Should I defer the start of my 3rd year?

[vulgata]

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So I have always been a really good standardized test taker (1590 SAT I, 750-800 SAT II, 37 MCAT) so naturally I assumed I would do well on the boards. First year I honored all my classes, but I'm not going to lie, I slacked off a bit in my second year and just passed everything (probably my biggest mistake, but that's spilt milk). I went through Goljan audio/RR 😍 during school for each system, I'm doing the Penn method now during break (annotating FA while going through Kaplan textbooks), and I have two weeks left until my Step 1 (I have path left and one more review of FA, I doubt I will get it done well in that short of a time 🙁). My UW is at 63% 🙁 with 57% completed 🙁 I haven't really done much of Q bank at all, and here are my scores:

3/15 NBME 6 198 (before finals)
5/8 NBME 7 221
5/15 Kaplan course simulation 68%
5/27 NBME 3 221
5/27 NBME 5 226 (did both on the same day to simulate full length)
6/2 UWSA 1 254 (??? I don't believe this AT ALL)

I can defer my first block to my fourth year, but that will mess up my awesome schedule (locations and timing) and won't allow me to do as many electives/sub-Is before I start my applications. I've fallen behind in my schedule and my test scores have not been improving; I keep missing stupid, easy, essential details especially in micro and pharm (I can visualize the page but I can't remember if it was + or -, etc.) and I keep mixing up basic, basic things like crypto/coccidioides, which I feel I can cram pretty easily if I just had more time. I have zero research from before med school and none from last summer so I feel like I have to rock Step 1 'cause that's all I got left.

My dean is super against deferral but it's our decision to make; he thinks I won't improve much since I'm passing already. Is there any truth to this? Is getting in an away rotation or sub-I that important? How do I get those details to stick? If I take the extra time I want to watch some Kaplan lectures, read some review books (HY Neuro, Micro Made Ridiculously Simple, Katzung?, Step-Up to Step 1/Medicine?), do more review questions (finish UW and redo incorrect/marked, Qbank/Qbook, review books like Robbin's review and Murray), and go over RR path and FA again for sure. What should I focus on? Are there any must-have/high-yield resources I'm missing? I keep reading more books but I keep reinforcing what I already know while forgetting the same details--how do I make them stick?

 

[SlaveOfTCMC]

Your practice scores are good.

I understand you may want a 250+ just to avert a psychological crisis on your hands..

But if that is the only reason... or if you simply want a high paying specialty ("high paying" is a misnomer... people look at median HOSPITAL salaries and do not factor in the business or hours parts of the equation)...


then those are not good reasons to defer..


But it's ultimately up to you. If you can afford the extra year and you need to have a full monty of top scores, then go right ahead and defer.

I know i sound like I am judging you. Please do not misunderstand me. This is just a cold hard analysis. If it is wrong, so be it. But your presentation leads me to believe this analysis has some semblance of truth.

 

[vulgata]

Thanks for your honest reply, I appreciate it.

But if that is the only reason... or if you simply want a high paying specialty ("high paying" is a misnomer... people look at median HOSPITAL salaries and do not factor in the business or hours parts of the equation)...


then those are not good reasons to defer..

I'm not sure what I want to go into, and I definitely will not choose my career based on salary. (Doing something I hate for the rest of my life for a few extra bucks? No thanks!) I just don't want my board scores to hold me back if I fall in love with a surgical subspecialty or something later, and since it's too late to have meaningful a research experience or a publication, I feel that boosting my Step 1 score is the only thing I can do to help my resume at this point. I was just wondering at the relative benefits of a good sub-I/away vs. a higher board score (and if I can actually get a higher score at this point). I don't think trying to make myself more competitive (in whatever specialty I ultimately choose) makes me a ROAD-er...

But it's ultimately up to you. If you can afford the extra year and you need to have a full monty of top scores, then go right ahead and defer.

It's not an extra year, just one block (6 weeks); I still graduate at the same time, I just lose some breaks in the middle.

 

[NERDY]

I would go ahead and take it. Plus, if you delay now, you'll have less time in year IV for step 2/interviews/etc. Remember, step 1 is just a piece of the application.

 

[medstar21]

just take it. Those scores aren't bad at all, and I understand not wanting to close doors for residency programs, but if you just work really hard throughout 3rd year, get good LORs, take step II early and rock it, that will help.

Step I is just a small piece like others have said. Not worth delaying one of your third year blocks in my opinion.

 

[vulgata]

I would go ahead and take it. Plus, if you delay now, you'll have less time in year IV for step 2/interviews/etc. Remember, step 1 is just a piece of the application.

Yeah, but isn't it the most important piece, by far?

just take it. Those scores aren't bad at all, and I understand not wanting to close doors for residency programs, but if you just work really hard throughout 3rd year, get good LORs, take step II early and rock it, that will help.

Sure, they will help, but I'd be doing that anyway even if I did defer...

Step I is just a small piece like others have said. Not worth delaying one of your third year blocks in my opinion.

Why? That's really the point of this thread, I want to know what I will lose with the delay and if it isn't worth a few extra points on Step 1. Will an extra elective or away rotation give me an edge over someone with a higher Step 1 score?

Edit: BTW thank you all for your responses so far, this is so stressful >.<

 

[quepatho]

(1) Decide on a goal score. Something that would make you happy.

(2) Take an NBME to figure out how close you are to said goal score. My guess is you are somewhere between a 226 and 254...You need at least one more test to figure it out, though.

(3) IF you are not close to where you want to be, decide if you can use maybe 4 of your six week elective to attain the goal (maybe do a 2 week elective?) Or 2 of your four weeks (and do a 4 week elective)? See if you can split it up.

(4) Don't panic, you'll do fine regardless. Good luck.

 

[NERDY]

Look at the NRMP's charting outcomes to see where you stand for your fields of interest.

 

[dozitgetchahi]

So I have always been a really good standardized test taker (1590 SAT I, 750-800 SAT II, 37 MCAT) so naturally I assumed I would do well on the boards. First year I honored all my classes, but I'm not going to lie, I slacked off a bit in my second year and just passed everything (probably my biggest mistake, but that's spilt milk). I went through Goljan audio/RR 😍 during school for each system, I'm doing the Penn method now during break (annotating FA while going through Kaplan textbooks), and I have two weeks left until my Step 1 (I have path left and one more review of FA, I doubt I will get it done well in that short of a time 🙁). My UW is at 63% 🙁 with 57% completed 🙁 I haven't really done much of Q bank at all, and here are my scores:

3/15 NBME 6 198 (before finals)
5/8 NBME 7 221
5/15 Kaplan course simulation 68%
5/27 NBME 3 221
5/27 NBME 5 226 (did both on the same day to simulate full length)
6/2 UWSA 1 254 (??? I don't believe this AT ALL)

I can defer my first block to my fourth year, but that will mess up my awesome schedule (locations and timing) and won't allow me to do as many electives/sub-Is before I start my applications. I've fallen behind in my schedule and my test scores have not been improving; I keep missing stupid, easy, essential details especially in micro and pharm (I can visualize the page but I can't remember if it was + or -, etc.) and I keep mixing up basic, basic things like crypto/coccidioides, which I feel I can cram pretty easily if I just had more time. I have zero research from before med school and none from last summer so I feel like I have to rock Step 1 'cause that's all I got left.

My dean is super against deferral but it's our decision to make; he thinks I won't improve much since I'm passing already. Is there any truth to this? Is getting in an away rotation or sub-I that important? How do I get those details to stick? If I take the extra time I want to watch some Kaplan lectures, read some review books (HY Neuro, Micro Made Ridiculously Simple, Katzung?, Step-Up to Step 1/Medicine?), do more review questions (finish UW and redo incorrect/marked, Qbank/Qbook, review books like Robbin's review and Murray), and go over RR path and FA again for sure. What should I focus on? Are there any must-have/high-yield resources I'm missing? I keep reading more books but I keep reinforcing what I already know while forgetting the same details--how do I make them stick?

For starters, dump all the Kaplan stuff (except for qbank, potentially). Their stuff is way too long and inefficient for you at this point, and IMHO much of it is of dubious value anyway.

Do not watch any Kaplan lecs.

Do not touch any other book aside from FA for the next 2 weeks unless you have a damn good reason to (perhaps HY Biostats if you're having trouble).

Now, quickly jot down a list of the stuff from FA that isn't sticking. Page through FA quickly and write down page numbers if you must.

Revisit the hard stuff in full or in part every day while continuing to make 2 more passes of FA before the exam (i.e., one a week).

Along with this, do a boatload of new qs. Finish UW and then finish qbank, if possible. If you're having trouble with specific areas (esp path/physio), then use Robbins/Cotran and/or the Kaplan Physio qbank.

This should take you 12+ hours a day, but it will definitely get the details to stick. If you were a bit further out I'd recommend you start Gunner Training *only* in your hard subjects, but you're a bit too close-in at this point. Read FA like a madman and make some custom flashcards for the tables, etc that refuse to stick.

Trust me, what you'll regret most post-test isn't that you failed to figure out the goofy, obscure questions - but rather that you failed to earn all the easy points from the stuff in FA. I didn't make too many dumb mistakes on FA material, but the ones I can remember certainly sting the most.

In short, dump the Kaplan crap and attack FA hard while doing lots of qs.

 

[Sheldor]

For starters, dump all the Kaplan stuff (except for qbank, potentially). Their stuff is way too long and inefficient for you at this point, and IMHO much of it is of dubious value anyway.

Do not watch any Kaplan lecs.

Do not touch any other book aside from FA for the next 2 weeks unless you have a damn good reason to (perhaps HY Biostats if you're having trouble).

Now, quickly jot down a list of the stuff from FA that isn't sticking. Page through FA quickly and write down page numbers if you must.

Revisit the hard stuff in full or in part every day while continuing to make 2 more passes of FA before the exam (i.e., one a week).

Along with this, do a boatload of new qs. Finish UW and then finish qbank, if possible. If you're having trouble with specific areas (esp path/physio), then use Robbins/Cotran and/or the Kaplan Physio qbank.

This should take you 12+ hours a day, but it will definitely get the details to stick. If you were a bit further out I'd recommend you start Gunner Training *only* in your hard subjects, but you're a bit too close-in at this point. Read FA like a madman and make some custom flashcards for the tables, etc that refuse to stick.

Trust me, what you'll regret most post-test isn't that you failed to figure out the goofy, obscure questions - but rather that you failed to earn all the easy points from the stuff in FA. I didn't make too many dumb mistakes on FA material, but the ones I can remember certainly sting the most.

In short, dump the Kaplan crap and attack FA hard while doing lots of qs.

Vulgata, this is amazing advice. Stop what you're doing and do this to a T and then take the test when it is currently scheduled. You get a point where no amount of studying is going to greatly effect your score on this test. There were times before I took it that I wished I had scheduled it for a later date, however once I took it I realized that you reach a point where how well you do is based on your ability to reason through questions and guess well. No amount of studying is going to help that!

My advice: Realize that you are going to score as well as you are going to score if you worked your bum off these last couple months. I know that not seeing 270+ NBME's leading up to the real thing can be intimidating, especially on SDN, but don't let that freak you out. You are scoring above average on a test that all med students study intensely for! I think when the time comes to deal with 4th year stuff, ie, interviews, away rotations, Step II's, etc you will regret not having some breathing room.

Again, do this quoted study schedule to a T and you can easily jump up closer to 240 by the real deal.

Good luck!

 

[ArcGurren]

For starters, dump all the Kaplan stuff (except for qbank, potentially). Their stuff is way too long and inefficient for you at this point, and IMHO much of it is of dubious value anyway.

Do not watch any Kaplan lecs.

Do not touch any other book aside from FA for the next 2 weeks unless you have a damn good reason to (perhaps HY Biostats if you're having trouble).

Now, quickly jot down a list of the stuff from FA that isn't sticking. Page through FA quickly and write down page numbers if you must.

Revisit the hard stuff in full or in part every day while continuing to make 2 more passes of FA before the exam (i.e., one a week).

Along with this, do a boatload of new qs. Finish UW and then finish qbank, if possible. If you're having trouble with specific areas (esp path/physio), then use Robbins/Cotran and/or the Kaplan Physio qbank.

This should take you 12+ hours a day, but it will definitely get the details to stick. If you were a bit further out I'd recommend you start Gunner Training *only* in your hard subjects, but you're a bit too close-in at this point. Read FA like a madman and make some custom flashcards for the tables, etc that refuse to stick.

Trust me, what you'll regret most post-test isn't that you failed to figure out the goofy, obscure questions - but rather that you failed to earn all the easy points from the stuff in FA. I didn't make too many dumb mistakes on FA material, but the ones I can remember certainly sting the most.

In short, dump the Kaplan crap and attack FA hard while doing lots of qs.

This is pretty solid advice - I actually found some of the Kaplan videos to be immensely helpful (in particular Pharm/Biochem) but if you do not have the time don't bother doing it. Stick to the qbank relevant questions as said above, OP, and try to finish UW and FA.

 

[vulgata]

So I took NBME 11 today and got 238... great confidence booster but I'm gonna sleep on it and decide tomorrow. Thank you all for your advice and input.

 

[Bingo87]

At my school, if a student wants to defer entry into 3rd year without a medical excuse, it comes with a negative connotation because it mean that person failed to comply with the Step 1 deadline... Make sure there aren't any consequences of deferring aside from just schedule mess-ups.