Class Rank with Given Pass/Fail Step

[workaholic007]

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Hello everyone - I go to a low tier medical school and now that I learned that step might be reported pass fail for class of 2023 I want to determine how to proceed. I am interested in general surgery, ENT, and perhaps orthopedics. I am a non-traditional student, and I believe I am ranked top 25% or so in the class. I am curious if how much ranking might matter for matching in the future or how much it did in the past for the competitive fields like ENT . I know conventional wisdom is that STEP 1>>>>>>>ranking but now that STEP is pass/fail and these fields are super competitive I dont know what to think. Is it worth it to attempt to be top 10% or top 5% in the class but sacrifice my happiness and perhaps do professor lectures instead of boards?

 

[Frogger27]

Doubt there will be much difference between top 25%, top 10%, top 5%.. How does your school report it? I know mine only does top quartile (which makes you AOA eligible).

My thought would be that those are all very similar... kind of like getting a Step 250 vs step 260. Basically you have shown you are a top med student at your school by being in top 25%. I would probably try to focus on other things, such as research and networking vs studying more to get in that top 10%

 

[OnePunchBiopsy]

I would aim for 1st quartile if your school does quartile reporting. Check and see how clerkship grades are factored in, because some schools weigh preclinical grades less.

Try and get AOA, but don’t be upset if you don’t get it. Different institutions vary in how they give it. As I’ve said many times, it was a popularity contest at my school.

Regarding what to study, with step being P/F I would just study whatever resources best help you learn the material. Our classmates who always went to class all passed Step 1, so focusing more on lecture content is not necessarily a bad thing. Just have insight as to whether certain lectures hit the right points, and ignore the few PhD’s who just drone on and on about their research.

When you get to clerkships try and get honors in your surgery rotation.

Whatever specialty you decide, go on some away rotations and get noticed. Get some good LOR. Who you know is the most important factor in matching.

Best of luck!

 

[workaholic007]

I would aim for 1st quartile if your school does quartile reporting. Check and see how clerkship grades are factored in, because some schools weigh preclinical grades less.

Try and get AOA, but don’t be upset if you don’t get it. Different institutions vary in how they give it. As I’ve said many times, it was a popularity contest at my school.

Regarding what to study, with step being P/F I would just study whatever resources best help you learn the material. Our classmates who always went to class all passed Step 1, so focusing more on lecture content is not necessarily a bad thing. Just have insight as to whether certain lectures hit the right points, and ignore the few PhD’s who just drone on and on about their research.

When you get to clerkships try and get honors in your surgery rotation.

Whatever specialty you decide, go on some away rotations and get noticed. Get some good LOR. Who you know is the most important factor in matching.

Best of luck!

how much difficult do you think it is that my school does not have a home department in regards to finding a LOR? my school does not have that home departments for many fields and does not have a home hospital

 

[OnePunchBiopsy]

how much difficult do you think it is that my school does not have a home department in regards to finding a LOR? my school does not have that home departments for many fields and does not have a home hospital

Not having a home department makes it more difficult. I would try applying broadly to away rotations.

 

[OnePunchBiopsy]

how much difficult do you think it is that my school does not have a home department in regards to finding a LOR? my school does not have that home departments for many fields and does not have a home hospital

It’s actually a coincidence that you asked this when you did.

Right now I’m sitting in a hotel conference room watching a presentation about factors that affect match rates in a competitive specialty. It was a survey sent to program directors.

Number 1 = Perceived performance during an away rotation
Number 2 = Perceived fit for the program

Step scores were not on the list.

 

[libertyyne]

It’s actually a coincidence that you asked this when you did.

Right now I’m sitting in a hotel conference room watching a presentation about factors that affect match rates in a competitive specialty. It was a survey sent to program directors.

Number 1 = Perceived performance during an away rotation
Number 2 = Perceived fit for the program

Step scores were not on the list.

This doesn’t tell the full story though. Considering there is a lot of self selection that has already occurred by the time applications have gone out. Traditionally right after step was when a lot of people gunning for ortho suddenly became interested in IM.
so by the time an app even got to thePDs deskit has been filtered a few times.

OP, you should be doing the best you can in school/ research as you can without sacrificing your sanity. This is true if you were going into fm or going into IR.
you class is still going to have scored Step 2. So the game hasn’t really changed.
do you go to a DO school?
the not having a home program is more problematic for you, considering when push comes to shove you need someone in your corner making a call for you, or giving advice in your field.

 

[OnePunchBiopsy]

This doesn’t tell the full story though. Considering there is a lot of self selection that has already occurred by the time applications have gone out. Traditionally right after step was when a lot of people gunning for ortho suddenly became interested in IM.
so by the time an app even got to thePDs deskit has been filtered a few times.

You bring up a good point. I think Step 1 becoming P/F makes the two points emphasized by the survey (including over 100 program directors) even MORE important. It removes one of the factors filtering applications before hitting a PD’s desk.

 

[libertyyne]

You bring up a good point. I think Step 1 becoming P/F makes the two points emphasized by the survey (including over 100 program directors) even MORE important. It removes one of the factors filtering applications before hitting a PD’s desk.

I think in a world where that filter does not exist, pds will start to apply a new filter to be able to focus on those points again. The program Director survey definitely speaks to STEP 1 being the most important factor for extending an interview.

 

[OnePunchBiopsy]

I think in a world where that filter does not exist, pds will start to apply a new filter to be able to focus on those points again. The program Director survey definitely speaks to STEP 1 being the most important factor for extending an interview.

You're right regarding Step 1 and extending an interview, but I the PD survey you are citing is no longer relevant for OP since Step 1 is now P/F.

I think you're missing my point about away rotations and matching. We can banter all day about what could happen tomorrow. It's not going to help OP or anyone else reading this thread. Aside from the theoretical probability of a "new filter," which doesn't currently exist....

OP doesn't have a home program for their specialty of interest.
With Step 1 now being P/F, programs accepting away rotation applications can't reliably use it as a metric.
Based on the data I mention above, curated from PD's, the people who determine if you match:

If OP gets accepted for an away rotation, and does well, their likelihood of matching is high.

 

[workaholic007]

This doesn’t tell the full story though. Considering there is a lot of self selection that has already occurred by the time applications have gone out. Traditionally right after step was when a lot of people gunning for ortho suddenly became interested in IM.
so by the time an app even got to thePDs deskit has been filtered a few times.

OP, you should be doing the best you can in school/ research as you can without sacrificing your sanity. This is true if you were going into fm or going into IR.
you class is still going to have scored Step 2. So the game hasn’t really changed.
do you go to a DO school?
the not having a home program is more problematic for you, considering when push comes to shove you need someone in your corner making a call for you, or giving advice in your field.

I do not go to a DO school but very bottom barrel MD school. I had to do a post-bac to get in as well (bad grades in college)...did lot of growing up.

What are the methods to overcome a low step score and how difficult is it to get accepted on aways.

 

[workaholic007]

You're right regarding Step 1 and extending an interview, but I the PD survey you are citing is no longer relevant for OP since Step 1 is now P/F.

I think you're missing my point about away rotations and matching. We can banter all day about what could happen tomorrow. It's not going to help OP or anyone else reading this thread. Aside from the theoretical probability of a "new filter," which doesn't currently exist....

OP doesn't have a home program for their specialty of interest.
With Step 1 now being P/F, programs accepting away rotation applications can't reliably use it as a metric.
Based on the data I mention above, curated from PD's, the people who determine if you match:

If OP gets accepted for an away rotation, and does well, their likelihood of matching is high.

I want to clarify, "OP doesn't have a home program for their specialty of interest." I do not know exactly what I am interested in, but our school lacks several home programs. It makes things much more difficult it seems

 

[libertyyne]

I do not go to a DO school but very bottom barrel MD school. I had to do a post-bac to get in as well (bad grades in college)...did lot of growing up.

What are the methods to overcome a low step score and how difficult is it to get accepted on aways.

I dont understand the question. Have you taken step 1 and have gotten a bad score? or are you anticipating a bad score?
Either way that is the wrong frame of mind to have in medical school, and the advice would be different for either circumstance. You are already disadvantaged by not having a home program.

The point is you should be working your behind off to excel. Do the best you can without burning out. Then let the chips fall where they may at least you will have no regret going forward knowing you gave it your all.

 

[Goro]

Hello everyone - I go to a low tier medical school and now that I learned that step might be reported pass fail for class of 2023 I want to determine how to proceed. I am interested in general surgery, ENT, and perhaps orthopedics. I am a non-traditional student, and I believe I am ranked top 25% or so in the class. I am curious if how much ranking might matter for matching in the future or how much it did in the past for the competitive fields like ENT . I know conventional wisdom is that STEP 1>>>>>>>ranking but now that STEP is pass/fail and these fields are super competitive I dont know what to think. Is it worth it to attempt to be top 10% or top 5% in the class but sacrifice my happiness and perhaps do professor lectures instead of boards?

What's your Step 2 score?

That's what will count, along with networks and audition rotations

 

[workaholic007]

I dont understand the question. Have you taken step 1 and have gotten a bad score? or are you anticipating a bad score?
Either way that is the wrong frame of mind to have in medical school, and the advice would be different for either circumstance. You are already disadvantaged by not having a home program.

The point is you should be working your behind off to excel. Do the best you can without burning out. Then let the chips fall where they may at least you will have no regret going forward knowing you gave it your all.

I miswrote, I meant overcome not having a step score. My apologies. And correct thank you