Possibilities of Matching into Cardiology with a Low Step 1 Score

[ballernation80]

Hi,

I am a current MS4 at a mid tier MD school in the North East. I have always been very interested in going into Cardiology and have some research in the area. I just wanted to hear thoughts on the possibility of me matching into Cardiology in the future at any institution that will take me and what I can do to improve my chances as well? My step 1 is a 219 and Step 2 is a 252. My mom died 5 months before Step 1 sadly and that definitely affected my performance on Step 1.
I am willing to go anywhere and will be applying to IM programs that have Cardiology fellowships attached to the hospital. Thanks in advance!

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[Egghead34]

I matched with a Step 1 just a few points higher and a Step 2 about 20 points lower, and I’m an FMG. You might not get into Mayo, but as an AMG this is totally within your reach.

 

[disorder]

Our program screens by Step1.
Sorry about your mom. It's an unfair lot in life to have happened when it did (and even at all).

But, you are going to graduate med school. You've done well on Step 2. You have the fortitude. Attempt to match into the best IM residency you can, and you will match into a cards program assuming you've done nothing egregious during residency.

 

[deleted709825]

@disorder
What cutoff do you use? Do you think that it will change in the coming years? (Either increase, or move to Step 2 screening as Step 1 will be pass/fail, even though you still have scores for current residents.)

 

[disorder]

@disorder
What cutoff do you use? Do you think that it will change in the coming years? (Either increase, or move to Step 2 screening as Step 1 will be pass/fail, even though you still have scores for current residents.)

Somewhere ~230.
I don't know what will happen when there's the transition between some residents with and without step 1 scores.
I think we'll likely move to Step 2 scores for screening and potentially place heavier emphasis on where future residents are coming from.

PSA- I'm not a PD.

 

[Prehealth1011]

Check the NRMP data:

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2018/10/2018-Charting-Outcomes-SMS.pdf

 

[shouldigomd]

Your chances are fine I wouldn't worry about it. Go to the most reputable IM program you can as unfortunately (dumb system) this is the most important thing you can do to improve your chances. Do research and stay involved.

Don't worry about an attached cards fellowship (although most reputable IM programs have this) as in many cases it is actually a disadvantage.

Your step score will perhaps hurt your chances at top programs but just work hard and you will have no issues landing a solid mid level program. I am a cards fellow and the truth is after having gone on 12 interviews you realize the vast majority of places will give you solid cardiology training and it is really on you to study / invest the effort to be a good cardiologist.

 

[deleted709825]

@shouldigomd Why is an attached fellowship a disadvantage? I usually hear that you should apply to a place with the fellowship you're interested in.

 

[disorder]

Your chances are fine I wouldn't worry about it. Go to the most reputable IM program you can as unfortunately (dumb system) this is the most important thing you can do to improve your chances. Do research and stay involved.

Don't worry about an attached cards fellowship (although most reputable IM programs have this) as in many cases it is actually a disadvantage.

Your step score will perhaps hurt your chances at top programs but just work hard and you will have no issues landing a solid mid level program. I am a cards fellow and the truth is after having gone on 12 interviews you realize the vast majority of places will give you solid cardiology training and it is really on you to study / invest the effort to be a good cardiologist.

I think your statement is more true for internal medicine training than cardiology fellowship.

I would really press the fellows hard during interview day about their training because there's actually a WIDE variance in exposure and volume (eg- some programs have fellows NEVER first to call on patients with house-staff as a buffer; other programs have fellows first to call on 50+ patients on nights/weekends). And it depends on what you want to do. The more you know about yourself and what you want to do in the future like - academics vs community and sub specialization - the easier it will be to find a program that suits you.

Want to do advanced HF/Tx? Not all programs have VAD or Tx programs. Honestly, programs with ROBUST advanced HF programs will probably give you the most solid training in that you will see the sickest patients. To aid an advanced HF program, you need robust EP and interventional programs.
Want to do structural interventions? Not all programs do high volumes of structural cases.
Want to do advanced imaging? Not all programs have cardiologists that read cardiac CT's or MRI's.
Want to do interventional? Every programs treats their general fellows differently. I've seen a wide variety in how much experience you get in the cath lab and it can be very hands off/on. Example- programs with robust interventional programs with several IV fellows won't let the general fellow utilize guide catheters, attempt to wire, balloon, etc.

 

[shouldigomd]

@shouldigomd Why is an attached fellowship a disadvantage? I usually hear that you should apply to a place with the fellowship you're interested in.

I think it can play in or out of your favor.... Some fellowships have a reputation of taking a lot of internal candidates and others take very few .... it just depends on many factors and politics. My point is really to say that more important than an in house fellowship are the trends of how many and where people do their cards fellowships.

Example:
Many programs only take a certain % of internals each year. For example if you take a mid sized program of 30-40 IM residents per year and 5-7 fellows per year .... In efforts to have a balanced class the cards program will take maybe 1-2 internal candidates. If nobody in your class wants to do cards you are in good shape but if 10 people do .... you are almost at a disadvantage coming from your own program if you really want to stay.

 

[deleted980918]

Yea there are step1 cutoffs. There is nothing you can do about it at this point. Based on personal experience, The biggest factor by far is your residency program. You can be worst candidate out of a top10 IM program I bet you will still match better than the chief coming out of a mid tier residency. that might be a overstatement but you get my point.

 

[ballernation80]

Awesome thank you all for the help! I will definitely put my best effort into matching the best possible IM program that I can and will continue to work hard to hopefully get to my goal

 

[Egghead34]

I’m a US IMG and matched at a strong community program with a ~225 step 1, ~230step 2, ~230 step 3.

 

[USIMGCardsFellow]

I'm a US IMG cards fellow - my step scores are similar, my step 1 was a little lower and I matched into a university cards fellowship. Unfortunately the scores are used as a screening tool which will definitely hurt you - I was a third year chief resident and that was looked at very favorably on the interview trail.