step 1, grades, and recs

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15+ Year Member
Oct 6, 2002
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Does anyone know if there's any kind of cut offs for an academic surgery programs?

Step I, class rank, and recs......

Will 4 outstanding recs make up for a board score <210 and bottom 1/3 of the class?

Should I take step 2 early?
I'm not putting much hope on that either judging from my track record on standardized tests.

Am I totally hopeless for a categorical spot?


Hi there,
Most residency directors will tell you that desire and work ethic will mean more than grades and board scores. They are looking for people who can get the work done. There is a publication on the website of the American College of Surgeons that gives you information about matching into programs. This book is on the website and called something like" How to Match into a Surgical Residency". It does not lie.

You will want to avoid the heavy academic programs that generally take AOA and top 10% of the graduating class. If you have your heart set on a very competitive program, do an acting intership there and let them take a look at you.Needless to say, you need to bust your butt and do well. You may still not get a residency there but you can usually get a good letter of recommendation that might get you into a better program than you ordinarily would have matched into.

Enlist the help of your department chairman. You and your department chairman should be well acquainted at this point. A strong letter followed up by a phone call from your Surgery Department Chairman can open some closed doors. You should also take Step II early and do very well. Keep in mind that most people gain at least 20 points on Step II over their Step I grade so do some serious prep for this exam.

There are plenty of good programs out there that will be within your reach provided you do your homework well and make some contacts. Everyone in surgery did not graduate at the top of their class or have board scores over 240 especially with the dropoff of applicants to general surgery. Another thing that makes you more competitive is to have some publications and research. While it is a little late if you are applying this year, you can hook up with a researcher and do an elective before you graduate.

Good luck


Junior Member
10+ Year Member
15+ Year Member
Oct 24, 2002
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I am a 4th year as well, but have been very involved in the surgery community.

You definately have a chance of a spot, interview well, or do an away and kick butt!

Programs are looking for people they can work with and will enjoy being around for the next 5 years, as well as make it through their program.

YOU MUST take Step II early and get those scores in, they will say a lot about your application of clinical info to problem solving (and its much easier than step 1, not difficult to scor 10-20 points higher)


I would like to match at a top 15 or so general surgery program- one that especially encourages residents to do basic scientific research and where cutting edge clinical trials are going on.

I'm an MD/PhD at a med school that is consistently ranked in the high 20s to low 30s (US NEWS and World Report.) I honored 2/3s of my MI and MII classes and scored 241 on Step 1. I did very well in my grad classes and published well. I have only done three clinical rotations (Peds, Surg and Medicine) and received Pass, Hi-Pass and probably Hi-Pass or Honors in Medicine (improving my performance each time after 5 years in the lab).
I also just finished a 2 month surgical sub-i. My LOR are above average (not incredible), one very solid one from a very well known surgeon. My Dean's letter will be excellent- it is written by the MD/PhD director who loves me.

My LORs were just put in this week. I have already received invites from Emory, Minnesota and Wisconsin (before I had any surgery letters).

Do I have a shot at Duke or Hopkins or UCSF or Michigan or equivalently excellent programs?