now that you've gotten your score, are you considering different fields of med?

[oreosandsake]

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my friend and I were having this discussion today on the way to the hospital. so, if you suddenly find yourself competitive for one of the ROAD specialties, is it responsible (to yourself) to take a closer look at those fields?

and yes, of course you should do something you have passion for (PM&R for myself).

My friend and I always disliked derm in school, yet now that he's competitive for it, he's considering exploring deeper...


on the other hand, my other friend who scored poorly feels like his options are limited to psych and fp.

just wondering how others are dealing with their scores

 

[MSKalltheway]

my friend and I were having this discussion today on the way to the hospital. so, if you suddenly find yourself competitive for one of the ROAD specialties, is it responsible (to yourself) to take a closer look at those fields?

and yes, of course you should do something you have passion for (PM&R for myself).

My friend and I always disliked derm in school, yet now that he's competitive for it, he's considering exploring deeper...


on the other hand, my other friend who scored poorly feels like his options are limited to psych and fp.

just wondering how others are dealing with their scores

I'm with you bro, I'm still PM&R all the way even after getting my score back. I'll be keeping my digits to myself, but I'm competitive for most things after taking that beast, and I dont think that suddenly looking at a field just because I could match would be responsible. In fact, its actually a pet peeve of mine.

I get annoyed when someone interested in IM, EM and Psych gets a 260 and suddenly decides Rad Onc, Derm and Plastics are the way to go. You should shoot for what you are interested in from the beginning. I think if you "consider" other things out of the blue after a high board score, you should think about why you are in medicine in the first place.

Maybe I'm just extra blunt since I'm in the middle of an overnight call and I'll probs get flamed for saying that, but I dont really care. Trying to match derm or something just cause you can is a sellout.

 

[LadyWolverine]

Agreed. It's one thing if you have always been interested in a particular competitive specialty, unsure of what you want to do, or keeping your options open. It's another thing entirely to do a 180 away from what you intended to go into in the first place, or to suddenly become interested in a specialty just because you are now "competitive" based on Step 1 scores.

Besides, it's a pretty big assumption that just because you did well on Step 1, you will remain ultra-competitive after 3rd/4th year. If I've learned anything in med school, it's to take things one day at a time, roll with what comes at you, and, above all, never assume anything.

Don't count your chickens before they've hatched (and other random assorted cliches).

Path, Rads, and EM are still looking just as enticing as they were before. 🙂 (Unlike MSK, I'm one of those "all over the map" med students).

 

[ZonaRidicularis]

z

 

[diosa428]

I don't think it's necessarily your "responsibility" to explore other career paths, but I don't see what's wrong with looking at some things that you weren't otherwise thinking about. Just because a person decides that maybe they'll do a rotation in derm doesn't mean that, at the end of the day, they'll be a dermatologist. I don't want to be a dermatologist, but I'm going to do a derm rotation during 4th year anyway b/c the hours are good. Maybe I'll like it. You don't know until you try it. FYI, you may think you'll like something, but rotations will likely change many minds next year. I honestly think that pursuing something that you decided you might like as a first or second year med student based on a few classes is really about as obscure as deciding you might like something based on your step 1 score.

 

[BillyRubinstein]

I'm with you bro, I'm still PM&R all the way even after getting my score back. I'll be keeping my digits to myself, but I'm competitive for most things after taking that beast, and I dont think that suddenly looking at a field just because I could match would be responsible. In fact, its actually a pet peeve of mine.

I get annoyed when someone interested in IM, EM and Psych gets a 260 and suddenly decides Rad Onc, Derm and Plastics are the way to go. You should shoot for what you are interested in from the beginning. I think if you "consider" other things out of the blue after a high board score, you should think about why you are in medicine in the first place.

Maybe I'm just extra blunt since I'm in the middle of an overnight call and I'll probs get flamed for saying that, but I dont really care. Trying to match derm or something just cause you can is a sellout.

Totally agree....nice to hear some people say the way it really is rather than everyone who gets a 250 suddenly wanting to become an aspiring dermoplasticneurosurgeon....

 

[ROBINHO]

Residency is a Long Road and after Residency comes years of selfless Services. Hence I think it is imperative that one goes into something that he has passion for. For example lets say you like IM, u really like talking with the patient,enjoy making ddx then it doesn't make sense to jump into Plastic just becos of a board score. plastic u will make loads of money...but what about personal satisfaction???

Well about your friend I can see it from this angle. Some pple would really want to be Derm,Plastics etc but are afraid to admit and there is this rxn formation whereby he wants everybody to believe that he hates it. Most atimes it is becos of the fear that it is an unattainable. As soon as the results come in, there is no reason to continue forcing the Repression. So I won't criticize your friend.

 

[45408]

Nah. I was hoping to do well enough that most/all career options would still be just that - options. Based on the averages published by the match, I could potentially get into almost anything. Like some of the others, I've always been interested in a wide array of things - EM, interventional rads, urology, trauma surgery, neonatology, etc. I just want to keep all my doors open.

I'll pass on derm. Ooooh, a rash. Ophtho makes my eyes water, and I want more interaction than radiology has to offer.

 

[LadyWolverine]

LadyWolverine,

Your avatar scares me. Just wanted you to know that.

That's kinda the point. Glad to know it's working!

 

[UditNarayan]

getting my score back has not changed my plans...im still heavily considering the field I was always interested in and as before, am still open minded. options are good here because nowadays, many fields overlap...neurosurg procedures can be performed by ENT docs, Ortho surgeons, interventional neurologists, interventional rads, etc so being able to feel out which path I want to take to get to my goal is great.

 

[MSKalltheway]

I don't think it's necessarily your "responsibility" to explore other career paths, but I don't see what's wrong with looking at some things that you weren't otherwise thinking about. Just because a person decides that maybe they'll do a rotation in derm doesn't mean that, at the end of the day, they'll be a dermatologist. I don't want to be a dermatologist, but I'm going to do a derm rotation during 4th year anyway b/c the hours are good. Maybe I'll like it. You don't know until you try it. FYI, you may think you'll like something, but rotations will likely change many minds next year. I honestly think that pursuing something that you decided you might like as a first or second year med student based on a few classes is really about as obscure as deciding you might like something based on your step 1 score.

You're right, but the instances you bring up arent the ones im talking about. I actually would like to do a derm rotation 4th year myself because I think it may serve useful to me during my residency if nothing else, and yes, because the hrs will be easy. I'll also plan on doing sports med, rads, likely another fam med and a few others because they are easy. But theres a difference between picking a 1 month rotation because its easy and a career path because its easy. I'm q3 overnight for this first part of my Surgery rotation and honestly if 3rd year is gonna be like this, I think we all should deserve a chilled out 4th year. Also, you should do electives in things you'll never go into, hence my thoughts of doing derm, rads, neurosurg, and urology electives. All are very competitive, but I'm not planning on going into any of them.

If you do an elective and decide you love it, thats one thing, I can't hate on that. If you were all over the map then got a good score, then later decided you like a competitive specialty, I can't hate on that either. If you were all about psych yrs 1 and 2, then got a 270 and decided plastics was your specialty, thats where I may have issues.

I wont begrudge someone who acutally wants to do a competitive specialty because they truly enjoy it. I do have problems when you have clearly shown that all youre gunning for is derm, plastics, rad onc, and ENT (pay and/or lifestyle) after your killer board score, when you were more open minded before Step 1.

Happens quite a bit on SDN, I'm sure you can look through old posts that show what I'm talking about.

 

[Tiger26]

Nah. I was hoping to do well enough that most/all career options would still be just that - options. Based on the averages published by the match, I could potentially get into almost anything. Like some of the others, I've always been interested in a wide array of things - EM, interventional rads, urology, trauma surgery, neonatology, etc. I just want to keep all my doors open.

I'll pass on derm. Ooooh, a rash. Ophtho makes my eyes water, and I want more interaction than radiology has to offer.

Agree w/Prowler--I just wanted to keep all the doors open so that if I liked something competitive that I could actually do it.

With that said, most people don't really know much about specialties M1/M2 year other than what they hear/see on tv, so I don't fault them for changing their minds, which coincidentally may be into more competitive ones.

Keep in mind that getting a great board score is something you earn, so if you put the time into it, you should be able to change your mind for even the most vain of reasons.

I kinda did this with med school in the first place: before junior year of college I had some exposure to medicine and had a great GPA (govt major/history minor) who decided I had the education capital I could spend on giving the application process a shot, so I did all the premed classes in about 9 months and applied and was accepted before all my friends who had wanted to be doctors since they were kids. I don't feel bad because even though they had the desire there for a long time, I still outworked them and got here sooner.

 

[diosa428]

You're right, but the instances you bring up arent the ones im talking about. I actually would like to do a derm rotation 4th year myself because I think it may serve useful to me during my residency if nothing else, and yes, because the hrs will be easy. I'll also plan on doing sports med, rads, likely another fam med and a few others because they are easy. But theres a difference between picking a 1 month rotation because its easy and a career path because its easy. I'm q3 overnight for this first part of my Surgery rotation and honestly if 3rd year is gonna be like this, I think we all should deserve a chilled out 4th year. Also, you should do electives in things you'll never go into, hence my thoughts of doing derm, rads, neurosurg, and urology electives. All are very competitive, but I'm not planning on going into any of them.

If you do an elective and decide you love it, thats one thing, I can't hate on that. If you were all over the map then got a good score, then later decided you like a competitive specialty, I can't hate on that either. If you were all about psych yrs 1 and 2, then got a 270 and decided plastics was your specialty, thats where I may have issues.

I wont begrudge someone who acutally wants to do a competitive specialty because they truly enjoy it. I do have problems when you have clearly shown that all youre gunning for is derm, plastics, rad onc, and ENT (pay and/or lifestyle) after your killer board score, when you were more open minded before Step 1.

Happens quite a bit on SDN, I'm sure you can look through old posts that show what I'm talking about.

I agree that it's dumb to go into something you don't like b/c you got a good board score and now you "can". But I find it very unlikely that someone will look at their board score and say "oh, well now I can do derm, which I HATE, but I'm going to do it anyway because I got a 270". I do think that getting a really high board score may open up doors for people that they never thought to open before... but why shouldn't they? Again, you don't know if you like something until you try it. So if so and so who was interested in psych wants to try out plastics, why not? Isn't that what 3rd and 4th year are about? And so they say that's absolutely positively what they want to do, and they'd never do psych - it doesn't matter. Because at the end of the day, they need to do the rotations to make up their minds, and most people will find things they don't like too unbearable to pursue residency in, regardless of their board scores. Second years don't really "know" what they want to do. Even people IN residency don't always know what they want to do.

 

[indo]

Agree w/Prowler--I just wanted to keep all the doors open so that if I liked something competitive that I could actually do it.

With that said, most people don't really know much about specialties M1/M2 year other than what they hear/see on tv, so I don't fault them for changing their minds, which coincidentally may be into more competitive ones.

Keep in mind that getting a great board score is something you earn, so if you put the time into it, you should be able to change your mind for even the most vain of reasons.

I kinda did this with med school in the first place: before junior year of college I had some exposure to medicine and had a great GPA (govt major/history minor) who decided I had the education capital I could spend on giving the application process a shot, so I did all the premed classes in about 9 months and applied and was accepted before all my friends who had wanted to be doctors since they were kids. I don't feel bad because even though they had the desire there for a long time, I still outworked them and got here sooner.

did you stretch your shoulders out before that pat-yourself-on-the-back session?

 

[UditNarayan]

did you stretch your shoulders out before that pat-yourself-on-the-back session?

rather i stretched my shoulders and pounded back the beers

 

[PAN627]

ill be the first to admit that my goal is pretty unattainable unless I get some ridiculous score on step 2, or do really well in clinicals... but speaking from the lil guys prespective who are not 99ers..if you guys arent interested in certain "competitive" fields .. us 95ers are more then happy for a spot in unattainable residencies as well haha 🙂 We can always dream can't we??

 

[Blesbok]

I thought about direct plastics for about 30 seconds, then went back to exactly where I was before.

 

[mjc48]

considering that most people have little to no clinical experience of real weight by the time they have taken step 1, how hard and fast do their decision have to be?

there is absolutely no reason to think that a decision made before medical school is more earnest in its intentions than one made after getting your step 1 score.

there is a lot more that goes into making professional decisions than just the coursework involved.

you can't call someone a sellout from within the medical profession. by definition it is throwing stones in a glass house. at some point in your career, you are almost guaranteed to do something that someone else would construe as "selling out." to many biologists, the act of becoming a doctor itself is selling out.

 

[Tiger26]

did you stretch your shoulders out before that pat-yourself-on-the-back session?

I did fail to mention that I got incredibly lucky in getting accepted in the first place with my "so you proved to us that you know how to read, but not much else" MCAT score.

 

[Mr. Freeze]

The fickle nature of some classmates has proven to me that I feel good about not knowing how I did. My wife knows my score, and told me in which half of the distribution I fell. I'm happy.

I didn't think I would change my interests based on it, so I didn't really see the need to find out. But it has been humorous to watch people go from being hardcore about one thing, then get scores and be hardcore about an entirely different field...🙄

 

[-Goose-]

My interests haven't changed, but if I had scored considerably lower than I did, I'd probably have to look at a different field.

 

[45408]

I did fail to mention that I got incredibly lucky in getting accepted in the first place with my "so you proved to us that you know how to read, but not much else" MCAT score.

lol. 11VR, 4BS, 6PS.

 

[45408]

did you stretch your shoulders out before that pat-yourself-on-the-back session?

he first paused to flex

 

[radslooking]

I'm with you bro, I'm still PM&R all the way even after getting my score back. I'll be keeping my digits to myself, but I'm competitive for most things after taking that beast, and I dont think that suddenly looking at a field just because I could match would be responsible. In fact, its actually a pet peeve of mine.

I get annoyed when someone interested in IM, EM and Psych gets a 260 and suddenly decides Rad Onc, Derm and Plastics are the way to go. You should shoot for what you are interested in from the beginning. I think if you "consider" other things out of the blue after a high board score, you should think about why you are in medicine in the first place.

Maybe I'm just extra blunt since I'm in the middle of an overnight call and I'll probs get flamed for saying that, but I dont really care. Trying to match derm or something just cause you can is a sellout.

yeah, well what would you do if PMNR paid 150 and primary care paid 330. tell me what you'd do then. i bet your enthusiasm for pmnr would be a bit muted.

 

[cmurda]

I'm with you bro, I'm still PM&R all the way even after getting my score back. I'll be keeping my digits to myself, but I'm competitive for most things after taking that beast, and I dont think that suddenly looking at a field just because I could match would be responsible. In fact, its actually a pet peeve of mine.

I rarely post here but i did pretty well on step 1 (not revealing my score b/c i know too many of my classmates lurk here and have been wondering what i made) but i have absolutely no desire to change from my original plan of peds.

I'll paraphrase a quote from former LSU Baseball coach Skip Bertman "anything you vividly imagine, ardently desire, sincerely believe and enthusiastically act upon must, absolutely must, come to pass"

So the way i see it, is that if your heart is set on some residency and you show true genuine interest in that field then just b/c your step score isn't what is typically associated with that field it doesn't preculde you from it. It may make things harder and you might have to convince a a few more people that you really want to be there but it can happen.

 

[thedrjojo]

I've always been interested in surgery, not sure what field though... now that i've killed the boards, i'm starting to take a closer look at ENT, NS (not Ortho or Plastics though)... I did NS because it was an option in my Neuro rotation (neuro is a 3rd year and is combined with Psych... fun having 2 shelfs and an osce at the end of a rotation like i do next week) and took it as seriously as I could because I wanted to see if it was something I was interested in... after being bored during a spine surgery, i wrote off NS even though the brain stuff was rediculasly cool (it also cemented me not wanting to do Ortho)... I feel that people who dedicated themselves to something before trying it aren't any better though, because how can you know... Did I look at ENT (or even know what ENT's did) before my 250+ board score? No... am I giving it a look and hopefully doing a 2 week elective in a few months? Yes... would I be looking if my score was 20-30pts less? Probably not... you have to be realistic with yourself... If I hate ENT, I'm not going to pursue it, but if I like it, of course I am going to go for it knowing I have a realistic shot of ending up where I want...

 

[osli]

I'm pretty sure that there are plenty of students who, in the back of their minds throughout their first two years, would love to enter one of the better paying, more glamorous, or whatever "competitive" specialties, but tell both themselves and others that they are really interested in FP, IM, EM, peds, psych, or whatever because historically they have never scored exceptionally on standardized tests, struggled to make the cut on the MCAT, were concerned about even getting into med school, and weren't setting the curve on med school tests. But when they work hard for and are rewarded with an unexpectedly good board score, suddenly those latent wishes come right on up to the surface, and now you hear what sounds like a 180 in interests.

I'm not saying that all students who say they are interested in the less competitive specialties are like that. In fact, I'd say that there are probably a lot of students who say they are interested in less competitive specialties are really are, and go there regardless of score and grades. And plenty who say they are interested in the more competitive specialties and really are, and go there if grades and scores permit.

Just think about the students in your class. There will be a few that would say "I've always wanted plastics, and will comit suicide if I don't make it." But then there's going to be a guy that you find out matches into ortho that you had no idea was capable of that and never expressed interest in anything but FP. If asked, he might well say "yeah, well I was always interested in ortho, but didn't expect to do very well on boards and would have been too embarassed and dissapointed to have told people, and then didn't match."

Just another way to look at it. I'd avoid making any gross generalizations. Myself, the field I really love happens to be competitive. I'm not going to comit suicide if things don't work out, but I'd take a substantial pay cut for a guarantee that I'd match there. 🙂

 

[MSKalltheway]

yeah, well what would you do if PMNR paid 150 and primary care paid 330. tell me what you'd do then. i bet your enthusiasm for pmnr would be a bit muted.

Um, if you actually knew me, you'd probably not say that. $150K is an @$$load of money, I'm trying only to live comfortably, not feed my kids gold and platinum for breakfast. Its far more important to "marry" a specialty you love regardless of money, rather than hate what you do and get paid a lot. High pay but poor specialty satisfaction makes for a bitter doc...not quite how I choose to live.

If PM&R didn't exist, I'd be going for FP most likely, so nice try.

I have no problem with someone going for a competitive specialty, especially if they scored well. You worked hard for it, its your right to do so. My only issue is the intent behind applying. Most people who match into competitive fields truly love what they are going into, and good for them.

I talked to an ortho resident the other night who talked about how much she adored it. Even at 3am and she was beaming about how she gets to "play with legos" all day. I think thats awesome! Its competitive and she worked hard for the great score Im sure she got, so thats cool. If she had nothing good to say about it and was like, "Well, I can make a ton of money after doing a spine fellowship", I shouldn't have to re-explain to you how that sounds.

 

[MSKalltheway]

So the way i see it, is that if your heart is set on some residency and you show true genuine interest in that field then just b/c your step score isn't what is typically associated with that field it doesn't preculde you from it. It may make things harder and you might have to convince a a few more people that you really want to be there but it can happen.

Completely agree with you! A lot of this whole game is selling yourself well.

 

[Labslave]

But when they work hard for and are rewarded with an unexpectedly good board score, suddenly those latent wishes come right on up to the surface, and now you hear what sounds like a 180 in interests.

I don't disagree that some med students are like this, but I think this group is in the minority compared to the numerous number of tools I've come across that engage in the process already documented in this thread.

As other people have said, exploring other options you didn't anticipate having as a result of a good score is totally legit. Letting your score dictate your choice of medical specialty, on the other hand, would make you a turd.

 

[Hurricane95]

Not really. I'm still interested in the same things as before, only now they are more attainable. My grades for years 1-2 were average, right in the middle of the class curve, and smashing the boards made me stand out from the rest. Getting an internal medicine slot is not that tough, but a cardio or GI fellowship is challenging so this will definitely help. As of now, that's my #1 choice, followed by anesthesia at #2 and possibly radiology at #3, but I need more exposure in that field (no pun intended).

 

[45408]

Not really. I'm still interested in the same things as before, only now they are more attainable. My grades for years 1-2 were average, right in the middle of the class curve, and smashing the boards made me stand out from the rest. Getting an internal medicine slot is not that tough, but a cardio or GI fellowship is challenging so this will definitely help. As of now, that's my #1 choice, followed by anesthesia at #2 and possibly radiology at #3, but I need more exposure in that field (no pun intended).

Just curious - since you don't apply for a fellowship until well into your residency, does your step 1 really mean anything?

 

[Doctor Bagel]

I'm still thinking pretty much what I was thinking before (psych or IM), but I'm not interested in surgical fields at all, so that rules out most of the super star types of stuff. Even with my good score, I think derm is still too much of a long shot because I don't have the research -- I've got to admit I might kinda like that one.

 

[PeepshowJohnny]

Just curious - since you don't apply for a fellowship until well into your residency, does your step 1 really mean anything?

The goal for anybody who's going to be applying for a competitive specialty in a generally noncompetitive field (for example, Cardiology out of Medicine) is to get into a residency that has a reputation for matching people into competitive fellowships in the past. These residencies tend to be quite competitive slots to get.

Thus, while the "average" Medicine residency has a boards average of say, national average, residency slots at "big name" places that get you into fellowships probably have higher board score averages than a lower tier radiology program, for example.

And I have heard of fellowships requesting ALL your pertinent testing info, but nothing is really as important as good letters of rec from known people in your field. And you get those by, again, going to competitive places.

Now, that's not to say you can't go from a lower tier place to a fellowship, but it's definitely harder.

 

[JeffLebowski]

The goal for anybody who's going to be applying for a competitive specialty in a generally noncompetitive field (for example, Cardiology out of Medicine) is to get into a residency that has a reputation for matching people into competitive fellowships in the past. These residencies tend to be quite competitive slots to get.

Thus, while the "average" Medicine residency has a boards average of say, national average, residency slots at "big name" places that get you into fellowships probably have higher board score averages than a lower tier radiology program, for example.

And I have heard of fellowships requesting ALL your pertinent testing info, but nothing is really as important as good letters of rec from known people in your field. And you get those by, again, going to competitive places.

Now, that's not to say you can't go from a lower tier place to a fellowship, but it's definitely harder.

Not to mention, if you're interested in a less competitive field, it's not like a high score is wasted - you'll likely have more control over where you match geographically. And obviously you'll have a shot at higher caliber programs. There are programs to match your goals/preferences and competitiveness no matter what you're going into.

 

[indo]

even if you want to do family med, with a huge step 1 score you're less likely to have to do a family med residency somewhere you don't want to live.