Is there a chance? Multiple Red Flags

[2MDorNot2MD]

So I'm an M3 (sorta) at a top 20 institution who had to do an alternative course schedule due to some issues that arose during med school.

First of all - I didn't take step 1 at the end of M2 as originally planned, when the time came I panicked and then after talking with my deans decided not to take it. We decided I should go ahead and just start my M3 year, assuming that clinical medicine would fit me better than the basic sciences. Unfortunately, after completing half of my M3 year, I had to step away from the curriculum due to personal issues and poor performance. In those 6 months I received 3 passes and a high pass (the only high pass coming in FM).

I spent the next 6 months away from school and working on my personal issues, along with finally taking Step 1. I studied my ass off for Step 1 for 3.5 months but it was a steep climb since I had not had any of the M1-M2 material in over a year. I finally managed to pass but did not perform at the level I was hoping/expecting. I scored a 207.

I have since resumed clerkships and it looks as though I will end up doing much better than the first time, but still not at honors level. I will likely receive HP in my final 3 clerkships, but my clinical evals have improved a lot.

I was originally considering med/peds but considering I would really like to get into an academic/university program I think it would be smarter to try and just do peds (especially since medicine is one of the clerkships I achieved Pass on).

My question is, coming out of a top 20 institution with strong letters in the field but spotty M3 grades and a meh Step 1, what are the chances of me being able to match a decent academic/university program in pediatrics?

I've found on FREIDA that there are some programs that will potentially screen me out based on Step 1 (not sure how accurate that is) but for the most part it seems that step 1 cutoffs are either unlisted or below my score.

Of note, I have a pretty strong leadership/volunteer/research CV. Led multiple student groups in medical school, lots of volunteering (especially with kids), and have had the chance to some oral and poster presentations on global health related topics. I also have a thesis from my masters that was not privately published but was at the school.

Thanks for any feedback anyone can give me!

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[bashwell]

So I'm an M3 (sorta) at a top 20 institution who had to do an alternative course schedule due to some issues that arose during med school.

First of all - I didn't take step 1 at the end of M2 as originally planned, when the time came I panicked and then after talking with my deans decided not to take it. We decided I should go ahead and just start my M3 year, assuming that clinical medicine would fit me better than the basic sciences. Unfortunately, after completing half of my M3 year, I had to step away from the curriculum due to personal issues and poor performance. In those 6 months I received 3 passes and a high pass (the only high pass coming in FM).

I spent the next 6 months away from school and working on my personal issues, along with finally taking Step 1. I studied my ass off for Step 1 for 3.5 months but it was a steep climb since I had not had any of the M1-M2 material in over a year. I finally managed to pass but did not perform at the level I was hoping/expecting. I scored a 207.

I have since resumed clerkships and it looks as though I will end up doing much better than the first time, but still not at honors level. I will likely receive HP in my final 3 clerkships, but my clinical evals have improved a lot.

I was originally considering med/peds but considering I would really like to get into an academic/university program I think it would be smarter to try and just do peds (especially since medicine is one of the clerkships I achieved Pass on).

My question is, coming out of a top 20 institution with strong letters in the field but spotty M3 grades and a meh Step 1, what are the chances of me being able to match a decent academic/university program in pediatrics?

I've found on FREIDA that there are some programs that will potentially screen me out based on Step 1 (not sure how accurate that is) but for the most part it seems that step 1 cutoffs are either unlisted or below my score.

Of note, I have a pretty strong leadership/volunteer/research CV. Led multiple student groups in medical school, lots of volunteering (especially with kids), and have had the chance to some oral and poster presentations on global health related topics. I also have a thesis from my masters that was not privately published but was at the school.

Thanks for any feedback anyone can give me!

I think you have a good chance for peds. See NRMP Charting Outcomes. I wouldn't necessarily trust FREIDA data. Peds seem to care a lot less about Step 1 than the person. But still try to crush Step 2. That should help get you past filters if a program you want has filters. And network, get the right people in your school to make calls for you, etc. You won't get into CHOP, but with the right people calling on your behalf, a much improved Step 2, etc., then you could get into some solid academic programs for peds. And have a good explanation for your LOA if that's what it was including showing in detail steps you took in how you improved and overcame that. Good luck!

 

[AdmiralChz]

If you want to match into academic peds, it's going to be an uphill climb for sure. Most of your peers are going to have better grades and Step 1, and these things matter as they can be predictive of board performance. I agree with Bashwell - you'll need an improved Step 2, there is no denying that. So start studying now (it's basically all the shelf exams put together). If you have letter writers that would be willing to make calls or speak for you, that would be helpful. What about your home program?

You will 100% need to have community programs on your list as backup or you run the risk of not matching.

Also, anecdotal note - I went unmatched in a competitive field, I hoped my "Top 20" school rank would help, but at the best programs there is no shortage of great applicants, so this effect tends to be watered down. You need to do more to beef up your application, get to it.

 

[2MDorNot2MD]

Thanks @bashwell & @AdmiralChz

I 100% agree with needing to improve Step 2.

Do my previous posters, presentations, pubs, volunteer experiences, leadership experiences, and URM/bilingual status help with residency? I know that they definitely helped boost me a bit for applying to med school so I didn't know how much they factored into residency applications.

I'll definitely keep all of your suggestions in mind!

 

[bashwell]

Thanks @bashwell & @AdmiralChz

I 100% agree with needing to improve Step 2.

Do my previous posters, presentations, pubs, volunteer experiences, leadership experiences, and URM/bilingual status help with residency? I know that they definitely helped boost me a bit for applying to med school so I didn't know how much they factored into residency applications.

I'll definitely keep all of your suggestions in mind!.

I think research, leadership, volunteer, URM/bilingual, etc. do help, sort of, but you first have to make it past the filters in order to get an interview. The easiest filters are USMLE Step 1/2 scores, US citizenship status, US MD. Of course, every program is different, but just speaking in general. Just consider that a program might get hundreds if not thousands of applications. Especially the top programs. They're unlikely to read through every single application. It's easiest for them to apply filters.

After that, they'll still have a lot of applications to look over. Depending on the size of the program, the aPDs might get an evenly divided stack of applications to go through after the filters have been applied. It's at that point that your research and other experiences might make a difference, depending on what they look at and prioritize.

However, other programs might not even look at your research experiences etc until you are invited to an interview. Again, just depends on the program.

Anecdotally, I've seen US-IMGs match into decent pediatric academic programs with Step 1 scores around yours (~210) so I'm probably more optimistic about your chances since you're actually a US MD etc. I even once met a girl who matched at UCLA peds with not so great USMLE scores. But she had connections to the area and school so I'm sure she worked those connections. In fairness, you can't assume what happened to her is necessarily going to happen to you.

So like @AdmiralChz said, definitely apply to community peds programs because you never know. And it's better to be matched than not matched.

But most likely you should definitely match somewhere. Whether or not it's academic though is not as certain. Like I said, I personally think you have a good chance, but that depends on how you do on Step 2, etc. I think if you can get past the filters with a higher Step 2 score, then you will have a good chance, and with your strong research and other experiences, you should do as well as anyone else.

Here's what NRMP Charting Outcomes (2016) says about your chances in general based on your Step 1/2 scores:

Good luck!

 

[2MDorNot2MD]

@bashwell - awesome response, thank you so much.

Any thoughts on how many programs I should plan to apply to? I made a rough list of university & community programs and it came out to almost 50 lol, 10 of which are community.

Thanks again for all of your help - this is definitely helping augment the advice I've gotten from admin at my school

 

[bashwell]

@bashwell - awesome response, thank you so much.

Any thoughts on how many programs I should plan to apply to? I made a rough list of university & community programs and it came out to almost 50 lol, 10 of which are community.

Thanks again for all of your help - this is definitely helping augment the advice I've gotten from admin at my school

I think 50 for you is fine. But I'd prefer to see the traditional 1/3 reach, 1/3 realistic, 1/3 safety approach, so maybe add more community programs. Of course, you can apply to more than 50 if you want, it never hurts to add more except your money, lol. But honestly it's always easier to turn down too many interviews than have to worry about scrambling. Hope that helps.