How Can Step 3 Change The Calculus?

[JamesGleaven]

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Hello Everybody,

 

[AdmiralChz]

What field are you hoping for? What are you doing this year - did you SOAP into a prelim? We need more information, here as even with 2 failures on CS your other scores and US MD status should have landed you somewhere.

 

[hamstergang]

We need more information, here as even with 2 failures on CS your other scores and US MD status should have landed you somewhere.

Well, there were also 4 professionalism citations and a reversed dismissal from med school. I get OP not wanting to talk about that again, but how else can anyone's advice be useful?

 

[J ROD]

:troll:

 

[AdmiralChz]

Oh, I totally forgot about this whole thread:

Assessment of Realistic Options

As we said months ago, Step 3 is unlikely to help move the needle at all in this case. Good for you for passing, but you’ll need to prove to programs that you aren’t a professionalism liability.

 

[GoSpursGo]

Will any of us on an anonymous message board tossing in our two cents actually change your outcome?

Sounds like you have some skeletons in your closet that go beyond your Step scores, but you managed to snag some interviews. Do your best. Worrying about your Step 3 score or prior failures on CS won't change anything; as you said, the past is past.

 

[mvenus929]

I’m not a PD, but I work closely with our administration. I wouldn’t want you in my program, because your test scores clearly show that you are book smart but have trouble interacting appropriately with people. That’s a really bad combination. I’d rather have someone that struggles with standardized tests, but mixes well with people. Knowledge base can be taught, professionalism really can’t.

 

[ThoracicGuy]

Well, there were also 4 professionalism citations and a reversed dismissal from med school. I get OP not wanting to talk about that again, but how else can anyone's advice be useful?

 

[GoSpursGo]

I’m not a PD, but I work closely with our administration. I wouldn’t want you in my program, because your test scores clearly show that you are book smart but have trouble interacting appropriately with people. That’s a really bad combination. I’d rather have someone that struggles with standardized tests, but mixes well with people. Knowledge base can be taught, professionalism really can’t.

I guess to piggy back on this, it's clear that the major skeletons have nothing to do with standardized testing. So Step 3 won't "change the calculus."

 

[JamesGleaven]

Thanks Folks. I just wanted to see How Step 3 might help me. I was very thrilled when I passed but then I quickly thought to myself "what does this mean in the grand scheme of things." I wanted to know, if at all, the CS failures were dragging me down in an potential ROL and if maybe the I could get some of that "ummph" back with a passed Step3. With that being said, I clearly don't know how ROL are synthesized and maybe I can be pointed to a thread with in-depth insight as to how a program synthesizes a ROL
If its not going to help then hey I'll just know that I've already taken care of that hurdle and I can get into meat and potatoes of residency.

 

[ddjamb]

I’m not a PD, but I work closely with our administration. I wouldn’t want you in my program, because your test scores clearly show that you are book smart but have trouble interacting appropriately with people. That’s a really bad combination. I’d rather have someone that struggles with standardized tests, but mixes well with people. Knowledge base can be taught, professionalism really can’t.

Edit: I apologize, I didn't read the whole story...

Now to OP, what matters is that you got IVs. In MHO, As long as programs invited you to meet you, it means that they are ok with your failures and they see you as a potential candidate. What matters is how you sell yourself to them, how you interact with them...Do they see themselves working with you for 3, 4 or more years depends on you not on your Step 3. Bonne chance.

 

[GoSpursGo]

How do you know that his CS failure is due to "trouble interacting appropriately with people"? Why would you assume that OP is nasty to patients? As a reminder, Step 2 CS has 3 components: ICE, CIS and SEP and the most commonly failed by US-Grads (when they fail) is ICE (Integrated Clinical Encounter), nothing to do with professionalism. So take him into your program and teach him how to write a patient note. LOL. my 2 cents

The thread linked by other members mentions professionalism citations and a reversed dismissal from school

 

[ddjamb]

My apologies...

 

[24blue8]

What field are you going into? I commend you for your perseverance. Goodluck with your interviews and the remaining season

 

[AdmiralChz]

Thanks Folks. I just wanted to see How Step 3 might help me. I was very thrilled when I passed but then I quickly thought to myself "what does this mean in the grand scheme of things." I wanted to know, if at all, the CS failures were dragging me down in an potential ROL and if maybe the I could get some of that "ummph" back with a passed Step3. With that being said, I clearly don't know how ROL are synthesized and maybe I can be pointed to a thread with in-depth insight as to how a program synthesizes a ROL
If its not going to help then hey I'll just know that I've already taken care of that hurdle and I can get into meat and potatoes of residency.

I think you already know this answer. It doesn’t move the needle at all. You can clearly pass a test, unlike many seeking help on this forum that’s not your shortcoming. Like @mvenus929 said, you have a severe history of professionalism problems - you can downplay this as much as you want and focus on unrelated issues like scores and how old your MD school is (you’ve mentioned it twice, so random) but this is clearly the issue at hand. There are very few applicants with your stats (including US MD, Dr. Old School) that don’t match in Internal Medicine.

The CS failures are strange, but also not the issue here. You have a pass, and that’s all most places will care about - IM has widely varied levels of competitiveness, and without other issues you shouldn’t have a problem finding a suitable program. Again, deep down you probably know this and it might (probably) is a symptom of the underlying program with regards to professionalism.

I’d be surprised if you can’t find a prelim surgery spot somewhere - anywhere - that wouldn’t be willing to take a chance. You’re still a warm body and can presumably do scut work. Your best shot is to go and work hella hard and show you have changed and can work well in a team. If you can then you should be able to match somewhere in IM or FM with some backup from faculty, but you won’t be able to be picky.

 

[JamesGleaven]

I was wondering about it from the standpoint of 1) PD can see I'm doing at least something in the mean time and 2) erasing doubt of my standardized test taking ability (if there was any) by passing a much more difficult exam under less than ideal circumstances. I've had a few people, including my friends in residency tell me that the CS failures are very alarming because its bizarre that a US student fails the CS twice given its 98% pass rate or so. I was told Step 3 MIGHT help and anything that might even a little is something I should invest in IMO

Oh and I was really just hoping for this question to be answered in a vacuum. I think that't why I put the "All things being equal phrase in there." I know what I'm facing soo I really doesn't phase me for people to bring that old ish up..even when I never asked for it.

right now the vote is like 3-1 (on SDN) anybody else wanna weigh in before I vanish from SDN for a while?

Thank You All for your Honest Opinions!

 

[neoexile]

Oh and I was really just hoping for this question to be answered in a vacuum.

This is a bad mentality to have. "In a vacuum"? A smart, reasonable person will consider all the variables before giving an answer.

I'm going to be honest. I think the problem is you can't accept the answers you are hearing.

 

[JamesGleaven]

What field are you going into? I commend you for your perseverance. Goodluck with your interviews and the remaining season

I appreciate the Felicitations man. I'm trying to match into FM now. "Forward ever, backwards never" is the guiding principle nowadays. All The Best to you on the Interview Trail Too!!

 

[AdmiralChz]

I've had a few people, including my friends in residency tell me that the CS failures are very alarming because its bizarre that a US student fails the CS twice given its 98% pass rate or so.

This used to be the case, back when I took Step 2 in 2011/12, but a big article came out heavily criticizing the NBME for charging so much for an exam which 98-99% of US Seniors pass. In response to criticism, they lowered the pass rate and from what I’ve seen it’s more like 85-90% for US students. It’s not infrequent to see some failures if you are looking at hundreds of applications.

That’s not the point, though. You clearly can take a test by your Step 1 and CK score. It would be much, MUCH more helpful to have PDs see you completing and thriving in the clinical realm rather than taking tests. Your other issues aren’t easily ignored, so don’t alight them. Just my two cents. Good luck.

 

[hamstergang]

In response to criticism, they lowered the pass rate and from what I’ve seen it’s more like 85-90% for US students.

Citation needed.

 

[mvenus929]

Edit: I apologize, I didn't read the whole story...

Now to OP, what matters is that you got IVs. In MHO, As long as programs invited you to meet you, it means that they are ok with your failures and they see you as a potential candidate. What matters is how you sell yourself to them, how you interact with them...Do they see themselves working with you for 3, 4 or more years depends on you not on your Step 3. Bonne chance.

Responding to your post before your edit...

I can forgive one CS failure. It’s hard to forgive two. I’m also smarting a bit because we are struggling to manage a resident who is extremely booksmart and does well on standardized tests who cannot for the life of them lead a team and has multiple professionalism concerns. Evidently, their application to residency focused on the booksmart piece and just casually left out the interaction with people piece.

And OP, as others have said, this question cannot be answered in a vacuum. But even if it could... CS and Step 3 test different skills. If you did well on Step 1 and CK, there’s little reason to suspect you’d do poorly on Step 3 because they are similar tests.

 

[Raryn]

This used to be the case, back when I took Step 2 in 2011/12, but a big article came out heavily criticizing the NBME for charging so much for an exam which 98-99% of US Seniors pass. In response to criticism, they lowered the pass rate and from what I’ve seen it’s more like 85-90% for US students. It’s not infrequent to see some failures if you are looking at hundreds of applications.

That’s not the point, though. You clearly can take a test by your Step 1 and CK score. It would be much, MUCH more helpful to have PDs see you completing and thriving in the clinical realm rather than taking tests. Your other issues aren’t easily ignored, so don’t alight them. Just my two cents. Good luck.

United States Medical Licensing Examination | Performance Data

Unless it's changed in the last year (data only goes through 2016), the pass rate for US MDs taking CS is still 97%.

 

[hallowmann]

United States Medical Licensing Examination | Performance Data

Unless it's changed in the last year (data only goes through 2016), the pass rate for US MDs taking CS is still 97%.

I believe it has changed in the past year. The numbers I have heard are in the 92-94% realm. Still no final tallies yet though.

As for the OP, yeah, Step 3 doesn't help. Your issue is the CS and clearly how interact with people. Even the way that you present things in this thread, interpret the statements of others, react to replies, etc. is all a bit telling. If this is how you come across in your application/interview, that's the part I'd be concerned about.

I would do as others have said, specifically try and focus on matching, and if you don't, SOAP into a prelim surg (or anything) spot. At least then you can become licensed in some states.

 

[Raryn]

I believe it has changed in the past year. The numbers I have heard are in the 92-94% realm. Still no final tallies yet though.

Color me skeptical.

I went back and did find the announcement that they updated the grading standard 3 months ago... but they do it every few years. I remember rumors that the fail rate was tripled going back to when I took it in 2012, and it has barely ever changed.

 

[AdmiralChz]

Being an interviewer, it seemed like we saw more failures more frequently. Maybe just anecdotal.

Anyway, here is the NEJM article slamming the exam as requested:

MMS: Error (despite it saying error, it seems to still work on my phone. Or you can just search NEJM Step 2 CS.)

 

[greenleaves]

OP there was no doubt about your standardized test taking abilities. You are more than qualified to take any paper based test. CS is not what I consider a standardized test, it is at minimum a good sieve for bringing to fore issues with communication, whether they be language or professionalism. An IMG with more than one attempt is pretty much guaranteed not to match but even so an AMG with three attempts also makes a PD look up and pay attention to the fact that there is an underlying problem.

OP if you don't believe you have a problem, I would ask you to meet with a therapist and get an independent assessment anyway. If you match, you can do it concurrently and avoid professionalism issues during residency and if you don't match you can show your efforts towards recognizing there is a problem and you're working your hardest to address it. If you fail to show reflection or insight about the issues that are holding you back, it's going to be only a desperate PD who might take a risk on you. I'm not a fan of the CS myself, having failed it the first time, but I can appreciate how it can serve as a wake up call for students who failed it for reasons besides english proficiency. It is unfortunate that the CS may have a high false positive rate when identifying problematic candidates but from the program's POV, it's probably better to be safe than sorry.

It's a plus that you took the Step 3 and passed but many IMGs do the same under as you said less than ideal circumstances. I'm making assumptions here, but your time would have been better served by consulting a mental health professional and doing a year of research at the very least. Forward ever, backward never is a good maxim but introspection is important to make that work. I wish you the best.

I was wondering about it from the standpoint of 1) PD can see I'm doing at least something in the mean time and 2) erasing doubt of my standardized test taking ability (if there was any) by passing a much more difficult exam under less than ideal circumstances. I've had a few people, including my friends in residency tell me that the CS failures are very alarming because its bizarre that a US student fails the CS twice given its 98% pass rate or so. I was told Step 3 MIGHT help and anything that might even a little is something I should invest in IMO

Oh and I was really just hoping for this question to be answered in a vacuum. I think that't why I put the "All things being equal phrase in there." I know what I'm facing soo I really doesn't phase me for people to bring that old ish up..even when I never asked for it.

right now the vote is like 3-1 (on SDN) anybody else wanna weigh in before I vanish from SDN for a while?

Thank You All for your Honest Opinions!