chances in IM?

[mossyfiber12]

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So I have come to the realization that I can't even begin to score average on step 1...quite frustrating and disappointing honestly. You would think, after all this time, a guy would at least be average but I guess I am not the only one feeling this way.

My exam is Friday and on my last practice exam I got a 205 on UWSA. That's right around what I have been scoring for the past 2 weeks. It's even more discouraging when I see the disappointed look on my parents face when I told them my score and the national average.

Anyway, I am wondering what my chances are of matching into an IM program in a big city. I attend a mid tier state school. I would definitely like to subspecialize in IM so hopefully this score is not gonna keep me back.

Also, I will start rotations soon so I just wanted to get an input from all my seniors on what I should be doing to give myself the best chance.

As always, thanks for listening and your helpful suggestions.

 

[jdh71]

So I have come to the realization that I can't even begin to score average on step 1...quite frustrating and disappointing honestly. You would think, after all this time, a guy would at least be average but I guess I am not the only one feeling this way.

My exam is Friday and on my last practice exam I got a 205 on UWSA. That's right around what I have been scoring for the past 2 weeks. It's even more discouraging when I see the disappointed look on my parents face when I told them my score and the national average.

Anyway, I am wondering what my chances are of matching into an IM program in a big city. I attend a mid tier state school. I would definitely like to subspecialize in IM so hopefully this score is not gonna keep me back.

Also, I will start rotations soon so I just wanted to get an input from all my seniors on what I should be doing to give myself the best chance.

As always, thanks for listening and your helpful suggestions.

Well . . . what's I'd say is that there is still A LOT of time and things to do between here and there . . .

1. You have no clue what you will score on step one until your get your score back. So STOP crossing that bridge before you get to it

2. Worst case scenario (I'm trying to say this with as a straight a face as possible . . . "worst case"), you score a 205. That's still plenty high to get into an Internal Medicine program. That score by itslef is not high enough to place you into any top program in any city though (remember there are plenty of community programs in most big cities).

3. Assuming #2, you will need to do as well as you can on your third year rotations, honoring medicine will help a lot. You will need to step 2 early and do well. You will ned to do a sub I early and honor it. You should get involved in a research project and also attempt to present a case/poster to a regional ACP meeting. All of these will increase your prospects of finding a better program. What I'm saying si that you will need to load your CV with enough other "stuff" that the isolated 205 can be largely ignored.

What city(ies)?

 

[Perrotfish]

How long have you been preparing and what have you been doing to get ready? Do you have to take the test now or can you push back a month? If you can possibly push this back I'd say you should.

 

[mossyfiber12]

Well I have taken 4 tests so far. NBME 4,6 and world self assessment 1 and 2. My range is 200-210. I have been studying for about a month more or less. I can't postpone my exam as my rotation starts the week after my exam.

I am looking for big cities like San Fran, Chicago, NYC, ATL.

My plan is to just read First Aid for the next couple of days because I am forgetting details here and there that might get me extra couple of points.

Do you guys have any idea what kind of research can I get involved in while I am doing my rotations?

 

[jdh71]

Well I have taken 4 tests so far. NBME 4,6 and world self assessment 1 and 2. My range is 200-210. I have been studying for about a month more or less. I can't postpone my exam as my rotation starts the week after my exam.

I am looking for big cities like San Fran, Chicago, NYC, ATL.

My plan is to just read First Aid for the next couple of days because I am forgetting details here and there that might get me extra couple of points.

Do you guys have any idea what kind of research can I get involved in while I am doing my rotations?

Which sub-speciality?

 

[Perrotfish]

do you not have vacation you can take? My advice would be to talk to your dean tomorrow, explain your situation and , and see if you can postpone a month by changing the rotation you start with. If you can then eat the fee to reschedulee and do Doctors in Training or somethng similar to get that score up.

If you can't... well, then don't worry about it until you have an actual score to work with. that practice test has a 10 point range on either side of it that you could get without even having a freakishly good or bad day, and a 215 is a lot different than a 195. Come back when you have a real score to assess your options.

 

[mossyfiber12]

Yeah right now I am just hoping I get lucky with my form and few good guesses here and there could put over 210.

We can't take a month off until at least 1 or 2 rotations. Also, there is a strict policy that if there is no family emergency, you can't get an extension.

At the moment, I am interested in Card and GI. Do subspecialties look at my step 1 score??? I was hoping that as long as I am in an IM program and perform well then it shouldn't be that much of a problem. Also, how much does step 2 count at this point in IM programs? I have heard rumors that some programs don't even bother with them as many people choose not to send in their scores.

 

[chitown82]

Yeah right now I am just hoping I get lucky with my form and few good guesses here and there could put over 210.

We can't take a month off until at least 1 or 2 rotations. Also, there is a strict policy that if there is no family emergency, you can't get an extension.

At the moment, I am interested in Card and GI. Do subspecialties look at my step 1 score??? I was hoping that as long as I am in an IM program and perform well then it shouldn't be that much of a problem. Also, how much does step 2 count at this point in IM programs? I have heard rumors that some programs don't even bother with them as many people choose not to send in their scores.

Lots of good advice here.

You might be surprised at your performance on the real test - focus on studying and stop worrying about residency. Once you get your score, come back here, tell us how you did, and we'll all go from there.

Having said that, you will have no problem landing a mid-tier or community program in any of the cities you mentioned provided the rest of your application is solid.

 

[Cardiologist]

Unfortunately, I am exactly in the same spot as OP except the STep 1 score is a reality for me. Everyone's telling me to study and do well in Step 2. Honestly, I am just scared and upset. I know I need to get out of it. I was wondering if talking to the PD at my school's IM program might be a good idea? just to get a sense of how screwed up am i? what do u guys think?

 

[jdh71]

Unfortunately, I am exactly in the same spot as OP except the STep 1 score is a reality for me. Everyone's telling me to study and do well in Step 2. Honestly, I am just scared and upset. I know I need to get out of it. I was wondering if talking to the PD at my school's IM program might be a good idea? just to get a sense of how screwed up am i? what do u guys think?

I had a dollar for every single neurotic overachiever . . .

You are NOT screwed

 

[ropeadope1983]

I scored around the national average on one of the NBME practice exams and within 7 weeks bumped-up my real Step1 score to 258.

Anything's possible.

Bust it right now until the end and focus all your effort on First Aid.

 

[jbz24]

I scored around the national average on one of the NBME practice exams and within 7 weeks bumped-up my real Step1 score to 258.

Anything's possible.

Bust it right now until the end and focus all your effort on First Aid.

Getting around the national average before having 7 weeks to study isn't the best example...🙄

 

[ropeadope1983]

Getting around the national average before having 7 weeks to study isn't the best example...🙄

Starting out in the same boat as everyone else and advancing to that level is a valid example of anything's possible. It show's the OP I didn't get there by being a genius test-taker or because of what my school did for me. I earned it in those 7 weeks and he can earn some good improvement too. Further, I believe the improvement curve is steepest in the beginning if you are doing the right things (he said he plans to focus 100% on First Aid, which tells me he's doing the right things). Did I say he could improve to 258 after a week? No. Everyone would be doing it if it were that easy. Could he bump it up to the 230s in a week. Definitely yes.

Anyway, you've wasted enough of my time. Hope I explained it well enough for you to understand...🙄

 

[jbz24]

Starting out in the same boat as everyone else and advancing to that level is a valid example of anything's possible. It show's the OP I didn't get there by being a genius test-taker or because of what my school did for me. I earned it in those 7 weeks and he can earn some good improvement too. Further, I believe the improvement curve is steepest in the beginning if you are doing the right things (he said he plans to focus 100% on First Aid, which tells me he's doing the right things). Did I say he could improve to 258 after a week? No. Everyone would be doing it if it were that easy. Could he bump it up to the 230s in a week. Definitely yes.

Anyway, you've wasted enough of my time. Hope I explained it well enough for you to understand...🙄

I guess my post was sarcastic enough to deserve a response like this. I just meant that it's much easier to raise your score with 7 weeks than it is with 1 week. Plus getting the national average at the start of your study time means you're a bit more knowledgeable than most. Yes, OP can raise his score in 1 week, but like you said, not to the level you achieved.

 

[ropeadope1983]

I guess my post was sarcastic enough to deserve a response like this. I just meant that it's much easier to raise your score with 7 weeks than it is with 1 week. Plus getting the national average at the start of your study time means you're a bit more knowledgeable than most. Yes, OP can raise his score in 1 week, but like you said, not to the level you achieved.

"I'm sorry. No, you're such a good guy, and I appreciate you." [1]

[1] The 40 Year Old Virgin (2005)

 

[chubbykid]

i only got a regular pass on my IM core clerkship. step 1 was 218. how much will this clerkship grade affect my chances? i would just like to get a university program anywhere in any state.

 

[jbz24]

i only got a regular pass on my IM core clerkship. step 1 was 218. how much will this clerkship grade affect my chances? i would just like to get a university program anywhere in any state.

You'll get into a university program somewhere if you want. It just won't be MGH.

 

[IMdocT]

i'm by far no expert, but my opinion is that a passing step 1, no matter how bad, will not make your chances 0%. if i remember the stats correctly from a couple years ago, 95% of US grads applying primarily for IM matched somewhere. that is a pretty good number, if you ask me. it's just that you shouldn't expect to match into top tier programs with a below average score.

these are some advice i've heard (and sound right) about things you can do to improve your match chances:
1. do your best on the shelf exams and rotations, especially in the IM rotations
2. establish connection with at least 2 IM attendings during IM rotations to get decent letters of recs
3. do well on step 2 and have the scores well before match day. i'm not sure when the best time is, late summer summer vs fall vs early winter. but don't take it so early that you aren't prepared for it. give yourself time to review
4. apply everywhere you want, not just only where you think you can get into. the only thing you have to lose is the application fee. you may get rejected, but your chances would be 0% if you didn't apply
5. have stuff to put in your CV like activities, research, etc, if you can
6. talk to your PD for help. with OP, this thread is like 2 weeks old, but there were plenty of people in my school who delayed step 1 by a month or so. they just had to sacrifice their 3rd year vacation time and start rotations later. the deans frowned on this, but you should do whatever is good for you. i kind of wish i did that, but that's in the past.

so to summarize, a passing but low step 1 is not going to keep you out of IM. if you still want a competitive program, you will have to compensate. just remember that your chances are never 0% unless you don't try. and even if you don't get the exact thing you aimed for, it's not the end of the world. there are plenty of options to choose from in IM.