DO Students that Matched, How Necessary is taking STEP 1?

[Pre-Medguy1995]

I'm a 3rd year DO Student who's recently become super interested in Anesthesia. Long story short, I was kind of scrambling to find a new test date from the pandemic after mine got canceled and was not really able to find one before my rotations started and after talking to some people, was told to just take COMLEX for now. I realize now that the advice might have been not so great.

COMLEX 1: 506
Class rank: Top quartile (school doesn't do ranks)
Clinical Grades: All Honors except for one High Pass.

I have not taken STEP 1 obviously, but have restarted UWorld (for STEP 1) after talking to some friends at FIU who take Step 1 at the end of third year.

Is it feasible for me to try and take STEP 1 at this point or would I be better off studying hard and doing really well on STEP 2 and COMLEX 2? Which would help my application more? And how necessary are audition rotations for someone like me?

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[FiO2@21]

Can you even take Step 2 CK without Step 1?

 

[ToKingdomCome]

Can you even take Step 2 CK without Step 1?

Yes

 

[ToKingdomCome]

I'm a 3rd year DO Student who's recently become super interested in Anesthesia. Long story short, I was kind of scrambling to find a new test date from the pandemic after mine got canceled and was not really able to find one before my rotations started and after talking to some people, was told to just take COMLEX for now. I realize now that the advice might have been not so great.

COMLEX 1: 506
Class rank: Top quartile (school doesn't do ranks)
Clinical Grades: All Honors except for one High Pass.

I have not taken STEP 1 obviously, but have restarted UWorld (for STEP 1) after talking to some friends at FIU who take Step 1 at the end of third year.

Is it feasible for me to try and take STEP 1 at this point or would I be better off studying hard and doing really well on STEP 2 and COMLEX 2? Which would help my application more? And how necessary are audition rotations for someone like me?

You should take it. Apparently things were competitive last match. Even when it wasn’t competitive programs still wanted step 1 score

 

[Pre-Medguy1995]

You should take it. Apparently things were competitive last match. Even when it wasn’t competitive programs still wanted step 1 score

Is it feasible to take STEP 1 and STEP 2 within a few months of each other?

 

[austintr]

I'm a 3rd year DO Student who's recently become super interested in Anesthesia. Long story short, I was kind of scrambling to find a new test date from the pandemic after mine got canceled and was not really able to find one before my rotations started and after talking to some people, was told to just take COMLEX for now. I realize now that the advice might have been not so great.

COMLEX 1: 506
Class rank: Top quartile (school doesn't do ranks)
Clinical Grades: All Honors except for one High Pass.

I have not taken STEP 1 obviously, but have restarted UWorld (for STEP 1) after talking to some friends at FIU who take Step 1 at the end of third year.

Is it feasible for me to try and take STEP 1 at this point or would I be better off studying hard and doing really well on STEP 2 and COMLEX 2? Which would help my application more? And how necessary are audition rotations for someone like me?

As someone that didn't match (and did take step 1 and did fine on it), you 100% need to take it.

The only programs that don't use it are old DO programs, and even some of them use it to stratify applicants. Many programs have a minimum score for screening and some flat out require it to apply.

You 99% won't match if you don't take step 1.

 

[BLADEMDA]

As someone that didn't match (and did take step 1 and did fine on it), you 100% need to take it.

The only programs that don't use it are old DO programs, and even some of them use it to stratify applicants. Many programs have a minimum score for screening and some flat out require it to apply.

You 99% won't match if you don't take step 1.

Can you shed any light or insight into why you didn't match this cycle? What's your plan going forward? Did you secure a PGY-1 spot?

 

[NICMAN]

I think I have actually answered this question probably 3 times before. As somebody who was on a recruitment committee for our residency program, we didn’t even look at an application without Step scores. It is an ACGME allopathic residency program then you need to take Step 1.
Might change with the pass/fail but that will probably make it even more important to take it to show you can pass an allopathic exam.

 

[abolt18]

I know my program is very open to DOs, but it's a very rare, very stellar applicant who gets an interview without having taken step 1/2CK.

 

[austintr]

Can you shed any light or insight into why you didn't match this cycle? What's your plan going forward? Did you secure a PGY-1 spot?

I've looked over my application several times since I found out I didn't match and between my dean and myself we can only come up with a couple of theories.

1. One of my LORs had great content and was extremely positive, but the format appeared somewhat "unprofessional" per my dean. No letterhead, practice address, phone number, etc. This is her leading theory, but I'm not sure it's the most likely.

2. My third LOR was submitted about a week after my initial apps went out, which I think may have resulted in screening by at least some programs.

3. My step 2 score hadn't been completely resulted yet by the time I submitted my apps because of COVID delays in getting a testing date. Like the LOR, it was submitted within days of the initial app.

Other than that, I really can't come up with much. My steps were OK for how/where I was applying (70 categorical/advanced and 10 prelim), mostly midwest and southern US. My personal statement was impactful and I had many interviewers comment on it and my uniqueish hobbies/interests. Of the 5 interviews I received, 4 were very good interactions with great feedback and one "we'll be working together next year". The other was kind of just neutral and nothing negative IMO.

I've considered trying to find someone on SDN that is trusted and experienced in these matters to see if they would be willing to look through everything, as my DO school has no anesthesia faculty. You were the first person I thought of, Blade, but I didn't want to pester you!

I did not get a PGY-1 spot and am still scrambling/looking for clinical jobs in my old field/looking for research. I will also take step 3 in the next few months. Next cycle I will likely apply to even lower tier programs with no reaches and also IM as a backup.

 

[UnoMas]

Is it feasible to take STEP 1 and STEP 2 within a few months of each other?

Yes. I took both Step 1 and Step 2 CK early 4th year. Did well (250s/250s). Sacrificed both 3rd and 4th year vacation blocks, totally worth it. Got 15 interviews, even at a few top tier places without any audition rotations.

I can tell you with almost 100% certainty that my step scores were essential to my success in the match. Nobody cared about my COMLEX scores despite them being of higher percentiles. In fact, when I filled out my paperwork for my matched program, there wasnt even a spot to fill out my COMLEX scores, and these information are essential to me getting licensed.

Your 3rd year shelf knowledge will make STEP 1 so much easier for you and having the STEP 1 knowledge so fresh in your mind, it helps reinforcing things for STEP 2. Feel free to PM me with questions.

 

[HoneyBadger3]

If the number of applicants keep on increasing or even stay the same the next 2 years, you MUST take step 1 as a DO to match anesthesia and you need 230+ to have a decent shot.

This cycle was an absolute NIGHTMARE for DO anesthesia applicants. Programs in the NE or desirable cities are getting 1000+ applications for ~10 spots, so not having a step 1 is almost a death sentence. Anesthesia discord had multiple surveys throughout the cycle and even with limited number of responses relative to the total applicant pool, it was clear that USMD had a huge advantage over DOs and IMGs in both # and quality of interviews received.

 

[JiPo]

You absolutely need to take STEP 1 and do well on it as DO. My program did not interview a single DO without step 1 this year, and all of DOs that we interviewed had stellar scores.

 

[ToKingdomCome]

I matched in 2018 and with every cycle I’m so fortunate I matched when I did because I don’t think I would have in any of the subsequent cycles. It’s good to keep things in perspective when things get tough

 

[Mehd School]

I'm a DO at a fairly big name program that is somewhat DO friendly. But we are not COMLEX friendly. DO's that match at my program take USMLE and do well on it (the one we matched this year scored >250 on both). Anesthesia has quickly become quite competitive just looking at the numbers. Something like only 65% of DO students matched this year.

 

[deleted986199]

This year match cycle was insane. The DO bias was very much real. I took step 1 and got a slightly below average score and thought I crushed step 2 (score in the 25Xs) but I struggled this cycle despite strong ECs, LORs and Aways. My step 1 held me back. It held quite a few DOs back. Be prepared to aim for a 260+ on step 2 as a DO to be competitive if you do not take step 1 or have a weak step 1 score. Anything under a 260 on step 2 doesn’t faze anyone anymore especially with anki and how competitive people are. Even if you do well on step 2, I can see programs not ranking you for having a step 1 score. If possible, take step 1 and take step 2 if you can and DO WELL.

 

[Modoc]

At our program, we do not interview anyone that has not taken STEP 1. So for short, yes you should take STEP 1. ( I am a DO, at a very DO friendly program- this year we matched all DOs)

 

[Pre-Medguy1995]

At our program, we do not interview anyone that has not taken STEP 1. So for short, yes you should take STEP 1. ( I am a DO, at a very DO friendly program- this year we matched all DOs)

How essential do you guys consider away rotations to be? I know for anesthesia it's a more nuanced conversation, but I would be interested in hearing your opinion as a DO friendly program

 

[abolt18]

How essential do you guys consider away rotations to be? I know for anesthesia it's a more nuanced conversation, but I would be interested in hearing your opinion as a DO friendly program

We are a DO friendly program, but USMLE is HIGHLY recommended and aways can make or break you here. If you work hard and are a reasonable person to work with, you're golden. An away can seriously hurt you as well if you have social challenges or if you're lazy, or just a giant douche canoe.

 

[Pre-Medguy1995]

We are a DO friendly program, but USMLE is HIGHLY recommended and aways can make or break you here. If you work hard and are a reasonable person to work with, you're golden. An away can seriously hurt you as well if you have social challenges or if you're lazy, or just a giant douche canoe.

How high of COMLEX score do you guys consider for aways? Would a score <510 automatically be screened out?

Thanks for all the help from all of y'all btw, this forum has been a priceless resource honestly.

 

[Modoc]

How essential do you guys consider away rotations to be? I know for anesthesia it's a more nuanced conversation, but I would be interested in hearing your opinion as a DO friendly program

its always a tricky question, as you may know by now, especially based on applicant character.

Away rotations can wreck you or can significantly help you (but mostly wreck you lol ). Ive seen people drop on the rank list significantly solely because 1 person felt that they would have been a difficult resident to teach while the entire committee thought they were a great applicant.

My recommendation is to get your letters of recommendations and never do another anesthesia rotation again, experience different specialties (card/pulm etc). I feel like its easier to mess up an audition rotation than it is to work in your favor. Speaking from experience. >90% of anesthesia residents match where they did not audition, so I wouldn't worry too much about it.

Anesthesia (in simple operating room cases, where med students typically are placed -appys, lap chole, hernias etc. ) is a one man job, and getting in the way is a lot easier than being helpful (even with the most sincere intentions).

So don't worry about away rotations unless you feel like you will geniunly crush them.

Just my cents...

 

[austintr]

How essential do you guys consider away rotations to be? I know for anesthesia it's a more nuanced conversation, but I would be interested in hearing your opinion as a DO friendly program

I'm about to do an away at a university program as my very last rotation of med school because I didn't match, if that tells you anything about my humble opinion on them. My dean thinks that getting an audition with an academic letter will get me over the threshold next year. We'll see.

 

[Pre-Medguy1995]

At our program, we do not interview anyone that has not taken STEP 1. So for short, yes you should take STEP 1. ( I am a DO, at a very DO friendly program- this year we matched all DOs)

Does your program have a cut off baseline STEP1 score?

 

[GassYous]

Isnt step 1 pass fail now

 

[Pre-Medguy1995]

Isnt step 1 pass fail now

From my understanding, not until 2022 and it will not matter for application cycles till 2023. Someone correct me if I'm wrong

 

[JiPo]

Isnt step 1 pass fail now

I think 2 or 3 more classes still have scores when they apply.

 

[JiPo]

Does your program have a cut off baseline STEP1 score?

Having been on the other side this year as chief resident, I can tell you that all programs will have some sort of cut off. Whether it be strict or loose is program dependent. It is simply impossible to thoroughly review 2000 applications for 200 interview spots. You have to trim off and start somewhere.

 

[Modoc]

Does your program have a cut off baseline STEP1 score?

yes, 225 step 1. They will likely use step 2 scores when step 1 becomes pass/fail.

 

[turnupthegas]

Been a while for me. But when I applied they definitely mattered

 

[AnonymousPD]

Is it feasible for me to try and take STEP 1 at this point or would I be better off studying hard and doing really well on STEP 2 and COMLEX 2? Which would help my application more? And how necessary are audition rotations for someone like me?

Medguy1995,

Because most of the world can be distilled to sports analogies, think of the application process as being analogous to athletes preparing for the NFL draft. Applicants/Players through a variety of objective and subjective means (test scores, grades, interviews, 40 yard dash times, bench press reps) are trying to convince Programs/Teams that they would be great fits in their organization. Every year in the NFL, there exist a few players of sufficient quality that can skip the draft combine and simply say that the quality of their work stands for itself. And likewise during the match, there exist a few candidates we know to be of high enough quality that outside of requirements for graduation and licensing, test scores are irrelevant. So when you think about skipping Step 1, ask yourself if the rest of your application is good enough to "skip the combine."

As for audition rotations. There really are two main reasons to go on them. One is to ostensibly to make a good impression at a program you are interested in with the hope of improving your position on the rank list. The other is to spend a month at a program and the city so that you can decide if you will enjoy spending 3-4 years there. I would respectfully disagree with @Modoc that most students hurt themselves while doing away rotations. My experience has been that most students are fine, with a minority of students moving the needle significantly one way or the other. Overall, given two applicants who are otherwise equal, we historically have preferred applicants we are comfortable working with and have spent enough time with us to know they are comfortable with the culture here.

 

[BLADEMDA]

I'm a 3rd year DO Student who's recently become super interested in Anesthesia. Long story short, I was kind of scrambling to find a new test date from the pandemic after mine got canceled and was not really able to find one before my rotations started and after talking to some people, was told to just take COMLEX for now. I realize now that the advice might have been not so great.

COMLEX 1: 506
Class rank: Top quartile (school doesn't do ranks)
Clinical Grades: All Honors except for one High Pass.

I have not taken STEP 1 obviously, but have restarted UWorld (for STEP 1) after talking to some friends at FIU who take Step 1 at the end of third year.

Is it feasible for me to try and take STEP 1 at this point or would I be better off studying hard and doing really well on STEP 2 and COMLEX 2? Which would help my application more? And how necessary are audition rotations for someone like me?

This year's match wasn't just competitive, it was brutal. So, YES you need Step 1 and Step 2. They are essential if you want to Match. Also, plan on doing away rotations at one mid tier and one lower tier DO friendly program. Realistically, Your Step scores won't be high enough for anything other than lower tier programs so your focus should be on matching at a quality program. I am not trying to rain on your parade but realism is part of the process and I would rather tell you the cold, hard truth now than after you fail to MATCH.

Based on your Step 1 and 2 scores we can better estimate your chances of matching into a program for 2022. Best of Luck.

 

[Pre-Medguy1995]

Medguy1995,

Because most of the world can be distilled to sports analogies, think of the application process as being analogous to athletes preparing for the NFL draft. Applicants/Players through a variety of objective and subjective means (test scores, grades, interviews, 40 yard dash times, bench press reps) are trying to convince Programs/Teams that they would be great fits in their organization. Every year in the NFL, there exist a few players of sufficient quality that can skip the draft combine and simply say that the quality of their work stands for itself. And likewise during the match, there exist a few candidates we know to be of high enough quality that outside of requirements for graduation and licensing, test scores are irrelevant. So when you think about skipping Step 1, ask yourself if the rest of your application is good enough to "skip the combine."

As for audition rotations. There really are two main reasons to go on them. One is to ostensibly to make a good impression at a program you are interested in with the hope of improving your position on the rank list. The other is to spend a month at a program and the city so that you can decide if you will enjoy spending 3-4 years there. I would respectfully disagree with @Modoc that most students hurt themselves while doing away rotations. My experience has been that most students are fine, with a minority of students moving the needle significantly one way or the other. Overall, given two applicants who are otherwise equal, we historically have preferred applicants we are comfortable working with and have spent enough time with us to know they are comfortable with the culture here.

Thank you for responding! I actually appreciate the analogy lol. I have applied to several audition programs already and I am just waiting to hear back from them.

I have received pretty much all H (with one HP) and easy to work with is always mentioned as a positive so I hope that translates to audition rotations as well.

Given my stats and knowing your program and the field in general, should I expect to get audition rotations?

 

[Pre-Medguy1995]

This year's match wasn't just competitive, it was brutal. So, YES you need Step 1 and Step 2. They are essential if you want to Match. Also, plan on doing away rotations at one mid tier and one lower tier DO friendly program. Realistically, Your Step scores won't be high enough for anything other than lower tier programs so your focus should be on matching at a quality program. I am not trying to rain on your parade but realism is part of the process and I would rather tell you the cold, hard truth now than after you fail to MATCH.

Based on your Step 1 and 2 scores we can better estimate your chances of matching into a program for 2022. Best of Luck.

Fair enough. Thank you for responding! I do have a couple of questions

1) What step score is good enough for a "lower tier" program?

2) What programs should I be looking at for applying? I have done the usual searches on SDN and Reddit but want to see if maybe there are more that I glanced over

3) I am also applying to IM just to see if I perhaps fair better there. At what point (if any) should I just commit to one speciality or the other?

 

[Gern Blansten]

Medguy1995,

Because most of the world can be distilled to sports analogies, think of the application process as being analogous to athletes preparing for the NFL draft. Applicants/Players through a variety of objective and subjective means (test scores, grades, interviews, 40 yard dash times, bench press reps) are trying to convince Programs/Teams that they would be great fits in their organization. Every year in the NFL, there exist a few players of sufficient quality that can skip the draft combine and simply say that the quality of their work stands for itself. And likewise during the match, there exist a few candidates we know to be of high enough quality that outside of requirements for graduation and licensing, test scores are irrelevant. So when you think about skipping Step 1, ask yourself if the rest of your application is good enough to "skip the combine."

As for audition rotations. There really are two main reasons to go on them. One is to ostensibly to make a good impression at a program you are interested in with the hope of improving your position on the rank list. The other is to spend a month at a program and the city so that you can decide if you will enjoy spending 3-4 years there. I would respectfully disagree with @Modoc that most students hurt themselves while doing away rotations. My experience has been that most students are fine, with a minority of students moving the needle significantly one way or the other. Overall, given two applicants who are otherwise equal, we historically have preferred applicants we are comfortable working with and have spent enough time with us to know they are comfortable with the culture here.

As a former longtime PD, I agree with this advice and love the football analogy. Many students who rotate somewhere end up with a spot at that program. It has been my experience that 5-10% of students have the potential to hurt themselves because their social skills are awkward and no one likes working with them. Regrettably, the students who have that issue are typically not insightful or introspective enough to recognize that about themselves, so they do not have the discernment to know that they should not do an away rotation at the place they wish to match. Those same students are often in the lower quartile of their medical school class, and so, need the away rotation more than anyone else. It is definitely a perplexing situation. People can change their social interactions for a day when they interview. It is hard to hide that for an entire month if you have awkward or toxic social skills or are inherently lazy.
Everyone needs a mentor who will be brutally honest with them and who knows how to navigate the process. I would venture a guess that 90% of osteopathic schools offer little to no mentorship for people choosing non primary care specialties. Therefore, getting any guidance, much less useful guidance, has been a challenge for DO students in my experience. That seems to be why the number of DO students who visit here with their questions is exaggerated.
With regards to taking step I, we do not have an iron clad rule that you have to, but it is pretty rare that we look closely at candidates who have not taken it. Not taking it would definitely eliminate you from consideration at many, if not most, programs.

 

[zonazoo34]

Im a DO at an MD residency program. It was definitely a must when I interviewed. In fact multiple programs thanked me for taking step 1 and 2 so they could at least compare scores. I even had a below average step 1. we have many DO residents. I think we all took the step exams.