step 2 more important than step 1 for a program

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

TheCat

Membership Revoked
Removed
10+ Year Member
15+ Year Member
Joined
Oct 1, 2005
Messages
184
Reaction score
1
I thought i would pass on some info i attained after talking to a residency director of surgery the other day. I wont mention the program for obvious reasons and it is a community program affiliated with a university but anyway for any 3rd or 4th year med students who may be disapointed with their step 1 and hope to improve on step 2, the director told me that he weighs step 2 a lot more heavily than step 1 and he will not even consider step 1 if step 2 is very solid. I know this is probably not how it is in most places but i found it encouraging as someone who hopes to improve on step 2 but didnt think anyone cared about step 2. So its kind of like a fresh start and i am sure some other programs are similiar in that they weight step 2 higher. The rational was that when you take step 2 you have really "completed it all" reffering to you really completed your training as a student and this is like one final test. Made sense to me since it is a lot more clinical but i understand it is harder to use to compare since not everyone takes it on time. Anyway thought i would pass along! Hopeful GS
 
they probably base this on an article that was published in the last 2 years (i forgot exactly where it was) but it said that the quality of the resident correlates with Step 2 performance and that there was no correlation to Step 1 performance or AOA or any of that other stuff. I honestly don't remember all the details but I do recall the definite step 2 thing.
 
Andriole DA, Jeffe DB, Whelan AJ. What predicts surgical internship performance? Am J Surg. 2004 Aug;188(2):161-4.
 
I am very interested in surgery, but my step 1 score is horrible - 192. I am not a great test taker, but that score was lower than I had expected. I plan to get over the anxiety and smash step 2.

Do you know if many programs won't even look at me because of the low step 1 score?
 
my step I was lower than yours, i took step II in july and got a 237. I also go to an osteopathic medical school, so thats two strikes against me. i have received 12 interview invitations, mostly community programs, but a couple of university ones. just make sure to cream step II and you should be OK.
 
What did you do to prepare for step 2?
 
pry said:
What did you do to prepare for step 2?

study throughout third year during each clerkship. try to get thru blueprints or first aid or whatever book you prefer for each subject, but try to get thru it at least once during the clerkship. then, before each shelf, review the most important chapters, and read thru boards and wards a couple days before, then do practice questions the day before the shelf. to prepare for step II, i used boards and wards and crush step II, got thru them once each, NMS medicine (because i felt particularly weak in this subject) i got thru about 3/4 of it, and usmleworld.com. be sure to do ALL the questions and also go thru the one's you answered incorrectly and do them over. the most important part of that is to read the explanations, don't just do questions for the sake of doing it. this was how i prepared, and my score went up over 50 points from step I. OK, good luck with step II and surgery.
 
This is the case with me. Ivy league med student. Pretty much the same situation regarding step 1. Getting good to excellent evals for third-year clerkships, though no honors. Not doing great with shelf exams despite studying with USMLE World, in addition to other resources (like uWise for OB, parts of mksap for medicine, blueprints and case files for surgery). Failed peds shelf in fact despite studying with pretest, USMLE world, and case files and am re-taking. I dunno if I stand a good chance of doing well on step 2, or getting into surg. Questions do seem a bit easier this time around, when studying for peds, maybe I'm just getting better at answering test questions. Advice?
 
There's a newer article along these lines:

Spurlock DR Jr, Holden C, Hartranft T Using United States Medical Licensing Examination (USMLE) examination results to predict later in-training examination performance among general surgery residents. J Surg Educ. 2010 Nov-Dec;67(6):452-6
 
I've always thought that the CK would be a better evaluation of your overall knowledge but apparently most surgery programs still rely heavily on the Step I. The only reason I can think of to support this is that maybe most med students haven't taken the CK early enough to have the results in by the time interviews go out?

I can't really say for sure since I'm an IMG, but those are just my thoughts. 😕
 
This article (dermatologyprofessors.org, posted by S4surgery) makes me feel that I am screwed. In fact, it kind of goes against what some of the others are saying in this thread, saying that preclinical grades are the most important factor for determining residency performance and step 1 is a better indicator than step 2. According to the article, Letters and clinical grades are secondary in importance (even though they may be weighted more in the residency process currently, they shouldn't be, as the paper suggests that preclinical grades are a better indicator of residency performance). So am I screwed for internship? My preclinical grades and step 1 sucked, but I've gotten it together for clinical clerkships (minus the shelfs) and am trying hard for step 2.
 
it is great that community-based programs have this insight that there may be better indicators than step 1 scores and preclinical grades (like step 2 scores), but I am really hoping for a shot at good university-based programs, ideally ones that have good program directors and a humane feel. Does anybody have insight into some excellent, yet humane, community-based and/or university-based programs?
 
Why is it that Step 1 is more important? I don't really get it since it is a basic sciences exam and the whole point of medical school is the clinical sciences (grossly)?
 
Why is it that Step 1 is more important? I don't really get it since it is a basic sciences exam and the whole point of medical school is the clinical sciences (grossly)?

Because EVERYONE has taken step 1 by interview season. Most people have not taken step 2.

Also, I would imagine that there is some regional variations in the "best next step" along with other aspects of clinical medicine. It may be harder to standardize.
 
Why is it that Step 1 is more important? I don't really get it since it is a basic sciences exam and the whole point of medical school is the clinical sciences (grossly)?

The reason it is more important is because it has a stronger correlation with your ability to pass your boards. Are you asking why it has a stronger correlation than Step II? I do not know if that answer has been elucidated yet.
 
Top