IM PGY1 set on PCCM. Are my board scores going to tank any chance I have?

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Espressso

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I'll just cut to it... Step 1 and 2 scores in the 21x's. Step 2 went up just a few points from step 1 unfortunately. I'm a DO and my COMLEX scores were eh too. I matched at my top spot for IM, a community program in the South East that has a good track record matching fellows in all competitive fields. Now that I'm finishing up PGY-1, I'm set on PCCM (although still open to CCM only). But I'm starting to worry that my application wouldn't even be looked at at any PCCM fellowship due to my scores.

Is this true. Are there any programs anecdotally that don't have strict USMLE cutoffs?

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Would have advised you to apply to program that had PCCM fellowship, but I wouldn’t lose hope yet. Do research, do well. Try to get some away time in 2nd year or early 3rd year. Worst case, you work as a Hospitalist for a couple years at a place with PCCM fellowship and make connections (was my plan until I decided that 3 years of fellowship may not be worth it. . . ). PCCM has been more competitive than some, but your step scores won’t automatically keep you from them.
 
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In my opinion, you're thinking about this the wrong way. If truly set on PCCM/CMM (also include pulm only as they are generally less competitive and can tack on single critical care year after), then you should be focusing only on the things you can control from this point out. Let everything else go.

Your step scores are what they are, can't do anything about that. Are there programs that will filter you out because of them? Most definitely. There are also programs that will filter you out because of DO, because of community residency program, etc. You will not be able to know which programs are which.

But, looking at the most recent charting outcomes document from NRMP, you can see ~50% of IMGs matched with your step scores, so it's certainly possible (step scores for DOs not available).
https://www.nrmp.org/wp-content/uploads/2021/08/2018-Charting-Outcomes-SMS.pdf

The things you can control going forward are,
1. Be a great resident. People underestimate the value of a phone call from PD/PCCM faculty stating this person is their best resident, hardest worker, etc.
2. Posters at national conferences (ATS, chest, SCCM).
3. Publish case reports. You don't need high level bench research. Publish an interesting case with a subject review. There are journals out there that will always publish these types of things.
4. Research which PCCM, CCM, and pulm programs are your targets. Most programs have websites these days. Look for places that have fellows like you (DO or IMG, community residencies, etc). Be creative and open to living somewhere for a few years that you might not want to permanently settle in.
 
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get pubmed citations for the pulmonary faculty at your program . This does not mean you need to be first author of a multinational rtc (impossible anyway for pgy1 who was not a phd first ).

Letters to the editors
Chest ultrasound corner
BMC research notes
Cureus

These are some low hanging fruit to get your case report manuscript (not just abstract poster to a conference but a written manuscript ) and interesting chart review project published and to get a pubmed citation also .

These pubmed citations are the key to “being impressive “ as it shows you will be able to help whichever program you match to get more pubs (the academic currency )
 
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Bumping this for hopes that applicants who matched last cycle can help chime in... Starting to fret!
 
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