Exceptional applicants and early interest in a p/f step 1 world

[faaang]

TL;DR how do I best align myself with top DR programs as an MS1 with step 1 p/f?

I'm a MS1 at a T20 MD school and very interested in DR. I've shadowed several specialties including DR in undergrad and will be shadowing more over the summer hopefully if/when COVID-19 dies down, but I thought a lot about my interests and priorities and they align the best with DR from what I can tell. I also tend to vibe with radiologists the best in general and find myself reading/learning about radiology the most in my free time.

With step 1 becoming p/f and all the changes in my application cycle that will precipitate from that decision, I'm wondering how I can differentiate myself early so that I can completely focus on clinical grades and step 2ck when I'm a MS3. I'm aiming for top programs and am on my way to building a strong application (doing well in classes using boards materials, already strong research and leadership, some interesting/impressive hooks). With all the uncertainty and contradictory opinions online, it would be great to have some rads-specific advice on the following questions:

1. What makes an exceptional applicant to radiology (besides AOA)? What research experiences/interests, work experiences, or ECs make someone stand out? I imagine these factors will only become more important when step 1 is p/f.

2. Will longitudinal interest in radiology become more important? I am guessing there will be more very late switches to radiology from competitive specialties after step 2ck in the class of 2024. Will my dedicated interest (shown through early networking and research) be advantageous at top programs, or will radiology continue to not care as much about an early interest as other specialties?

Thanks in advance!

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[AzBasRad]

If you're at a T20 school, you are already at a significant advantage for "top tier" rads programs.

Get your basics aligned - good clinical grades, board scores, AOA (if applicable), solid letter of recommendations. I don't think DR will care about early interests. However, early interest means more time to get rads specific connections and pubs, which can be especially valuable for IR. Try to present at a national rads conference (RSNA, ARRS, SIR). Exploring peripheral interests pertinent to rads such as med ed or global can also help set you apart.

Also, here's a hot-take, but I think there is a value in maintaining a clean twitter account and connecting with faculty and residents. I have seen PDs and faculty from top institutions congratulating certain applicants publicly on twitter after their interviews.

 

[.Asterion]

Clinical grades matter more than you’d expect. Most people at top programs have mostly or all honors.
Obviously step 2 will be huge.

 

[JRY6788]

TL;DR how do I best align myself with top DR programs as an MS1 with step 1 p/f?

I'm a MS1 at a T20 MD school and very interested in DR. I've shadowed several specialties including DR in undergrad and will be shadowing more over the summer hopefully if/when COVID-19 dies down, but I thought a lot about my interests and priorities and they align the best with DR from what I can tell. I also tend to vibe with radiologists the best in general and find myself reading/learning about radiology the most in my free time.

With step 1 becoming p/f and all the changes in my application cycle that will precipitate from that decision, I'm wondering how I can differentiate myself early so that I can completely focus on clinical grades and step 2ck when I'm a MS3. I'm aiming for top programs and am on my way to building a strong application (doing well in classes using boards materials, already strong research and leadership, some interesting/impressive hooks). With all the uncertainty and contradictory opinions online, it would be great to have some rads-specific advice on the following questions:

1. What makes an exceptional applicant to radiology (besides AOA)? What research experiences/interests, work experiences, or ECs make someone stand out? I imagine these factors will only become more important when step 1 is p/f.

2. Will longitudinal interest in radiology become more important? I am guessing there will be more very late switches to radiology from competitive specialties after step 2ck in the class of 2024. Will my dedicated interest (shown through early networking and research) be advantageous at top programs, or will radiology continue to not care as much about an early interest as other specialties?

Thanks in advance!

Unfortunately there's no way to objectively compare applicants based on clerkship/clinical grades. There's far too much variation in curriculum, grading breakdown, evaluations, and grading curve when you compare any one school to the next. Like you already suggested, Step 2 is probably the single most important factor for applications now that Step 1 is becoming P/F.

 

[Cognovi]

In my opinion, a competitive applicant for a top radiology program fulfills the following criteria:

1. Excellent USMLE score: >250 Step 1 = >260 Step 2 preferred; >240 Step 1 = >250 Step 2 acceptable; exceptions occasionally made for lower.
2. Excellent clinical grades: AOA or equivalent (top 15-20% of class) preferred; above-average acceptable especially at more competitive schools.
3. Superlative letters of recommendation: strong praise from at least 2 non-radiology clinical faculty, a radiologist, and often a research/extracurricular supervisor.
4. Interest: able to articulate a strong interest in and appropriate understanding of radiology and have demonstrated interest by involvement with related activities.
5. An edge: a track record of mission-relevant excellence other than standard clinical work, such as research (basic, translational, clinical, or health services research), education (teaching, mentoring, curricular development or other educational content creation), leadership and service to an institution (such as medical student government, interest group, national society/association, or publication), outreach and service to a community (eg, global health, work with local underserved community, lay public medical/science communication), innovation (medical device invention, software creation, entrepreneurship, organizational development), or other talents that could conceivably be applied to radiology (eg, medical illustration, writing, bioethics, law). Bonus points are afforded for women, underrepresented racial/ethnic minorities, and home institution or other local personal/professional ties.
6. Professional, personable, positive: respectful, tolerable to interact socially; one who will contribute positively to the inner working/learning environment of the residency program, and one who will enhance the outward image of the program.

 

[Cognovi]

To answer your second question, longitudinal dedicated interest is always advantageous but it is definitely not a requirement and not as important as in more competitive fields.