Step 1 score and advice on applying to Anesthesia residency

[Smess]

HELLO!!

I recently took step 1 as a 3rd year DO student. Unfortunately, I did worse than every NBME practice exam that I had taken prior. 🙁Not quite sure what went wrong, however, there is nothing I can do about it now except for try to figure out a way for anesthesia programs to look at my whole resume. My only concern is that with the COVID regulations, there will be many programs who filter out scores. I got a 209 which is below some programs 210 cut off. I also got a 529 on my COMLEX, which isn't great, but not as bad as the 209. My entire resume, other than those two scores, I would say, is very good. I have a past experience in anesthesia in the veterinary world, as well as great LORs, ranked 44th in my class (2nd Q), and HP or honors on all rotations . Any advice on how to compete with those who got a 220 and above which meet many of the cut off scores?

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[liquidstatic]

Unfortunately a 209 means a lot of programs aren't even going to see your application. It's going to be difficult to show them you're a great applicant when aways are pretty restricted this year as well. Your past experience and good letters will help with anyone that looks at your app.

While the match statistics don't look TOO bad (from the 2018 charting match outcomes data) I suspect that anesthesia has gotten a bit more competitive over the last couple years and there is a real chance of you not matching. We should get new outcomes data this summer which will clarify this.

My advice is to apply very broadly (80-100 programs) to traditionally less competitive programs and to have a backup plan if you arent getting the interviews you need (probably IM or FM). Matching into SOMETHING is much better than putting yourself through the SOAP.

 

[Smess]

Unfortunately a 209 means a lot of programs aren't even going to see your application. It's going to be difficult to show them you're a great applicant when aways are pretty restricted this year as well. Your past experience and good letters will help with anyone that looks at your app.

My advice is to apply very broadly (80-100 programs) to traditionally less competitive programs and to have a backup plan if you arent getting the interviews you need (probably IM or FM). Matching into SOMETHING is much better than putting yourself through the SOAP.

Thanks for your response!! I figured that my application would get instantly overlooked. I want to be 100% transparent though, so even though my COMLEX is better, I think I am still going to report my USMLE score as well. What are your thoughts on crushing my step 2 that I take in 7 weeks? Will that help my application not get thrown out?

I also was thinking of backup plans. I thought about doing a TY program and then being able to reapply to an anesthesia program for PGY2. I honestly got into medicine to become an anesthesiologist so I don't see myself giving up on anesthesia at all, regardless of my score. I have read blogs of a couple people actually failing their step 1 and still matching GAS so I know it is not impossible. I know I am going to have an uphill battle, but I can't change my score unfortunately. I plan to apply to as many programs as possible and I will probably apply close to 80 or more.

 

[MikeMerk-MtS]

You will be fine. I matched with a 205 in step 1 (followed by 240s in step 2 and 3) and had 10 interviews (out of 20 applications... and some to top tier programs). Yes, step 1 is important but the entire app matters. If you can do an away that would be great... but only if you will kill it (many have been burned by looking better on paper than in real life). As long as your LORs are great, experiences are great, personal statement is great and maybe have 1-2 people who can call some PDs in the programs you are interested in and have a reasonable shot at getting an interview, you will be fine. I have no doubt. Not to toot my own horn but I got a 205 and eventually became chief resident... PDs know it's not just about numbers. Good luck!

 

[Smess]

You will be fine. I matched with a 205 in step 1 (followed by 240s in step 2 and 3) and had 10 interviews (out of 20 applications... and some to top tier programs). Yes, step 1 is important but the entire app matters. If you can do an away that would be great... but only if you will kill it (many have been burned by looking better on paper than in real life). As long as your LORs are great, experiences are great, personal statement is great and maybe have 1-2 people who can call some PDs in the programs you are interested in and have a reasonable shot at getting an interview, you will be fine. I have no doubt. Not to toot my own horn but I got a 205 and eventually became chief resident... PDs know it's not just about numbers. Good luck!

Thank you so much, that makes me feel so much better!!

 

[APA 32]

Not a DO but do better on Step 2 and it’ll help your application.

 

[Consigliere]

ranked 44th in my class

There aren't 45 people in your class are there?

 

[abolt18]

44 actually.

There aren't 45 people in your class are there?

But really, they're at a DO school so it's probably more like 44/300.

 

[Sandman192799229]

I feel like anesthesia is going to be less competitive next year. Med students follow the money and recent CRNA independence pushes and deaths of private practice is going to have an effect. It's something always talked about on these forums, but it feels like it's coming to a boil on a national level now.

 

[Smess]

There aren't 45 people in your class are there?

lol that would make me the 5th quintile, not 2nd... so nope there are more of us 😉

 

[kittykat57]

I applied last year, and it seemed super competitive. Just be careful and definitely apply with a backup. You'll probably need to show interest by emailing programs.

 

[Dr. wait for it...]

I applied last year, and it seemed super competitive. Just be careful and definitely apply with a backup. You'll probably need to show interest by emailing programs.

Hey I'm working on what to say in an email similar to this and wanted to ask if you have any tips on how to approach an email that shows interest?

 

[BLADEMDA]

There are more people/med students applying for residency positions then there are spots. This means the MATCH is competitive especially for those scoring well below the median of their Classmates. NO offense, but as a DO a score of 209 isn't going to light up the score board. You should apply to the bottom 1/3 programs especially the community based ones sponsored by HCA. Please don't misconstrue my post as saying you shouldn't apply to some solid "reach" programs because you should definitely do so but make sure to include those community programs to increase your chance of success.

 

[Smess]

NO offense, but as a DO a score of 209 isn't going to light up the score board.

I realize my 209 is not great, trust me. I did end up getting a 243 on Step 2 and a 669 on my COMLEX level 2 ( 87th percentile) which, to me, is a big improvement in my score. Although I understand your thought process on applying broadly, I believe in myself and I know my capabilities clinically outweigh one exam that was a poor performance. I want a program who looks at me holistically as an applicant and will realize that although yes, my step 1 score was not good, I was willing to put in as much effort as it took to improve on step 2.

I have also been told that statistically a step 2 score above 220 is a better predictor of passing the anesthesia boards than a step 1 score.

What exactly do you mean when you say bottom 1/3 programs? What does a bottom 1/3 program look like in your opinion?

 

[Angus Avagadro]

All good advice IMO. My students who matched university programs had 230+ step 1 scores. Community affiliates 220+. Comlex is not that helpful as many PDs are unfamiliar with exam results. You will get screened at many programs with the 209 score. You need to get someone to look closer at your app other than your Step 1 score. Other posters have given great advice on how to do that. During the last few cycles, my students have been getting late interviews. I mention this so you dont get discouraged. One with a 240+ step 1, didnt get a single interview until Dec. I think they look at DO apps last. No proof, but no other explanation comes to mind. Btw, that student ended up with 3 interviews at very good programs. Matched a top 10, program, many consider it #1. Apply broadly to community programs, university affiliates, and a couple reach programs. Do whatever you can to make yourself an attractive candidate. Get glowing letters and maybe a few phone calls to PDs from attendings. Good luck and best wishes!

 

[BLADEMDA]

I realize my 209 is not great, trust me. I did end up getting a 243 on Step 2 and a 669 on my COMLEX level 2 ( 87th percentile) which, to me, is a big improvement in my score. Although I understand your thought process on applying broadly, I believe in myself and I know my capabilities clinically outweigh one exam that was a poor performance. I want a program who looks at me holistically as an applicant and will realize that although yes, my step 1 score was not good, I was willing to put in as much effort as it took to improve on step 2.

I have also been told that statistically a step 2 score above 220 is a better predictor of passing the anesthesia boards than a step 1 score.

What exactly do you mean when you say bottom 1/3 programs? What does a bottom 1/3 program look like in your opinion?

I think you can Match. What I’m saying to you is apply broadly especially to lower tier university and community programs. I don’t think you should give up or become despondent over the process. Instead, focus on those programs accepting a fair number of DOs. Also, some of your interviews will likely occur later this year so don’t be concerned if there is silence until December/January.

Best of luck.

 

[GassYous]

All good advice IMO. My students who matched university programs had 230+ step 1 scores. Community affiliates 220+. Comlex is not that helpful as many PDs are unfamiliar with exam results. You will get screened at many programs with the 209 score. You need to get someone to look closer at your app other than your Step 1 score. Other posters have given great advice on how to do that. During the last few cycles, my students have been getting late interviews. I mention this so you dont get discouraged. One with a 240+ step 1, didnt get a single interview until Dec. I think they look at DO apps last. No proof, but no other explanation comes to mind. Btw, that student ended up with 3 interviews at very good programs. Matched a top 10, program, many consider it #1. Apply broadly to community programs, university affiliates, and a couple reach programs. Do whatever you can to make yourself an attractive candidate. Get glowing letters and maybe a few phone calls to PDs from attendings. Good luck and best wishes!

Didn't know Stanford takes DOs

 

[Angus Avagadro]

Didn't know Stanford takes DOs

East coast obviously more progressive

 

[ButterButter]

I don’t wanna sound crazy or alarmist but I would look at every program’s roster and apply to literally every one that has at least one DO resident. If you apply to only categoricals, this will be in the neighborhood of 80 programs. Sure, it might be expensive, and several people here will tell you that’s overkill, but that will ensure you have your apps in as many inboxes as possible. Believe me, that money is a drop in the bucket. The last thing you want to wonder about when you’re slogging through a bunch of crappy 3am medicine admits at the community FM program you scrambled into is “dang, wish I applied to more programs like that crazy butter guy said.” Also, submit your app the day it opens. If you don’t, you’re toast. And don’t limp in with 20 programs, get no interviews and decide two months later that you’ll apply to 60 more. Because literally no program will look at an app that late unless you’re a baller.

Don’t be afraid to send some well-written emails early in the process. This may get some interviews from programs that would never offer otherwise. Let them know you’re truly interested in their program not just interested in matching. Best of luck!