late step 2 scores and psych residency applications

[The Squid]

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Hi. I could use your help. I am not doing ob/gyn until December of 4th year. I finish internal medicine at the beginning of July. So, I have a bit of a dilemma about when to take step 2. My options are:

1. Take it at the end of July when medicine is fresh in my mind. I could take 3 weeks to study then before I do my psych AI in August. Risk screwing up and having my score hurt me.

2. Take it after ob/gyn and take January off to interview and study. Will not have scores before rank lists are due. Risk being ranked lower because I don't have a passing score yet.

My step 1 score was 231. I am concerned that taking step 2 before ob/gyn will result in my step 2 score being lower than my step 1. My psych advisor said he worries about students who have step 2 scores lower than their step 1 scores because it's more clinical knowledge and that's what is more important to him. He also said he worries about students not passing step 2 and putting it off until late in the year isn't a good idea either. I know that most programs don't require step 2 scores to rank students, but I worry that it will still hurt me that they don't know my scores and could result in a lower ranking. I am aware I can decide not to release my step 2 scores but if they ask me about it, I will have to tell them what my score was. What would you do? Thanks for your time.

 

[josehernandez94]

Hi. I could use your help. I am not doing ob/gyn until December of 4th year. I finish internal medicine at the beginning of July. So, I have a bit of a dilemma about when to take step 2. My options are:

1. Take it at the end of July when medicine is fresh in my mind. I could take 3 weeks to study then before I do my psych AI in August. Risk screwing up and having my score hurt me.

2. Take it after ob/gyn and take January off to interview and study. Will not have scores before rank lists are due. Risk being ranked lower because I don't have a passing score yet.

My step 1 score was 231. I am concerned that taking step 2 before ob/gyn will result in my step 2 score being lower than my step 1. My psych advisor said he worries about students who have step 2 scores lower than their step 1 scores because it's more clinical knowledge and that's what is more important to him. He also said he worries about students not passing step 2 and putting it off until late in the year isn't a good idea either. I know that most programs don't require step 2 scores to rank students, but I worry that it will still hurt me that they don't know my scores and could result in a lower ranking. I am aware I can decide not to release my step 2 scores but if they ask me about it, I will have to tell them what my score was. What would you do? Thanks for your time.

that's an interesting dilemma. i'll offer whatever i can as someone who's applying this year.

i took step 2 in july of 4th year, right after i finished my medicine clerkship (similar to you). i really think this was a great idea for me for several reasons: 1) i'd say the test is about 70+% medicine/medicine-related and since i had just studied for the shelf, all of that was fresh in my mind. this made studying for the exam pretty easy and i subsequently did really well on it. 2) i didn't have to worry about scheduling/studying for the exam later in the year. i think it could be a bit cumbersome to have to try to fit in step 2 among interviews, sub-is, etc.

there really isn't that much ob/gyn on the actual exam. if there's ~30% of nonmedicine questions, those are divided up between surgery, psych, ob/gyn, peds, ethics, statistics, so maybe about 5% of the entire exam is ob/gyn. plus, i think if you get a good review book and do questions from usmle world, you'll be well prepared. i certainly don't think there was anything in particular i learned on my ob/gyn rotation itself that was instrumental in my doing well on step 2. plus, i took it in october, so whatever i did learn, i'd probably forgotten by july.

another thing to consider is that some states are planning to require applicants to pass step 2 before granting provisional licenses necessary to start internship. ultimately, i think this will mean that programs might not be able to rank applicants unless they know they've passed step 2 (i actually received an email specifically regarding this from one of the programs i applied to). if you do the math, rank lists must be in by late february. selection committees probably meet a week or two before that to finalize their list. it takes about 5-6 weeks to get your step 2 score. so the absolute latest you could safely take it would be about the beginning of january and that might be pushing it. if your ob/gyn rotation is in december, i'm not sure you'd have enough time to properly study for step 2 in this scenario.

in sum, my thinking would be to take the thing in july. you did really well on step 1, which should bode well for step 2. i'm sure you can learn whatever you need to about ob/gyn with a good book and question bank.

 

[SpiritiualDuck]

I got about what you did on Step 1 and did better on Step 2. I think you're better off taking sooner than later. It really just didn't seem too difficult.

Have you done well on Shelf Exams? For OB/GYN, I literally memorized every case that was in Case Files. I hated Ob/Gyn and didn't want to do too much. I read through F/A for Step 2 a few times and read crush. I also did usmleworld question bank. I spent a few weeks working on it, but not killing myself like I did on Step 1.

So, it's a very fair exam especially if you worked hard during 3rd year. I think you'll feel better knocking out. Good luck. But do the work and do it early.

 

[sunlioness]

My step 2 was lower than my step 1. And my step 3 was lower than my step 2. I think it reflected how much time and effort I put into studying specifically for the tests than anything else. Anyway, I agree with the above posters. I think it's probably better to take it earlier than to not have it when you are applying. But I'm not an expert by any stretch. 🙂

 

[mgdsh]

I think it also depends on if you are a FMG/IMG vs an AMG. If you are the former, you should definitely take it early, even if it hurts your score. I remember taking my step 2 with out having done Peds or OB and ended up with a score 1 std dev below Step 1.

 

[Anasazi23]

OB/GYN blueprints. You can read it in a weekend. You'll be fine.

Having step II done prior is more important.

 

[SpiritiualDuck]

I liked Ob/Gyn blueprints, but there is too much in it that is not going to be tested on Step 2. I used blueprints during that rotation, but you have pages on pregnancy physiology that doesn't show up, it's actually quite a bit of reading.

So, I used CaseFiles for Ob/Gyn because the questions are based on case senarios. You'll have 2 or 3 questions just on the types of urinary incontinence like stress, overflow, urge. Case files does a great job, easy read. You can knock it out in a day.

 

[The Squid]

Thanks for the great advice!

 

[RaistlinMajere]

OB/GYN blueprints. You can read it in a weekend. You'll be fine.

Having step II done prior is more important.

Hi Anasazi,

Why is it more important to have step 2 done prior? I'm in a similar situation as the OP and an AMG. The advice I got received from the dean of student affairs was to take step II in December. I'd like more info before I decide to schedule the exam.

 

[Anasazi23]

Hi Anasazi,

Why is it more important to have step 2 done prior? I'm in a similar situation as the OP and an AMG. The advice I got received from the dean of student affairs was to take step II in December. I'd like more info before I decide to schedule the exam.

I wrote a long answer which was erased by the cyberspace demons.

The take home message was that all things being equal, a program wants a resident that shows the ability to pass step III and the psych boards. Those that fail step I or II multiple times look risky to PDs, particularly when they need that resident to be independently licensed, especially for the outpatient year (and to be eligible for fellowships). By passing both step I and II, you demonstrate that you can do this.

 

[Doc Samson]

I'm going to disagree with Sazi here. Your step I score is strong enough to get you an interview at any program (assuming you're coming from an allopathic US med school). I'd submit your app with Step II score pending and not reveal your step II score to the programs. No-one's going to think that you're going to fail step II based on your step I performance, and once you make it past the interview algorithm, your interview and LORs are more important than your scores anyway. Why take the risk of your step II score negatively impacting your app when it's not going to significantly improvement regardless of how well you do?

 

[Anasazi23]

I'm going to disagree with Sazi here. Your step I score is strong enough to get you an interview at any program (assuming you're coming from an allopathic US med school). I'd submit your app with Step II score pending and not reveal your step II score to the programs. No-one's going to think that you're going to fail step II based on your step I performance, and once you make it past the interview algorithm, your interview and LORs are more important than your scores anyway. Why take the risk of your step II score negatively impacting your app when it's not going to significantly improvement regardless of how well you do?

Weren't you asked about your step II at all your interviews?
I was, particulary because my step I wasn't stellar, though I passed the first time around.

In fact, I was contacted by a PD by phone to ask specifically about my step scores, and my confidence in passing step III and the boards a couple weeks after my interview. I was taken slightly aback, since my scores weren't really too bad and I had never failed a step.

Maybe that experience is weighing heavy in my mind. But, I remember our own program being quite interested in that too.

 

[Doc Samson]

Weren't you asked about your step II at all your interviews?
I was, particulary because my step I wasn't stellar, though I passed the first time around.

In fact, I was contacted by a PD by phone to ask specifically about my step scores, and my confidence in passing step III and the boards a couple weeks after my interview. I was taken slightly aback, since my scores weren't really too bad and I had never failed a step.

Maybe that experience is weighing heavy in my mind. But, I remember our own program being quite interested in that too.

No-one ever mentioned my step 2. The advice to withold step 2 scores if you'd done well on Step 1 came from our Academic Dean and worked well for me and my classmates. The OP scored 231 on step 1, so programs shouldn't be worried about steps 2+3.

 

[Anasazi23]

No-one ever mentioned my step 2. The advice to withold step 2 scores if you'd done well on Step 1 came from our Academic Dean and worked well for me and my classmates. The OP scored 231 on step 1, so programs shouldn't be worried about steps 2+3.

That makes sense.

Yes, in this case, I'd say that if your step I was mediocre or borderline, (or if you failed it), then a passing step II might alleviate some fears. In the case that DS mentions, it's much less imperitive.

 

[RaistlinMajere]

That makes sense.

Yes, in this case, I'd say that if your step I was mediocre or borderline, (or if you failed it), then a passing step II might alleviate some fears. In the case that DS mentions, it's much less imperitive.

Thanks for clarifying.