Can 250+ step 2 make up for 230 step 1?

[Syndicate]

Interested in matching at a top 20-50 IM program but I only got 230 on step 1. I assume the top 20-50 IM programs average around 240 for step 1. Can getting 250+ on step 2 kind of make up for my poor step 1 performance? I have honors in medicine and will likely honor 2 medicine sub-I's prior to applying.

---

Members don't see this ad.

 

[Stagg737]

What does the rest of your CV look like? Do you have any publications or presentations you've done? I really don't know, but I'd guess having some solid pubs on your app might also help make up for the Step 1 score.

 

[Syndicate]

What does the rest of your CV look like? Do you have any publications or presentations you've done? I really don't know, but I'd guess having some solid pubs on your app might also help make up for the Step 1 score.

Yea I have 4 coauthored pubs and 1 first author. Rest of my clinical grades are high pass except honors in family med and a pass in ObGyn. Not involved in any organizations or extracurriculars. Coming from above average allopathic school

 

[Redpancreas]

Interested in matching at a top 20-50 IM program but I only got 230 on step 1. I assume the top 20-50 IM programs average around 240 for step 1. Can getting 250+ on step 2 kind of make up for my poor step 1 performance? I have honors in medicine and will likely honor 2 medicine sub-I's prior to applying.

Absolutely! My school keeps an Excel spreadsheet of who matched IM and what their scores were and I've many 230s Step 1 --> HPs in rotations and 250 USMLE students match into upper tier (not elite) IM programs in the midwest and NE area. I've. talked with many people and they say that a Step 2 can absolutely make up for an AVERAGE (not mediocre) Step 1 performance like yours. Go kill it!

 

[Syndicate]

Absolutely! My school keeps an Excel spreadsheet of who matched IM and what their scores were and I've many 230s Step 1 --> HPs in rotations and 250 USMLE students match into upper tier (not elite) IM programs in the midwest and NE area. I've. talked with many people and they say that a Step 2 can absolutely make up for an AVERAGE (not mediocre) Step 1 performance like yours. Go kill it!

Thanks for the encouragement! Definitely will study hard for step 2. I'm just shooting for any mid/upper mid tier IM programs with no geographic preference so hopefully things work out.


Sent from my iPad using SDN mobile

 

[Gorne]

Absolutely! My school keeps an Excel spreadsheet of who matched IM and what their scores were and I've many 230s Step 1 --> HPs in rotations and 250 USMLE students match into upper tier (not elite) IM programs in the midwest and NE area. I've. talked with many people and they say that a Step 2 can absolutely make up for an AVERAGE (not mediocre) Step 1 performance like yours. Go kill it!

You know average and mediocre are synonyms?

 

[W19]

If you are not planning on applying to a fellowship, I would rethink your plan of applying to IM.

Why?

 

[Syndicate]

I did honor IM in 3rd year.


Sent from my iPad using SDN mobile

 

[iceman55]

The step 1 is not low enough to be out of the cutoff zone for a lot of the upper tier programs, so that should be okay. No honors in IM hurts you with the combo average step 1 score. The things that will decide where you go from here ASSUMING Step 2 CK score 250's:
1a. Letters of recommendation (slight edge)
1b. Reputation of your medical school (this does make a big difference... with a 230 from certain programs you might not be interviewed at the best programs but if you go to an upper level medical school, that alone could make a difference in IM for some reason)
2. Research (looks like you're good here, a lot of people match with an abstract, or abstract+pub to upper tier programs)

It does not exactly "make up" for an average step 1. It just adds to your CV separately. If you got a 260, people will still look at the step 1 separately. I don't think it is so low that it will screen you out as I said before, but some upper tier programs have average step 1's in the mid 240's. If you are not an elite candidate on the academic side, it does hurt that you did not honor your rotation. For example, if you got a 250+ on step 1 but high passed IM, that would be fine, but I still know people who were not interviewed at some places who were otherwise stellar applicants because no honors. This is all assuming that you are targeting an upper tier program. Elite programs are more like top 20; upper tier is like top 35. There are tons of programs at the lower end of the top 50 who do not touch a 240 average, so if that is all you are targeting, you don't need to worry at all. I think if you kill step 2, you will have some nice options in the end to match into whatever fellowship will make you happy. If you are not planning on applying to a fellowship, I would rethink your plan of applying to IM.

I don't know where you are getting the idea that honors in medicine makes such a difference. Yes, i agree its important but does not seem to be deal breaker at top 20 schools. As i know two people applying this cycle who were able to get more than a handful of interviews at those places with mid 240s step 1 and only HP in IM and some research. One got 245 step 1 took step 2 early and ended up with 259. And only had a few HP third year, no honors. He still received like 7 interviews from top 25. Overall it seems like this whole process is a crap shoot, and no one really what will happen.




Sent from my iPhone using SDN mobile app

 

[iceman55]

No, the whole process is not a "crap shoot." I did not isolate honors in IM in any way shape or form in my post. I put a considerable amount of context around it. You knew people: people who scored better than the OP on step 1, considerably better with step scores that are competitive for top programs and you gave no context at all regarding how high ranked the med school is, which does make a difference in IM for top programs. I am getting the idea from being a medical resident and talking to tons of people who applied and matched in IM in a range of competitiveness.

This is coming from a state school in new york, so mid to low tier.


Sent from my iPhone using SDN mobile app

 

[W19]

General and hospitalist medicine both suck. The picture that it tries to paint of being a cerebral field where you can think through the problems, consider the pathophys, and really give time with the patients is false. It may have been that in the past. The majority of the time is spent behind a computer writing notes and trying to get **** done as soon as possible. Even the attending hospitalists are like residents who get paid more. Gen med is boring... some people can like it I guess, it has a decent lifestyle, but I find it really unrewarding: you have to deal with a lot of bull**** all the other fields will push on you. I can go on and on about it. Most people who match into the top tier IM programs are just brave enough to do an IM residency so that they could specialize in whatever field they actually want to do. I truly think most people who don't specialize regret it at some point.I mean 90% of the IM interviews are basically discussion about what specialty you actually want to do and how that program can help you get to that field. It's like medical school again lol. I don't regret anything. This is not me being jaded or bitter. I knew this is what the deal would be when I applied to IM, and I'm okay with it.

Sadly, I agree but my step1 score and lack of research will not allow me to pursue something 'better'... I guess will do IM and then ID...

 

[Goro]

See page 44. Step 1 = Step 2 in terms of importance.

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

Interested in matching at a top 20-50 IM program but I only got 230 on step 1. I assume the top 20-50 IM programs average around 240 for step 1. Can getting 250+ on step 2 kind of make up for my poor step 1 performance? I have honors in medicine and will likely honor 2 medicine sub-I's prior to applying.

 

[Redpancreas]

You know average and mediocre are synonyms?

Whoops. Well, should have said average, not poor.


Sent from my iPhone using SDN mobile

 

[Syndicate]

See page 44. Step 1 = Step 2 in terms of importance.

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

As a school faculty, do you feel like Step1=Step2 in terms of importance is really the case for IM?


Sent from my iPad using SDN mobile

 

[Tenk]

Nothing "makes up" for anything. Everything has different importance. In the past, the answer to this would have been laughable since most people didn't even take step 2 until much later fourth year and it didn't even matter much. This is no longer the case and step 2 is much more important. Currently I would say step 1 is still more important than step 2 but only slightly. It is not as big a difference as it once was. When I talk to PDs it's always the step 1 they recite, I dunno if this is out of habit or what. But! An upward trend for a step 2 is great and definitely looks good. It still won't "make up" for your 230 since someone out there has a 250+ in both. This is why you need to figure out all the parts to the application and do your best to maximize each part. Your step 1 score is set in stone. It's best to stop thinking about it and focusing on improving everything else you can on your application and do your best to network (Very important!) By doing so you will increase your chance of a successful match. Good luck.

 

[Goro]

I can't comment on this since I am not a PD or a resident. Thus, I defer to my wise colleagues like Tenk on that score.

No single metric anywhere in the medical education process, including admissions, will salvage something else that is substandard. You have to look at the entire package.

For whatever it's worth, I remember seeing a survey that showed that ACGME PDs in the more competitive specialties were more willing to accept COMLEX II than COMLEX I!

As a school faculty, do you feel like Step1=Step2 in terms of importance is really the case for IM?

Nothing "makes up" for anything. Everything has different importance. In the past, the answer to this would have been laughable since most people didn't even take step 2 until much later fourth year and it didn't even matter much. This is no longer the case and step 2 is much more important. Currently I would say step 1 is still more important than step 2 but only slightly. It is not as big a difference as it once was. When I talk to PDs it's always the step 1 they recite, I dunno if this is out of habit or what. But! An upward trend for a step 2 is great and definitely looks good. It still won't "make up" for your 230 since someone out there has a 250+ in both. This is why you need to figure out all the parts to the application and do your best to maximize each part. Your step 1 score is set in stone. It's best to stop thinking about it and focusing on improving everything else you can on your application and do your best to network (Very important!) By doing so you will increase your chance of a successful match. Good luck.