Scrambling into Rejected or Unanswered Locations

[neurosurg777]

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Hey Guys,

I am preparing for the scramble and was wondering if anyone could help me out. I am trying to have a game plan as to where to apply once the list comes out. In doing so I had a thought about applying to places that had rejected me or not answered me at all and wasn't sure if it's a good or bad idea.

What I mean is, if on scramble day one or more of the places I applied to that rejected me or did not even send a response to my application is on the list would it be a good idea to apply their. Would they immediately reject me cause they know I have already applied there and they didn't give me a chance the first time or would it look like I am being persistent and be taken in a good way?

If anyone has any experience with this please let me know. Thanks.

 

[gutonc]

Hey Guys,

I am preparing for the scramble and was wondering if anyone could help me out. I am trying to have a game plan as to where to apply once the list comes out. In doing so I had a thought about applying to places that had rejected me or not answered me at all and wasn't sure if it's a good or bad idea.

What I mean is, if on scramble day one or more of the places I applied to that rejected me or did not even send a response to my application is on the list would it be a good idea to apply their. Would they immediately reject me cause they know I have already applied there and they didn't give me a chance the first time or would it look like I am being persistent and be taken in a good way?

If anyone has any experience with this please let me know. Thanks.

The intersection of those two sets (Set 1: Places that rejected or ignored you; Set 2: Places with spots in the scramble) is likely to be vanishingly small (like, asymptotically approaching zero) so it's unlikely to be an issue.

You have little if anything to lose by applying to that program in the Scramble so, why not? Quite honestly, the programs you should focus your energy on are the first 30 you can click on in ERAS.

 

[mcl]

Hey Guys,

I am preparing for the scramble and was wondering if anyone could help me out. I am trying to have a game plan as to where to apply once the list comes out. In doing so I had a thought about applying to places that had rejected me or not answered me at all and wasn't sure if it's a good or bad idea.

What I mean is, if on scramble day one or more of the places I applied to that rejected me or did not even send a response to my application is on the list would it be a good idea to apply their. Would they immediately reject me cause they know I have already applied there and they didn't give me a chance the first time or would it look like I am being persistent and be taken in a good way?

If anyone has any experience with this please let me know. Thanks.

If those programs are participating in the scramble, I doubt they will be using the same interview criteria they initially used duirng the recruting season. There's not a guarantee you'll be considered, of course, but they wouldn't reject you just because you had previously applied.

When my program didn't fill, we ended up taking someone in the scramble who had applied to our program but had not been given an interview. It was before ERAS was used as a scramble tool, and I appreciated having the applicant's information already available for me to print for the PD.

 

[Law2Doc]

Hey Guys,

I am preparing for the scramble and was wondering if anyone could help me out. I am trying to have a game plan as to where to apply once the list comes out. In doing so I had a thought about applying to places that had rejected me or not answered me at all and wasn't sure if it's a good or bad idea.

What I mean is, if on scramble day one or more of the places I applied to that rejected me or did not even send a response to my application is on the list would it be a good idea to apply their. Would they immediately reject me cause they know I have already applied there and they didn't give me a chance the first time or would it look like I am being persistent and be taken in a good way?

If anyone has any experience with this please let me know. Thanks.

Well, there's really two possibilities: (1) they didn't want to touch you before so they won't want you any better now, or (2) they will appreciate your continued interest more now that they are desperate. As gutonc said, the places that rejected you or ignored you may well not end up on the scramble list so I wouldn't spent too much time on this. I personally think you probably are better off with places where you don't have a history, but it probably doesn't matter that much. The goal in the scramble is to fire off as many salvos as you can and hope you hit something. Focus on specialty and location and don't be unrealistic or try to game the system.

 

[neurosurg777]

Thanks a lot for all the info guys. I really appreciate it. So I guess then if those programs do by chance (however small) end up on the list then no harm, no foul for trying again.

Also if you guys have any advice on what I can do to prepare before hand that would be great. I mean other than the usual stuff like fax machine, multiple lines to call with, friends and family helping in faxing/calling etc. I mean is there anything I can do to guesstimate at what programs may be on the list so that I can concentrate on the ones I want. That way I can do some research on them and be able to be better prepared for the phone interview. Would looking at last years match outcome give an idea? Would emailing on scramble day after picking those 30 spots on ERAS in order to apply to more places be better than faxing? Any help to get me prepared for that day so that I can be systematic would be great. Thanks again.

 

[gutonc]

Thanks a lot for all the info guys. I really appreciate it. So I guess then if those programs do by chance (however small) end up on the list then no harm, no foul for trying again.

Also if you guys have any advice on what I can do to prepare before hand that would be great. I mean other than the usual stuff like fax machine, multiple lines to call with, friends and family helping in faxing/calling etc. I mean is there anything I can do to guesstimate at what programs may be on the list so that I can concentrate on the ones I want. That way I can do some research on them and be able to be better prepared for the phone interview. Would looking at last years match outcome give an idea? Would emailing on scramble day after picking those 30 spots on ERAS in order to apply to more places be better than faxing? Any help to get me prepared for that day so that I can be systematic would be great. Thanks again.

Looking at a single year's unmatched list is not likely to be helpful. 1 or 2 good programs in competitive specialties go unmatched every year, usually due to some failure in submitting their rank list. The money is going to be on programs that consistently go unfilled for one reason (they suck) or another (their location sucks). That's where the money's going to be.

 

[neurosurg777]

Looking at a single year's unmatched list is not likely to be helpful. 1 or 2 good programs in competitive specialties go unmatched every year, usually due to some failure in submitting their rank list. The money is going to be on programs that consistently go unfilled for one reason (they suck) or another (their location sucks). That's where the money's going to be.

Thanks again for the help. Looking at a single years wouldn't be helpful, but how about looking at the last two or three? At this point I don't know who sucks and which locations suck because when I applied I didn't think I wouldn't have anyone interested in me. I mean correct me if I am wrong but is Harlem a competitive/highly sought after spot because they rejected me.

I applied to 95% community/less competitive programs and thought that I would get at least a few IV's. I didn't think I would get 50 of them but at least 5 would have been nice. So now I don't know who and where I am competitive enough for. This is actually really stressing me out because I don't know what I should do on scramble day. I mean I understand if I had some IV's, made a ROL and then didn't match and had to scramble then I could kinda chose where to apply again because someone gave me chance but when no one does you tend to think you are a pretty horrible candidate and don't know where to begin.

Is there nothing I can do, other than the usual fax, email, phone, paperwork, etc. to get prepared for that day in advance? Is there no research I can do to ensure that I can pick quickly and correctly in order to better prepare myself for that day and increase my chances of ending up somewhere? I just feel like there is more that could be done. I feel like somewhere someone else has done all their homework and are already ready for that day and know exactly what to do and how to do it and will in turn be faster and end up in a place.

Would emailing other programs after choosing my 30 on ERAS be better than faxing them when trying to apply to more locations?

Sorry if I am bugging, I'm just trying to ensure that the scramble goes well for me since the match didn't work out so well. Thanks again for your help.

 

[gutonc]

Thanks again for the help. Looking at a single years wouldn't be helpful, but how about looking at the last two or three? At this point I don't know who sucks and which locations suck because when I applied I didn't think I wouldn't have anyone interested in me. I mean correct me if I am wrong but is Harlem a competitive/highly sought after spot because they rejected me.

I applied to 95% community/less competitive programs and thought that I would get at least a few IV's. I didn't think I would get 50 of them but at least 5 would have been nice. So now I don't know who and where I am competitive enough for. This is actually really stressing me out because I don't know what I should do on scramble day. I mean I understand if I had some IV's, made a ROL and then didn't match and had to scramble then I could kinda chose where to apply again because someone gave me chance but when no one does you tend to think you are a pretty horrible candidate and don't know where to begin.

Is there nothing I can do, other than the usual fax, email, phone, paperwork, etc. to get prepared for that day in advance? Is there no research I can do to ensure that I can pick quickly and correctly in order to better prepare myself for that day and increase my chances of ending up somewhere? I just feel like there is more that could be done. I feel like somewhere someone else has done all their homework and are already ready for that day and know exactly what to do and how to do it and will in turn be faster and end up in a place.

Would emailing other programs after choosing my 30 on ERAS be better than faxing them when trying to apply to more locations?

Sorry if I am bugging, I'm just trying to ensure that the scramble goes well for me since the match didn't work out so well. Thanks again for your help.

Specialty?

Locations you applied?

Red flags (you clearly have some, what are they and how bad are they...this matters)?

Did you get any interviews or will you be scrambling no matter what happens?

 

[neurosurg777]

Specialty?

Locations you applied?

Red flags (you clearly have some, what are they and how bad are they...this matters)?

Did you get any interviews or will you be scrambling no matter what happens?

Hey thanks again for taking the time to help.

I have always wanted surgery but knowing the red flags I have I split my list up into about 50/50 in General Surgery and IM with a few FP in there for backup.

I applied to 150 places, everywhere from Northridge and Glendale FP in California to Harlem and Jersey shore surgery, flushing IM, etc. Places I know my fellow classmates have applied and gotten in. There are too many to list but states wise I applied to California, Arizona, Colorado, Florida, Idaho, Illinois, Massachusetts, Michigan, New Mexico, Nevada, Oregon, Utah, Washington, Alabama, Georgia, New York, New Jersey, and Connecticut.

Yes I have three major red flags which I wish I could change but unfortunately I can't. Low step 1 score, low step 2 score, and caribbean grad. However I have all the right LOR's, evals, etc. I have top surgeons/PD in their field writing me LOR's and all me evals are basically honors with statements like "worked on an intern level and showed above average surgical skills compared to other students and learns quickly and knows the basic science of medicine well and implements it clinically well". So what I look like on paper is the exact opposite of what I end up reflecting as in real life.

No IV's which is why I don't know how to feel and what to think.

Hope this helps. Thanks again

 

[gutonc]

Hey thanks again for taking the time to help.

I have always wanted surgery but knowing the red flags I have I split my list up into about 50/50 in General Surgery and IM with a few FP in there for backup.

I applied to 150 places, everywhere from Northridge and Glendale FP in California to Harlem and Jersey shore surgery, flushing IM, etc. Places I know my fellow classmates have applied and gotten in. There are too many to list but states wise I applied to California, Arizona, Colorado, Florida, Idaho, Illinois, Massachusetts, Michigan, New Mexico, Nevada, Oregon, Utah, Washington, Alabama, Georgia, New York, New Jersey, and Connecticut.

Yes I have three major red flags which I wish I could change but unfortunately I can't. Low step 1 score, low step 2 score, and caribbean grad. However I have all the right LOR's, evals, etc. I have top surgeons/PD in their field writing me LOR's and all me evals are basically honors with statements like "worked on an intern level and showed above average surgical skills compared to other students and learns quickly and knows the basic science of medicine well and implements it clinically well". So what I look like on paper is the exact opposite of what I end up reflecting as in real life.

No IV's which is why I don't know how to feel and what to think.

Hope this helps. Thanks again

OK, so that's 3 strikes against you. I would venture to guess that your "strong LORs, evals, etc" didn't even get looked at by most programs since your IMG status and/or bad step scores probably got your app screened out before they even got that far.

Your red flags will put essentially all Gen Surg programs (aside from prelim) out of reach for you. A prelim GS spot will give you a chance to be somebody's whipping boy for a year or two and will be unlikely to get you further than that. As such, it's probably not worth focusing on any GS programs (prelim or cat) in the scramble...it'll be a waste of your time.

As for IM, while less competitive than GS, is still hard to get into if you have a sketchy CV. Also, if all of your LORs say "Neurosurg777 will make a great surgeon" that's probably not helping your case, if you get past the initial IMG/Step filters. Also, you did write separate personal statements for the different specialties, didn't you?

FM is less competitive but the LOR/PS issue above likely applies here too. Also, people not going into FM tend to think that the programs in the middle of nowhere are going to be less competitive when the opposite is true. An unopposed (no other residents in the hospital) FM program can be a really tough program to get into since the FM residents are going to get all the medicine, peds, OB and surgery they want (probably more of some than they want) and don't have to fend off other residents.

So what can you do now?

1. If you don't have them already, get LORs that don't say you're going to be a great surgeon...unfortunately, you're unlikely to have that chance...sorry.

2. Make sure you write new, fresh PS's for IM and FM (Psych? Peds?).

3. Find old Scramble lists and look at who's gone unmatched year after year (again, ignore prelim surg spots...you don't want that). Focus your ERAS 30 (and faxing/emailing) there, that's likely to be your best shot.

 

[Law2Doc]

... A prelim GS spot will give you a chance to be somebody's whipping boy for a year or two and will be unlikely to get you further than that. As such, it's probably not worth focusing on any GS programs (prelim or cat) in the scramble...it'll be a waste of your time.
...

I'm going to take a slightly different view on this one. I know a few folks who managed to turn a prelim GS spot into a categorical one. Some community programs are willing to do this for 1-2 of the better undesignated interns each year. Makes sense -- if they like you as an intern and you do solid on the absite, etc, it doesn't really make sense for them to gamble on someone in the match. Sometimes folks get grabbed with the condition that you repeat your intern year again after they make you categorical, which means a longer residency, but at least you get in. Whether they will do this for an offshore grad depends on the program, and how well you do during your prelim. So you really want to tap your surgery alumni and see if any are on such a path, or know which places might be fruitful. So yeah, I think if you are really hell bent on surgery, landing one of the MANY prelims out there, whichever gives you the most hope of staying on, might be the right move.

You have to ask around, and then ask again during the PD telephone "interview" in the scramble. They may give you false hope -- they don't even know whether you will work out, be liked, etc. They just want to fill the spot. And you may have to go that extra mile during intern year, even if it means doing more than everyone else, just to prove yourself. You will have a rough year, and there's still a decent chance you will have nothing to show for it at the end. It's a hail mary pass for sure, and will cost you a year. But the game isn't over if you don't want it to be.

If you don't really care about field and just want to be a doctor already, then gutonc is right. There will be lower hanging categorical fruit that you may a shot at. But either way, if landing a passed over FM/peds spot is an option, it still will be after a prelim surgery year. For those with application red flags, having completed an intern year without any issues is sometimes helpful. Plus after an intern year, even a rough prelim year, you will be able to get licensed, which opens the GP door if need be. That's my two cents.

 

[medocus]

I'm going to take a slightly different view on this one. I know a few folks who managed to turn a prelim GS spot into a categorical one. Some community programs are willing to do this for 1-2 of the better undesignated interns each year. Makes sense -- if they like you as an intern and you do solid on the absite, etc, it doesn't really make sense for them to gamble on someone in the match. Sometimes folks get grabbed with the condition that you repeat your intern year again after they make you categorical, which means a longer residency, but at least you get in. Whether they will do this for an offshore grad depends on the program, and how well you do during your prelim. So you really want to tap your surgery alumni and see if any are on such a path, or know which places might be fruitful. So yeah, I think if you are really hell bent on surgery, landing one of the MANY prelims out there, whichever gives you the most hope of staying on, might be the right move.

You have to ask around, and then ask again during the PD telephone "interview" in the scramble. They may give you false hope -- they don't even know whether you will work out, be liked, etc. They just want to fill the spot. And you may have to go that extra mile during intern year, even if it means doing more than everyone else, just to prove yourself. You will have a rough year, and there's still a decent chance you will have nothing to show for it at the end. It's a hail mary pass for sure, and will cost you a year. But the game isn't over if you don't want it to be.

If you don't really care about field and just want to be a doctor already, then gutonc is right. There will be lower hanging categorical fruit that you may a shot at. But either way, if landing a passed over FM/peds spot is an option, it still will be after a prelim surgery year. For those with application red flags, having completed an intern year without any issues is sometimes helpful. Plus after an intern year, even a rough prelim year, you will be able to get licensed, which opens the GP door if need be. That's my two cents.

Thank you for this post. At least you didn't take all hope away. Having said that, it is really difficult out there. I guess the only way to get where you want to be, is to keep fighting.

 

[neurosurg777]

OK, so that's 3 strikes against you. I would venture to guess that your "strong LORs, evals, etc" didn't even get looked at by most programs since your IMG status and/or bad step scores probably got your app screened out before they even got that far.

Your red flags will put essentially all Gen Surg programs (aside from prelim) out of reach for you. A prelim GS spot will give you a chance to be somebody's whipping boy for a year or two and will be unlikely to get you further than that. As such, it's probably not worth focusing on any GS programs (prelim or cat) in the scramble...it'll be a waste of your time.

As for IM, while less competitive than GS, is still hard to get into if you have a sketchy CV. Also, if all of your LORs say "Neurosurg777 will make a great surgeon" that's probably not helping your case, if you get past the initial IMG/Step filters. Also, you did write separate personal statements for the different specialties, didn't you?

FM is less competitive but the LOR/PS issue above likely applies here too. Also, people not going into FM tend to think that the programs in the middle of nowhere are going to be less competitive when the opposite is true. An unopposed (no other residents in the hospital) FM program can be a really tough program to get into since the FM residents are going to get all the medicine, peds, OB and surgery they want (probably more of some than they want) and don't have to fend off other residents.

So what can you do now?

1. If you don't have them already, get LORs that don't say you're going to be a great surgeon...unfortunately, you're unlikely to have that chance...sorry.

2. Make sure you write new, fresh PS's for IM and FM (Psych? Peds?).

3. Find old Scramble lists and look at who's gone unmatched year after year (again, ignore prelim surg spots...you don't want that). Focus your ERAS 30 (and faxing/emailing) there, that's likely to be your best shot.

Yeah I figured that much. It's sad because most physicians that knew me on rotations would never guess I was that bad on paper.

That's kinda disheartening because I know I am cut out for surgery. I'm just not cut out for exams. I mean if a top pediatric neurosurgeon thinks I am cut out for surgery and can do well shouldn't that mean more to a PD than a step score saying that I suck and don't know anything. I don't know maybe it's just me but this whole system has gotten to the point where it rewards people who look better on paper rather than in real life.

I thought IM would be almost as tough as well but I looked at it like I could at least do something more with it. Sure it won't be surgery but at least I could specialize and work with my hands, like interventional cardio.

It's funny you say that but none of my LOR's say anything specific like that. All they talk about is my strengths and say stuff like "would make a great physician" and "would make a great asset to any residency program" among other nice things. So they really are just general LOR's but they are however mostly from surgeons. I have three from surgery and one from IM.

Yes I wrote different PS for each. I may have some similar themes in each one but I taylored them specifically to each field.

So if the opposite is true then I guess I have been looking at this the wrong way this whole time. I mean I don't know then where to apply. Can you give me some specific examples. I thought I was applying to community/less competitive programs. I actually avoided major University ones because I thought they were out of the question. Can you list a few specific locations that you think may work.

So since I do already have #1, #2 (can adjust them for peds because the theme still works just needs to be tweaked towards them), and can't find #3 (found last years but can't seem to find any year before that other than the NRMP one that stops at 2007) then what should I do. Do you think having the PD (assuming I get lucky and get a phone IV on that day) talk to one of the people that wrote my LOR help? Or would having a chief resident that is from the same hospital, for example a UCLA neurosurg chief resident calling in for me for the general surgery program help?

Thanks again for all your help, I really appreciate it.

 

[neurosurg777]

I'm going to take a slightly different view on this one. I know a few folks who managed to turn a prelim GS spot into a categorical one. Some community programs are willing to do this for 1-2 of the better undesignated interns each year. Makes sense -- if they like you as an intern and you do solid on the absite, etc, it doesn't really make sense for them to gamble on someone in the match. Sometimes folks get grabbed with the condition that you repeat your intern year again after they make you categorical, which means a longer residency, but at least you get in. Whether they will do this for an offshore grad depends on the program, and how well you do during your prelim. So you really want to tap your surgery alumni and see if any are on such a path, or know which places might be fruitful. So yeah, I think if you are really hell bent on surgery, landing one of the MANY prelims out there, whichever gives you the most hope of staying on, might be the right move.

You have to ask around, and then ask again during the PD telephone "interview" in the scramble. They may give you false hope -- they don't even know whether you will work out, be liked, etc. They just want to fill the spot. And you may have to go that extra mile during intern year, even if it means doing more than everyone else, just to prove yourself. You will have a rough year, and there's still a decent chance you will have nothing to show for it at the end. It's a hail mary pass for sure, and will cost you a year. But the game isn't over if you don't want it to be.

If you don't really care about field and just want to be a doctor already, then gutonc is right. There will be lower hanging categorical fruit that you may a shot at. But either way, if landing a passed over FM/peds spot is an option, it still will be after a prelim surgery year. For those with application red flags, having completed an intern year without any issues is sometimes helpful. Plus after an intern year, even a rough prelim year, you will be able to get licensed, which opens the GP door if need be. That's my two cents.

Hey thanks for taking the time to help too. I have heard that too and am hoping that as a last resort if that happens that if I do work really hard that I may end up being one of those people. I know however that it is really hard and does not happen frequently. I am sure that if I was a US grad then the chance would be higher. Yeah I have done that which is why I applied to many of the locations I did but I think their scores are much better. I know my scores are really screwing me but then again that's nothing new. I have been battling that my whole life. First the SAT's said I would be no good in college and then I got in and double majored, honored both majors, part of honor societies, graduated with honors, tutored/Ta, etc. all the right stuff where everyone in my school knew me and assumed I would succeed. Then the MCAT said I would be horrible in med school so I got lucky and got into a caribbean school and honored all my rotations and had physicians loving me and other students on my team jealously calling me the golden child. Then the USMLE said that I suck, don't know anything about medicine and would be a horrible resident but got offered a position with Kaplan to review their step 2 Qbank because I found so many mistakes (actual knowledge, not grammatical). So I know if I can just get lucky again that maybe, hopefully things will work out.

I thought about those options as well but unfortunately every time I think about it I get this feeling like I don't belong and it's not right for me and I steer back to my dreams of surgery. I wish I wasn't so stubborn but I just can't seem to shake this gut feeling. If I could my life would be easier.

Thanks for the help and if there is anything else you can think of that may help please let me know. Thanks again.

 

[MiniNMD]

First the SAT's said I would be no good in college and then I got in and double majored, honored both majors, part of honor societies, graduated with honors, tutored/Ta, etc. all the right stuff where everyone in my school knew me and assumed I would succeed. Then the MCAT said I would be horrible in med school so I got lucky and got into a caribbean school and honored all my rotations and had physicians loving me and other students on my team jealously calling me the golden child. Then the USMLE said that I suck, don't know anything about medicine and would be a horrible resident but got offered a position with Kaplan to review their step 2 Qbank because I found so many mistakes (actual knowledge, not grammatical). So I know if I can just get lucky again that maybe, hopefully things will work out.

There are a lot of people who think that low test scores shouldn't hold an otherwise amazing person back from pursuing what they want to in medicine. The problem with that idea, and you've sort of captured it here describing all the tests you've taken, is that you will have to take standardized testing for the rest of your life in medicine. It's not just getting the license, it's getting board certified, and then continually re-certified, etc. The problem with just ignoring test scores in trying to get a global picture of the applicant is that you can end up with someone who might fail an important exam and it can be hard to want to support someone's training if they run the risk of winding up in a bad situation because of a failed exam. A pattern of low test scores represents a risk in an applicant that some people are just not willing to take regardless of what everything else says, and I don't think it's unreasonable to have that point of view especially when there are so many out there without the same problem.

 

[ranmyaku]

Sure it won't be surgery but at least I could specialize and work with my hands, like interventional cardio.

This is funny. Can't get into general surg so I'll settle for an interventional cards spot. lmao.

I wouldn't do IM b/c you want to do interventional cards. You will be posting the exact same thing in a few years about how you can't get the fellowship you want. You will be unlikely to match in a cards fellowship with your red flags.

 

[neurosurg777]

There are a lot of people who think that low test scores shouldn't hold an otherwise amazing person back from pursuing what they want to in medicine. The problem with that idea, and you've sort of captured it here describing all the tests you've taken, is that you will have to take standardized testing for the rest of your life in medicine. It's not just getting the license, it's getting board certified, and then continually re-certified, etc. The problem with just ignoring test scores in trying to get a global picture of the applicant is that you can end up with someone who might fail an important exam and it can be hard to want to support someone's training if they run the risk of winding up in a bad situation because of a failed exam. A pattern of low test scores represents a risk in an applicant that some people are just not willing to take regardless of what everything else says, and I don't think it's unreasonable to have that point of view especially when there are so many out there without the same problem.

Yes I understand this but the counter balance to that argument is that there are many people who do well on those exams but lack the social skill to be a good physician. Being a good physician is much more than passing exams so while the risk of failing may be there it's only people that are in the profession that know stuff like that. A patients satisfaction is measured, especially in these days with how you interact with them much more than where you went and how you did on an exam. I have spoken to program directors that have agreed with me that they have residents that had all the right scores but can't seem to get the fundamental nature of how to treat ( I don't mean medically) a patient. They walk in do what they have to and then leave while the patients sits more confused. While someone like me had patients calling in for me by name when I was on rotations.

I may not do well but I don't fail so while those exams are important right now, the future ones you speak of have no bearing on your career other than to just pass. There is no score you have to get to be able to compete and get into a program and all that stuff. I studied less than two weeks for CS and passed with honors and that is supposed to show that you have the skills to be a physician so then why is that not weighted just as equally as CK which is supposedly the knowledge. Oh and don't kid yourself, CK is less about knowledge and more about lets see if you can get a question right based on some physician who was told to write a difficult question on something he feels others should know about a disease, disease process or management. That's even more true about step 1 with added minutia. I do have to admit though that my CK was more reasonable. I knew a lot of the answers. My problem is my reading comprehension speed and answering. It's not a lack of knowledge, it's a can't read and process fast enough to answer the question. I know that lots of people have time difficulties on these exams but mine compared to my average peers is much slower. If exam scores were right then according to my SAT's I should have been flipping burgers but my undergrad proved that wrong. I proved the MCAT wrong and now I have to prove the USMLE wrong. So while what you say may be true doesn't mean it applies across the board to everyone. Oh and if we use that logic then every physician should have to go back and take the exams that didn't exist when they were beginning training which they would probably fail because there is much more to know now than ever before and the level of difficulty has exponentially increased since their time. I remember a world renowned pediatric neurosurgeon admitting to his residents that he would probably fail the boards now if he had to take it again.

Thanks for your input though. At this point I am more concerned about making the right decisions on the scramble rather than what I may or may not fail in the future based on what I've done in the past.

 

[neurosurg777]

This is funny. Can't get into general surg so I'll settle for an interventional cards spot. lmao.

I wouldn't do IM b/c you want to do interventional cards. You will be posting the exact same thing in a few years about how you can't get the fellowship you want. You will be unlikely to match in a cards fellowship with your red flags.

That was just a general example of how you can still do stuff even though your not a surgeon. For example, I know people who couldn't get surg so they did OB/Gyn because you still get to operate. I didn't mean that's what I was thinking of doing if I don't get surg. It was just to show that IM has more opportunities for branching as opposed to some other fields, like primary care for example.

 

[Neuro or Derm]

My problem is my reading comprehension speed and answering. It's not a lack of knowledge, it's a can't read and process fast enough to answer the question.

I can understand your frustration with this. I agree that test-taking skills are not necessarily an indicator of the type of doctor one will be. There are ways for people to make it through if given the right opportunities. For a caribbean grad with added red flags, getting one foot in the door is all that is needed. What about the surgeons who wrote you those letters, can none of them put some good words in at the institutions they work at to help you get a prelim spot there or maybe at another place where they are well respected? or maybe you could approach one of them to do an observership with them if you are unsuccessful in the scramble? maybe that might help you? or maybe even if you scramble into FM you could still find a way to do minor surgeries and that might be able to satisfy your need to cut? there's always a way, even if we can't see it ourselves sometimes...its there. I wish you all the best

 

[Neuro or Derm]

So what can you do now?

1. If you don't have them already, get LORs that don't say you're going to be a great surgeon...unfortunately, you're unlikely to have that chance...sorry.

2. Make sure you write new, fresh PS's for IM and FM (Psych? Peds?).

3. Find old Scramble lists and look at who's gone unmatched year after year (again, ignore prelim surg spots...you don't want that). Focus your ERAS 30 (and faxing/emailing) there, that's likely to be your best shot.

Ok so I know a guy with okay scores who matched into prelim surgery two years ago. the next year, his program took him for a second prelim year. this year he is applying again to several specialties since he cannot do a 3rd prelim year there. he wanted to be a surgeon more than anything else, but now it's looking like surgery is not happening. He got great letters and experience out of it and above all, he did get to cut so that's great, but would you recommend a person not interested in surgery to try to scramble into prelim surgery? last year there were 461 unfilled prelim surgery spots and 224 FM spots in the scramble. with only 45 eras applications allowed, wouldn't it make more sense to try harder to scramble into prelim surgery or will that hurt the application for the following year?

 

[neurosurg777]

I can understand your frustration with this. I agree that test-taking skills are not necessarily an indicator of the type of doctor one will be. There are ways for people to make it through if given the right opportunities. For a caribbean grad with added red flags, getting one foot in the door is all that is needed. What about the surgeons who wrote you those letters, can none of them put some good words in at the institutions they work at to help you get a prelim spot there or maybe at another place where they are well respected? or maybe you could approach one of them to do an observership with them if you are unsuccessful in the scramble? maybe that might help you? or maybe even if you scramble into FM you could still find a way to do minor surgeries and that might be able to satisfy your need to cut? there's always a way, even if we can't see it ourselves sometimes...its there. I wish you all the best

Hey thanks for understanding. That is exactly what I am trying to do but getting that foot in the door is proving to be extremely difficult even with some of the people I know. I think being a caribbean grad is killing it for me because those people don't know my scores. I'm sure they can help put in a good word on scramble day so that I can get a prelim spot or at least I hope. They just weren't able to do anything before for a cat spot. If the scramble doesn't work out then I will probably try the observership/research method. Yeah that may be a possibility. I hope it works out in the end. Thank you for your sentiments, I appreciate it. Good luck to you as well.

 

[Gentle]

There are a lot of people who think that low test scores shouldn't hold an otherwise amazing person back from pursuing what they want to in medicine. The problem with that idea, and you've sort of captured it here describing all the tests you've taken, is that you will have to take standardized testing for the rest of your life in medicine. It's not just getting the license, it's getting board certified, and then continually re-certified, etc. The problem with just ignoring test scores in trying to get a global picture of the applicant is that you can end up with someone who might fail an important exam and it can be hard to want to support someone's training if they run the risk of winding up in a bad situation because of a failed exam. A pattern of low test scores represents a risk in an applicant that some people are just not willing to take regardless of what everything else says, and I don't think it's unreasonable to have that point of view especially when there are so many out there without the same problem.

I don't know how you processed the OP's posting but he NEVER told us that he has failed an exam. He said he has LOW SCORES which DOES NOT EQUAL FAIL my friend. Given that he doesn't have a failing history, albeit, low scores what makes you take that leap in to the failing zone. I think your analogy is overkill here. I believe those programs that live and breath by scores wouldn't look at the OP NOT b/c they think he'll fail BUT b/c of their addiction to high scores. Good luck to the OP, you'll do just fine, it's a matter of time.

 

[MiniNMD]

I don't know how you processed the OP's posting but he NEVER told us that he has failed an exam. He said he has LOW SCORES which DOES NOT EQUAL FAIL my friend. Given that he doesn't have a failing history, albeit, low scores what makes you take that leap in to the failing zone. I think your analogy is overkill here. I believe those programs that live and breath by scores wouldn't look at the OP NOT b/c they think he'll fail BUT b/c of their addiction to high scores. Good luck to the OP, you'll do just fine, it's a matter of time.

No need to go caps crazy. I know that low score does not equal fail and I think perhaps I should have phrased it differently. I maintain the thought that some residency selection committees have low cutoffs in their heads that are above the range of failing but still at the point where they consider the scores a risky trend. You can call it an addiction to high scores if you like but I've actually heard someone on a committee mention that she does think people with a trend of low scores are at risk to fail board exams. I don't know if there are data to support that thought but sometimes in medicine, one persons opinion can make or break you regardless of whether it's a well thought out idea.

Is it unfortunate that some people may be great otherwise but can't take a standardized test to save their lives? Yes. But the fact of the matter is that people have score cutoffs whether we like it or not and it's often a screening criteria for interviews.

Sorry OP I know you can't re-take the Steps but hopefully you can scramble yourself into a spot, and you can figure out what plagues you with test taking and use your knowledge to do really well on Step 3.

 

[Golding]

I remember some of your posts in the Step 2 forum, so I'm sad to see that the exam didn't go quite as planned. I probably don't have to tell you that surgery is pretty competitive right now, and just being a Carib student already works against you pretty harshly. A poor Step 1 score makes it even harder, and a poor Step 2 score makes the application somewhat unredeemable. I feel the frustration with how SAT didn't predict you ability in college, MCAT didn't predict your ability in med school, and likewise the USMLE most probably hasn't predicted your ability as a resident. But the trend of poor testing does indicate that you may have trouble with the ABSITE and subsequently the surgery boards. The latter in particular is a big deal for programs, who get put on probation if not enough people pass.

The trouble with awesome LOR's is that just about everybody gets them from someone, including the people who also got awesome scores. There's really only a few ways they can assess you - scores, interviews, and maybe if you personally know the program through rotations or other means.

If you really think you can break through out of a prelim spot, you can go for that. But for the long term, I'd strongly recommend a Plan B that you can find yourself satisfied with in case after prelim year you don't get a categorical spot. Surgery isn't the only profession doing procedures these days, and the lifestyle of an alternative may be superior. You don't want to be the guy doing his third intern year with nowhere left to go.