Low step 1, do I still have a shot at integrated vascular residency?

[SpinDrift]

I bombed step 1, low 200's. I'm starting my 3rd year clerkships and aside from crushing step 2 and getting good clinicals grades and good LOR's what else can I do to up my chances of matching integrated vasc.? I'm 1st author on a AAA research paper that is in the works to be published and I'm in good with the vascular attendings. My home program is starting an integrated vascular residency that should be up and running the same year I go into the match, maybe that's my best shot? Thanks for any advice.

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[ThoracicGuy]

I bombed step 1, low 200's. I'm starting my 3rd year clerkships and aside from crushing step 2 and getting good clinicals grades and good LOR's what else can I do to up my chances of matching integrated vasc.? I'm 1st author on a AAA research paper that is in the works to be published and I'm in good with the vascular attendings. My home program is starting an integrated vascular residency that should be up and running the same year I go into the match, maybe that's my best shot? Thanks for any advice.

Your home program is definitely your best shot. Unfortunately you'll probably be screened out in most of them to even get an interview. General surgery can still be an option with the traditional vascular pathway.

 

[LucidSplash]

Your home program is definitely your best shot. Unfortunately you'll probably be screened out in most of them to even get an interview. General surgery can still be an option with the traditional vascular pathway.

Agree with this. And if you can have a well-known vascular champion who can call places for you, you may get some interviews where you might otherwise be screened out. But those kind of interviews won’t necessarily automatically translate to being ranked well.

Also, if you’re going to shoot for integrated anyway then you’ll need to dual apply to Gen surg. I have seen otherwise good candidates, who tried to apply to integrated only, end up SOAPing for a prelim spot. You’ll need to hedge all your bets.

 

[Lem0nz]

Your home program is probably your only shot to be honest. Even if you crush step 2.

General surgery into vascular however is still possible if you crush step 2 and apply very broadly. You should realistically entertain a backup plan to general surgery as well though.

With the exception of your home program, I would advise to apply strictly to general surgery. I do not think you will get interview invitations for an integrated program, though I admittedly do not know how competitive they are. I do know that that step score is not competitive for GS though so I can't imagine iVasc will be easier. I think iVasc applications will be just throwing money into the wind for no chance of success. If you get into your home program, awesome. But I would anticipate that they don't even offer an interview and mentally prepare yourself to really push to be able to match GS at all, and to also mentally prepare a backup plan to GS. Be that prelim positions or non-surgery, that's your call. Just be realistic.

Good luck friend.

 

[Pir8DeacDoc]

While I'm not in vascular or gen surg, I did residency at a place with a really good vascular program including integrated and fellowship. Applicants/residents were truly the best of the best. Great folks. Very accomplished. So it seems unlikely you'd fare well amongst that bunch, unfortunately. But, I am in ent which is competitive in its own right. We had a guy with low 200 step rotate with us. Just crushed it. We ranked him very highly. And he ended up at another program. So you never know for sure. The numbers game screens out some otherwise great future surgeons. Best of luck.

 

[mikeGR]

In general, I agree with everything above. You may have already thought of what I' about to say, but many people overlook it, so bear with me.

In general, there is always a chance something may happen, and the exceptions get all the publicity. Extraordinary people may accomplish extraordinary things if they are also lucky and all the stars align. That said, if you "bombed" step 1, do you have a realistic expectation that you can crush step 2? Should you expect that you will be THE ONE student that the faculty will be talking about in years to come?

If yes, then that's great, push on, and best of luck - one test result will not define you. But if you think you will be an otherwise "average" candidate, with a below-average score, it might be a good time to start thinking about alternate plans/pathways (i.e. are you sure that surgery absolutely is the only thing that would make you happy). How about IM -> cards, or rads -> IR?

Sorry to be the downer, but I saw too many gen surg prelims (and their families) struggling for years before switching careers, and most are way happier now.

 

[SpinDrift]

Thank you all for your input, it's greatly appreciated. I plan on keeping an open mind throughout 3rd year and follow what feels right, maybe that's pushing for integrated or gen surg or maybe something different. Either way I just feel fortunate to be able to practice any form of medicine. SDN advice can go either way but I feel like you all have offered really solid recommendations.