Did well on Step 1. Now what?

[wtr24]

---

Members do not see this ad.

Hey everyone,

So I am about to start MS3 in May after taking a year off to do an MPH. I was always a average/slightly-above average student during MS1/2 but I did well on Step 1 (251). I had never really considered myself to be a good applicant for the more competitive specialties or programs but I feel like I may be a have a better shot now.

I don't really know what I would like to do, but are there things that would be open to me now that weren't before? Or even among the less competitive specialties (in terms of numbers to match, like IM/EM/FM/GS) how well do I sit for the more competitive residency programs?

Thanks for the help.

 

[Slack3r]

Well, since the highest average step 1 score is ENT with a 249, I'm going to say no doors are closed based on your step 1 score. That said, there's much more that goes into matching (especially in highly competitive fields) than a good board score. Connections (and LORs), research, clinical grades, etc. Figure out what you'd like to do, and make sure you have every base covered.

 

[TBV]

Yeah nothing's closed but for something like derm you need to publish and most importantly rub elbows. Get letters and more importantly get someone important to like you enough to make a phone call.

 

[DryHopped]

Yeah, you have a shot at competitive fields with that step 1 score but now your goal should be to back your score up with good clinical grades, research, and LORs. This is not an easy task as clinical rotations are a different beast than just taking tests. Some people transition into 3rd year smoothly and some don't. I unfortunately was one of those people that struggled to back up my step 1 with honors grades and I am pretty worried about matching. So just take it one step at a time and see if you can do what is needed to continue having a shot at the competitive specialties you are interested in.

 

[atomi]

With a sufficiently high step 1 score, you should not let it have any bearing on your specialty choice. Your score is sufficiently high. Please don't be one of those people that suddenly declares a lifelong interest and burning passion in radiation oncology or ophthalmology a month after getting the step 1 score back and does the bare minimum of research and rotations to get a look. Yes, you can match this way, but I think it's a bad idea to look at three variables: step 1 score, avg. specialty income, and avg. hours worked and use solely those three things to choose a specialty. I don't think most people do this, but we all know a few who do.

 

[Quaero]

Congrats on your awesome step 1 score. Now, you can start 3rd year with the full knowledge that most doors are open for you. You'll still have to honor your clerkships (and more) if you want to get into a competitive residency though.




Sent from my iPhone using SDN mobile

 

[operaman]

There was a time not so long ago when having a step score like yours was, by itself, enough to guarantee a match almost anywhere. You may even come across faculty who still think this is the case and advise you as such. Unfortunately, times have definitely changed. I've known people with much higher step scores who didn't match because they mistakenly thought the number alone would carry the day.

As noted above, no doors are closed to you. Put another way: your step one score will not be what prevents you from matching into whatever field you decide to pursue. If you've never seriously looked at competitive fields, you may want to start looking, but if you settle on one, the hard work is just beginning.

 

[235009]

Hey everyone,

So I am about to start MS3 in May after taking a year off to do an MPH. I was always a average/slightly-above average student during MS1/2 but I did well on Step 1 (251). I had never really considered myself to be a good applicant for the more competitive specialties or programs but I feel like I may be a have a better shot now.

I don't really know what I would like to do, but are there things that would be open to me now that weren't before? Or even among the less competitive specialties (in terms of numbers to match, like IM/EM/FM/GS) how well do I sit for the more competitive residency programs?

Thanks for the help.

I was in this same position. Was slightly above average in pre-clinical years and got a step 1 score 3 points lower than yours so thought I owed it to myself to explore the "desirable" or "competitive" specialties. After looking into ortho, radiology, anesthesia, derm I ended up deciding to do IM and it was absolutely the right choice for me. Your step 1 score doesn't change what you value or your personality. Those are the things that determine whether you'll be happy with your career choice. Don't let a high step 1 score cloud your judgement.

 

[KinesiologyNerd]

I was in this same position. Was slightly above average in pre-clinical years and got a step 1 score 3 points lower than yours so thought I owed it to myself to explore the "desirable" or "competitive" specialties. After looking into ortho, radiology, anesthesia, derm I ended up deciding to do IM and it was absolutely the right choice for me. Your step 1 score doesn't change what you value or your personality. Those are the things that determine whether you'll be happy with your career choice. Don't let a high step 1 score cloud your judgement.

This. A >250 step 1 made me think I wanted to be a urologist. 3 weeks in urology made me realize EM will always be the place for me.

 

[LoveIR]

The more common scenario is that someone has their heart set on something competitive and the step one score shuts them out. I saw that happen to a number of classmates.

With all your options open it would be a great idea to check out everything. Most med students have little to no contact with Derm, surgical subspecialties, optho, Anesthesiology, Radiology or Rad Onc, etc.

If you decide to go into a less competitive field a step 1>250 will help you match to a top program and/or great location.

But in my opinion the actual most important thing is third year clinical grades. When I was interviewing I noticed that at the top of the interviewer's sheet of paper they usually had written step 1 score AND #of Honors in 3rd year. So the residency game is really just getting started for you.

 

[235009]

With all your options open it would be a great idea to check out everything. Most med students have little to no contact with Derm, surgical subspecialties, optho, Anesthesiology, Radiology or Rad Onc, etc.

If you decide to go into a less competitive field a step 1>250 will help you match to a top program and/or great location.

I agree that you should explore all fields but don't try to convince yourself you like something that doesn't fit your personality just because you got a high step 1 score.

Also, realize that in less competitive fields the top programs or those in desirable locations are still extremely competitive and a step 1 score is nowhere near sufficient to even get an interview. It's certainly true for IM as I found out.

 

[DoReMiFaSo]

I was always a average/slightly-above average student during MS1/2 but I did well on Step 1 (251).

Gonna side track this thread slightly...

Out of curiosity OP, what do you think contributed towards you getting a phenomenal Step1 but with "an average/slightly-above average" preclinical scores? And plz don't get me wrong, your grades are perfectly fine, I'm just curious as to what you make of your outstanding step.

And I think @MeatTornado covered your original question quite well.

 

[wtr24]

Gonna side track this thread slightly...

Out of curiosity OP, what do you think contributed towards you getting a phenomenal Step1 but with "an average/slightly-above average" preclinical scores? And plz don't get me wrong, your grades are perfectly fine, I'm just curious as to what you make of your outstanding step.

And I think @MeatTornado covered your original question quite well.

I think it was a couple of things. 1) As time went on I think I learned how to study more effectively and grew more comfortable with learning the material in ways that worked for me. So part of my improved performance was simply because I was getting better or studying/testing as time went on. 2) There are a bunch of study resources for Step 1, and since it's standardized you generally can trust that the material will be useful on your test (with some obvious variation). This is different than how tests were at my school (which may be pretty common?) in that each test was written by the professors that had taught during that previous unit, so you had different types of questions written by different types of people for much of the year. This made it hard to study for because I never really knew what to expect.

I was typically right at the mean (+/- a couple points) during most of MS1, but towards the middle/end of MS2 I was typically around +1 SD.

I really appreciate the feedback that I've gotten. I was worried that this would come of as a humble brag type of thread and thats really not what I wanted. So thank you guys.

 

[kmp0410]

Enjoy it and truly try to find out what you want to do for the rest of you life and consider all options. Be honest with yourself.

 

[HereWeGo21]

Yeah nothing's closed but for something like derm you need to publish and most importantly rub elbows. Get letters and more importantly get someone important to like you enough to make a phone call.

Jumping in here:
Say you're at medical school A, and want to get into subspecialty X, at residency program B.
Would you ask someone in the X department, at med school A, to make a call to residency program B? Or does it only help to get into the X residency program at A?

It seems kinda weird to ask someone at A to make a call to help you get into B. Like, the people at A might want you to go into X, but only at their residency program. It seems weird to ask them to help you get into B.

It's like when a girl says, "help me get a date with...your best friend".

 

[KinesiologyNerd]

Jumping in here:
Say you're at medical school A, and want to get into subspecialty X, at residency program B.
Would you ask someone in the X department, at med school A, to make a call to residency program B? Or does it only help to get into the X residency program at A?

It seems kinda weird to ask someone at A to make a call to help you get into B. Like, the people at A might want you to go into X, but only at their residency program. It seems weird to ask them to help you get into B.

It's like when a girl says, "help me get a date with...your best friend".

These docs are still human beings. Sure they might want to keep the star student, but they realize there are a billion legitimate reasons you may want to leave. They'd be doing you a big disservice if they had strings to pull, but didn't because you're leaving.

 

[hello lady!]

Your step 1 does not decide your specialty!

Find out what you love regardless of what the average step score is for that specialty and go for it. You can sleep a little easier at night that your step 1 won't hold you back.

 

[J ROD]

Simple. No doors are closed. Just make sure you walk through the right one at the end of this.

 

[wtr24]

Sent from my iPhone using Tapatalk

 

[studentofsdn]

This. A >250 step 1 made me think I wanted to be a urologist. 3 weeks in urology made me realize EM will always be the place for me.

What made you stop considering urology? Asking since I'm thinking about that field as well.

 

[KinesiologyNerd]

What made you stop considering urology? Asking since I'm thinking about that field as well.

I've discovered I hate pretty much anything to do with cancer and cystoscopies are a real snooze fest.

 

[hallowmann]

I agree that you should explore all fields but don't try to convince yourself you like something that doesn't fit your personality just because you got a high step 1 score.

Also, realize that in less competitive fields the top programs or those in desirable locations are still extremely competitive and a step 1 score is nowhere near sufficient to even get an interview. It's certainly true for IM as I found out.

Good advice. No matter how much you try to convince yourself you like something "more competitive" or that at least matches your competitiveness, you're better off going with what you actually like, want, and will work hard at.

Also true about competitive programs in less competitive fields.

 

[Tenk]

The next step is to find a job (medicine is a job, never forget this) that you can see yourself doing for the REST OF YOUR LIFE. You then network like crazy in this one field and you're set.

Networking + good scores = set.

You can do all the research in the world or you can be BFFs with a program director. Doesn't take much to figure out which will get you in. (You can do both but networking has much higher payout).

Nice job. Don't screw it up from here!

 

[cripplepundit]

Now walk past your school's Hallowed Gate; three paces North and five paces Westward. Whistle an arpeggio consisting of major triads and then whisper "the password is doot doot." Smoke a Cuban cigar and with the ashes draw a silhouette of Bill Murray posing like one of your French girls. Leave immediately and sleep in the nearest Motel 6. When you awake, they'll be surrounding you -- the step testers themselves. If it's truly the greatest fame and fortune you desire, you won't say no to their Three Menacing Trials. After all, you did well on their first test already...