Can a stellar Step 2 make up for Step 1?

[MSRunner]

I've heard that many orthopedic residency programs employ cutoffs and I am worried that my 234 on Step 1 will screen me out of interviews. (Everything else on my application is very strong). Could a Step 2 of 250+ effectively negate this, or do program directors ignore the Step 2 scores?

(More info: I actually was expecting something much better for Step 1 based on NBMEs and such, but I was awake for 24 hours before starting the exam due to stupid nerves. I'm doing fairly well on my shelf exams in 3rd year (range 85 -98 for percentiles) and believe that I could translate that into a good Step 2 score).

 

[Stellar Clouds]

Yes a very good step 2 can make up for your step 1 score, but to play it safe, I would recommend applying to most if not ALL of the orthopedics programs.

If you check out NRMP Charting Outcomes, you'll see that 87/121 people in your step 1 score range matched, so you definitely have a good shot still.

 

[MSRunner]

Thanks for your reply. As a follow up question, would it be advisable to take a year off to do more research and nail the step 2 in the process? Other than my step score, my application would certainly hold its own, and there's a part of me that still believes that I should pursue the best residency programs I can.

 

[Stellar Clouds]

I would stay stay from taking a year off. You will just have to explain yourself on every interview. Instead, apply for away rotations at top tier programs and bust your a** off and get great letters.

 

[AlexMorph]

It can curb the damage but no way can it completely overcome a low Step 1.

 

[mimelim]

I've heard that many orthopedic residency programs employ cutoffs and I am worried that my 234 on Step 1 will screen me out of interviews. (Everything else on my application is very strong). Could a Step 2 of 250+ effectively negate this, or do program directors ignore the Step 2 scores?

(More info: I actually was expecting something much better for Step 1 based on NBMEs and such, but I was awake for 24 hours before starting the exam due to stupid nerves. I'm doing fairly well on my shelf exams in 3rd year (range 85 -98 for percentiles) and believe that I could translate that into a good Step 2 score).

1) A step 1 score of 234 is not low, even for Ortho. 72% of students with that score matched Ortho 2 years ago with a 234 and that is all comers, including the people with nothing else on their app besides a step 1 score.
2) Do not take a year off. You should never take a year off unless you have something specific planned. It is a waste of your time. The marginal benefit of doing ortho research or something else is vastly outweighed by the time you lose.
3) A step 2 score is never going to out weigh a step 1 score. It is really silly and archane, but that is the process that we have. Will it help, of course, a better score will always be worth it, but it will never 'make up' for a low step 1 score.
4) Step 2 scores are very program specific. Some care about it, some don't. Some don't even require it prior to matching. If you have particular programs that you are interested in, I'd ask in the ortho forum here or talk to people from your school applying this year since they all should have finished their interviews by now.

 

[OrthoPod57]

234 is not real low, but it's definitely well below average and will barely miss the step 1 cutoff for some programs (some use 235 or 240). You definitely NEED to rock step 2 and have strong letters, research, work hard in aways, etc. if you want to get a lot of interviews. Some programs love to see high step 2 scores because the in fact correlate better with OITE performance than step 1 scores. Other schools could care less about step 2. The problem is you don't know which schools do this so yes you definitely need to apply broadly.

My case study:

Mid tier MW state school
Step 1: mid 230s
Step 2:mid 260s
Several pubs (2 first author)
Strong letters from top tier ortho rotations
Applied: 70s
Interview offers: 31
Attended: 16
Matched at: Nowhere yet, we'll see in a few weeks

Hope that helps. Ball is in your court. I don't think you need a year off but more and more are doing that.

 

[MSRunner]

Thanks everyone for your input! OrthoPod57, I find your "case study" to be particularly encouraging. What part of your application do you believe was most responsible for eliciting so many interviews?

In terms of a year off, I'm currently involved in three separate research projects involving a new medical device, clinical research, and improving/revamping the anatomy curriculum. My PIs are all the head of their departments (joints, spine surgery, anatomy), and have expressed interest in having me take a year off so I can make sure to continue and finish these ongoing projects with them. If I DID take a year off, that would give me an opportunity to 1) produce more awesome research 2) have strong letters from well-known faculty and 3) way too much time to study for step 2.

Honestly, I probably don't need any extra research experience (I have 5 publications already with 5 more being worked on), and I'm torn as to whether the LORs, publications, and Step2 are worth the year downtime. Furthermore, if these endeavors won't make a dent in my competitiveness for residency then I would prefer to graduate on time.

Does anyone have input on whether a year leave of absence is worthwhile?

 

[OrthoPod57]

Having active projects with your home program will only make them want to rank you all the higher. Tell them you hope to match do you can work on these projects for the next 5 yrs! Especially if research is not a weakness, I wouldn't take the year off. Also, my school has data showing that the optimal amt of time to take off to study for step 2 is around 3 weeks. Any longer than one month and you start getting too far out from third year. I think the best time to take step 2 is a few weeks directly after finishing third year (I took 2 wks off). If you can finish third year with your IM rotation that's even better because all the material will be fresh. You only get dumber during 4th year (as far as step 2 goes) if you are doing ortho aways.

I think the biggest strengths of my app were the step1-step2 jump, honors on third year clerkships, and strong research (done mainly with our program chair so he wrote me a strong chairman letter).

 

[Stellar Clouds]

Thanks everyone for your input! OrthoPod57, I find your "case study" to be particularly encouraging. What part of your application do you believe was most responsible for eliciting so many interviews?

In terms of a year off, I'm currently involved in three separate research projects involving a new medical device, clinical research, and improving/revamping the anatomy curriculum. My PIs are all the head of their departments (joints, spine surgery, anatomy), and have expressed interest in having me take a year off so I can make sure to continue and finish these ongoing projects with them. If I DID take a year off, that would give me an opportunity to 1) produce more awesome research 2) have strong letters from well-known faculty and 3) way too much time to study for step 2.

Honestly, I probably don't need any extra research experience (I have 5 publications already with 5 more being worked on), and I'm torn as to whether the LORs, publications, and Step2 are worth the year downtime. Furthermore, if these endeavors won't make a dent in my competitiveness for residency then I would prefer to graduate on time.

Does anyone have input on whether a year leave of absence is worthwhile?

I'm sure they would love to keep their cheap labor for another year. They are telling you what is in their best interest, not yours.

If you did take a year off, you would have the benefit of what you listed above, but you would also have to answer yes to and explain the following, taken directly from ERAS:

Medical Education/Training Extended or Interrupted?

Smells like a red flag to me.

 

[GoSpursGo]

At least at my school (and I feel like many schools), there is a formalized "research year" that interested students can take while remaining enrolled in the school. So I don't think people necessarily wind up having to answer yes to that question.

That said, if research isn't really a weak point that needs shoring up, you have to ask what you would really get out of the year. I think taking a year off would really just be something to do if you are personally interested in seeing the project through, or if you thought that by doing so these PIs would seriously go to bat for you and they hold a lot of sway either at your home program (if you want to stay) or nationally.