General Surgery - 227 on Step

[froggies123]

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Hi!

I was just wondering if a step 1 score of 227 was a "good enough" score to be obtain a surgical residency at university programs (or at least an interview...). I was a disappointed in my score, but it is what it is and life goes on!

Any suggestions on how to strengthen my application as I start rotations? Is it recommended to take Step 2 early so that I can submit a score?

Anyway, any advice would be greatly appreciated!

 

[Oso]

I think you still have a shot. As shown below, most applicants with step 1 scores between 221-230 matched. I don't have data for what percent of those were at university based programs, but I would think that a fair amount of them were (just my guess).

My advice would be to just work hard and do as well as you can on your rotations. Try your hardest to honors surgery. Doing well in medicine always looks good as well. Aim to get strong LOR's. I would definitely recommend applying to residency with a step 2 CK score in hand. Some surgery research would also be very beneficial, especially for academic programs. Good luck!

 

[Redpancreas]

Improve on step two CK but they may not even look at it to be honest. Research also helps out a bit. Aside from M3 grades and evaluations, as well as letters of recommendation I’m not too sure what general surgery looks at besides step one. A lot of people at my low to mid tier state I’m in the school who applied to general surgery and SOAPing into pre-lim spots. That being said I don’t know if the students had 200 or 220 step 1 as that’s a big difference. Also, whether or not you attend an M.D. school will make a significant difference. At the end of the day if you really want to do Gen Surg I’m sure you can do a preliminary year and get in eventually but you need to ask yourself if that level of delayed gratification is really worth it for you when you could do EM and make 350K out of a 3 year residency.

 

[darklabel]

There should be a new Charting Outcomes coming soon for the 2018 match class so I would wait on that. I think it's gotten more competitive than 2016's numbers.

 

[NYCdude]

There should be a new Charting Outcomes coming soon for the 2018 match class so I would wait on that. I think it's gotten more competitive than 2016's numbers.

Any idea when that's coming out?

 

[jurisburger]

Improve on step two CK but they may not even look at it to be honest. Research also helps out a bit. Aside from M3 grades and evaluations, as well as letters of recommendation I’m not too sure what general surgery looks at besides step one. A lot of people at my low to mid tier state I’m in the school who applied to general surgery and SOAPing into pre-lim spots. That being said I don’t know if the students had 200 or 220 step 1 as that’s a big difference. Also, whether or not you attend an M.D. school will make a significant difference. At the end of the day if you really want to do Gen Surg I’m sure you can do a preliminary year and get in eventually but you need to ask yourself if that level of delayed gratification is really worth it for you when you could do EM and make 350K out of a 3 year residency.

LOL you're really advertising EM hardcore aren't you =)

 

[studentdocftw]

Improve on step two CK but they may not even look at it to be honest. Research also helps out a bit. Aside from M3 grades and evaluations, as well as letters of recommendation I’m not too sure what general surgery looks at besides step one. A lot of people at my low to mid tier state I’m in the school who applied to general surgery and SOAPing into pre-lim spots. That being said I don’t know if the students had 200 or 220 step 1 as that’s a big difference. Also, whether or not you attend an M.D. school will make a significant difference. At the end of the day if you really want to do Gen Surg I’m sure you can do a preliminary year and get in eventually but you need to ask yourself if that level of delayed gratification is really worth it for you when you could do EM and make 350K out of a 3 year residency.

Let's chill on the EM advertising. Currently considering it...heard incoming saturation issues...would rather nobody know it exists. 😉


OP, that step is fine for GS if you are USMD.

 

[CyrusHabs7695]

Assuming OP matches into a university GS program, would the lower end step score allow them to specialize, or are they kind of stuck in general?

 

[doc05]

Hi!

I was just wondering if a step 1 score of 227 was a "good enough" score to be obtain a surgical residency at university programs (or at least an interview...). I was a disappointed in my score, but it is what it is and life goes on!

Any suggestions on how to strengthen my application as I start rotations? Is it recommended to take Step 2 early so that I can submit a score?

Anyway, any advice would be greatly appreciated!

Yes, you will have a shot at most university programs. But not the top ones.

 

[doc05]

Assuming OP matches into a university GS program, would the lower end step score allow them to specialize, or are they kind of stuck in general?

"Stuck in general" means you don't really know anything about the field.

Fellowship match has almost nothing to do with your step 1/2 scores.

And the job market is so good for general surgery, incomes are quite high to the point where doing 1-2 years of fellowship isn't sensible.

 

[CyrusHabs7695]

"Stuck in general" means you don't really know anything about the field.

Fellowship match has almost nothing to do with your step 1/2 scores.

And the job market is so good for general surgery, incomes are quite high to the point where doing 1-2 years of fellowship isn't sensible.

No I didn't mean it in a negative way at all. And I don't really know anything about the field, that's why im asking

 

[Redpancreas]

Let's chill on the EM advertising. Currently considering it...heard incoming saturation issues...would rather nobody know it exists. 😉


OP, that step is fine for GS if you are USMD.

It’s currently the opportunity cost for any US MD and even WhiteCoat Investor chose it.

 

[Redpancreas]

LOL you're really advertising EM hardcore aren't you =)

Yeah I think it’s an awesome field and I’m enjoying it quite a bit and pay is great. A bit too late for me with residency starting in a month. None of the downsides are real (like the so called midlevel creep or saturation) despite what others (I.e. future EM applicants) tell you. Look at Anesthesia or Radiology, they’ve been receiving flack for decades. Worst thing that can happen is that they increase EM training (invent extra years or fellowships...which won’t affect you If you’re doing it now). Name me any other non-competitive field that you exit in 3 years with that salary. The system’s currently got a cheat code and it’s EM and AMGs should take full advantage of it.

Also look at their organization (EMRA). It’s very involved and has guide books for everything and probably the best application tool since MSAR. You’ll easily find a mentor whether it’s here on SDN (just go to the EM forum) or at your school. The culture’s pretty awesome too. Residents make a ton of mistakes daily, but attendings are non-malignant and incredibly patient. Also, look at their recruiting process. If I had to come up with a system for evaluation it would look very much like a SLOE and their extensive process seems like it weeds out bad apples and FMGs attendings so everyone starts out the same. There’s also no added pressure to publish to advance your career. EM has basically taken all the bull**** entry barriers to other fields and gotten rid of it. Lastly you’re literally saving lives (or atleast trained too). You’re the girl or guy on the airplane that’ll be prepared when the Intercom asks if there’s a doctor on the plane.

 

[froggies123]

Improve on step two CK but they may not even look at it to be honest. Research also helps out a bit. Aside from M3 grades and evaluations, as well as letters of recommendation I’m not too sure what general surgery looks at besides step one. A lot of people at my low to mid tier state I’m in the school who applied to general surgery and SOAPing into pre-lim spots. That being said I don’t know if the students had 200 or 220 step 1 as that’s a big difference. Also, whether or not you attend an M.D. school will make a significant difference. At the end of the day if you really want to do Gen Surg I’m sure you can do a preliminary year and get in eventually but you need to ask yourself if that level of delayed gratification is really worth it for you when you could do EM and make 350K out of a 3 year residency.

Hi - Thanks for your reply. I am at a U.S allopathic medical school.

 

[sinombre]

Improve on step two CK but they may not even look at it to be honest. Research also helps out a bit. Aside from M3 grades and evaluations, as well as letters of recommendation I’m not too sure what general surgery looks at besides step one. A lot of people at my low to mid tier state I’m in the school who applied to general surgery and SOAPing into pre-lim spots. That being said I don’t know if the students had 200 or 220 step 1 as that’s a big difference. Also, whether or not you attend an M.D. school will make a significant difference. At the end of the day if you really want to do Gen Surg I’m sure you can do a preliminary year and get in eventually but you need to ask yourself if that level of delayed gratification is really worth it for you when you could do EM and make 350K out of a 3 year residency.

1) Surgery programs definitely look at step 2
2) This is a good point. Financially it makes a lot of sense to pick a shorter training pathway, but people who go into surgery generally do it because they actually enjoy surgery and view it as a sort of calling. Emergency medicine and surgery are very different specialties. I would never want to work as an EM physician, but I’m glad there are people who do.

 

[sinombre]

Also to address the OP: yes, you can still match at a university program with that score if the rest of your application is solid.

 

[Anicetus]

Hi!

I was just wondering if a step 1 score of 227 was a "good enough" score to be obtain a surgical residency at university programs (or at least an interview...). I was a disappointed in my score, but it is what it is and life goes on!

Any suggestions on how to strengthen my application as I start rotations? Is it recommended to take Step 2 early so that I can submit a score?

Anyway, any advice would be greatly appreciated!

If you don’t care about what city you’ll live in you’ll be fine.

 

[DubbiDoctor]

Yeah I think it’s an awesome field and I’m enjoying it quite a bit and pay is great.

Hey, what do you think of radiology as a specialty? EM is a stressful job with long hours, druggies, and lots of bad smells. Of all physicians, EM doctors retire the earliest, consistent with its high burnout rates. With diagnostic radiology, you don't really have to see patients - and certainly don't have to deal with the gross aspects of medicine - get paid really well, and get to do a lot of problem solving. I'm starting medical school in August, and EM, radiology, and psychiatry are the three specialties I'm interested in. Will try to do extensive shadowing soon after I start (kind of hard to shadow doctors where I live). I would rather not practice medicine than become a surgeon.

 

[Rekt]

Yeah I think it’s an awesome field and I’m enjoying it quite a bit and pay is great. A bit too late for me with residency starting in a month. None of the downsides are real (like the so called midlevel creep or saturation) despite what others (I.e. future EM applicants) tell you. Look at Anesthesia or Radiology, they’ve been receiving flack for decades. Worst thing that can happen is that they increase EM training (invent extra years or fellowships...which won’t affect you If you’re doing it now). Name me any other non-competitive field that you exit in 3 years with that salary. The system’s currently got a cheat code and it’s EM and AMGs should take full advantage of it.

Also look at their organization (EMRA). It’s very involved and has guide books for everything and probably the best application tool since MSAR. You’ll easily find a mentor whether it’s here on SDN (just go to the EM forum) or at your school. The culture’s pretty awesome too. Residents make a ton of mistakes daily, but attendings are non-malignant and incredibly patient. Also, look at their recruiting process. If I had to come up with a system for evaluation it would look very much like a SLOE and their extensive process seems like it weeds out bad apples and FMGs attendings so everyone starts out the same. There’s also no added pressure to publish to advance your career. EM has basically taken all the bull**** entry barriers to other fields and gotten rid of it. Lastly you’re literally saving lives (or atleast trained too). You’re the girl or guy on the airplane that’ll be prepared when the Intercom asks if there’s a doctor on the plane.

Your single ED rotation has suddenly made you an expert? It makes all of what multiple physicians, residents, students that are actually pursing EM are saying, incorrect? Your type of misinformed posts about EM being a lifestyle specialty/really high pay/saving lives/etc, are what causes people to incorrectly enter field, which attributes to physician burnout and specialty dissatisfaction.

 

[Redpancreas]

Your single ED rotation has suddenly made you an expert? It makes all of what multiple physicians, residents, students that are actually pursing EM are saying, incorrect? Your type of misinformed posts about EM being a lifestyle specialty/really high pay/saving lives/etc, are what causes people to incorrectly enter field, which attributes to physician burnout and specialty dissatisfaction.

I’m not an expert and maybe I was a bit hyperbolic, but please expand on how exactly my posts are misinformed? I’m yet to see an EM doc who isn’t on SDN or Reddit raving about his or her job. I’ve seen many family friends who have earned a great amount and are still at that level a few years out of residency and I’ve seen others (women primarily) who have scaled back and are very satisfied with their job. I just keep hearing this thing about burn out, but if you look at surveys or think about it, there are other fields with more significant burn out for lesser pay per hour or increased time in training (Intensivist/Hospitalist comes to mind). Regarding schedules surgical and IM subspecialties or anyone who wants that level of pay works undesirable times too. The circadian rhythm thing seems mostly speculative and I trust the opinions of people on here as anyone can have an opinion and then pull up a study supporting their opinion (EM hours must suck, I wonder what the consequences of it are, oh look circadian rhythms are linked to dementia...well, maybe they should just drink 3-5 cups of coffee daily as thaf supposedly reduces the risk of dementia by 65% ).

 

[Redpancreas]

Hey, what do you think of radiology as a specialty? EM is a stressful job with long hours, druggies, and lots of bad smells. Of all physicians, EM doctors retire the earliest, consistent with its high burnout rates. With diagnostic radiology, you don't really have to see patients - and certainly don't have to deal with the gross aspects of medicine - get paid really well, and get to do a lot of problem solving. I'm starting medical school in August, and EM, radiology, and psychiatry are the three specialties I'm interested in. Will try to do extensive shadowing soon after I start (kind of hard to shadow doctors where I live). I would rather not practice medicine then become a surgeon.

I think Radiology still makes bank overall (also remember their residency programs are pretty open to moonlighting and I’ve heard of people doubling their salaries that way). Some people forget that with all the talk about AI taking over the field. For someone entering medical school now, you’re concerned about the next 40 years. Keep in mind that one of the main reasons you’re paid is because they need someone to hold accountable for decisions and that’s you. So machines/AI might start overtaking human skill in Radiology but I think the technology is still too far away from a pure replacement anywhere in the next 40 or so. My main problem with it is not seeing patients (something I’d like to do) and also it’s not like EM in that it’s 5 years and seems like most residents I work with say you have to do a fellowship so that adds a year. 6 years for a Rads salary is a smart decision if you like Rads, but I wouldn’t call it THE optimal decision from a financial standpoint, just a good one.

One thing I have mixed opinions about with Radiology is what they contribute vs. their potential. I’m very impressed by their overall medical knowledge (not just anatomy/indications for tests, but pathophysiology and indications for medications/etc.). I totally buy the notion that you need to know clinical medicine well to correlate the read and they develop that knowledge. That being said, maybe I haven’t been involved in enough reads yet, but when I see a lot of the scan interpretations that come back, the radiologist doesn’t seem to be making a decision but rather lists 3-4 different possibilities that an IM or EM physician would have already thought of based on their Imaging 101 knowledge from medical school.

 

[CherryRedDracul]

One thing I have mixed opinions about with Radiology is what they contribute vs. their potential. I’m very impressed by their overall medical knowledge (not just anatomy/indications for tests, but pathophysiology and indications for medications/etc.). I totally buy the notion that you need to know clinical medicine well to correlate the read and they develop that knowledge. That being said, maybe I haven’t been involved in enough reads yet, but when I see a lot of the scan interpretations that come back, the radiologist doesn’t seem to be making a decision but rather lists 3-4 different possibilities that an IM or EM physician would have already thought of based on their Imaging 101 knowledge from medical school.

Perhaps you've been exposed to mostly bread-and-butter cases. And the fact is that most things you'll see, regardless of specialty, will be bread-and-butter. In that case, maybe NPs and PAs can replace us physicians for them.

But there will be that smaller percentages of cases which will be difficult to figure out and will require the radiologist's expertise. Their other role is to make sure nothing else is missed. Sure, the orthopod may be able to identify and characterize the fracture or dislocation on CT, but will he/she necessarily identify that incidental malignant mass?

A large bulk of our calls to the reading room are clinicians with questions about imaging findings so that they can narrow down a differential. I often don't give a differential if imaging findings are very likely to represent one thing. If imaging findings are more ambiguous, I offer a short differential based on clinical history and suggest the most likely one as the top differential.

As an aside, the radiology department keeps the hospital afloat. When there are technical difficulties, the hospital is in chaos. I've unfortunately seen it firsthand.

 

[Redpancreas]

Perhaps you've been exposed to mostly bread-and-butter cases. And the fact is that most things you'll see, regardless of specialty, will be bread-and-butter. In that case, maybe NPs and PAs can replace us physicians for them.

But there will be that smaller percentages of cases which will be difficult to figure out and will require the radiologist's expertise. Their other role is to make sure nothing else is missed. Sure, the orthopod may be able to identify and characterize the fracture or dislocation on CT, but will he/she necessarily identify that incidental malignant mass?

A large bulk of our calls to the reading room are clinicians with questions about imaging findings so that they can narrow down a differential. I often don't give a differential if imaging findings are very likely to represent one thing. If imaging findings are more ambiguous, I offer a short differential based on clinical history and suggest the most likely one as the top differential.

As an aside, the radiology department keeps the hospital afloat. When there are technical difficulties, the hospital is in chaos. I've unfortunately seen it firsthand.

I appreciate the insight. Thanks so much!