souljah1

Attending
10+ Year Member
15+ Year Member
Feb 7, 2002
1,667
6
241
In order to make yourself feel better (or more secure) - take a look at how UCSF has done historically in the match. When I was there, people with Step1 scores < 220 were matching into fantastic places. Whether or not that is fair, coming from UCSF is just about enough to get you into a strong place for IM.

I will say that you don't need to suck up in order to get honors. There definitely were plenty of people well versed in gamesmenship, but there were also plenty of people who truly were outstanding. Your comment gives the impression that to get honors you have to play games. That's just not true.

Your biggest ding is not your step score, but the fact that you didn't honor anything. That puts you in the bottom 30% of the class for your dean's letter.

You MUST honor your sub-internship in medicine.
 
Feb 2, 2010
245
1
0
Status
MD/PhD Student
My stats:
Currently at end of 3rd year at UCSF
Step 1: 228
Clinical grades: good to great evaluations w/ no honors (I work very hard, but can't stand sucking up or playing games), definitely no red flags
Research: did research after 1st year, no publication

On paper, I'm very average from my school. But will I have a shot at places like Beth Israel, UCLA, UCSD, UW, Stanford? If so, I'm planning on taking step 2 later as opposed to earlier and getting a 230 or so. If not, do you think if I take step 2 earlier and get >250 it will significantly increase my competitiveness?
Let's face it, you are still exquisitely competitive for internal medicine; your school name will carry you very very far in terms of getting interviews. All of those schools, except maybe UCLA, will be easily doable for you. However, as the previous poster mentioned, the lack of honors in IM is egregious. You will have to honor a sub-i and get great letters to actually be ranked to match. If I were you, I'd focus on rotation performance and let step 2 be your secondary priority after that.
 

souljah1

Attending
10+ Year Member
15+ Year Member
Feb 7, 2002
1,667
6
241
Just to be clear - I know for a fact that MANY students from UCSF don't honor their IM clerkship and go on to match at places like UCSF, BWH, MGH, Columbia, Penn, etc. They all honor their sub-I.

What most people don't know about UCSF is that the clerkship students do not take the shelf exam. For medicine, there is a multiple choice question that serves as 10% of your grade. Pretty much your entire grade is based on your evaluations made by interns, residents, and attendings. In addition, there is no high pass. About 30% of people honor medicine clerkships so the overwhelming number of clerkship students at UCSF get a regular pass grade in medicine. This is explicit in the dean's letter and most big programs know that about UCSF. They also know that there's no cut off to honor a sub-I so if you don't honor your sub-I you will look like a problem student.

Step II doesn't mean anything..
 
Mar 19, 2010
7
0
0
Status
Thanks for the advice guys. Your words of wisdom are very much appreciated. I've decided to take about 6 weeks off to study for Step 2 so that I can not only kill it, but also be more confident with my clinical knowledge before doing my SubI. Any tips for securing on honors during my SubI?
Thanks again!
 
Last edited:

souljah1

Attending
10+ Year Member
15+ Year Member
Feb 7, 2002
1,667
6
241
Step II matters, especially if you apply to fellowship.
I disagree. Step II isn't necessary for residency applications, but I would encourage taking it prior to residency applications if you didn't do that well on Step I. Step scores are not used at all for fellowship applications. It is all about where you train, your letters of recommendation, your research, etc. Step scores mean jack for fellowship.
 

souljah1

Attending
10+ Year Member
15+ Year Member
Feb 7, 2002
1,667
6
241
To the original poster - not honoring anything is pretty rare at UCSF. Most people at least honor something. Bottom 30% was an estimate, but definitely lower 50%. Your dean's letter adjective is determined solely by how many honors you receive - and the dean's letter adjective is what other programs use to gauge how competitive you are at your home institution.

What I will reinforce is that I know a lot of people who are now done residencies at places like UCSF, Stanford, BWH, Columbia, Penn, UW, etc who did NOT honor their 3rd year medicine clerkship. All of them, however, honored their subI.

Feel free to PM me if you want to chat SubI stuff for UCSF. Things may have changed a little bit since I've been there, but probably not too much. Additionally, the recipe for success is similar at most programs.
 

RonBurgandy

5+ Year Member
Dec 31, 2009
53
3
91
Status
Resident [Any Field]
There's a lot of he said, she said stuff on student doc, so I would take everything you read on here with a grain of salt.

Here's where I'm coming from: I'm a fourth year med student, not a resident, not a fellow, and by no means a program or fellowship director.

I believe "aProgDirector" has posted on here before that he or she likes to look at Step 2 because it gives him a sense of how applicants may be able to perform clinically. Maybe I'm not remembering his post correctly, but if he reads this, maybe he can respond, and I believe he would be a credible source.

In regards to fellowship. On one of my cardiology rotations, one of the cardiologists on the ad com explained to me that our program has such a surplus of qualified applicants, that they have to use step scores to screen candidates. He told me that they not only use all three steps, but also emphasized that they will ding people who screwed up just one step. He didn't think it was particularly fair, but again, there's a surplus of qualified applicants for cardiology, and it's an easy way to screen people. Having heard this, I will take all my steps seriously.

Now all that said, it's obviously only one part of an application. I imagine that a letter or phone call from a famous cardiologist would be far more important. I would also guess that if you train for IM at a place like UCSF or Brigham, or any of the other Big 8, that you have the luxury of not having to ace your steps. Maybe just doing med school at UCSF is enough.

However, it's possible that you won't train at one of these elite programs or have a chance to work closely with a famous cardiologist (or GI doc or whoever). So I'd recommend not having any easily identifiable blemishes on your record.

Just my $.02.
 
Mar 19, 2010
7
0
0
Status
Thanks again for all the responses. How much would it help to take a bunch of medicine subspecialty electives early on in 4th year? I've heard that it's much easier to honor as a 4th year.
 

gutonc

No Meat, No Treat
Staff member
Administrator
10+ Year Member
Mar 6, 2005
17,935
10,709
481
Status
Attending Physician
Thanks again for all the responses. How much would it help to take a bunch of medicine subspecialty electives early on in 4th year? I've heard that it's much easier to honor as a 4th year.
The only Honors anyone cares about in your 4th year is your SubI, precisely because everyone honors their 4th year electives (esp in IM) and not doing so is something of a red flag. Besides, your transcript will get locked down in early Sept anyway so no matter how many H's you get after that, it won't really matter.

Here's the deal...you have a decent Step 1 score and you're @ UCSF. That will get you interviews at a lot of great places. Honoring your SubI and bumping your Step 2 score by 15+ points will get you interviews most anywhere.

And as RonBurgundy pointed out (and in contrast to souljah1), Step II does matter for fellowships (except things like Renal, Endo, Pall Care) simply because the # of applicants is so huge that the programs need to screen anyway they can.
 

aProgDirector

Pastafarians Unite!
Moderator
10+ Year Member
Oct 11, 2006
8,087
6,550
381
Status
Attending Physician
I believe "aProgDirector" has posted on here before that he or she likes to look at Step 2 because it gives him a sense of how applicants may be able to perform clinically. Maybe I'm not remembering his post correctly, but if he reads this, maybe he can respond, and I believe he would be a credible source.
I think it's fair to say that "everything counts". The more competitive the program / field, the more things count for.

My advice to the OP -- do as well as you can on everything you have coming up. That's the best way to do well!
 
Feb 10, 2010
13
0
0
Status
Medical Student
To match to a top, say top 10, internal medicine program, what kindof step I is sufficient for a student with average grades and little research from a top 20 med. school (say baylor or northwestern)? Thanks!

I think it's fair to say that "everything counts". The more competitive the program / field, the more things count for.

My advice to the OP -- do as well as you can on everything you have coming up. That's the best way to do well!
 

jbz24

5+ Year Member
Jan 22, 2010
670
3
91
Status
Attending Physician
What do you mean by average grades? Your grades are more important than step 1 score (230 should be a sufficient cut-off for most programs). Average grades might not land you a top 10 residency unless you come from a top 10 school.
 

gutonc

No Meat, No Treat
Staff member
Administrator
10+ Year Member
Mar 6, 2005
17,935
10,709
481
Status
Attending Physician
What do you mean by average grades? Your grades are more important than step 1 score (230 should be a sufficient cut-off for most programs). Average grades might not land you a top 10 residency unless you come from a top 10 school.
Agreed. Remember the Step 1 "Cutoff" is usually just a screening tool. aPD has posted many times about how flexible ERAS is in terms of filtering apps. And the most common is a Step 1 score. Once you get through that, THEN they actually look at your app and see your grades, letters, pubs, etc. So an average student with mostly B/HP/P grades and a 250 on Step 1 will likely get through the initial screen @ places like UCSF and Hopkins but still won't get an interview.

So yes, a 230 or so should be enough to get you through the first screen, but as aPD says in this thread, "everything counts."
 
Feb 10, 2010
13
0
0
Status
Medical Student
How important are the pre-clinical grades to IM application, compared with the 3rd yr grades? Thanks again!
Agreed. Remember the Step 1 "Cutoff" is usually just a screening tool. aPD has posted many times about how flexible ERAS is in terms of filtering apps. And the most common is a Step 1 score. Once you get through that, THEN they actually look at your app and see your grades, letters, pubs, etc. So an average student with mostly B/HP/P grades and a 250 on Step 1 will likely get through the initial screen @ places like UCSF and Hopkins but still won't get an interview.

So yes, a 230 or so should be enough to get you through the first screen, but as aPD says in this thread, "everything counts."
 

gutonc

No Meat, No Treat
Staff member
Administrator
10+ Year Member
Mar 6, 2005
17,935
10,709
481
Status
Attending Physician
How important are the pre-clinical grades to IM application, compared with the 3rd yr grades? Thanks again!
Assuming no failures and good performance on clinicals? Essentially irrelevant.