SLOR or good Step 2 score

[j1234]

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So, I have a 228 step 1. Will probably end up with a low class rank. 3rd year grades are ok (Bs and a B+ in surgery) There is nothing special to put on my CV.

I already have my home emergency rotation for July and one externship scheduled that will be done at the end of Sept. So, I figure I can get two good SLORs from those in time for interviews.

I'm wondering, what would be more helpful for me to do in August: studying and taking Step 2 to get a really good score or taking an externship to get another really good SLOR, to offset average 3rd year grades? Thanks for any advice I can get.

 

[BKN]

Go for the step 2. Two good slors is enough. good step 2 would be helpful.

 

[Richspiders07]

Go for the step 2. Two good slors is enough. good step 2 would be helpful.

Agreed - and studying your rear off for Step 2 will undoubtedly help you perfom well during your away rotation as all your medicine/peds/obgyn knowledge will start coming back!

 

[RxnMan]

High step II has a greater correlation with application performance than away grades (admittedly not the same thing as SLOR). Data to back this statement up will be forthcoming.

 

[The Buff]

Anecdotal admittedly, but my step 2 score was extremely high and did very little for me (although step 1 was pretty good as well). I feel like the more people who will vouch for you the better. I've always felt like EM as a whole cares less about your usmle and more about you as a person. I have no data to back this up, however.

 

[qwerty1234]

I don't have any data to back this up, but if it was my choice I'd go with the extra SLOR.

Your Step 1 is not deficient, but your clinical grades are definitely a weakness. Why not show that when you're in your field you can do well?

My Step 1 never came up during interviews, but where I rotated and what aspects of each setting I liked came up a lot. I spent most of my interviews talking about academic vs county vs community settings.

I was told that if your Step 1 is > average for EM thats fine, a higher score won't significantly change your ap. I'd like to hear from RXN man if having a 228 vs a 245 significantly increased someones ability to match at a program of their choosing (or if when he says Steps matter he means 228 is way better than 205)

 

[RxnMan]

...I'd like to hear from RXN man if having a 228 vs a 245 significantly increased someones ability to match at a program of their choosing (or if when he says Steps matter he means 228 is way better than 205)

I need to get that g-- d--- survey out...

In last year's cohort, Step II score had the strongest correlation with increases in application effectiveness (# interview offers per # apps sent out). Grades in aways did not (neither did home rotation grades!). Overall grades, in the form of class rank and AOA status, did correlate, but one rotation won't change that.

Your question is a good one: how much of an increase are we talking about? IIRC, the slope of the correlation is ~0.008, so a bump of 20 points would increase one's AE ~0.16, so the NNT is 6.

EDIT: This is a little overstated, as there's other factors at play. Step II score isn't going to get you THAT much bang for your buck.

This assumes that next year performs like last year, and that last year's sample is representative. Also, I did not get enough information to make inferences about number of aways (i.e., 1 < 2 < 3 < etc.).

 

[Tiger26]

I'd say getting a good grade/SLOR is way better than a step 2 score, given that your step 1 score is actually pretty good as it is

 

[IgM]

I'm in the same boat as you. Same board score. My grades are actually rather worse, but I go to a highly ranked school. I don't know how school name affects the way one's grades are perceived (probably not at all). Anyway my adviser in EM told me to take Step II early instead of do an away for a SLOR. I still have qualms about it though... sigh. rock and a hard place, I guess? I'm going with what my adviser told me because I figure he knows more than I do.

PS: j1234, where will your 3rd letter come from? will you ask an attending from a service you got a B on? idle curiosity.

 

[j1234]

@IGM: most likely would get one from an attending where I got a B. Shelf exams were always brought my grades down in my clerkships this year I feel like, it wasn't so much being deficient on the wards. If I do another away elective, I'll get three slors and forget about getting any third year letters I guess. Thanks for all the replies.