My step 1 was painfully bad, 211. I've done alright 3rd year with 3 honors (medicine, surgery, psych) with high passes in all the other rotations. I haven't taken step 2 yet but I know I would need to knock it out of the park to even have a remote chance. I also in the middle of setting up a research year at Mass Eye and Ear to help my odds, but should I start looking in other specialties given my step 1 score?
Chances of matching with low step 1
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I would never tell anyone that their numbers or application is not good enough for a field they really, really like and want to match into. However, a 211 is more than 30 points below the average Step 1 score and therefore makes extremely difficult (not impossible) for someone to match. You can win the Nobel prize, but the thing that will keep your application from getting reviewed is Step 1 score cut-offs. Nearly every program has them at some score level.
If you are determined and love ophthalmology enough, then you can certainly do it if you push the 'pedal to the metal.' Do everything you possibly can. Score >245 on Step 2 CK. Knock out all the remaining rotations with the highest grade. Do away rotations at realistic programs. And publish as much as you can. Basically, you need to show that you would be an asset to ophthalmology. You need to show that ophthalmology would be less awesome without you in it. You can do research that is groundbreaking or you can do something completely different that changes the field for the better. That's up to you.
Once you have done that, you can ask your mentors, who I hope will write you astounding letters, to contact people they know at all the different programs and try to get your application reviewed despite the cut-offs. You need to do your work and mine each program for faculty and chair and PDs that your mentors would know. You need mentors who will put their reputation on the line for you and vouch for you highly. And this will happen if you are a stellar performer in whatever research and other activities you do with them.
There's no guarantee in life so I would always have a backup plan. It sucks that a score can decide your future like this. But you eventually need to move on with your career and do medicine in another form or specialty.
If you are determined and love ophthalmology enough, then you can certainly do it if you push the 'pedal to the metal.' Do everything you possibly can. Score >245 on Step 2 CK. Knock out all the remaining rotations with the highest grade. Do away rotations at realistic programs. And publish as much as you can. Basically, you need to show that you would be an asset to ophthalmology. You need to show that ophthalmology would be less awesome without you in it. You can do research that is groundbreaking or you can do something completely different that changes the field for the better. That's up to you.
Once you have done that, you can ask your mentors, who I hope will write you astounding letters, to contact people they know at all the different programs and try to get your application reviewed despite the cut-offs. You need to do your work and mine each program for faculty and chair and PDs that your mentors would know. You need mentors who will put their reputation on the line for you and vouch for you highly. And this will happen if you are a stellar performer in whatever research and other activities you do with them.
There's no guarantee in life so I would always have a backup plan. It sucks that a score can decide your future like this. But you eventually need to move on with your career and do medicine in another form or specialty.
I know someone with very similar stats who unfortunately went unmatched in 2016. Here are some thoughts from her.
-First, you need to figure out how your program would feel about you. Have you cultivated a relationship with your home chair and program director thus far? Would they be willing to match you at your home program after 1 productive year of research? What about two? If the people who know you "best" at this point remain hesitant, it will remain difficult to convince outside programs where you may only rotate for a month at a time that you are a viable candidate.
-Also, what is your institutional prestige like? Are you IMG or DO? That's going to kill your chances. Low tier allopathic MD will also be very hard. Upper tier will make it slightly easier.
-If you just submit an application with that step 1, your application materials will not get looked at UNLESS
1) You do an away rotation at that institution and are viewed favorably
2) Your mentor directly contacts a PD/chair and they are willing to bypass the initial step 1 screen and grant you an interview. That being said, PDs are very open to this kind of thing if they know your mentors. Case in point, my friend went to the AAO meeting in mid october (well after a number of interviews were sent out) and strolled the halls with her mentor. They encountered several chairs and PDs who offered said applicant an interview on the spot without reviewing their credentials simply because her mentor was that well known.
-As such, mentorship is key for you going forward. Who are your mentors, and who are you thinking about doing research with? Have they helped out other students with your scores from your caliber of school recently? If the answer is yes, then thats a great sign! Are they willing not just to write you a great letter, but to actually make phone calls and write emails on your behalf? Ask what other medical students and residents have worked with that researcher recently and find out where their paths took them.
-Realize that step 2 can be just as challenging as step 1 for some people....
-First, you need to figure out how your program would feel about you. Have you cultivated a relationship with your home chair and program director thus far? Would they be willing to match you at your home program after 1 productive year of research? What about two? If the people who know you "best" at this point remain hesitant, it will remain difficult to convince outside programs where you may only rotate for a month at a time that you are a viable candidate.
-Also, what is your institutional prestige like? Are you IMG or DO? That's going to kill your chances. Low tier allopathic MD will also be very hard. Upper tier will make it slightly easier.
-If you just submit an application with that step 1, your application materials will not get looked at UNLESS
1) You do an away rotation at that institution and are viewed favorably
2) Your mentor directly contacts a PD/chair and they are willing to bypass the initial step 1 screen and grant you an interview. That being said, PDs are very open to this kind of thing if they know your mentors. Case in point, my friend went to the AAO meeting in mid october (well after a number of interviews were sent out) and strolled the halls with her mentor. They encountered several chairs and PDs who offered said applicant an interview on the spot without reviewing their credentials simply because her mentor was that well known.
-As such, mentorship is key for you going forward. Who are your mentors, and who are you thinking about doing research with? Have they helped out other students with your scores from your caliber of school recently? If the answer is yes, then thats a great sign! Are they willing not just to write you a great letter, but to actually make phone calls and write emails on your behalf? Ask what other medical students and residents have worked with that researcher recently and find out where their paths took them.
-Realize that step 2 can be just as challenging as step 1 for some people....
