Need some help making a difficult decision...

[APDoc]

I'm currently a 2nd year med student prepping for my Step I, but I'm coming to the conclusion that I'm probably not going to be as ready as I would like come test time. Our 3rd year rotations start in early July, and we must have Step I completed before we can begin rotations. I spoke with one of our advisors about the potential consequences of delaying my Step I test date and not starting 3rd year rotations until September. He stated that few students do better on Step I by prolonging their study time for a month or two, and due to the delay in third year rotations students end up losing time for away rotations and interviews because they're trying to catch up during the 4th year in order to graduate on time.

I'm in a diffucult predicament because at the moment, Anesthesia is probably at the top of my list of career choices, and I don't want to not perform well on Step I (or worse yet fail it) and hurt my chances for interviews. On the other hand, will it hurt me more to delay 3rd year rotations and lose important interview time in December and away rotation time because I'll still be completing 3rd year rotations through August?

I guess what I'm looking for is someone who may have had or knows someone who had such a delay so they can give me some advice about what to do. I know I may sound like the typical 2nd year student getting nervous as Step I approaches, but I have never been a good standardized test taker, and my previous MCAT scores and shelf exam scores (barely passing in some cases) reflect this. I just don't want to sell myself short and not be competitive for solid anesthesia programs just because my Step I score was poor-- I want to give myself every opportunity that I can to do well on it.

Any advice from people who could help would be much appreciated. Thanks in advance.

- APDoc

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[powermd]

I'm currently a 2nd year med student prepping for my Step I, but I'm coming to the conclusion that I'm probably not going to be as ready as I would like come test time. Our 3rd year rotations start in early July, and we must have Step I completed before we can begin rotations. I spoke with one of our advisors about the potential consequences of delaying my Step I test date and not starting 3rd year rotations until September. He stated that few students do better on Step I by prolonging their study time for a month or two, and due to the delay in third year rotations students end up losing time for away rotations and interviews because they're trying to catch up during the 4th year in order to graduate on time.

I'm in a diffucult predicament because at the moment, Anesthesia is probably at the top of my list of career choices, and I don't want to not perform well on Step I (or worse yet fail it) and hurt my chances for interviews. On the other hand, will it hurt me more to delay 3rd year rotations and lose important interview time in December and away rotation time because I'll still be completing 3rd year rotations through August?

I guess what I'm looking for is someone who may have had or knows someone who had such a delay so they can give me some advice about what to do. I know I may sound like the typical 2nd year student getting nervous as Step I approaches, but I have never been a good standardized test taker, and my previous MCAT scores and shelf exam scores (barely passing in some cases) reflect this. I just don't want to sell myself short and not be competitive for solid anesthesia programs just because my Step I score was poor-- I want to give myself every opportunity that I can to do well on it.

Any advice from people who could help would be much appreciated. Thanks in advance.

- APDoc

How are you preparing for the test? 3 more weeks ought to be enough time.

A good barometer for step 1 performance is Kaplan's Q-bank. If you can score 60% or better on most tests, you should be good to go for the real thing. I was scoring 65-75% and got a 229 on step 1. The prep I found most useful was the Board Simulator Series books. They don't simulate anything, but the questions are hard, the answers are well-explained, and you come out with a very solid review of all the basic science concepts. Don't get carried away with rote memorization (First Aid, High Yield, etc), that is not as well rewarded as thoroughly understanding the concepts.

 

[gaslady]

I guess the answer to your question depends on why exactly you don't feel ready and how delaying it would allow you to better prepare.

Keep in mind that there is always more you could know. It is highly unlikely that you would ever feel fully prepared or as prepared as you would like to take this test. Dedicated study time for Step 1 is very important. However, it really does just solidify what you have already learned. The majority of your preparation is the preclinical course work. The only thing I really remember from when I studied was that the Kaplan question bank was the most representative of the actual exam.

Anesthesia has gotten more competitive than is used to be. However, this is relative to when they couldn't fill the spots and a decent US grad can still get a spot a a good program. You don't need to ace the exam to get a good spot.

If you have a specific deficiency than delaying the exam might help, if and only if you have a specific plan to deal with it. The more you delay it the more you will build up the whole exam in your mind and make it a bigger deal than it is.

 

[2ndyear]

I agree with the above, just hang in there! Step 1 sucks. You'll get through it. The q-bank suggestion is right on, if you haven't enrolled in it, do it now. If you can get around 60% on there, you will pass and do well. Don't let your MCAT and shelf scores get you down. Step 1 is a different test. You'll never feel fully prepared. Even during the test there will be more than a few questions that you won't know. You'll probably walk out thinking that you failed. This is all normal. I thought I failed Step 2 a few months ago when I came out too. These tests are hard, but passing them isn't. I'd say go for q-bank. Really analyze where you are at by taking a few tests. If you are at 50-55% then study your weak areas and you can do well. Remember, even q-bank doesn't correlate perfectly to Step 1 in terms of percentage. I have heard estimates of around 50-55% of questions correct to get a passing score. Look on the bright side, that's half that you can get wrong!

As far as Step 1 scores and matching anesthesiology goes, there is room to work even with a below average score. Yeah, you might not get interviews at the most competitive programs, but there are very solid programs out there, including big university programs that don't screen by really high scores. But you're not at that point yet. Take each step in this process in due time, right now focus on doing as well as you can possibly do on Step 1.

Good luck, and know that this will all be over in less than a month!

 

[APDoc]

I appreciate the advice and encouragement concerning Step I. I will do my best to be ready for the big day!

However, if by chance I were to delay my rotations, can anyone here comment on the effects it would have on my fourth year from personal experience? I'm just curious as to how the interview time and away rotations would be affected. Again, thanks in advance for everyone's advice!

 

[bchang74]

I'm currently a 2nd year med student prepping for my Step I, but I'm coming to the conclusion that I'm probably not going to be as ready as I would like come test time. Our 3rd year rotations start in early July, and we must have Step I completed before we can begin rotations. I spoke with one of our advisors about the potential consequences of delaying my Step I test date and not starting 3rd year rotations until September. He stated that few students do better on Step I by prolonging their study time for a month or two, and due to the delay in third year rotations students end up losing time for away rotations and interviews because they're trying to catch up during the 4th year in order to graduate on time.

I'm in a diffucult predicament because at the moment, Anesthesia is probably at the top of my list of career choices, and I don't want to not perform well on Step I (or worse yet fail it) and hurt my chances for interviews. On the other hand, will it hurt me more to delay 3rd year rotations and lose important interview time in December and away rotation time because I'll still be completing 3rd year rotations through August?

I guess what I'm looking for is someone who may have had or knows someone who had such a delay so they can give me some advice about what to do. I know I may sound like the typical 2nd year student getting nervous as Step I approaches, but I have never been a good standardized test taker, and my previous MCAT scores and shelf exam scores (barely passing in some cases) reflect this. I just don't want to sell myself short and not be competitive for solid anesthesia programs just because my Step I score was poor-- I want to give myself every opportunity that I can to do well on it.

Any advice from people who could help would be much appreciated. Thanks in advance.

- APDoc

Dear APDoc,

First off, i would like to agree with everybody else and say that there is still time for you to cram and do well on Step I. I would start taking as many practice tests as you can and reading / rereading First Aid....but anyway...


I know two people who delayed Step I. In the first case, he delayed taking USMLE Step I until August, and started their 3rd year late, and he matched at a very good anesthesia program this past march.

His 3rd year schedule was a bit messed up....he didn't even do anesthesia until summer / fall 2003, and he just finished some up some of his required courses this past month, but he still did it. I think that he did benefit from the extra study time, but he also did an any rotation at the place that he matched at and did really well / made a good impression with the residents / program director / faculty members. All of his rotations were also delayed...he did not do his away rotation at the place that he matched until january / february. If you are really going to delay your third year and want to do away rotations, make sure that you have at least completed the core requirements early that the away rotation school requires before securing the away rotation spot.

In another case (this is kind of funny), my med school classmate was goofing around the night before Step I by sticking Q-tips in his ears and making goofy faces at his girlfriend, when his girlfriend tried to slap him away, she ruptured his ear drum. My friend, then missed day one of Step I (we took it in June 1998) because he was in the ER, and had to take the make up exam in August 1998....he ended up taking the rest of that year off and doing research, but ultimately matched at Mass Eye & Ear for Optho.....but, anyway....

I guess, ultimately, whenever you take Step I, make sure that you do well, and if you are not a strong exam taker, you have to strengthen your application by doing away rotations / getting good letters of rec...

Hope that helps,
ben

 

[moha]

I actually took my Step 1 in August because I was sick...I ended up studying for about a good one month for the test, and if I had studied longer I don't think it would have made a difference. I'm glad I took the time off because I had not studied before hand and would have probably failed the test. However, I now have so much of my fourth year filled up where as other students will be done in March 2005. I do have about 2 months during my fourth year off, so it won't come in the way of interview time, etc. Some things to think about though are:
1. Step 2 - when are you going to take it and are you going to need time off to study for this during fourth year? Don't forget we now have to take the CAE as well!!!
2. Grades - some of your 3rd year grades may not show up on your transcripts by the time you apply....I'm not sure yet if I can send in those grades at a later time.
3. LORs - I would suggest not pushing off a big rotation until 4th year if you are looking for a letter from them.
4. Taking time off just because you aren't prepared for the test may not look too good unless you can come up with another valid reason...you may have to explain this to residency programs.
5. You may want to take some elective rotations during the time off you are given in the 3rd year to minimize time lost during fourth year.

 

[APDoc]

As I expected, it sounds like delaying 3rd year rotations can be done, but not without some extra planning and work to make up for lost time. I do have a question for you about your friend that matched into anesthesia though. Did he interview at the place he did his away rotation at before he rotated there? If so, is that common? I know that the prime interview season is between November and January, and since his 3rd year rotations were delayed I would imagine he was heavy into doing 4th year rotations during that interview time as well. Did he have any problems getting his interviews scheduled or any problems getting to them while he was doing his mandatory 4th year rotations? Also, how can you find out what an away rotation requires before you go to do it? I apologize for the numerous questions, but I'm just trying to figure some things out here since I'm not real up to speed on the interviews and away rotations. Thanks again for the reply Ben.

 

[APDoc]

At our school, we have to have all of our 3rd year clerkships finished before we can start 4th year rotations/electives. Also, if you're getting two months off during your 4th year after delaying your 3rd year rotations, are you still going to graduate in May? If I delay the test, I would like to still graduate on time if at all possible.

 

[2ndyear]

Just a follow up post regarding timing: At my school we weren't allowed to do 4th year rotations until September. If you're worried about doing your first anesthesiology rotation in September, don't worry too much. It all worked out fine for me, just make sure you have a solid plan in place when you get there. If you have two interview or 'vacation' months in your 4th year schedule, could you take only one and still delay starting 3rd year but still graduate on time? My school also only allowed one interview month, but it worked out fine. November is a pretty light month interview-wise. I had one, maybe two right at the very end. I took December off and was gone pretty much non-stop. January I did an easy elective and was gone every weekend and a few week days to interview. I had a few in February too, another light rotation.

Keep studying!

 

[giznut12]

I just had a question concerning the USMLE...It was said that most people come out of the test feeling as if they failed. I actually felt like I did very well. It seemed like there were 5-10 ?'s on every block that I struggled with along with a few questions that I missed bc of pure stupidity. If I were to get around 70-75% of the questions correct on the actual exam, what kind of score should I expect? I was shooting for a 220-230. The anxiety of waiting for 6 weeks is going to kill me. Can anyone give me an estimate? Thanks.

 

[Lonestar]

you will get a 234, because thats how I felt before I got my results. 😀

 

[bchang74]

As I expected, it sounds like delaying 3rd year rotations can be done, but not without some extra planning and work to make up for lost time. I do have a question for you about your friend that matched into anesthesia though. Did he interview at the place he did his away rotation at before he rotated there? If so, is that common? I know that the prime interview season is between November and January, and since his 3rd year rotations were delayed I would imagine he was heavy into doing 4th year rotations during that interview time as well. Did he have any problems getting his interviews scheduled or any problems getting to them while he was doing his mandatory 4th year rotations? Also, how can you find out what an away rotation requires before you go to do it? I apologize for the numerous questions, but I'm just trying to figure some things out here since I'm not real up to speed on the interviews and away rotations. Thanks again for the reply Ben.

Dear APDoc, to answer your questions:

1. Regarding my friend that we have been discussing: he did interview at the place that he matched prior to his away rotation there (interview in January, away rotation end of january / february). I would say that doing it this way is not very common, mostly because people do away rotations at places they really want to match prior to interview day, so that they may run into people / interview with people who they have worked with.

2. He actually did have some trouble getting away to do interviews while doing his mandatory rotations. His school was very anal about working a certain number of shifts / week, but everything worked out. Ultimately, most of your attendings understand that you have to interview, and they aren't going to stop you, IMHO.

3. You should call the place where you are going to do your away rotation and explain to them that you delayed starting your 3rd year and ask them if it would be a problem if you haven't completed all of your mandatory 3rd year rotations prior to starting your away rotation. For example, my friend had not done his neurology rotation (mandatory at his school), until after the match, the place where he matched didn't really care when he was going pass neurology, as long as he did it prior to graduating 😉.

 

[moha]

At our school, we have to have all of our 3rd year clerkships finished before we can start 4th year rotations/electives. Also, if you're getting two months off during your 4th year after delaying your 3rd year rotations, are you still going to graduate in May? If I delay the test, I would like to still graduate on time if at all possible.

I will be graduating on time...there's a lot of flexibility at my school, so I would suggest talking with the person in charge of scheduling to see what you can make of it.