Can a KILLER Step 2 Make Up For a Good Step 1 in Competitive Fields?

[surfguy84]

Title should say, competitive fields or competitive programs.

Basically, I got low 240s on step 1, which I totally recognize is a good score. Though, probably not good enough for some of the most competitive things as a DO. Would a 260s step 2 be a big help and open doors or not so much?

Basically, I want to figure out if I should go all out and study like crazy for step 2 or do the regular stuff and just be happy with a similar or slight increase in score.

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[W19]

low 240 is a pretty good score IMO... Let's just assume you get 265 in step2, which is entirely possible. Will that make you competitive for derm, neurosurgery, ophthal, urology, ortho, plastic, interventional radiology etc in the ACGME world...? It's tough to say.

It seems like there is a ceiling (gen surgery) for DO in the ACGME world. Yeah, I am sure someone has a story about a DO who matched derm at UPenn, but most DO students should not count on penetrating the 'big ticket items' in the ACGME world.

However, I think that score along with a good step2 will open doors to some solid IM/EM/Gen surgery/Radiology etc... programs in the ACGME world...

 

[Rekt]

At the top, it isn't your numbers that is the barrier, it is your initials.

 

[AnatomyGrey12]

So interestingly enough I have done some digging and networking and have seen the profiles of some of the “wow” DO matches from the last few years, a lot of the matches had Step 1s in the 240s. On derm match in particular was low 240s. Once you hit a certain level on boards it becomes about how much you look like an MD applicant (ie RESEARCH) and if you’ve networked and have some people going to bat for you. Being a normal, cool person on aways and at interviews plays a role as well. And as always, be a tad lucky.

Edit: I should add for general surgery you will have good success if that’s why you are looking for, although mid-tier University is probably the realistic ceiling being a DO applicant.

 

[zero0]

So interestingly enough I have done some digging and networking and have seen the profiles of some of the “wow” DO matches from the last few years, a lot of the matches had Step 1s in the 240s. On derm match in particular was low 240s. Once you hit a certain level on boards it becomes about how much you look like an MD applicant (ie RESEARCH) and if you’ve networked and have some people going to bat for you. Being a normal, cool person on aways and at interviews plays a role as well. And as always, be a tad lucky.

Edit: I should add for general surgery you will have good success if that’s why you are looking for, although mid-tier University is probably the realistic ceiling being a DO applicant.

I wouldn't read that much into it. Those people are likely either directly related to the PD or married to their daughter.

 

[AnatomyGrey12]

I wouldn't read that much into it. Those people are likely either directly related to the PD or married to their daughter.

But they aren’t. SDN is way over the top when it comes to competitive specialties, the problem is exactly how few DO applicants actually look like an MD applicant on paper.

 

[sab3156]

Adding to this, it really helps to have strong mentorship in your field of interest. Especially as a DO.

 

[ThreeCheers]

So interestingly enough I have done some digging and networking and have seen the profiles of some of the “wow” DO matches from the last few years, a lot of the matches had Step 1s in the 240s. On derm match in particular was low 240s. Once you hit a certain level on boards it becomes about how much you look like an MD applicant (ie RESEARCH) and if you’ve networked and have some people going to bat for you. Being a normal, cool person on aways and at interviews plays a role as well. And as always, be a tad lucky.

Edit: I should add for general surgery you will have good success if that’s why you are looking for, although mid-tier University is probably the realistic ceiling being a DO applicant.

This is something I feel like SDN gets really wrong. Step 1 is important, but it isn’t everything. A 260+ may look sexy, but it doesn’t entitle an applicant to a higher rank than a 240+ with an all-around impressive CV. Research and strong connections are key in competitive and surgical fields.

 

[surfguy84]

I'm mostly interested in psych, EM, gas. I did enjoy my optho rotation, but I'm not holding my breath for that. I'm mainly hoping to get into a more competitive program/better location. I don't enjoy research at all, which I realize hurts for optho, but probably not much at all for the other three.

 

[sab3156]

I'm mostly interested in psych, EM, gas. I did enjoy my optho rotation, but I'm not holding my breath for that. I'm mainly hoping to get into a more competitive program/better location. I don't enjoy research at all, which I realize hurts for optho, but probably not much at all for the other three.

The biggest thing that will keep you out of Ophtho is the fact that PDs will throw out your app when they see you spelled it "Optho".

OP, I say this after talking to tons of residents/fellows, as well as PDs and chairs of departments at some of the top hospitals in the country -> the only thing that will reliably make a DO competitive at the elite programs is a phone call from an influential person in the field. Other than that, you're playing with a pretty bad hand.

 

[Goro]

Title should say, competitive fields or competitive programs.

Basically, I got low 240s on step 1, which I totally recognize is a good score. Though, probably not good enough for some of the most competitive things as a DO. Would a 260s step 2 be a big help and open doors or not so much?

Basically, I want to figure out if I should go all out and study like crazy for step 2 or do the regular stuff and just be happy with a similar or slight increase in score.

Where is the wise @aProgDirector when you need him????

 

[NotAProgDirector]

Where is the wise @aProgDirector when you need him????

Sucked into the black hole vortex of resident recruiting...

There's no answer to the OP's question, exactly. A higher step 2 score will help on many levels -- it will make you more competitive in all fields. perhaps it opens Ortho doors, or perhaps not. But any doors that are open (IM, gas, rads, etc) are open wider because of the better score. I agree that if you're interested in the most competitive fields, a "good enough" score is needed, and after that you need mentorship / research / connections.

IMHO, one of the biggest problems that DO's face is that it's very hard to assess their training. I interview a handful of the nest DO's that apply, and we regularly match a few. I've reviewed lots of DO MSPE's and LOR's. It's not uncommon for a DO MSPE to say: Internal Medicine - High Pass. "Student Dr. XXX worked really hard and was well liked." End of story. 1 or 2 line comments like this are the norm. On the allo side, the IM clerkship would come with multiple paragraphs of description and feedback. I often can't tell if the DO did an inpatient or outpatient experience, how much autonomy they had, or whether they worked with residents in a teaching program. if that's the case, the ONLY thing I have to go on is exam scores, and track record of previous grads of the school.

So:

Get the best Step 2 score you can. If you're the kind of person who lazily does enough to get by, I have no interest in you.

For DO's in general, a rotation at an institution that hosts MD/Allopathic students that gives you an LOR is invaluable.

 

[ortnakas]

I've reviewed lots of DO MSPE's and LOR's. It's not uncommon for a DO MSPE to say: Internal Medicine - High Pass. "Student Dr. XXX worked really hard and was well liked." End of story. 1 or 2 line comments like this are the norm. On the allo side, the IM clerkship would come with multiple paragraphs of description and feedback. I often can't tell if the DO did an inpatient or outpatient experience, how much autonomy they had, or whether they worked with residents in a teaching program. if that's the case, the ONLY thing I have to go on is exam scores, and track record of previous grads of the school.

I have gotten positive feedback about my LORs, but I have no idea what’s in my MSPE/Dean’s Letter. Based on the pretty brief evaluation forms my school has, I don’t doubt that what you’re saying is true. I had never realized how that could come back to bite us for residency applications; I wonder if our deans/clinical deans are aware of it.

Not to say that 100% of my rotations have been awesome; most have been solid though. But if all you have to go on is internet rumors I couldn’t blame you for thinking I probably didn’t see/do much, and it sounds like even just a few extra lines on our eval forms (and thus the MSPE) might help rectify that.

 

[apr27]

Sucked into the black hole vortex of resident recruiting...

There's no answer to the OP's question, exactly. A higher step 2 score will help on many levels -- it will make you more competitive in all fields. perhaps it opens Ortho doors, or perhaps not. But any doors that are open (IM, gas, rads, etc) are open wider because of the better score. I agree that if you're interested in the most competitive fields, a "good enough" score is needed, and after that you need mentorship / research / connections.

IMHO, one of the biggest problems that DO's face is that it's very hard to assess their training. I interview a handful of the nest DO's that apply, and we regularly match a few. I've reviewed lots of DO MSPE's and LOR's. It's not uncommon for a DO MSPE to say: Internal Medicine - High Pass. "Student Dr. XXX worked really hard and was well liked." End of story. 1 or 2 line comments like this are the norm. On the allo side, the IM clerkship would come with multiple paragraphs of description and feedback. I often can't tell if the DO did an inpatient or outpatient experience, how much autonomy they had, or whether they worked with residents in a teaching program. if that's the case, the ONLY thing I have to go on is exam scores, and track record of previous grads of the school.

So:

Get the best Step 2 score you can. If you're the kind of person who lazily does enough to get by, I have no interest in you.

For DO's in general, a rotation at an institution that hosts MD/Allopathic students that gives you an LOR is invaluable.

I found this out too from talking to PDs regarding DO applicants. YMMV of course, but I've found there to be a disconnect from our school and our clinical years relative to our preclinical years. I think it's important thing to address this "concern" with the your school's admin or at least when our preceptors are writing our evals. Regardless, I just wanted to bud in a little bit, because I think every DO applicant should be aware of this.