How common is a Step 2 CS requirement for ranking?

[AldousHux]

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Hey guys,
So I know there is a similar post just a few down, but I guess I'm looking for more specific stats. I originally had my Step 2 CS scheduled in early November, right after my EM rotation, but then I got an interview for that date, and the only date left was one in early Jan. I wasn't too worried cause I know I'll pass and I thought you just had to have taken it to get ranked by most programs. Now one of my places requires to have passed it to be ranked, so I'm going to look into getting a spot sometime before Jan 1, but is this common? Do most places require Step 2 CS score report before ranking you? If it helps, I'm going into Gen Surg. Of course now I wish I had taken it way earlier, but that's not what my school recommended, so spilt milk and all. Any stats people know are greatly appreciated.
Thanks!

 

[SouthernSurgeon]

Hey guys,
So I know there is a similar post just a few down, but I guess I'm looking for more specific stats. I originally had my Step 2 CS scheduled in early November, right after my EM rotation, but then I got an interview for that date, and the only date left was one in early Jan. I wasn't too worried cause I know I'll pass and I thought you just had to have taken it to get ranked by most programs. Now one of my places requires to have passed it to be ranked, so I'm going to look into getting a spot sometime before Jan 1, but is this common? Do most places require Step 2 CS score report before ranking you? If it helps, I'm going into Gen Surg. Of course now I wish I had taken it way earlier, but that's not what my school recommended, so spilt milk and all. Any stats people know are greatly appreciated.
Thanks!

It is becoming increasingly common. The only way to know is to check with the individual programs in question (look and see if it is on their website, or their hospital's GME website; call or email PC only as a last resort).

It is not really a specialty dependent thing, so much as a hospital system dependent thing, so it is very hard to generalize. The reason this is becoming more prevalent is that every year, a few people either fail it at the last minute or have their scores come back so late that their medical license application gets held up and they can't start residency on time. This is, obviously, a nightmare for a GME office, so they in response start making their residency programs require it for ranking.

Given that like 98% of US students pass, I recommend to all the M3/M4s I know to take it super early and just get it out of the way to avoid this problem (I know that doesn't help you...just for anyone else reading the thread).

 

[Psychotic]

I commented about this in the thread I think you are talking about, but if not, I searched every program website on my app list for any information on this issue, and found that most programs (approx 2/3 or so) either say nothing about it, or some actually say "by matriculation." I recall one program that specifically required a CK pass, but made no mention of CS, leading me to assume that CS was not required to rank.

I have read elsewhere that some residencies place much more value on CS than others. The primary care oriented residencies, like FM, for instance, vs say radiology or pathology or maybe even surgery (not sure). And that sort of makes sense to me given the nature of patient/doctor interactions in these residencies. I am applying to psychiatry, and I think they tend to care about CS a little more than, say, path and rads. I think that there is data in the NRMP outcomes data base that supports this idea of the relative importance of CS to residencies, but I don't have a link to it. Of course ultimately everyone needs to pass CS (even pathologists), so I am not sure if this is a real factor or not.

Also, I did not find a direct correlation between the relative competitiveness of the program and the requirement to have a CS pass before rank. For instance some big name programs on my list like Duke and Mt Sinai explicitly say it is not needed for ranking, but other lower rung programs require it, so it pays to actually check each program for specifics.

I think the view on the importance of having a passing CS score before ranking by programs is shifting now that the grading has been tightened to intentionally fail a higher percentage of test takers. In other words, whereas prior to 2013 the AMG pass rate was 98 or 99 percent, I think programs may have looked the other way at rank time, but my logic tells me that if the pass rate is now in the low 90s for AMGs, it has become riskier to "rank to match" applicants who don't have that passing score in the book by rank time.

An otherwise desirable candidate missing a CS pass may still get ranked, but just a little lower than if they had the CS pass in the file. What a shame to end up out of the money because of it.

Good luck.

 

[SouthernSurgeon]

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I have read elsewhere that some residencies place much more value on CS than others. The primary care oriented residencies, like FM, for instance, vs say radiology or pathology or maybe even surgery (not sure). And that sort of makes sense to me given the nature of patient/doctor interactions in these residencies. I am applying to psychiatry, and I think they tend to care about CS a little more than, say, path and rads. I think that there is data in the NRMP outcomes data base that supports this idea of the relative importance of CS to residencies, but I don't have a link to it.

Also, I did not find a direct correlation between the relative competitiveness of the program and the requirement to have a CS pass before rank. For instance some big name programs on my list like Duke and Mt Sinai explicitly say it is not needed for ranking, but other lower rung programs require it, so it pays to actually check each program for specifics.

As I said, I think the reason programs require it is much more pragmatic than any perceived value/relevance of the test itself. Simply, it's a PITA to deal with an incoming intern that has either failed it at the last minute, or hasn't gotten their score back at all. Programs dislike things that are a PITA; by requiring the score ahead of time they avoid the last minute hassle.

 

[Psychotic]

As I said, I think the reason programs require it is much more pragmatic than any perceived value/relevance of the test itself. Simply, it's a PITA to deal with an incoming intern that has either failed it at the last minute, or hasn't gotten their score back at all. Programs dislike things that are a PITA; by requiring the score ahead of time they avoid the last minute hassle.

I agree. It is one of those "all else being equal" things when a program ranks applicants, the "bird in the hand" at work. Why highly rank someone who has not reported a passing CS score when there are plenty of others to rank who have all their Steps passed in the file?

And when there is no CS (or CK) in the transcript, it begs the question of if the applicant is "hiding" a fail, gaming the transcript release system by withholding bad news in the hopes of getting a passing score in before or after the ranking.

"Risk Management 101" for programs; applicants beware.

 

[Psychotic]

oops - double post.