Please help. I can't study for Step 2 with this dilemma in my head!!

[melonque]

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Hi, guys,
Thanks for giving advice to my dilemma!

Situation 1: During my third year, I did a preceptorship for 0.5 year with the PD of my own school's program, and it turns out that the PD loves my enthusiasm, but very dissatified with my clinical judgement in the ED. Not that I can't take criticism, but one of the consistent comment I get from all rotations in my third year is "outstanding clinical judgement" . Basically I have shot myself in the foot with this PD/program.

Situation 2: I just finished my first EM sub-I at aother school affiliated program. I was told that I have done a pretty awesome job, and I am pretty sure the comment about my clinical judgement in ED will be opposite to what that PD thought based on what they told me. cross-fingers.

Situation 3: but my step 1 score is only 204! Right now I am taking time off to take Step 2. My school is only pass/fail. All passes in third year with comments from excellent to outstanding/awesome. But I am NOT good at taking any standardized test, and I don't have any confidence to crack above 220... 🙁 I barely passed all my shelfs... I really started to think what the hell went wrong in all these tests, and I know the problem must be me, and I don't foresee that problem will change for my step 2. honestly.

Stiutation 4: 3 years of EM research resulting in 3 abstract (1 first author, 2 second author) and 2 manuscripts (both second author) and tons of extra stuff like interest group, etc

Dilemma/question: I will have one more rotation to do of which the evaluation will be in the Dean's letter. Should I still do another EM sub-I at my own school or should I do it at other school (if I can still get a spot for the sub-I) given that I have already shot myself in that program. Or should I do a Medicine sub-I or something unrelevant instead? If you were me, how many programs should I apply??

Thanks for sincere answer. 🙂

 

[Seaglass]

As for the clinical judgement thing - I doubt that your PD will count that as a significant negative - third years aren't supposed to have attending-like clinical judgement, that's what residency is for. As for your other questions, I doubt another EM elective or medicine AI will be able to swing things much either way right now. I think overall you are an acceptable canididate, just not an extremely competitive one. Try hard to get some fabulous letters of recommendation. # of programs ~30.

C

Side note: I don't think students pay enough attention to letters of recommendation and how important they are (arguably more than Step 1 in EM and probably many other fields). Get great ones.

 

[margaritaboy]

As for the clinical judgement thing - I doubt that your PD will count that as a significant negative - third years aren't supposed to have attending-like clinical judgement, that's what residency is for. As for your other questions, I doubt another EM elective or medicine AI will be able to swing things much either way right now. I think overall you are an acceptable canididate, just not an extremely competitive one. Try hard to get some fabulous letters of recommendation. # of programs ~30.

C

Side note: I don't think students pay enough attention to letters of recommendation and how important they are (arguably more than Step 1 in EM and probably many other fields). Get great ones.

Agree with above excellent resident note.

Also try to kick ass on step 2. It would only help if you topped your step 1 score.

 

[roja]

Concur as well. Also, one outlying 'bad' eval doesn't really make that much of a difference.
Especially if all of your others are really really strong.

Your research is good as are extraciricular activities... It doesn't hurt to do a rotation at another hospital.

Think of what you want in a program, where you want to be adn apply strategically...

 

[Strongman]

Concur as well. Also, one outlying 'bad' eval doesn't really make that much of a difference.
Especially if all of your others are really really strong.

Your research is good as are extraciricular activities... It doesn't hurt to do a rotation at another hospital.

Think of what you want in a program, where you want to be adn apply strategically...

Agree with the apply strategically. 30 is a good number provided that you have a wide range of programs so that you can have a shot at a few top programs but make sure that you match in EM. I really DID NOT want to go to my home school program even though they loved me, but I included it in my rank list in case I did not make my other top or reach choices.

 

[melonque]

Thank you so much for the advice. I really appreciate it. For the step 2, my studying is coming really bad even it's just 3 weeks away. I think at best I will probably get about the same score as my step 1 (203), or maybe slightly less with bad luck. Should I go ahead to take step 2 now? Or should I just go ahead with my step 1 score? Thanks.

 

[FoughtFyr]

Thank you so much for the advice. I really appreciate it. For the step 2, my studying is coming really bad even it's just 3 weeks away. I think at best I will probably get about the same score as my step 1 (203), or maybe slightly less with bad luck. Should I go ahead to take step 2 now? Or should I just go ahead with my step 1 score? Thanks.

I was in the same boat last year. I had a 210 and felt as though I was not going to raise it with a step 2 taken in late August. I bailed on step 2 until late December (I passed, but did worse than on step 1). My logic went like this...

1. For those programs with cutoffs, I made the 200s but wasn't going to make the 220s.

2. If I "left well enough alone", those programs that wanted to extend me the benefit of the doubt as to my ability to score better still could, but if I took step 2 and bombed, I would remove all doubt.

3. I figured there really are only three scores in EM first is "oh no - that's ugly" (i.e., sub 200 or 190), "holy cow - that rocks" (i.e., 230 or 240 +) and then "everyone else". I really didn't think I was going to change my score on this scale.

So, I guess my advice is don't take step 2 yet, let the step 1 score ride. I did with a very similar score and matched at my #1 (Mayo).

- H

 

[melonque]

Foughtfyr, thanks for the encouraging advice. Just quick question. How about I take the test in Sep, but withhold the score for ERAS. Will residency program know that I took the test, but choose not releasing the score? If they know, then I guess they will definitely think that I must have done bad in the test, and that's why I withhold the score...Right? Thanks. This thread is very helpful for me. 🙂

 

[FoughtFyr]

Foughtfyr, thanks for the encouraging advice. Just quick question. How about I take the test in Sep, but withhold the score for ERAS. Will residency program know that I took the test, but choose not releasing the score? If they know, then I guess they will definitely think that I must have done bad in the test, and that's why I withhold the score...Right? Thanks. This thread is very helpful for me. 🙂

I don't know. I just delayed my test until late December (originally scheduled it in August) so it wouldn't matter. Plus, it was a HUGE relief to have the test "not matter" beyond pass/fail.

- H