EM programs value step 2 equally with step 1

[tsbqb]

Hi everyone,

I just read in the latest NRMP program director survey that EM programs put equal eight on step 2 scores as they do on step 1 scores (3.8 and 3.8)

Everyone keeps telling me that step 1 is so much more important. One EM attending even told me he doesnt even look at step 2 scores.

Can anyone weigh in on what they feel is correct? THank you!

---

Members don't see this ad.

 

[deleted109597]

Sure. Attendings do not necessarily equal program directors.

I would take the NRMP survey to be more correct than your n=1.

 

[Khaos]

Let's see...when I helped interview with the residency and then we sat down for the pow wow after the interviews to decide rough ranking numbers this is how we looked at step scores...

That's a good step 1 score (>225) I guess they just haven't taken step 2 yet...not a big deal, grades look good and letters are good.

Good step 1 score and good step 2 score = great
Good step 1 score and lower step 2 score = not so good but no out, what do letters say and stuff
Average step 1 score (around 210 - 220) and good step 2 score = good, they knew what they messed up on and worked on it on their own
Average step 1 score and average step 2 score = what do grades and letters say and did they rotate
low step 1 score and good step 2 score = good but does this mean they were a bit lazy and they realized they screwed up and worked their butt off. Need to ask about what happened
low step 1 and average step 2 = harder to say, what was interview like
low step 1 and low step 2 = unlikely to interview unless you rotated and did an outstanding job and obviously those scores were a fluke

 

[Khaos]

Oh and if you have average step 1 or low step 1, take step 2 and blow it out of the water to redeem yourself and always have a reason why you did poor on step 1 and great on step 2

 

[EMmotherhen]

We value step 2!! And the score is important - if it's lower than step 1 we won't rule you out but we also won't push you higher up the list no matter how nice a person you are. If you blow step 2 out of the water then we sit up and take more notice of you.

 

[tsbqb]

hahaha, fair enough

 

[ruralmd]

Let's see...when I helped interview with the residency and then we sat down for the pow wow after the interviews to decide rough ranking numbers this is how we looked at step scores...

That's a good step 1 score (>225) I guess they just haven't taken step 2 yet...not a big deal, grades look good and letters are good.

Good step 1 score and good step 2 score = great
Good step 1 score and lower step 2 score = not so good but no out, what do letters say and stuff
Average step 1 score (around 210 - 220) and good step 2 score = good, they knew what they messed up on and worked on it on their own
Average step 1 score and average step 2 score = what do grades and letters say and did they rotate
low step 1 score and good step 2 score = good but does this mean they were a bit lazy and they realized they screwed up and worked their butt off. Need to ask about what happened
low step 1 and average step 2 = harder to say, what was interview like
low step 1 and low step 2 = unlikely to interview unless you rotated and did an outstanding job and obviously those scores were a fluke

We value step 2!! And the score is important - if it's lower than step 1 we won't rule you out but we also won't push you higher up the list no matter how nice a person you are. If you blow step 2 out of the water then we sit up and take more notice of you.

Having finished the trail and being one of those students (step 2 >>> step 1) I can attest to this. Probably the reason why I got some of the interviews that I got. People I interviewed with either asked me about the improvement or stated that I had a very nice improvement and moved on.

Was also told that I didn't make the step 1 cutoff at one place but they interviewed me because of my step 2 improvement.

 

[GoGetEM]

No one ever commented on my step scores while on the interview trail, but I have heard that step 2 is more important for EM.

 

[EvoDevo]

All that I can say is that at my program, what Khaos posted was pretty much spot on.

 

[deleted109597]

All that I can say is that at my program, what Khaos posted was pretty much spot on.

To a certain degree. Step II won't make up for mediocre letters/evals.

 

[EvoDevo]

To a certain degree. Step II won't make up for mediocre letters/evals.

Indeed. It's much more of "How does the 'whole person' impress?" Or not, as is the case for many.
.
.
.
.

I have to admit that this year (and last), I was shocked at how many med students, having worked hard to get where they are, gave the most vapid answers to questions about "Why EM? And really, where do you see yourself?" etc. Lotsa vague answers. Honestly, it seemed that there was a vast, undifferentiated middle. (Normal distribution?)

- I'm sure a lot of it is "don't rock the boat" thinking.

 

[turkeyjerky]

Indeed. It's much more of "How does the 'whole person' impress?" Or not, as is the case for many.
.
.
.
.

I have to admit that this year (and last), I was shocked at how many med students, having worked hard to get where they are, gave the most vapid answers to questions about "Why EM? And really, where do you see yourself?" etc. Lotsa vague answers. Honestly, it seemed that there was a vast, undifferentiated middle. (Normal distribution?)

- I'm sure a lot of it is "don't rock the boat" thinking.

What exactly do you want from people???

Sorry we're all too boring for you. Sorry we don't have our next 35 years of practice planned out (or we do but don't want to admit that we "just" want to be a community doc in BFE). Sorry we don't all have a super intersting story about being a medic in afghanistan to explain our interest in EM.

Honestly! I bet you were just as uninteresting as anyone else.

 

[DreamingTheLive]

Let's see...when I helped interview with the residency and then we sat down for the pow wow after the interviews to decide rough ranking numbers this is how we looked at step scores...

That's a good step 1 score (>225) I guess they just haven't taken step 2 yet...not a big deal, grades look good and letters are good.

Good step 1 score and good step 2 score = great
Good step 1 score and lower step 2 score = not so good but no out, what do letters say and stuff
Average step 1 score (around 210 - 220) and good step 2 score = good, they knew what they messed up on and worked on it on their own
Average step 1 score and average step 2 score = what do grades and letters say and did they rotate
low step 1 score and good step 2 score = good but does this mean they were a bit lazy and they realized they screwed up and worked their butt off. Need to ask about what happened
low step 1 and average step 2 = harder to say, what was interview like
low step 1 and low step 2 = unlikely to interview unless you rotated and did an outstanding job and obviously those scores were a fluke

Concurrent with thoughts I've heard from Attendings/PD's. But, Many also reiterated the NFL Combine/Draft analogy in that Students with good resumes and 240+ step 1 have nothing/little to gain from taking step 2 early.

 

[deleted109597]

What exactly do you want from people???

Sorry we're all too boring for you. Sorry we don't have our next 35 years of practice planned out (or we do but don't want to admit that we "just" want to be a community doc in BFE). Sorry we don't all have a super intersting story about being a medic in afghanistan to explain our interest in EM.

Honestly! I bet you were just as uninteresting as anyone else.

Truly, nobody looks down on someone wanting to be a community doc. More than 90% of people end up doing that.
It isn't about being interesting, it ends up being something to talk about. Mention whatever recreation you like to do. As long as it isn't something appalling (cross burning or the like), you'll be able to chat about it. They want people that they can work with and talk to. Not robots.

 

[turkeyjerky]

Truly, nobody looks down on someone wanting to be a community doc. More than 90% of people end up doing that.
It isn't about being interesting, it ends up being something to talk about. Mention whatever recreation you like to do. As long as it isn't something appalling (cross burning or the like), you'll be able to chat about it. They want people that they can work with and talk to. Not robots.

That was in response to his post about interviewees giving

vapid answers to questions about "Why EM? And really, where do you see yourself?" etc. Lotsa vague answers.

But, c'mon. You want someone to be interesting? Then learn how to conduct an interview. When have you ever asked someone, "What do you like to do for fun?" outside of a residency or med school interview? That's not a good conversation starter.

 

[Hypomanics]

I agree with what's already been said. Just to give another n=1, I failed step 1 with a 181. Retook and scored 205. Then got 225 on step 2. I got 5 interviews. Granted, I've been told that my SLOR's are really good, but I know my step 1 was enough to screen me from most places, and my step 2 was enough for those 5 places to give me a chance. Now I'm just wondering how the scores will affect me on ROL's.

 

[DreamingTheLive]

I agree with what's already been said. Just to give another n=1, I failed step 1 with a 181. Retook and scored 205. Then got 225 on step 2. I got 5 interviews. Granted, I've been told that my SLOR's are really good, but I know my step 1 was enough to screen me from most places, and my step 2 was enough for those 5 places to give me a chance. Now I'm just wondering how the scores will affect me on ROL's.

Awesome work. I look forward to your celebratory post come late march.

 

[Hypomanics]

Oh, there will be one.

 

[gutonc]

Hi everyone,

I just read in the latest NRMP program director survey that EM programs put equal eight on step 2 scores as they do on step 1 scores (3.8 and 3.8)

Everyone keeps telling me that step 1 is so much more important. One EM attending even told me he doesnt even look at step 2 scores.

Can anyone weigh in on what they feel is correct? THank you!

I think that what you (and many people) may be confusing are the roles of Step 1 in the screening process vs. in the selection process, as they tend to be different. Nearly every program will try to cut down on the number of apps they have to wade through by setting a Step 1 cutoff (while others will include Step 1 OR 2 cutoffs or Step 1 AND 2 cutoffs).

So Step 1 is probably more important in terms of keeping your app out of the electronic round-file. Step 2 (if available) is probably more important in terms of comparing two otherwise equivalent applicants.

 

[deleted109597]

That was in response to his post about interviewees giving "vapid answers to questions about "Why EM? And really, where do you see yourself?" etc. Lotsa vague answers"

Nobody is arguing that you need to know exactly what you want to do 35 years from now. But you should have a pretty good idea what you want to do 4-5 years from now, as you've spent 8 years getting to this point, and are going to do another 3-4 years training in ED.

But, c'mon. You want someone to be interesting? Then learn how to conduct an interview. When have you ever asked someone, "What do you like to do for fun?" outside of a residency or med school interview? That's not a good conversation starter.

It's their job interview. They don't have to be interesting. People who are middle of the road are simply not chosen by selective programs. You don't want to be interesting without prompting, that's fine. You'll do just fine at a middle of the road program. But you likely aren't going to get into the places that are very selective, be it because of prestige, location, or whatever they get to be selective about. You'll still get a job, but again, you'll have the same vague questions when you get to your next job interview as well. And if you aren't what they want, you can continue to blame the interviewer, but I'm sure their lobby has a mirror for you to look at as well.

 

[Arcan57]

This was kind of cropping up in another thread also (the "Do you have any questions" thread). It's fine to b-tch about an interviewer's poor technique, but at the residency level it's the student that needs to impress. You flew across the country and plopped down hundreds of dollars to interview at this program. Spend an hour on the web to come up with talking points for why you did. The truth may be that you're just hedging your bets by making sure you have enough names on your ROL, but the program doesn't need to know that. If you don't have any interesting or relevant extra-curriculars to talk about then ask geography questions. Ask about the city (smaller cities love to point out their ethnic restaurants), about what neighborhoods the residents live in. Presumably your interviewer lives in the region and can answer the questions (saving you both from uncomfortable silence), and it shows you're thinking about matching at their program. So save the complaining for the Internet, and prep for the interview.

 

[turkeyjerky]

Nobody is arguing that you need to know exactly what you want to do 35 years from now. But you should have a pretty good idea what you want to do 4-5 years from now, as you've spent 8 years getting to this point, and are going to do another 3-4 years training in ED.


It's their job interview. They don't have to be interesting. People who are middle of the road are simply not chosen by selective programs. You don't want to be interesting without prompting, that's fine. You'll do just fine at a middle of the road program. But you likely aren't going to get into the places that are very selective, be it because of prestige, location, or whatever they get to be selective about. You'll still get a job, but again, you'll have the same vague questions when you get to your next job interview as well. And if you aren't what they want, you can continue to blame the interviewer, but I'm sure their lobby has a mirror for you to look at as well.

Look man, no one's gonna disagree w/ you on that. But if someone believes that the vast majority of people are vapid and uninteresting, then they're either (a) an @sshole, or (b) have a talent for bringing out the vapid and uninteresting in people.

 

[Dane07MD]

This was kind of cropping up in another thread also (the "Do you have any questions" thread). It's fine to b-tch about an interviewer's poor technique, but at the residency level it's the student that needs to impress. You flew across the country and plopped down hundreds of dollars to interview at this program. Spend an hour on the web to come up with talking points for why you did. The truth may be that you're just hedging your bets by making sure you have enough names on your ROL, but the program doesn't need to know that. If you don't have any interesting or relevant extra-curriculars to talk about then ask geography questions. Ask about the city (smaller cities love to point out their ethnic restaurants), about what neighborhoods the residents live in. Presumably your interviewer lives in the region and can answer the questions (saving you both from uncomfortable silence), and it shows you're thinking about matching at their program. So save the complaining for the Internet, and prep for the interview.

I agree with this post.

The student DOES need to impress in order to be considered, but so does the program.

At the end of the day, the applicants actually have the upper hand (albeit incredibly slight) in the matching process. Keep in mind that an applicant can be number 1 on ten program ROLs, but can ultimately only make one program the top of their ROL. Thus, if 10 programs want an applicant, the applicant is ultimately the deciding factor on where he/she ends up.

The counter argument is that a program can NOT rank an applicant, and they're toast. But since the applicant has the same ability, it's kind of a draw in that regard.

At the end of the day, there are more unmatched applicants than unmatched program slots, so programs needn't truly worry, but to say that the onus is completely on the applicant during an interview may not be entirely accurate.

We've gotten off track. I am a +1 for the average (210-220) Step 1, with a top tier step 2 that was commented on in interviews and also told that the jump was the reason for an interview. Also agree with someone else who said SLORs/Evals are pretty damn important too. If there's one thing I feel like I learned duing this process is that strong letters from important players make the most difference...

 

[quemas]

I earned a step 1 score (>270) that I can't possibly replicate on step 2. Will that be a problem? How late should I wait to take step 2? How much lower of a step 2 score would be worrisome? thanks.

 

[cofcemt]

I earned a step 1 score (>270) that I can't possibly replicate on step 2. Will that be a problem? How late should I wait to take step 2? How much lower of a step 2 score would be worrisome? thanks.

Seriously, just go ahead and take step 2 and get it out of the way. Anything above a 240 and you won't have any problem I wouldn't think. Take step 2 early and enjoy the rest of 4th year.

 

[winkleweizen]

I earned a step 1 score (>270) that I can't possibly replicate on step 2. Will that be a problem? How late should I wait to take step 2? How much lower of a step 2 score would be worrisome? thanks.

Havent you heard. Residencies actually recommend that you dont do well on Step 1. youre doomed for scoring so well, o well

 

[gro2001]

I earned a step 1 score (>270) that I can't possibly replicate on step 2. Will that be a problem? How late should I wait to take step 2? How much lower of a step 2 score would be worrisome? thanks.

If you can get >270 on step I and ~240 or really even ~230 on step 2, then you've pretty much proved that you definitely can pass standardized tests. If that is STILL not good enough for someone, then run as far away from that program as you can.

 

[SeekerOfTheTree]

Is this thread for getting interviewed or for match? I thought on the other discussion earlier we decided step 1 was only needed to interview at most places. Just curious.

 

[gro2001]

I thought on the other discussion earlier we decided step 1 was only needed to interview at most places.

We changed our mind.