M4 question RE: Step 2 scheduling

[WaryWildcat]

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Hello SDN,

So I'm nearing the end of M3 year and am trying to plan out my fourth year. I'm interested in IM. I currently have my schedule packed through the ERAS submission date (there's three months between the end of M3 and Sept 15, which I'm filling with 4 weeks each of Cards, Critical Care, and Sub-I), and afterwards am taking 2 weeks off for dedicated Step 2 study (though I'm planning on doing some stuff during my cards and crit care electives as well). I'm presently sitting on one rec letter (which will likely be good but not great), so I was hoping to get some better ones out of these first three rotations. However, I'm reconsidering, because I've been reading that there is an advantage to taking Step 2 before ERAS is out, provided you rock it, even if you have a solid Step 1 (mine is >250). So now, I'm considering sliding down the Step 2, devoting a month to studying for it, and rescheduling either cards or critical care for later in M4. Is the advantage conferred by taking Step 2 earlier in M4 year worth having less opportunities to get letters of recommendation?

Let me know your thoughts, SDN - I'd appreciate it!

 

[Stellar Clouds]

You will get a lot of interviews (assuming you are at an allopathic school) with your step 1 score alone. Stick with your original plan to get some good letters and just take step after your 2 week dedicated study period. Assuming you studied well for your M3 shelf exams, 2 weeks will be more than enough to get an excellent step 2 score.

 

[235009]

Hello SDN,

So I'm nearing the end of M3 year and am trying to plan out my fourth year. I'm interested in IM. I currently have my schedule packed through the ERAS submission date (there's three months between the end of M3 and Sept 15, which I'm filling with 4 weeks each of Cards, Critical Care, and Sub-I), and afterwards am taking 2 weeks off for dedicated Step 2 study (though I'm planning on doing some stuff during my cards and crit care electives as well). I'm presently sitting on one rec letter (which will likely be good but not great), so I was hoping to get some better ones out of these first three rotations. However, I'm reconsidering, because I've been reading that there is an advantage to taking Step 2 before ERAS is out, provided you rock it, even if you have a solid Step 1 (mine is 255). So now, I'm considering sliding down the Step 2, devoting a month to studying for it, and rescheduling either cards or critical care for later in M4. Is the advantage conferred by taking Step 2 earlier in M4 year worth having less opportunities to get letters of recommendation?

Let me know your thoughts, SDN - I'd appreciate it!

well you NEED the letters of rec so you have to at least do SubI and one of the electives early on to secure the remaining 2 letters. I don't see any disadvantage to taking step 2 ck early enough for it to count if you have a good score but late enough to be able to hide it if it's not going to help your app (i.e. score needs to come back a couple weeks or so after you submit ERAS)

equally important.... how is your class rank? AOA? which school do you go to? if you are top of your class and/or go to a school with a good reputation then you can more comfortably hold off on step 2 until later and go with your original plan.

 

[WaryWildcat]

Yeah, to be clear, I'd only be dropping one of the two clerkships, not both. The issue is having to go 2 for 2 in terms of securing letters from them... In my experience, clinical performance has as much to do with how well you click with your team as it does your own ability to convince the attending you are capable of managing patients.

Not to turn this into a WAMC thread, but to answer your other questions:

1) I go to an average state allopathic school in the midwest... Match lists are highly variable from year to year from our school but are usually pretty solid for IM, where the solid non-MD/PhD people tend to end up at regional powerhouses (except for NU, which is convinced its farts don't stink), or occasionally a place like Penn, UCLA, or UW.
2) My school doesn't class rank except by quartiles, of which I'll be in the top barring a catastrophe. AOA is a possibility. My school bases it half on Step, half on a weighted average of the shelves (I have all H's third year (we have rampant grade inflation) with my shelves around the level one needs to get an H on the shelf component). It's hard to call this for sure as the year is not over and I still have Peds and OB to go.

As it stands right now, I'm taking Step 2 on September 26, which means the score will be out around 6 weeks post-ERAS. I think that is too late to count it if it comes back really high (but correct me if I'm wrong)... the only issue with your plan (which I like) is that I'd have to take it during my sub-I (which I cannot move, because I am one of the lucky few to secure a spot at the university hospital by lottery), which I am treating as an audition and during which I don't want to be studying hardcore for a board exam.

 

[235009]

Yeah, to be clear, I'd only be dropping one of the two clerkships, not both. The issue is having to go 2 for 2 in terms of securing letters from them... In my experience, clinical performance has as much to do with how well you click with your team as it does your own ability to convince the attending you are capable of managing patients.

Not to turn this into a WAMC thread, but to answer your other questions:

1) I go to an average state allopathic school in the midwest... Match lists are highly variable from year to year from our school but are usually pretty solid for IM, where the solid non-MD/PhD people tend to end up at regional powerhouses (except for NU, which is convinced its farts don't stink), or occasionally a place like Penn, UCLA, or UW.
2) My school doesn't class rank except by quartiles, of which I'll be in the top barring a catastrophe. AOA is a possibility. My school bases it half on Step, half on a weighted average of the shelves (I have all H's third year (we have rampant grade inflation) with my shelves around the level one needs to get an H on the shelf component). It's hard to call this for sure as the year is not over and I still have Peds and OB to go.

As it stands right now, I'm taking Step 2 on September 26, which means the score will be out around 6 weeks post-ERAS. I think that is too late to count it if it comes back really high (but correct me if I'm wrong)... the only issue with your plan (which I like) is that I'd have to take it during my sub-I (which I cannot move, because I am one of the lucky few to secure a spot at the university hospital by lottery), which I am treating as an audition and during which I don't want to be studying hardcore for a board exam.

absolutely agree with the bolded statement above

given the rest of your stats I think your schedule is fine the way you have it. absolutely don't take step 2 during sub-I, that would be insane. When i gave my initial advice i assumed you'd be able to move your sub-I earlier. just keep everything the way it is and you'll likely be fine. step 2 score 6 weeks after ERAS is likely going to be too late for it to matter for interview invites but it seems like you're presenting a nice complete package so it won't make too big of a difference.

Initially i was going to say that 2 weeks isn't enough time for step 2 studying but since you've honored all your clerkships I think you'll be fine.

good luck!

 

[jerseytrash]

Hello SDN,

So I'm nearing the end of M3 year and am trying to plan out my fourth year. I'm interested in IM. I currently have my schedule packed through the ERAS submission date (there's three months between the end of M3 and Sept 15, which I'm filling with 4 weeks each of Cards, Critical Care, and Sub-I), and afterwards am taking 2 weeks off for dedicated Step 2 study (though I'm planning on doing some stuff during my cards and crit care electives as well). I'm presently sitting on one rec letter (which will likely be good but not great), so I was hoping to get some better ones out of these first three rotations. However, I'm reconsidering, because I've been reading that there is an advantage to taking Step 2 before ERAS is out, provided you rock it, even if you have a solid Step 1 (mine is 255). So now, I'm considering sliding down the Step 2, devoting a month to studying for it, and rescheduling either cards or critical care for later in M4. Is the advantage conferred by taking Step 2 earlier in M4 year worth having less opportunities to get letters of recommendation?

Let me know your thoughts, SDN - I'd appreciate it!

Don't worry about it. I was in a similar position as you actually. I took my Step 2 in November after I had started getting my interview offers and I ended up getting most of the ones I wanted + matching where I wanted.

Yes, Step 2 is being taken more and more into consideration, but if you do not feel confident about how you'll do if you take it earlier, then don't do it. IMO, Step 2, while curved much more nicely than Step 1, was still overall a harder exam after studying for a month, so you can't just blow it off completely. It certainly can help your application to have a strong Step 2 score in (and I do think the score is getting more important especially in IM residency selection) but don't take it earlier and bomb it of course.

Your strong Step 1 score and clinical grades will probably already jump out at committees selecting people to interview and will of course play a big factor in ranking.

 

[hepato]

I'm in a similar position - almost identical stats and applying to IM. I decided to take CK in June, thinking that since it's important for some programs (I believe UCSF says that they require it to rank), and that I may end up releasing anyway (ideally because I'm happy with my score), I might as well take it soon after the end of third year when some of the clerkship knowledge is fresher. I've also always been one to get things over with earlier rather than later.

I don't think there's a wrong way to go about it - with your step 1 score and stats, you should get plenty of invites from competitive programs. And, of course, it's likely that you'll do very well on CK regardless of when you take it. If you're happy with your schedule as is, I wouldn't rock the boat.

 

[azuka]

I'm in a similar position - almost identical stats and applying to IM. I decided to take CK in June, thinking that since it's important for some programs (I believe UCSF says that they require it to rank), and that I may end up releasing anyway (ideally because I'm happy with my score), I might as well take it soon after the end of third year when some of the clerkship knowledge is fresher. I've also always been one to get things over with earlier rather than later.

I don't think there's a wrong way to go about it - with your step 1 score and stats, you should get plenty of invites from competitive programs. And, of course, it's likely that you'll do very well on CK regardless of when you take it. If you're happy with your schedule as is, I wouldn't rock the boat.

similar questions but got 4months, 224 on step 1, and 3.03 GPA (puts me in bottom 50% eras rank) and wanting to go into Ob/Gyn in a descent. I don't know if I should concentrate on my grade (I need at least 3.25 to above class average), or take step ii early or get those letters, or travel abroad to help my extracurricular and have some thing to talk about during interviews given that I have spend the past 3years doing medicine and less interesting things.

 

[WaryWildcat]

I'm in a similar position - almost identical stats and applying to IM. I decided to take CK in June, thinking that since it's important for some programs (I believe UCSF says that they require it to rank), and that I may end up releasing anyway (ideally because I'm happy with my score), I might as well take it soon after the end of third year when some of the clerkship knowledge is fresher. I've also always been one to get things over with earlier rather than later.

I don't think there's a wrong way to go about it - with your step 1 score and stats, you should get plenty of invites from competitive programs. And, of course, it's likely that you'll do very well on CK regardless of when you take it. If you're happy with your schedule as is, I wouldn't rock the boat.

Do you know any other schools that require step 2?

 

[hepato]

Not off the top of my head. I only remember UCSF because they state it on their website - http://medicine.ucsf.edu/education/residency/application/faqs.html

 

[evilbooyaa]

Not off the top of my head. I only remember UCSF because they state it on their website - http://medicine.ucsf.edu/education/residency/application/faqs.html

Every program requires to you to have passed step 2 to be RANKED. This is not the same as being offered an interview.

No where in that FAQ does it state that you need to have taken Step 2 to be offered an interview. Ranked = Submitting a rank list, which is done after interview season is over.

 

[VenusinFurs]

similar questions but got 4months, 224 on step 1, and 3.03 GPA (puts me in bottom 50% eras rank) and wanting to go into Ob/Gyn in a descent. I don't know if I should concentrate on my grade (I need at least 3.25 to above class average), or take step ii early or get those letters, or travel abroad to help my extracurricular and have some thing to talk about during interviews given that I have spend the past 3years doing medicine and less interesting things.

Is it even possible to get your GPA that much higher at this point? I think of all of these your GPA is the least important/ least modifiable. You should only travel if you want to; if it will be stressful financially or in terms of scheduling and you just want to look good I'd give it a pass, because it ain't going to get you into residency. I'd focus on trying to rock Step 2 AND make sure you apply broadly. OB apparently had very few unfilled spots after the match this year, so I'd consider applying to larger programs in areas fewer people want to live (like the Midwest), community as well as academic programs (though I've heard it's not a great idea for OB).

To the OP: I managed to get a Step 2 score similar to my Step 1 score after a month of non-dedicated study right at the beginning of my 4th year. Might be worth considering if you just want to get it out of the way.

 

[hepato]

Every program requires to you to have passed step 2 to be RANKED. This is not the same as being offered an interview.

No where in that FAQ does it state that you need to have taken Step 2 to be offered an interview. Ranked = Submitting a rank list, which is done after interview season is over.

Right - I didn't say otherwise.

And do all programs really require CK to rank? I picked a random program (northwestern) and they mentioned that it is just a requirement to enter the program.

 

[ohyeahbaby]

Right - I didn't say otherwise.

And do all programs really require CK to rank? I picked a random program (northwestern) and they mentioned that it is just a requirement to enter the program.

I didn't think it mattered if they ranked you with or without CK. We can't graduate w/o CK and CS - I was under the impression that all US schools were like that

 

[evilbooyaa]

Right - I didn't say otherwise.

And do all programs really require CK to rank? I picked a random program (northwestern) and they mentioned that it is just a requirement to enter the program.

Um, I was referencing this post you made.

I decided to take CK in June, thinking that since it's important for some programs (I believe UCSF says that they require it to rank), and that I may end up releasing anyway (ideally because I'm happy with my score),.

If you were taking CK in June, it would mean that the score would be released before September 15th, and would therefore be a factor in determining whether you get interviews or not.

And yes, I don't know of a single program that doesn't require CK to rank. Like ohyeahbaby said, it doesn't really matter b/c you need to have passed CK and CS before graduating 4th year anyways.

 

[Stellar Clouds]

Some schools, like mine, only require you to take CS and CK before you graduate.

 

[hepato]

Um, I was referencing this post you made.



If you were taking CK in June, it would mean that the score would be released before September 15th, and would therefore be a factor in determining whether you get interviews or not.

And yes, I don't know of a single program that doesn't require CK to rank. Like ohyeahbaby said, it doesn't really matter b/c you need to have passed CK and CS before graduating 4th year anyways.

Yeah - my point wasn't that I'm taking it early because it's a prerequisite for invites, but that if it's at all a factor in a program evaluating me for their rank list (as UCSF seems to imply), then I want to take it early when I may have a better chance of doing well on it. And, more to the point, I'd like to get it out of the way early.

And where have you read that all programs require CK to rank? And are you talking about IM programs in particular? I'm genuinely curious because I've been reading IM program websites where they state that they only require CK before starting intern year, which seems to imply that they don't require for ranking.

 

[evilbooyaa]

Yeah - my point wasn't that I'm taking it early because it's a prerequisite for invites, but that if it's at all a factor in a program evaluating me for their rank list (as UCSF seems to imply), then I want to take it early when I may have a better chance of doing well on it. And, more to the point, I'd like to get it out of the way early.

And where have you read that all programs require CK to rank? And are you talking about IM programs in particular? I'm genuinely curious because I've been reading IM program websites where they state that they only require CK before starting intern year, which seems to imply that they don't require for ranking.

Ah alright. I thought you planning to take it in June meant that you wanted it to visible when you were getting interviews. I see the point you are making now.

And I was under the impression all programs required CK to rank. I guess maybe that isn't true. Maybe once you've received all your interview invites and made your own rank lists, you can look up if any schools on your rank list require a CK to rank.

I don't personally care to look into this deeper, since I will be taking CK early, and therefore all this talk is moot for me. Good luck gaming the system so you only have to barely pass CK between matching and starting intern year. I know if I had to study at all for CK (even to just make sure I passed) around the time of the match, I'd be pretty bitter about the whole situation.

 

[VenusinFurs]

It's a terrible idea to wait until the end of the year to take step 2 even if your programs and your school don't require it (our school required both CS and CK to be taken before the end of January). Do you know how much dumber I am than the beginning of the year?

 

[survivordo]

Many of the programs I applied to wouldn't rank an applicant unless they had passed Step 2. Might want to think about this before you consider delaying. Also, you would miss out on the sweetness of the end of 4th year when you are matched, boards are passed and you're on cruise control!

Survivor DO