Has anyone seen a high scoring student shoot themselves in the foot by relying too much on their Step score?

[deleted1168269]

Currently on my SUBI and the other MS4 got his score back - 273. This was 2 weeks ago. Since then he’s been very dismissive about putting together the rest of his application. He said he’ll type up the CV the week before the app is due. He wrote his personal statement and asked me to take a look at it (before getting his score back). After he got his score I gave him feedback and he pretty much said “no worries I think I’ll just use what I wrote, I feel too lazy to change it”.

Thoughts?

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[operaman]

Yeah I knew a guy who scored over 280 on S1 and thought he was gods gift to ent and that he didn’t really need to worry about the rest of his application. He also hadn’t put much effort into the department, minimal research, etc, so when it came time for letters many faculty wondered who the heck this guy was.

He ended up not matching at all and soaped into a GS prelim year. He got lucky and was able to pick up a pgy2 spot outside the match, went on to a nice fellowship and is now in academic practice and doing well.

So yes it definitely happens, especially in more competitive fields. But on the other hand, these tend to be strong students so even without much effort they tend to have pretty solid applications.

A 270+ step score should be the icing on top of a solid application. It has surprisingly little ability to overcome severe deficiencies elsewhere.

 

[ProReduction]

My story was the opposite. I was a weak medical student M1/M2 in terms of grades (almost all Pass), in the bottom 50% of my class (and maybe even in the bottom 25% but I can't remember), not particularly great in M3 either. I was not applying to anything overly competitive but knew I wanted to be in one of the most desirable cities for residency training. I ended up getting a 265 (would be like getting a 275-280 with today's distribution). I was told on the interview trail at most places from at least one interviewer that I had the highest USMLE score they had ever seen. I took the rest of my application seriously, wrote solid essays, and was not a prick on the trail. I matched in my top city but not my #1.
An amazing Step will not make up for bad grades (me), average evals (me), and will certainly not make up for being a prick on the trail (not me but likely the 280 referenced above).
In the end, I knew that any other 265er on the trail other than me probably had great grades and evals and they would clearly pick that applicant over me.

 

[deleted1139416]

I was told on the interview trail at most places from at least one interviewer that I had the highest USMLE score they had ever seen.

Is this like a regular thing where interviewers give you insight on your application and competitiveness? It almost never happens in a med school interview.

 

[ProReduction]

Is this like a regular thing where interviewers give you insight on your application and competitiveness? It almost never happens in a med school interview.

If you are a desirable candidate (good scores, not a total prick, good social skills, some research) applying to a specialty of average competitiveness, chances are that the residency program is being sold to you more than you are selling yourself to them. Granted I am old so this was all > 10 years ago. I'd say that at 90% of my interviews, they were the seller. At only 1-2 interviews did I really feel like I was selling the program on me, and in the end those happened to be the 2 programs with the most socially awkward attendings and residents.

 

[voxveritatisetlucis]

He’s probably already been working on it for months

These are the type of people who say “I didn’t even study bro” and get a 95

 

[AnonymousDoctorGuyPerson]

He’s probably already been working on it for months

These are the type of people who say “I didn’t even study bro” and get a 95

Eh, sometimes the people who really didn't even study bro do get a 95, but I think people just don't want to believe it.

To OP, I know very similar people but the thing is Step 2 (unlike Step 1) is much closer to ERAS submission so this new onset laziness may not have as much impact, assuming they weren't twiddling their thumbs beforehand and were doing equally as well.
A forgettable, but not problematic, PS won't be the deciding factor most likely.

 

[mrbreakfast]

Is this like a regular thing where interviewers give you insight on your application and competitiveness? It almost never happens in a med school interview.

No, but it's not uncommon for programs to tell you "you've a very competitive applicant and we'd love to have you" or "we're going to rank you highly" in some variation.

 

[Goro]

Currently on my SUBI and the other MS4 got his score back - 273. This was 2 weeks ago. Since then he’s been very dismissive about putting together the rest of his application. He said he’ll type up the CV the week before the app is due. He wrote his personal statement and asked me to take a look at it (before getting his score back). After he got his score I gave him feedback and he pretty much said “no worries I think I’ll just use what I wrote, I feel too lazy to change it”.

Thoughts?

I see people on SDN do this more than you think

 

[rebuilteva]

look up (his SDN handle was "Phloston") for an interesting case of this happening to someone.

 

[ProReduction]

Tbh, people like you are the problem of medicine. Mind your own business!

The 273er involved the OP in his business when he asked the OP to review his personal statement and also shared his 273 with the OP. I am guessing that the OP did not hack the 273er's Google Drive to read his personal statement and did not hack his other accounts to gain his scores. I'd say that a 273 bragger that likely could not pass engineering calculus or explain the way that bonds move in a rapidly changing interest rate environment is more reflective of the people in medicine that are a problem.

 

[lacrossegirl420]

@ProReduction - how did you not match at your #1 with a 275-280 (by today’s standards) and a strong application otherwise? were you applying into dermatology or something?

 

[ProReduction]

@ProReduction - how did you not match at your #1 with a 275-280 (by today’s standards) and a strong application otherwise? were you applying into dermatology or something?

Nothing overly competitive and certainly not Derm. My M1/M2 grades were bad and my evaluations from M3 were 10% bad, 80% just OK, and 10% great. I have great social skills but never played "the game" of medicine. If I was not interested in something then I did not feign interest. Having bad grades and a really good USMLE score is a red flag as it should be. Consistent good grades mean that the person "shows up" every day, studies consistently, jumps through all the hoops even when not feeling it at the moment. Bad grades with a 99th percentile USMLE tells the residency program that you are more than capable but only "turn it on" when you desire or out of necessity.
Almost all residency programs would rather have a role-player that consistently gives you the same effort each day than a volatile superstar.

 

[aldol16]

The USMLE score is just one thing in the application and yes, every year people don't match because they think they have a great Step score and that's all they have. This is very important for smaller subspecialties where the fit matters more than just the score.

 

[DarkBluMage]

The USMLE score is just one thing in the application and yes, every year people don't match because they think they have a great Step score and that's all they have. This is very important for smaller subspecialties where the fit matters more than just the score.

This is honestly so interesting to me when people point out the importance of a well rounded application yet the reality is that a student could have a great app in every other area but get screened out or their app disregarded for not having a great step 2 score for a competitive field. It makes me feel like PDs are just going to say and do whatever they want at the end of the day. No good step 2 score, but well rounded app otherwise? Too bad. Great step 2 score, but a less than stellar app otherwise? Too bad. Lmbo it’s just all a game at this point and students get the short end no matter what unless they’re top tier in everything or have great connections. Sad situation after all the hard work students put in just to even simply complete medical school itself. Just constantly more hoops and bs 😂

 

[voxveritatisetlucis]

This is honestly so interesting to me when people point out the importance of a well rounded application yet the reality is that a student could have a great app in every other area but get screened out or their app disregarded for not having a great step 2 score for a competitive field. It makes me feel like PDs are just going to say and do whatever they want at the end of the day. No good step 2 score, but well rounded app otherwise? Too bad. Great step 2 score, but a less than stellar app otherwise? Too bad. Lmbo it’s just all a game at this point and students get the short end no matter what unless they’re top tier in everything or have great connections. Sad situation after all the hard work students put in just to even simply complete medical school itself. Just constantly more hoops and bs 😂

Because there are probably plenty of applicants with a great step two and application/research/connections

 

[Esmolol]

It's rough out there... eat or be eaten!

 

[ProReduction]

This is honestly so interesting to me when people point out the importance of a well rounded application yet the reality is that a student could have a great app in every other area but get screened out or their app disregarded for not having a great step 2 score for a competitive field. It makes me feel like PDs are just going to say and do whatever they want at the end of the day. No good step 2 score, but well rounded app otherwise? Too bad. Great step 2 score, but a less than stellar app otherwise? Too bad. Lmbo it’s just all a game at this point and students get the short end no matter what unless they’re top tier in everything or have great connections. Sad situation after all the hard work students put in just to even simply complete medical school itself. Just constantly more hoops and bs 😂

Yes, for very competitive specialties a great Step 2 score is "necessary but not sufficient" as they say in formal logic. You need great grades, great recs, and great social skills to become "sufficient" to match.

 

[Mr.Smile12]

This is honestly so interesting to me when people point out the importance of a well rounded application yet the reality is that a student could have a great app in every other area but get screened out or their app disregarded for not having a great step 2 score for a competitive field. It makes me feel like PDs are just going to say and do whatever they want at the end of the day. No good step 2 score, but well rounded app otherwise? Too bad. Great step 2 score, but a less than stellar app otherwise? Too bad. Lmbo it’s just all a game at this point and students get the short end no matter what unless they’re top tier in everything or have great connections. Sad situation after all the hard work students put in just to even simply complete medical school itself. Just constantly more hoops and bs 😂

Don't look at me. I just do admissions.

 

[operaman]

This is honestly so interesting to me when people point out the importance of a well rounded application yet the reality is that a student could have a great app in every other area but get screened out or their app disregarded for not having a great step 2 score for a competitive field. It makes me feel like PDs are just going to say and do whatever they want at the end of the day. No good step 2 score, but well rounded app otherwise? Too bad. Great step 2 score, but a less than stellar app otherwise? Too bad. Lmbo it’s just all a game at this point and students get the short end no matter what unless they’re top tier in everything or have great connections. Sad situation after all the hard work students put in just to even simply complete medical school itself. Just constantly more hoops and bs 😂

This is simply a function of the competition for more desirable specialties and programs. People will select the best they can get, and precisely what that is can vary.

The fact is that competition is brutal for the competitive fields and top programs. Even with a flawless app you can count on some random pre-II rejections.

Best that students know about this early on so they can prepare. I think students get a lot of bad advice and it’s sad to see a student realize this toward the end of school when it’s too late.

To be a top applicant you need to be either in top percentile of intellectual ability among med students or an extremely hard worker or both. There’s sadly a point at which hard work can’t overcome below average ability, but it’s hard to say where that line lies. Most often it’s simply too difficult for most students to sustain work required to be assured of being a top applicant even if they do possess the underlying ability. It’s very much a game of sustained mental fortitude.

The flip side of this is that when someone has done this, they will probably continue to do it in training and therefore tend to be really good residents. So as long as a program CAN recruit from the very best students, they will continue to do so.

 

[aldol16]

This is honestly so interesting to me when people point out the importance of a well rounded application yet the reality is that a student could have a great app in every other area but get screened out or their app disregarded for not having a great step 2 score for a competitive field. It makes me feel like PDs are just going to say and do whatever they want at the end of the day. No good step 2 score, but well rounded app otherwise? Too bad. Great step 2 score, but a less than stellar app otherwise? Too bad. Lmbo it’s just all a game at this point and students get the short end no matter what unless they’re top tier in everything or have great connections. Sad situation after all the hard work students put in just to even simply complete medical school itself. Just constantly more hoops and bs 😂

It's not symmetric like that. Excellent Step 2 score but lacks in other areas? No go. Poor Step 2 score but excellent in other areas? Would get screened out at some programs. In scientific terms, a good Step 2 score is necessary but not sufficient.

 

[deleted1168269]

It's not symmetric like that. Excellent Step 2 score but lacks in other areas? No go. Poor Step 2 score but excellent in other areas? Would get screened out at some programs. In scientific terms, a good Step 2 score is necessary but not sufficient.

I will say that the mentality of “Step + LORs are all that matter” is something I’ve only heard older attendings and faculty say

 

[operaman]

I will say that the mentality of “Step + LORs are all that matter” is something I’ve only heard older attendings and faculty say

Yeah there’s definitely a lot of older docs giving good but outdated advice. I applied to residency in 2015 and already the landscape and competition has grown rapidly. I think upperclassmen at the end of m4 post match and current residents are good up to date sources. And then PDs/assoc PDs usually spend enough time looking at apps they can offer some guidance and perspective that’s accurate.

But yeah that old gray beard attending who trained in the 80s may not have the most current sense of what’s necessary.

Essentially just remember that while things vary in importance, everything is ultimately important. Outstanding performance in one area will rarely compensate for poor performance in another. Strong students tend to be strong across the board, and it shows.

 

[MDMechEngr]

"Strong students tend to be strong across the board, and it shows."

This 100%.

 

[aldol16]

Strong students tend to be strong across the board, and it shows.

I mean, this is essentially a truism. The question is what to do if a student has a poor Step 2 score and needs to do some repair or if a student has a strong Step 2 score but lacks in other areas. I think the latter is probably easier to fix, though it does require time.

 

[seroquantom]

Yes! I have seen this. Thought his high STEP score would make up for the fact that he was an absolute menace on clinical rotations not-specific to his specialty. He was wrong.