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Med students matching: What do you wish you would have known/done in med school?

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I love this post and here's why... had I trusted the advice of the "experts" on SDN, I would have been convinced that my chances of getting in to medical school and being successful were slim to none. As a non-traditional student, I had less than stellar grades from some UG classes very early in life and knew that it would be a challenge to improve my GPA. Indeed, it was... but I did not get all A's as it was suggested would be necessary. My MCAT was just a hair above average and yet I got in to medical not once, but twice. I was accepted in 2007 but decided not to go at that time. I finished a Master's and reapplied at a later date without retaking the MCAT. And now, as an MS2, although there have been subjects with which I struggled, I have not failed any nor had to re-mediate. Likewise, my CBSE scores, while not even close to predicting a 260 like a few of our top students, are nonetheless higher than several of my younger and presumably more intelligent classmates.

I recognize my limitations and while I will put forth my best effort on Step 1, I refuse to allow the naysayers to convince me that a "low" (call it <240) score will mean a career in my chosen specialty (whatever that might be) is out of the question. Perhaps I might have a harder time getting what I want, maybe I would have to be in a less desirable (whatever that is) program, or to have to apply more broadly... but it is no means an impossibility. Don't believe me? Take a look at the match statistics... http://www.nrmp.org/data/chartingoutcomes2011.pdf

Since we keep talking about Derm, let me draw your attention to page 36. Now, when you look at the those applicants with a 201-210, you'll see that nearly 50% matched, and this figure went up slightly with scores of 211-220. While I'd admit those aren't great odds, they are far better than zero. And that's not all... if you look at the others specialties mentioned (anesthesiology, EM, Rads - not Oc Rads) you'll see that 85-95% of those scoring at 220 and below matched.

My point is this... if you read these posts and think "Well, I'm f***ed..." DON'T!! We all know this test is important, so study hard. But at the end of the day, recognize that there are a handful of students who beat the odds. Your challenge is to figure out what separated the two groups if you happen to be stuck with a score on the lower end for your desired specialty.

Best of luck to all of you!

:thumbup: X 2
Great post. Wow. And let's be real: a lot of these kids make up their stats, and THEN talk ish about yours....funny eh?
 

rocketbooster

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I love this post and here's why... had I trusted the advice of the "experts" on SDN, I would have been convinced that my chances of getting in to medical school and being successful were slim to none. As a non-traditional student, I had less than stellar grades from some UG classes very early in life and knew that it would be a challenge to improve my GPA. Indeed, it was... but I did not get all A's as it was suggested would be necessary. My MCAT was just a hair above average and yet I got in to medical not once, but twice. I was accepted in 2007 but decided not to go at that time. I finished a Master's and reapplied at a later date without retaking the MCAT. And now, as an MS2, although there have been subjects with which I struggled, I have not failed any nor had to re-mediate. Likewise, my CBSE scores, while not even close to predicting a 260 like a few of our top students, are nonetheless higher than several of my younger and presumably more intelligent classmates.

I recognize my limitations and while I will put forth my best effort on Step 1, I refuse to allow the naysayers to convince me that a "low" (call it <240) score will mean a career in my chosen specialty (whatever that might be) is out of the question. Perhaps I might have a harder time getting what I want, maybe I would have to be in a less desirable (whatever that is) program, or to have to apply more broadly... but it is no means an impossibility. Don't believe me? Take a look at the match statistics... http://www.nrmp.org/data/chartingoutcomes2011.pdf

Since we keep talking about Derm, let me draw your attention to page 36. Now, when you look at the those applicants with a 201-210, you'll see that nearly 50% matched, and this figure went up slightly with scores of 211-220. While I'd admit those aren't great odds, they are far better than zero. And that's not all... if you look at the others specialties mentioned (anesthesiology, EM, Rads - not Oc Rads) you'll see that 85-95% of those scoring at 220 and below matched.

My point is this... if you read these posts and think "Well, I'm f***ed..." DON'T!! We all know this test is important, so study hard. But at the end of the day, recognize that there are a handful of students who beat the odds. Your challenge is to figure out what separated the two groups if you happen to be stuck with a score on the lower end for your desired specialty.

Best of luck to all of you!

No offense, but your post is much worse than the majority of SDN posts because your post provides false hope to students. Yes there are always exceptions and some students sneak into uber competitive specialties when their #s are below the average for that field. However, as I said, those are the exceptions. Their special circumstances/CV/background does not apply to the average student. When giving advice to younger students, you need to give advice that every student can actually use.

When applying to any program, it's foolish to assume you'll be the exception and it's everyone else who the average stats apply to and not yourself. When applying to med school or residency, you need to be practical and realistic. You should expect to be competitive at schools that have average #s similar to your own and expect it a longshot to get into a program with #s way above your own. It's always good to apply to a few reaches, but you should never think you have a realistic chance at those programs.

If you only apply to ortho with a 220 Step 1, you're not going to get matched. My friend applied only to ortho with a 228 because he thought his other strengths could get him in. He was close to the ortho PD at his school and had published a few papers with him. He got 2 ortho interviews, one at his school. The residents told him that he was almost for sure in. But guess what, he went unmatched. He was very capable of being matched to many other fields, but he was stubborn and thought the average #s did not apply to him because of his ECs. He used your philosophy and went unmatched because of it. He ended up taking a year off and did research and recently matched to rad onc. That's nearly as competitive as ortho, so things worked out for him but only because he was a non-traditional med student applying the 2nd time. He said it was definitely the research that got him in.

Moral of the story: the typical med student will not get matched to a competitive field following your advice. If they keep trying after going unmatched, then sure they will probably get it eventually. But I don't think it's sound advice to say "you'll have to fail the first time, but eventually you can get there." Good advice will help you get there the first time. And the best advice is to only consider yourself competitive when you have that program's average numbers.
 

flatearth22

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It's simply not true that 50% of applicants with 201-210 matched derm. That chart is for people who ranked programs in derm, meaning they had to have received an interview. If you're applying with those scores, you're almost certain to go uninterviewed, and wouldn't be in the statistics. As you can see, only 47 people ranked programs with a score below 221 and of those only 21 matched.

:laugh: way to ruin her derm dreams
 

momgracea

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No offense, but your post is much worse than the majority of SDN posts because your post provides false hope to students. Yes there are always exceptions and some students sneak into uber competitive specialties when their #s are below the average for that field. However, as I said, those are the exceptions. Their special circumstances/CV/background does not apply to the average student. When giving advice to younger students, you need to give advice that every student can actually use.

When applying to any program, it's foolish to assume you'll be the exception and it's everyone else who the average stats apply to and not yourself. When applying to med school or residency, you need to be practical and realistic. You should expect to be competitive at schools that have average #s similar to your own and expect it a longshot to get into a program with #s way above your own. It's always good to apply to a few reaches, but you should never think you have a realistic chance at those programs.

If you only apply to ortho with a 220 Step 1, you're not going to get matched. My friend applied only to ortho with a 228 because he thought his other strengths could get him in. He was close to the ortho PD at his school and had published a few papers with him. He got 2 ortho interviews, one at his school. The residents told him that he was almost for sure in. But guess what, he went unmatched. He was very capable of being matched to many other fields, but he was stubborn and thought the average #s did not apply to him because of his ECs. He used your philosophy and went unmatched because of it. He ended up taking a year off and did research and recently matched to rad onc. That's nearly as competitive as ortho, so things worked out for him but only because he was a non-traditional med student applying the 2nd time. He said it was definitely the research that got him in.

Moral of the story: the typical med student will not get matched to a competitive field following your advice. If they keep trying after going unmatched, then sure they will probably get it eventually. But I don't think it's sound advice to say "you'll have to fail the first time, but eventually you can get there." Good advice will help you get there the first time. And the best advice is to only consider yourself competitive when you have that program's average numbers.

And guess what... you just PROVED my point. So, he didn't get in on the first go around but then matched to rad onc after taking a year off to do research?? Indeed, seems that he figured out the way to get what he wanted which, if you recall my initial advice, was exactly what I said to do.

I didn't say screw around and try to get into X on your good looks and 220 score. What I said was that IF you are trying to get into some competitive residency and your scores (despite your best effort) wind up mediocre, you shouldn't lose hope. I truly believe that where there is a will, there is a way - - and like most highly motivated individuals who have dreams or aspirations - - it seems that your friend found his.

False hope? On the contrary... my advice doesn't suggest that it will be easy, only that it is possible. And those who find a way to succeed most assuredly will not be counted among the "typical" medical students of whom you speak..
 

JackShephard MD

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And guess what... you just PROVED my point. So, he didn't get in on the first go around but then matched to rad onc after taking a year off to do research?? Indeed, seems that he figured out the way to get what he wanted which, if you recall my initial advice, was exactly what I said to do.

I didn't say screw around and try to get into X on your good looks and 220 score. What I said was that IF you are trying to get into some competitive residency and your scores (despite your best effort) wind up mediocre, you shouldn't lose hope. I truly believe that where there is a will, there is a way - - and like most highly motivated individuals who have dreams or aspirations - - it seems that your friend found his.

False hope? On the contrary... my advice doesn't suggest that it will be easy, only that it is possible. And those who find a way to succeed most assuredly will not be counted among the "typical" medical students of whom you speak..

I agree that if you are really dedicated, you can find a way to match with below average (yet not poor) stats. I think you need to be willing to go unmatched and/or do extra research year(s). Seemingly a success story, the individual who went unmatched in Ortho and then matched RadOnc would actually support drizzt3117's stance, which was to have a solid app to match (i.e. not go unmatched) in these competitive fields.

Anything is possible, yet when you give advice you don't base it upon the tails of the distribution curve. In this way, the "SDN wisdom" is not misleading, it's just the most realistic assessment of the situation. Which is not much different from how we perform medicine. Rarely will you make a decision in favor of the 5% of the distribution, but rather the 95%.

Your advice brings together hope and delusion.

I think you're merging all SDN advice to discredit it. Yet, the advice on the allo/residency forums is much different from the pre-allo forums.
 
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I'm just telling how things really are. A good portion of my friends are doing IM. None of them have taken step 2. Seems pretty vital, huh? Hasn't stopped them from interviewing at MGH, Hopkins, ucsf, etc. Lors and the rest of your app are certainly taken into account, but many people don't even take step 2 until 2nd sem of m4. Afaik only ucsf requires step 2(cs and ck) to rank.
Having sat through a rank list meeting, your Step 2 score does count at some places/specialties, and I was asked point blank what mine was at a few interviews (I had taken it later, and the score wasn't released automatically).
 

2012mdc

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Having sat through a rank list meeting, your Step 2 score does count at some places/specialties, and I was asked point blank what mine was at a few interviews (I had taken it later, and the score wasn't released automatically).

It's definitely important to talk to upperclassmen about their experiences with specific specialties and programs.

I applied to rads like drizz and held my score. Not a single rads program asked about my step 2 and only 2 prelim IM programs asked about it.

I'm sure people applying to other specialties had very different experiences.
 

drizzt3117

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My friends that did what you recommend are now sitting at home hoping against hope that some bullsh*t malignant prelim surgery programs call them so they can slave away for 100 hours a week for a year without a guarantee of a future spot. Better get very familiar with how SOAP works, because you're going to need it.

And guess what... you just PROVED my point. So, he didn't get in on the first go around but then matched to rad onc after taking a year off to do research?? Indeed, seems that he figured out the way to get what he wanted which, if you recall my initial advice, was exactly what I said to do.

I didn't say screw around and try to get into X on your good looks and 220 score. What I said was that IF you are trying to get into some competitive residency and your scores (despite your best effort) wind up mediocre, you shouldn't lose hope. I truly believe that where there is a will, there is a way - - and like most highly motivated individuals who have dreams or aspirations - - it seems that your friend found his.

False hope? On the contrary... my advice doesn't suggest that it will be easy, only that it is possible. And those who find a way to succeed most assuredly will not be counted among the "typical" medical students of whom you speak..
 

turkeyjerky

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My friends that did what you recommend are now sitting at home hoping against hope that some bullsh*t malignant prelim surgery programs call them so they can slave away for 100 hours a week for a year without a guarantee of a future spot. Better get very familiar with how SOAP works, because you're going to need it.
Well, I'm sure that's just God's plan for them.


Right?
 

2012mdc

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Nothing wrong with having hope but if you are a below average candidate or applying to something extremely competitive it is smart to have a backup plan. Whether that be another specialty or a research year.

Be hopeful but be realistic and most of all be prepared.
 

thestrokes14

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I know that school matters for residency, as was recently mentioned in this thread, but do any medical students have advice for choosing between an established (albeit low ranked school), vs. a new school for med school? In this case: Wright State vs. Oakland University William Beaumont? I've heard that Oakland has drawn some good professors to their school, and Beaumont is a nationally ranked hospital.

In other words, would you take a chance on a new school? I guess there haven't been very many new schools in the last couple of decades.
 

JackShephard MD

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I know that school matters for residency, as was recently mentioned in this thread, but do any medical students have advice for choosing between an established (albeit low ranked school), vs. a new school for med school? In this case: Wright State vs. Oakland University William Beaumont? I've heard that Oakland has drawn some good professors to their school, and Beaumont is a nationally ranked hospital.

In other words, would you take a chance on a new school? I guess there haven't been very many new schools in the last couple of decades.

Doesn't sound like it will make much of a difference. Attend the school you like more or the cheaper one.
 
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TAWS

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In other words, would you take a chance on a new school? I guess there haven't been very many new schools in the last couple of decades.

I think new schools don't have full LCME accreditation, just temporary accreditation. Look at the Commonwealth Medical College. They opened a couple of years ago but have been put on probation by the LCME because they didn't have enough money. If they fail to get full LCME accreditation, the students there are screwed.
 

rocketbooster

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And guess what... you just PROVED my point. So, he didn't get in on the first go around but then matched to rad onc after taking a year off to do research?? Indeed, seems that he figured out the way to get what he wanted which, if you recall my initial advice, was exactly what I said to do.

No actually I didn't prove your point. Your point was the typical student can get in with lower numbers into the uber competitive specialties. The typical med student, as in the 4th year med student applying to residency, cannot (or at least is VERY unlikely to) get in to a very competitive residency with lower numbers than that field's average. The typical med student applying does not have an extra, solid year of research to make up for the lower scores. My point was that your advice is bad advice for the typical med student. The typical med student wants to be matched during 4th year and start residency right after med school. If they want a certain competitive field so badly over everything else and want to take a year off to try again, then yes you are right that they have hope. When giving advice, though, you should make it good advice that applies to getting in the first time. The good advice is don't expect to get in to a competitive residency if you have lower numbers applying as a 4th year med student. This thread is for that year of students. This thread is not about how to be more competitive when reapplying to residency, or at least I didn't think it was haha.
 
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momgracea

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My friends that did what you recommend are now sitting at home hoping against hope that some bullsh*t malignant prelim surgery programs call them so they can slave away for 100 hours a week for a year without a guarantee of a future spot. Better get very familiar with how SOAP works, because you're going to need it.

Good lord, why must this become personal? I'm not looking for validation. I have no doubt in my abilities nor my capacity to succeed. I do, however, think that there are others out there who could use a little more optimism and quite frankly, encouragement.

Sure, it sucks that your "friends" didn't score high enough to get into a surgery program right off the bat. I don't know their personal circumstances and if they could have done better if they tried. If they were playing beer pong every weekend and assuming daddy's (or mummy's) money and connections would get them a spot... well, then obviously, my advice wasn't for them. However, if they did the best they could and still wound up having to, as you put it, enter "bullsh*t malignant prelim surgery programs" why would you begrudge this decision? Would you rather that they simply give up?

Honestly, this whole conversation is getting incredibly tedious so I won't belabor the point any further except to say this... I am firmly convinced that for those who have the will and desire, success is, more often than not, within their reach. It's really unfortunate that so many of you seem to think otherwise.
 

2012mdc

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Good lord, why must this become personal? I'm not looking for validation. I have no doubt in my abilities nor my capacity to succeed. I do, however, think that there are others out there who could use a little more optimism and quite frankly, encouragement.

Sure, it sucks that your "friends" didn't score high enough to get into a surgery program right off the bat. I don't know their personal circumstances and if they could have done better if they tried. If they were playing beer pong every weekend and assuming daddy's (or mummy's) money and connections would get them a spot... well, then obviously, my advice wasn't for them. However, if they did the best they could and still wound up having to, as you put it, enter "bullsh*t malignant prelim surgery programs" why would you begrudge this decision? Would you rather that they simply give up?

Honestly, this whole conversation is getting incredibly tedious so I won't belabor the point any further except to say this... I am firmly convinced that for those who have the will and desire, success is, more often than not, within their reach. It's really unfortunate that so many of you seem to think otherwise.

There is nothing wrong with optimism but there is something wrong with optimism without any reality.

Say someone gets a 195 on Step 1. Derm is going to be extremely tough match no matter how much will and desire they have. This is not pessimism, this is realism.

People have jumped all over you because this thread is supposed to be for advice for matching and you're essentially saying "don't worry if you don't do well on Step 1, if you try hard enough you can match into your desired specialty." Unfortunately this does not apply to the very large majority of students.
 

JackShephard MD

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Good lord, why must this become personal? I'm not looking for validation. I have no doubt in my abilities nor my capacity to succeed. I do, however, think that there are others out there who could use a little more optimism and quite frankly, encouragement.

Sure, it sucks that your "friends" didn't score high enough to get into a surgery program right off the bat. I don't know their personal circumstances and if they could have done better if they tried. If they were playing beer pong every weekend and assuming daddy's (or mummy's) money and connections would get them a spot... well, then obviously, my advice wasn't for them. However, if they did the best they could and still wound up having to, as you put it, enter "bullsh*t malignant prelim surgery programs" why would you begrudge this decision? Would you rather that they simply give up?

Honestly, this whole conversation is getting incredibly tedious so I won't belabor the point any further except to say this... I am firmly convinced that for those who have the will and desire, success is, more often than not, within their reach. It's really unfortunate that so many of you seem to think otherwise.

Honestly, you come off more prideful and self-centered in these debates than helpful/optimistic. You've assured of everyone you ability to succeed and informed us your practices scores were better than the intelligent people in your class, all while giving up false match information in a thread for matching student to advise non-matching students.

An applicant matched plastics last year with a 181-190 Step 1 score, so it's possible... I don't know what the point of this advice is. Everyone knows anything is possible, but advice is supposed to include wisdom and not unbridled false optimism.
 

drizzt3117

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Reading charting outcomes doesn't really tell you how competitive the match is; it's a cutthroat world out there. My one friend had decent but not great #s, perhaps 8 pts below the ortho average, interviewed at a decent number of programs but obviously it wasn't enough. My other friend who didn't match ortho had 253 step 1, 272 step 2, AOA, and 3 first author pubs including one in JBJS and had interviewed at 13 programs and ranked 10. You have no idea what you're talking about regarding the match, stop giving people bad advice. Derm and surgical specialty programs interview 50+ people for 3 spots. Even if they really like you and rank you 4-5, you may still not match depending on other applicants; you can be ranked highly by everyone and not match; always a bridesmaid, but never a bride.

I applied to more programs that I needed and ranked more than I had to simply because it doesn't make sense to take chances when applying to competitive specialties where everyone is really good. In the end I was ranked to match by half my rank list but you don't know that going in. You might think you're a rockstar med student but there are always better people out there; you'll meet them on the interview trail (or maybe you won't, if you apply to something you're not qualified for.

I

Good lord, why must this become personal? I'm not looking for validation. I have no doubt in my abilities nor my capacity to succeed. I do, however, think that there are others out there who could use a little more optimism and quite frankly, encouragement.

Sure, it sucks that your "friends" didn't score high enough to get into a surgery program right off the bat. I don't know their personal circumstances and if they could have done better if they tried. If they were playing beer pong every weekend and assuming daddy's (or mummy's) money and connections would get them a spot... well, then obviously, my advice wasn't for them. However, if they did the best they could and still wound up having to, as you put it, enter "bullsh*t malignant prelim surgery programs" why would you begrudge this decision? Would you rather that they simply give up?

Honestly, this whole conversation is getting incredibly tedious so I won't belabor the point any further except to say this... I am firmly convinced that for those who have the will and desire, success is, more often than not, within their reach. It's really unfortunate that so many of you seem to think otherwise.
 
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ppfizenm

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This thread was really helpful but has turned into a pissing contest.
 
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Megatron2016

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This thread was really helpful but has turned into a pissing contest.

True. It seems true that most useful threads tend to have some sort of expiration date, where they descend into....this.
 

SoundofSilver

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In terms of research experiences and publications on the "charting the outcomes" pdf, is this just med school research experiences or do people put research experience from undergrad and med school on their residency apps?

I ask because "5 or more" research experiences during only med school seems like alot...
 

ppfizenm

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In terms of research experiences and publications on the "charting the outcomes" pdf, is this just med school research experiences or do people put research experience from undergrad and med school on their residency apps?

I ask because "5 or more" research experiences during only med school seems like alot...

I'd imagine some arise from a year off to do research. Also assume some of them can be broken up into different experiences even though technically it was the same project overall.
 

drizzt3117

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In terms of research experiences and publications on the "charting the outcomes" pdf, is this just med school research experiences or do people put research experience from undergrad and med school on their residency apps?

I ask because "5 or more" research experiences during only med school seems like alot...

It's both, and includes abstracts and pubs.
 

drizzt3117

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This thread was really helpful but has turned into a pissing contest.

The thread was created to solicit advice from students who've matched (like myself and 2012mdc) to younger med students and premeds. Her advice is wrong and not supported by evidence and will only bring heartache to those that follow it.
 
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I'd avoid new schools since their curriculum is likely still in flux. It's not fun to be experimented on.
This is probably the biggest problem. The "adapting phase" could be pretty painful.

Beaumont is a great hospital though.
 

thomprya

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Good lord, why must this become personal? I'm not looking for validation. I have no doubt in my abilities nor my capacity to succeed. I do, however, think that there are others out there who could use a little more optimism and quite frankly, encouragement.

Sure, it sucks that your "friends" didn't score high enough to get into a surgery program right off the bat. I don't know their personal circumstances and if they could have done better if they tried. If they were playing beer pong every weekend and assuming daddy's (or mummy's) money and connections would get them a spot... well, then obviously, my advice wasn't for them. However, if they did the best they could and still wound up having to, as you put it, enter "bullsh*t malignant prelim surgery programs" why would you begrudge this decision? Would you rather that they simply give up?

Honestly, this whole conversation is getting incredibly tedious so I won't belabor the point any further except to say this... I am firmly convinced that for those who have the will and desire, success is, more often than not, within their reach. It's really unfortunate that so many of you seem to think otherwise.

You and I are now internet best friends, done! I agree with what you are saying. Med students are a pretty interesting group in how self-selective they are. "I only scored a 220, well ortho is out of the question" Maybe maybe not, it is definitely out of the question if you don't apply and use what options you have. It's funny how that message gets turned into:

You can do anything with a 190
No need to have a backup plan, spread your wing young child
Everyone matches every program they want

and then they promptly being debating these points. All that is being said is there are ways around crappy scores and there is no need to self select yourself right out of an area of medicine you want to match.
 

Slack3r

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Could we get this back on track? I had this thread bookmarked and subscribed, but it's been pretty useless for the last 2 pages or so.
 

drizzt3117

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You and I are now internet best friends, done! I agree with what you are saying. Med students are a pretty interesting group in how self-selective they are. "I only scored a 220, well ortho is out of the question" Maybe maybe not, it is definitely out of the question if you don't apply and use what options you have. It's funny how that message gets turned into:

You can do anything with a 190
No need to have a backup plan, spread your wing young child
Everyone matches every program they want

and then they promptly being debating these points. All that is being said is there are ways around crappy scores and there is no need to self select yourself right out of an area of medicine you want to match.

Well yes. Say you get a 220 and want to apply ortho, you can do a year of research or two, try to get close to faculty at your institution, and try to wiggle your way into a spot. Some people have success doing this, and if you're dead set on ortho, sure, it's an option.

The problem is, that doesn't always work. There's never any unfilled spots for ortho in the scramble, so your options if you don't match are severely limited. You'll be among 2000+ applicants trying to get 50 categorical spots in internal med or something from last year's data, or do a prelim surgery year with no guarantee of getting into anything or making yourself a more competitive applicant, or doing MORE research and reapplying, but the further you get away from clinical medicine, the weaker candidate you are. This is stuff you just won't really understand unless you are close to the match. If you did two years of research and a prelim and don't match you've essentially taken an amount of time equivalent to med school, used up a year of your federal funding towards residency, and accomplished NOTHING.

IMO the best strategy is to find a specialty you're competitive for that fits your personal/professional goals, and then make yourself the best possible applicant. You have to realistic in the process or you're going to be scrambling.
 

drizzt3117

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Could we get this back on track? I had this thread bookmarked and subscribed, but it's been pretty useless for the last 2 pages or so.

Personally I think this is more important than anything that's been said in the beginning of the thread. Every med student knows they should study for step 1, do research, whatever. People know very little about the mechanics of the match and what if anything happens if they don't match, and most schools really don't educate them on this. Program selection is also a big issue, as far as how many programs to apply to and which programs to apply to, program directors and administration are often not good choices in guiding students in this area either.
 
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thomprya

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Well yes. Say you get a 220 and want to apply ortho, you can do a year of research or two, try to get close to faculty at your institution, and try to wiggle your way into a spot. Some people have success doing this, and if you're dead set on ortho, sure, it's an option.

The problem is, that doesn't always work. There's never any unfilled spots for ortho in the scramble, so your options if you don't match are severely limited. You'll be among 2000+ applicants trying to get 50 categorical spots in internal med or something from last year's data, or do a prelim surgery year with no guarantee of getting into anything or making yourself a more competitive applicant, or doing MORE research and reapplying, but the further you get away from clinical medicine, the weaker candidate you are. This is stuff you just won't really understand unless you are close to the match. If you did two years of research and a prelim and don't match you've essentially taken an amount of time equivalent to med school, used up a year of your federal funding towards residency, and accomplished NOTHING.

IMO the best strategy is to find a specialty you're competitive for that fits your personal/professional goals, and then make yourself the best possible applicant. You have to realistic in the process or you're going to be scrambling.

Not to be contradictory to you but if you score a 220 realistically you probably wont match ortho, but realistically you won't know until you try and you really don't lose much (app fees? heartache?) for trying. If it was me then I would try to match ortho and have a backup specialty planned and apply to both. As I understand it you really wont get hurt much by doing this. I just don't understand the whole don't apply if you are not looking at a great score.

And to refute it before it gets brought up yeah, if you for example failed usmle twice then got a 190 ortho isn't in the cards. I get that, but for the people who are looking at the wrong side of a bell curve I don't get what they have to lose by applying.
 

MilkmanAl

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I don't get what they have to lose by applying.
Money, time, and valuable rank list spots (i.e., that top of your rank list) come to mind. Note that "money" may include a year (or more) of physician pay and that "time" is likely at least a year if the person is serious about buffing his application.
 

drizzt3117

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Not to be contradictory to you but if you score a 220 realistically you probably wont match ortho, but realistically you won't know until you try and you really don't lose much (app fees? heartache?) for trying. If it was me then I would try to match ortho and have a backup specialty planned and apply to both. As I understand it you really wont get hurt much by doing this. I just don't understand the whole don't apply if you are not looking at a great score.

That sounds like a good idea, but it's not as easy as you think; the logistics are hard to pull off. First of all, residencies interview at about the same time, so you'll probably have to make tough choices regarding which interviews to attend. You also probably don't want to interview at more than one program at the same institution because if they find out, they might throw your app out. That being said, people do dual-apply, like medicine and dermatology, or to ortho/gen surg, etc but rarely apply medicine/surgery etc. The problem is that your application will be weaker than if you applied to just one specialty. For example, if you applied ortho/gen surg with 220, you're below average for both, with almost no chance of matching ortho but a reasonable chance of matching gen surg (average is 227), however, if you prioritize ortho interviews to give yourself the best chance of success there, you'll do it at the expense of gen surg interviews. Your best option would have been to apply gen surg and apply to like 80 programs and interview at like 30 which would make your chance of matching close to 100%, whereas if you applied to fewer of both, your chances of matching into anything would be lower.

And to refute it before it gets brought up yeah, if you for example failed usmle twice then got a 190 ortho isn't in the cards. I get that, but for the people who are looking at the wrong side of a bell curve I don't get what they have to lose by applying.

Well obviously. I wasn't talking about people who were applying plastics with 190 or whatever, I'm talking about people applying ortho or ENT with 220, or gen surg with 205.

Obviously if you have like a 190 on step 1, it'll be an upward struggle for any specialty, but you should still put yourself in the best position for success; apply to lots of FM/IM/OB/Psych programs; it'll prolly cost you a couple thousand dollars on your ERAS but go to as many interviews as possible regardless of specalty and find yoruself a spot.

The biggest take home message here IMO is to be realistic and put yourself in the best position for success. People talk about "nothing risked, nothing gained" etc but this isn't the best attitude for the match. Banking on a 30% match rate with your stats is a good way to go unmatched; yes you have a chance to match, but it's miniscule, and you're better off maximizing your odds, even if it isn't exactly what you wanted to go into than risk getting something that's the opposite of what you want like prelim surgery or rural FM when you wanted to do ortho.
 

thomprya

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drizzt3117 - I appreciate the advice, it's an good point and well received. Don't want to stretch yourself out too thin since you should probably only apply to one program at any given hospital. If money and rejection were the only issues then eh, I can handle both fine. While some may think the thread had derailed a bit I find THIS info to be extremely valuable.
 

JackShephard MD

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Personally I think this is more important than anything that's been said in the beginning of the thread. Every med student knows they should study for step 1, do research, whatever. People know very little about the mechanics of the match and what if anything happens if they don't match, and most schools really don't educate them on this. Program selection is also a big issue, as far as how many programs to apply to and which programs to apply to, program directors and administration are often not good choices in guiding students in this area either.

:thumbup:
 

ppfizenm

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Personally I think this is more important than anything that's been said in the beginning of the thread. Every med student knows they should study for step 1, do research, whatever. People know very little about the mechanics of the match and what if anything happens if they don't match, and most schools really don't educate them on this. Program selection is also a big issue, as far as how many programs to apply to and which programs to apply to, program directors and administration are often not good choices in guiding students in this area either.

two pages ago yes. The same points are being belabored redundantly though.
 

normtheniner

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Personally I think this is more important than anything that's been said in the beginning of the thread. Every med student knows they should study for step 1, do research, whatever. People know very little about the mechanics of the match and what if anything happens if they don't match, and most schools really don't educate them on this. Program selection is also a big issue, as far as how many programs to apply to and which programs to apply to, program directors and administration are often not good choices in guiding students in this area either.

We (me and the rest of the first year class at my school) met in small groups with fourth years and residency directors from our school yesterday to talk about what the fourth years were going through.

It was actually very interesting and I learned a lot based on what the M4's told us about their experience. So I completely agree with you, I think its extremely important for schools to educate their students on how the match works and how to do everything possible to avoid having to experience SOAP.
 

username456789

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Also, to help put the big picture in perspective, you guys should go on over to the ERAS/NRMP sub-forum of the General Residency Issues forum and read the dozen or so threads detailing the train-wreck that is SOAP (previously the "Scramble").

Knowing what a nightmare that whole process is should convince anyone with a good head on their shoulder that - while being optimistic and reaching for the stars is great - having realistic expectations and/or backup plans that don't include fighting with 8,000 other rabid dobermans over the same couple rancid T-bone steaks is essential.

The amount of stress you cause yourself will often be inversely proportional to the amount of planning you do. Know as much as you can about the road ahead of you, and while you shouldn't live and die by the published stats for a given field, be a sponge and soak up as much info (objective or otherwise) about your potential field(s) as you can.

Ultimately, successfully matching should be one of your primary goals in medical school . . . and to this end, it is probably the last place you want to slack off. It is also not the time to skimp on finances. After dropping hundreds of thousands of dollars on medical education for 4 years, spending a little extra to apply to a few more programs or go on a few more interviews is unquestionably worth it if it means the difference between matching successfully or SOAPing/going unmatched.
 

drizzt3117

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Here's the thing. If that person put together a solid app, they could match anesthesia, gen surg, rads (community or low tier academic), IM w/e, where as after a failed cycle they'll be less competitive and would be lucky to get a decent IM match. Is that worth it when they have little chance to succeed?

agreed.

however, I do think it is OK to at least try once. If a person with 220 who had some research, good grades, good step 2, etc really really wanted ortho I think it is OK to try. But if that person doesn't get it he/she should suck it up and pick something they are more competitive for the next go around so as not to waste any more of his/her life.

a good buddy of mine with really good scores who interviewed at 10+ GENERAL surgery programs and ranked them all went UNMATCHED. No red flags. He didn't have research but still needless to say I was very surprised. This person now is still waiting on the SOAP to work itself out. Point is that the match is extremely difficult and unpredictable. You can try and try all you want but nothing is a guarantee. Step 1 is very important. In fact everything is very important.

Don't give up on your dreams but there comes a time when you have to be realistic about your chances and you then have to decide if your dream is worth the risk. To some it is. But don't listen to ANYONE (and that means deans too) who say you'll be fine. That is absolutely false even if your numbers seem OK. It is 10000% false if your numbers are not that great and especially if you don't have significant ECs.
 

SteinUmStein

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Here's the thing. If that person put together a solid app, they could match anesthesia, gen surg, rads (community or low tier academic), IM w/e, where as after a failed cycle they'll be less competitive and would be lucky to get a decent IM match. Is that worth it when they have little chance to succeed?

Agreed. I think what drizzt is getting at that some people aren't grasping (and that is an important point relevant to the original purpose of the thread) is that the match is not like applying to med school, grad school, or any job. "If at first you don't succeed, try, try again" does not apply in a system where the best chance you'll ever have is your first one. Even if you take time off to do research you may be weakening your overall application if you don't publish, and the further you get from clinical medicine the more your chances diminish.

This is not to crush people's dreams, it's to allow them to realistically assess what fields they most enjoy that are within their reach. If everyone who dreamed of derm/ortho/plastics M1 and M2 year applied to those fields regardless of their scores and clinical grades or even split their application with a back-up field, they may end up with a much worse outcome when the dust settles than if they had identified a field within their reach that they also enjoyed to focus on.
 

loveoforganic

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Does the previous attempt to match show up, or would a gap year be something you couldn't directly tell the reason for?
 

gutonc

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Does the previous attempt to match show up, or would a gap year be something you couldn't directly tell the reason for?

The previous match attempt will only be obvious if you apply to the same program(s) the second time, and then, only they will know.

BUT...you will be asked (and must tell the truth about) why you had a gap year. And you'd best have a good reason for why you didn't match, and what you did to better yourself in the interim.

If you're trying to hide something, you will fail. While the Match itself is biased toward the applicant, the overall process is biased toward the programs. You will have to explain anything and everything in your application that deviates from "the norm."
 

loveoforganic

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Thanks for the info. I'm still a long way out, so just curiosity of the way it is, not looking for loopholes
 

drizzt3117

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Does the previous attempt to match show up, or would a gap year be something you couldn't directly tell the reason for?

US grads have a much lower match rate than us seniors (like 30% lower) and with the demise of pre-match offers...
 

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I'm just sitting here having matched into neurosurgery with a 222 on Step 1 grinning like an idiot... With an average Step 1 score of 239, neurosurgery is obviously a competitive field, but I had a very strong and well rounded application. I sent out 70 applications, got 27 invites, and went on 16 interviews. I received a lot of good feedback. One of the unfilled programs is on my list, so I know that I matched in my top-9.

I am, of course, very much the exception, not the rule when it comes to these things.

EDIT: reading back it appears that I'm tooting my own horn a little too much. What I'm trying to offer is first hand experience of matching into a competitive specialty with a sub-optimal Step1 score. Its important to emphasize that it was not at all an easy process for me, and included tons of stomach churning days waiting for the match results. And I had to set a laser-like focus on the field very early in college and continue working in the field through med school to have had the opportunity. This may not be applicable to someone who hasnt put in the same amount of time into a single specialty.
 
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