Match with 222/92 Step I from Top 10 School

[medstudent35]

I just got my Step I score back and I was pretty disappointed with a 222. I know it's not too bad, but pretty much every friend I have did better than me. I go to a top 10 med school right now and am matching in internal medicine. I know IM is not hard to match in, but I was wondering what you all thought about my chances at top 5 programs? top 10? top 15? top 20?

I have average grades my first three years of med school with good extracurriculars and research experiences in med school and before.

I assume I'm out due to cutoffs at MGH, UCSF, etc. but what do you think about yale, chicago, etc. Anyone have any experience with my questions/know someone who has?

Anyone have advice? I only started looking at the forum here towards the end of Step I, but wish I had started earlier. Thanks in advance.

Rob

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[greenbean]

what year are you?

if you go to a top10 school, u should go ahead and apply to top IM programs. look at your schools prior match lists and see where ppl go for IM, are those 'top programs'?,

this match process isnt just about numbers, sometimes its just about connections(who writes your LORs, does your school 'trade' students: like duke does with harvard, or harvard with hopkins, etc, many exist im just giving examples), did you get honors in your IM rotation, did you get honors in your sub-I in IM, did you do any aways at the 'top programs', did you do any electives in IM subspecialties?

also, top academic programs look for research, do you have any? not necessarily published but have you done any research at all in medschool? and what did u do it in? on interviews, i got lots of questions on research i did, all the way back to highschool, some were nitpicky questions(and im not going into IM), so i would so just make sure you know yourself well and all your qualifications show off you in the best light.

peace,
green

 

[buckley]

actually i have yet to encounter a program which publishes a required MLE > 90. i say go for it...

 

[jennyboo]

Relax -- you got a good score. No, you didn't blow that test outta the water, but you did good enough to put together a strong application. You should apply to any place where you're interested in going, including "top" programs.

You had the guts to apply to your top 10 school. Now gather up the guts to apply to whatever highly competitive program you want. Hey, you can't get in if you don't at least try.

Things you can do to strengthen your application:

1) Get above-average grades in your clinical rotations. Ask students in the year above you what counts for EACH clerkship. Don't spend all your time kissing butt on the wards if your grade is 90% based on your shelf exam score.

2) Consider away sub-I rotations. You'll get the opportunity to meet the program director of that residency program. Make an appointment with him/her, do your research about the program, figure out what you like and don't like about it and treat that appointment like a real interview. Send a thanks by email or written note. When you apply for the program, if you're afraid you won't make the program's cutoff, EMAIL THE PROGRAM DIRECTOR to remind him/her of your meeting and rotation, and tell him/her that you're strongly interested and that you hope they'll look at your application. Even if there is a board cutoff that you don't make (which I highly doubt; in IM any cutoff probably isn't above 220), this is a good way to see if you can get around it!

3) Sell yourself. Even if you don't think you look good on paper, MAKE yourself look good on paper.

4) Collect letters of recommendation as you go along. Don't wait until a year after the end of your clerkship to ask that faculty member for a letter. Do it during the last week of the rotation, and follow up with emails and provide any materials requested (such as CV, transcript, USMLE, anything they ask for) promptly. Call your dean's office to make sure the letter is received, and if not, follow up again! Be strategic about WHO you choose to write your LORs. If you're interested in a particular program, any faculty member KNOWN to that program and RESPECTED by them is a good choice (as long as that faculty member likes you).

 

[medstudent35]

thanks for the responses. i do have a lot of research. i took a year off after third year to work in a lab. will have a publication or two most likely. i just started back on fourth year a bit ago. i had honors in medicine my third year along with a few other rotations.

i appreciate the encouragement and will of course do everything i can. has anyone known anyone who matched at a top place with avg. grades and step I?

 

[mlw03]

i'm confused - you completed MS3 without taking step 1? what school allows that? of course there's people who match into "top" programs with average grades and average step 1 score. just like there are people with rocking numbers who don't match into those same top programs because they're buttheads.

genuinely think about why you want to go to a top ___ program for internal medicine - is it because you have an ego the size of texas and going anywhere less than MGH will cause you massive shame? if so, that's a poor reason. if you want solid training there are plenty of places that will do that. if it's because you want to be in academics, that's legit and make sure you make that well-known. my point is that your post comes across as someone who wants to plaster his walls with impressive names, and i assure you that does not make a good doctor. there's a psychiatrist at my school who think he can walk on water because he went to yale, and and he's certainly no better at managing the crazies than the faculty who went to state schools for their entire education. please evaluate your motivations and act based on fulfilling those aspirations, and if you do that i think you'll find the rest takes care of itself.

 

[medstudent35]

i'm confused - you completed MS3 without taking step 1? what school allows that? of course there's people who match into "top" programs with average grades and average step 1 score. just like there are people with rocking numbers who don't match into those same top programs because they're buttheads.

genuinely think about why you want to go to a top ___ program for internal medicine - is it because you have an ego the size of texas and going anywhere less than MGH will cause you massive shame? if so, that's a poor reason. if you want solid training there are plenty of places that will do that. if it's because you want to be in academics, that's legit and make sure you make that well-known. my point is that your post comes across as someone who wants to plaster his walls with impressive names, and i assure you that does not make a good doctor. there's a psychiatrist at my school who think he can walk on water because he went to yale, and and he's certainly no better at managing the crazies than the faculty who went to state schools for their entire education. please evaluate your motivations and act based on fulfilling those aspirations, and if you do that i think you'll find the rest takes care of itself.

easy tiger. i took a year off to do research and was unable to take step I after 2nd year so i took it during my year away. i was given permission to do this. sorry if my post comes off as wanting to plaster my walls with impressive names. i do indeed want to go into academics. i realize you can get good training at many places, but I (like most) hope to go to the best possible place for my future. I believe that to be a good academic program.

 

[jennyboo]

has anyone known anyone who matched at a top place with avg. grades and step I?

Of course. Lots of people match at a "top" place (whatever that means, since opinions differ sometimes on what is a top program and what is not) with average numbers.

As in the rest of the world, the best bit of advice I ever received about applying and interviewing for jobs is, "Hiring decisions are made with emotion and justified with logic." Not the other way around. This applies to residency as well. They don't hire people because they have high numbers. They hire people they like and justify that with the numbers. (Having sat through and met the groups of students interviewing at my program, it's unbelievable how many people can look okay on paper and be complete tools in person.)

Anyway, to answer your question, I did.

 

[percysmith]

For one of the schools that you mentioned (i.e. MGH/UCSF), there is no board score cutoff and the IM dept places honors in 3rd year clerkship and sub-I's much more highly than board scores. Also more important than board scores, they emphasize good LOR's, quality of school/medicine dept you trained at, and other clinical honors/AOA.

I don't know about other schools, but had a friend with much lower board scores that interviewed at all the "top" schools for IM last year.

Good luck.

 

[medstudent35]

thanks jennyboo, percy, and others. i appreciate you sharing your experiences and advice.

 

[gutonc]

For one of the schools that you mentioned (i.e. MGH/UCSF), there is no board score cutoff and the IM dept places honors in 3rd year clerkship and sub-I's much more highly than board scores. Also more important than board scores, they emphasize good LOR's, quality of school/medicine dept you trained at, and other clinical honors/AOA.

Not exactly true, but true in spirit. EVERY program has a Step 1 cut-off. Do you really think that Hopkins is interviewing folks w/ a 75 on Step 1 for anything other than food service or janitorial work? Most places put that number at 80 or 85 but some will use a 90 or even higher, depending on the competitiveness of the specilaty (N.B. - I use the 2 digit score because it's the only one that can legitimately compared b/w years of test administration and it's the one that programs use).

HOWEVER, most places use the Step 1 score as only an initial cut-off as to whether or not they'll review the rest of your application. Step 1 gets you in the door, the rest of your app gets you an interview (or not) and a high ranking (or not).

Put another way, Honors in your specialty-of-interest clerkship and Sub-I will not help your 75 Step 1 score, while a Pass in your specialty-of-interest clerkship and Sub-I will hurt your 99 Step 1 score.

The OP has scored well within pretty much any programs initial cut-off and has nothing to worry about WRT board scores. Clerkship grades, research, LORs and phases of the moon will have far more to do with where you do and don't get interviews.

Particularly the phases of the moon. And how much the program coordinator had to drink the night before reviewing your app.

Good luck. And remember that, in the end, it all comes down to drunk monkeys with darts.

 

[Hard24Get]

i'm confused - you completed MS3 without taking step 1? what school allows that?

at Penn we do core clerkships before step 1 b/c we go to clinics earlier and end up taking it in the middle of ms3

 

[mlw03]

at Penn we do core clerkships before step 1 b/c we go to clinics earlier and end up taking it in the middle of ms3

wow - that seems very tough. the material one needs to do well on step 1 versus the material needed to succeed on the wards and clinics is so different. to say nothing of the fact that taking step 1 in the middle of ms3 while you're also presumably having to study for shelf exams at the end of each clerkship... rough.

to bring it back to the original point of this thread, do you think that practice that penn has hurts, helps, or doesn't affect step 1 scores?

 

[Hard24Get]

wow - that seems very tough. the material one needs to do well on step 1 versus the material needed to succeed on the wards and clinics is so different. to say nothing of the fact that taking step 1 in the middle of ms3 while you're also presumably having to study for shelf exams at the end of each clerkship... rough.

to bring it back to the original point of this thread, do you think that practice that penn has hurts, helps, or doesn't affect step 1 scores?

Eh, we get a month plus off to study and it's only a year afterwards (admittedly, I took mine at 6mos). Most people think it helps (it makes the clinical vignettes seem silly). I heard the average Penn Step 1 is like 230 something, though I can't find the data to back it up.