Failed Step 2 CS: What do I do if I was shooting for Gen surg?

[greg.house1408]

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I found out yesterday that I failed Step 2 CS. I'm devastated and extremely worried about what I'm going to do. I take CK in early September and am unsure how to proceed, as I was already worried for my chances in Gen Surg with a low Step 1 score (213). I've completed my Gen Surg sub-I, I have two awesome LORs so far, and a decent amount of research with posters at multiple national surgery meetings. I also have at least one guaranteed interview thus far. What are my chances of matching Gen surg if I retake CS and pass CK with a 225-235?

 

[sovereign0]

If you're a US MD I think you still have a good shot at matching somewhere, though it may be challenging to land a spot in academics.

 

[CidHighwind]

I hate that everyone has the “CS is so easy guys, don’t worry about it” attitude even though more people fail it than Step 1. I dislike how that rhetoric gets repeated over and over and ends up screwing people over.

IDK OP. A lot of programs screen for Step failures, and I’m afraid that includes CS. It’s easy to say “do well on Step 2”, but then most people do “well” on Step 2. Charting Outcomes puts you at around 55% on matching based on Step 1. I believe you’ll pull through though OP

 

[twospadz]

Step 2cs is such a bogus test. Alot of people who i know passed it, dont realize from.their score report that they were 1 or 2 cases from failing. They really should scrap it and have med schools administer it.

 

[greg.house1408]

Followup question then: can you still get into a subspecialty, like Transplant, if you go to a hybrid, or even community program? I figure that the potential to have exposure to Transplant surgeries during residency my have a bearing, but can graduates of community programs go into a more academic subspecialty, like Transplant?

 

[NYCdude]

Based on the charting outcomes, a step 1 score between 210 and 220 has a 71% chance of matching.

Unfortunately, there's no way to know how low that percentage goes when you throw a major red flag like failing CS into the mix.

Based on nothing but a hunch I'd have to wager that it goes below 50%.

If you can stand to do something else, I would start thinking about that. If you can't even imagine doing anything but GS, you need to go all in on the first application cycle and empty the bank account to apply to as many programs as humanly possible.

 

[FindersFee5]

Followup question then: can you still get into a subspecialty, like Transplant, if you go to a hybrid, or even community program? I figure that the potential to have exposure to Transplant surgeries during residency my have a bearing, but can graduates of community programs go into a more academic subspecialty, like Transplant?

I could be wrong, but I don't believe transplant is that competitive. You could probably get into it from most programs if you networked well?

 

[CidHighwind]

Your best bet may be to do a prelim surgery year somewhere and blow them away clinically. I would look at programs that have a track record of actually taking a decent number of their prelims vs just using them as cheap labor. Also I would try to retake CS ASAP. Some places use it to filter, but it’s better to have a pass on your application versus a fail, and if you’re an AMG it may not hurt you as much as if you were an IMG.

 

[crunchywhit]

So I asked this question of someone who knows something about surgery admissions, but not an adcom or anything like that, and the response was something like, we need a pass eventually for being able to put someone on a rank list and not much else. This wasn't a big fancy program that this person was connected to but the impression overall indicated that 1) you aren't the first person that this has happened to, and 2) it wasn't a death sentence. I'm sorry - the situation hurts. I'm rooting for you - I believe that it could happen to anyone and agree with above poster that we do each other no favors by saying things like "I didn't even study for CS", "be a normal person and you'll be fine." It's not representative at all.

 

[AnatomyGrey12]

Followup question then: can you still get into a subspecialty, like Transplant, if you go to a hybrid, or even community program? I figure that the potential to have exposure to Transplant surgeries during residency my have a bearing, but can graduates of community programs go into a more academic subspecialty, like Transplant?

Transplant is the definition of “uncompetitive.” My understanding is they have unfilled spots every year.

Edit: I agree that with that Step and a CS fail on your app you should go for GS but you need a back up plan prepared.

 

[Rekt]

Either Gen Surg isn't competitive at all anymore or you guys are being generous.

I would 100% apply to a backup specialty. Not just because the CS, but that's a very low Step 1.

 

[GoSpursGo]

So I asked this question of someone who knows something about surgery admissions, but not an adcom or anything like that, and the response was something like, we need a pass eventually for being able to put someone on a rank list and not much else. This wasn't a big fancy program that this person was connected to but the impression overall indicated that 1) you aren't the first person that this has happened to, and 2) it wasn't a death sentence. I'm sorry - the situation hurts. I'm rooting for you - I believe that it could happen to anyone and agree with above poster that we do each other no favors by saying things like "I didn't even study for CS", "be a normal person and you'll be fine." It's not representative at all.

I think the biggest problem is that the OP was likely borderline to get invites at most programs already--the match rate for someone with his step 1 score was already only ~60%, and this failure will hurt.

THAT SAID: I'm a strong believer that if you have your heart set on a specialty that you shouldn't do a backup specialty and you should go all-in at least once. The reason is that if you hedge your bets, you're going to lower your already tenuous chances for the specialty you really want even further by spending time getting a second application ready. While going through the SOAP or taking a gap year sucks it's not the end of the world, and at least you can say you gave it your best shot. FM/PM&R/whatever his second choice specialty would be will still be attainable for an allopathic applicant who delayed graduation by a year. It also opens up the possibility of doing a surgical prelim year, as someone else said.

Plus, it's pretty late in the day to call an audible into another specialty or try to throw together a backup application. You're not in a great spot, and honestly you may at best be a coinflip to match, but if your connections and research is as good as it sounds I don't think your app is DOA.

 

[Lawpy]

Step 2cs is such a bogus test. Alot of people who i know passed it, dont realize from.their score report that they were 1 or 2 cases from failing. They really should scrap it and have med schools administer it.

Unfortunately i doubt medical education leaders care about scrapping that garbage test.

 

[AnatomyGrey12]

Not taking the CS into account, 213 step 1 for USMD going for GS and just trying to match is fine.

Eh it’s on the low end. It’s a far cry from a sure match. Definitely still worth going for, but it’s at that point where there should be a plan in the back pocket just in case.

 

[AnatomyGrey12]

Everyone regardless of their pedigree is a far cry from a sure match so no idea what you’re trying to say.

Based on Charting Outcomes that isn’t true...

I’m saying your statement of “a 213 for a USMD just trying to match GS is just fine” is wrong.

OP should definitely apply, but they need to have a plan for if they don’t match because they are at increased risk of that based on numbers alone.

 

[GoSpursGo]

Not taking the CS into account, 213 step 1 for USMD going for GS and just trying to match is fine.

Yeah I don't get what you're trying to say, literally 40% of US applicants with a 213 don't match, compare to only ~5% who are at least at the mean score of 236 for GS. If you're looking for a guarantee, then you're never going to find it because one poor sap out of 133 applicants between 251-260 failed to match, but clearly 40% is a relatively high number. And it's not like you can ignore the CS failure, regardless of whether it's a garbage test unfortunately it's going to be part of the calculus for prospective programs.

Again, not that the OP does anything differently based on this right now, but after the OP puts in his/her app he/she should start planning a backup in case things don't turn out as hoped in the spring.

 

[crunchywhit]

Are we speaking in terms of only categorical in this thread? Or are we considering Prelim as well?

 

[AnatomyGrey12]

Are we speaking in terms of only categorical in this thread? Or are we considering Prelim as well?

I assumed categorical, because basically anyone can match a pre-lim....

 

[crunchywhit]

I assumed categorical, because basically anyone can match a pre-lim....

I was making the same assumption, but I thought we'd clarify real quick. In the event that a back-up was in fact Prelim applications out the wazoo (which is what I would do in this situation, if I was absolutely dead-set on surgery as the end game).

 

[greg.house1408]

Thanks for replying everyone. I knew my chances were already low, now I just have to see how it will play out after my retake. For those who spoke of backups, I have them.

 

[Giovanotto]

I think the biggest problem is that the OP was likely borderline to get invites at most programs already--the match rate for someone with his step 1 score was already only ~60%, and this failure will hurt.

THAT SAID: I'm a strong believer that if you have your heart set on a specialty that you shouldn't do a backup specialty and you should go all-in at least once. The reason is that if you hedge your bets, you're going to lower your already tenuous chances for the specialty you really want even further by spending time getting a second application ready. While going through the SOAP or taking a gap year sucks it's not the end of the world, and at least you can say you gave it your best shot. FM/PM&R/whatever his second choice specialty would be will still be attainable for an allopathic applicant who delayed graduation by a year. It also opens up the possibility of doing a surgical prelim year, as someone else said.

Plus, it's pretty late in the day to call an audible into another specialty or try to throw together a backup application. You're not in a great spot, and honestly you may at best be a coinflip to match, but if your connections and research is as good as it sounds I don't think your app is DOA.

Do you think this is still true for a DO applicant moving forward? Is that what happens if you don't match? I.e. you delay graduation for another year. Are all schools okay with that? Can anyone comment on this as far as the DO world is concerned.

 

[AnatomyGrey12]

Do you think this is still true for a DO applicant moving forward? Is that what happens if you don't match? I.e. you delay graduation for another year. Are all schools okay with that? Can anyone comment on this as far as the DO world is concerned.

More likely they will attempt to force you into a local pre-lim year so they can keep publishing that pristine 100% "match" rate.

 

[Giovanotto]

More likely they will attempt to force you into a local pre-lim year so they can keep publishing that pristine 100% "match" rate.

I mean, hey, I wouldn't mind. At that point I may just do my year and hang up the OMM shingle and partner with that footy poster from here. Something about turkish hair transplants. I hear istanbul is nice.