Is it true that you might not to get into the speciality you want if you dont do well on the step 1?

[username456789]

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That's unreal. However, while you're here, can you shed some light on the concept of DermBucks™ for us?



(I hope you're familiar with the Streampaw phenomenon)

I think the given explanation actually is an underestimation. The threshold for a solid chance to match should be much closer to 100,000.

 

[mcloaf]

People can divide each other based off difficulty of their programs and devise ways of limiting others, but a good portion of those who supposedly aren't cut out for certain specialities could probably make it and do damn well without the quality of care depreciating in any way.

At this point I'm fairly certain that you're willfully misinterpreting or ignoring what people are telling you. It's not really more complicated than basic supply and demand. Desirable positions are limited, lots of people want them. Competition is inevitable.

 

[SunsFun]

Normally, I am very sympathetic to people like OP making an argument about inherent injustices within the system of medical education but not this time. I think I am just failing to understand what the OP is suggesting and what's the exact nature of her "beef" with step 1.

You keep talking about standardized testing as a bad thing but in my opinion you fail to understand what standardized testing or evaluation actually is. Standardized means the same for everybody. Test or evaluation can be in any form and measure anything you want: knowledge, skill, etc. Are you unhappy that there is one test for all specialties? Are you unhappy about the format of the test? Are you unhappy about what it is testing? Are you unhappy that it's the same test used for everyone as a yardstick to have at least some reference for comparing two very different candidates? Are you unhappy that the test favor certain demographic groups? What is your problem with step 1 specifically?

If you don't believe in standardized testing at all then you're just wasting your time with any education as there is no other way for anyone to see if you have learned anything without checking it.

 

[BlueLabel]

I think the given explanation actually is an underestimation. The threshold for a solid chance to match should be much closer to 100,000.

I'll never forget when I shadowed a plastic surgeon in The Woodlands, TX. He kept asking if I had any more questions so eventually I trotted out the old chestnut "so... Do you really have to be super good-looking to match in derm?" His reply: "Actually, my wife is a dermatologist... So yes, that is absolutely correct."


I also asked an MS4 student interviewer about this while on the trail, and he told me "...honestly... You would really not believe how good-looking these people are. Just good-looking women and.. Well.. Really, good-looking men. Anyway, what were you saying?"

 

[Frazier]

Agree with a part of the OP's original sentiment: sucks that a single exam (Step1) has so much inherent risk.

However, that's why you study like hell for it.

Like someone mentioned earlier, there are other ways for you to strengthen your app in light of a mediocre Step1 performance....clinical grades, publications, powerful networking.

If you suspect that you aren't going to sit on the far right of the Step1 curve, then start early with strengthening yourself in other ways.

I am interested in a competitive field (albeit not quite PRS/derm) and since I can't picture myself scoring a 250-260 no matter how much I study (I'm a good test taker, but not 99th percentile great) I bust my butt as an MS1 (and pre-med) strengthening my app. Through some strategic initial networking, I've already made connections with perhaps the 'top guy' in said specialty at my home institution (which is great because turns out he's an awesome dude in general)... Now we're working together. I imagine if I do good work for him over the next 3 years, he'll go to bat for me when in comes time for LOR's/making calls.

I started heavy on research as a premed, I hope by the time I apply for residency to have ~16 publications... Over a handful already, currently ongoing with 5 more manuscripts at the moment. It's a lot of work and a lot of time management. It is what it is.

This post is longer than I wanted. Brief version: if you aren't the type of person that will likely destroy Step1, bust you butt and do the best you can early on with the variables you can control. Hope for the best.

If you want PRS/derm. Sorry, you are going to have to have it all.

 

[DermViser]

If so it seems more than a bit crazy that a test like that decides if you have a chance at a particular speciality (put anyone who doesnt do well on that test in a residency they want and they'll probably do damn well in time and pass the exam related to what they're ACTUALLY DOING). This overemphasis on standardized testing is really eroding my interest in medicine. I'd rather not be unable to get into the speciality i want because all the hotshot pro test takers, who have taken tests all their life are better at taking tests than the majority.

I don't even mind college exams or probably exams at med school (when I get in), but stuff like the mcat and step sounds like absolute crap.

Um, what exams are the "hotshot pro test takers" taking, that you're not?

 

[username456789]

Um, what exams are the "hotshot pro test takers" taking, that you're not?

Yeah that was a dumb statement by that poster.

 

[ace12345]

Agree with a part of the OP's original sentiment: sucks that a single exam (Step1) has so much inherent risk.

However, that's why you study like hell for it.

Like someone mentioned earlier, there are other ways for you to strengthen your app in light of a mediocre Step1 performance....clinical grades, publications, powerful networking.

If you suspect that you aren't going to sit on the far right of the Step1 curve, then start early with strengthening yourself in other ways.

I am interested in a competitive field (albeit not quite PRS/derm) and since I can't picture myself scoring a 250-260 no matter how much I study (I'm a good test taker, but not 99th percentile great) I bust my butt as an MS1 (and pre-med) strengthening my app. Through some strategic initial networking, I've already made connections with perhaps the 'top guy' in said specialty at my home institution (which is great because turns out he's an awesome dude in general)... Now we're working together. I imagine if I do good work for him over the next 3 years, he'll go to bat for me when in comes time for LOR's/making calls.

I started heavy on research as a premed, I hope by the time I apply for residency to have ~16 publications... Over a handful already, currently ongoing with 5 more manuscripts at the moment. It's a lot of work and a lot of time management. It is what it is.

This post is longer than I wanted. Brief version: if you aren't the type of person that will likely destroy Step1, bust you butt and do the best you can early on with the variables you can control. Hope for the best.

If you want PRS/derm. Sorry, you are going to have to have it all.

16 publications? Is that normal?

 

[QuantumJ]

16 publications? Is that normal?

No it's not normal but like the poster is saying, for most of the competitive specialties besides derm/PRS you can overcome lower Step 1 score with more research and/or outstanding LORs. Take Rad Onc for example. For 2010, the mean number of abstracts, presentations and publications was about 8. The average Step 1 is either in the 230s or 240s. And yet the majority of applicants with a Step 1 between 181-220 still matched. However, only 1 person matched who had no research whatsoever. The point being is that if you want to set yourself up to match a competitive speciatly it's best to have a bit of everything but defencies in one area can be tempered with extras in another.

 

[Frazier]

16 publications? Is that normal?

To my understanding, it isn't common. There are more extreme outliers. I remember a SDN poster, drizzt, had 30-something papers by the time he graduated. I think he is a rads resident now.

A few thoughts on research for anyone interested:

I wouldn't do it at all if I wasn't able to engage in the type of research I enjoy. In other words, if I have to be present in a lab to do the study, it isn't a study for me. So, reading between the lines, you can conclude I lean more clinical/outcomes.

I would not be able to achieve my goal of 16 papers, unless I got creative with my time and networking. As a premed, I pretty much had one PI and we worked on 1 project at a time. It wasn't until a manuscript was accepted that I would be assigned a new project...at one point it took a year to progress. It didn't seem very efficient to me since there was a lot of time twiddling my thumbs as coauthors review papers for weeks, the paper would sit in peer review for weeks, need revised, coauthors review revisions for weeks, paper resubmitted, etc.

...but, nevertheless, I got a handful that way and am grateful.

When I entered med school, the research opportunities were all over the place...basically shoved down our throats (research heavy institution). I started meeting different PI's in different fields with different interests. I like a lot of the projects and if I like it and our time frames match up, I jump on it.

As a result, I'm involved with 5 projects at the moment. Which isn't too bad really other than the hassle of trying to coordinate my class schedule with the schedules of the different PI's when it comes to meetings and what not. For example, one of my PI's is at an institution a couple hours away, so when we have a face-to-face meeting (albeit rare), it takes up a hefty chunk out of my day. Obviously if I had a love for bench research and a single project required me to be present in a lab for hours and hours, this approach would be impossible for a med student.

Do what you like. Research will only compensate so much. Very little for failed classes and crappy board scores. But, since I enjoy it to a reasonable degree (sure I rather be on a beach), I go ahead and pursue it.

 

[SunsFun]

To my understanding, it isn't common. There are more extreme outliers. I remember a SDN poster, drizzt, had 30-something papers by the time he graduated. I think he is a rads resident now.

A few thoughts on research for anyone interested:

I wouldn't do it at all if I wasn't able to engage in the type of research I enjoy. In other words, if I have to be present in a lab to do the study, it isn't a study for me. So, reading between the lines, you can conclude I lean more clinical/outcomes.

I would not be able to achieve my goal of 16 papers, unless I got creative with my time and networking. As a premed, I pretty much had one PI and we worked on 1 project at a time. It wasn't until a manuscript was accepted that I would be assigned a new project...at one point it took a year to progress. It didn't seem very efficient to me since there was a lot of time twiddling my thumbs as coauthors review papers for weeks, the paper would sit in peer review for weeks, need revised, coauthors review revisions for weeks, paper resubmitted, etc.

...but, nevertheless, I got a handful that way and am grateful.

When I entered med school, the research opportunities were all over the place...basically shoved down our throats (research heavy institution). I started meeting different PI's in different fields with different interests. I like a lot of the projects and if I like it and our time frames match up, I jump on it.

As a result, I'm involved with 5 projects at the moment. Which isn't too bad really other than the hassle of trying to coordinate my class schedule with the schedules of the different PI's when it comes to meetings and what not. For example, one of my PI's is at an institution a couple hours away, so when we have a face-to-face meeting (albeit rare), it takes up a hefty chunk out of my day. Obviously if I had a love for bench research and a single project required me to be present in a lab for hours and hours, this approach would be impossible for a med student.

Do what you like. Research will only compensate so much. Very little for failed classes and crappy board scores. But, since I enjoy it to a reasonable degree (sure I rather be on a beach), I go ahead and pursue it.

Did you get involved with research at day one of medical school? Is it all clinical? How do you figure how much time a project would take in a week and how do you know if you can take on another one? If you don't know what specialty you're going to, is there any universal clinical research you can do that is interesting and helpful? Is all your research in one area? Would it look bad if you do projects in different areas?

Sorry for so many questions and thanks for all the help. So far I have been doing benchwork but I want to transition to what you're doing once in medical school.

 

[trino]

Did you get involved with research at day one of medical school? Is it all clinical? How do you figure how much time a project would take in a week and how do you know if you can take on another one? If you don't know what specialty you're going to, is there any universal clinical research you can do that is interesting and helpful? Is all your research in one area? Would it look bad if you do projects in different areas?

Sorry for so many questions and thanks for all the help. So far I have been doing benchwork but I want to transition to what you're doing once in medical school.

+1 to questions #1 and #3

 

[Frazier]

Did you get involved with research at day one of medical school?

Yes and no. I continued working on a project with my PI from pre-med. That finished up a couple months into MS1 and now we're working on a new project.

I did not meet any new mentors/PI's at my med school until November.

Is it all clinical?

Yes, in the sense that they pertain to the human body/well-being in various ways and don't entail benchwork.

How do you figure how much time a project would take in a week and how do you know if you can take on another one?

I try to keep things transparent with the PI's and ask what my duties would be, where they hope for the project to go, and the timeline. The beauty of clinical/outcomes/public health research is that once you have the data, you can analyze it/write it up/etc from home at 3AM (you get the idea).

If you don't know what specialty you're going to, is there any universal clinical research you can do that is interesting and helpful?

My projects so far span maybe ~3 specialties. They are broad enough in subject matter to be understood and appreciated by both a lay person and professionals in other specialties.

Is all your research in one area?

No, but rather multiple areas. However, there is typically 3-4 common themes that connect the projects -- even across different specialties.

Would it look bad if you do projects in different areas?

I don't see why it would look bad. I'm not one dimensional or a PhD carving out a tiny niche. I have different interests, so I pursue those projects that strive to answer questions that interest me. Furthermore, like I mentioned earlier, many of the projects have some common ties that could theoretically connect them -- even though they are in different areas.

Sorry for so many questions and thanks for all the help. So far I have been doing benchwork but I want to transition to what you're doing once in medical school.

No problem. Feel free to ask away.

 

[DermViser]

Tears of happiness.

You find out on the Monday before Match Day if you matched or didn't match. I guess you could cry if you didn't get your top choice program, but that would be rather silly.

So then you cry on Monday then. Are you kidding me? There are tons of students across the nation, who cry when they don't get into the specialty they want, many of whom have worked for years for.

 

[trino]

Yes and no. I continued working on a project with my PI from pre-med. That finished up a couple months into MS1 and now we're working on a new project.

I did not meet any new mentors/PI's at my med school until November.



Yes, in the sense that they pertain to the human body/well-being in various ways and don't entail benchwork.



I try to keep things transparent with the PI's and ask what my duties would be, where they hope for the project to go, and the timeline. The beauty of clinical/outcomes/public health research is that once you have the data, you can analyze it/write it up/etc from home at 3AM (you get the idea).



My projects so far span maybe ~3 specialties. They are broad enough in subject matter to be understood and appreciated by both a lay person and professionals in other specialties.



No, but rather multiple areas. However, there is typically 3-4 common themes that connect the projects -- even across different specialties.



I don't see why it would look bad. I'm not one dimensional or a PhD carving out a tiny niche. I have different interests, so I pursue those projects that strive to answer questions that interest me. Furthermore, like I mentioned earlier, many of the projects have some common ties that could theoretically connect them -- even though they are in different areas.



No problem. Feel free to ask away.

If I may ask one more, how important is a background in statistics to get started in clinical research. I haven't taken stats since high school, and the research I'm doing now has me doing pre-analytical stuff. I feel confident that I could recall/relearn basic stats in a week. How far does your "toolbox" expand beyond that?

I've read a bunch of clinical cases and some of the analyzing makes sense and some of it doesn't. I know statistics can only help and I'm wondering if I should start learning some before med school or if it will come with lab experience

 

[RogueUnicorn]

I am interested in a competitive field (albeit not quite PRS/derm) and since I can't picture myself scoring a 250-260 no matter how much I study (I'm a good test taker, but not 99th percentile great) I bust my butt as an MS1 (and pre-med) strengthening my app.

Don't sell yourself short yet, Step 1 is a really different exam than anything else you've taken and doesn't play to the same strengths and weaknesses. You may be surprised... whether that's pleasantly or not of course is also a mystery

 

[Frazier]

If I may ask one more, how important is a background in statistics to get started in clinical research. I haven't taken stats since high school, and the research I'm doing now has me doing pre-analytical stuff. I feel confident that I could recall/relearn basic stats in a week. How far does your "toolbox" expand beyond that?

I've read a bunch of clinical cases and some of the analyzing makes sense and some of it doesn't. I know statistics can only help and I'm wondering if I should start learning some before med school or if it will come with lab experience

It depends on the lab/PI.

One of my projects basically requires me to deal with all the raw data/excel sheets/stats software on my own... in other words, it helps to have a good handle on things.

Another project is with a department that has a dedicated statistician on board and his job is to basically run the stats for everyone else... in other words, no dirty work on my end.

 

[Lya]

It depends on the lab/PI.

One of my projects basically requires me to deal with all the raw data/excel sheets/stats software on my own... in other words, it helps to have a good handle on things.

Another project is with a department that has a dedicated statistician on board and his job is to basically run the stats for everyone else... in other words, no dirty work on my end.

Do you know a good crash course or a short-term, online course to review how to use software programs for stats in clinical research?

 

[Frazier]

Do you know a good crash course or a short-term, online course to review how to use software programs for stats in clinical research?

While there is a lot of overlap between different brands...say SAS vs SPSS... there is a lot of little differences that really make you need to find out what software you will be utilizing and then pursue the relevant knowledgebase. You will likely be able to get the software for free from whatever school you end up at.

You can find a lot of how-to's about software on youtube/google. In regards to particular stat tests, your PI should give you an idea of what you will be running for analysis, so you can just look them up online if you need more insight into the particular measures....(unless you are doing a project on your own)

I'd love if anyone who has anymore info could chime in. I am not a fan of stats myself and could always use additional resources.

 

[orangeman25]

Quick question - is it harder to do really well on the MCAT or really well on Step 1? I understand that Step 1 is a much harder exam.

So I guess anything above a 37 on the MCAT would be considered "crushing the exam". I'm not really sure what score equates to "crushing Step 1" but what do you guys think? Harder to do really really well on the MCAT or Step 1?

 

[NickNaylor]

Quick question - is it harder to do really well on the MCAT or really well on Step 1? I understand that Step 1 is a much harder exam.

So I guess anything above a 37 on the MCAT would be considered "crushing the exam". I'm not really sure what score equates to "crushing Step 1" but what do you guys think? Harder to do really really well on the MCAT or Step 1?

They are two very different tests. Comparisons like this fail to take that into account. Step 1 is almost certainly a "harder" exam because of the sheer amount of content you're responsible for knowing, but the types of questions asked and the skills necessary to answer those questions are, IMO, different than those required for the MCAT.

 

[thesauce]

Um, what exams are the "hotshot pro test takers" taking, that you're not?

Entrance exams to private elementary, middle, and high schools, AP/IB exams, multiple PSATs before the real thing. Or in other countries where they have 1-2 big tests that determine your grade for the whole course/semester.

 

[touchpause13]

If so it seems more than a bit crazy that a test like that decides if you have a chance at a particular speciality (put anyone who doesnt do well on that test in a residency they want and they'll probably do damn well in time and pass the exam related to what they're ACTUALLY DOin'). This overemphasis on standardized testin' be really erodin' my interest in medicine. me'd rather not be unable to get into the speciality me want because all the hotshot pro test takers, who have taken tests all their life be better at takin' tests than the majority.


me don't even mind college exams or probably exams at med school (when me get in), but stuff like the mcat and step sounds like absolute crap.

I mean it kind of depends on what you want to specialize in. I mean, I want psych so