huge step 2 drop from step 1, don't know what to do.

[dentalhopeful10]

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As the title says, I got my score back last week and after a spiral of depression I am trying to see what I can do to salvage my application. My step 1 is a low 240s and my step 2 is a low 220s. I honestly cannot tell you guys what happened. I took a couple of practice tests and scored in the 250-260s (USWA and NBME).

I go to school in NYC and was hoping to match into one of the bigger name Academic institutions here for internal medicine. Any advice is welcome.

 

[Tenk]

Score is fine. Network.

 

[Redpancreas]

It's not a good thing, that's for sure but you've demonstrated that you can step up and score well on a standardized exam once and while a low Step 2 is a knock, it's probably not going to be as scrutinized as you think. Head up 🙂 and keep going with your application as if it didn't happen.

 

[AcademicNeurosurgery]

Agree with the above posters. No use in worrying about something you can't change - maximize the rest of your app (research, letters, etc) and apply broadly. You will be just fine!

And make sure the depression does not go unchecked, do what you need to do to address it so you can be at your best for your patients. We all hit speed bumps along the way, and they do not define us.

 

[bannie22]

Just dont share the score. Step 2 is important for IM and a 220 will hurt more than a missing score.

 

[sloop]

Just dont share the score. Step 2 is important for IM and a 220 will hurt more than a missing score.

I don't think this is how it works (unless something has changed substantially since I applied). Considering that it is currently June and OP has his score before ERAS even opens, it will show up on his USMLE transcript. He will have to show his Step 1 score and his Step 2 score is on the same document. The only way to control disclosure of Step 2 (at least this is how it was last cycle when I applied) would be to time sitting for Step 2 such that the results would come back after ERAS went out, so that you would have submitted your USMLE (presumably with Step 1 only) and could then choose whether or not to hit the "resend transcript" button when you got your Step 2 scores. For someone who took the exam this early, there exists no choice.

OP, just try to work on what you can control. Work hard, do your best, and apply to all the places you'd like to go as well as some safer bets. Rank in order of preference. That's all you can do. I know it sucks not having more control over such an important thing but that's just how it is in this process.

 

[CharlieBillings]

What is the benefit of taking step 2 when your step 1 score is already in the 240s?

I thought people only took step 2 before residency application because they wanted to improve over a less than perfect step 1, or because a program specifically desires it.

 

[sliceofbread136]

What is the benefit of taking step 2 when your step 1 score is already in the 240s?

I thought people only took step 2 before residency application because they wanted to improve over a less than perfect step 1, or because a program specifically desires it.

A lot of people just want to get it out of the way. Otherwise not much benefit, personally I think beginning of December is the best time to take it

 

[W19]

A lot of people just want to get it out of the way. Otherwise not much benefit, personally I think beginning of December is the best time to take it

I was told that they are MANY programs who will not interview you if you don't have a step2 ck

 

[dentalhopeful10]

What is the benefit of taking step 2 when your step 1 score is already in the 240s?

I thought people only took step 2 before residency application because they wanted to improve over a less than perfect step 1, or because a program specifically desires it.

I scored in the 250-260 range on my practice exams, if I would have scored below or near the 240s I probably would not have taken it early. I'm not sure what happened.

 

[BamaNicole]

What is the benefit of taking step 2 when your step 1 score is already in the 240s?

I thought people only took step 2 before residency application because they wanted to improve over a less than perfect step 1, or because a program specifically desires it.

We're required to take it before september at my school.

 

[W19]

We're required to take it before september at my school.

I wonder what's the purpose of that requirement? My school requires it (with CS) only for graduation... In fact, I know one individual who matched into a good IM program in NY city without CK/CS scores in... I was told she did away rotation at that place; she must have made a good impression on that PD...

 

[postbacpremed87]

I wish I never read this thread. I scored a 262 on UWSA and a 262 on NBME 4 and I take Step 2 on Monday. I'm a DO student so I would be destroyed if I dropped like you. My good Step 1 would be erased.

 

[jw3600]

I wish I never read this thread. I scored a 262 on UWSA and a 262 on NBME 4 and I take Step 2 on Monday. I'm a DO student so I would be destroyed if I dropped like you. My good Step 1 would be erased.

Man. You are literally my inner monologue right now.

 

[coolschool1239]

I take STEP 2 in a week and this is concerning haha

 

[sliceofbread136]

I was told that they are MANY programs who will not interview you if you don't have a step2 ck

I haven't come across a program that didn't give interviews, but many said that they would not rank you. It could be different for other fields though

 

[Anicetus]

I wish I never read this thread. I scored a 262 on UWSA and a 262 on NBME 4 and I take Step 2 on Monday. I'm a DO student so I would be destroyed if I dropped like you. My good Step 1 would be erased.

The obligatory "man I hope the same sh**ty situation you're in doesn't happen to me!" Post.

 

[Brorthopedic]

I wish I never read this thread. I scored a 262 on UWSA and a 262 on NBME 4 and I take Step 2 on Monday. I'm a DO student so I would be destroyed if I dropped like you. My good Step 1 would be erased.

piss off

 

[Donald Juan]

I haven't come across a program that didn't give interviews, but many said that they would not rank you. It could be different for other fields though

This is what I've heard of much more commonly. Many programs just want to make sure you have that pass so they don't have a spot go unfilled because you fail step 2 in May

 

[jw3600]

piss off

I mean the OP bascially had this happen. So it's not entirely unrealistic.

 

[dentalhopeful10]

I believe I was told that if you take it before applications, it shows up that you took it on that certain date. So the programs can assume I did not release it for a negative reason (which in my case they would be right lol).

 

[W19]

A lot of people just want to get it out of the way. Otherwise not much benefit, personally I think beginning of December is the best time to take it

Why?

 

[tantacles]

I don't think this is how it works (unless something has changed substantially since I applied). Considering that it is currently June and OP has his score before ERAS even opens, it will show up on his USMLE transcript. He will have to show his Step 1 score and his Step 2 score is on the same document. The only way to control disclosure of Step 2 (at least this is how it was last cycle when I applied) would be to time sitting for Step 2 such that the results would come back after ERAS went out, so that you would have submitted your USMLE (presumably with Step 1 only) and could then choose whether or not to hit the "resend transcript" button when you got your Step 2 scores. For someone who took the exam this early, there exists no choice.

OP, just try to work on what you can control. Work hard, do your best, and apply to all the places you'd like to go as well as some safer bets. Rank in order of preference. That's all you can do. I know it sucks not having more control over such an important thing but that's just how it is in this process.

This is why I always advise students to take Step 2 in early September if they can.

 

[tantacles]

I believe I was told that if you take it before applications, it shows up that you took it on that certain date. So the programs can assume I did not release it for a negative reason (which in my case they would be right lol).

No you just literally are unable to hide your score because you have to send all USMLE transcripts. All you can do is send it and wait. This piece of your application is beyond your control. Don't worry; you'll still match, provided you apply broadly and avoid only applying to super competitive programs.

 

[dentalhopeful10]

No you just literally are unable to hide your score because you have to send all USMLE transcripts. All you can do is send it and wait. This piece of your application is beyond your control. Don't worry; you'll still match, provided you apply broadly and avoid only applying to super competitive programs.

What would you consider super competitive vs what I would
Be competitive for? I would love to match NYU, Jefferson, Temple or somewhere around that caliber.

 

[tantacles]

What would you consider super competitive vs what I would
Be competitive for? I would love to match NYU, Jefferson, Temple or somewhere around that caliber.

NYU is competitive, Jefferson and Temple aren't. Here's my suggestion: Make a list of 30 programs that you want to go to and let us know your regional preferences (big city vs. not, region of the United States) and we can better advise you.

 

[dentalhopeful10]

This is a rough draft of the list I came up with, when I had my meeting with my adviser(when we both thought I was going to score in the 250-260 range because of my practice tests =[ ).


***Sorry I typed this on my cellphone because I am on a very long train ride today and will not get home until very late.

1. UPMC
2. Allegheny
3. Jeff
4. Temple
5. Drexel
6. Albert Einstein (philadelphia)
7. Cornell
8. Icahn School of Medicine at Mount Sinai (Bronx)
9. SUNY downstate
10. UMASS
11. Boston University
12. Dartmouth
13. Tufts
14. Brown
15. UMD
16. George Washington
17. Georgetown
18. University of Virginia
19. Virginia Commonwealth University
20. UNC
21. Wake Forest
22. Charleston, SC
23. University of Alabama
24. University of Miami
25. Cleveland Center
26. Case Western
27. Ohio State
28. Northwestern
29. University of Chicago
30. Rush
31. Washington university at St. Louis
32. University of Colorado
33. University of Washington
34. Baylor (I believe there are two)
35. University of Texas Health Science center

I wanted to go to an academic center in order to best set myself up for fellowship. I am couples matching and she is applying to peds, matching together is more important than location. Preferably east coast in a larger city.

Again just apologizing I did this on my phone, and do not have my list on me.

 

[dentalhopeful10]

NYU is competitive, Jefferson and Temple aren't. Here's my suggestion: Make a list of 30 programs that you want to go to and let us know your regional preferences (big city vs. not, region of the United States) and we can better advise you.

We were also thinking about adding a few schools from California, but I am afraid those are completely out of the picture now.

 

[tantacles]

This is a rough draft of the list I came up with, when I had my meeting with my adviser(when we both thought I was going to score in the 250-260 range because of my practice tests =[ ).


***Sorry I typed this on my cellphone because I am on a very long train ride today and will not get home until very late.

1. UPMC
2. Allegheny
3. Jeff
4. Temple
5. Drexel
6. Albert Einstein (philadelphia)
7. Cornell
8. Icahn School of Medicine at Mount Sinai (Bronx)
9. SUNY downstate
10. UMASS
11. Boston University
12. Dartmouth
13. Tufts
14. Brown
15. UMD
16. George Washington
17. Georgetown
18. University of Virginia
19. Virginia Commonwealth University
20. UNC
21. Wake Forest
22. Charleston, SC
23. University of Alabama
24. University of Miami
25. Cleveland Center
26. Case Western
27. Ohio State
28. Northwestern
29. University of Chicago
30. Rush
31. Washington university at St. Louis
32. University of Colorado
33. University of Washington
34. Baylor (I believe there are two)
35. University of Texas Health Science center

I wanted to go to an academic center in order to best set myself up for fellowship. I am couples matching and she is applying to peds, matching together is more important than location. Preferably east coast in a larger city.

Again just apologizing I did this on my phone, and do not have my list on me.

Safety: Allegheny, Jefferson, Temple, Drexel, SUNY Downstate, UMass, UMD, GW, Wake Forest, Charleston, SC, Miami, Cleveland Clinic, VCU

Target: Boston University, Dartmouth, Tufts, Brown, Georgetown, UNC, UAB, U of Miami, Case Western University Hospitals, Ohio State, Rush, Einstein

Reach: UPMC, Cornell, Sinai, Northwestern, University of Chicago, Wash U, U of Colorado, U of Washington, Baylor, UVA

Don't know: UTHSC

You have a LOT of safeties. You probably only need to apply to 6-7 of those schools, so choose the ones you don't like and get rid of them. And I would focus that mainly on cities you want to be in.

Otherwise, your program list looks fine with one exception: I can't tell where you want to go in terms of regional preference at all, and since you're couples matching, that means a lot more expensive travel. Choose a region you're interested in and go for that.

We were also thinking about adding a few schools from California, but I am afraid those are completely out of the picture now.

But you won't know unless you apply to them, and if you get interviews, that means you have a shot. There are a lot of not-so-competitive programs in California. Your application is unlikely to get a bite from UCLA or UCSF, but USC, UCLA Olive View, UCSD, and a bunch of other places are probably within reach for you. Modify your list and add those in so we can advise you. And if UCLA or UCSF are your dream programs, add those in too. It doesn't hurt to apply to more reaches.

 

[Redpancreas]

Safety: Allegheny, Jefferson, Temple, Drexel, SUNY Downstate, UMass, UMD, GW, Wake Forest, Charleston, SC, Miami, Cleveland Clinic, VCU

Target: Boston University, Dartmouth, Tufts, Brown, Georgetown, UNC, UAB, U of Miami, Case Western University Hospitals, Ohio State, Rush, Einstein

Reach: UPMC, Cornell, Sinai, Northwestern, University of Chicago, Wash U, U of Colorado, U of Washington, Baylor, UVA

Don't know: UTHSC

You have a LOT of safeties. You probably only need to apply to 6-7 of those schools, so choose the ones you don't like and get rid of them. And I would focus that mainly on cities you want to be in.

Otherwise, your program list looks fine with one exception: I can't tell where you want to go in terms of regional preference at all, and since you're couples matching, that means a lot more expensive travel. Choose a region you're interested in and go for that.



But you won't know unless you apply to them, and if you get interviews, that means you have a shot. There are a lot of not-so-competitive programs in California. Your application is unlikely to get a bite from UCLA or UCSF, but USC, UCLA Olive View, UCSD, and a bunch of other places are probably within reach for you. Modify your list and add those in so we can advise you. And if UCLA or UCSF are your dream programs, add those in too. It doesn't hurt to apply to more reaches.

Just wanted to thank you publicly for going out of your way to do this for everyone. Medical schools are large and our advisors don't break it down this well. OP, in the IM residency forum, there's a WAMC forum with active posters like tantacles!

 

[tantacles]

Just wanted to thank you publicly for going out of your way to do this for everyone. Medical school's are large and our advisors don't break it down this well. OP, in the IM residency forum, there's a WAMC forum with active posters like @tentacles.

I would use my special mod powers to edit your post so my username is spelled correctly, but that's unethical. ;-)

 

[dentalhopeful10]

Safety: Allegheny, Jefferson, Temple, Drexel, SUNY Downstate, UMass, UMD, GW, Wake Forest, Charleston, SC, Miami, Cleveland Clinic, VCU

Target: Boston University, Dartmouth, Tufts, Brown, Georgetown, UNC, UAB, U of Miami, Case Western University Hospitals, Ohio State, Rush, Einstein

Reach: UPMC, Cornell, Sinai, Northwestern, University of Chicago, Wash U, U of Colorado, U of Washington, Baylor, UVA

Don't know: UTHSC

You have a LOT of safeties. You probably only need to apply to 6-7 of those schools, so choose the ones you don't like and get rid of them. And I would focus that mainly on cities you want to be in.

Otherwise, your program list looks fine with one exception: I can't tell where you want to go in terms of regional preference at all, and since you're couples matching, that means a lot more expensive travel. Choose a region you're interested in and go for that.



But you won't know unless you apply to them, and if you get interviews, that means you have a shot. There are a lot of not-so-competitive programs in California. Your application is unlikely to get a bite from UCLA or UCSF, but USC, UCLA Olive View, UCSD, and a bunch of other places are probably within reach for you. Modify your list and add those in so we can advise you. And if UCLA or UCSF are your dream programs, add those in too. It doesn't hurt to apply to more reaches.

thank you so much for the advise 🙂, I thought I was a goner. I'm going to talk to my wife about it tonight and try to come up with a smaller list that is more geographically sensible.

 

[dentalhopeful10]

I would use my special mod powers to edit your post so my username is spelled correctly, but that's unethical. ;-)

I recently had a meeting with one our advisers for residency and we had a talk about programs for me and my wife.

He came up with this list, but I do not know if he is just trying to be safe with our lists? He is known for under estimating applicants and make them apply to more safeties in order to make sure they match.

Reaches: Mount Sinai, NYU, Cornell, Columbia, UPENN, BU, Tufts, UNC, Duke, Cleveland Clinic

Target: Montefiore, Brown, Georgetown, Hopkins Bayview, UMD, Case Western

Safeties: Mt. Sinai Beth Israel, Rutgers Newark, Jeff, Temple, VCU, GW, Wake Forest, Ohio State, Cincinnati, MUSC, Jackson memorial

geographically we were trying to stay in the NE but if there are any other good clusters of recommendations we would greatly appreciate it + any advice with boston.

His overall suggestions were that BU and Tufts were too competitive for me (which I heard were targets from other people as well). He also said that UNC was a huge reach. Also was told not to apply to Chicago as that was too competitive.

I do not have any other red flags in my application I believe besides step 2. I did not honor medicine third year but did honor my sub I and MICU. I have a reasonable number of leadership experience and research.

 

[zero0]

I wish I never read this thread. I scored a 262 on UWSA and a 262 on NBME 4 and I take Step 2 on Monday. I'm a DO student so I would be destroyed if I dropped like you. My good Step 1 would be erased.

Yup stories like this terrify me. He did well on step 1 so he can take big tests and not choke. Is it possible for the material to change that drastically in one year? I just don't get it. NBMEs are supposed to be the best predictor.

 

[dentalhopeful10]

Yup stories like this terrify me. He did well on step 1 so he can take big tests and not choke. Is it possible for the material to change that drastically in one year? I just don't get it. NBMEs are supposed to be the best predictor.

I had a family emergency around the exam time which really affected me around my exam date. There were some days I couldn't study (due to obligations or just felt drained). I did not want to bring it up during my interviews because it was very personal , but I talked to some advisers and they said it may be a good idea to bring it up if I felt comfortable. I was just worried because I felt like I couldn't blame it all on that, but I was doing well on the UWSAs and NBMEs about a week or two out. When test day came I think I tried to power through it as fast as I could to get back to my family.

 

[wegh]

What is the benefit of taking step 2 when your step 1 score is already in the 240s?

I thought people only took step 2 before residency application because they wanted to improve over a less than perfect step 1, or because a program specifically desires it.

I did well on shelf exams so I expected to do better on step 2, which I did. I am hoping that score will help give me a boost compared to other applicants who do not have a score yet or who did worse

 

[zero0]

I had a family emergency around the exam time which really affected me around my exam date. There were some days I couldn't study (due to obligations or just felt drained). I did not want to bring it up during my interviews because it was very personal , but I talked to some advisers and they said it may be a good idea to bring it up if I felt comfortable. I was just worried because I felt like I couldn't blame it all on that, but I was doing well on the UWSAs and NBMEs about a week or two out. When test day came I think I tried to power through it as fast as I could to get back to my family.

Sorry to hear that. FWIW you're still in great shape.

 

[Eithz H]

I think it is important to remember that although Step 2 CK is still considered important it is simply one piece in a greater pie. If you did well on Step 1 (which you did) , you did well on your shelf exams/clerkships (I'm not sure if you did), and you have a couple of other things going for you then it would be unreasonable for a PD to discount you for one blemish. To expand on the pie metaphor....if most of the pie looks good, one bad piece isn't going to ruin the whole thing.

I am currently applying to general surgery and have discussed the application process with four different PD's. Although I will agree it is a small population size, they all stated that one (or even a few) missteps will not discount an applicant if they still have other things going for them.

Another way to put it....just imagine if you were a PD, would you discount someone's application with one bad score when that person may still be a great applicant? I certainly would not and I doubt you would either.

Good luck and keep your head up. This process will be over soon enough.

 

[dentalhopeful10]

I think it is important to remember that although Step 2 CK is still considered important it is simply one piece in a greater pie. If you did well on Step 1 (which you did) , you did well on your shelf exams/clerkships (I'm not sure if you did), and you have a couple of other things going for you then it would be unreasonable for a PD to discount you for one blemish. To expand on the pie metaphor....if most of the pie looks good, one bad piece isn't going to ruin the whole thing.

I am currently applying to general surgery and have discussed the application process with four different PD's. Although I will agree it is a small population size, they all stated that one (or even a few) missteps will not discount an applicant if they still have other things going for them.

Another way to put it....just imagine if you were a PD, would you discount someone's application with one bad score when that person may still be a great applicant? I certainly would not and I doubt you would either.

Good luck and keep your head up. This process will be over soon enough.

Thank you all for the kind words. It's harder couple matching because I feel like I did this to the both of us. I can't wait until all this worrying is behind me.