Oh, so this is what "failure" feels like

[swa1331]

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...No, I didn't actually fail. I feel like I did though.

Hi guys.

First post on this wonderful website that I've been reading for years.

Like a lot of med students, I've completely rocked everything in my academic life (3.9 GPA, 37 MCAT, great in many of my med school classes at a top 10 school). I prepared for Step 1 very well. Then I took it.

Ever have one of those days that just nothing goes right? Morning of Step 1, I woke up with a headache. Forgot my glasses at home and my contacts proceeded to itch through the whole exam. Left my lunch at home, too. Missed the train. Forgot my exam permit so had to go back and get it.

I had a particularly rough stretch of 15-20 questions on the third section of the 7 sections of the exam, and on top of everything else (including typical nerves/anxiety that we all have for step 1), I guess I was sent into a bit of a panic, I guess.

Long story short, got my score today. 202. I fell out of my chair when I saw that number. First time I've ever really done crappy on something. I was getting practice tests correlating regularly in the 230-240 range (not kidding).

Someone, anyone, talk to me and make me feel better. My entire life has been about being "that cousin" on the other side of the family that the rest of the family talks about as overachieving, and I hate that this one bad exam is going to haunt me forever. I'd love advice on what to do now, as well. Trust me, I've already set aside the fact that my number one goal in life at this moment is getting AOA next year and returning to form for Step 2 and reporting it early.

🙁

 

[quepatho]

Yeah I sympathize (probably empathize, too, after I take the exam). I was a high achiever until I started studying for this silly exam, haha ;-) There's nothing quite like Step 1 to make you feel like any other life achievement you've had is not worth anything.

But you KNOW in your head, that's not true. You've done a lot of great things so far; something tells me you'll absolutely nail Step 2. It's not over till it's over.

Give yourself some time to be angry at how much life can suck (and it CAN), and then take a deep breath...keep going...we're halfway through...this isn't the end...this isn't the final word, and you're not done fighting yet.

Step 1 isn't a measure of anything in particular - other than how you did on that particular exam on that particular day.

Keep your head high and keep doing what you can to make things better for yourself and for the world.

 

[SeekerOfTheTree]

Sorry to hear about your situation. I don't know what to say that would make you feel any better. It does suck. It is depressing to know that the NBMEs weren't helpful for you in predicting your score. I hope you feel better.

 

[SlaveOfTCMC]

Primary Care can make 7 figures if you operate in private practice in a big market, try to evade taxes (legally through loopholes and investments, of course), and work 6 days a week with a high patient volume (think about 40 patients)

I don't want to sound like a mercenary, but any medical student who says money is not a factor at all needs to commit to go overseas to palpate spleens and screen for tuberculosis in rural India... now...

 

[winkleweizen]

Primary Care can make 7 figures if you operate in private practice in a big market, try to evade taxes (legally through loopholes and investments, of course), and work 6 days a week with a high patient volume (think about 40 patients)

I don't want to sound like a mercenary, but any medical student who says money is not a factor at all needs to commit to go overseas to palpate spleens and screen for tuberculosis in rural India... now...

hahaha to be fair, the Op isnt required to go into PC. Pretty much the only thing that it strikes off the list are Derm, Plastics and the surg subspecialties. especially since hes at a top 10 and may get AOA.

 

[swa1331]

I actually did/do (am now forced to) plan on going into internal medicine. I would be 100% satisfied with internal medicine at a university-based tertiary care type place in an urban environment. Like 150% satisfied, would bounce off the walls if I matched into such a place.

But 202. Shiite. Lol. Now I even wonder if I can even manage matching into ANY such place let alone one in a preferred location.

 

[SlaveOfTCMC]

uhh some procedure based internal medicine subspecialties pay quite a lot... if you are in private practice...

you know those "median salary" projections on websites? that's only if you are chained.. I mean... salaried to a corporation.. I mean hospital...


but enough of the money aspect...


the clinical faculty at my school have a joke... i can't remember how it went... something along the lines about how the surgeons take a nuke and blow the thing to bits and then ask the pathologists to tell them what they hit... and yadda yadda... but the internal medicine guy is the one who can explain everything...

in short, if you put your mind into it, you can also be a very knowledgeable clinician as an internist.

 

[winkleweizen]

I actually did/do (am now forced to) plan on going into internal medicine. I would be 100% satisfied with internal medicine at a university-based tertiary care type place in an urban environment. Like 150% satisfied, would bounce off the walls if I matched into such a place.

But 202. Shiite. Lol. Now I even wonder if I can even manage matching into ANY such place let alone one in a preferred location.

Schedule a couple of aways and do better on Step2. They will realize step 1 was just a hiccup and doesnt reflect your abilities

 

[Bloor]

I feel ya brother, a similar score here.

We just gotta stiff upper lip it. Onto the next hurdle- time to make lemonade

 

[Zoom-Zoom]

I know it's hard to appreciate right now...but truly...it's just one test. We all have off days, we all have tests that happen to ask those Q's we were less prepared for. It sucks. You got unlucky and had a bad day. But that's all. Don't make it mean anything about yourself. The important thing is that you remember it's just a test, you know you're an all star and that you can't be summed up by this silly system.

 

[julyjones]

I actually did/do (am now forced to) plan on going into internal medicine. I would be 100% satisfied with internal medicine at a university-based tertiary care type place in an urban environment. Like 150% satisfied, would bounce off the walls if I matched into such a place.

But 202. Shiite. Lol. Now I even wonder if I can even manage matching into ANY such place let alone one in a preferred location.

You can definitely still match somewhere you want. This sucks, but it isn't the end of the world at all. We all get sucked into the idea that Step 1 is the end all be all, but there are lots of other factors that go into residency placement. Letters of recommendation, interviews and away rotations are all really important.

I was able to chat with a Peds residency director for a (pretty awesome) California university-based hospital and he told me that the most important aspect was the away rotation- if you came and kicked ass and they liked you, you were in. The NRMP also has some really interesting/reassuring data about what residencies are looking for (look under their research reports).

 

[hyrule]

You're clearly a driven and intelligent person. You scored a 98%ile on the MCAT, did well in college, are at a top school. Clearly the Step 1 was an anomaly and not a trend. Your medical career will also follow the trend you've been showing.

 

[swa1331]

Thank you for the kind words, guys. I guess I just needed to be brought back down to Earth. Today has been quite the odd combination of emotions.

 

[DreamingTheLive]

That sucks and I'm sorry. That being said, the road just got a little tougher, a slight incline, but you're at a top-ten school (which in itself can open a lot of doors) and you sound like you'll be a rockstar on the wards. Hang in there, and you'll be giving this same advice to some downtrodden M2/3 in 2016 when you're an IM resident at Michigan, laughing about this experience (hopefully).

That being said, you could maybe help out some future test takers by talking about which (& when) specific practice tests you took and what about the exam was so jarring.

Best of luck, I'll be looking for your post in a few years when you're chief resident at some cush spot.👍

 

[jfgavina]

Don't demoralize: ace part II.

 

[SpunkySpunk]

you are freaking me out 2 days before my test.

 

[SlaveOfTCMC]

you are freaking me out 2 days before my test.

Do not utilize the UNDOING defense mechanism

Utilize the SUPPRESSION defense mechanism

 

[Gabby]

I actually did/do (am now forced to) plan on going into internal medicine. I would be 100% satisfied with internal medicine at a university-based tertiary care type place in an urban environment. Like 150% satisfied, would bounce off the walls if I matched into such a place.

I agree with what everyone else has said. Pick yourself up, dust yourself off. You'll be a prime candidate for IM, given your background and academics, assuming you do well on rotations and on Step 2.

But 202. Shiite. Lol. Now I even wonder if I can even manage matching into ANY such place let alone one in a preferred location.

This is a bit melodramatic, don't you think?

 

[shaman06]

Primary Care can make 7 figures if you operate in private practice in a big market, try to evade taxes (legally through loopholes and investments, of course), and work 6 days a week with a high patient volume (think about 40 patients)

I don't want to sound like a mercenary, but any medical student who says money is not a factor at all needs to commit to go overseas to palpate spleens and screen for tuberculosis in rural India... now...

Is this what becoming a doctor is about? Money? Thank you, SDN gunners, for showing me how my priorities have been lacking.


As for the original post - I'm sorry to hear about your situation. You sound like an ambitious and talented person, and you'll make it work. You have AOA, Step2, and clerkship grades & letters of recommendations to help you out. I've seen people match into crazy-competitive specialties and residency programs with mediocre & below average Step1s - they worked extra hard with Step2s, AOA, or added a couple publications to their resume, etc. You'll make it happen!

 

[lackli]

All I can say is, don't let a number define you! You're much more than a three digit score could ever represent.

From your posts it sounds like you are a smart capable person. Don't let a single test score hold you back from what you want to do in life.

 

[ProtossCarrier]

how can you AOA with a low step? Doesnt compute for my school.

 

[thepoopologist]

[YOUTUBE]hW8KbFh1RSM[/YOUTUBE]

 

[raynor123456]

Sorry to hear about your luck 🙁 But, having said that, you've still got PLENTY of opportunity. ~25% of practicing physicians got a 202 or lower on Step 1. That's 1 in 4! BIG number.

Just keep your heart open to all options and keep doing well in your courses. 🙂

P.S. Step 2 is almost as important as, or even equally as important as, Step 1 to many program directors based on what I've read.

 

[RapplixGmed]

how can you AOA with a low step? Doesnt compute for my school.

Its not taken into account at some schools. At my school, your rank for AOA is completely independent of your performance on step 1.