Step 1 for FM in a desirable residency?

[dabears405]

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I am debating whether or not to take step 1/2 for FM for solid training programs but specifically in large cities in like NY,Chicago, LA etc. Problem is I am a third year on rotations and it is difficult to study for step 1 when you have shelf exams. I was not ready during dedicated to get close to an average score for step. It is a huge decision to take step 1 in my situation. COMLEX is not impressive slightly >500. Of course FM is not competitive but I am choosy when it comes to location and strength of the program. Some advice is appreciated.

 

[chizledfrmstone]

You can definitely get FM in a large city. I have friends who got FM residencies in Chicago with average COMLEX scores. University programs probably want USMLE though.

 

[AnatomyGrey12]

More or less the vast vast vast majority of acgme residencies in your desired field will provide you with the clinical training to make you a competent physician.

Excellent post, I was actually told this same thing by family friend MD who was an ivory tower plastic surgeon type. The differences in programs are largely that they all have slightly different focuses and will prepare you for different practice models and are not really related to the quality of the foundation of your training..

 

[Black Coffee 24/7]

There is this delusion among med students that there are these awful training places and these AMAZING training places. More or less the vast vast vast majority of acgme residencies in your desired field will provide you with the clinical training to make you a competent physician. Whether you become an excellent one is up to you and your work ethic, they provide the scaffold. In FM though wouldn't you want to train at a non-university program that is unopposed so that you are doing as much as possible without interference? If I was applying FM I would avoid university programs with every specialty in house like the plague, as I would want as much breadth and depth as possible since I'll be seeing and doing (to a point) almost everything.

Food for thought

Have to agree with this post 100% especially for FM training, after my three months of third year exp through both a teaching hospital and a rural hospital.

 

[SLC]

All ACGME programs will appreciate a USMLE score.

 

[crazyboi1993]

What is a good USMLE step 1 score, for a DO student with a 520-530 COMLEX score, to have a solid chance of matching into FM? Location is probably the most important for me

 

[AnatomyGrey12]

What is a good USMLE step 1 score, for a DO student with a 520-530 COMLEX score, to have a solid chance of matching into FM? Location is probably the most important for me

It's FM dude....

 

[ciestar]

It's FM dude....

Answer: pass

 

[Black Coffee 24/7]

What is a good USMLE step 1 score, for a DO student with a 520-530 COMLEX score, to have a solid chance of matching into FM? Location is probably the most important for me

Since location is the most important factor for you, nothing short of 250+ Step 1 and Step 2, min 3 first author pubs, and 500 community service hrs.

 

[chizledfrmstone]

It's FM dude....

Still relatively competitive if you want a good location.

 

[sab3156]

It's FM dude....

Still relatively competitive if you want a good location.

If you want to do FM in a city like Boston, you better have a strong Step 1...

Meet Our Residents » Family Medicine | Boston University
Academics | Faculty & Residents

FM at BUSM is more difficult for a DO - they usually don't take DOs. Tufts has graduated more DOs, every once in a long while. The pedigree in the list of FM residents at BUSM and Tufts is pretty ridiculous. Bottom line is this: in order to compete as a DO for spots in the most desirable cities in the country (even in the least competitive specialty in all of medicine - FM), you need a strong application, period.

 

[AnatomyGrey12]

If you want to do FM in a city like Boston, you better have a strong Step 1...

Meet Our Residents » Family Medicine | Boston University
Academics | Faculty & Residents

FM at BUSM will not likely take DOs, though, to be fair. Tufts has graduated DOs, every once in a long while. The pedigree in the list of FM residents at BUSM and Tufts is pretty ridiculous. Bottom line is this: in order to compete as a DO for spots in the most desirable cities in the country (even in the least competitive specialty in all of medicine - FM), you need a strong application, period.

Sure but the question wasn’t for desirable locations he was talking about good programs overall. It’s FM and the answer is “any passing score.”

As an aside if I were interested in FM the last place I would want to train would be a big city saturated with specialists or at a university that has a dozens of training programs. I would look for an unopposed program where the FM residents do everything.

 

[SLC]

Sure but the question wasn’t for desirable locations he was talking about good programs overall. It’s FM and the answer is “any passing score.”

As an aside if I were interested in FM the last place I would want to train would be a big city saturated with specialists or at a university that has a dozens of training programs. I would look for an unopposed program where the FM residents do everything.

The first paragraph is not quite true. At my program, a barely passing score wouldn’t have gotten you in the top half of our list, and if you weren’t in the top half, you didn’t match with us.

I think for FM overall, if you have no aspirations as to where and just want to match, then sure maybe a barely passing score will suffice (as it will in a lot of fields). But for a quality residency, that’s just bad advice. I interviewed at 10 (what I considered to be) quality programs with a 227/558 step/level 1 combo; result was a trip to the SOAP.

As for your second paragraph, that I generally agree with. Though unopposed does not automatically mean excellent training, and tertiary care center doesn’t mean bad training. My program was a mix of both (we had our own hospital we ran, but did a lot of our specialty rotations as visiting residents in the other university training programs. By and large, we were integrated into those programs and treated as equals. The exception being surgical field rotations done in 3rd year when those residents had been at it for 2 already, we functioned as interns then, which was appropriate for what we were there to gain from the experience IMO.

As an example: I wasn’t trying to be an ophthalmologist, just trying to learn some basic eye care and how to recognize and stabilize eye emergencies/things that require prompt referral to the ophthalmologist. I didn’t need to be in the OR, would have been a waste of my time. Working with interns (or I guess, fresh 2nd year’s) was where I should have been based on what I needed from that rotation.

 

[Tozanzibarbymotorcar]

The first paragraph is not quite true. At my program, a barely passing score wouldn’t have gotten you in the top half of our list, and if you weren’t in the top half, you didn’t match with us.

I think for FM overall, if you have no aspirations as to where and just want to match, then sure maybe a barely passing score will suffice (as it will in a lot of fields). But for a quality residency, that’s just bad advice. I interviewed at 10 (what I considered to be) quality programs with a 227/558 step/level 1 combo; result was a trip to the SOAP.

This ^. I also understand that for some of the top FM programs, proven dedication to FM as well as quality extracurriculars count in addition to good board scores and good grades. They don't want people who "barely passed" and chose FM because it was their only option.

 

[sab3156]

Sure but the question wasn’t for desirable locations he was talking about good programs overall. It’s FM and the answer is “any passing score.”

As an aside if I were interested in FM the last place I would want to train would be a big city saturated with specialists or at a university that has a dozens of training programs. I would look for an unopposed program where the FM residents do everything.

Yeah but the OP and the guy who asked about what a good Step 1 score is for a DO -> they cited location as either the most important thing (second guy) or their question was specifically about big cities (OP). But like you said, these programs may end up being "Family Medicine Lite v1.0" and not provide them with the training they want.

Basically... @dabears405 and @crazyboi1993 ... FM, and any specialty really, became way more competitive when you're talking about these types of cities: Boston, NYC (especially Manhattan), San Francisco, Chicago, etc. Everyone wants to be there. It's the glamour life. And you better have an application that can outshine the Harvard/Hopkins/Stanford applicants that are applying for FM and consistently matching in these programs. Like it's been stated here and elsewhere, just because you do FM residency at a top hospital, it doesn't mean you're going to get good training - you may end up having that "big city" stereotypical training where you are trained as a "referralist" and not have as much free reign over your patients. This may be true in hospitals like Boston Medical Center, Tufts Medical Center, New York Presbyterian, etc., which have every specialty department you can think of, including sizable IM programs, and will be eager to take up your referrals quickly. Best to talk to the residents at these programs directly and find out what they can tell you about this.

 

[Tozanzibarbymotorcar]

Even unopposed programs in places outside the big cities can be competitive unless you are looking to go to remote Montana. Then you might be competing with IMGs that have killer board schools but couldn't get into a specialty. I think people really need to think twice before thinking of FM has the fallback plan when they are plotting out their med school career. Yes, there are more FM programs that take board failures, etc, than in the specialties but the best ones (top unopposed, etc) are going to be a bit more competitive..

 

[chizledfrmstone]

Sure but the question wasn’t for desirable locations he was talking about good programs overall. It’s FM and the answer is “any passing score.”

As an aside if I were interested in FM the last place I would want to train would be a big city saturated with specialists or at a university that has a dozens of training programs. I would look for an unopposed program where the FM residents do everything.

The only problem is you end up in BFE.

 

[Black Coffee 24/7]

Yeah but the OP and the guy who asked about what a good Step 1 score is for a DO -> they cited location as either the most important thing (second guy) or their question was specifically about big cities (OP). But like you said, these programs may end up being "Family Medicine Lite v1.0" and not provide them with the training they want.

Basically... @dabears405 and @crazyboi1993 ... FM, and any specialty really, became way more competitive when you're talking about these types of cities: Boston, NYC (especially Manhattan), San Francisco, Chicago, etc. Everyone wants to be there. It's the glamour life. And you better have an application that can outshine the Harvard/Hopkins/Stanford applicants that are applying for FM and consistently matching in these programs. Like it's been stated here and elsewhere, just because you do FM residency at a top hospital, it doesn't mean you're going to get good training - you may end up having that "big city" stereotypical training where you are trained as a "referralist" and not have as much free reign over your patients. This may be true in hospitals like Boston Medical Center, Tufts Medical Center, New York Presbyterian, etc., which have every specialty department you can think of, including sizable IM programs, and will be eager to take up your referrals quickly. Best to talk to the residents at these programs directly and find out what they can tell you about this.

Why do residents care about high quality imported strippers and drugs when you're working 60-70 hrs/wk?

 

[BorntobeDO?]

Why do residents care about high quality imported strippers and drugs when you're working 60-70 hrs/wk?

I would take a mass general residency above any other for the name only. Just having that on your diploma probably doubles your earning potential. How many super concierge groups only consider physicians with Ivy connections in say San Francisco and NY. The training could be subpar, but the name will draw rich patients in like butterflies (and I am sure the training is just fine).

 

[AnatomyGrey12]

The only problem is you end up in BFE.

Eh sure, but only if BFE means anywhere other than California and New York 😉