Step 1 as a DO

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bananabreadman

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2+ Year Member
I recently found out that I did not pass step 1 as a DO. I did pass comlex and have passed all my classes. I am interested in radiation oncology and I wanted to hear from some of your opinions if I should retake step 1 after further study or just continue with comlex. Thank you all for your advice
 
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bananabreadman said:
I recently found out that I did not pass step 1 as a DO. I did pass comlex and have passed all my classes. I am interested in radiation oncology and I wanted to hear from some of your opinions if I should retake step 1 after further study or just continue with comlex. Thank you all for your advice
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Thats a really good question. Is it true that passing comlex but failing step 1 would present no administrative weirdness with GME? (I genuinely don't know)

Do you know any RO program directors? I'd ask them directly.

It would be worth networking even before you apply, rotate in the field to make sure you like it, and you could meet some program directors. This would help you as DOs are not traditional applicants to our field, and some people may offer you an interview if they knew you as a strong candidate despite the step 1 issue.
 
medgator said:
Will definitely match somewhere in rad onc imo, maybe not mid tier but definitely competitive somewhere. A decade ago their application would have gone straight in the trash
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It’s your fault for scaring away all the applicants here with fake stories of a bad job market because you are greedy and don’t want downward pressure on your income from high quality new grads.
 
As someone who went through match not long ago, here’s my two cents:
-rad onc competitiveness has been slightly going up and I believe the trend continues the for next couple years but there are still decent amount of IMGs so as an american grad, you’ll have advantage over them
-You’re a DO so I believe you don’t have to report step, so don’t. It won’t benefit you. The programs who would red flag you for not having step scores, would red flag you even more for failed step 1.
-Do as many audition rotations as you can since you probably don’t have a home program. And crush those audition. Read up on the new consults the night before, look up the treatment guidelines, the recent trials, alternative treatments etc. then when seeing patients, be kind, be compassionate, be thorough with your history taking and PE. Make sure to have questions about the case to ask your attendings that shows that you’ve done your job and you’re genuinely interested in learning more.
-make connections. Rad onc is a small field. Strong LORs especially from PDs will go a long way!
-if there’s a research opportunity, make sure to get involved and if you do, make sure to understand the research and be able to talk about it
Lastly, good luck! Feel free to message me if you have any questions!
 
If the OP shows strong interest in RO (ie do a rotation or two and get rec letters) and passes Step 1 on next attempt you probably have a 95%+ of matching at a decent program if you apply widely and no further big red flags are on your application. Most places would gladly take some they interview and rank over risking going unfilled.
 
I’ll tell you a story. I reviewed applications for multiple years for my department. Some of the last few classes I reviewed are graduating in last few years. I remember many of the applicants and their files. There were multiple people who had low scores who ended up in quite “top” programs. They have now gone on to good placement in jobs from their good program. I do not say this to knock on them, but mostly to highlight that people are successful despite scores in the most recent current environment. Clearly there are ways to make up for this.
 
medgator said:
Which are great ivy names and historically very mediocre training programs, RO wise
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Disagree. NYC historically has gotten better qualified trainees relative to program ranking as a function of location. They receive strong training (if desired) by rotating with top attendings throughout the city. Rad bio training was historically excellent as most of the programs participated by attending a course with residents from throughout the city weekly at Mt. Sinai.
Beyond that, as a result of the programs being more “hands off,” the graduates learn how to actually manage patients and handle issues on their own. You don’t quite see that with Florida Man!!
 
radoncle said:
Disagree. NYC historically has gotten better qualified trainees relative to program ranking as a function of location. They receive strong training (if desired) by rotating with top attendings throughout the city. Rad bio training was historically excellent as most of the programs participated by attending a course with residents from throughout the city weekly at Mt. Sinai.
Beyond that, as a result of the programs being more “hands off,” the graduates learn how to actually manage patients and handle issues on their own. You don’t quite see that with Florida Man!!
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I've heard it all. Lol. Ok. Plenty of great training down south... UF (duh!), UAB (varian clinical training site), UNC, Emory.

Wasn't Cornell pretty malignant and ended up closing? Downstate? Methodist? Honestly outside of perhaps NYU and Sinai and obviously msk, who else needs to really be training anyone in the city? It's not like there's a shortage of well trained ROs there to begin with.
 
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medgator said:
I've heard it all. Lol. Ok. Plenty of great training down south... UF (duh!), UAB (varian clinical training site), UNC, Emory.

Wasn't Cornell pretty malignant and ended up closing? Downstate? Methodist? Honestly outside of perhaps NYU and Sinai and obviously msk, who else needs to really be training anyone in the city? It's not like there's a shortage of well trained ROs in the city.
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You mentioned “great ivy names and historically very mediocre training programs, RO wise.”


Having experienced rad onc in NYC and rad onc in the south, I’ll take the “mediocre” trainees from NYC over the “great” trainees from the south every day of the week. Not to say ALL of the southern rad oncs are “mediocre”’or bad. But comparing “elite” onc in the south to “mediocre” rad onc in NYC is basically the same as comparing a grad from a top training program
now to a grad from an average rad onc program during peak rad onc years. There is no comparison! It’s apples to oranges. And UF?? 😂
 
thecarbonionangle said:
but mostly to highlight that people are successful despite scores in the most recent current environment
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Peak radonc corresponded with peak misconstruing of board scores. The steps should never have been used to differentiate between good candidates (largely memorization tests) and the disparity in prep between candidates could be remarkable. The dramatic drift in scores over time indicates that these tests are the furthest thing from aptitude measures.

However, I like a passing score. (Establishing a floor is what the tests are appropriate for IMO. A trainee should be able to focus on clinical practice, reading non-prep materials and research if they like while not having to spend the bulk of their time prepping for boards). A single fail is not something I would be very concerned about...persistent struggles are concerning.

I am not in academics, much less a program director, but I have spoken to many reasonable people about this. If the OP can hide that they failed Step 1, I have no insight into how this would impact applications. If they can't, I believe that a retake with a passing score is probably worth something? It does seem to me that the bulk of DO students are taking the USMLEs at this point (I do get rotating DO students on occasion).

The DO students are in general good BTW.
 
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