Low Step 1, need advice on residencies

[Fidgety]

I just wanted to float this out there in hopes that some people may be in the same boat as me and be able to give me some advice. I'm happy to hear about how screwed I am, but would also appreciate some positive feedback if anyone has any.

I did very poorly on step 1, I struggle with test timing and received accommodations for tests delivered through my school. I unfortunately did not receive these accommodations for step 1 and ended up scoring a 206 (following a 227 on my last practice test, but that's a whole other story). Excuses aside, my score is what it is.

I'm at a good US medical school, was pretty much average in my class and continue to be through MS3 year, but I really wanted to match into diagnostic radiology. I have a 3 publications (two first authors, both case reports) and 6 other research experiences, mostly in radiology. Application is decent besides my step 1 score.

I have two questions:
1. Should I even bother applying to DR? My academic adviser tells me that it is still very possible. I obviously want to believe him, but would like to see if anyone with my step score even got interviews at rad programs.
2. I have no desire to do IM or peds, and a very small desire to do FM (although the amount of charting just makes me cringe) and otherwise have no other interests besides ophthalmology which is obviously not possible now. What other options do you think I should consider?

Thanks everyone.

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[deleted480308]

Go ahead and apply to DR so you can say you did

....but acknowledge emotionally it probably won’t happen and apply to FM as though you had never sent out a DR app

 

[mrbreakfast]

would like to see if anyone with my step score even got interviews at rad programs.

It's possible in the sense that apparently a handful of people matched DR with a step 1 score <210 last year. If you have a home program, spend all your free time in the reading room befriending the attendings and hope that gets you in. I'm assuming that's what those people did.

You could also consider pathology.

 

[fantasticman221]

I just wanted to float this out there in hopes that some people may be in the same boat as me and be able to give me some advice. I'm happy to hear about how screwed I am, but would also appreciate some positive feedback if anyone has any.

I did very poorly on step 1, I struggle with test timing and received accommodations for tests delivered through my school. I unfortunately did not receive these accommodations for step 1 and ended up scoring a 206 (following a 227 on my last practice test, but that's a whole other story). Excuses aside, my score is what it is.

I'm at a good US medical school, was pretty much average in my class and continue to be through MS3 year, but I really wanted to match into diagnostic radiology. I have a 3 publications (two first authors, both case reports) and 6 other research experiences, mostly in radiology. Application is decent besides my step 1 score.

I have two questions:
1. Should I even bother applying to DR? My academic adviser tells me that it is still very possible. I obviously want to believe him, but would like to see if anyone with my step score even got interviews at rad programs.
2. I have no desire to do IM or peds, and a very small desire to do FM (although the amount of charting just makes me cringe) and otherwise have no other interests besides ophthalmology which is obviously not possible now. What other options do you think I should consider?

Thanks everyone.

Just out of curiosity how far in advance did you start prepping for step?

 

[jurisburger]

http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Seniors.pdf

According to slide 54 there were 17 applicants to DR that matched with step 1 between 201-210 and 12 that did not. But considering the average step 1 for matched applicants was 240 that means those "low" scorers likely had something else going for them (i.e. research, connections, nepotism, connections, etc.). If you have those factors as well then you have a shot...otherwise I guess it doesn't hurt to try but I would go in to the match with a back up plan as well.

As a side note did you go into med school with the notion that you were going exclusively for DR or ophtho? Because that was a risky gamble =/

 

[Fidgety]

http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Seniors.pdf

According to slide 54 there were 17 applicants to DR that matched with step 1 between 201-210 and 12 that did not. But considering the average step 1 for matched applicants was 240 that means those "low" scorers likely had something else going for them (i.e. research, connections, nepotism, connections, etc.). If you have those factors as well then you have a shot...otherwise I guess it doesn't hurt to try but I would go in to the match with a back up plan as well.

As a side note did you go into med school with the notion that you were going exclusively for DR or ophtho? Because that was a risky gamble =/

No, those were definitely my two interests but I was open to other things until I realized how much I hate inpatient medicine.

 

[Fidgety]

Just out of curiosity how far in advance did you start prepping for step?

Throughout second year and then exclusively for 2 months, I gave myself a shot, at least I thought I did.

 

[Splenda88]

There is a chance but you will have to go all in (100+ community and low tier university programs) and still have FM as plan B. You don't want to go into the SOAP with that low step1 score.

 

[DubbiDoctor]

Why not pursue pathology? Seems pretty similar to radiology based on my limited understanding, far more so than FM. You should have no problem matching since it's one of the least competitive specialties.

 

[Splenda88]

Why not pursue pathology? Seems pretty similar to radiology based on my limited understanding, far more so than FM. You should have no problem matching since it's one of the least competitive specialties.

I was told the job market is not great... Besides, most pathologists are not making 450-500k/yr.

 

[Med Ed]

But considering the average step 1 for matched applicants was 240 that means those "low" scorers likely had something else going for them (i.e. research, connections, nepotism, connections, etc.).

This cannot be excluded, but in my experience it is more likely that those 17 matches were simply otherwise good applicants who had isolated subpar Step 1 scores and smart application strategies.

The 12 who went unmatched are more likely to have other red flags and/or lousy application strategies.

 

[Med Ed]

I have two questions:
1. Should I even bother applying to DR? My academic adviser tells me that it is still very possible. I obviously want to believe him, but would like to see if anyone with my step score even got interviews at rad programs.
2. I have no desire to do IM or peds, and a very small desire to do FM (although the amount of charting just makes me cringe) and otherwise have no other interests besides ophthalmology which is obviously not possible now. What other options do you think I should consider?

You should absolutely apply to DR. Marked improvement on Step 2 CK would be partially mitigating.

I would also suggest a backup plan, FM if you want but also look into pathology. The job market has historically been crummy, but then I don't know many unemployed pathologists. The rule of thumb for most fields is "location, salary, lifestyle - pick two." For pathology you may only get to pick one.