How good do you have to be to match a competitive specialty?

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MilesDavisTheDoctor

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I'm an M1 at a top school and 8 months in it's looking like pre-clinical-wise im pretty average lol. I want to go into a competitive specialty and I understand that things like clinical grades, usmle and research all matter a million times more than my P/F pre-clincial, but I'm just wondering should I be worried lol? It is making me a little intimidated that I want to match into something like ortho when all of my classmates seem 100 times more on top of their stuff than me. Did any of you guys end up matching something competitive but had the same sort of feeling as me pre-clinical lol? Do people who are kinda meh throughout med school but dunk on usmle end up matching competitive stuff often?
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Dryad8212 said:
In order to match into a competitive specialty, you must be competitive.
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cover3.jpg
 
Dryad8212 said:
I mean come on man, thats like asking how to be competitive for medical school. GPA, mcat, show some work experience.

For med school the following: Step 2, honor shelf exams, dont have any red flags, show demonstration for passion for the field.
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No i agree with you + Charting Outcomes answer the question. But i couldn't resist posting that meme
 
Just look at outcomes of the match. If you're a MD with a 240 step, you can probably match every specialty barring you have no red flags, apply broadly etc. Now, to match in a competitive place will take a lot more effort, but to match say ortho anywhere, a 240 MD can prolly do it.
 
MilesDavisTheDoctor said:
I'm an M1 at a top school and 8 months in it's looking like pre-clinical-wise im pretty average lol. I want to go into a competitive specialty and I understand that things like clinical grades, usmle and research all matter a million times more than my P/F pre-clincial, but I'm just wondering should I be worried lol? It is making me a little intimidated that I want to match into something like ortho when all of my classmates seem 100 times more on top of their stuff than me. Did any of you guys end up matching something competitive but had the same sort of feeling as me pre-clinical lol? Do people who are kinda meh throughout med school but dunk on usmle end up matching competitive stuff often?
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Here's what the PDs like.
 
1) Crush Step 1 (nowadays it looks like that'll be Step 2 CK).
2) Do well on clinical rotations. Most important to honor medicine and surgery if you're going into a competitive surgical specialty but obviously the more honors you get the better.
3) Network with faculty and residents in the specialty you want to go into. These are people who will go to bat for you down the line. It's important to have people on your side when you're applying.
4) Get involved in research. This goes hand in hand with #3. People like to see that you're intellectually curious in the field and quality and quantity both matter.
5) Do well on your away/audition rotations. Make a positive impression.

These are not in order of importance.
 
scoopdaboop said:
Just look at outcomes of the match. If you're a MD with a 240 step, you can probably match every specialty barring you have no red flags, apply broadly etc. Now, to match in a competitive place will take a lot more effort, but to match say ortho anywhere, a 240 MD can prolly do it.
Click to expand...
It always amazes me that the most competitive specialties (ortho, derm, urology, etc) require the highest usmle scores but require the least amount of brain power to practice it. Some of the attendings in those competitive specialties are some of the least well rounded (medical-wise) physicians around.
 
Test Boy said:
It always amazes me that the most competitive specialties (ortho, derm, urology, etc) require the highest usmle scores but require the least amount of brain power to practice it. Some of the attendings in those competitive specialties are some of the least well rounded (medical-wise) physicians around.
Click to expand...

Somebody is salty. Was your ex a Urologist or something? Was your home village raided and pillaged by a rival tribe of soft-skinned dermatologists? Did somebody gouge out your eyeballs?

I just want to know who hurt you??!
 
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Test Boy said:
It always amazes me that the most competitive specialties (ortho, derm, urology, etc) require the highest usmle scores but require the least amount of brain power to practice it. Some of the attendings in those competitive specialties are some of the least well rounded (medical-wise) physicians around.
Click to expand...
It always amazes me that when I think I’ve already read the most idiotic comment of all time on SDN, someone like you comes along and proves me wrong.
 
I was bottom quartile until halfway through third year and had a sub-240 Step 1 and matched ortho. So no, you don’t have to be a perfect applicant.

You do need to have something that stands out though if you’re gonna be an average or below average applicant applying to a competitive specialty. A lot of time (including me), it is research and strong LORs.

And to answer your question, yes I had the same feeling as you when I was an M1. I was pretty self aware and knew I was never gonna get 260/270 Step scores, so made sure to get involved with research and making connections early.
 
MilesDavisTheDoctor said:
I'm an M1 at a top school and 8 months in it's looking like pre-clinical-wise im pretty average lol. I want to go into a competitive specialty and I understand that things like clinical grades, usmle and research all matter a million times more than my P/F pre-clincial, but I'm just wondering should I be worried lol? It is making me a little intimidated that I want to match into something like ortho when all of my classmates seem 100 times more on top of their stuff than me. Did any of you guys end up matching something competitive but had the same sort of feeling as me pre-clinical lol? Do people who are kinda meh throughout med school but dunk on usmle end up matching competitive stuff often?
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Hey Miles, your band was at it's best with Trane, Evans, Cobb, Chambers, and my man Cannonball. The electric stuff was meh.

On to less important issues. You should look at the data in Charting Outcomes in the Match. Peruse this:
SAP Crystal Reports - (kinstacdn.com)
The Step 1 data will, of course, not apply to your cohort. Good luck.
 
Test Boy said:
It always amazes me that the most competitive specialties (ortho, derm, urology, etc) require the highest usmle scores but require the least amount of brain power to practice it. Some of the attendings in those competitive specialties are some of the least well rounded (medical-wise) physicians around.
Click to expand...

You could argue they were smart enough to pick and get into specialties with the best financial ROI. Very well rounded I would say. Life well rounded.
 
sloh said:
You could argue they were smart enough to pick and get into specialties with the best financial ROI. Very well rounded I would say. Life well rounded.
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Not disagreeing with your statement at all but that wasn’t my point.
 
I know multiple people who were barely passing, or even repeatedly re-taking, preclinical units but then dunked 250+ USMLEs and had great interview invites. That's the whole point of unranked Pass/Fail grading, you don't need to pay any mind to the distribution, just your score and the Pass cutoff.
 
Dryad8212 said:
I mean come on man, thats like asking how to be competitive for medical school. GPA, mcat, show some work experience.

For med school the following: Step 2, honor shelf exams, dont have any red flags, show demonstration for passion for the field.
Click to expand...
What’s considered a red flag
 
MilesDavisTheDoctor said:
I'm an M1 at a top school and 8 months in it's looking like pre-clinical-wise im pretty average lol. I want to go into a competitive specialty and I understand that things like clinical grades, usmle and research all matter a million times more than my P/F pre-clincial, but I'm just wondering should I be worried lol? It is making me a little intimidated that I want to match into something like ortho when all of my classmates seem 100 times more on top of their stuff than me. Did any of you guys end up matching something competitive but had the same sort of feeling as me pre-clinical lol? Do people who are kinda meh throughout med school but dunk on usmle end up matching competitive stuff often?
Click to expand...
First get through your preclinicals, your clinical rotations, and your Step exams, getting as high scores as you can. Then you can decide if you want to go for a competitive specialty. Sometimes students change their minds after doing rotations. When I first started, I was so sure I was going to be a gung ho trauma surgeon. Ended up doing IM, then nephro, and am perfectly happy with my choice.
 
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You busted your ass to get into a top school. Your colleagues did too. Make sure you are still busting your ass. A lot of top students coast in med school having already paid a steep price to get there. Don't coast. Don't party. Bust your ass. It never stops paying off. That being said, its hard to stand out in a great school. I didn't stand out in pre-clinical years at a top 5 school. I didn't do great on Step 1. I killed it in clinical years, graduated AOA, and had my pick of residency slots. Throw everything into it, especially medicine and surgery rotations. Be that one that gets up an hour before your overworked intern and rounds on all his patients and writes all the notes. Smile at your patients, sit on their bed, know they are scared and hold their hand if you have to. Let them know you aren't scared for them and they will feel better and heal faster. Be the last one out of the hospital. Be useful, not a brown nose. Study your patient's diseases and be able to communicate intelligently. Be the one that sprints to every code. Be the one they are relieved to see when you walk in. Be the one that they want to write a letter for because you were so awesome. Be awesome.
 
Pshalt said:
You busted your ass to get into a top school. Your colleagues did too. Make sure you are still busting your ass. A lot of top students coast in med school having already paid a steep price to get there. Don't coast. Don't party. Bust your ass. It never stops paying off. That being said, its hard to stand out in a great school. I didn't stand out in pre-clinical years at a top 5 school. I didn't do great on Step 1. I killed it in clinical years, graduated AOA, and had my pick of residency slots. Throw everything into it, especially medicine and surgery rotations. Be that one that gets up an hour before your overworked intern and rounds on all his patients and writes all the notes. Smile at your patients, sit on their bed, know they are scared and hold their hand if you have to. Let them know you aren't scared for them and they will feel better and heal faster. Be the last one out of the hospital. Be useful, not a brown nose. Study your patient's diseases and be able to communicate intelligently. Be the one that sprints to every code. Be the one they are relieved to see when you walk in. Be the one that they want to write a letter for because you were so awesome. Be awesome.
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I dunno man, I never did any freak level stuff like rounding an hour before the intern, did above average on steps for my specialty and got my #1 position which ended up being highly competitive.
 
Frogger27 said:
I was bottom quartile until halfway through third year and had a sub-240 Step 1 and matched ortho. So no, you don’t have to be a perfect applicant.

You do need to have something that stands out though if you’re gonna be an average or below average applicant applying to a competitive specialty. A lot of time (including me), it is research and strong LORs.

And to answer your question, yes I had the same feeling as you when I was an M1. I was pretty self aware and knew I was never gonna get 260/270 Step scores, so made sure to get involved with research and making connections early.
Click to expand...
When did you do research? What yr did you start?
 
jimminyhalbert said:
When did you do research? What yr did you start?
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Started probably October/November of first year. It was actually a different surgical subspecialty, but I was really productive and when I switched to ortho I was able to be productive quickly due to learning how to do research the first couple years of Med school
 
Pshalt said:
You busted your ass to get into a top school. Your colleagues did too. Make sure you are still busting your ass. A lot of top students coast in med school having already paid a steep price to get there. Don't coast. Don't party. Bust your ass. It never stops paying off. That being said, its hard to stand out in a great school. I didn't stand out in pre-clinical years at a top 5 school. I didn't do great on Step 1. I killed it in clinical years, graduated AOA, and had my pick of residency slots. Throw everything into it, especially medicine and surgery rotations. Be that one that gets up an hour before your overworked intern and rounds on all his patients and writes all the notes. Smile at your patients, sit on their bed, know they are scared and hold their hand if you have to. Let them know you aren't scared for them and they will feel better and heal faster. Be the last one out of the hospital. Be useful, not a brown nose. Study your patient's diseases and be able to communicate intelligently. Be the one that sprints to every code. Be the one they are relieved to see when you walk in. Be the one that they want to write a letter for because you were so awesome. Be awesome.
Click to expand...
Or do all of this and still have an attending give you the "3/5 good student, nice guy, needs reading"
 
Yes, there is that. Although I was described as too arrogant by the chief of plastic surgery, which made my dean so amused, she overlooked much of my preclinical mediocrity. It is a bit of a crapshoot and a popularity contest but busting your ass will never hurt you.
 
Pshalt said:
Yes, there is that. Although I was described as too arrogant by the chief of plastic surgery, which made my dean so amused, she overlooked much of my preclinical mediocrity. It is a bit of a crapshoot and a popularity contest but busting your ass will never hurt you.
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This is why the number 1 rule of clinical year is to be likable.

(not knocking you, you obviously did very well overall, just reiterating for those reading).
 
linking the charting outcomes doesn't seem entirely helpful to me. If this guy does go to a top 10 program then having a 230 + connections seems sufficient for most "competitive" fields.
 
MilesDavisTheDoctor said:
I'm an M1 at a top school and 8 months in it's looking like pre-clinical-wise im pretty average lol. I want to go into a competitive specialty and I understand that things like clinical grades, usmle and research all matter a million times more than my P/F pre-clincial, but I'm just wondering should I be worried lol? It is making me a little intimidated that I want to match into something like ortho when all of my classmates seem 100 times more on top of their stuff than me. Did any of you guys end up matching something competitive but had the same sort of feeling as me pre-clinical lol? Do people who are kinda meh throughout med school but dunk on usmle end up matching competitive stuff often?
Click to expand...
Generally if you're at a top school you can have one "problem" with your application (e.g., low-ish STEP, a bad clinical grade, one bad letter of rec) and NO red flags (e.g., suspension, failing) and still match in a competitive specialty. You won't be at the best of the best residency programs but you can still match.
 
SpliceOfLife said:
Generally if you're at a top school you can have one "problem" with your application (e.g., low-ish STEP, a bad clinical grade, one bad letter of rec) and NO red flags (e.g., suspension, failing) and still match in a competitive specialty. You won't be at the best of the best residency programs but you can still match.
Click to expand...
how much does preclinical grades matter in terms of matching somewhere competitive ?
 
scoopdaboop said:
Just look at outcomes of the match. If you're a MD with a 240 step, you can probably match every specialty barring you have no red flags, apply broadly etc. Now, to match in a competitive place will take a lot more effort, but to match say ortho anywhere, a 240 MD can prolly do it.
Click to expand...
Step1 is going to be p/f
 
Test Boy said:
It always amazes me that the most competitive specialties (ortho, derm, urology, etc) require the highest usmle scores but require the least amount of brain power to practice it. Some of the attendings in those competitive specialties are some of the least well rounded (medical-wise) physicians around.
Click to expand...
Huh? There are specialties for a reason. Have you ever sat down and actually look what an orthopedic surgeon or dermatologist has to learn/know to be good at what they do? You lose what you don't use.
 
Let's say you go to a place like NYU, Duke, or UCLA, will that in and of itself significantly help you match something competitive even if you are the same as another student at a "non-top school" in every other way?- most of the benefit I've heard from going to these schools is due to the opportunities for research rather than just "going there".
 
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MilesDavisTheDoctor said:
Let's say you go to a place like NYU, Duke, or UCLA, will that in and of itself significantly help you match something competitive even if you are the same as another student at a "non-top school" in every other way?- most of the benefit I've heard from going to these schools is due to the opportunities for research rather than just "going there".
Click to expand...
Name helps you get interviews, dont ever let anyone convince you otherwise
 
MilesDavisTheDoctor said:
Let's say you go to a place like NYU, Duke, or UCLA, will that in and of itself significantly help you match something competitive even if you are the same as another student at a "non-top school" in every other way?- most of the benefit I've heard from going to these schools is due to the opportunities for research rather than just "going there".
Click to expand...
efle said:
Name helps you get interviews, dont ever let anyone convince you otherwise
Click to expand...

Idk man, the name may help a little bit but if you are a crappy applicant with mediocre LORs, etc but go to one of those schools vs some kid from a mediocre Med school but is AOA, strong LORs, etc I guarantee you the kid from mediocre Med school will do better in the match.

The benefits of a top school are research opportunities and getting LORs from influential people. It becomes a who knows who game inevitably and if people know your letter writers AND they are strong, that’s the benefit of these schools.
 
Frogger27 said:
Idk man, the name may help a little bit but if you are a crappy applicant with mediocre LORs, etc but go to one of those schools vs some kid from a mediocre Med school but is AOA, strong LORs, etc I guarantee you the kid from mediocre Med school will do better in the match.

The benefits of a top school are research opportunities and getting LORs from influential people. It becomes a who knows who game inevitably and if people know your letter writers AND they are strong, that’s the benefit of these schools.
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Theres not a lot to differentiate people at these schools. Pass/fail preclinical, high board avg, AOA is disappearing or delayed until past match, everyone has research, during COVID people are even Pass/fail on the wards. Everyone has letters from established faculty. It's extremely easy to be around average at these schools, relative to being AOA elsewhere, and their median match goes to brand name academic centers. You can call it whatever you want - prestige vs being put on the easy track - the end result is the same, you can rest on your laurels much more and still have a fantastic set of interviews at the end of it.
 
Test Boy said:
It always amazes me that the most competitive specialties (ortho, derm, urology, etc) require the highest usmle scores but require the least amount of brain power to practice it. Some of the attendings in those competitive specialties are some of the least well rounded (medical-wise) physicians around.
Click to expand...

There’s enough material on just the knee to publish a two volume textbook.
 
MilesDavisTheDoctor said:
Let's say you go to a place like NYU, Duke, or UCLA, will that in and of itself significantly help you match something competitive even if you are the same as another student at a "non-top school" in every other way?- most of the benefit I've heard from going to these schools is due to the opportunities for research rather than just "going there".
Click to expand...

Name plays a factor. But yes, so do opportunities in research, getting LORs from well-known people.

Also, the step 1 average for many (most?) of these schools is 240+...I'm sure that helps too.

For competitive specialties, you need to put in the work. You can't just waltz in. Some places will make it easier than others.
 
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