Do I need to apply preliminary? (Gen surg)

[music2med]

Had an advisor meeting and was told to apply prelim programs as I have a very strong west coast preference (since I'm from there and want to practice there as well)- however this was without my advisor knowing certain factors such as my STEP score, which is in the high 250s. After telling some residents and my PD about my STEP they agreed I should have a pretty good shot for categorical in any region I prefer (although I am worried as high 250s seems to be becoming closer to the norm now). I have a very strong home program preference but have ties to all the west coast states and would be happy in any of them. I have a good amount of leadership in surg orgs and volunteering, but research is a weak point for me, <5 projects and only 1 pub, HP surgery rotation. Otherwise no red flags, no repeated rotations/years, passed STEP 1 first try. Currently planning to apply to pretty much all of the west coast programs (I'm probably going to max out at ~40 or so programs including some in mountain states) which I feel has a broad scope with a large percentage of community and hybrid programs, only applying to a few top tier/fully academic institutions. Also, if I would be okay with a few programs in the mountain states, do I need to place a geographic preference for that area too? I don't know how I'd explain it on ERAS as I have no ties to the specific area.
I already know there will be some advice along the lines of "well if you want to match badly enough you'll expand your location/program stipulations" which does make sense, so I guess my real question should be do I need to either apply prelims OR significantly expand my location preference/apply broadly outside of west coast or will applying ~40 programs in the general area be okay given my stats?

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[operaman]

Not sure how competitive categorical Gen surg has gotten. You’ve got some real dings with the HP and the poor research, but does seem like you should be able to find a decent program to train.

The prelim idea is not a bad idea as a hedge, especially since you’re applying categorical as well. SOAP is definitely something to be avoided if possible, and applying prelims could potentially let you land somewhere desirable for a prelim in case you don’t match.

Personally I think you would be wise to maximize your chances. Additional applications aren’t that expensive - definitely cheaper than not matching. You can always cancel those interviews later, but you can’t really apply to 40 programs, get 5 interviews, and then submit more applications months later and expect to get any more. Much easier to apply to 100 programs, get 20 interviews, and then pare it down to 10-15.

I think more categorical apps would be better than a prelim simply because you’re guaranteed to get trained. A prelim may still lead nowhere and it’s harder to match a the second time around.

 

[SweetBurger]

the new step 2 average released this year was a 248 (last year was a 247). The reporting bias of scores online is real

 

[music2med]

the new step 2 average released this year was a 248 (last year was a 247). The reporting bias of scores online is real

was this released after the Step 1 P/F change? at my institution seems like the avg step 2 score shot up for my class according to admin

 

[SweetBurger]

was this released after the Step 1 P/F change? at my institution seems like the avg step 2 score shot up for my class according to admin

this was released august of 2023, aka this month

 

[ACSurgeon]

Had an advisor meeting and was told to apply prelim programs as I have a very strong west coast preference (since I'm from there and want to practice there as well)- however this was without my advisor knowing certain factors such as my STEP score, which is in the high 250s. After telling some residents and my PD about my STEP they agreed I should have a pretty good shot for categorical in any region I prefer (although I am worried as high 250s seems to be becoming closer to the norm now). I have a very strong home program preference but have ties to all the west coast states and would be happy in any of them. I have a good amount of leadership in surg orgs and volunteering, but research is a weak point for me, <5 projects and only 1 pub, HP surgery rotation. Otherwise no red flags, no repeated rotations/years, passed STEP 1 first try. Currently planning to apply to pretty much all of the west coast programs (I'm probably going to max out at ~40 or so programs including some in mountain states) which I feel has a broad scope with a large percentage of community and hybrid programs, only applying to a few top tier/fully academic institutions. Also, if I would be okay with a few programs in the mountain states, do I need to place a geographic preference for that area too? I don't know how I'd explain it on ERAS as I have no ties to the specific area.
I already know there will be some advice along the lines of "well if you want to match badly enough you'll expand your location/program stipulations" which does make sense, so I guess my real question should be do I need to either apply prelims OR significantly expand my location preference/apply broadly outside of west coast or will applying ~40 programs in the general area be okay given my stats?

A prelim spot puts you in a situation of being desperate for any categorical program anywhere in the country. Why do that to yourself? If you want to be a surgeon, apply to all the west coast programs but do apply to some safety programs even if it means coming to the Midwest or other parts of the country. That said, if there’s enough safety programs along the west coast, you might be fine.