Need Advice: Failed Step 1 and Residency

[biomedperson]

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I failed step 1 due to illness, if I take it again and do well (above 220) will I still have a chance at a decent residency? I'm not interested in anything super competitive like ortho, derm, radio, or optho. I'm interested in ob/gyn, surgery, int med, family med, and EM. My grades were just average, and I have a few publications and extracurricular activities.

Has anyone gone thru this already or have any advice? Thanks.

 

[elwademd]

I failed step 1 due to illness, if I take it again and do well (above 220) will I still have a chance at a decent residency? I'm not interested in anything super competitive like ortho, derm, radio, or optho. I'm interested in ob/gyn, surgery, int med, family med, and EM. My grades were just average, and I have a few publications and extracurricular activities.

Has anyone gone thru this already or have any advice? Thanks.

concentrate on passing step 1. if you don't pass step 1, you have nothing... if you pass step 1, things may work out for you.

there are people who have failed step 1 and have gone onto residency and never looked back.

you'll likely have to explain in your eras application or in interviews as to why you think you failed step 1, what you learned about yourself, and how you were able to correct it.

 

[Blade28]

OK, first, you can't be interested in EVERYTHING yet! Wait until after your MS-III rotations are over. 🙂

Why use 220 as an arbitrary goal score? All you can do is study hard and try your best to rock the exam the second time around. That's your only task.

 

[Pir8DeacDoc]

are you at an American allopathic school? That will help..


Also, you should probably not include surgery in that list of not so competitive things. GS has become pretty darn competitive, at least from looking at the numbers. I have no first hand knowledge.

 

[dream2008]

GS is not so competitive!!!

 

[Blade28]

GS is not so competitive!!!

No?

The last 2-3 years, there have been a TON of unmatched US seniors, not to mention only a handful of Categorical spots available during the Scramble.

 

[Tired]

GS is not so competitive!!!

You wish.

 

[dream2008]

93 us seniors did not match in 2007. about 10% of applicants.

for ob/gyn, 11% us seniors did not match in 2007, 11% for rehab medicine. both of them are not considered to be competitive speciality. So GS is not competitve, either. At least in my opinion.

 

[Blade28]

93 us seniors did not match in 2007. about 10% of applicants.

for ob/gyn, 11% us seniors did not match in 2007, 11% for rehab medicine. both of them are not considered to be competitive speciality. So GS is not competitve, either. At least in my opinion.

Partly this is due to self-selection, though - a lot of people not competitive for certain fields won't bother applying.

For example, Rads (a pretty damn competitive match) had 84 US seniors not matching, out of 915 total US senior applicants, for an unmatched rate of 9.2%. Does this mean it's less competitive than G Surg or OB/GYN? No way.

I would also look at things such as average Step 1 score of matched applicants, AOA status, research and publications/presentations, etc.

G Surg: mean Step 1 222, 12.1% AOA, mean research experiences 2.1, mean publications/presentations 2.2.

OB/GYN: mean Step 1 214, 11.8% AOA, mean research experiences 1.8, mean publications/presentations 1.4.

Rads: mean Step 1 235, 25.8% AOA, mean research experiences 2.5, mean publications/presentations 2.8.

BTW, don't mean to pick on OB/GYN or anything - just using them as an example since you mentioned them.

Reference: http://www.nrmp.org/data/chartingoutcomes2007.pdf

 

[dream2008]

just want to point out that GS's number is more close to ob/gyn than rad. does that tell you something?

 

[Blade28]

just want to point out that GS's number is more close to ob/gyn than rad. does that tell you something?

I'm just saying, it's become a LOT more competitive the last 3 years.

 

[dream2008]

I'm just saying, it's become a LOT more competitive the last 3 years.

Not sure where you get this from.

2005 average step 1 is 222, % not match is >10%, close to 20%

2007 average step 1 is 222, % not match is =10%

 

[Winged Scapula]

just want to point out that GS's number is more close to ob/gyn than rad. does that tell you something?

Uh....more competitive than OB/Gyn but less than Rads?

Do you have some sort of axe to grind? Regardless of your opinion on the matter, those who are involved can tell you that:

applications are way up from qualified applicants
applicant stats are up
more people are going unmatched
fewer positions open in the scramble

Comparing 2005 to 2007 data is not particularly helpful, as the increase in popularity and competitiveness of GS started in 2004. As it has gotten more and more competitive, the applicant pool self-selects.

All the above posters were trying to do is to point out to the OP that Gen Surg does not belong in the same category as Ob/Gyn, IM and FP when talking about overall competitiveness.

 

[Blade28]

Not sure where you get this from.

2005 average step 1 is 222, % not match is >10%, close to 20%

2007 average step 1 is 222, % not match is =10%

So 2005, 2006, 2007 matches = last 3 years.

Pretty sure it was much less popular before that.

 

[dream2008]

Uh....more competitive than OB/Gyn but less than Rads?

Do you have some sort of axe to grind? Regardless of your opinion on the matter, those who are involved can tell you that:

applications are way up from qualified applicants
applicant stats are up
more people are going unmatched
fewer positions open in the scramble

Comparing 2005 to 2007 data is not particularly helpful, as the increase in popularity and competitiveness of GS started in 2004. As it has gotten more and more competitive, the applicant pool self-selects.

All the above posters were trying to do is to point out to the OP that Gen Surg does not belong in the same category as Ob/Gyn, IM and FP when talking about overall competitiveness.

Any data to back up your claim that "the increase in popularity and competitiveness of GS started in 2004"? please do not tell your experience as everyone had difference/bias when talking about "experience".

" applicant stats are up" --- you can see above posts why this is not true at least by comparing 2005 with 2007.

"more people are going unmatched" -- same to this one. not true at least from 2005 to 2007.

I just want to point out that please don't just listen to what people think. Look at HARD DATA when it is available.

Btw, I am not going to convince GS about noncompetitiveness of GS. Just want OP know that GS is still possible for him/her.

 

[dream2008]

I am arguing with asst mod and admin..... Am I doomed?😛

 

[dream2008]

Pretty sure it was much less popular before that.

sense some weakness here. how many time you hear someone say "pretty sure" K/Na/Cr/Bun is normal and found out later that K =3.0,Cr=1.5,BUN is elevated.🙂

 

[Blade28]

" applicant stats are up" --- you can see above posts why this is not true at least by comparing 2005 with 2007.

"more people are going unmatched" -- same to this one. not true at least from 2005 to 2007.

Again, popularity of G Surg picked up over the past 3 years. That's the 2005, 2006, and 2007 Matches.

You need to look at stats from before 2005 to see how it was before.

sense some weakness here. how many time you hear someone say "pretty sure" K/Na/Cr/Bun is normal and found out later that K =3.0,Cr=1.5,BUN is elevated.🙂

😕 Uh, no.

And trust me, as someone who's done their fair share of presentations/card rounds/team rounds/pre-rounds/attending rounds/work rounds/etc. over the past 2 years of residency, I don't tend to make up labs. 🙂

 

[dream2008]

And trust me, as someone who's done their fair share of presentations/card rounds/team rounds/pre-rounds/attending rounds/work rounds/etc. over the past 2 years of residency, I don't tend to make up labs. 🙂

Just kidding.😀

I think OP has his/her own conclusion by now. I don't want to argue any more.🙂

btw, what is card round?

 

[Blade28]

I think OP has his/her own conclusion by now. I don't want to argue any more.🙂

Agreed! 👍

btw, what is card round?

Card rounds, or "card flip," is when your team gathers, and the senior resident traditionally flips through their patient cards, one at a time, while you present your findings from pre-rounds. The difference in surgery is that they don't have "cards" (that's more of a Medicine thing) - usually just a patient census printed on a single sheet of paper.

 

[Winged Scapula]

Any data to back up your claim that "the increase in popularity and competitiveness of GS started in 2004"? please do not tell your experience as everyone had difference/bias when talking about "experience".

Sure...I could find it, but I'm too lazy to do so. But there is something to be said for an attending general surgeon who was involved in the interview process every year during residency and completed residency during the period in question.

Then again, I'm sure as a 4th year medical student applying to internal medicine you know more about the process than I.

" applicant stats are up" --- you can see above posts why this is not true at least by comparing 2005 with 2007.

All you've provided is the average Step 1 score from 2005 and 2007. Without looking at the average before 2005, your argument that general surgery is not more competitive in the years prior holds no water. A review of the data from the NRMP and JAMA published every year will tell you that the average Step 1 score (if you are intent on using that to measure competitiveness) is higher now than it was before 2005.

"more people are going unmatched" -- same to this one. not true at least from 2005 to 2007.

I was not the one who said that competitiveness increased in 2005. You are arguing with the wrong person. I believe the competitiveness started around 2003-2004. In 2003 the field was "shocked" because only 9 categorical positions were open that year after the match; the following year it dropped to 2 and subsequently to 1.

Btw, I am not going to convince GS about noncompetitiveness of GS. Just want OP know that GS is still possible for him/her.

That's where you are wrong. I am perfectly happy to tell you that I matched during the nadir of competitiveness...I have no ego involved in believing my specialty is the most competitive out there. But the facts, even if I don't produce them here, are available and support the contention (as does my extensive experience but you've discounted that).

Your final sentence is perfectly legit...but your initial point to the OP was NOT that Gen Surg is possible but rather that it is NOT competitive. Two entirely different concepts, IMHO.

 

[Winged Scapula]

sense some weakness here. how many time you hear someone say "pretty sure" K/Na/Cr/Bun is normal and found out later that K =3.0,Cr=1.5,BUN is elevated.🙂

Sorry that only happens with weak or stupid residents. Maybe you've seen it, but in my program you didn't dare do that because our attendings knew how to work the EMR and often knew the labs they were asking about. Word of warning for my students and residents: I look up the labs myself. Don't say you weren't told.

Its sad to see an intern or student taken down because of lying...

 

[dream2008]

man... want to dispute all my points w/o a single data. very very weak... can you really find any supporting data? .... probably not, i guess.

but anyway, who care if GS is competitive. OP still have a chance, but probably need some hard-working, or maybe he/she won't even like GS in the end.

Still think GS is not competitive. Sorry to let you know. 🙁

 

[Winged Scapula]

man... want to dispute all my points w/o a single data. very very weak... can you really find any supporting data? .... probably not, i guess.

The data is available back to 2003 on the NRMP website; http://www.nrmp.org

If you want more, I invite YOU to look it up. I don't need to.

Still think GS is not competitive. Sorry to let you know. 🙁

You don't have to apologize. As I said, I don't care whether its competitive or not...I got my spot.

Pssst....internal medicine is NOT competitive. Thought you would like to know.

 

[dream2008]

Sorry that only happens with weak or stupid residents. Maybe you've seen it, but in my program you didn't dare do that because our attendings knew how to work the EMR and often knew the labs they were asking about. Word of warning for my students and residents: I look up the labs myself. Don't say you weren't told.

Its sad to see an intern or student taken down because of lying...

I saw attendings made up things, too. No kidding.

 

[dream2008]

The data is available back to 2003 on the NRMP website; http://www.nrmp.org

If you want more, I invite YOU to look it up. I don't need to.



You don't have to apologize. As I said, I don't care whether its competitive or not...I got my spot.

Pssst....internal medicine is NOT competitive. Thought you would like to know.

I know that IM is not competitive, that's why I apply IM.😀😀😀

btw, nrmp probably had data back in 1800s... whether anyone can find those claim-to-exist data is a question by itself.

 

[Winged Scapula]

I saw attendings made up things, too. No kidding.

That's too bad...sets a poor example for students and co-workers.

 

[Winged Scapula]

I know that IM is not competitive, that's why I apply IM.😀😀😀

btw, nrmp probably had data back in 1800s... whether anyone can find those claim-to-exist data is a question by itself.

The data is also available in every September Medical Education issue of JAMA. If you have a subscription you can take a look at the dizzying number of tables and charts on-line, which I think you can see at least 15 years of issues back electronically.

At any rate, this is stupid...general surgery is not the most competitive specialty but to inform the OP that it is in the same category as Ob/Gyn, IM and FP is to give him/her incorrect information.

 

[Pir8DeacDoc]

No reason to indulge in this tomfoolery any further. Clearly this poster has some agenda.


All I was doing was making a simple statement of fact that GS is more competitive than IM,FP, Ob-Gyn. Personally I don't have a dog in the fight. However, I don't want the OP to lump these fields together in competitiveness when they just aren't.

 

[Winged Scapula]

No reason to indulge in this tomfoolery any further. Clearly this poster has some agenda.


All I was doing was making a simple statement of fact that GS is more competitive than IM,FP, Ob-Gyn. Personally I don't have a dog in the fight. However, I don't want the OP to lump these fields together in competitiveness when they just aren't.

Exactly my point as well...but I agree, our IM friend seems to have some agenda which involves derogating other specialties and passing around false information.

 

[dream2008]

I don't think that OP will have so much more advantage when applying ob/gyn, EM, IM, FM comparing to GS. And honestly, OP does not think GS is THAT competitive, either, dude!!! I am not the only one who think GS is getting less competitive now.

Average students with less than average stats can still easily match if they want to go anywhere.

please don't bite me, dogs.....

 

[Miami_med]

GS is probably in the same middle of the road category as EM and gas. These are popular enough that most of the positions are sought out by US grads, and the less competitive programs have enough IMG applicants to fill any remaining spots. A close look at the data shows that there are enough spots for US grads if they apply broadly. There is definitely a split between the "high level" and "low level" programs as well, with the Harvards being as competative as anything and some of the small community programs that wouldn't fill were it not for IMGs. Now, rumor has it that pre- "80 hour" work week, many fewer people were interested.

P.S. this isn't to disparage IMGs, but it is a reflection of the fact that programs generally go after US grads first.

 

[dream2008]

"Now, rumor has it that pre- "80 hour" work week, many fewer people were interested."

I thought 80 hour rule was before 2004.....what exactly happened in 2004 that make people feel that GS was getting competitive/popular at that time?

 

[Winged Scapula]

"Now, rumor has it that pre- "80 hour" work week, many fewer people were interested."

I thought 80 hour rule was before 2004.....what exactly happened in 2004 that make people feel that GS was getting competitive/popular at that time?

The 2004 match was the first after the 2003 institution of the 80 hr workweek. But I believe that most specialties run in cycles, generally 5-7 years in length, of popularity. Surgery had hit its nadir around 2000, so it was time for apps to increase, regardless of the 80 hr workweek.

 

[TRAMD]

I failed step 1 due to illness, if I take it again and do well (above 220) will I still have a chance at a decent residency? I'm not interested in anything super competitive like ortho, derm, radio, or optho. I'm interested in ob/gyn, surgery, int med, family med, and EM. My grades were just average, and I have a few publications and extracurricular activities.

Has anyone gone thru this already or have any advice? Thanks.

You didn't mention any highly competitive residencies so you should be ok with an average step 1 (215) even if it is a retake. Try to do better on Step 2 and take it early. My perception of the competitiveness of these specialties is as follows:

1. EM
2. Gen Surg
3. OB/GYN
4. IM
5. FM

The first three are all average competitive-wise and the last two are not competitive and you should be able to match into them with ANY passing step 1. There are, of course, competitive and non-competitive residencies in all these fields so I wouldn't give up on whichever one you decide to pursue.