Radiology/DO/Step 1 P/F

[Butters Stotch]

Hello I am currently an incoming DO student and looking to match into a diagnostic radiology program. Just wanted the input of anyone involved in residency selection on the outlook and chances and how important will research play a role. Thank you.

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[giguerex35]

also interested in this

 

[SeisK]

Likely that Step 2 CK will replace Step 1 in terms of filtering applicants. Be sure to take it early after clerkships are complete, before applications go out. As far as determining if you’re good enough to reasonably hope for a competitive specialty, use your clerkship NBMEs as your gauge.

The scariest part of this change is you can bomb Step 2 CK literally weeks before applications go out and you can be utterly hosed, so take it as soon as you reasonably can, after a month’s worth of dedicated studying.

You’re going to have to hedge now as part of your strategy—you can’t just follow one specialty at a time anymore. Have radiology in mind, but then a less competitive specialty backup simultaneously, and act like you’re applying for both as you go through third year, in particular how you’re acquiring your letters. As radiology 4th year electives really don’t matter, I’d probably recommend front-loading your 4th year with your backup / 2nd specialty electives (as this way you can accrue letters for both specialties), and then using your CK result as your key to determine which specialty to finalize on as application submission nears.

Thankfully radiology is one of those specialties where you really don’t have to have a huge amount of commitment early on. I feel really bad for ortho/derm/nsg applicants, as one bad test result can well and truly rip their life plans apart, or throw an extra year into the mix, with as little as a few days to weeks to plan, execute, and then accustom yourself to the change. Third through early 4th year is going to be a damned nightmare.

 

[odyssey2]

For those of us applying in the next couple cycles, when Step 1 is still scored, do you see it being deemphasized with more of an emphasis placed on Step 2, given that adcoms are aware of the change that's about to happen?

 

[SeisK]

For those of us applying in the next couple cycles, when Step 1 is still scored, do you see it being deemphasized with more of an emphasis placed on Step 2, given that adcoms are aware of the change that's about to happen?

Sincerely doubt it. The utility of Step 1 comes from its ability to 1) predict Core exam performance and 2) its utility as a means of forming a spectrum of applicant performance with a universal standard. Those two things haven’t changed. Step 1 will remain king until it’s gone, I believe.

 

[Butters Stotch]

Sincerely doubt it. The utility of Step 1 comes from its ability to 1) predict Core exam performance and 2) its utility as a means of forming a spectrum of applicant performance with a universal standard. Those two things haven’t changed. Step 1 will remain king until it’s gone, I believe.

How important is research and aways (if I’m hoping to match into any university MD program)?

 

[SeisK]

How important is research and aways (if I’m hoping to match into any university MD program)?

Aways are like auditions for a program you really want to match at, moreso if your Step 2 is borderline. Really only gets your foot in the door for an interview at that one program, but doesn’t add benefit if your Step 2 is above and beyond.

One productive rads research project should meet the requirement for any academic MD program.

 

[Butters Stotch]

Aways are like auditions for a program you really want to match at, moreso if your Step 2 is borderline. Really only gets your foot in the door for an interview at that one program, but doesn’t add benefit if your Step 2 is above and beyond.

One productive rads research project should meet the requirement for any academic MD program.

What about aways to obtain a radiology LoR? The DO school has a MD radiology program nearby and will try to establish a connection so I can shadow and volunteer on research projects.

 

[recycledpaper]

I'm a DO grad who tried to match rads in California but fell short despite having 3 interviews, although those 3 interviews likely came as a result of my aways there. I felt like it was really hard to impress attendings on radiology rotations, except for IR, so it's likely I hurt myself by doing an away, despite getting interviews. I would not recommend doing aways at places you want to go, unless you are 100% sure you can knock it out of the park.

Otherwise, my LORs were from my clinical rotations: one surgery, one ob/gyn, and one radiology from a community radiologist.

I don't think it is hard to match radiology as a DO if you have a certain set of checked boxes on your application, but it is a bit more difficult to match at a good program in a desirable location. Feel free to PM me and I can break down my interviews and the gist of my app (keep in mind I applied in 2018).

 

[Alex1991]

Do you think past working experience as a registered radiologic technologist RT (R) (8 years) would help a DO matching into diagnostic radiology residency?

 

[deleted564680]

The Step 1 score was the only thing DOs could use to have a chance at any of the top 50 programs. The P/F change will hurt DOs a ton. The only chance you have now is to do aways at prestigious hospitals and hope to get good letters from their "famous" people.

The future is clear... DO = primary care, MD = specialist.

 

[Butters Stotch]

The Step 1 score was the only thing DOs could use to have a chance at any of the top 50 programs. The P/F change will hurt DOs a ton. The only chance you have now is to do aways at prestigious hospitals and hope to get good letters from their "famous" people.

The future is clear... DO = primary care, MD = specialist.

Lol with all due respect not every Md wants to specialize, 1/3 to 40% of schools have their kids do PC bc that’s what they actually want to do. There is still step 2. If there wasn’t that then yeah I would agree. This only puts a stronger glass ceiling on surgical specialties and matching into top 50 programs. Even before this p/f nearly 50% of DO students match into PC doubt it will change

 

[bigt1mer]

The Step 1 score was the only thing DOs could use to have a chance at any of the top 50 programs. The P/F change will hurt DOs a ton. The only chance you have now is to do aways at prestigious hospitals and hope to get good letters from their "famous" people.

The future is clear... DO = primary care, MD = specialist.

Even getting an away at a big place might be harder going forward. I'm a 3rd year DO student already in the process of applying for aways and I don't know if I would stand a chance without my step 1 score. I'm glad I made it through before the p/f step 1.

 

[thatsrad]

COMLEX 1 is still going to be scored. Many programs who have a history of taking DOs are actually familiar with what a good COMLEX score is, so do well on it. Pass/fall for Step 1 is actually good for DOs because they historically don’t do as well and it hurts them. For those who do well (>240), it doesn’t really open any real doors. It’s been a lose-lose situation.

I know multiple people who matched to MD programs (before merger) with only COMLEX. Borderline candidates can now take Step 1 and just barely pass and it will be a positive instead of hindrance. I don’t think DOs should take Step 2, it is very high risk with extremely limited upside. Most programs do not require it for ranking DO students (COMLEX Level 2 suffices). For those that do require Step 2 from DOs, you probably won’t match there anyway.

Based on my experience as a DO matching radiology, later being involved on the program side, seeing how DO friends and classmates fared, especially given these changes, I think this will be a good change overall. DOs are not seriously considered at top 50 programs other than exceptional cases. But don’t worry, you will be more prepared for PP volumes and most jobs coming from a good community or busy pseudo academic program. You can even still end up in academics if you want. Just go to a big name fellowship and you can get into academics. Fellowships are a buyers market and you can have your pick in many subspecialties (excluding IR and MSK).

 

[thatsrad]

As far as aways, do NOT do them if you are doing it to get some sort of advantage there. It WILL NOT help you.

Only do it at a program you already have a high chance of matching and you want to get an inside view to see if the place is right for you.

 

[thatsrad]

I encourage more DOs to apply radiology. You can match if you are not picky about programs/locations.

If you are a weak candidate (bottom 1/2 of your DO class), don’t take step 1. And definitely don’t take step 2. I would only take Step 2 if you are a superstar. You can match with COMLEX only.

 

[risus_sardonicus]

I encourage more DOs to apply radiology. You can match if you are not picky about programs/locations.

If you are a weak candidate (bottom 1/2 of your DO class), don’t take step 1. And definitely don’t take step 2. I would only take Step 2 if you are a superstar. You can match with COMLEX only.

This sounds like terrible advice. Unless your goal is to match former AOA programs, taking USMLE exams is not only mandatory but doing well on them is also just as important. Met with a ton of PDs this cycle who had no idea how COMLEX is scored.


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[Butters Stotch]

This sounds like terrible advice. Unless your goal is to match former AOA programs, taking USMLE exams is not only mandatory but doing well on them is also just as important. Met with a ton of PDs this cycle who had no idea how COMLEX is scored.


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how is the outlook for dos matching with the step 1 going p/f?

 

[Butters Stotch]

COMLEX 1 is still going to be scored. Many programs who have a history of taking DOs are actually familiar with what a good COMLEX score is, so do well on it. Pass/fall for Step 1 is actually good for DOs because they historically don’t do as well and it hurts them. For those who do well (>240), it doesn’t really open any real doors. It’s been a lose-lose situation.

I know multiple people who matched to MD programs (before merger) with only COMLEX. Borderline candidates can now take Step 1 and just barely pass and it will be a positive instead of hindrance. I don’t think DOs should take Step 2, it is very high risk with extremely limited upside. Most programs do not require it for ranking DO students (COMLEX Level 2 suffices). For those that do require Step 2 from DOs, you probably won’t match there anyway.

Based on my experience as a DO matching radiology, later being involved on the program side, seeing how DO friends and classmates fared, especially given these changes, I think this will be a good change overall. DOs are not seriously considered at top 50 programs other than exceptional cases. But don’t worry, you will be more prepared for PP volumes and most jobs coming from a good community or busy pseudo academic program. You can even still end up in academics if you want. Just go to a big name fellowship and you can get into academics. Fellowships are a buyers market and you can have your pick in many subspecialties (excluding IR and MSK).

what is considered a good comlex score? any other boxes that need to be checked in order to ensure a good match from the DO side?

 

[thatsrad]

what is considered a good comlex score? any other boxes that need to be checked in order to ensure a good match from the DO side?

600+ great
550+ good

 

[thatsrad]

This sounds like terrible advice. Unless your goal is to match former AOA programs, taking USMLE exams is not only mandatory but doing well on them is also just as important. Met with a ton of PDs this cycle who had no idea how COMLEX is scored.


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USMLE is certainly not mandatory. I matched my #2 on MD side before merger without it, had plenty of interviews. I know of at least a few others who had similar results.

 

[thatsrad]

A bad USMLE score (or even worse... failing) on Step 1 or Step 2 for a DO is much much worse than not taking it. Sure, many programs will absolutely not consider you without them, but they won’t consider someone (especially who happens to be DO) with a Step 1 of <220 anyways. Any Step 1 <230 is probably worse than not having one. 230’s is a wash. If you are very confident you’ll score at least 240, then do it. But then don’t take Step 2, it’s an unnecessary risk. Honestly, most DO’s are not going to be scoring 240+, so unless you’re top notch, it’s risky.

 

[thatsrad]

I think with P/F, it will then be a good idea for DOs to take Step 1, because no risk of a below average or “barely passing” score hurting you, and most people will pass no problem. Then you’ll be on equal footing scores-wise.

 

[risus_sardonicus]

how is the outlook for dos matching with the step 1 going p/f?

Hard to say, but based on the last few cycles: not good. More and more programs are requiring a decent step 1 score (>235-240) as a screen, and now that it won’t exist, I expect step 2 CK to replace it.


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[risus_sardonicus]

USMLE is certainly not mandatory. I matched my #2 on MD side before merger without it, had plenty of interviews. I know of at least a few others who had similar results.

I almost don’t believe you. Either you got really lucky or you applied during that one strange cycle where radiology was taking anyone with a pulse. Regardless, without a decent step 1 score (at least before it becomes P/F) I would not count on landing many interviews as a DO


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[Butters Stotch]

Hard to say, but based on the last few cycles: not good. More and more programs are requiring a decent step 1 score (>235-240) as a screen, and now that it won’t exist, I expect step 2 CK to replace it.


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I mean of course it’s not good in the grand scheme of things as DO tend to score lower on step 1(even though some don’t). Would the cutoff just be 235-240 step 2 ck?

 

[risus_sardonicus]

I mean of course it’s not good in the grand scheme of things as DO tend to score lower on step 1(even though some don’t). Would the cutoff just be 235-240 step 2 ck?

I would expect it to be higher. When I took the exam last year the median was 244. I would not be surprised if the cutoff is at least >240-245.


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[Butters Stotch]

I would expect it to be higher. When I took the exam last year the median was 244. I would not be surprised if the cutoff is at least >240-245.


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Which resources did you use for step 2?

 

[thatsrad]

I almost don’t believe you. Either you got really lucky or you applied during that one strange cycle where radiology was taking anyone with a pulse. Regardless, without a decent step 1 score (at least before it becomes P/F) I would not count on landing many interviews as a DO


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My year wasn’t the 140 unfilled spots.

I had 7 interviews on MD side with only COMLEX and know others who had several too, so it wasn’t a fluke.

 

[risus_sardonicus]

Which resources did you use for step 2?

There are a lot of posts on step 2 in separate forums. But the usual that most ppl use:
1. Uworld Qbank
2. Online Med Ed
3. Step up to medicine
4. Comquest Qbank (for the strange COMLEX 2 CE style questions)


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[risus_sardonicus]

My year wasn’t the 140 unfilled spots.

I had 7 interviews on MD side with only COMLEX and know others who had several too, so it wasn’t a fluke.

I gotta say I’m surprised and impressed. Maybe things have changed significantly but I highly doubt you would have the same return without any Step exams on your app.

 

[thatsrad]

I gotta say I’m surprised and impressed. Maybe things have changed significantly but I highly doubt you would have the same return without any Step exams on your app.

It does seem that competitiveness for diagnostic radiology spots has increased over the past few years, so maybe wouldn’t have the same results in today’s environment.

 

[OlivesandChips]

I encourage more DOs to apply radiology. You can match if you are not picky about programs/locations.

If you are a weak candidate (bottom 1/2 of your DO class), don’t take step 1. And definitely don’t take step 2. I would only take Step 2 if you are a superstar. You can match with COMLEX only.

Not applying rads but was viewing this thread for a friend. I’m a fourth year applying primary care. Failed comlex level 1 but salvaged my app with a 258 on step 2 ck and scored similarly well on comlex level 2. no step 1 score. Step 2 CK has nothing to do with being a rockstar in my case at least. The decision whether or not to take that test should entirely be made on performance on the shelf exams, U world, Uworld assessments and NBME exams. The performance of the first two years does not need to necessarily correlate with third year.

I think DO applicants applying radiology in the future should do everything they can to make their apps comparable: take step 1 even with it being p/f, and subsequently take and perform well on Step 2 CK. Having gaps or missing variables from MD applicants will not help.

 

[mediscene]

COMLEX 1 is still going to be scored. Many programs who have a history of taking DOs are actually familiar with what a good COMLEX score is, so do well on it. Pass/fall for Step 1 is actually good for DOs because they historically don’t do as well and it hurts them. For those who do well (>240), it doesn’t really open any real doors. It’s been a lose-lose situation.

I know multiple people who matched to MD programs (before merger) with only COMLEX. Borderline candidates can now take Step 1 and just barely pass and it will be a positive instead of hindrance. I don’t think DOs should take Step 2, it is very high risk with extremely limited upside. Most programs do not require it for ranking DO students (COMLEX Level 2 suffices). For those that do require Step 2 from DOs, you probably won’t match there anyway.

Based on my experience as a DO matching radiology, later being involved on the program side, seeing how DO friends and classmates fared, especially given these changes, I think this will be a good change overall. DOs are not seriously considered at top 50 programs other than exceptional cases. But don’t worry, you will be more prepared for PP volumes and most jobs coming from a good community or busy pseudo academic program. You can even still end up in academics if you want. Just go to a big name fellowship and you can get into academics. Fellowships are a buyers market and you can have your pick in many subspecialties (excluding IR and MSK).

Surprise, complex 1 is going p/f also

 

[Steve_Zissou]

I would expect it to be higher. When I took the exam last year the median was 244. I would not be surprised if the cutoff is at least >240-245.


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The range for step 1 scores that match is fairly large, is this the same case for step 2?