pathology? Do I have a chance?

[astro411]

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Hi,

I am a third year med student with a score of 196 on USMLE Step I / 80%

I am interested in Pathology but am worried that I am not competitive enough. I've passed all my classes so far, honored 4 preclinical classes first year but none second year.

I am interested in San Francisco, Cali, Chicago, and New York, and was wondering what I should do to improve my application. I am going to try to take Step IIs early and do well, but other than that what should I do?

Do I have a chance in placing in these locations?

Any advice would be greatly appreciated. I am willing to work hard and do whatever it takes 🙂
Thanks!
astro411

 

[DarksideAllstar]

I'm a 4th year medical student, so take any of my advice with a grain of salt as 1) I haven't matched yet, 2) I am not sitting on a residency selection committee, and 3) I may have no idea what I am talking about.

If I were in your shoes I would...

1) Try and honor as many third year rotations as you can. Secure one or two solid clinical medicine letters.

2) Take Step II early and destroy it.

3) Schedule away surg path rotations at 2-3 places that you are seriously considering. Keep in mind that this may also hurt you if you screw up (ie dont show, show late, bother residents with inane and multiple questions, yell at faculty, fall asleep at scope and while faculty are directly talking to you (which I have seen) etc). This time will also give you a feel (although somewhat limited) for the program and help you decide if you really want to be there for 4-5 years. Make sure you schedule them as soon as you can because they will fill (first hand experience).

4) Secure letters of rec from faculty at your aways (or your med schools path dept if you have one).

5) Get your ERAS in early (ie have everything except your letters ready for upload on Sept 1st).

If you are an AMG, you will definitely match, although I think some of the potential programs you have mentioned will be more competitive because of their perceived "greatness" or "desirable" location (although some CA programs are very attainable). Keep in mind these are goals that I would set for myself personally, and they may not be directly applicable to securing the residency of your choice (but they cant hurt either). Good luck and hopefully some others (ie residents) can offer their insight as well.

Edit: Do a search on these forums as well. This topic has been frequently discussed.

 

[yaah]

It sounds like you are interested in competitive programs and thus the advice above is very pertinent - as your resume is good but not great, and has nothing outstanding that you mentioned (unless you neglected to mention your PhD or your grants). Thus, you have to distinguish yourself some way. You have proven to be a capable student and thus, as said, will match in a good program (if you are an AMG - if you are an IMG it will be tougher but certainly not impossible).

But you have to distinguish yourself. The best way to do this is through performance, away rotations, and good reference letters which indicate your potential is ahead of you and you would perform well as a resident. When you get interviews, you need to distinguish yourself there as well. A good score on Step II would help but not that much. Honoring clinical stuff will help a tad but not that much.

Look at it from the perspective of a residency program - they have to know WHY to take you. Why to rank you higher. Having good but not great grades won't get this. It will get you ranked because you are likely "safe" but not much more. What will move you up the list is what distinguishes you individually.

 

[mlw03]

What will move you up the list is what distinguishes you individually.

so what distinguishes a candidate individually? short of research, what can a med student do to make themselves stand out to a path program? do you mean non-medical stuff can distinguish you? as you mentioned, 3rd year grades and step II don't carry as much weight in path as in other specialties, so what are the kind of things that make path applicants stand out? are the letters of rec that much more important? it can't be away rotations, as many residents have posted on here that those aren't required to make a strong applicant. i think the point about distinguishing oneself is important, but the way to really do that is what eludes me (and presumably many other applicants). if those that have come before us have any specific ways we can do that i know many of us would appreciate it.

 

[DarksideAllstar]

so what distinguishes a candidate individually? short of research, what can a med student do to make themselves stand out to a path program? do you mean non-medical stuff can distinguish you? as you mentioned, 3rd year grades and step II don't carry as much weight in path as in other specialties, so what are the kind of things that make path applicants stand out? are the letters of rec that much more important? it can't be away rotations, as many residents have posted on here that those aren't required to make a strong applicant. i think the point about distinguishing oneself is important, but the way to really do that is what eludes me (and presumably many other applicants). if those that have come before us have any specific ways we can do that i know many of us would appreciate it.

I think it is very hard for medical students to "stand out" in general. The first two years are really when you can make this happen (ie research, etc). I bolded the statement above for the following. While I dont disagree that 3rd year grades dont mean as much for path, one thing they do count toward is AOA nomination. This can really open a lot of doors for an applicant to the large academic programs, particularly if she is from a smaller, lesser known medical school. However, you typically need at least some service work or research to be considered at many medical schools, so in a sense you may "stand out" even without AOA. One "big name" program I know of uses the following criteria for assessing a candidate, along with the performance at interview:

1. AOA
2. Board scores (excellent being considered >90th percentile)
3. Research (with publications)
4. Quality of letters of recommendation

Based on a combination of these applicant strengths, they rank the applicant on a scale of 1-10. A person with a 10 would generally possess all 4 that I listed above, the remaining 1-9 scale scores would be some combination of these (or lack thereof).

 

[deleted113029]

Come on people...let's be a little realistic. A 196 will not get you into a program like Stanford, UCSF or any other elite/elitist program. (And btw astro411, a 196 is NOT the 80%ile...not even close.) And what kind of quality research is done in the hectic 3rd year of med school especially if you want a decent publication? It sounds a little too late for you since you're a 3rd year already and are now just beginning to understand your predicament.

Astro411, your chances of matching at other programs in your favorite areas may be a lot better. Of course, do exceptionally well in your 3rd year and follow the advice of UCSFbound, Yaah and others, but don't get your hopes up.

(I am not a I swear!)

 

[pathstudent]

One "big name" program I know of uses the following criteria for assessing a candidate, along with the performance at interview:

1. AOA
2. Board scores (excellent being considered >90th percentile)
3. Research (with publications)
4. Quality of letters of recommendation
.

I thought board score percentiles aren't calculated anymore by the USMLE people.


But to the OP:

Matching in SF would be tough as there is only one program in SF and it get apps from all over the country. Even if you are willing to live in the suburbs/exurbs, the Bay Area is not that easy as Stanford also skims the cream of the applicant pool and Davis has a tiny program.

LA and its brubs have a lot of programs I think , so if you apply to all of them and get a few interviews you might land there. However, I can't imagine someone who is interested in NYC finding Irvine or Loma Linda very interesting.

NYC and Chicago have many programs, some which chronically don't fill with AMGs. If you restrict yourself to only wanting to live in Alphabet City and walk to NYU everyday, then you might be screwed, but if you are willing to apply to every program in the NY and/or Chicago area, you will land one of them for sure.

So in short, my advice is that if you apply to every program in Cali, NYC, and Chicago, and are willing to rank all of them, you will for sure match at one provided you don't demonstrate overt sociopathic tendencies during interviews.

 

[djmd]

Come on people...let's be a little realistic. A 196 will not get you into a program like Stanford, UCSF or any other elite/elitist program. (And btw astro411, a 196 is NOT the 80%ile...not even close.)

They might be thinking that the second score is %. The two digit score is NOT %. And on that scale what is it, 70? 75? is the pass point?

 

[DarksideAllstar]

I thought board score percentiles aren't calculated anymore by the USMLE people.

They aren't, but it also doesn't take a rocket scientitst to calculate the percentile given the mean and SD, either.

As someone alluded to earlier, no a 196 isnt going to get some of the big names, but we aren't looking at that score in a vacuum. If this person busts his or her ass during third year, secures good LOR from faculty where they want to go, does extremely well on Step II , I think it is not unreasonable to imagine a program taking someone with a below avg Step I. Whether this actually happens is another thing. I was merely giving advice to help them have a better chance.

 

[DarksideAllstar]

They might be thinking that the second score is %. The two digit score is NOT %. And on that scale what is it, 70? 75? is the pass point?

75 is the pass. You can easily figure out the %ile from the info that the NBME sends along with your score, but a 196 is NOT the 80%ile.

 

[deleted113029]

They aren't, but it also doesn't take a rocket scientitst to calculate the percentile given the mean and SD, either.

As someone alluded to earlier, no a 196 isnt going to get some of the big names, but we aren't looking at that score in a vacuum. If this person busts his or her ass during third year, secures good LOR from faculty where they want to go, does extremely well on Step II , I think it is not unreasonable to imagine a program taking someone with a below avg Step I. Whether this actually happens is another thing. I was merely giving advice to help them have a better chance.

I know you're just being nice and supportive, but a lot of other people have the complete/more complete package. I think it is reasonable to assume his chances are poor considering he is 1/3 done with his 3rd year and now deciding what he can do to improve his situation.

Anyway...UCSF good luck on your interviews! After several of my interviews, I cannot wait until December when all my interviews will be over. No real bad encounters, just interesting observations of each program. Haven't found the one yet! 🙂

 

[DarksideAllstar]

I know you're just being nice and supportive, but a lot of other people have the complete/more complete package. I think it is reasonable to assume his chances are poor considering he is 1/3 done with his 3rd year and now deciding what he can do to improve his situation.

It is true that this person has little to no shot at the Brighams, Hopkins, et al of the world, but he/she asked what they could do to improve their chances. I dont recall ever stating that if they do x, y, and z then you will match at the bestest place on earth. By the way, there are many smaller California programs which are less competitive and probably more attainable (UCI, UCD, Loma Linda, etc).

My first interview is on Monday, then its 4 weeks of roving around. Luckily there will only be one flight to the east coast; the rest are all out west. By the way, did I mention it was 80 degrees in San Diego last weekend? Gotta love it...

 

[yaah]

so what distinguishes a candidate individually? short of research, what can a med student do to make themselves stand out to a path program? do you mean non-medical stuff can distinguish you? as you mentioned, 3rd year grades and step II don't carry as much weight in path as in other specialties, so what are the kind of things that make path applicants stand out? are the letters of rec that much more important? it can't be away rotations, as many residents have posted on here that those aren't required to make a strong applicant. i think the point about distinguishing oneself is important, but the way to really do that is what eludes me (and presumably many other applicants). if those that have come before us have any specific ways we can do that i know many of us would appreciate it.

What I am referring to is why they should pick you. So yes, it is letters of reference, your behavior during the interviews, even your personal statement. Scores and grades are sterile numbers which reflect part of the candidate. High scores and grades reflect a solid applicant who will likely excel. There are no "specific ways" to distinguish yourself individually - that defeats the purpose - it has to be a reason why you are a unique and different candidate, not one that is like everyone else.

 

[deleted113029]

It is true that this person has little to no shot at the Brighams, Hopkins, et al of the world, but he/she asked what they could do to improve their chances. I dont recall ever stating that if they do x, y, and z then you will match at the bestest place on earth. By the way, there are many smaller California programs which are less competitive and probably more attainable (UCI, UCD, Loma Linda, etc).

My first interview is on Monday, then its 4 weeks of roving around. Luckily there will only be one flight to the east coast; the rest are all out west. By the way, did I mention it was 80 degrees in San Diego last weekend? Gotta love it...

my bad! 😳

 

[cytoborg]

Hi,

I am a third year med student with a score of 196 on USMLE Step I / 80%

I am interested in Pathology but am worried that I am not competitive enough. I've passed all my classes so far, honored 4 preclinical classes first year but none second year.

I am interested in San Francisco, Cali, Chicago, and New York, and was wondering what I should do to improve my application. I am going to try to take Step IIs early and do well, but other than that what should I do?

Do I have a chance in placing in these locations?

Any advice would be greatly appreciated. I am willing to work hard and do whatever it takes 🙂
Thanks!
astro411

You're still a 2nd year - no need to panic yet. One number on a piece of paper is not going to make or break you. It depends what the rest of your app looks like and what kind of relationship you have with the individual programs you're interested in. This is a great time to start getting your ducks in a row.

You could consider taking a year off to get some research and/or work experience in an area you are sincerely interested in (for example, the NIH, Howard Hughes and Doris Duke offer generous grants for 1 year of research). Not likely to get a Nature paper out of 1 year, but it's a chance to gain some cool experience and get perspective on future career interests & possibilities. Also, start cultivating your letters of recommendation - a research mentor, any attending on the wards who thinks you are the bomb, and most importantly at least a couple path attendings. The most important thing is doing rotations in pathology and doing excellently in them. A close second is displaying your interest & motivation to the programs you're interested in. This can be done via a rotation at that institution, or over phone/email. Programs want someone motivated and who sincerely wants to be at their program, and this counts for a lot.

 

[cytoborg]

so what distinguishes a candidate individually? short of research, what can a med student do to make themselves stand out to a path program? do you mean non-medical stuff can distinguish you? as you mentioned, 3rd year grades and step II don't carry as much weight in path as in other specialties, so what are the kind of things that make path applicants stand out? are the letters of rec that much more important? it can't be away rotations, as many residents have posted on here that those aren't required to make a strong applicant. i think the point about distinguishing oneself is important, but the way to really do that is what eludes me (and presumably many other applicants). if those that have come before us have any specific ways we can do that i know many of us would appreciate it.

There's no formula, what distinguishes you is the cool stuff you've done that other people haven't. Unique research interests or work experience, a unique relationship with the program (like having done a research project in their dept for example), a unique level of motivation/interpersonal skills. And yes uniqueness can be non-medical, and can certainly facilitate an interview by helping rapport with the interviewer.

Don't worry too much about "distinguishing yourself" from others, just make your application the best it can be and stick to what truly interests you.