recording his statement to expose him.

Good luck to you and by all means, remember that getting a residency is primarily a numbers game--apply to 15 programs and you're almost certainly guaranteed to get one of them. I thought my academic records would get me anything I wanted, and so applied for only 2 programs in 1 big city, and got screwed. I'll never make the mistake again of thinking that high grades and board scores guarantee anything, and in the future, I'll devote my time to learning practical manual skills and political games, and just pass the exams without even studying.

Dr. Morgus

 

I agree with the above...once you start doing your rotations you'll find out that grades don't make the difference. I've found out that a lot of people look at how hard you work, how well you work with other people, do you have some common sense, and are you responsible. Plus, another thing you'll realize is the political side to medicine. People with connections have it easier. A lot of people in my class have a relative whose a doctor or residency director and so they work the network and they end up getting things when you don't think they are as qualified as they should be. Plus, grades during the 3rd and 4th years are a joke. They are so subjective. If the doc loves you then you get great grades no matter how smart you are. If he's an dingus then no matter how hard you try you'll get crap. I think they're called "inflated grades" Its best to get good rec letters from doctors in the field you want to go into and just put in the extra hours during your rotations.

 

I agree completely with Morgus. I would have never believed what he wrote was true before I went thorugh the application process and match.

Having good grades and board scores is just a small part of a succesful application for a competitive field. It is more important to have great letters, show some serious interest in the field (research, volunteering, etc.), Have a great personality and work ethic, have the ability to kiss ass very well but not obviously (perhaps the best quality), and communication skills.

 

I disagree with the above sentiments re. the lack of importance placed on grades & board scores. After having seen & participated in how applicants are "triaged" during the application process to a competative residency program, grades do indeed play a huge part of how a program evaluates you before and after you arrive. Class rank & board scores are some of the only ways to objectively look at large groups of applicants, and at many places they will determine whether you get an interview or not. For some competative subspecialties, you will not get an interview with USMLE step I scores below some cutoff unless you have rotated there or are a student from there.
With interviews in competative specialties @ competative institutions everybody will have GPA's & board scores in the high range. Letters of reference are usually ignored unless they are from a prominent name,a prestigious program, or a friend of the chairman/program director.
What does stand out & is coveted by programs is a CV with multiple publications.


In re. to some of the above who did not match with outstanding USMLE score/class rank... The only people who I have heard of not matching somewhere with numbers like that are people who applied for
1. Orthopedic surgery
2. Integrated Plastic Surgery programs
3. Dermatology

Was this the case with yourself???

As far as not ranking more than 2 programs in
your match list.... This happened to several friends of mine, all of whom will tell you they ignored multiple warnings about how you should not do something like that with the match & blame themselves for their own stupidity. Luckily, things all worked out for them eventually, but they had to either change subspecialties or take an extra year to finish their training.

 

dr. oliver,

I agree with you that board scores and grades are crucial for getting an interview. After that the things that I mentioned are the most important. It is difficult to distinguish amongst the applicants who recieved an interview based on grades and scores (most have very similar academic records). Therefore the other factors come into play that I mentioned.

 

Great board scores and grades will always GET you an INTERVIEW. They DON'T GUARANTEE snything. I've seen lots of students get an interview in ophthalmology, orthopedics, radiology, and surgery with board scores in the 180-200 range (minus 1 standard deviation to mean) and class standing in the 3rd or 4th quarter of the class. Those people worked hard in their 3rd year, kissed ass, and MOST OF ALL, in my opinion, RESEMBLED PHYSICALLY AND IN MANNERISMS, PERSONALITY, DRESS, ETC., ATTENDINGS AND RESIDENTS ALREADY IN THOSE SPECIALITIES.

One of my close friends got a 180 on Step 1, failed Step 2 once before getting a 181, and was 194/205 in the class. He got a top ophthalmology spot. But he was a classy dresser, "looked like an ophthalmologist", ordered gourmet dinners delivered to his team when on call (my idea for him), and "sounded intelligent". He privately admits to me, now that he's in his 3rd year of ophthalmology, that he's completely outclassed by his peers, and that he's considering switching to FP because he feels like he's just not talented enough to not make mistakes. He's very uncomfortable with any surgery. When he got ophthalmology, we felt like the joke was on the system. Now, he feels like the joke is on him. I wish I had advised him to take something that he could do well.

I have another close friend who failed 2 years which he repeated, barely passing. He failed Step 1 twice, finally passing the 3rd time with a 183. He failed Step 2 the first time (after he got matched in March of that year, so no one knew it was going to be a failure) and has never taken Step 2 again yet. He got emergency medicine in one of the very best programs in the country. Why? Because he was the ultimate scutmaster on his 3rd year and 4th year guest rotations in trauma. EM. and surgery. He is closing in on finishing his 4 year program in EM, and is worried about how to pass Step 2 first. Yet, in his case, he really is a terrifically gifted EM doc. I'd trust my life to him anytime.

Now, there are also lots of smart people with high boards and high grades who have gotten ortho, ophthal, ENT, radiology and the like. But the above stories go to show that there are flagrant exceptions to the rule, and that nothing is certain.

My final story: When I tried to get radiology with my Step 1 = 246 and Step 2 = 248 and top 5-%ile class standing, I got knocked out in the 2 programs that I applied for by students from my school ranking 120/205 and 138/205, that had board scores on both I and II of 198-205. (It was common knowledge that such programs try to take only 1 person from each med school to achieve "balance".) One of them was a terrific golfer; he used that to socialize when he was doing a guest 4th year rotation at the program that took him. The other "looked and talked like a radiologist already" according to the program that took him. We were both at a lunch with radiology when they said that about him. I visit them occasionally to help them read films, and yet I'm out for a year doing research.

My biggest 2 mistakes: assuming that my terrific academic profile would guarantee me either of the 2 programs, and then only applying to the 2. I'll apply to 15 next time.

Perhaps the other thing to remember is this: I don't choose my friends based on their grades and boards, and perhaps residencies think the same way. I'm taking golf lessons as insurance.

 

Jeeezus H Christ, man!!
That puts you way over 95 on both steps!
YOu could get into NASA with those scores!!!

Anywayz...too bad you didnt get radio..did you do a 4th year rotation????

My father also had the same problem...He had stellar boards and was #1 in his class, but it didnt guarantee him jack...

Moral of the story?
I dont know...learn golf?..kiss ass like a freak?...
I think probably, a history of Radio rotations would help a lot, and shows that you are serious about it...im willing to bet you never did one..
anywayz..good luck in research

 

To Dr_Joyce_Brutha. . . I did 4 different senior year rotations in radiology, and the last 2 of them were at the 2 programs I applied to, in Oct & Nov. I had hired radiology residents as tutors privately since I was a MS-1, and by the time I was on my 2 audition rotations, I could read as well as the 2nd year residents. Maybe that was the problem. . .I might have been pissing people off since I was such a gunner at reading, when everyone else was just playing the "nice" game. I'll never act like a gunner again--I'll just shut up and smile and let others answer questions. Anyway, I'm applying to 15 or more programs of various fields next time, and still feel a bit paranoid. Maybe I should marry into the right family.

Best wishes to all,
Dr. Morgus

 

I don't know...this reads like a big pile of bs, Morgus...how could someone like yourself not match into the specialty of your choice...It just does not make any sense to me...In addition, how could someone with such a low class rank and board scores get such highly competitive residencies...I know you stated your cases and all...However, it's just too hard to believe

 

Maybe when it came down to common sense Morgus was kind of lacking. Someone with "intelligence" should have realized that you don't just apply to 2 programs. If you rotated at 4 different sites, why didn't you just apply to the other 2? Its your future and something that serious should have been handled with a lot of care. It is a hard story to believe but there are people out there that don't make any sense.

 

Good points. Also, repeatedly mentioning things like "my Step 1 = 246 and Step 2 = 248 and top 5-%ile class standing" and "my terrific academic profile" tends to come off sounding fairly pompous and arrogant. Trying to show people up is another way to cause yourself to be disliked. When you are disliked for these reasons, there are no boards scores high enough to compensate. Morgus, you are obviously fairly jaded and a self-admitted "gunner," but it would be much better to stop thinking other people are simply being "scutmonkeys" or "kissing ass," and instead consider that maybe they are very hardworking people who try their best to impress others without appearing self-righteous and arrogant. A positive attitude with humility go a long way when dealing with people. Just some friendly advice.

 

yeah..ive heard of people with "malignant personalities" being rejected despite stellar scores...Maybe Morgus was just too much af a gunner...

 

I'm sorry but I'm calling BS on Morgus
for numerous reasons

1) there are too many people with 248 on step one on this site........it is utterly preposterous considering less than 300
people every year (~1% of the approx 30k who take step 1) make that score....odd that all 300 of them post on this site and like to talk about their scores
2) how the hell does playing golf figure into this equation....I don't know alot of attendings at top academic programs and medical students who have enough free time (let alone enough overlapping free time) during the day to play 18 holes...so while they might have something interesting to talk about I doubt they sped up afternoon rounds to head out to the driving range together
3) people who have enough money to afford medical school and gourmet meals for all the residents usually pass on medicine to live off their parents or take over the family fortune......hell with my loans I cant afford to share a large bag of Fun-yuns with the residents
4) your buddies who failed the boards would not have ever gotten a second look at anywhere decent in optho unless they were married to the dept chairs daughter......just like med school admissions.....jesus christ himself would get a rejection if his numbers didnt clear the computer....despite his extensive publications regarding the treatment of m. leprae
5) a good lie is based in plausibility whilst youre dabbles in the extreme....lets just say that most individuals who fail a year of school dont end up training at MGH

even if this is true my explanation for why you didnt match is that while I don't know you....you sound like alot of whiny people I know.....everything has a excuse that doesn't involve you......experience has taught me that most attendings cant stand whining.....

 

Hello. Let me say that I have no animosity for anyone here. I'd like to clarify things.

My purpose in making my original post was to encourage those medical students who think that they can't get ahead because they have average or below average grades and board scores. It was also to warn others with high grades and scores not to simply depend on them to get any difficult goal whatsoever.

I can assure that I'm not seen as malignant by my many friends and patients. I wasn't good at manual skills in 3rd year, but I was great with patients as well as with diagnosis and treatment plans. But then I knew I wouldn't be going into surgery or some manual procedure oriented field.

The people with the low board scores and grades that I spoke of are some of my closest friends. The gourmet meals thing was actually my idea for my friend. Yes he has family money, but also wants to be a good doctor.

These friends encouraged me to write about them anonymously to help others get ahead who may be in their positions. They further encouraged me to write anonymously about myself to warn others in my position not to assume anything.

I wanted radiology because it has easy call and (excepting interventional rad) is not procedure oriented. I also love reading films. There are only 2 programs in the home town city where I live. My girlfriend also lives here and cannot move because of her career. My dean and professors and friends advised me that I could have my cake and eat it too in terms of only choosing 1 speciality and only choosing 1 city. As it turns out, nothing could have been further from the truth. In retrospect, I should have had a lot of alternate choices in easy to get things like psych and FP and medicine, or whatever fields, since my biggest goal was to stay in the city where I am.

I felt struck by lightning when I didn't match, and didn't want this to happen to anyone else. It actually happened to another friend of mine with similar academic record who was also trying to go to only 1 city, albeit another 1 besides mine. He wanted surgery, ranked the 4 choices in that city for surgery, and didn't match either. Neither of us want this to happen to others.

Reiterating, we also don't want those without stellar performance to give up on the field of their dreams. This entire exposition was meant to help everyone else.

The only thing that I really complain about is that the whole med school system reinforces us for top grades and board scores when in fact it might be more interested in some other, more important qualities. If that is the case, they should stop the hypocrisy, make everything pass-fail, and let everything be based on written evaluations, like it is in other real world jobs.

By the way, all the numbers on scores, etc. for my friends and me are true. I can't post their records, but I just may make available my records for those doubting Thomases. Not to rub a nose in it, but to show that the real system is a lot more complex than the "cosmetic system" we are meant to see.

I hope we all become great doctors and live in peace with each other.

Best wishes to all,
Dr. Morgus

 

Thanks for your candid advice Dr. Morgus, I am a second year medical student and I agree with many of your statements. I actually worry that I will have mediocre scores but lose so many points on the personal level with attendings (I tend to get nervous around authority figures) that I will not be able to get into any residency program regardless of how many I apply to. Best of luck in the future.

 

hmmmm..morgus is tough to figure out...BS or not?

 

Joyce,


For once, give up on flaming people...it appears that someone is only trying to give out good advice and I would take it as that.

 

Dr Morgus

Your insight is very encouraging to those average students. I do hope that matched in a PGY1 position. Are you from the Detroit or New Orleans, Morgus family?

 

Well, PlatinumDoc, I see that someone knows the origin of my pseudonym here. Momus Alexander Morgus MD, eccentric graduate of Tulane Medical School in 1857, lives on past his years of TV fame. The original Morgus show started in New Orleans, where I'm from, and spread to a number of other cities. I didn't know it hit Detroit. It's too bad that most of the syndicated episodes are from the politically correct 80's, because the ancient B/W episodes from the late 50's and 60's, copies of which are owned by a friend of mine, are much closer to my taste. In fact, you might say that the original Dr. Morgus inspired me to want to go into medicine, although I'm not sure that he understood "primum, non nocere" (LOL). Only you PlatinumDoc, and others of our genre, will know what I'm talking about here.

Now a question for you, PlatinumDoc. . .is your moniker related to your practicing a "platinum" standard of medicine above the usual "gold". . .or is it related to something else? Feel free to reply privately.

I'm happy to see that my true intentions in making my experiences public are beginning to be realized.

Best,
Dr. Morgus

 

If I can ask a question....

I got an MS and an MBA before I started medical school. Does anyone have any ideas on whether these experiences will be advantageous in my quest to procure a competitive residency position? I'm confident that they wont hurt me, but am curious as to just how much they will help.

 

Hi Yigit,

I have an MSEE as well as MD. I talked to a lot of others with master's and doctoral level degrees as well as the MD (or pending MD/DO) and the consensus seems to be that residencies are 98% looking at what kind of team player doctor you are going to be.

The trouble with any bachelor's or master's degree is that it is completely overshadowed and trumped by any doctoral level degree, no matter how relevant or useful it is. Although my background in electrical engineering should be thought of as useful in radiology, it wasn't. I have 2 friends, one with an MS in geology and the other with an MS in biology, and both tell me that it made little or no difference to them, as they only got their 4th and 6th choices on residencies, respectively. I have another friend who has an MBA and worked in the financial section of an oil company, and he told me that he was advised to de-emphasize his business background and to focus on MD interests and motivations.

This is a piss off to me, because "the system" is always mouthing off about wanting "diversity of experience", and yet at the residency level doesn't seem to reward for it. I will say that med school admissions do seem to be favorably influenced by such diversity of backgrounds, however. At least they put their money where their mouth is there.

My MD/PhD friends have a mixed experience. If the PhD is in a life science such as biochemistry or microbiology, it can be a considerable advantage, since a residency program would probably expect you to contribute to their research paper output in some way. If the PhD is in engineering or a physical science, it may or may not make a difference in this sense. There was a person in my med school class with a PhD in nuclear physics who worked in the nuclear reactor industry, and he said that he was looked on as smarter because of it, but not as having anything to contribute (hey residency director dudes, ever hear of radiology or nuclear medicine?) If the PhD is in a humanity, it seems to make no difference at all, which I think is a total crock. I saw Nobel prize winner Eric Kandel MD PhD interviewed on TV last week--his Harvard PhD (which he got before his MD) was in European Literature. It didn't seem to hurt his career in neurobiology!

There was a JD lawyer in my med school class, but she would never talk to anyone about anything, so we know almost nothing about her experiences. Probably afraid of potential liability in litigation, LOL. I do know that law schools and MBA schools and other graduate schools love to get MD's for their classes, however. No one ever called an MD lazy.

I think that all of us will find that the MS or MBA we have may not benefit us a whole lot in getting a dream residency, but that if we wish to work in private biotech industry, pharmaceuticals or management in either these or the hospital or med school system, that they will be of considerable advantage.

Best,
Dr. Morgus

 

While I am in no way trying to discredit the good Dr. Morgus, I would like to point out to everyone that the examples he has given are incredible outliers, statistical improbabilities. And thats the trick here, overall its a numbers game. No single aspect of your application, nor an entire application good or bad can guarantee you anything when it comes to the match. Any given criteria can only enhance or diminish your chances. This means of course that given a large enough pool there will be times when people "defy the odds". And while what happened to Dr. Morgus and Co. seems to be impossible, it is merely very improbable. But still, with thousands of medical students graduating every year, at some point what happened to his friends and he was bound to happen. And so it did.

The point is that what happened to Morgus is unlikely to happen to any of you, but it it COULD happen (as he said). So don't give up hope, or don't give up in general. The only way to guarantee that you don't get a residency is to not apply for it because you think you are under qualified. Always try for what you want, but be prepared to get something else just in case. That was Morgus' mistake, something he admitted to.

Now from the experience of my friends I would say that board scores do matter. There are national averages, cut off points, and all sorts of things that prove this to be so. But the bottom line is that wherever it is that you are trying to get to, you are going to have to go through people to get there. And while numbers can impress, if they just "don't like you", you're screwed. Or if they really like you, you've got it made. Numbers be damned. The Doc's that make the call on residents, and thats what it is... Doc's sitting at a table... are real people, and like real people they are going to like you or hate you. And whether you like it or not they get to judge you, subjectively, and decide your fate depending on the impression you've made. Banking on any one aspect of your resume or personality to make the impression you want is likely to totally screw you. Best come with a complete package. So be nice, be on time, dress well, fly under the radar, kiss some ass when it needs to be kissed, and study for your tests.


Tiger

 

Why dig up a thread from 2001? This should be closed. Since you're a noobie I won't rip into you.