Step 2 CK (strategic scheduling)

[minwoo]

Hey all,
General consensus on here seems to be that most residencies (if not all) don't require a Step 2 CK score for interview invites. Currently have a Step 1 score of 248 and am scheduled to take Step 2 in late august. More than anything, I want to get Step 2 out of the way as soon as possible since I'll just forget more material OBGYN, Peds, etc as 4th year goes on. I know everybody says that Step 2 is much easier than Step 1 and people usually get 15-20 points higher than Step 1 but honestly, I am not too confident that I can exceed a 248 on Step 2 as my clerkship shelf exam scores were mostly in the 55th - 70th percentile. I understand that I'm not doing myself any favors if I don't get a Step 2 score that exceeds my Step 1 score.

Since I am taking it in late August, I know that my Step 2 score will be released after the Sept. 15 date when ERAS apps can be submitted, and that I will have a choice of whether to release my Step 2 score or not.

My question: in the case that I don't do as well on Step 2 and choose not to release the score, will residency programs be able to see that I already took Step 2 but chose not to release my scores? If not, I don't really see any advantage to delaying Step 2 until Nov/Dec...but in case I'm missing something, are there ANY advantages to taking Step 2 CK in the latter months (Nov/Dec) vs taking it in late August?

Appreciate any input!

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[partydoc]

I think you're overthinking it. Just take the exam, get it over with, as long as you don't tank your score you will be fine. Avg score for that exam is high 230s anyways.

And yes, residencies can see that you took the exam but did not release your scores. That just looks shady in my opinion.

 

[minwoo]

For anyone who has a competitive Step 1 score, is there any upside to taking Step 2 CK early?
Why take the test early at all and risk the chance of getting a lower Step 2 score that would hurt your overall competitiveness? "Just to get it over with" isn't a good enough reason IMHO

I always assumed that the optimal strategy (with a decent Step 1 score) would be to take Step 2 CK at a date (ie: mid August/Sept) where results would be available after ERAS apps went out so that you can have some control over whether to release the score or not. Thoughts on this?

 

[GABAergic]

Just take it early enough to have the score out before the programs submit their rank lists IMO

 

[boogaloo]

For anyone who has a competitive Step 1 score, is there any upside to taking Step 2 CK early?
Why take the test early at all and risk the chance of getting a lower Step 2 score that would hurt your overall competitiveness? "Just to get it over with" isn't a good enough reason IMHO

I always assumed that the optimal strategy (with a decent Step 1 score) would be to take Step 2 CK at a date (ie: mid August/Sept) where results would be available after ERAS apps went out so that you can have some control over whether to release a score or not. Thoughts on this?

Some schools require Step 2 CK scores to be in before they will review your app. I think UCSF is one of them.

 

[partydoc]

I say just get it over with because it makes no sense to wait to take the exam, you will forget a lot of the OB/Peds/Family med stuff and have to spend more time reviewing it later on. If you have a such a high step 1 score, chances are you will do well on the exam anyways. If you did poorly on Step 1 and feel that you really need to put in some time to study for Step 2 to increase your score, that's cool too.

The upside is enjoying the rest of your 4th year of med school and getting one more road block out of the way. Not having to study for Step 2 during an interview or SUB-I month or whatever. The only reason I see for taking the exam later is scheduling issues.

Plus if you do well on Step 2 as ERAS is goes out PD's will see the consistency- which they like. IMHO

And why do people always wonder about releasing their Step 2 scores? I don't even understand why this is an option anymore, it's not as if you're not going to tell them your score if they ask you.

 

[NoHumbug]

Some schools require Step 2 CK scores to be in before they will review your app. I think UCSF is one of them.

According to the UCSF anesthesiology FAQ webpage they are not one of them:

Must I take USMLE Part 2 prior to interviewing?
A passing score on both parts of USMLE Step II (CK and CS) is required for all trainees beginning a UCSF GME program. To meet this requirement, applicants should have passed USMLE Step II (CK and CS) prior to placement on UCSF rank order lists. So, you must take both parts of USMLE step 2 in time for the results to return by February 26, 2014. In selected cases, with the approval of the Program Director and the Office of GME, applicants may be placed on UCSF rank order lists without the USMLE Step II (CK and CS) score.

 

[IkeBoy18]

I know that most scores will be out around Sept 24, programs wont even have my deans letter until Oct 1st, so I figured taking it intime for the sept 24 release would be fine as I want my score to be considered. Is this not accurate? Will programs start rejecting people with no deans letter and only step 1?

 

[minwoo]

I say just get it over with because it makes no sense to wait to take the exam, you will forget a lot of the OB/Peds/Family med stuff and have to spend more time reviewing it later on. If you have a such a high step 1 score, chances are you will do well on the exam anyways.

I think the opposite may be true. Because the higher your step 1 score is, the harder it might be to exceed that score. It might be easier to go from a 225 on step 1 to a 235 on step 2 but I don't think you can say that someone who got a 240 on step 1 can just as easily go up to a 250 on step 2. So I think it makes every sense to wait to take the exam if a lower score on Step 2 doesn't help your application any AND if there are no consequences to taking Step 2 at a later date. From what I've read, most programs, if not all, will give you an interview with a competitive step 1 score.

The upside is enjoying the rest of your 4th year of med school and getting one more road block out of the way. Not having to study for Step 2 during an interview or SUB-I month or whatever.

If you ask me, those are not good enough reasons. I studied my butt off to get a decent Step 1 score, why risk messing it up just because I want to have a slightly more comfortable 4th year?

Plus if you do well on Step 2 as ERAS is goes out PD's will see the consistency- which they like. IMHO

I can agree with this and would really like to know how often Anesthesiology PDs ask about Step 2 and how much weight they put on it vs Step 1.
A friend of mine who matched into his #1 for neurosurgery this past cycle, did very well on Step 1 (250+) and deliberately took Step 2 in mid January with just a week of studying and got 230. All strategically planned out. Seems to me that neurosurgery doesn't care so much for Step 2 when a good Step 1 score is already in the books. Wouldn't be out of the questions for anesthesiology residencies to take a similar approach.

And why do people always wonder about releasing their Step 2 scores? I don't even understand why this is an option anymore, it's not as if you're not going to tell them your score if they ask you.

Again, would really like to know how often PDs ask about Step 2 scores if they already have a satisfactory Step 1 score on file!

 

[GABAergic]

It's quite obvious from your responses that you've pretty much made up your mind and want affirmation. I think I was asked about my step 2 score by one pd on the interview trail in the time between taking the exam and getting the score back. More than one pd said they believe step 2 correlates more closely to how a resident will do on later exams. It is important for many programs prior to ranking.

 

[minwoo]

It's quite obvious from your responses that you've pretty much made up your mind and want affirmation. I think I was asked about my step 2 score by one pd on the interview trail in the time between taking the exam and getting the score back. More than one pd said they believe step 2 correlates more closely to how a resident will do on later exams. It is important for many programs prior to ranking.

On the contrary, I am still scheduled to take Step 2 CK in late August since that was the only month I could dedicate uninterrupted study time for it, without canceling away rotations and making other drastic changes to my schedule.
I'm just logically trying to reason out this process and feel like I might be shooting myself in the foot if I don't do as well on Step 2. If I just decided to take Step 2 in the latter months, I could simply say that I haven't taken Step 2 yet, if asked about it on the interview trail. And as long as this approach didn't hinder my competitiveness, this seems like the most optimal way to go about it.

With more definitive answers from experienced former applicants, I would likely go ahead and defer Step 2 until a later date. However, for now, most responses seem speculative at best..

 

[deleted171991]

Take the exam whenever you are prepared enough to score similarly to Step 1, even if it's later. Those scores will follow you around when applying for fellowship, and a great Step 1 with a mediocre Step 2 is just another average candidate (plus Steps 2 and 3 are far more predictive of a good clinician).

 

[Nivens]

I originally planned to take it in January- I have a ~250 on Step 1 and, while I think I'll do fine, cannot be assured I'll do better on Step 2. But then I thought about interviews and the holidays and asked myself how much I am really going to feel like studying during that time. Plus, I think we as med students have a tendency to put far too much emphasis on things that, looking back, really don't matter. I'm taking it in 3 weeks, and am very much looking forward to 12 weeks of boards-free anesthesia electives afterwards.

 

[deleted171991]

12 weeks of anesthesia electives as a med student? Holy Moly, that meets the definition of time waste. But I am a FMG, so what do I know? I did 2 weeks as an intern, and it still was a time waste.

As a resident, we had med students rotating in our department, and they were useless, so we let them learn some minor stuff and that was it. Out of the 5-10 students I met, just one was so impressive that I wanted to actively teach her, but s/he was going into oncology.

You'll learn more in your first week of anesthesia residency than during all those electives as a med student.

 

[deleted171991]

According to the UCSF anesthesiology FAQ webpage they are not one of them:

Must I take USMLE Part 2 prior to interviewing?
A passing score on both parts of USMLE Step II (CK and CS) is required for all trainees beginning a UCSF GME program. To meet this requirement, applicants should have passed USMLE Step II (CK and CS) prior to placement on UCSF rank order lists. So, you must take both parts of USMLE step 2 in time for the results to return by February 26, 2014. In selected cases, with the approval of the Program Director and the Office of GME, applicants may be placed on UCSF rank order lists without the USMLE Step II (CK and CS) score.

Smart people. I have always wondered why most PD's rank AMGs without a Step 2 score, the standardized measurement of their clinical knowledge.

 

[Nivens]

As a resident, we had med students rotating in our department, and they were useless, so we let them learn some minor stuff and that was it. Out of the 5-10 students I met, just one was so impressive that I wanted to actively teach her, but s/he was going into oncology.

But see now, you've already taught me: "Don't be useless."

 

[eablackwell]

I'm taking my step 2 CK the first week of September. My Step 1 score isn't quite as high as yours, but nothing to sneeze at either. I'm taking it then because 1) I don't want to forget a lot, considering my last rotation of the year is in October and 2) A few of the programs on my list want step 2 scores in October. I honestly don't remember which ones, just when I went through all the sites of my 40+ (fml) programs, I was shocked that some of them specifically stated October.

As for spending time in anesthesia as a med student, I've so far done 5 weeks total (1 in 3rd year and 4 in 4th), and I have an externship in California next month. So far it's been a great experience. I was allowed to intubate, do spinals for OB, and nerve blocks for ortho procedures with an attending watching over my shoulder. I think it really depends on where you rotate.

 

[Colbare]

12 weeks of anesthesia electives as a med student? Holy Moly, that meets the definition of time waste. But I am a FMG, so what do I know? I did 2 weeks as an intern, and it still was a time waste.

As a resident, we had med students rotating in our department, and they were useless, so we let them learn some minor stuff and that was it. Out of the 5-10 students I met, just one was so impressive that I wanted to actively teach her, but s/he was going into oncology.

You'll learn more in your first week of anesthesia residency than during all those electives as a med student.

I've done 4 weeks now and have about 7 left of anesthesia electives. Absolutely not a waste of time for me as a med student. I'm learning basics and being allowed to do whatever I'm confident doing. If it's what you want to do for the rest of your life why not start asap?

There are useless med students, but maybe those are the ones who are still deciding on the field.

 

[courtnes]

I opted for the sub-I/away research 8 week combo, possibly adding 2 weeks of peds if I can swing it. Had 3 weeks of anesthesia during surgery third year. I chose not to do clinical aways, but I don't think this will be a big problem.

A PD I talked to said he thinks it's a waste to do a lot of anesthesia fourth year - I'm taking that advice and doing a bunch of rotations I won't have the chance to do again.

 

[Ronin786]

Just take it and don't release it. Then in February programs that want it for ROL will email you asking about it.

You might not interview at any program that does want that and at ROL time you'll have a better idea of how good of an idea it is to release your score.