Is all lost?

[bball1]

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US MD here really interested in anesthesiology. However my step 1 score is slightly below 200 and I had to repeat M1 year due to medical issues. Looking at the NRMP data, 20 people with step scores in that range matched in 2017. I have great anesthesiology research and publications. Should I take the chance of applying with a backup of course or just choose a less competitive specialty? Yes, this is another chance thread but any advice would be appreciated.

 

[Consigliere]

Family practice or IM.

 

[naijacardriodoc]

They couldnt match into anesthesiology?


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[Twiggidy]

US MD here really interested in anesthesiology. However my step 1 score is slightly below 200 and I had to repeat M1 year due to medical issues. Looking at the NRMP data, 20 people with step scores in that range matched in 2017. I have great anesthesiology research and publications. Should I take the chance of applying with a backup of course or just choose a less competitive specialty? Yes, this is another chance thread but any advice would be appreciated.

Take the L

Do IM. Do well on you ITE. Go into interventional cards or GI. Look at this thread/forum in the rearview.

 

[Neurodelic]

It's a long shot. With a STEP 1 below 200 you'll be screened out for programs on the first pass. With that in mind, you'll need to be willing to apply ($$) to every anesthesia program that isn't elite and apply ($$) to back up specialties as well. Your best bet is to try to match at your home institution if they have an anesthesia program.

 

[AdmiralChz]

Going to be an uphill battle for sure. Research and strong Step 2 will help, but that's easier said than done. You'll need a backup (or honestly, a primary specialty you are applying for), probably FM over IM.

 

[Katheudontas parateroumen]

US MD here really interested in anesthesiology. However my step 1 score is slightly below 200 and I had to repeat M1 year due to medical issues. Looking at the NRMP data, 20 people with step scores in that range matched in 2017. I have great anesthesiology research and publications. Should I take the chance of applying with a backup of course or just choose a less competitive specialty? Yes, this is another chance thread but any advice would be appreciated.

Hey buddy, I hear you. This will be an uphill battle and in the case if it is anesthesia or bust, you already know you're gonna have to bust your butt. Are you MD/DO/IMG? Makes a huge difference. Like said above, best chance is to match at your own home institution. Step 1 is not all end be all so you need to kill step 2, like 250+, really prove it. But even just improving like 235+ may be beneficial. Plain and simple. Step 2 is Uworld over and over, that's all, a very smashable test. You should shine and honor as many of your 3rd year clerkships. Do plenty of aways if possible in anesthesia/ICU/pain to increase chances of getting like 5 at places you can realistically match from July-Dec when interviews happening, if they take you for an away they usually interview you too. Might be undesirable places but that's the name of the game. I don't really think anesthesia really needs research, especially since you won't be really applying to the research powerhouses, focus on your scores and clerkships and dab in a project here and there if you have an anesthesia department preferably. But that's good you got publications and such. Then apply to every anesthesia program in the country, probably 100+. Charting Outcomes says you got a shot with 25/33 people matching with <200 step 1. Anesthesia isn't horribly competitive for a US MD. Your goal is to interview at least 10+ places. So do aways, get those, and maybe get lucky on a few other invites. But in all, first talk to your mentorship person if you have one to guide your individual situation. You should evaluate your progress in 3rd year so far. All things being equal, FM is the best chance for you matching. Next is IM an with that could do like CCM fellowship or something. Good luck

 

[deleted87051]

It's a long shot. With a STEP 1 below 200 you'll be screened out for programs on the first pass. With that in mind, you'll need to be willing to apply ($$) to every anesthesia program that isn't elite and apply ($$) to back up specialties as well. Your best bet is to try to match at your home institution if they have an anesthesia program.

And it would help if your home institution is not Stanford or Harvard.

 

[flightnurse2MD]

US MD here really interested in anesthesiology. However my step 1 score is slightly below 200 and I had to repeat M1 year due to medical issues. Looking at the NRMP data, 20 people with step scores in that range matched in 2017. I have great anesthesiology research and publications. Should I take the chance of applying with a backup of course or just choose a less competitive specialty? Yes, this is another chance thread but any advice would be appreciated.

Slightly similar situation without the repeat year. Low step score with a 25 point improvement on Step 2. I have a background in nursing before medical school and involvement in the ASA as a medical student officer. Applied to 50 programs and got 16 interview invites. I didn't bother applying to any Ivy league programs, applied to 7-8 community hospital programs as a "backup", and I did an away rotation elective. It's doable- just need to improve on Step 2 and network, network, and network some more...

 

[Chip N Sawbones]

I'm in a somewhat similar situation, with a Step I failure and not much more than 200 on the retake. On top of that, I had to repeat my surgery rotation. I've only got three interview invites, so I don't know how things are going to work out for me. Ask me again in March and I'll let you know. The good news is that I got two LORs from one of my away rotations, so I'm hoping they'll rank me high enough to match. My advice is to do as many away rotations as you can and work hard on them. Nobody expects much from a 4th year med student, so if you actually do show up early every day and work hard it makes you look way better than the competition. Learn how to set up as much of the monitors, IVs, syringes and airway equipment as you can. Once you've learned how to do a few things, arrive at the room 15 minutes before the resident in the morning and set up as much as you can. Stay until the end of the last case every day. You'll still work less than you did on your surg rotation and you'll look like a rock star.

 

[deleted641888]

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[Psai]

I have never ever had a fourth-year medical student beat me to my room in the morning and set anything up beforehand, and I've worked with a lot of medical students. This means I don't expect that from any MS4s, and I like my room set up a certain way every single time so it might be more of a hindrance than anything else.

A couple of things I have noticed about excellent medical students vs. "okay" medical students is that the former tend to have a willingness or eagerness to learn, and they always have a high degree of emotional intelligence--this means knowing when to ask questions and when not to, when to offer help and when to stay out of the way, when to argue with the resident in front of the patient about the diagnosis/treatment and when not to (i.e., never), etc. I don't know that the latter trait can be learned. I can think of 3-4 MS4s this year who rotated with us and had these traits, and I really hope they match to our program.

We all know that the good ones will never end up at our program. Not sure where they go but I'm sure it's something like ortho or ophtho

 

[Chip N Sawbones]

I have never ever had a fourth-year medical student beat me to my room in the morning and set anything up beforehand, and I've worked with a lot of medical students. This means I don't expect that from any MS4s, and I like my room set up a certain way every single time so it might be more of a hindrance than anything else.

A couple of things I have noticed about excellent medical students vs. "okay" medical students is that the former tend to have a willingness or eagerness to learn, and they always have a high degree of emotional intelligence--this means knowing when to ask questions and when not to, when to offer help and when to stay out of the way, when to argue with the resident in front of the patient about the diagnosis/treatment and when not to (i.e., never), etc. I don't know that the latter trait can be learned. I can think of 3-4 MS4s this year who rotated with us and had these traits, and I really hope they match to our program.

I was always worried that I'd set up a room in a way that the resident didn't like, but it impressed the heck out of most of the residents I worked with and I don't think it upset any. If I was working with an unfamiliar resident I stuck with the basic parts of setup that are pretty much the same everywhere. There was one guy who was very particular about having the labels on his syringes always around the base, and I had them along the sides. I solved that problem by putting two labels on each syringe from then on.

 

[BLADEMDA]

I was always worried that I'd set up a room in a way that the resident didn't like, but it impressed the heck out of most of the residents I worked with and I don't think it upset any. If I was working with an unfamiliar resident I stuck with the basic parts of setup that are pretty much the same everywhere. There was one guy who was very particular about having the labels on his syringes always around the base, and I had them along the sides. I solved that problem by putting two labels on each syringe from then on.

I see you clearly want to match badly into Anesthesiology. I hope you did your "away" at a bottom tier program because with your application that is the most likely "match" for you. Of course, anything is possible so hope for the best but honestly you really need to apply to new community programs and have a back-up specialty like I.M.

 

[Chip N Sawbones]

I see you clearly want to match badly into Anesthesiology. I hope you did your "away" at a bottom tier program because with your application that is the most likely "match" for you. Of course, anything is possible so hope for the best but honestly you really need to apply to new community programs and have a back-up specialty like I.M.

Thanks for rubbing it in. I know my chances of matching aren't great. I did my away rotations at some small but good community programs with state schools, because those were the ones that accepted me for aways. I got two good LORs from the one that gave me an interview, so hopefully it wasn't just a courtesy interview. I applied pretty much anywhere that wasn't Ivy League, California, or New York City, including all the bottom tier programs I could find. I suppose you're right and that I should apply to IM and FM, but honestly I'd rather go back to remodeling houses than face a lifetime of circling the wards rounding on floor patients or doing well patient exams in clinic. On March 16th I'll let you know how it went.

 

[BLADEMDA]

Thanks for rubbing it in. I know my chances of matching aren't great. I did my away rotations at some small but good community programs with state schools, because those were the ones that accepted me for aways. I got two good LORs from the one that gave me an interview, so hopefully it wasn't just a courtesy interview. I applied pretty much anywhere that wasn't Ivy League, California, or New York City, including all the bottom tier programs I could find. I suppose you're right and that I should apply to IM and FM, but honestly I'd rather go back to remodeling houses than face a lifetime of circling the wards rounding on floor patients or doing well patient exams in clinic. On March 16th I'll let you know how it went.

I'm actually optimistic that you will match at a community program. I'm glad you did "aways" at community programs. That shows you are realistic about your stats but still want to match into Anesthesiology.

Honestly, let us know what happens on match day. Best of luck and I hope you land a position.

 

[Twiggidy]

Thanks for rubbing it in. I know my chances of matching aren't great. I did my away rotations at some small but good community programs with state schools, because those were the ones that accepted me for aways. I got two good LORs from the one that gave me an interview, so hopefully it wasn't just a courtesy interview. I applied pretty much anywhere that wasn't Ivy League, California, or New York City, including all the bottom tier programs I could find. I suppose you're right and that I should apply to IM and FM, but honestly I'd rather go back to remodeling houses than face a lifetime of circling the wards rounding on floor patients or doing well patient exams in clinic. On March 16th I'll let you know how it went.

I don't think Blade was rubbing it in versus being very realistic. Trust me, I know Step One can be hard but it is used as a marker (and in some cases a cutoff). Many PDs will look at that Step and then question how well you can do on the ITE, which reflects on their program. Anesthesiology is in a strange phase currently versus when I applied so I wouldn't be surprised if you match somewhere that isn't on many others' radar, but as Blade was saying, put some effort in on some IM or FP backups and if your Step is really that low, get ready to scramble. If you match in anesthesia, more power to you. Truth be told, you may like your life better remodeling homes rather than being a doctor.

 

[TheOther]

I don't think Blade was rubbing it in versus being very realistic. Trust me, I know Step One can be hard but it is used as a marker (and in some cases a cutoff). Many PDs will look at that Step and then question how well you can do on the ITE, which reflects on their program. Anesthesiology is in a strange phase currently versus when I applied so I wouldn't be surprised if you match somewhere that isn't on many others' radar, but as Blade was saying, put some effort in on some IM or FP backups and if your Step is really that low, get ready to scramble. If you match in anesthesia, more power to you. Truth be told, you may like your life better remodeling homes rather than being a doctor.

Could you please clarify this “strange phase” please?

 

[gasman2014]

Apply broadly. Have back up prelim (surg/IM). Do away rotations and rock them. Find a way to make your attendings/residents lives easier (continue to set their rooms up, etc....BE THERE BEFORE THEM). Be a team player. Don't be weird. If you don't have tier 1 stats, don't apply to only tier 1 programs and then later wonder why you didn't match. Don't be weird 😉 Be a genuine person and have real interest in the field.