Chances at residency with low scores

[Vrach]

Hi everyone,

I'm writing on behalf of my fiance.
He's an IMG, graduated 2 year ago. Within these 2 years he's done residency in his home country and took the steps.
His step 1 score was 203 and his step 2 ck is 227. He's going to be taking CS in November and starting next month he's going to be doing research at a pretty good university (he got a grant).

With regards to USCE he's done 1 month observership at family medicine office but he's planning on applying for some hospital observerships.

He wants to apply to IM and pathology. What are his chances?

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[W19]

He might have a chance at path, but IM chances are pretty low...

 

[Vrach]

He might have a chance at path, but IM chances are pretty low...

thank you very much! other than doing research, getting published and taking step 3, what else could he do to increase his chances? especially for pathology?

 

[Aspiringdoc235]

He might have a chance at path, but IM chances are pretty low...

Hi,

I'm a Caribbean med student (US citizen) about to graduate in 2months. I have a very bad step 1 score of 204 but I've also been a critical care RN working in ICU and ER for last 17yrs. My poor score definitely doesn't truly represent me and I got that score due to sickness and was in a situation where I couldn't postpone my exam. I went straight to the exam after forcefully getting discharged form hospital. I know it's no excuse but would love to get any help in finding programs who will offer IM residency. I really really love IM and ER and can't think of any other specialty. Any help is greatly appreciated. Thanks in advance.

 

[bashwell]

Hi,

I'm a Caribbean med student (US citizen) about to graduate in 2months. I have a very bad step 1 score of 204 but I've also been a critical care RN working in ICU and ER for last 17yrs. My poor score definitely doesn't truly represent me and I got that score due to sickness and was in a situation where I couldn't postpone my exam. I went straight to the exam after forcefully getting discharged form hospital. I know it's no excuse but would love to get any help in finding programs who will offer IM residency. I really really love IM and ER and can't think of any other specialty. Any help is greatly appreciated. Thanks in advance.

See NRMP for data.

If you improve dramatically on Step 2 you'll have a better chance at IM.

If you don't want a fellowship then definitely consider community IM programs. There are many good ones where you can come out a great internist. Search FREIDA.

Practically speaking I probably wouldn't consider EM given your IMG/Carib status, low Step 1, and (I assume) older age.

 

[W19]

Hi,

I'm a Caribbean med student (US citizen) about to graduate in 2months. I have a very bad step 1 score of 204 but I've also been a critical care RN working in ICU and ER for last 17yrs. My poor score definitely doesn't truly represent me and I got that score due to sickness and was in a situation where I couldn't postpone my exam. I went straight to the exam after forcefully getting discharged form hospital. I know it's no excuse but would love to get any help in finding programs who will offer IM residency. I really really love IM and ER and can't think of any other specialty. Any help is greatly appreciated. Thanks in advance.

Forget about EM... Try IM, but you would have to do better on step2 (240+)...

 

[Aspiringdoc235]

See NRMP for data.

If you improve dramatically on Step 2 you'll have a better chance at IM.

If you don't want a fellowship then definitely consider community IM programs. There are many good ones where you can come out a great internist. Search FREIDA.

Practically speaking I probably wouldn't consider EM given your IMG/Carib status, low Step 1, and (I assume) older age.

I'm 38 and not sure if that's considered being too old but I'm definitely very young at heart and also take care of myself well. I gave my step 2 CK couple days ago and still waiting for my results... I'm hoping for a miracle to happen after trying my best... So I'm confused here, Community IM programs don't allow you to consider fellowship in future? I'm apologize ahead if I'm asking dumb questions.. Again thanks everyone for contributing to my queries

 

[bashwell]

I'm 38 and not sure if that's considered being too old but I'm definitely very young at heart and also take care of myself well. I gave my step 2 CK couple days ago and still waiting for my results... I'm hoping for a miracle to happen after trying my best... So I'm confused here, Community IM programs don't allow you to consider fellowship in future? I'm apologize ahead if I'm asking dumb questions.. Again thanks everyone for contributing to my queries

Sorry I should've been clearer. Please let me clarify.

1) I just mean if you're going for a fellowship, especially a competitive fellowship (e.g., GI, cards), then generally speaking it's more difficult to obtain one coming from a community IM program than an academic/university program. That's because "reputation" of the IM program (rightly or wrongly) still matters to some extent when applying for fellowship.

2) Also, the perception (rightly or wrongly) is that academic/university programs tend to see a greater variety of pathology, more volume of patients, and have other advantages over community programs. But that depends on the specific community program, and many community programs are perfectly fine. There are some strong community IM programs, where you can get a fellowship coming from them. So I don't mean to denigrate community programs. I'm just speaking in general.

3) With age, I just mean that it seems more difficult to do EM as you get older. The shift work, the patients, etc. EM has a high burnout rate. And EM residency could be tough for someone starting EM residency around age 40.

4) But even besides age, I'm sorry to say, but realistically I don't think your application is very competitive for EM. Not unless you absolutely crush Step 2CK, do as many away rotations in EM as you can and get amazing SLOEs, and have no visa issues -- and even still there might not be any guarantees.

5) I think you should go for critical care instead. Do IM then CCM and work in the ICU and make very good money (~$400k is the MGMA median). CCM only fellowships are not hard to get. Pulm/CCM is harder, but even pulm/CCM could be achievable for you coming from a community IM program. I think that's a better route than EM in the long-term too.

 

[Aspiringdoc235]

Sorry I should've been clearer. Please let me clarify.

1) I just mean if you're going for a fellowship, especially a competitive fellowship (e.g., GI, cards), then generally speaking it's more difficult to obtain one coming from a community IM program than an academic/university program. That's because "reputation" of the IM program (rightly or wrongly) still matters to some extent when applying for fellowship.

2) Also, the perception (rightly or wrongly) is that academic/university programs tend to see a greater variety of pathology, more volume of patients, and have other advantages over community programs. But that depends on the specific community program, and many community programs are perfectly fine. There are some strong community IM programs, where you can get a fellowship coming from them. So I don't mean to denigrate community programs. I'm just speaking in general.

3) With age, I just mean that it seems more difficult to do EM as you get older. The shift work, the patients, etc. EM has a high burnout rate. And EM residency could be tough for someone starting EM residency around age 40.

4) But even besides age, I'm sorry to say, but realistically I don't think your application is very competitive for EM. Not unless you absolutely crush Step 2CK, do as many away rotations in EM as you can and get amazing SLOEs, and have no visa issues -- and even still there might not be any guarantees.

5) I think you should go for critical care instead. Do IM then CCM and work in the ICU and make very good money (~$400k is the MGMA median). CCM only fellowships are not hard to get. Pulm/CCM is harder, but even pulm/CCM could be achievable for you coming from a community IM program. I think that's a better route than EM in the long-term too.

Thanks for your valued inputs and for your time in responding to my post... I sincerely went to medical school with an interest in primary care and ER (ER because I've been an ER and critical care nurse for many years and thought I'm good at it). Primary care has always been my true first passion since joining med school and not because of low step 1 score... Matter of fact, I very honestly want to practice as a physician through Doctors Without Borders and serve community more than choosing medicine as a source of higher income... I was very content with a critical care RN pay with my experience in the past. I strongly feel I have a calling for mission work which I want to do in coming years... I currently volunteer through my church as well as Medical emergency response team and serve underprivileged and homeless shelters and organize community screening tests etc..

I have 3.97 GPA in my BSN, graduated in distinction honors, then all along in med school too I did well along with being on deans' list and consider myself very thorough with my critical thinking and skills in medical and nursing procedures... I'm just very disappointed with my poor step 1 score which I gave under unavoidable circumstances while not being well... Also it it helps, I'm a US citizen with no visa issues.. I also have work experience as a clinical safety analyst in drug research making narrative reports on side effects of drugs and reporting to FDA.. I really hope any PD will look past my step 1 score and offer me an interview and not weed me off based on their cut off step 1 score because I know I will do my interview well and I have lot to offer as a good candidate for residency...

 

[bashwell]

Thanks for your valued inputs and for your time in responding to my post... I sincerely went to medical school with an interest in primary care and ER (ER because I've been an ER and critical care nurse for many years and thought I'm good at it). Primary care has always been my true first passion since joining med school and not because of low step 1 score... Matter of fact, I very honestly want to practice as a physician through Doctors Without Borders and serve community more than choosing medicine as a source of higher income... I was very content with a critical care RN pay with my experience in the past. I strongly feel I have a calling for mission work which I want to do in coming years... I currently volunteer through my church as well as Medical emergency response team and serve underprivileged and homeless shelters and organize community screening tests etc..

I have 3.97 GPA in my BSN, graduated in distinction honors, then all along in med school too I did well along with being on deans' list and consider myself very thorough with my critical thinking and skills in medical and nursing procedures... I'm just very disappointed with my poor step 1 score which I gave under unavoidable circumstances while not being well... Also it it helps, I'm a US citizen with no visa issues.. I also have work experience as a clinical safety analyst in drug research making narrative reports on side effects of drugs and reporting to FDA.. I really hope any PD will look past my step 1 score and offer me an interview and not weed me off based on their cut off step 1 score because I know I will do my interview well and I have lot to offer as a good candidate for residency...

If you like primary care, you could apply for FM. That should be achievable for you especially since you're a US citizen. See NRMP data for FM based on your Step 1 score (and hopefully you improve significantly on Step 2 because that will help as many FM programs care more about Step 2). Apply broadly. Be willing to go anywhere. Although it's decreasing, you could work in some rural EDs as FM. Actually I think FM has a really good future if you can deal with being a PCP (which I personally can't but if you can then that's really good).

 

[Aspiringdoc235]

If you like primary care, you could apply for FM. That should be achievable for you especially since you're a US citizen. See NRMP data for FM based on your Step 1 score (and hopefully you improve significantly on Step 2 because that will help as many FM programs care more about Step 2). Apply broadly. Be willing to go anywhere. Although it's decreasing, you could work in some rural EDs as FM. Actually I think FM has a really good future if you can deal with being a PCP (which I personally can't but if you can then that's really good).

Thanks for your reply... I really really love IM and for some reason don't like FM... I would have just done FNP (family nurse practitioner) and wouldn't have gone through all this.. I'm not belittling FM in any way.. It's just something I was never interested in... That's why I'm so sad and stressed out... I'm however, willing to go to ANY place in US and have no problem with ANY IM program.. Any suggestions or recommendations will be highly appreciated.. Thanks

 

[bashwell]

Thanks for your reply... I really really love IM and for some reason don't like FM... I would have just done FNP (family nurse practitioner) and wouldn't have gone through all this.. I'm not belittling FM in any way.. It's just something I was never interested in... That's why I'm so sad and stressed out... I'm however, willing to go to ANY place in US and have no problem with ANY IM program.. Any suggestions or recommendations will be highly appreciated.. Thanks

So the facts are you are a US-IMG in the Caribbean with a 204 on Step 1, you've taken Step 2 but haven't gotten your score back, and you are hoping for IM (and you have no other red flags)? If that's correct, then wait to see what you get on Step 2, so people can have a better idea how to help you.

Otherwise, all I can tell you is what your chances are based on your Step 1 score in Charting Outcomes in the Match for the IMG (2016):

 

[xoxoloula]

Hello everyone, I just thought of asking as well..

I am a non US IMG, passed step 1 with a score of 221 and passed CS first attempt.. Was wondering if i have a shot at IM as well? I saw the NRMP chart but I don't find it that clear.. Was hoping to hear from people who were in my same boat last year or if anyone has heard of a similar case?

Thanks in advance

 

[bashwell]

Hello everyone, I just thought of asking as well..

I am a non US IMG, passed step 1 with a score of 221 and passed CS first attempt.. Was wondering if i have a shot at IM as well? I saw the NRMP chart but I don't find it that clear.. Was hoping to hear from people who were in my same boat last year or if anyone has heard of a similar case?

Thanks in advance

What's so unclear about it? That it's very roughly half are accepted, half aren't? In that case, see how you do on Step 2CK, since IMGs are required to take Step 2CK, and since your Step 2CK score should help clarify things for you. Of course, nothing wrong with looking for anecdotes either.

 

[xoxoloula]

What's so unclear about it? USMLE scores (Step 1 and/or 2CK) are one of the main filters for IM programs. But nothing wrong with looking for anecdotes either.

Thank you for your reply - will try my best and see how this goes.

 

[bashwell]

If my math is correct, that's around a 48% chance - is that good enough ?

I'd recommend taking Step 2CK first and seeing what you get. As an IMG, Step 2CK is a requirement anyway. Obviously the better you do, the better chances you have for an interview. Otherwise, the only way to know for sure is to apply and see what happens.

 

[lolita90]

Hi,

I'm a Caribbean med student (US citizen) about to graduate in 2months. I have a very bad step 1 score of 204 but I've also been a critical care RN working in ICU and ER for last 17yrs. My poor score definitely doesn't truly represent me and I got that score due to sickness and was in a situation where I couldn't postpone my exam. I went straight to the exam after forcefully getting discharged form hospital. I know it's no excuse but would love to get any help in finding programs who will offer IM residency. I really really love IM and ER and can't think of any other specialty. Any help is greatly appreciated. Thanks in advance.

Hi, I just got my USMLE Step 1 score and the results were disappointing... i got a 211 when i thought i had at least a 230... I really don't know what happened. I am an US citizen, IMG who graduated on July in DR, I have an AS degree on Liberal Arts and Science and worked as a Lab assistant during my undergraduate training at BCC. I also graduated with Honors in my medical school. I would like to know recommendations in order for me to have a chance on the next match ( planning to take CS on March) and Ck by Aug (2018). Any help will be kindly appreciated.
I wanted to go for Anesthesio but with this score I believe it won't be happening. I'll go for IM or FM

 

[W19]

@lolita90
You might have a shot at Pathology/IM/FM/anesthesiology in that order. Speaking another 'useful' language might also work in your favor.

 

[lolita90]

@lolita90
You might have a shot at Pathology/IM/FM/anesthesiology in that order. Speaking another 'useful' language might also work in your favor.

what "useful" language means? sorry for my ignorance

 

[W19]

what "useful" language means? sorry for my ignorance

If you study in DR, I am assuming that you speak spanish; therefore, programs located in states like NV, CA, AZ, FL, TX, NY, NJ, MA etc... and a few states (like Colorado) where there are pockets of Hispanic communities might give your application a good look over another IMG who speaks Finnish (nothing against people from Finland).

 

[lolita90]

If you study in DR, I am assuming that you speak spanish; therefore, programs located in states like NV, CA, AZ, FL, TX, NY, NJ, MA etc... and a few states (like Colorado) where there are pockets of Hispanic communities might give your application a good look over another IMG who speaks Finnish (nothing against people from Finland).

oh perfect, got it! THank you so much, so i guess i still have a chance if i make it up with higher ck.