Medical Not sure what speciality to apply to, please advise!

[GoSpursGo]

Hello,

I'd really appreciate some advice. I'm a 3rd year med student at a state DO school. I need help deciding and strategizing on what speciality to apply to this September. My Level 1 score is 458. I am planning on taking Step 1 soon. In addition to my low COMLEX, I also had two course failures during 2nd year, both remediated and passed.

Currently I am trying to plan my 4th year schedule and I have no idea what to do. I think if I can get a decent score on step 1 (say 220s) I will have more options open to me. I am interested in DR, anesthesia, and pathology. I don't find pathology particularly interesting but I've read that the lifestyle and hours are good and that is important to me. I really dislike clinic. I'm on family med right now and its awful. I can't see myself doing it long term.

I've been looking at the NRMP match data for 2020 and although DR has an average step 1 of 240, it seems people have some success even with lower scores. 9/11 DOs matched with COMLEX 451-500 and 18/19 DOs matched with a step 1 of 220-230.

Is there any hope for me for DR? I am willing to apply to low tier and community programs and go anywhere. What would I need to do in the next few months to match DR? Can I make up for my low COMLEX with step 1? Am I better off focusing on pathology even though it doesn't interest me as much and the job market is bad?

Thanks for the help.

(I'm asking this for my husband btw, I know my sig says c/o 2025)

Let's just start and say that anesthesiology would be extremely risky. <50% with that COMLEX score range matched last year. With the extra red flag of multiple remediated courses, unless your husband is truly committed to anesthesiology and couldn't see himself doing anything else then I think he should avoid that.

DR, there's a chance, but again those who matched in that app range likely did not have the additional red flags and/or may not have scored on the low end. A higher step 1 score certainly could help, but given prior academic struggles really make sure that you are scoring ABOVE your target score before you take the test, as another low score would really hurt you.

Path is certainly within reach.

Bottom line, at some point you have to decide whether you're willing to take the risk of failing to match in exchange for shooting for a specialty that appeals to you more. None of us can help you make that personal valuation. If you do decide to shoot for a specialty where failing to match is possible, then you really need to have a good idea going in of what you would do in a potential gap year.

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[TheBoneDoctah]

Yeah we are thinking he should play it safe and apply pathology. That way he would have more options as far as location or university programs as well. Thanks for the info.

Your chance of matching anesthesia or radiology are very low with that COMLEX score. If you scored well 230+ on Step 1, you MAY have a shot, but your academic record thus far doesn't make me too confident that would happen. Also, a low Step score will actually hurt you so you may not want to take it at all.

The last 2-3 years have been rough for DR and anesthesia matches. There are plenty of applicants with good scores and no red flags not getting spots.

IMO, I would shoot for pathology, pediatrics, family medicine, or internal medicine (maybe anesthesia if you can swing a 220+, but would still apply to one of the four specialties as a backup.) It is just too risky and if you don't match, now you have yet ANOTHER red flag on your application.