Chance for anesthesiology? Below average USMLE/COMLEX scores

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DEBO-18

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A bit late to ask this. So the date is as below:

COMLEX level 1: 510
USMLE step 1: 224
COMLEX PE: passed at first attempt
COMLEX level 2: pending (will take very soon)
(No USMLE step 2 taken)
-LORs: 1 from IM attending in Hackensack NJ, 2 from chief cardiologists at big teaching hospitals (Jacobi/Good Sam NY), 1 pending from an private anesthesiologist.
-Very light research experience, no publication, no extraordinary work/volunteer experience except community service.
-3.1 GPA pre-clinically, 3.6 on 3rd year clerkships (6 A's +5 B's)

Before that I always want to apply for IM and thought this as the only residency I'll apply. However a rotation in anesthesia really made me consider the possibility of anesthesia. I'm a procedure guy and like working in OR assisting the surgeons, and anesthesia does have good life pace.

I'm an international student at DO school so visa issue will limit me.

Honestly I don't have a specific reason to take gas over IM, both work to me. The step 1 score I have at the lower side, plus the immigration status limitation, worries me. Should I consider applying for it???
 
DEBO-18 said:
A bit late to ask this. So the date is as below:

COMLEX level 1: 510
USMLE step 1: 224
COMLEX PE: passed at first attempt
COMLEX level 2: pending (will take very soon)
(No USMLE step 2 taken)
-LORs: 1 from IM attending in Hackensack NJ, 2 from chief cardiologists at big teaching hospitals (Jacobi/Good Sam NY), 1 pending from an private anesthesiologist.
-Very light research experience, no publication, no extraordinary work/volunteer experience except community service.
-3.1 GPA pre-clinically, 3.6 on 3rd year clerkships (6 A's +5 B's)

Before that I always want to apply for IM and thought this as the only residency I'll apply. However a rotation in anesthesia really made me consider the possibility of anesthesia. I'm a procedure guy and like working in OR assisting the surgeons, and anesthesia does have good life pace.

I'm an international student at DO school so visa issue will limit me.

Honestly I don't have a specific reason to take gas over IM, both work to me. The step 1 score I have at the lower side, plus the immigration status limitation, worries me. Should I consider applying for it???
Click to expand...

First, the bold is confusing to me. You should have a solid reason to pick one or the other as they are quite different. With that being said, Anesthesia likes having both Step exams and also it seems like your LORs are much more geared towards IM and I can't image that would be viewed favorably by anesthesia programs. I feel that your chances are much better going IM.
 
Thank you for the reply. Yes I'm preparing my application towards the IM program. I feel like anesthesia makes me feel more like something I could do for lifelong after the rotation, by performing procedures in OR every day. Just wondering if I should immediately correct my direction now, do more anesthesia away rotations and get more letters.
 
DEBO-18 said:
Thank you for the reply. Yes I'm preparing my application towards the IM program. I feel like anesthesia makes me feel more like something I could do for lifelong after the rotation, by performing procedures in OR every day. Just wondering if I should immediately correct my direction now, do more anesthesia away rotations and get more letters.
Click to expand...
You need to take Step 2 if you decide to go all in for gas. As an international student, you're should also be looking for a H1B Visa. If you don't plan to take Step 2 at all, you might as well cancel the plan and go for IM. Even though gas is less competitive than before, many ACGME programs will not interview nor rank you without a Step 2 score.
 
Doesn't seem like a lot of residency's do H1B anymore at all (just offhand from the 80 residency's I checked out the other night, wasn't looking specifically for that, but I did notice a bunch took J's but no H1B). That will really limit you. I would do FREIDA of all the Anesthesia programs in flyover states, and find the ones that have DO's and will do H1B (will probably not be a lot). Then I would call and see what they want. I think legwork is the only way you will really know the answer.
 
Your step scores are fine for gas and you would normally match without issue. However, your LORs are a problem and the visa issue will most likely limit you a fair amount. You need to get into co tact with programs stat and feel out the feedback they will give you
 
AnatomyGrey12 said:
Your step scores are fine for gas and you would normally match without issue. However, your LORs are a problem and the visa issue will most likely limit you a fair amount. You need to get into co tact with programs stat and feel out the feedback they will give you
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Why are OP's LoRs an issue? He will get a LoR from a gas doc...
 
kenjixshadow said:
You need to take Step 2 if you decide to go all in for gas. As an international student, you're should also be looking for a H1B Visa. If you don't plan to take Step 2 at all, you might as well cancel the plan and go for IM. Even though gas is less competitive than before, many ACGME programs will not interview nor rank you without a Step 2 score.
Click to expand...

For a point of clarification, many (most) ACGME programs absolutely will interview you without a step 2 score, given your step 1 is okay. I called 25 programs and all but one said absolutely, the other said "we prefer it but it's a case by case basis". My step 1 score is higher than OP's, but not by much. Most told me I'd be good to go for their program. I take step 2 late, that's why I called around.
 
zdbsy said:
I'm the OP, logged in with another account




Thank you for the suggestions. LORs are not a problem anymore as I contacted 2 anesthesiologists that I ever worked with. They both kindly agreed to give me a strong one as possible and encouraged me to apply. The first one is private pain management doctor in NJ, ever with Hackensack UMC; the other is private practice, with Columbia and some other hospitals. Also I'm trying to setup more rotations in anesthesia inpatient and/or research.



Yes the step 1 score actually concerned me, considering I'm international, and anesthesiology is still competitive even though I'm open to all programs. I scanned the comments and wondering if taking step 2 late is better than nothing?
Click to expand...

Late step 2 is better than nothing. Being international you're in a different ballgame, but late is still better than nothing.
 
How about a DO willing to Match anywhere with good research, EC's but a 213/227 on step exams?

Comlex 495/554 FWIW
 
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ToKingdomCome said:
How about a DO willing to Match anywhere with good research, EC's but a 213/227 on step exams?

Comlex 495/554 FWIW
Click to expand...
Audition Rotations, as many as you can. Don't apply to backup fields (FM) so you have those available in the SOAP (a likely possibility). Call and ask each program if they would consider a student in your shoes. Only apply to the ones who answer and will talk to you. Try to get auditions there. Make it clear that you are not geographically limited. Your chances are poor, you need to use people skills to make up the deficit.
 
Anesthesiology is not as competitive as it used to be. It's fairly common for a DO or IMG with average or even slightly sub average scores to match at a community or county program. Do audition rotations for sure..be likable, I think you'll be fine.
 
Rads312 said:
Anesthesiology is not as competitive as it used to be. It's fairly common for a DO or IMG with average or even slightly sub average scores to match at a community or county program. Do audition rotations for sure..be likable, I think you'll be fine.
Click to expand...

While it may not be as competitive as it used to be, whatever that means, it is still competitive. My overall impression based on my interactions and observations and discussions with a few PDs is that interest in anesthesiology is up this year from the last few years. Why wouldn't it be? It is a great specialty.
 
Precedexed Out said:
While it may not be as competitive as it used to be, whatever that means, it is still competitive. My overall impression based on my interactions and observations and discussions with a few PDs is that interest in anesthesiology is up this year from the last few years. Why wouldn't it be? It is a great specialty.
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They had a ton of unfilled spots last few years. More and more IMG's and DO's every year. It's not 'competitive' - Derm, Optho, Vascular Surgery, ophtho, ER are competitive. You are pretty much guaranteed to match anesthesia as long as you apply broadly - even with low step scores. Just the facts.

PS - it IS a great field. I just think the CRNA infiltration and decline in reimbursement has scared off the more talented med students since the early 2000's.
 
Rads312 said:
They had a ton of unfilled spots last few years. More and more IMG's and DO's every year. It's not 'competitive' - Derm, Optho, Vascular Surgery, ophtho, ER are competitive. You are pretty much guaranteed to match anesthesia as long as you apply broadly - even with low step scores. Just the facts.

PS - it IS a great field. I just think the CRNA infiltration and decline in reimbursement has scared off the more talented med students since the early 2000's.
Click to expand...

You're pretty much not guaranteed a spot, even if you apply broadly with board scores that are too low. I'm not saying it is as competitive as those you listed above, but to say applying broadly will get anyone a spot is misleading.
 
Precedexed Out said:
You're pretty much not guaranteed a spot, even if you apply broadly with board scores that are too low. I'm not saying it is as competitive as those you listed above, but to say applying broadly will get anyone a spot is misleading.
Click to expand...

Sure. That can be said of any specialty. You're not "guaranteed" a spot in Pediatrics either. Just saying these days if you have a pulse, you can match Anesthesia.
 
Rads312 said:
Sure. That can be said of any specialty. You're not "guaranteed" a spot in Pediatrics either. Just saying these days if you have a pulse, you can match Anesthesia.
Click to expand...

Whatever you think...🙄
 
Precedexed Out is correct. There are still many who apply for anesthesiology that do not get spots because they have low step scores, had to repeat courses/year, had negative MSPE comments from third year clerkships, etc. Those may find a spot, but many find themselves with zero interviews in those situations and the need to change plans at the last minute (usually it is too late). Most who have 215 or above step scores, first/second/third quartile class rank, and a clean MSPE (no negative comments) will get a spot without too much trouble if you apply to enough places. Applying to all 130-something programs will not get you many more invites than applying to 50 programs when you have a lot of strikes against you on your application.
It is getting worse every year. US med schools are proliferating like bunnies in heat and churning out more students than ever. Each year, several more new schools have their first graduating classes. A couple of years ago, 500 more US med students graduated than there were residency positions available. Each year, those students go back into the mix for the next year to mix with the ever growing number of graduating students as the residency positions available remain stagnant. In addition, many Caribbean school grads and IMG's have step scores that are 240+ and many programs are happy to take them over 4th quartile US grads. Many of the IMG's are fully trained in their specialty, they just need a route into the US medical system. Lots of programs are happy to have those residents.
Med students today should do their best to be in the top half of their med school class, get at least average step scores, and be hard working team players so they have no negative comments on the MSPE. The road to a good residency has been getting consistently more difficult for the below average students. Many med students are finishing med school with $2-300K in debt and no residency program with which to finish their training.
I suspect this will be one of the new "crises" that will be thrust to the forefront in the next few years.
 
Gern Blansten said:
Precedexed Out is correct. There are still many who apply for anesthesiology that do not get spots because they have low step scores, had to repeat courses/year, had negative MSPE comments from third year clerkships, etc. Those may find a spot, but many find themselves with zero interviews in those situations and the need to change plans at the last minute (usually it is too late). Most who have 215 or above step scores, first/second/third quartile class rank, and a clean MSPE (no negative comments) will get a spot without too much trouble if you apply to enough places. Applying to all 130-something programs will not get you many more invites than applying to 50 programs when you have a lot of strikes against you on your application.
It is getting worse every year. US med schools are proliferating like bunnies in heat and churning out more students than ever. Each year, several more new schools have their first graduating classes. A couple of years ago, 500 more US med students graduated than there were residency positions available. Each year, those students go back into the mix for the next year to mix with the ever growing number of graduating students as the residency positions available remain stagnant. In addition, many Caribbean school grads and IMG's have step scores that are 240+ and many programs are happy to take them over 4th quartile US grads. Many of the IMG's are fully trained in their specialty, they just need a route into the US medical system. Lots of programs are happy to have those residents.
Med students today should do their best to be in the top half of their med school class, get at least average step scores, and be hard working team players so they have no negative comments on the MSPE. The road to a good residency has been getting consistently more difficult for the below average students. Many med students are finishing med school with $2-300K in debt and no residency program with which to finish their training.
I suspect this will be one of the new "crises" that will be thrust to the forefront in the next few years.
Click to expand...

Agreed. The ridiculous expansion of medical schools needs to stop immediately, but does anyone actually believe the crooked entities that control this behavior actually care about students or the profession? They are just in it for taking as much money as possible from students.

I think it is important to emphasize having no negative comments on the MSPE, that is extremely important.
 
AnatomyGrey12 said:
I'm not so sure this is a true statement. The total number of residency positions exceeds that of US graduates by about 6,000
Click to expand...
Shortage of residency slots may have chilling effect on next generation of physicians

the opposing view is here:
U.S. medical school graduates aren't enough to fill the physician shortage

However, please note that the first link is written by the Dean of an US Medical school and the second opinion is offered by the Dean of a Caribbean medical school. The stats can likely be manipulated to support whichever view you wish.
 
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AnatomyGrey12 said:
500 or so US trained physicians failed to find a spot, that is NOT the same as there being 500 more US graduates than residency spots. The number of residency spots is roughly 6000 spots greater than the number of US graduates.
Click to expand...

Yes, those are not the same. We need to ensure AMGs get to fill these spots first as the spots continue to dwindle.
 
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