Step II motivation for the MD/PhD student

[happyresearcher]

Advice please:
How to keep up the motivation of studying for step 2 after going through an md-phd program, being near the end, looking forward to interviews and getting back into research and starting residency? There are so many things i would rather be doing than preparing for a multiple choice test.

i did well on step 1, and back in the day...step 2 was not supposed to matter. but then i got the impression it is now part of the review process for residency from the internal medicine forum, maybe more important (?).

Anyone have stories about how step 2 was the reason they did not match somewhere? other ways to motivate? other suggestions? anyone else going through this semi-senioritis?

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[gbwillner]

Advice please:
How to keep up the motivation of studying for step 2 after going through an md-phd program, being near the end, looking forward to interviews and getting back into research and starting residency? There are so many things i would rather be doing than preparing for a multiple choice test.

i did well on step 1, and back in the day...step 2 was not supposed to matter. but then i got the impression it is now part of the review process for residency from the internal medicine forum, maybe more important (?).

Anyone have stories about how step 2 was the reason they did not match somewhere? other ways to motivate? other suggestions? anyone else going through this semi-senioritis?

Depends on your specialty. Some want to see your score from what I hear (the competitive surgical subspecialties), although this may not be true. Otherwise you are better off putting off the test so that scores come back after your interviews, so they can't hurt you in any way (but you should say you are taking it soon).

 

[QofQuimica]

Advice please:
How to keep up the motivation of studying for step 2 after going through an md-phd program, being near the end, looking forward to interviews and getting back into research and starting residency? There are so many things i would rather be doing than preparing for a multiple choice test.

i did well on step 1, and back in the day...step 2 was not supposed to matter. but then i got the impression it is now part of the review process for residency from the internal medicine forum, maybe more important (?).

Anyone have stories about how step 2 was the reason they did not match somewhere? other ways to motivate? other suggestions? anyone else going through this semi-senioritis?

The biggest motivation for me this year was the sobering realization that I've now shelled out over $2000 for the two parts of Step 2, including travel for CS, practice question bank, NBMEs, etc. That doesn't include the time necessary to do the registration, prepare, etc. Unless you, unlike me, are made of money, wanting to pass these tests on the first try is a pretty powerful motivator! There is also a lot to be said for getting it over and done with. Who wants to be coming off their interview high in January and then start worrying about Step 2 when everyone else is chilling? Spring of senior year should be a virtual six-month holiday if you plan it right.

My advice: register for the stupid thing, set a date before the end of next month, and spend 2-4 weeks studying depending on how much review you need. Take one or two NBMEs (maybe before and halfway through) to make sure you're on the right track, then go take it and get it over with. You can definitely motivate yourself to study for two weeks.

As for whether Step 2 is required, I agree that it probably depends on specialty and program. When I was a second year, I spoke to the anesthesia PD at my school, and he said that he does want Step 2 scores. Well, I don't know if that's a ranking requirement or just heavily desirable, but the knowledge that even some PDs in some specialties want it before they'll rank you is reason enough for me. Then again, I've never been the type who likes to put things off until the last minute; I'd much rather pay now and party later....

 

[Neuronix]

I'm taking my Step II so I'll get my scores back by the time I transmit ERAS. This was recommended by two advisors since my Step I isn't so hot for the big name academic programs.

 

[QofQuimica]

I'm taking my Step II so I'll get my scores back by the time I transmit ERAS. This was recommended by two advisors since my Step I isn't so hot for the big name academic programs.

Neuro, didn't you get a 240-something? That's like a whole SD above the mean. How can that not be at least competitive for rads programs? Even derm and plastics don't average above that.

 

[Neuronix]

Neuro, didn't you get a 240-something? That's like a whole SD above the mean.

Yep. But remember, any program that is strong in research and in a good location for me is not your standard Radiology program. The competition for academics is extreme. The averages for matched students at the big name, "research-oriented", programs is more like 260.

My home program told me flat out they wouldn't take me, and they said that will be the same for the other big name places. I talked to someone at a mid-tier place and they told me similar things. My Step I score is decent, but a better Step II score would help. Also, I better get honors in several core clerkships or else.

 

[Treg]

I am planning for step 2 in December or early Jan. I was going to do it this month but I got side-tracked with other things. I think that September would be a good time to do it if you can, it is after ERAS is due but before a lot of invites come in.

Finding the motivation is hard though! I am doing CS on the 17th, anyone have any advice for me?

 

[QofQuimica]

Yep. But remember, any program that is strong in research and in a good location for me is not your standard Radiology program. The competition for academics is extreme. The averages for matched students at the big name, "research-oriented", programs is more like 260.

My home program told me flat out they wouldn't take me, and they said that will be the same for the other big name places. I talked to someone at a mid-tier place and they told me similar things. My Step I score is decent, but a better Step II score would help. Also, I better get honors in several core clerkships or else.

I'm not saying you or they are wrong, but I still think it's ridiculous to put that much emphasis on the USMLE. I can see a program hesitate about taking someone who finally passes with a 188 on their third try, but does it really make people better radiologists if they get 260 instead of 245?

Speaking of clerkships, are things going better since you last posted?

 

[Neuronix]

Speaking of clerkships, are things going better since you last posted?

Yeah, I'm not FREAKING OUT anymore. I finished Pediatrics on Friday with the shelf, but towards the end of the rotation I was beginning to feel comfortable again.

The true test will be when I get my Peds grade back. I worked really hard on what I would find out is the worst service for medical students. I admitted over double the number of patients that the other students did on other services. I was almost to the workload of a Peds Sub-I. I just hope it all pays off.

Unfortunately, for all that work I don't think it was a great learning experience. My outpatient office was in a wealthy suburb and almost exclusively saw very well, upper class kids with every resource available. On inpatient the hospitalist team I was assigned to pretty much takes only mild-moderate asthma and bronchiolitis kids. So that's all I know now, mild-moderate asthma and bronchiolitis. But I knew them so well I'd impress the new attendings, especially since I got a new attending on average every 2 days. There were no residents to guide me, so I was just kind of expected to figure out what the attendings wanted at first. I was so lousy, being my first rotation back and all, that it was really intimidating and there was a lot of talk of just cramming me into another team (so there would be 3 med students on another service). I grinned and played happy happy medical student as much as possible though, and I insisted I not be part of the mega-team. I rotated at that hospital before on a 3 student team and the experience was really lousy the other way. I got to do nothing. Sigh, third year.

 

[Doctor&Geek]

Of course, when I pointed out USMLE scores being of great importance at a recent meeting of faculty, one of them stood up and pointed out that USMLE scores were expressly not supposed to be used in evaluating residency applicants.

 

[Neuronix]

How disconnected is that faculty member from the real world .

The obvious fix if they really cared would be to make Step I and Step II CK pass/fail only with no scores released. Will that ever happen? Of course not.

 

[QofQuimica]

The obvious fix if they really cared would be to make Step I and Step II CK pass/fail only with no scores released. Will that ever happen? Of course not.

I think that's a reasonable solution. My understanding is that the point of the test is to show that you have a basic knowledge of principles and practice that are minimally expected of a licensed physician. So the powers that be should decide what basic things a physician should know, and either we students reach that level and pass, or we don't know enough and need to remediate. At some point, placing more and more emphasis on astronomical USMLE scores becomes less about improving new physicians' proficiency in medicine, and more about improving our ability to take standardized exams. Since none of us is going into the professional standardized exam business, achieving 260 USMLE scores is not exactly the most sensible hoop to jump us through.

 

[Neuronix]

At some point, placing more and more emphasis on astronomical USMLE scores becomes less about improving new physicians' proficiency in medicine, and more about improving our ability to take standardized exams.

The reason residency faculty like Step I scores is because it gives them an easy criteria to select who to interview and accept. When you have hundreds of applications for each spot, one or two numbers are a lot easier to evaluate than trying to evaluate each person as a whole.