Help!! Late step 2 or take a research year?

[Rambunctious_Barbie]

I am in a situation where I will not be able to take step2 until the second week of October, and I'm applying for internal medicine this cycle. I planned to send in ERAS on time and update programs with my score when it is released. I have solid research and extracurriculars, and about half H/HP on clinical rotations. Great letters and clerkship evals. People are warning me that most programs fill up their interviews within the first couple of weeks, and I'm not likely to get any without a step2 score. Should I take a research year instead and apply next cycle? I really want to graduate on time and I have plenty of research, so I would prefer not to do this, but I don't want all these years of hard work to go to waste and not get any interviews.

*Edit: forget to mention that I passed step 1.

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[Euxox]

Will your application have a numerical Step 1 or just the P/F? Are you a US allopathic student?

There are some IM programs that continue to review applications into early November, but that is a smallish fraction, and your Step 2 score may not be back in time even for those programs.

If you won't have a numerical Step 1 score or a Step 2 score on your application, you may be best off taking a research year. If you decide to apply now, you might be able to match into a categorical IM spot if you apply very broadly. But it is not a given, and the quality of programs you will be in contention for will likely be significantly lower than if you had a middling Step 2 score attached to your application.

I would also advise you to schedule a time to speak with the PD for your home program and ask them how they would evaluate your application.

 

[NotAProgDirector]

Also depends on what timeline your school may allow, and how competitive a spot you're looking for. If your school allows it, you could apply this year and see how it goes. If you get a poor number of interviews, you could start a gap year (or 6 months) in January and then apply next year. if you get a goo dnumber of interviews, then you forge ahead. You would not know if you would get "better" interviews with a S2 score.

 

[Rambunctious_Barbie]

Will your application have a numerical Step 1 or just the P/F? Are you a US allopathic student?

There are some IM programs that continue to review applications into early November, but that is a smallish fraction, and your Step 2 score may not be back in time even for those programs.

If you won't have a numerical Step 1 score or a Step 2 score on your application, you may be best off taking a research year. If you decide to apply now, you might be able to match into a categorical IM spot if you apply very broadly. But it is not a given, and the quality of programs you will be in contention for will likely be significantly lower than if you had a middling Step 2 score attached to your application.

I would also advise you to schedule a time to speak with the PD for your home program and ask them how they would evaluate your application.

My step 1 is pass/fail, and I believe I'll get my score back on 10/25, so exactly one month late. Thanks for the advice!

 

[Rambunctious_Barbie]

Also depends on what timeline your school may allow, and how competitive a spot you're looking for. If your school allows it, you could apply this year and see how it goes. If you get a poor number of interviews, you could start a gap year (or 6 months) in January and then apply next year. if you get a goo dnumber of interviews, then you forge ahead. You would not know if you would get "better" interviews with a S2 score.

What do you mean by this? Like I can withdraw my ERAS and start a gap year? Does that mean I won't technically be a re-applicant? I'm hoping for a mid-tier academic IM program. I'm at a mid-tier MD school and hope to do a competitive IM fellowship.

 

[Euxox]

Yes, you have the option of withdrawing your applications (or not submitting a rank list) and doing a gap year.

It was definitely not an issue to apply without Step 2 while Step 1 was still scored. (Unless you had red flags on your application, like multiple Step 1 attempts, failed courses, etc.) The situation is different now and unfortunately we don't have much precedent.

I reviewed applications while I was a resident at mid tier IM program (relative term, but IMO). I never saw an application without any Step score attached - those were likely filtered out by the PD before they got to us. The closest situation that I can think of is that there was one (1) applicant in three years who we invited for interview with a Step 2 CK failure and no reattempt. He was told to submit his reattempt score in time for ranking. He did not end up matching to our program.

 

[NotAProgDirector]

Yes, that's exactly what I mean. If you were to start an LOA in December or January, you would withdraw from ERAS and stop interviewing (or never start). You'd do research or whatever you planned with your gap. You would then restart clinical work in July, generate some new LORs (although using those from the prior year is fine also), and apply again with everything on time. You would graduate in December (some schools have graduation twice a year, some will make you wait until May but you'd be done with classes). You'd still be an enrolled 4th year student when you applied again next year.

 

[Rambunctious_Barbie]

Yes, you have the option of withdrawing your applications (or not submitting a rank list) and doing a gap year.

A mid tier program is a possibility, but it is definitely not a sure thing. I went to a mid tier IM program (relative term, but IMO) and reviewed applications myself. I never saw an application without any Step score attached - those were likely filtered out by the PD before they got to us. The closest situation that I can think of is that there was one (1) applicant in three years who we invited for interview with a Step 2 CK failure and no reattempt. He was told to submit his reattempt score in time for ranking. He did not end up matching to our program.

Yeah, I am really worried about it. I was hoping that since this is the first year for p/f step 1, programs may be a little more understanding as it was common to take step 2 in october/november/december until this year. I am also more than happy staying at my home program and I have good relationships with all of our faculty. Weirdly, my advisor and even the department chair didn't act like this would be a big deal, but everyone online says it is the kiss of death. I think I may risk it and see what happens, and if I have no interviews by January I'll withdraw my app and make a new plan.

 

[Rambunctious_Barbie]

Yes, that's exactly what I mean. If you were to start an LOA in December or January, you would withdraw from ERAS and stop interviewing (or never start). You'd do research or whatever you planned with your gap. You would then restart clinical work in July, generate some new LORs (although using those from the prior year is fine also), and apply again with everything on time. You would graduate in December (some schools have graduation twice a year, some will make you wait until May but you'd be done with classes). You'd still be an enrolled 4th year student when you applied again next year.

This is great to know. Will there be any indication that I applied before, other than programs potentially remembering my application?

 

[Splenda88]

My application was complete at the end of November when I applied in 2017 to start IM residency in 2018. Step 1 score was < 220 and step2 was 220+ and I had multiple invites and even cancelled 1. But I applied to almost 80 programs given how late my application was. I ended matching at my #2, which was a low tier academic program. I think you should be ok if you are a US student.

 

[Rambunctious_Barbie]

My application was complete at the end of November when I applied in 2017 to start IM residency in 2018. Step 1 score was < 220 and step2 was 220+ and I had multiple invites and even cancelled 1. But I applied to almost 80 programs given how late my application was. I ended matching at my #2, which was a low tier academic program. I think you should be ok if you are a US student.

Thanks! Out of curiosity, how many interviews did you end up getting? I am also planning to apply to at least 80.

 

[Splenda88]

Thanks! Out of curiosity, how many interviews did you end up getting? I am also planning to apply to at least 80.

I think it was 10 or 11.

 

[Dantes]

Also depends on what timeline your school may allow, and how competitive a spot you're looking for. If your school allows it, you could apply this year and see how it goes. If you get a poor number of interviews, you could start a gap year (or 6 months) in January and then apply next year. if you get a goo dnumber of interviews, then you forge ahead. You would not know if you would get "better" interviews with a S2 score.

Can't programs track re-applicants or at the very least recognize an application in back to back years? I wonder if that could put them at a disadvantage, even if they would still be considered a graduating senior.

 

[Euxox]

My application was complete at the end of November when I applied in 2017 to start IM residency in 2018. Step 1 score was < 220 and step2 was 220+ and I had multiple invites and even cancelled 1. But I applied to almost 80 programs given how late my application was. I ended matching at my #2, which was a low tier academic program. I think you should be ok if you are a US student.

Thanks! Out of curiosity, how many interviews did you end up getting? I am also planning to apply to at least 80.

I think it was 10 or 11.

What parts of your application were complete before the end of November? Did you have a Step 1 score on file?

 

[Splenda88]

What parts of your application were complete before the end of November? Did you have a Step 1 score on file?

I don't remember all the details. But my step1 was in but my MSPE was not because I screwed up. I forgot to log in a few of my patient encounters during my IM clerkship and my school made me do another month of IM clerkship so I had enough patient encounters.

I just looked at my step2 transcript and I took it October 31st, 2017, so I am assuming my I received the score at the end of November. So I did not have my MSPE and step2.

 

[Rambunctious_Barbie]

I don't remember all the details. But my step1 was in but my MSPE was not because I screwed up. I forgot to log in a few of my patient encounters during my IM clerkship and my school made me do another month of IM clerkship so I had enough patient encounters.

I just looked at my step2 transcript and I took it October 31st, 2017, so I am assuming my I received the score at the end of November. So I did not have my MSPE and step2.

Did all your interviews come after you were complete? Or were some programs willing to interview you without step2 and the MSPE?

 

[Splenda88]

Did all your interviews come after you were complete? Or were some programs willing to interview you without step2 and the MSPE?

Only 1 invite came before I was complete (the program that I ended up attending; my #2 ROL). I remember that I had 2 invites (U of AZ and probably Florida Atlantic University) the same day I was complete.

I interviewed at that program even before I was complete and the interviewers were asking why my application was not complete yet.

A lot of leeways are given to US students at the less competitive specialties/programs. FWIW, I attended (arguably) a bottom 20 US MD school

 

[NotAProgDirector]

This is great to know. Will there be any indication that I applied before, other than programs potentially remembering my application?

Can't programs track re-applicants or at the very least recognize an application in back to back years? I wonder if that could put them at a disadvantage, even if they would still be considered a graduating senior.

Theoretically yes, realistically no. There is not any marker that you applied in a prior year. We would need to pull out files and review. And we have 1000's of applications - no one is going to remember someone who didn't interview. Blow off an interview? Sure we'll probably remember that.

Even if someone noticed, and you had a research LOA, and now have a S2 score, no one will care.

It's not clear what programs will do without a S2 score this year. But I wouldn't be surprised if programs waited for a result.