low step 1 -- sorry to ask, but really need advice

[icare4u]

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I know everyone hates these kinds of questions, but I'm really scared. I want to do surgery, but I have a terrible Step 1 board score - a 192. I know how competitive it has become, so just wondering, has anyone heard of somebody getting a surgery residency ANYWHERE IN THE U.S. with that low of a score?

I guess it boils down to I'm a TERRIBLE TEST-TAKER. I know some will say, "you need to study," but I did! I'm a 3rd year, have mediocre grades, (A's and B's), attend a well-known school, have done really well on all of my 3rd year clinical rotations. My attending reviews are all 5's, which is the best they can be, all with great comments such as "Wish you wanted to do medicine, you'd be my first choice," and the same in all my rotations. But when I get to the shelf tests, it is not uncommon for it to pull my grade down to a B.

I'm so discouraged. I guess I should do something else, (I'm thinking at this point, I should have been a nurse!) but I REALLY WANT TO DO SURGERY! My attendings in surgery rotations were amazed with me, but I'm sure they don't know my board score.

I'm going to try to do better on my Step 2, but I'm nervous, b/c I tried my hardest on my Step 1. It would have been better, I think, if I had failed so I could take it again, but nothing I can do about that now.

If anybody has any info about low board scores matching into surgery in 2007, I would SO MUCH APPRECIATE a response.
Thanks --

 

[icare4u]

Dr. Cox,

I've been reading this thread for a while, and you seem so knowledgeable. You are the one that is really making this thread worthwhile, and I would really value your opinion. Wish I could find a mentor that is willing to give so much time. I'll bet you're a wonderful doctor.

Now, back to my problem with the low board score...Do you think I should change my career choice? I'm scared to death that FP is the only thing I can get into. Not that there is anything wrong with that, but I Just love surgery. Please let me know your insight.

Looking forward to your reply...I've checked this site at least 30 times to see if there is a response!

-- Regards

 

[SocialistMD]

Talk with either your surgical education corrdinator, the clerkship director or the program director at your school (if you attend a top medical school, you should have all three). They would (especially the program director) be able to give you much better insight to your competitiveness as well as advice for what to do next. I am sure there are people who have matched into surgery with your board scores in the last 2-3 years. Are they at Hopkins or MGH? Probably not, but there are many good surgery programs out there. If you really want to be a surgeon, go for it. Your letters of rec will carry you far if they sing your praises.

Another thing I might suggest is that you invest in a test-taking skills course during your fourth year. The ABSITE is a yearly exam surgery residents must take (and every other field also has an inservice exam for that matter), and some programs fire residents with scores too low, so learing to take tests is something that you are going to have to do.

Best of luck.

 

[icare4u]

Thanks for the reply. I have talked with my program director, and she indicated that she is relatively new to the position, doesn't really have that much experience, and just doesn't know, basically, but that -- what were her words, the test scores are "worrisome." She went further and said my grades are not a problem, and the attending reviews are wonderful.
Then she suggested FP or IM. Now, she didn't say I didn't have a shot, but was trying to be very kind, I'm afraid, and just not wanting to hurt my feelings.
She is a very kind person.

I am going to check into the test-taking skills course -- off the cuff, anyone know how long those courses are or if they are helpful?

Thanks so much for your response!
Regards --

 

[SLUser11]

Thanks for the reply. I have talked with my program director, and she indicated that she is new the position, doesn't really have that much experience, and just doesn't know, basically, but that -- what were her words, the test scores are "worrisome." She went further and said my grades are no problem at all, and the attending reviews are wonderful.
Then she suggested FP or IM. She didn't say I didn't have a shot, but was trying to be very kind, I'm afraid, and just not wanting to hurt my feelings.

Sounds fishy.

There are plenty of people that match into surgery with low step 1 scores. The obvious advice is study your @ss off for Step 2, and when it comes time to apply, you will have to cast a large net that includes lesser-known community programs.

You're coming off kind of helpless, which honestly makes your chances of matching much worse......

 

[TaiShan]

Surgery is becoming more competitive but it is not Derm/orthorad yet. I am sure pelenty of people are matched with a score below 200. Yes, it is hard to get in MGH or your home program with a 192 but there are other programs that are less competitive. Apply wide and apply both catogerical and pre-lim spots. (I mean, every year there are literally hundreds of unfilled pre-lim spots). With a fact that 15-20% of surgery residents drop out each year, you are likely to find some PGY2 position.

 

[icare4u]

SLuser,
Well, not quite sure what you mean by "fishy". My program director admittedly doesn't have much experience, and I was seeking it here. If you'll check some of my posts, what I am wanting to know if anyone has heard of anyone matching with low step 1 scores in the last match, as that is when it has apparently become more competitive. That's all I'm wanting...sorry if that sounds "fishy" to you, and it's CERTAINLY not my intent to sound "helpless."

 

[SocialistMD]

I am going to check into the test-taking skills course -- off the cuff, do you know how long those courses are?

Short answer, no.

I know that some universities offer them as courses (so I'd check to see if there are online courses) and I'm sure there are books that have been published that you can [search for on amazon.com or barnesandnoble.com and then] read.

 

[icare4u]

Has anyone out there ever taken one of these test-taker skills courses...do they really help? I've never had that problem before, just when I hit med school. I've never "FAILED" a test, but I'm just not performing at the level that I should be. I had a 4.0 in a major university with a degree in cell and molecular biology -- not bragging, please understand, but just letting you see that I've never had this problem before. And it is a REAL problem. It has me wringing my hands, in fact. I have to work 10 times harder than everybody else, it seems, in my clinicals, b/c I know that that shelf test is going to pull my grade down. Thanks for your input, any info is appreciated.

 

[Miami_med]

I don't remember the link to the website, but the official statistics as of 2005 has around a 70% match rate with your board score into gen surg. I assume that a willingness to go anywhere would help.

 

[icare4u]

Miami_Med,
I had seen those stats, but my director says that was 2005 and that is much more competitive now. Do you know of a site that has the stats for 2007 or even 2006? Thanks so much for your input!

 

[icare4u]

I directed my post to Miami_Med, but if there is anyone else out there that knows of 2006 or 2007 general surgery matching stats relating to step 1 scores, I would appreciate any input. Thanks!

 

[popbirch]

www.nrmp.org/matchoutcomes.pdf

I know this is from 2005, but it could give a better idea of what people are getting score wise.

For example the interquartile range (25%-75%) for gen surg is from 205-235. avg is 220, for med seniors. For others it was 195-222. That is for matched students. So even if you take a conservative look to include the bottom 25% and just use 15 points, the med seniors are matching with scores all the way to 190, and others are matching with scores that are barely passing. So statistically a 192 doesn't rule out the possibility of matching. In fact in that category (190-200) it shows that 49/90 matched. So it seems as though people are still capable of doing that. If you have other stuff going on, that makes you an attractive candidate, interview skills, research, good lor's. I don't see why a 192 would rule you out. The other thing that the data show is that the more programs you rank on your list the more likely you are to match. 447 out of 475 people that ranked more than 10 programs matched. So that would be one way to help yourself out, apply to lots of programs and put them all on the list. Also, it may be best to take this all with a grain of salt, I'm just finishing my first year so I don't know much but I like looking at the numbers so I thought I would chime in.

 

[Miami_med]

Just for some perspective however, that 25-75% is probably not too dissimilar to the regular distribution on the boards. In other words, surgery has an average to slightly above average distribution of board scores compared to everyone who took the boards.

 

[icare4u]

Miami,
can you expound on that a little bit? Not sure I understand what you're saying...

 

[Miami_med]

Miami,
can you expound on that a little bit? Not sure I understand what you're saying...

If you take all med students who took the boards, the way the distribution probably runs is something like 25%=200-205, 50%=215-220, 75%=230-235. That's not exact, but it's got to be pretty close. Likewise, surgery has a distribution of roughly the same. Their average board score is statistically indistinguishable from the average board score in general. There is no real difference in the distribution either. Basically, this means that though doing better=better chances, the reason that the 25% of surgery is below 205 is because only about 25% of the applicants had a score below that number, not because they were systematically excluded from all surgery residencies because of their low scores.

 

[icare4u]

Miami_med,
Thanks for the response, that's helpful. I hadn't thought about it like that, so surely that would be right.

 

[Dunce]

If you take all med students who took the boards, the way the distribution probably runs is something like 25%=200-205, 50%=215-220, 75%=230-235. That's not exact, but it's got to be pretty close. Likewise, surgery has a distribution of roughly the same. Their average board score is statistically indistinguishable from the average board score in general. There is no real difference in the distribution either. Basically, this means that though doing better=better chances, the reason that the 25% of surgery is below 205 is because only about 25% of the applicants had a score below that number, not because they were systematically excluded from all surgery residencies because of their low scores.

Is there anything to back up those general numbers or were you just throwing stuff around to illustrate the point? I haven't seen much data that gives a good assessment of the actual distribution of Step scores for all test takers, but I would like to.

 

[Miami_med]

Is there anything to back up those general numbers or were you just throwing stuff around to illustrate the point? I haven't seen much data that gives a good assessment of the actual distribution of Step scores for all test takers, but I would like to.

I wish I had a better answer than the one I'm gonna give you. We know that the average last year was 219, so that is 50%. I can't remember if it was Kaplan or FA that said that there is generally about a 20 point Standard Deviation. So, I figure that means that 14%=~199 and 86%=~239. I figure the test has to follow something that resembles a gaussian distribution, though I could be wrong. If that's the case, the 25 and 75th percentiles would approximately be what I said. That's really all I did.

 

[icare4u]

The NRMP match outcome for 2005 is a very information source, but there again, that's 2005...wonder why no update? Even my school's charts for matching are 2005-2007 all lumped together, not broken down from year to year. so that's really no help, as the match results for different fields differ greatly from year to year.

 

[Faebinder]

I wish I had a better answer than the one I'm gonna give you. We know that the average last year was 219, so that is 50%. I can't remember if it was Kaplan or FA that said that there is generally about a 20 point Standard Deviation. So, I figure that means that 14%=~199 and 86%=~239. I figure the test has to follow something that resembles a gaussian distribution, though I could be wrong. If that's the case, the 25 and 75th percentiles would approximately be what I said. That's really all I did.

Miami, I think you are mixing the concept of Median and Mean because you are assuming the passers represent a bell curve.

219 is the mean.. but I am pretty sure it is not the median.

Think about it this way.... there are more people scoring 190 than there are people scoring 230. I think the passing grade for step 1 is on the right side of the curve not the left and therefore the ranges of step 1 passes are not a bell curve but rather section of the bell curve. If you want to see a bell curve, you'd need to include those that failed step 1.

 

[popbirch]

"On the three-digit scale, most Step 1, 2 CK, or 3 scores fall between 140 and 260. The mean score for first-time examinees from accredited medical school programs in the United States is in the range of 200 to 220, and the standard deviation is approximately 20. "

from
http://www.usmle.org/bulletin/2006/scoring.htm

table attached is from
http://www.studentdoc.com/usmle-scores.html

 

[Dunce]

This is only slightly off topic.

The 2005 match statistics hae been raved about by everyone and rightfully so. Apparently we can expect the next installment in the near future (August). 👍👍👍

The following is from the AAMC-OSR update June 2007
http://www.aamc.org/members/osr/chairsmessage.htm

Charting Outcomes in the Match
The OSR Ad Board has put forth considerable effort in deliberating and soliciting feedback from medical students on the 2006 NRMP and AAMC report, "Charting Outcomes in the Match." Following discussions at the AAMC Annual Meeting and ensuing OSR meetings, the OSR Ad Board recently made recommendations for the next iteration of the report in an effort to make this information even more useful for medical students considering which medical specialty to pursue. The next report is scheduled for release in August. View previous report.

 

[Miami_med]

Miami, I think you are mixing the concept of Median and Mean because you are assuming the passers represent a bell curve.

219 is the mean.. but I am pretty sure it is not the median.

Think about it this way.... there are more people scoring 190 than there are people scoring 230. I think the passing grade for step 1 is on the right side of the curve not the left and therefore the ranges of step 1 passes are not a bell curve but rather section of the bell curve. If you want to see a bell curve, you'd need to include those that failed step 1.

It would be pretty close though. I've never claimed that it was 100% accurate. I was just making the point that the 185-200 crowd (since below 185 is failing) is a relatively small percentage of the applicants, and would thus make up a small percentage of the acceptances. Looking at that Jpeg posted below your original post, assuming it's correct, really does sort of imply that it isn't TOO far off. You're right though, my methods are flawed and wouldn't hold as a serious statistical analysis subjected to peer review.👍

 

[Pilot Doc]

Another thing to keep in mind is that surgery matches something like 20% of positions with non-US seniors. This is quite odd because there are far more US senior applicants than positiosn, e.g. IMG are getting some spots that US seniors presumably want.

I have some theories, but no good explanation from this. It is not something seen in derm, rads, etc.

Moral of our story - there are programs who would likely be very happy to take a personable, hard-working, English-fluent US Senior who isn't a very good test taker.

 

[Faebinder]

Another thing to keep in mind is that surgery matches something like 20% of positions with non-US seniors. This is quite odd because there are far more US senior applicants than positiosn, e.g. IMG are getting some spots that US seniors presumably want.

I have some theories, but no good explanation from this. It is not something seen in derm, rads, etc.

Moral of our story - there are programs who would likely be very happy to take a personable, hard-working, English-fluent US Senior who isn't a very good test taker.

Disagree with you there. The reason why catagorical surgery is sooooo competitive compared to prelim is that the US seniors wont apply for prelim. And why should they? Almost all residencies will favor them over an FMG/IMG with the same scores. I think the reason you are seeing heavy IMG/FMG in surgery is the fact that they are willing to a) apply to prelims and risk the match again b) Residencies filter using USMLE SCORES and so many US graduates with lower scores will get filtered in favor of some IMGs/FMGs that scored higher and passed the filter.

(PS: I know people think there is a favor of English-fluent US Seniors over good test takers from outside the US, but that is not true again for similar reasons... residencies filter their 4000 applicants using scores. If they didn't have that many applicants, they wouldn't need the filter and would start looking at backgrounds more.)

 

[Faebinder]

It would be pretty close though. I've never claimed that it was 100% accurate. I was just making the point that the 185-200 crowd (since below 185 is failing) is a relatively small percentage of the applicants, and would thus make up a small percentage of the acceptances. Looking at that Jpeg posted below your original post, assuming it's correct, really does sort of imply that it isn't TOO far off. You're right though, my methods are flawed and wouldn't hold as a serious statistical analysis subjected to peer review.👍

Miami, that's what I am trying to say is wrong. The crowd of 185-200 is bigger than the 200-219 but the applicants for surgery crowd of 185-200 is smaller because they self filter. The curve is not a bell curve. The median is probably around 170-180 which close to the percentile value they used to give in the old days before they turned it to the two digit score. Of course this is all theorizing and I have no solid data but I am stating all this based on assumptions from past/current numbers.

 

[Miami_med]

Miami, that's what I am trying to say is wrong. The crowd of 185-200 is bigger than the 200-219 but the applicants for surgery crowd of 185-200 is smaller because they self filter. The curve is not a bell curve. The median is probably around 170-180 which close to the percentile value they used to give in the old days before they turned it to the two digit score. Of course this is all theorizing and I have no solid data but I am stating all this based on assumptions from past/current numbers.

The median can't be 170-180, because that is failing. More than half of the applicant's didn't fail the boards. The Median is probably pretty close to the mean, though it may be slightly lower. Atleast according to the graph on this post, the differentiation from a Gaussian distribution is a slight negative skew. Remember that all of the applicants below 185 will have to retake, so they don't really count.

Look, I know board scores count. I'm not saying the OP is going to get into Columbia with a 192. I'm saying that if you apply broadly in surgery, that the number of acceptances versus applications at low numbers isn't as bad as people would make it out to be. The reason that only 25% of acceptances are below 205 is because not significantly more than 25% of the applicants had scores below that number. This is not because 50% of the applicants had scores below 200, but 1/2 were excluded. Self-selection on the part of the applicants further backs up this premise, because it means that 25% of surgery acceptances went to people with scores below 205, and many potential applicants self-selected out at those numbers, leaving fewer total people to get those 25% of spots.

 

[Pilot Doc]

Maybe I wasn't clear in my post. This has nothing to do with prelims who if they get a categorical spot generally receive an offer outside the match.

These are people who match into PGY1 categorical spots. And about 20% (check nrmp.org for the exact #'s) of those who match in surgery are not US seniors.

As for people using filters, that's where you have to work the system. If you are truly personable and clinically competent, people make phone calls for you and the filter doesn't matter.

 

[icare4u]

I'm considering an away sub-I at a "safer" program to try to better my chances. I pretty much know that the competitive programs may not within my reach b/c of the 192. Some say away sub-I's are risky, but I'm thinking my clinical skills, personality and work ethic are my strong points, and that may be my only shot is to let them get to know me. My numbers are surely not going to get me there.

I'm going to dig in my heels and give it everything I've got on the Step 2, hopefully that will turn out better.

What do y'all think about that strategy? So, now, to find the "safer" programs. Any ideas on that? I'm in Texas, would love to stay here, but at the end of the day, I'll go anywhere surgery calls.

 

[icare4u]

Also, have y'all looked at the residentscafe.com site? It lists all of the surgery programs, as well as other fields, but gives their cut-off scores for boards and the size of the program, that sort of thing. Anybody know if that's pretty accurate? Some of them that don't have the mininum cut-off scores, maybe that means they don't screen them automatically b/c of the score...hopehopehope

 

[Bitsy3221]

Also, have y'all looked at the residentscafe.com site? It lists all of the surgery programs, as well as other fields, but gives their cut-off scores for boards and the size of the program, that sort of thing. Anybody know if that's pretty accurate? Some of them that don't have the mininum cut-off scores, maybe that means they don't screen them automatically b/c of the score...hopehopehope

I know of no one who used this site when I was applying. Personally, I think the site looks a bit like a rip off, trying to prey on frantic med students. I think if a program is going to have cut-offs (Step 1, GPA, AOA status, etc..) they will either be open and let you know up front (on website, mailings, etc) or not at all. I can't imagine a lot of well regarded programs volunteering their closed door policies to a private website that will turn around and sell this info to med students. I would say if you haven't already spent the cash, don't bother. Look at this website: http://www.facs.org/residencysearch/search/search.html It doesn't list hard and fast numbers per se, but it does give you some idea about the academics of its residents, and is from info reported from the programs to the ACS.

Try to personalize your approach a little. You said you did great on the wards; go to the attending surgeons you really connected with and pick their brains. Where did they train? Do they still know someone there that they would be willing to make a call to on your behalf? Where else do they know people? A well placed phone call can be surprisingly useful for offsetting the subpar board score.

In the mean time, what are you doing to strengthen your application? You can't change the scores now, but you can get active in research. Like you mentioned, think about doing an away rotation--it is no secret that some programs out there are partial to students who show a great deal of genuine interest in their program. Make a prelim list of where you want to apply, and consider doing a couple of aways, maybe one at a reach program and one at a safer program for you. If you are truly that great in person, you are just the sort of applicant the away rotation can help.

 

[Winged Scapula]

Also, have y'all looked at the residentscafe.com site? It lists all of the surgery programs, as well as other fields, but gives their cut-off scores for boards and the size of the program, that sort of thing. Anybody know if that's pretty accurate? Some of them that don't have the mininum cut-off scores, maybe that means they don't screen them automatically b/c of the score...hopehopehope

I agree with Bitsy - I don't know anyone who's used it and it seems to cater to FMGs rather than US grads.

You're paying for work that you can do yourself...and you have no way of verifying that the info you're paying for is correct. Unfortunately, its somewhat of a crap shoot because many programs will claim they don't have minimum scores, but they may, many may claim that they review the application thoroughly and they don't, etc.

I know that's not very comforting but if the information was available, you can get it yourself free from the programs - or at least for the cost of a phone call or email. Why pay someone to do that for you and relinquish the control that us surgeons so crave?

 

[nutcancer]

hah, the funniest part of this thread was ' i should have been a nurse '

GIRL - YOU WILL MATCH IF YOU APPLY BROADLY.

your 3rd year grades are stellar and that's the most important part of anybody's application. your dean's letter is going to be stellar if you got all As/Bs in the last 3 years. Your step 1 score blows, yes. But you have a 85/(85+42) chance of matching per the charting outcomes in the match file. Those are pretty good odds considering everything is stellar. You should apply broadly and have some of those attendings that love you make phone calls on your behalf. Don't listen to your b!tch faculty advisor as they only try to improve their school's match outcomes. You paid 200k to be in this position and you make it count. Don't settle for the dregs of medicine, peds/fm (unless you truly enjoy those as well).

Of course you should really try to improve on step 2. I don't really buy this bad at test taking thing. Test taking is not an art or a state of mind. You either know the answer or you don't. That's how I look at it - I know its primitive. Just study hard every time and calm down and think rationally when taking the test.

And I hate to say this, but if you're pretty, your chances of matching will be much higher than a fugly.

 

[icare4u]

Nutcancer,
you're a hoot!!! Made my day...makes me feel "revived" again, and like there's something to work for. I've just got to think positively and get in there and get after it. I just hate to admit this, but it's REALLY DIFFICULT for me to go in to those attendings and own up to the 192 score...REALLY DIFFICULT FOR ME. These people are SO SMART. I've got to get past that, though. Boy, it just hurts through and through, if you know what I mean.

 

[DNASplicer]

I come from a very similar boat. My step 1 = 194

FIRST... I have to say that poor test taking skills ARE a reality. It's not a matter of simply knowing the info or not. Speaking from experience here. There are actually a couple of people that are trying to look at this from an objective, scientific perspective. I can look up the posters if you are interested.

Anyway...

I know people that have gotten into Gen Surg with even lower scores than what you or I have. They applied broadly (+KEY+), had FABULOUS LORs and other items on the CV to establish intellectual finess or leadership abilities.

Statistically, your 3rd yr clerkship grades hold more weight. Honest!

Okay, so what ARE those books that teach good test taking skills??

I gotta tell ya, I spent a lot of time last year looking for a good PREP course for step 2, books, whatever. I wished I would have taken a prep course for step 1. I was not impressed with my research on step 2 prep courses. What I found was most of the Step 2 prep courses were glorified step 1 courses. And step 2 is not step 1 (thank god). Step 2 = 224

I know many of you stomped my step 2 score, but for me, that was awesome. What I did was study USMLEworld.com questions. I need practice with questions. Obviously you need a foundation of knowlege, but that's not all.

Getting ahead of myself here...

First you need to figure out why you are not testing well. Is it a matter of not understanding the info? Is it really test taking? Then identify a strategy that works for you. Your advisor may help you with this. Mine did.

And if your program director is new, find out who the old one was and talk to them. I talked to as many people as I could.

When you ahve your step 2 score, go to your adviors with a list of programs and ask what their opinon is. Of course I applied to MGH, but I did not get an interview. But wow, I was very pleased to visit some of the "top" academic and community programs in our country.

Of course then you are in a pool of people that tested well and you feel inadequate (just what an intern needs). But surgery is way to !@## cool for me to do anything else. I just work that much harder...

Please PM me if you want more info.

Sorry to go on and on and on... I have invested so much time into this and am luckily starting as a surgical intern soon! Phew...

But now I gotta be a surgical intern... 😀

 

[icare4u]

DNASplicer,
Ah, finally, somebody that sounds JUST LIKE ME! Will be contacting you soon, but I'm on call.......gotta run! By the way, thanks for making my day --

 

[SLUser11]

Okay, so what ARE those books that teach good test taking skills??

D

First Aid for Step 1.

 

[njbmd]

I know everyone hates these kinds of questions, but I'm really scared. I want to do surgery, but I have a terrible Step 1 board score - a 192. I know how competitive it has become, so just wondering, has anyone heard of somebody getting a surgery residency ANYWHERE IN THE U.S. with that low of a score?

I guess it boils down to I'm a TERRIBLE TEST-TAKER. I know some will say, "you need to study," but I did! I'm a 3rd year, have mediocre grades, (A's and B's), attend a well-known school, have done really well on all of my 3rd year clinical rotations. My attending reviews are all 5's, which is the best they can be, all with great comments such as "Wish you wanted to do medicine, you'd be my first choice," and the same in all my rotations. But when I get to the shelf tests, it is not uncommon for it to pull my grade down to a B.

I'm so discouraged. I guess I should do something else, (I'm thinking at this point, I should have been a nurse!) but I REALLY WANT TO DO SURGERY! My attendings in surgery rotations were amazed with me, but I'm sure they don't know my board score.

I'm going to try to do better on my Step 2, but I'm nervous, b/c I tried my hardest on my Step 1. It would have been better, I think, if I had failed so I could take it again, but nothing I can do about that now.

If anybody has any info about low board scores matching into surgery in 2007, I would SO MUCH APPRECIATE a response.
Thanks --

The lowest USMLE Step I score that I know of matching into General Surgery is one more than passing. Seriously, USMLE Step I, while important, is not the sole criterion for matching into General Surgery. Other things like your grades and your letters of recommendation also weigh into the process.

As you are planning, do an audition rotation at a couple of programs (community and mid-level university) where you might be a good candidate and do well. Make sure that catch the eye of the program director and be sure that you work your rear-end off. Let the program director know that you are interested in matching in their program. A known applicant with a strong work ethic beats an unknown with a better USMLE Step I score. Larger departments have more room across the board so apply to departments that have a larger number of residents too. Also consult your chairman of surgery and ask for recommendations as to which departments might be a good match for you.

Do apply for some prelim spots if you are really concerned that your Step I score is going to be that much of a liability. The worst case scenario is that you match into a strong prelim, do a stellar job and get some solid letters that place you into a categorical slot (either at your program where you are a prelim or another that you match into) next year.

In the meantime, work on your test-taking skills. Figure out your problems and correct them. Did you have a knowledge deficit or did you have difficulty applying the knowledge that you have to problems that were on USMLE Step I. If you take Step II early and do a stellar job, you can greatly help your case too.

Talk to some of the residents (especially the interns) at your medical school to find out about departments that they interviewed at. They generally will have good information about placed that they visited the year before.

Finally, if surgery is your goal, then make sure that you do everything that you can to get into surgery. Don't take a Family Medicine or Internal Medicine slot if you are interested in Surgery. You will be miserable and you won't do a good job.

Good luck! BTW, my best friend from medical school matched into General Surgery with an 189 (three digit score) so it can be done. It turns out that after one year, she left her program because she didn't even like surgery after all.

 

[surgeon2b forev]

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