I love surgery but my step 1 score sucks!

[monkeyMD]

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All during third year, I've been jumping all over the place in regards to what specialty I want to apply to come 4th year. Now I'm really liking surgery. And of all things, I am interested in applying to general surgery. But. My step 1 was abysmal at 213. I am hoping to get 245+ on step 2. I have no research under my belt, since surgery was the last thing I thought I'd be interested in. Haven't received my grades for surgery or IM yet. But looking at the match stats 2014, I'm losing all hope fast. But I've never felt so passionate about a field before. Not peds, not IM. Not family med. not neuro. I just really enjoy the Or, the procedures, reading about the procedures, the attendings, the residents. But really. How realistic is it that I can match into gen surg given my bad step 1 score. And the score cut offs for so many of the programs?

 

[paradoxofchoice]

I have no real advice for you, but I was in a similar boat to you. I really loved all my rotations, but particularly like both medicine and surgery. I'm currently a 4th year who applied only to OB/GYN where I could still do a little bit of surgery because I thought my STEP scores are too low for surgery. My Step 1 was around yours and Step 2 was 10 points more. I don't have AOA, I passed surgery clerkship.

Turns out I don't particularly like OB/GYN. But now I'm stuck.

Apply to two specialties.

Don't be me.

 

[DermatoFIGHT]

In surgery, you can do everything correct and a case won't go as planned. There is M&M for a reason to re-assess what happened and how to improve.

I think you should approach your Step 1 scores like an M&M, understand where you went wrong and what you could have done better. Have a plan of action how to improve that and doing some diagnostics now to see if your method is successful. This is what you will be doing as a surgeon your entire career. I think if you improve your Step 2 score drastically and explain it the way I just did, you will leave a great impression and show tremendous maturity. Best way to become a better doctor is understanding your strength and weaknesses.

I tutored a guy who failed his Step 2 exam, his next score was competitive for Ortho! He went to interviews and explained it. He matched his #1 Surgery position. It isn't all about numbers. The neurotic med students, pre-meds, student doctor posters are obsessed with numbers because they are young and don't offer much to the table other than a few numbers.

Get a mentor somewhere (not the medical school, but the department). Do whatever it takes. If you do not match, do a year of research (IF the department recommends that).

Be the outlier, carpe diem!

 

[thedrjojo]

http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

Ppl need to look at this more.

To op, are you us allo, Caribbean, fmg?

If you are us allo, page 101 shows you still have ~75% (129 matched, 31 didnt) match rate into gs with step 1 of 211-220... Sure, likely a less than ideal community program but categorical never the less...

 

[thedrjojo]

I have no real advice for you, but I was in a similar boat to you. I really loved all my rotations, but particularly like both medicine and surgery. I'm currently a 4th year who applied only to OB/GYN where I could still do a little bit of surgery because I thought my STEP scores are too low for surgery. My Step 1 was around yours and Step 2 was 10 points more. I don't have AOA, I passed surgery clerkship.

Turns out I don't particularly like OB/GYN. But now I'm stuck.

Apply to two specialties.

Don't be me.

Who gave you that advice? Smh

 

[DermatoFIGHT]

Who gave you that advice? Smh

Lots of bad advice out there. You would be floored by the bad advice my medical school gave students. Their motive was to have primary care graduates.

 

[paradoxofchoice]

Who gave you that advice? Smh

The damn program director at my school. He "strongly encouraged" me to choose another residency since "no one respectable" would look at an application with step 1 below 220. Indeed, FRIEDA agreed that many programs had that cut off, and even where there was no cut off, average step 1 score range was 221-240. Even my own school has that cut off. I thought here's a man who's been doing this for a long time. He must know what he's doing. But I know for a fact now that they interviewed my classmates who had less than that.😡

Now I want to reapply as a PGY-1 in September when my chances will have dropped below 50% for even community programs and I'll be spending thousands in just application costs. I'll still need an LOR from that PD who discouraged me in the first place.

But hey, if my OB program doesn't fire me at the end of the year, I'll still have that residency. Which is why I'm advising OP to apply to two residencies, even if it's a bigger hassle and way more expensive. You owe it to yourself to like your job and your patients.

 

[fishingboat]

my n=1 experience: similar step 1 to OP. got a very realistic and perhaps pessimistic advice session as 3rd year started. basically was told that i needed to (1) honor rotations, esp surgery, (2) show huge improvement on step 2, (3) get good letters, (4) apply broadly. this made third year a lot more stressful, feeling like i couldnt make a mistake. somehow...well, not somehow...but studying all the time and really busting my ass, i honored pretty much everything, got 260+ on step 2, excellent letters--all that stuff. the worst part of it all was that the most important thing (apart from the H in surg) was step 2, and I didnt get those results until a few days after ERAS opened. I applied to a huge number of programs, got a ton of interview invites at a wide range of academic and community programs, and went on a bunch of interviews all over the country. we will see how it works out in 3 weeks.

pretty much everything above you can find in charting the outcomes--what you need to do is right there. what you can't appreciate from reading it is how psychologically taxing this makes third year, because actually doing really well on shelf exams, excelling clinically, and then acing step 2 is hard for everybody; it is especially hard--and let us face reality, less likely--for those who showed poor performance on step 1. good luck.