Chances / Competitiveness for General Surgery

[MemphisBlues]

Hello all,

* Not sure if there is a better "forum" in which to post such a request, so here it goes. *

US Allopathic MS4, top-25-30 (if such a thing matters) medical school

USMLE Step 1: 260
USMLE Step 2 CK: 272
USMLE Step 2 CS: FAIL (first attempt) -- will retake in December***

Member, AOA (nominated as a junior)
Research x years; 2 publications (1 case report, 1 in surgical education)

Multiple awards for top overall score in blocks during pre-clinical (3)

Other academic & classmate-nominated awards during preclinical

*** Obvious my failed USMLE Step 2 CS is what is making me very nervous. Unfortunately, it looks as though I will not get my passing result back until mid-February, perhaps after I submit my match list. I'm very worried this has knocked my application down to a much lower level than I "deserve" - and perhaps that I won't even match. It was a devastating result.

I am a native English-speaker, and honestly this test result came out of nowhere. I would never have expected this result, but now I'm forced to deal with it.

Thanks all for your thoughts.

Best,
MB

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[MemphisBlues]

You HAVE to retake CS sooner than that. No ifs ands or buts.

No test dates available before December anywhere in the country, mate.

 

[ERDOC555]

Hello all,

* Not sure if there is a better "forum" in which to post such a request, so here it goes. *

US Allopathic MS4, top-25-30 (if such a thing matters) medical school

USMLE Step 1: 260
USMLE Step 2 CK: 272
USMLE Step 2 CS: FAIL (first attempt) -- will retake in December***

Member, AOA (nominated as a junior)
Research x years; 2 publications (1 case report, 1 in surgical education)

Multiple awards for top overall score in blocks during pre-clinical (3)

Other academic & classmate-nominated awards during preclinical

*** Obvious my failed USMLE Step 2 CS is what is making me very nervous. Unfortunately, it looks as though I will not get my passing result back until mid-February, perhaps after I submit my match list. I'm very worried this has knocked my application down to a much lower level than I "deserve" - and perhaps that I won't even match. It was a devastating result.

I am a native English-speaker, and honestly this test result came out of nowhere. I would never have expected this result, but now I'm forced to deal with it.

Thanks all for your thoughts.

Best,
MB

I can't image a failed CS will knock you out of the running for matching a GS program entirely. There are over 1200 spots each year and not enough US MDs to fill even close to that. Your stats and application are phenomenal and could likely get you into some of the best gen surg programs and likely competitive subspecialties as well.

However, a failed CS is a huge red flag, and could very well be something that could keep you out of a top tier program. I'm confident you'll match somewhere, as for a top program I doubt it, but that's merely speculation. There also aren't that many people with your stats applying GS, so I could see some PDs be willing to overlook that one red flag, considering everything else.

 

[MemphisBlues]

There are a lot of tips on this site about how to snag an earlier date.

The third party scheduler stuff is against the exam rules.

 

[MemphisBlues]

Using a Firefox extension and frequently checking the site for openings is against the rules?

Your back is against the wall here dude. Finding an exam date sooner is the single most important thing in your life right now.

I'm using Page Monitor and checking the site as often as I can.

The third party scheduler thing where you give the guy your log-in information and they use that automated system to schedule for you is definitely against the rules.

 

[JamesPotterMS-3]

OP, honestly, you have to fight for an earlier spot. If I were you, I would literally be doing everything and anything within the rules to get a date changed.

 

[Merely]

let's assume OP doesn't get an earlier date. So what? Can anyone explain what that means to him practically? Will he not match even tho he's literally a top 5 percent med student simply due to one subjective stupid test????

 

[JamesPotterMS-3]

let's assume OP doesn't get an earlier date. So what? Can anyone explain what that means to him practically? Will he not match even tho he's literally a top 5 percent med student simply due to one subjective stupid test????

I don't know about academic programs, but a handful of community programs I'm looking into specifically say "must pass CS within first attempt." I don't know if it is because these programs tend to attract more FMGs/IMGs but there are programs that may have rules that would (unfairly, I may add) disqualify him/her automatically.

 

[Merely]

Hes a native language speaker, top MD graduate...this is so sick honestly. He worked his ass off for 3 years only to get arbitrarily failed on a bull**** test and now his amazing application gets completely destroyed over something he couldn't even completely control...this needs to change

 

[AcademicNeurosurgery]

It's a game changer.

At a lot of institutions he would be unrankable per GME policy.

At my program he wouldn't get an interview without a passing score.

Honestly if OP had sights set on a top program, it wouldn't be unreasonable to consider a research year at this point. Get the CS squared away and then apply fresh next year.

Great advice here. Sorry this happened OP, a shame given your stellar app otherwise. Do everything you can to get a sooner CS date but also start making a plan B. You should be reaching out to PIs at your institution and finding labs that are willing to take you on should you not find a date. I know it may be a hard decision in the moment but a year spent doing research could pay off big time down the line.

 

[bannie22]

tbh thats unfortunate. but if you look at the flipside the applicants who get into top top tier usually have no flaws.
and if they have flaws. they have something spectacular to make up for it.
i dont tink your odds are out for a top10 to be honest, i just tink this is a little roadbump but u really gotta take it and pass it.

 

[zero0]

You're fine for GS, maybe even at top places. You passed both the important, non-bs sad joke of an exam boards with flying colors. Most places just want to see a pass on CS before they offer an interview. Doesn't necessarily matter if it's on the 2nd try. Don't get me wrong, this is a red flag, but you've got a strong resume otherwise to make up for it.

What went wrong on CS?

 

[W19]

Why would OP be 'unrankable' when he will get his result by Feb 21st, which is the same exact date of ROL submission deadline (9pm)?

This thread scares the bejesus out of me... Taking mine mid November and hoping I will get my result early February when programs are submitting their ROL..

 

[Smurfette]

Why would OP be 'unrankable' when he will get his result by Feb 21st, which is the same exact date of ROL submission deadline (9pm)?

This thread scares the bejesus out of me... Taking mine mid November and hoping I will get my result early February when programs are submitting their ROL..

If the CS fail prevents the OP from getting interviews, a score by Feb 21 is of no help since programs aren't going to rank someone they didn't interview. Many programs will be finished with their ROLs before the deadline. The later that result comes back, the less likely it is to help him/her. Getting a pass early on will maximize potential interview invites and minimize how far down programs rank him/her because it reassures programs that the OP will be able to start on time and get a license.

 

[Tenk]

Do you even know what you did wrong on CS? I agree with SouthernSurgeon that this is the most important thing in your life right now but I don't think scheduling is more important than fixing your mistake first. The only thing worse than failing CS is failing CS twice. Did you forget a whole portion of the exam on every patient? That's pretty much the only way to fail the thing if you speak great English. Sorry that happened though, gl.

 

[W19]

If the CS fail prevents the OP from getting interviews, a score by Feb 21 is of no help since programs aren't going to rank someone they didn't interview. Many programs will be finished with their ROLs before the deadline. The later that result comes back, the less likely it is to help him/her. Getting a pass early on will maximize potential interview invites and minimize how far down programs rank him/her because it reassures programs that the OP will be able to start on time and get a license.

People weren't talking about interviews... They were saying OP will be 'unrankable' per GME policy (post #12), and I believe they are saying that because they think OP won't get his result back before ROL deadline. And he will per NBME score reporting date calendar.

United States Medical Licensing Examination | Step 2 CS (Clinical Skills)

Let's assume he finds a spot in Sept, he still will get his result back December thru early January, which is late if we are talking about interview invites.

I don't think OP needs to force the issue...

 

[Goro]

let's assume OP doesn't get an earlier date. So what? Can anyone explain what that means to him practically? Will he not match even tho he's literally a top 5 percent med student simply due to one subjective stupid test????

Hes a native language speaker, top MD graduate...this is so sick honestly. He worked his ass off for 3 years only to get arbitrarily failed on a bull**** test and now his amazing application gets completely destroyed over something he couldn't even completely control...this needs to change

Alas for OP, PD's don't appear to view Step 2 as a "stupid test".

See page 143 for Surgery. Yes, it's an n= 88. I defer to the wise SS for more insider knowledge.

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

 

[MemphisBlues]

Using a Firefox extension and frequently checking the site for openings is against the rules?

Your back is against the wall here dude. Finding an exam date sooner is the single most important thing in your life right now.

Actually, my family is the single most important thing in my life, friend.

But seriously, thanks for your thoughts. I would be indebted if you could comment - as precisely as possible - what my chances of NOT matching are as things stand (ie, applying without a passing score and - probably - submitting a rank list with a passing score if I test in early December). This prospect terrifies me.

It's a game changer.

At a lot of institutions he would be unrankable per GME policy.

At my program he wouldn't get an interview without a passing score.

Honestly if OP had sights set on a top program, it wouldn't be unreasonable to consider a research year at this point. Get the CS squared away and then apply fresh next year.

I'm not necessarily interested in the most prestigious programs. I would like to be in a location I prefer most of all (big city, southeast/southwest) and I would like to be at an academic institution more than a community one.

Hes a native language speaker, top MD graduate...this is so sick honestly. He worked his ass off for 3 years only to get arbitrarily failed on a bull**** test and now his amazing application gets completely destroyed over something he couldn't even completely control...this needs to change

I hear your frustration - and thanks, I suppose, for your commiseration. Of course, it does nothing to change facts. I considered seeking legal counsel to see if I could challenge the exam and get a rescoring somehow, but I don't think this would be resolved (even if I did somehow force the NBME's hand) by ERAS submission day in September.

Great advice here. Sorry this happened OP, a shame given your stellar app otherwise. Do everything you can to get a sooner CS date but also start making a plan B. You should be reaching out to PIs at your institution and finding labs that are willing to take you on should you not find a date. I know it may be a hard decision in the moment but a year spent doing research could pay off big time down the line.

I really don't want to do a research year. I want to start residency ASAP.

You're fine for GS, maybe even at top places. You passed both the important, non-bs sad joke of an exam boards with flying colors. Most places just want to see a pass on CS before they offer an interview. Doesn't necessarily matter if it's on the 2nd try. Don't get me wrong, this is a red flag, but you've got a strong resume otherwise to make up for it.

What went wrong on CS?

Do you even know what you did wrong on CS? I agree with SouthernSurgeon that this is the most important thing in your life right now but I don't think scheduling is more important than fixing your mistake first. The only thing worse than failing CS is failing CS twice. Did you forget a whole portion of the exam on every patient? That's pretty much the only way to fail the thing if you speak great English. Sorry that happened though, gl.

Great question. Has been haunting me now for a month. Honestly I really don't believe that my performance on test day was subpar -- I thought it went very well. I really can't think of a single patient station that (I believe) went poorly (the only mistake I do remember making is not washing my hands before shaking a patient's hand ... at one patient station). I am tempted to believe that it was some kind of "glitch" as I am not inclined to be conspiratorial. Of course, however, I think it would be somewhat ignoble of me to present this as some sort of error in the system. The correct answer, it seems to me, is to "own it" but I express no insincerity when I say that I don't know what it is I am taking responsibility for.

I prepared the way I wanted, got an adequate amount of sleep, showed up early, ate a good breakfast and lunch, and executed everything almost exactly how I wanted. I have never performed as well and done so poorly -- this has never happened. It has shaken me to my very core -- challenged my identity.

Alas for OP, PD's don't appear to view Step 2 as a "stupid test".

See page 143 for Surgery. Yes, it's an n= 88. I defer to the wise SS for more insider knowledge.

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

@Goro ... good to hear from you. Thanks for replying. Appreciate your counsel, as always.

I am not sure how to interpret this result as I considered my performance to be quite strong. Your thoughts on interpreting exams generally speaking?

Same question as to SS... what do you think my chances of not matching are? Given that I am not necessarily interested in the most prestigious institutions, but would like an academic institution, in the southeast/southwest, and in a big city.

 

[AcademicNeurosurgery]

Actually, my family is the single most important thing in my life, friend.

But seriously, thanks for your thoughts. I would be indebted if you could comment - as precisely as possible - what my chances of NOT matching are as things stand (ie, applying without a passing score and - probably - submitting a rank list with a passing score if I test in early December). This prospect terrifies me.



I'm not necessarily interested in the most prestigious programs. I would like to be in a location I prefer most of all (big city, southeast/southwest) and I would like to be at an academic institution more than a community one.



I hear your frustration - and thanks, I suppose, for your commiseration. Of course, it does nothing to change facts. I considered seeking legal counsel to see if I could challenge the exam and get a rescoring somehow, but I don't think this would be resolved (even if I did somehow force the NBME's hand) by ERAS submission day in September.



I really don't want to do a research year. I want to start residency ASAP.





Great question. Has been haunting me now for a month. Honestly I really don't believe that my performance on test day was subpar -- I thought it went very well. I really can't think of a single patient station that (I believe) went poorly (the only mistake I do remember making is not washing my hands before shaking a patient's hand ... at one patient station). I am tempted to believe that it was some kind of "glitch" as I am not inclined to be conspiratorial. Of course, however, I think it would be somewhat ignoble of me to present this as some sort of error in the system. The correct answer, it seems to me, is to "own it" but I express no insincerity when I say that I don't know what it is I am taking responsibility for.

I prepared the way I wanted, got an adequate amount of sleep, showed up early, ate a good breakfast and lunch, and executed everything almost exactly how I wanted. I have never performed as well and done so poorly -- this has never happened. It has shaken me to my very core -- challenged my identity.



@Goro ... good to hear from you. Thanks for replying. Appreciate your counsel, as always.

I am not sure how to interpret this result as I considered my performance to be quite strong. Your thoughts on interpreting exams generally speaking?

Same question as to SS... what do you think my chances of not matching are? Given that I am not necessarily interested in the most prestigious institutions, but would like an academic institution, in the southeast/southwest, and in a big city.

If you are adamant about applying this cycle, I would recommend doing everything you can to pursue the possibility of an NBME error. It can be a process that occurs simultaneously with trying to find a new date. And I think there is enough time between now and Sept 15 for them to look into it. Your choice, but I think you have nothing to lose and everything to gain.

Here is a document from ECFMG that essentially states they won't re-score your exam (due to built-in safeguards) but will re-calculate your score to ensure accuracy. Given the information you have provided to us here (strong app, can't think of any major reason flaws from test day, etc.), you should look into this: http://www.ecfmg.org/forms/steprchk.pdf

 

[Tenk]

Actually, my family is the single most important thing in my life, friend.

But seriously, thanks for your thoughts. I would be indebted if you could comment - as precisely as possible - what my chances of NOT matching are as things stand (ie, applying without a passing score and - probably - submitting a rank list with a passing score if I test in early December). This prospect terrifies me.



I'm not necessarily interested in the most prestigious programs. I would like to be in a location I prefer most of all (big city, southeast/southwest) and I would like to be at an academic institution more than a community one.



I hear your frustration - and thanks, I suppose, for your commiseration. Of course, it does nothing to change facts. I considered seeking legal counsel to see if I could challenge the exam and get a rescoring somehow, but I don't think this would be resolved (even if I did somehow force the NBME's hand) by ERAS submission day in September.



I really don't want to do a research year. I want to start residency ASAP.





Great question. Has been haunting me now for a month. Honestly I really don't believe that my performance on test day was subpar -- I thought it went very well. I really can't think of a single patient station that (I believe) went poorly (the only mistake I do remember making is not washing my hands before shaking a patient's hand ... at one patient station). I am tempted to believe that it was some kind of "glitch" as I am not inclined to be conspiratorial. Of course, however, I think it would be somewhat ignoble of me to present this as some sort of error in the system. The correct answer, it seems to me, is to "own it" but I express no insincerity when I say that I don't know what it is I am taking responsibility for.

I prepared the way I wanted, got an adequate amount of sleep, showed up early, ate a good breakfast and lunch, and executed everything almost exactly how I wanted. I have never performed as well and done so poorly -- this has never happened. It has shaken me to my very core -- challenged my identity.



@Goro ... good to hear from you. Thanks for replying. Appreciate your counsel, as always.

I am not sure how to interpret this result as I considered my performance to be quite strong. Your thoughts on interpreting exams generally speaking?

Same question as to SS... what do you think my chances of not matching are? Given that I am not necessarily interested in the most prestigious institutions, but would like an academic institution, in the southeast/southwest, and in a big city.

Like I said. The only way to fail CS is to forget to do an entire portion on every patient: i.e. Don't do a physical, don't take a pmsh, etc or be horrible at English. Or I guess forget to do the differential portion. Do NOT take this test again without taking some sort of formal training as this test is incredibly hard to fail and you probably forgot to do something major on every patient that you didn't even know you had to do. It's a game and you have to play the game to pass. If you don't play the game you fail.

 

[doyouhaveaflag]

Man, I'm sorry this happened to you. It's the stuff of nightmares and I hope you're able to work out an earlier retake date.

Do you mind if I ask which subsection you failed?

 

[jhamaican]

such a stupid test. Just a money grab imho. I am also a native English speaker and *almost* failed Step 2 CS . The stars on the performance evaluation were deep into the "grey bar" on the printout.

OP, I am sorry this happened to you, but it will all look like the true joke it is 10 years from now when you are a practicing physician with a beautiful family.

 

[NotAProgDirector]

Unfortunately, there is no answer to your question. There's no way to know what your chances of matching are, other than saying that it's less than it would have been with a pass.

There will be three types of programs:
1. Those that don't consider anyone with a fail, at all.
2. Those that consider those that have failed, but have since passed.
3. Those that don't care at all.

As you can imagine, the more competitive programs probably will be at the upper end of that list, but it's completely the program's option. I used to be in the #2 camp. Then we matched someone who fail/passed, and they were a disaster. Fair or not, we now don't take anyone who has failed.

As a super-competitive candidate except for the CS fail, I think you'll end up doing fine. The top programs may decline to interview you at all, and/or rank you low enough that you're unlikely to end up there. But mid tier programs may see you as a "steal" -- someone whom would have ended up at a top flight program but that they now have a good chance at instead.

As far as asking for a regrade, I'm somewhat mixed. My initial answer was: "Go ahead and waste your money. They will add up your score, and get the same result". But then I had a PM discussion with an SDN member who did that, and had their score changed to a Pass. USMLE refunded their money, and then paid them something (as they ended up not being able to match). Unfortunately I don't see any way to search my PM's, so I can't find it. What are the chances this would happen to you? I have no idea. You would think that all fails would automatically be rescored.

What part of CS did you fail?

 

[MemphisBlues]

Chances of not matching are extremely low.

But this has potentially taken you from being one of the top applicants in the country to a "red flag"

That is what I expected you to say. Any sense of what "caliber" of school I should aim to apply to? (with an eye towards my priorities being location in the southeast/southwest, a big city, and an academic program)...

Thanks again for your candor.

If you are adamant about applying this cycle, I would recommend doing everything you can to pursue the possibility of an NBME error. It can be a process that occurs simultaneously with trying to find a new date. And I think there is enough time between now and Sept 15 for them to look into it. Your choice, but I think you have nothing to lose and everything to gain.

Here is a document from ECFMG that essentially states they won't re-score your exam (due to built-in safeguards) but will re-calculate your score to ensure accuracy. Given the information you have provided to us here (strong app, can't think of any major reason flaws from test day, etc.), you should look into this: http://www.ecfmg.org/forms/steprchk.pdf

I already did the recheck. Sadly a negative result. But - as you say - it is simple them adding up my score to make sure it was correctly summed, NOT checking to make sure the grades of my raters were accurate in the first place (which is where I would suspect an error).

Thanks though.

More formal action on my part would require seeking legal counsel to compel the NBME to disclose information on why I failed. But I think it very unlikely that this would be successful, and I think it would take too long. (And honestly I don't even know what my angle is -- I don't think it is a conspiracy. I don't think anyone is out to get me or that I failed unfairly. I just suspect that somehow a mistake was made and I was given a lower score than my performance deserved -- but this hardly seems the basis for legal action).

Like I said. The only way to fail CS is to forget to do an entire portion on every patient: i.e. Don't do a physical, don't take a pmsh, etc or be horrible at English. Or I guess forget to do the differential portion. Do NOT take this test again without taking some sort of formal training as this test is incredibly hard to fail and you probably forgot to do something major on every patient that you didn't even know you had to do. It's a game and you have to play the game to pass. If you don't play the game you fail.

With reference to my answers above, I simply don't know what I did wrong. I am tempted to believe that it was nothing I did wrong as I don't remember any glaring weaknesses, and that it was simply some kind of error. The more I read about CS -- the more convinced I become that I did everything according to the "textbook" -- I took histories systematically, I did relevant physical exams, asked relevant review of systems/PMH/PSH/All/Med/FamHx/SocHx and I wrote concise notes and never ran out of time -- I gave, as far as I remember, reasonable differentials and work-ups. I am simply at a loss to explain this failure.

My institution has offered me remediation and I have accepted the help. Otherwise, I'll read through First Aid for USMLE Step 2 CS and go from there. Shrug.

Man, I'm sorry this happened to you. It's the stuff of nightmares and I hope you're able to work out an earlier retake date.

Do you mind if I ask which subsection you failed?

The Integrated Clinical Encounter (ICE) section... although it is vaguely defined in the PDF describing CS, it is this section of the exam (ie, the knowledge relevant portion) that I least expected to fail. Even above the Communication Skills and English Language Proficiency sections. As a native English speaker, I would have expected to fail the English Language Proficiency portion before I failed the ICE portion -- as I believe, with reference to my USMLE Step 1 and USMLE step 2 CK scores (260 & 272, respectively) that I am highly knowledgeable about medicine. I simply cannot explain this result. I am at my wit's end.

Unfortunately, there is no answer to your question. There's no way to know what your chances of matching are, other than saying that it's less than it would have been with a pass.

There will be three types of programs:
1. Those that don't consider anyone with a fail, at all.
2. Those that consider those that have failed, but have since passed.
3. Those that don't care at all.

As you can imagine, the more competitive programs probably will be at the upper end of that list, but it's completely the program's option. I used to be in the #2 camp. Then we matched someone who fail/passed, and they were a disaster. Fair or not, we now don't take anyone who has failed.

As a super-competitive candidate except for the CS fail, I think you'll end up doing fine. The top programs may decline to interview you at all, and/or rank you low enough that you're unlikely to end up there. But mid tier programs may see you as a "steal" -- someone whom would have ended up at a top flight program but that they now have a good chance at instead.

As far as asking for a regrade, I'm somewhat mixed. My initial answer was: "Go ahead and waste your money. They will add up your score, and get the same result". But then I had a PM discussion with an SDN member who did that, and had their score changed to a Pass. USMLE refunded their money, and then paid them something (as they ended up not being able to match). Unfortunately I don't see any way to search my PM's, so I can't find it. What are the chances this would happen to you? I have no idea. You would think that all fails would automatically be rescored.

What part of CS did you fail?

The bolded portion of your answer is what I am hoping for. I would love to end up at a mid-tier academic institution in a big city in the southeast/southwest. I think I can still convince them that I am a strong candidate, based on the rest of my application.

My answer about the recheck thing is above. It didn't work out... but the summing of my scores is not where I would expect an error in the process.


ALL --> if anyone has an idea about getting an earlier CS date (as soon as possible, but certainly before November) -- please let me know. I am using the "Page Monitor" application but the third party scheduler automated systems are against the rules, to my knowledge.

 

[Merely]

Wait if you don't even know why you failed, what happens if you make the same "mistake" and fail again? You don't even know why you failed. What is this guy supposed to do?

 

[Goro]

I don't think there is any good way to predict which programs you should consider at this point.

Like @aProgDirector said, there are programs that are going to reject you because of this, period. There are also programs that will overlook it (to a degree) once you have a passing score.

I think your only solution is to cast an extremely wide net and apply to a ton of programs and see what sticks.

Unfortunately I worry that without a passing score your interview yield is going to be very low.

Are there any programs that you can recommend to OP?

 

[mw18]

It's a game changer.

At a lot of institutions he would be unrankable per GME policy.

At my program he wouldn't get an interview without a passing score.

Honestly if OP had sights set on a top program, it wouldn't be unreasonable to consider a research year at this point. Get the CS squared away and then apply fresh next year.

The bolded was my first instinct. You've put together a tremendous three years with one hiccup that seems relatively inexplicable. It is absolutely mind-boggling that someone scoring anywhere near as high as you have on Step 1/2CK could fail the medical knowledge part of Step 2 CS. But if you're not going to have a passing score until late winter/early spring then you may be better served doing research this year and re-taking Step 2. The research will help your app some, the pass will help it immensely. It would be terrible to have to scramble into a spot or a prelim year, or match in a program you would really rather not all for a year of your time. This is obviously a nightmare scenario, but it is something to seriously consider, particularly if you can't get a date in the next few months.

 

[sliceofbread136]

Do you even know what you did wrong on CS? I agree with SouthernSurgeon that this is the most important thing in your life right now but I don't think scheduling is more important than fixing your mistake first. The only thing worse than failing CS is failing CS twice. Did you forget a whole portion of the exam on every patient? That's pretty much the only way to fail the thing if you speak great English. Sorry that happened though, gl.

I don't think this is true anymore. In order to justify keeping this ******ed test and forcing us Med students to fork over $2k they increased failure rate to almost 5%. If you aren't hitting enough of the needed questions on their scoring rubic and not hitting enough of the needed differentials then it is definitely possible to fail from just that. In my opinion what best prevents this is coming in with a good ros memorized to cover all your bases

 

[ACSurgeon]

Why would OP be 'unrankable' when he will get his result by Feb 21st, which is the same exact date of ROL submission deadline (9pm)?

This thread scares the bejesus out of me... Taking mine mid November and hoping I will get my result early February when programs are submitting their ROL..

It's one thing to not have a score. It's another to have a failing score.

 

[Merely]

It's one thing to not have a score. It's another to have a failing score.

Interesting...does this imply we should postpone taking cs?

 

[ACSurgeon]

Interesting...does this imply we should postpone taking cs?

I'm no program director, but it makes sense that it's more harmful to have a failed score than not have a score at all. Now, if you're applying to a program that requires a passing score, you should plan to have it complete before the deadline.

In general, I think it's smart to take both parts of step 2 such that scores come out after eras submission. That's just my personal opinion.

 

[MemphisBlues]

I don't think there is any good way to predict which programs you should consider at this point.

Like @aProgDirector said, there are programs that are going to reject you because of this, period. There are also programs that will overlook it (to a degree) once you have a passing score.

I think your only solution is to cast an extremely wide net and apply to a ton of programs and see what sticks.

Unfortunately I worry that without a passing score your interview yield is going to be very low.

The bolded is what I intend to do.

I hope it won't be too low. Speculation is too difficult, of course, but I'm cautiously optimistic. I'll apply to 40-50 programs and hope for 7-10 interviews. With that anticipated yield, I think I'll have a good shot at matching somewhere I like.

Are there any programs that you can recommend to OP?

I don't specifically know the USMLE policies of any programs except my own; we would not consider OP. I think if they had a passing score, and had some people calling to advocate for him, then that would be reconsidered. But it's definitely a no go without a pass first.

A shame that no programs come to mind, but thanks again for your candor about your own program's stance on this.

I am under the impression that many mid-level academic programs will not view my application in this way, but will instead view me as a "steal" in that I had strong Step 1 and Step 2 CK scores but will be passed over by the Vandy's/JHU/UPenn/Columbias of the world because of the failed USMLE Step 2 CS. I care not that I won't have the prestigious name on my resume -- so long as I can still have a shot at some academic programs in big cities.

Anyway, thanks again SS! Your willingness to address many points in this thread is surely not solely appreciated by myself.

I don't think this is true anymore. In order to justify keeping this [silly] test and forcing us Med students to fork over $2k they increased failure rate to almost 5%. If you aren't hitting enough of the needed questions on their scoring rubic and not hitting enough of the needed differentials then it is definitely possible to fail from just that. In my opinion what best prevents this is coming in with a good ros memorized to cover all your bases

Who knows what was operative in my case, of course. However, as you say, there doesn't seem to be a good reason why the failure rate has increased. Perhaps there is a good reason? I don't know.

 

[Goro]

The bolded is what I intend to do.

I hope it won't be too low. Speculation is too difficult, of course, but I'm cautiously optimistic. I'll apply to 40-50 programs and hope for 7-10 interviews. With that anticipated yield, I think I'll have a good shot at matching somewhere I like.





A shame that no programs come to mind, but thanks again for your candor about your own program's stance on this.

I am under the impression that many mid-level academic programs will not view my application in this way, but will instead view me as a "steal" in that I had strong Step 1 and Step 2 CK scores but will be passed over by the Vandy's/JHU/UPenn/Columbias of the world because of the failed USMLE Step 2 CS. I care not that I won't have the prestigious name on my resume -- so long as I can still have a shot at some academic programs in big cities.

Anyway, thanks again SS! Your willingness to address many points in this thread is surely not solely appreciated by myself.



Who knows what was operative in my case, of course. However, as you say, there doesn't seem to be a good reason why the failure rate has increased. Perhaps there is a good reason? I don't know.

Good luck!

 

[MemphisBlues]

Good luck!

Thanks Goro! Your commentary is always appreciated.

 

[iceman55]

The bolded is what I intend to do.

I hope it won't be too low. Speculation is too difficult, of course, but I'm cautiously optimistic. I'll apply to 40-50 programs and hope for 7-10 interviews. With that anticipated yield, I think I'll have a good shot at matching somewhere I like.





A shame that no programs come to mind, but thanks again for your candor about your own program's stance on this.

I am under the impression that many mid-level academic programs will not view my application in this way, but will instead view me as a "steal" in that I had strong Step 1 and Step 2 CK scores but will be passed over by the Vandy's/JHU/UPenn/Columbias of the world because of the failed USMLE Step 2 CS. I care not that I won't have the prestigious name on my resume -- so long as I can still have a shot at some academic programs in big cities.

Anyway, thanks again SS! Your willingness to address many points in this thread is surely not solely appreciated by myself.



Who knows what was operative in my case, of course. However, as you say, there doesn't seem to be a good reason why the failure rate has increased. Perhaps there is a good reason? I don't know.

Current ms4 that will be going through application process with you. If i were you i would double that number of applications to like 80-100 programs. And aim to go on at least 15 interviews. Its much safer to overshoot at this point.


Sent from my iPhone using SDN mobile

 

[ACSurgeon]

Another vote for continuing to try to find a date sooner if at all possible. This might mean getting a last minute exam date so do your best to prepare early and be ready for a redo.

 

[doyouhaveaflag]

My buddy is planning to cancel his CS date in Atlanta for next week. Hope you get it man!

 

[MemphisBlues]

Current ms4 that will be going through application process with you. If i were you i would double that number of applications to like 80-100 programs. And aim to go on at least 15 interviews. Its much safer to overshoot at this point.


Sent from my iPhone using SDN mobile

Agreed that 15 is probably a better goal for number of interviews. Not sure that it will have to be >80. I'll just do what my advisor tells me to do.

Another vote for continuing to try to find a date sooner if at all possible. This might mean getting a last minute exam date so do your best to prepare early and be ready for a redo.

My buddy is planning to cancel his CS date in Atlanta for next week. Hope you get it man!

Agreed with above. Have seen some reassuring signs that earlier spots will open up if I continue to be persistent with the Page Monitor tool.

 

[Planes2Doc]

You can always roll the dice and apply for preliminary positions. It's risky because there is no guarantee if you will get a PGY-2 position, but some people go that route.

 

[MemphisBlues]

I think this is bad advice.

If OP were to have a "wasted" year, it's much better to delay graduation and do research, then apply freshly as an M4 next year (with a CS pass in hand), than to get a prelim spot.

Advantages of a research year:
1. Build CV with research/pubs and possibly improved LORs
2. Have passing CS score lined up at start of application season
3. More time to interview compared to a prelim year
4. No stigma of "unmatched"/prelim

Advantages of a prelim year: ~10-20% probability of finding a PGY2 position (But likely in a worse program than OP would otherwise be capable of matching in)

Agree. Trying to avoid prelim year.

Current plan is to apply widely and broadly (probably 70+ programs) and then add prelim programs in November if I am getting few (eg, <10) interviews at that point.

Hopefully, however, this will all be irrelevant as I'll be able to take CS much earlier (eg, August or September) and I'll have a passing CS to present to schools and the interview offers will not be in short supply.

But I should obviously prepare for the worst (ie, I actually have to wait til December to take CS).

Nevertheless, I am cautiously optimistic that the pros in my application outweigh the cons as - I believe, per my advisor - that some programs do not take CS as seriously as other parts of the application.

 

[Jabbed]

So given that your CS fail will be on your ERAS, I would presume that any program that interviews you would be amenable to either a) ranking you if/when you pass or b) ranking you without a passing score. While not overly reassuring, I think that it's safe to say that any program that does interview you is willing to overlook this.

 

[MemphisBlues]

Was able to move my exam up and took it again prior to September 8th (such that my result will return before the first week of November 2017 -- prior to many interview invitations are extended).

Extremely confident that I passed.

Any thoughts on how the (presumably) passing result prior to interview invitations will change things?

@SouthernSurgeon @Goro

 

[jw3600]

Was able to move my exam up and took it again prior to September 8th (such that my result will return before the first week of November 2017 -- prior to many interview invitations are extended).

Extremely confident that I passed.

Any thoughts on how the (presumably) passing result prior to interview invitations will change things?

@SouthernSurgeon @Goro

No one really knows. I think you're fine now. Your app is so competitive that if you just take ownership of the failure and have the proof (a now passing score) that it was a fluke it will just be a small blemish. Good job getting it done early. Blast email PDs the minute you get your score.

 

[Goro]

Was able to move my exam up and took it again prior to September 8th (such that my result will return before the first week of November 2017 -- prior to many interview invitations are extended).

SS is the guy to answer this!!!

Extremely confident that I passed.

Any thoughts on how the (presumably) passing result prior to interview invitations will change things?

@SouthernSurgeon @Goro

 

[ACSurgeon]

Was able to move my exam up and took it again prior to September 8th (such that my result will return before the first week of November 2017 -- prior to many interview invitations are extended).

Extremely confident that I passed.

Any thoughts on how the (presumably) passing result prior to interview invitations will change things?

@SouthernSurgeon @Goro

Your chances are hurt at the most competitive programs but you should be able to match at a solid academic program.

 

[MemphisBlues]

Your chances are hurt at the most competitive programs but you should be able to match at a solid academic program.

That is my understanding as well. My PD is actually more optimistic than I am. We'll see.

 

[SpecializedSurgeon]

We actually saw, and interviewed, several applicants in the same boat as you last year -- AOA, top scores, etc. but for some reason failed CS. We looked at the entire application and ranked accordingly, as well as how we felt they fit in to the program.
Several programs wont want to take a "risk" whereas others won't care. All you can do is send out your application and see what happens.
To answer your last question, it will help if you've already remedied the failure with a pass on the second attempt.

 

[MemphisBlues]

Would make sure that this is directly addressed in your application - perhaps the PD's letter is a good place? (i.e. that you've already retaken the exam and that the PD believes this is not representative of your performance/caliber/etc).

I don't know how to predict "how much" better this makes the situation, but it certainly helps.

If interview yield is low, need to get your home PD and other mentors on the horn trying to get you hooked up with more interviews.

Thanks for your thoughts!

We actually saw, and interviewed, several applicants in the same boat as you last year -- AOA, top scores, etc. but for some reason failed CS. We looked at the entire application and ranked accordingly, as well as how we felt they fit in to the program.
Several programs wont want to take a "risk" whereas others won't care. All you can do is send out your application and see what happens.
To answer your last question, it will help if you've already remedied the failure with a pass on the second attempt.

yea I'm expecting to lose out on a few programs, but my PD counseled me not to worry about it too much as he believes I will still match very well. I'm cautiously optimistic, and have applied to ~ twice as many programs as I otherwise would have.

Thanks for replying!

 

[NorthernDO]

Wondering about my competitiveness for general surgery residency programs in acgme world as a 3rd year osteopathic student with USMLE Step 1 237 and COMLEX Level 1 661. Haven't taken Step or Level 2 yet. I want to do a community general surgery program.

 

[AthleteDoc7]

Thanks for your thoughts!



yea I'm expecting to lose out on a few programs, but my PD counseled me not to worry about it too much as he believes I will still match very well. I'm cautiously optimistic, and have applied to ~ twice as many programs as I otherwise would have.

Thanks for replying!

how did your interview season end up going OP? did you pass CS the second time?