Step 1 score vs. Research

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Obviously, Step 1 is more important overall, but they're both required for super competitive specialties like derm and ortho. So what is the maximization function, given that one's time is finite? i.e. is it better to have a 245 and 10 pubs/presentations or a 260 and 2 pubs/presentations?
 
You're applying "maximization" function incorrectly. Pubs are not all created equal and hey are not produced in a factory as a function of time or some other resource. Neither is step 1 score. Instead of wasting your time with this, why not try to study so that you can do well on step 1 while also actively looking for suitable projects to work on?


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You're applying "maximization" function incorrectly. Pubs are not all created equal and hey are not produced in a factory as a function of time or some other resource. Neither is step 1 score. Instead of wasting your time with this, why not try to study so that you can do well on step 1 while also actively looking for suitable projects to work on?


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Tell that to people like @failedatlife ...
How is time not a variable? Imagine the extremes. You spend 100% of your time outside of class doing research, get like 20 pubs/posters, but obviously you won't score as high on boards as you would have if you studied. On the flipside, if you spend all your time studying, you'll unlock the maximum score that you have the potential for, but you'll have no pubs. An oversimplification, sure, but the idea is valid. Compromises must be made at some point.
 
Tell that to people like @failedatlife ...
How is time not a variable? Imagine the extremes. You spend 100% of your time outside of class doing research, get like 20 pubs/posters, but obviously you won't score as high on boards as you would have if you studied. On the flipside, if you spend all your time studying, you'll unlock the maximum score that you have the potential for, but you'll have no pubs. An oversimplification, sure, but the idea is valid. Compromises must be made at some point.
One great pub is better than ten minor ones. Step scores aren't entirely a function of time spent either- some people can work 24/7 and fail while others put in 4 hours a day and do very well. The most important thing is to focus on the quality of your application, not the quantity of things in checkboxes.
 
Given your reference to @failedatlife I'm sure you even know that this question is kind of silly. Obviously Step 1 matters the most. After that, QUALITY of a publications and your role plays a huge factor.
 
Tell that to people like @failedatlife ...
How is time not a variable? Imagine the extremes. You spend 100% of your time outside of class doing research, get like 20 pubs/posters, but obviously you won't score as high on boards as you would have if you studied. On the flipside, if you spend all your time studying, you'll unlock the maximum score that you have the potential for, but you'll have no pubs. An oversimplification, sure, but the idea is valid. Compromises must be made at some point.

This hypothetical is too far removed from reality to be worth entertaining.


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Unrealistic hypothetical, but I'll bite. A lot of the top academic programs for derm and competitive surgical subs have pretty high step 1 cut-offs (250+ for an interview invite), so I'd likely opt for the latter. However, I'd agree that there are enough people with 260+ and 10 pubs/presentations that only sinking your time /esources into exclusively studying for step 1 or research will be detrimental in putting together a competitive app.
 
The problem with these types of questions is feasibility - how do you know how much time is required for a 240 versus a 260? It is impossible to tell and you likely won't be able to titrate your time to say "if I shift 5 hours a week from studying to research, I'll go from a 260 to a 240 but will have some publications". It is just not realistic to have this much control over your Step 1 score.

First and foremost, you are a student. Not a research assistant. This is easier said than done. If you feel you are mastering the material/performing where you'd like to on exams, then you can take a step back and see if you can incorporate some research. Personally, I sacrificed time spent doing non-academic things. I would study or work on research over meals, spent Friday nights during M1 analyzing data, and went into lab before morning classes. Evenings after exams, I would work on research while some classmates took the night off.

I wasn't perfect - I often disrupted my life-work balance and research time crept into studying time even though I tried to protect my study schedule. My board score probably took a hit due to mental fatigue and time lost to research. But I enjoyed my research, was productive, and have a research mentor that is now a life coach.

If I could go back, I would do it again but I'd pick only 1-2 things to sacrifice in my day instead of finding every single opportunity to cram in as much research/studying into my day as possible. This would be more for my personal wellness than a higher board score.
 
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What is your goal? Is it prestige and academia or is it "I just want to be a surgical subspecialist"?

If you're trying to match into top academic places for something like medicine, 240 step 1 + pubs >>> 260 step 1 + half-assed research project with a poster at your own school's mandatory poster session.

If you're trying to match into ENT or something anywhere, you need the high step 1 to get your foot in the door, and community programs won't care as much about your lack of research.

If you're trying to match a surgical subspecialty at a top... even 50 academic place, then get off SDN and start putting in your 12 hour days, because you need everything.

Well, I just want to be an orthopedic surgeon. I would go anywhere that will take me. I don't care about the ranking of the program. So, I guess by your logic, I should focus on Step 1. Fair enough.
 
I'm a terrible example, please don't take my situation as the norm. Usually when someone is a gunner, they are a competent gunner. I am just an extremely terrible NMBE test taker. You should put most/all of your time into Step 1. I put an EXTREMELY large amount of time into Step 1 and knew it was more important than research. I never let research get in the way of Step studying. I'm just terrible at those a**wipes' questions (and this continues into 3rd year shelves). Publications can help, but at the end of the day your Step 1 gets you your future job.

Also, you don't know how much more studying will yield a higher score. Remember that garbage exam has like a 10 point standard error. And 10 questions out of 280 can sway your score 20 points. You can get an exam that fits your strengths or one that works towards your weaknesses. You just never know. Luck certainly plays a part, and I have none.

With publications you don't know if your work will end up in a manuscript. You could either strike lucky and bank a bunch of pubs like me, or you can sit on a project and go nowhere with it. Again luck plays a big role.

The whole system sucks.
 
I'm a terrible example, please don't take my situation as the norm. Usually when someone is a gunner, they are a competent gunner. I am just an extremely terrible NMBE test taker. You should put most/all of your time into Step 1. I put an EXTREMELY large amount of time into Step 1 and knew it was more important than research. I never let research get in the way of Step studying. I'm just terrible at those a**wipes' questions (and this continues into 3rd year shelves). Publications can help, but at the end of the day your Step 1 gets you your future job.

Also, you don't know how much more studying will yield a higher score. Remember that garbage exam has like a 10 point standard error. And 10 questions out of 280 can sway your score 20 points. You can get an exam that fits your strengths or one that works towards your weaknesses. You just never know. Luck certainly plays a part, and I have none.

With publications you don't know if your work will end up in a manuscript. You could either strike lucky and bank a bunch of pubs like me, or you can sit on a project and go nowhere with it. Again luck plays a big role.

The whole system sucks.

The man of the hour.
 
Based on family member's experience, with a 265 Step 1, all Honors in rotations but only 1 or 2 research publications, leading to only four interviews and no match, I'd say research is pretty important. Hindsight is 20/20. You'd be smart to maximize your efforts with both step score and research.
 
Also, ortho doesn't care about research. I know so many people that matched great programs with 0 publications and 245+ on Step 1. If you want to match ortho do everything possible to get a high step score. Research is not the key there.
 
Based on family member's experience, with a 265 Step 1, all Honors in rotations but only 1 or 2 research publications, leading to only four interviews and no match, I'd say research is pretty important. Hindsight is 20/20. You'd be smart to maximize your efforts with both step score and research.
That is not commonplace. 265, all honors, 2 publications and only 4 interviews and no match? What specialty?
 
Based on family member's experience, with a 265 Step 1, all Honors in rotations but only 1 or 2 research publications, leading to only four interviews and no match, I'd say research is pretty important. Hindsight is 20/20. You'd be smart to maximize your efforts with both step score and research.
Seems like they either had a red flag or were not applying broadly enough tbh, there are no guarantees in this field. Despite what adcoms on here will say, there is absolutely some luck/randomness to the process; the only way to combat this is to make sure you've applied to enough places-with a good distribution of safeties/reaches (I know a guy who had a great gpa, 523 MCAT and did research in undergrad who got exactly one acceptance ...and he's an awesome person). He nabbed an acceptance only bc he had the humility to apply to places that by all standards he should've been a shoe-in for. Ik crappier people with worse stats and more/better acceptances bc they applied to more schools. From the few residents I know, it is no different. You have to apply broadly. I'm rambling on about this bc I don't want people going through the cycle of hopelessness I felt in undergrad during med school bc of some rare circumstance they read on sdn-just wanna make sure they know that it was likely avoidable (two crappy pubs should've been plenty to match in any specialty as long as a person with those stats had no red flags and approached the match cautiously).
 
No red flags, applied to almost 100 derm programs. Totally shocked. School admins say no red flags in app. Can you just fall through the cracks? Doesn't seem possible, but it seems it happens. But things tend to work out for the best. Has a two-year research fellowship lined up after prelim year (two different out of state places).
 
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Seems like they either had a red flag or were not applying broadly enough tbh, there are no guarantees in this field. Despite what adcoms on here will say, there is absolutely some luck/randomness to the process; the only way to combat this is to make sure you've applied to enough places-with a good distribution of safeties/reaches (I know a guy who had a great gpa, 523 MCAT and did research in undergrad who got exactly one acceptance ...and he's an awesome person). He nabbed an acceptance only bc he had the humility to apply to places that by all standards he should've been a shoe-in for. Ik crappier people with worse stats and more/better acceptances bc they applied to more schools. From the few residents I know, it is no different. You have to apply broadly. I'm rambling on about this bc I don't want people going through the cycle of hopelessness I felt in undergrad during med school bc of some rare circumstance they read on sdn-just wanna make sure they know that it was likely avoidable (two crappy pubs should've been plenty to match in any specialty as long as a person with those stats had no red flags and approached the match cautiously).

This person applied to 100 derm programs (with the average being ~75 this year). While applying broadly is crucial this is definitely not what kept this person from matching.
 
Seems like they either had a red flag or were not applying broadly enough tbh, there are no guarantees in this field. Despite what adcoms on here will say, there is absolutely some luck/randomness to the process; the only way to combat this is to make sure you've applied to enough places-with a good distribution of safeties/reaches (I know a guy who had a great gpa, 523 MCAT and did research in undergrad who got exactly one acceptance ...and he's an awesome person). He nabbed an acceptance only bc he had the humility to apply to places that by all standards he should've been a shoe-in for. Ik crappier people with worse stats and more/better acceptances bc they applied to more schools. From the few residents I know, it is no different. You have to apply broadly. I'm rambling on about this bc I don't want people going through the cycle of hopelessness I felt in undergrad during med school bc of some rare circumstance they read on sdn-just wanna make sure they know that it was likely avoidable (two crappy pubs should've been plenty to match in any specialty as long as a person with those stats had no red flags and approached the match cautiously).

So you're saying 2 pubs is enough to get into derm if you have a 260+ Step 1 score plus Honors in your clerkships?
Idk, I feel like that SHOULD be enough...but then again the average # of pubs/posters is 12 for derm...
Can a high step score really make up for poor research experience? I don't see myself getting more than 5 pubs/posters max by the time I'm applying to derm.
And is there really a difference between academic vs. community programs in terms of their research requirements/expectations? I am planning on applying to basically every derm program in the country. And I refuse to take a research year. I'm goin' straight through or bust.
 
Having 2 actual Pubmed publications in their specialty of interest + (I am assuming) some conference presentations, work-in-progress, etc will probably be right around average of US MD matriculant even for specialty like derm. I am also not buying that research was the issue.


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Based on family member's experience, with a 265 Step 1, all Honors in rotations but only 1 or 2 research publications, leading to only four interviews and no match, I'd say research is pretty important. Hindsight is 20/20. You'd be smart to maximize your efforts with both step score and research.

Your family member was probably a tool.
 
Your family member was probably a tool.
Really? Is that the best you can come up with? Or are you just trolling for the fun of it. And, no, my "family member" is not a tool. Finished first in med school class. Can you say that?
 
Not even close.
The average number of abstracts, presentations, and/or publications for derm in 2016 was 11.7.

Source: https://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf
Page 37.
It depends what we are talking about. I assumed actual publications...the numbers you quoted are incredibly inflated, as each project could turn into 3 or more of those...also look at the number of people getting in: with a 265 they had about 90% chance of matching based off that data alone-I'd wager 1/10 with that score are not very good socially, as I'd say 1/10 of my class as a whole isn't the best with social skills. Even those with FOUR "publications" went 15-4 (79% of those people matched, not even taking step 1 into account). Bottom line is that is likely not what kept them out...people do fall through the cracks, but with those stats (yes, even in derm-where the average step is "only" 249, a 265 puts you at an advantage) I'd wager there was some problem whether they were forward about it or not. The problem could've been as simple as they just don't have the personality to fit in, but they might not feel comfortable saying that.

@dermmom17 I know I don't know them personally so I don't mean to seem like I'm assuming something about their personality/situation, there is the possibility that they were just very unlucky. I'm just making sure others know that this should not technically keep someone out (in the vast majority of circumstances, barring something game-changing)

also: And is there really a difference between academic vs. community programs in terms of their research requirements/expectations?
Others are way more qualified to answer this, but as I understand it yes there is a difference, even for derm.
(use search function for examples/full explanation for the publication numbers being inflated as I am too lazy to fetch)
 
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The man of the year.

FTFY

Based on family member's experience, with a 265 Step 1, all Honors in rotations but only 1 or 2 research publications, leading to only four interviews and no match, I'd say research is pretty important. Hindsight is 20/20. You'd be smart to maximize your efforts with both step score and research.

How many programs did he/she apply to? Did they only apply to "elite" programs b/c they felt they were a sure thing or did they apply wisely? Did they have a decent personal statement/did they show actual interest in derm? Given their Step score, class rank, and straight Honors in clinicals, I don't believe for a second that research is the reason they didn't match. A factor? Sure. But there's something else about your family member's application that you're either not telling us or you don't know about...
 
You only get to take step 1 once (if you pass). Do all step 1 during M1, do research during first summer if you have the ability/thought of it soon enough, study your butt off all M2, see if ortho is still a reasonable option after step 1, pursue research during M3 with your department, be a cool person, try to honor clerkships which will translate into a good CK score.

Something that hasn't been mentioned is to crush your ortho externships. By crush, I mean show up early and prepared (you checked the OR schedule the day before and read up on the cases and know the ANATOMY). Be helpful by getting comfortable in the OR and learn how each resident/attending sets up the cases so you can anticipate what they need ahead of time (this comes with repetition and it shows you're paying attention and are a quick learner). Set up the splints. Write the notes. Smile and be happy. Never ask to leave the OR so you can eat lunch (saw a M3 do it). Never yawn. Never say you're tired. Never complain. Never try to answer a question over a resident that was asked by an attending or other resident (unless they specifically ask you) - I've seen this and heard how the residents talk about it later on. That's called being a gunner and people don't like gunners. These qualities can land you a spot (or take it away) faster than research or your 260 (although both always help). I know a guy that had a 230 and one research project, but went to every morning conference for his ortho dept during third year before his required clerkships. He was #1 on that rank list (per a resident who told him that). So while step and research are big and helpful, just being a humble, hard-working, cool, normal person goes a really long way.

Hope this helps, and remember... you can only take step 1 once if you pass.
 
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Thank yall for your ideas. I truly am baffled, as if she. She is very personable, beautiful (I'm, of course, biased), and does very well in social situations. I don't know what happened. And I believe her when she says she has no clue and that everyone at her school was surprised that she didn't match. I guess it does happen, and she will learn from this experience and come out for the better -- it's just going to take longer than she planned for.
 
Thank yall for your ideas. I truly am baffled, as if she. She is very personable, beautiful (I'm, of course, biased), and does very well in social situations. I don't know what happened. And I believe her when she says she has no clue and that everyone at her school was surprised that she didn't match. I guess it does happen, and she will learn from this experience and come out for the better -- it's just going to take longer than she planned for.

I'm curious - did she ever approach her home program to talk about her application post-match? She clearly did not receive an interview (or if she did was not ranked to match) by her home program and they may be able to shed light as to why..
 
I'm curious - did she ever approach her home program to talk about her application post-match? She clearly did not receive an interview (or if she did was not ranked to match) by her home program and they may be able to shed light as to why..
Yes, she did, immediately afterwards. She did interview at home program and thought it went well. The PD didn't give her any feedback.
 
Your family member was probably a tool.
Even if personality was an issue, the bigger problem here is that this person only got 4 interviews despite having 260s, all honors, and publications. Really strange.
 
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Really? Is that the best you can come up with? Or are you just trolling for the fun of it. And, no, my "family member" is not a tool. Finished first in med school class. Can you say that?

Ya, and I matched.

Even if personality was an issue, the bigger problem here is that this person only got 4 interviews despite having 260s, all honors, and publications. Really strange. Hope that doesn't happen to me this upcoming cycle.

As much as it may pain med students to realize it, the residency selection process is not an objective process. Personality and "fit" are just as important, often more so, than any numerical metric, particularly in smaller fields (such as derm, surgical subspecialties, etc.). While there are certainly those that are "unlucky", the more likely explanation is that there is some personality issue or red flag that precludes an otherwise stellar candidate from matching.
 
How many interviews do you expect a candidate with 260s, honors, AOA, and multiple publications to get assuming applying broadly and no red flags?

Not sure anyone can answer that question, but I would expect someone that is well above average by every objective metric to have their number of interviews reflect that. For derm, the 2016 charting outcomes says the number of "mean contiguous ranks" for matched applicants was 8.9, fwiw.
 
245 and 10 vs 260 and 2 are very very close to call

i think clarity on the research quality would be needed to determine between them
 
Based on family member's experience, with a 265 Step 1, all Honors in rotations but only 1 or 2 research publications, leading to only four interviews and no match, I'd say research is pretty important. Hindsight is 20/20. You'd be smart to maximize your efforts with both step score and research.

If you're the applicant's mother I think we may have found the issue
 
Another key point. Just because somebody tells someone else they scored a 265, does in no way mean they scored a 265. Ever hear of a student exaggerating an exam score to a parent? Especially a parent as over-bearing as one who posts on SDN as dermmom when their kid hasn't even matched derm yet?
 
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Yes, she did, immediately afterwards. She did interview at home program and thought it went well. The PD didn't give her any feedback.

This to me seems concerning. If I were in your daughter's shoes, I would have been blunt and asked why I wasn't ranked to match and if there was anything in my application I could have improved to have matched at my home institution. It's somewhat of a red flag if her home institution didn't fully back her candidacy for a competitive residency and this likely may have reflected in her LORs as well.
 
Excuse me. I didn't realize that it was a crime to post on this forum. No wonder doctors have such a reputation. I only wanted some objective feedback on why she might not have matched. I'll leave the forum to you know-it-alls. To the ones actually being helpful, thank you. I'm out.

What was your plan exactly? To get some feedback so that you can tell your daughter what to do now?

I can't imagine how infuriated I would be if after not matching derm my mom would call me and tell me why she think I didn't match after reading SDN.


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