Competitive?

[dhalstead387]

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This may be a silly question, but I'm wondering if someone might be able to give some insight.

I'm a third year medical student at a "top 20" med school who is interested in pathology. My Step 1 score is 249. Most of my preclinical grades are honors. Thus far have only received one grade for third year (HP). Overall, I don't feel terribly confident that I will be able to get many/any H's...but hopefully I will. I have 1 platform presentation, five other abstracts, and one second- or third-author manuscript (all non-pathology). Looking into getting involved with some pathology research soon.

My question is...given my strong step 1, "top" school, decent research, and perhaps mostly HP clinical grades, do you all feel like I would still have a good chance at some of the top pathology programs? I know some of you will shun me for asking only about the "top" programs, but if you don't mind, I'd appreciate your input. Thanks!

 

[mlw03]

Yes, it's a silly question. Yes, you're competitive.

This may be a silly question, but I'm wondering if someone might be able to give some insight.

I'm a third year medical student at a "top 20" med school who is interested in pathology. My Step 1 score is 249. Most of my preclinical grades are honors. Thus far have only received one grade for third year (HP). Overall, I don't feel terribly confident that I will be able to get many/any H's...but hopefully I will. I have 1 platform presentation, five other abstracts, and one second- or third-author manuscript (all non-pathology). Looking into getting involved with some pathology research soon.

My question is...given my strong step 1, "top" school, decent research, and perhaps mostly HP clinical grades, do you all feel like I would still have a good chance at some of the top pathology programs? I know some of you will shun me for asking only about the "top" programs, but if you don't mind, I'd appreciate your input. Thanks!

 

[Deucedano]

My stats are similar except step1 was 256 and I go to a mid-lower tier medschool. I had a little research in college and medschool w/o pubs. I felt the same way about my application but I got interviews at every "top" program (MGH, JHU, Penn, UCSF, Stanford, UW, ect.) except Brigham. Most if not all of them will probably kiss your $&@ at interviews too, so dont worry youll be fine

 

[2121115]

Step 1 is the only thing that matters. Everyone will "officially" tell you that isn't true, but it starts and stops there in reality. No one can officially go on record and say that it starts and stops with a test score, but having sat on residency application review committees I can tell you that it trumps all. Everyone likes to tell stories about someone they knew one time with a 255 Step 1 but a bad personality who didn't get ranked or whatever but that is just hogwash frankly. You can barely pass medical school and have a dud personality, but if you have a top Step 1 score people will just assume that your medical school was wrong and that you had a random bad day interviewing because you were tired or whatever. No one will question that the Step 1 score is the anomaly on your application and not the other way around.

Program directors unofficially know what other programs average Step 1 scores are for their incoming classes. No one will tell you this and there is no official document, but they know. And they care.

 

[dhalstead387]

Thanks for the replies. I wasn't concerned with Step 1, research, my med school, etc....mostly just hoping that "just" getting HPs throughout third year won't preclude me from interviewing at top places. Obviously I'll work hard and make sure I get the H in my pathology electives.

 

[mlw03]

Thanks for the replies. I wasn't concerned with Step 1, research, my med school, etc....mostly just hoping that "just" getting HPs throughout third year won't preclude me from interviewing at top places. Obviously I'll work hard and make sure I get the H in my pathology electives.

Highly doubt anyone will care about your MS3 grades so long as they're in the passing range.

 

[yaah]

Yep. Was similar to my application (you have more publications/abstracts than I did) and I got interviews everywhere I applied. Path is slightly more competitive these days but when I applied it was also competitive.

The comment about step I being "the only thing that matters" is incorrect. Step I is important but doesn't outweigh other weaknesses, if they are there. Step I is most important if it is really high (yours is close to really high I would say) or really low.

I don't think your third year grades should hurt. High pass is good. Not going to hold you back. A failing grade would be a problem.

 

[deleted314957]

amazing how things have changed since 1977 when i graduated. there was no usmle, our school did not give out grades (only had to pass several comprehensive exams) and anybody could go into any residency field they wanted. same with fellowships although they were not common then.

 

[KCShaw]

IMO most of those things were added as ways to rank people, which also made it easier on program directors who found it too annoying to try to rank folks based on things not so numeric. Fortunately or not along with it is a torrent of competitiveness as everyone fights for limited positions, and many schools and programs appear to be happy to promote as much paranoia as possible among the masses. And we end up with this same question it seems like every month or more -- I got this that and the other but I was born with polydactyly, surgery before I could remember, and I never knew until Mom told me last night, so could I possibly still get in anywhere??

As for those with very high Step scores, yeah, I remember interviewing one person when I was just starting residency who had some absurdly high Step I but literally couldn't figure out how to button his pants and had social skills to match his pants. The residents threatened to quit if he was -ranked-, not to mention if he matched. Of course the academic PD wanted him to start a grant or somesuch, though eventually claimed he wasn't "really" ranked. Bottom line is that, in general, I agree that "very high" and fail/"low pass" step scores can almost be the end-all-be-all (though at least some of the latter will still find positions), but for the most part step scores just do or don't get you the interview. Most PD's have no idea what your med school grades mean and probably don't care, so long as nothing equates to "fail" without a good explanation and your dean's letter summarizes you as at least a decent applicant.

 

[2121115]

I remember interviewing one person when I was just starting residency who had some absurdly high Step I but literally couldn't figure out how to button his pants and had social skills to match his pants. The residents threatened to quit if he was -ranked-, not to mention if he matched. Of course the academic PD wanted him to start a grant or somesuch, though eventually claimed he wasn't "really" ranked.

This is a common story that people tell. Any time Step scores come up someone is quick to point out this one time that there was someone with a 260 Step 1 and a terrible personality that got turned away or some such thing. But in 4 years of reviewing residency applications I never saw this happen. Not once. If this scenario happened (which was rare that someone had a bad enough personality for it to matter, I mean almost anyone can put on a suit and smile for a day or go to dinner with residents and not be a total douche canoe) it was always 100% of the time explained away for candidates with high Step 1 scores. Think about it - pathology is full of these people. Are you really going to say that smart but socially awkward people get ranked low in the pathology residency match? That accounts for like half the profession. Same thing with medical school applications - everyone says that they've seen an applicant with a 4.0 GPA and a 45 MCAT who was too much of a nerd or too poor of an attitude or too cynical or whatever on interview day and got rejected, but we all know that medical school is full of these people.

I am not saying it should be that way, but reality is reality.

 

[skew2002]

This is a common story that people tell. Any time Step scores come up someone is quick to point out this one time that there was someone with a 260 Step 1 and a terrible personality that got turned away or some such thing. But in 4 years of reviewing residency applications I never saw this happen. Not once. If this scenario happened (which was rare that someone had a bad enough personality for it to matter, I mean almost anyone can put on a suit and smile for a day or go to dinner with residents and not be a total douche canoe) it was always 100% of the time explained away for candidates with high Step 1 scores. Think about it - pathology is full of these people. Are you really going to say that smart but socially awkward people get ranked low in the pathology residency match? That accounts for like half the profession. Same thing with medical school applications - everyone says that they've seen an applicant with a 4.0 GPA and a 45 MCAT who was too much of a nerd or too poor of an attitude or too cynical or whatever on interview day and got rejected, but we all know that medical school is full of these people.

I am not saying it should be that way, but reality is reality.

I would also agree with this based on my involvement with resident selection committees. Don't get me wrong, if you have tremendous USMLE score but are TERRIBLE on the interview day then you could be ranked lower. However, most faculty I have known from selection committees are still very much impressed by very high scores and good grades. On some level they figure that high scores and grades mean the person will be mentally capable of mastering the amount of information they will see in residency and thus have a better chance of reflecting positively on the program when they pass their future Pathology Boards. Don't think for a second that programs don't think about those board pass rates!

I also think there is a lot of truth in other comments on here and that a "top" residency program is not a necessity to getting a good fellowship or job. It can help since many faculty at big name programs are well connected in the Pathology world. Also most big names programs also have good fellowship programs which can be helpful. Then again, plenty of "regular" tier residency programs , like the one I went to, can provide you with similar opportunities. I would also add that your ability to rotate at places you are interested in for Fellowships is HUGE! So make connections and use them, and try to get exposure at places you want a fellowship.

Finally, there is a whole new set a criteria for jobs. For academic jobs I think the big name programs do help, and again you will be well connected at those programs. For private practice jobs, board certification, holding a state license, good communications skills & leadership, and your fellowship specialty/location (more than residency program) are important. In my current job search I have had ZERO people ask me about my residency experience, while EVERYONE asks about my fellowship training. Those that I interview with also seem very happy that I already hold a license in my state and am AP/CP board certified. Just my 2 cents...

 

[deleted314957]

I would also agree with this based on my involvement with resident selection committees. Don't get me wrong, if you have tremendous USMLE score but are TERRIBLE on the interview day then you could be ranked lower. However, most faculty I have known from selection committees are still very much impressed by very high scores and good grades. On some level they figure that high scores and grades mean the person will be mentally capable of mastering the amount of information they will see in residency and thus have a better chance of reflecting positively on the program when they pass their future Pathology Boards. Don't think for a second that programs don't think about those board pass rates!

I also think there is a lot of truth in other comments on here and that a "top" residency program is not a necessity to getting a good fellowship or job. It can help since many faculty at big name programs are well connected in the Pathology world. Also most big names programs also have good fellowship programs which can be helpful. Then again, plenty of "regular" tier residency programs , like the one I went to, can provide you with similar opportunities. I would also add that your ability to rotate at places you are interested in for Fellowships is HUGE! So make connections and use them, and try to get exposure at places you want a fellowship.

Finally, there is a whole new set a criteria for jobs. For academic jobs I think the big name programs do help, and again you will be well connected at those programs. For private practice jobs, board certification, holding a state license, good communications skills & leadership, and your fellowship specialty/location (more than residency program) are important. In my current job search I have had ZERO people ask me about my residency experience, while EVERYONE asks about my fellowship training. Those that I interview with also seem very happy that I already hold a license in my state and am AP/CP board certified. Just my 2 cents...

agree very much with 3rd paragraph (although fellowships were pretty uncommon when i went into pp) but i would also add post training EXPERIENCE. granted , it is a catch-22 as to how to get the experience to get the job. my situation was unique and required some sacrifices but also had nice pay-off---the military and AFIP. when i was looking for a job i had boards and 2 years post boards staff/attending experience which seemed more attractive than any surg path generic fellowship.

 

[yaah]

I saw it happen plenty of times. Unimpressive candidates in person with high scores getting severely downgraded. Interpersonal skills are important, ok? Usually the last person to realize that interpersonal skills are important are the ones with no interpersonal skills. Note that this doesn't mean you have to be bubbly and enthusiastic. Some bubbly and enthusiastic people have horrible interpersonal skills for pathology.

 

[KCShaw]

...Usually the last person to realize that interpersonal skills are important are the ones with no interpersonal skills. Note that this doesn't mean you have to be bubbly and enthusiastic. Some bubbly and enthusiastic people have horrible interpersonal skills for pathology.

(Emphasis mine)
👍
I would even drop the "for pathology" caveat in the last sentence. I'd rather work with certain ***holes than certain bubbleicious folk.

 

[lipomas]

(Emphasis mine)
👍
I would even drop the "for pathology" caveat in the last sentence. I'd rather work with certain ***holes than certain bubbleicious folk.

It all depends on the type of *******. The curmudgeon who is gruff and rude is fine. The sleazy unethical ******* is worse than almost anyone except the sleazy unethical ******* who is also incompetent.

 

[BrainPathology]

This may be a silly question, but I'm wondering if someone might be able to give some insight.

I'm a third year medical student at a "top 20" med school who is interested in pathology. My Step 1 score is 249. Most of my preclinical grades are honors. Thus far have only received one grade for third year (HP). Overall, I don't feel terribly confident that I will be able to get many/any H's...but hopefully I will. I have 1 platform presentation, five other abstracts, and one second- or third-author manuscript (all non-pathology). Looking into getting involved with some pathology research soon.

My question is...given my strong step 1, "top" school, decent research, and perhaps mostly HP clinical grades, do you all feel like I would still have a good chance at some of the top pathology programs? I know some of you will shun me for asking only about the "top" programs, but if you don't mind, I'd appreciate your input. Thanks!

You'll do great... with those numbers you'll find at least one PD who won't even care if you can dress yourself since he'll be using the stats you offer him to make his **** look longer at PD meetings around the country. Maybe not all top teir programs will want you but you have a good amount of research, good grades and can take tests well. In short you're in the iphone category of applicants. PD's will want you so they look cool. They won't care if you can actually hold a phone call.

I'm not saying that to be insulting either. You may well end up being a terrific pathologist. Your path to proving that to yourself is going to be a lot easier than for a lot of applicants though.

 

[NYnow]

My Step 1 score is 249.

This is all that matters unless you are a really horrible interviewee.

So many interviewers have told me that the best predictor for pathology board success is high step 1 score. Now, all programs love to boast about their 100% board success rates. Do the math..