Take Step 2 early with low Step 1?

[Himanshusingh]

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If I passed Step 1, but got a score below 200, should I take Step 2 early to have it considered with my residency applications? I go to a top tier medical school. but I have been an average medical student. I am not trying to match at top tier Anesthesia programs like Hopkins, UCSF, or MGH. I would however like to match at a decent Southern California program (UCLA, UCSD, etc.)

I keep going back and forth about this so any ideas/words of wisdom would be appreciated.

 

[Gas]

With anesthesia becoming more and more competitive, maximizing your application is a good idea. I think it's pretty safe to say taking Step 2 early enough to have it reported is a good idea. However, if you are going to take Step 2, make sure you rock it. As for getting a spot at those programs, board scores are a large component of your application, but not everything.

It may be a good idea to look into doing an away elective at places you are interested in. Try to make some contacts at that program, especially those involved in the admissions process. Also, talk to attendings at your school and see if they know attendings at places you are interested in. Letters are also important, so try to get good ones from big names. Write a good personal statement and bone up on your interviewing skills too - those can be the clinchers.

 

[Himanshusingh]

Thank you for the reply. As for letters of rec, how many have to be from anesthesiologists?

I know that board scores aren't everything, but how much weight does the applicant's medical school carry? In other words, would an applicant from a school like Harvard or UCSF have to worry as much with a low Step 1 score?

 

[Gas]

There is no set rule as to how many have to be from anesthesiologists. However, common sense would dictate that you should have at least one. Most programs require 3 letters and ERAS lets you submit up to 4. IMHO, it's the quality of the letters that matters more than the quantity. Try to obtain letters from big names or with direct connections to the programs you are interested in. Personally, I submitted 4 letters - one from an internal medicine attending and the other 3 from anesthesiology attendings, and I matched at my #1's for both transitional year and anesthesiology.

As for the school, coming from a big name school looks nice on your resume. This is just speculation, but I do believe coming from a well-known med school helps you more than coming from a mediocre school.

But it's also important to have additional credentials like good board scores, letters, interview, etc. Does ths mean that if you graduate from Harvard you are guaranteed a residency spot there? Of course not, but all else being equal, I'm sure they would give you preference over someone from a no-name school. On the flipside, that someone from the no-name school has a better chance of matching at their program, and even at Harvard if they have connections or did an away elective there.

Just take Step 2 and rock it - that and the letters are the two most important things you can do to bolster your application.

 

[Himanshusingh]

What is considered rocking Step 2? 250?

Do you think a strong letter from a Surgery Attending could also be of benefit?

And you said you did a transitional year. Is there an advantage of doing that over an internal med year?

How about research in Anesthesiology.. even if it's only for a short period of time?

Sorry so many questions. I appreciate you taking the time to respond.

 

[Skylizard]

Originally posted by Himanshusingh
What is considered rocking Step 2? 250?

250 would definately be "rocking". However, it is all relative. If you do fairly below 200 on Step I, then 5-10 points over 200 on Step II would be beneficial and you really don't need 250. Clearly, the higher score you get the more likely you will be to get the geography you want. 220 on Step III would be quite good and show substantial improvement and lay to rest any fear that you will take Step II late in the year and potentially fail it...after matching. Another thing I would say is that if you pass step II and score equal to step I, you can argue that you aren't a good test taker (if this is the case) but you are consistent and have passed Step II.

Originally posted by Himanshusingh
Do you think a strong letter from a Surgery Attending could also be of benefit?...

Originally posted by SomeOne
I can't speak to anesthesia. However, in general when talking to PD's, they have told me they like strong letters from attendings in different fields (i.e. surgery, IM, OB/Gyn, etc...). Their reasoning was that if the attending strongly recommends you then you more then likely took your education seriously even in the fields you do not intend to practice...i.e. IM, etc... There is a common sense out there that attendings try to recruit to their own field and some may be over generous in their evaluation and less objective. So, letters from an IM attending saying you are great go far to support what the other recommendation writers say and clear any doubt that you might have only had a good month in anesthesia.

SomeOne

 

[Gas]

I start my transitional year in a month. The advantage it has over internal med is that usually, transitional years allow more elective time, which makes for a more well-rounded learning experience. Also, they tend to be cushier than regular internal med years because of the elective time.

Research is a good idea which I failed to mention. Even if it is for a short period, that is better than nothing. If you can publish something, that is a huge bonus, especially when applying to the more research-oriented anesthesiology departments. It may also help you get a letter from a big name and gives you something to talk about on the interviews.

As for Step 2, the higher the better, there is no mystery about that. But remember, board scores are just one factor in the equation.

 

[gaslady]

There's pros and cons of all internship choices. Some people say that IM is better because you learn medicine well, whereas in a transitional year you're a "jack of all trades, but master of none". IM is definitely a better choice for someone who is applying to a competitive field and thinks they may not get a spot in that field. This is more the case for people going into ultracompetitive fields like derm. The IM year is a back-up and gives the person the option of continuing on in medicine, as most prelim IM programs will try to get spots for prelims who want to stay on. However, as already stated you generally work more and have less elective time, but that's not uniform. There's also usually more floor time, which I personally don't enjoy (all the rounding makes me dizzy). Easy transitional years are more competitive. It's preference, do you want to learn alot and work hard, have a really easy year and not learn much or have something in between? There's all kinds of programs. You can get an idea by looking at the schedule.

A strong letter from a surgeon would be looked upon favorably. Research is always a plus, but not necessary. However, if your application is lacking it might boost it a bit.

 

[Himanshusingh]

Again I'd like to thank everybody for taking the time to reply. I still keep coming up with questions however so I hope these continue to be answered.

Coming from a tip tier school, is there any utility in doing audition rotations? I know some programs like UCSD "frown" upon these and don't take these into consideration. I heard that you should only do audition rotations if you come from a lesser-known school. Any takes on this?

 

[gaslady]

I have never heard of a program frowning on students doing an away rotation, but I don't have any experience with West Coast programs. It's possible that some places won't take it into consideration, but I think it highly unlikely that if you did an away rotation somewhere and you preformed like a superstar, they wouldn't look favorably upon that. If there is a particular program you are very interested in you could contact some of their residents. I'm sure the residency office would give you some names. Alternatively you could call the hospital and ask to speak with the anesthesia resident on call. That may be a shot in the dark though. If you don't get an interview somewhere after doing a rotation there, you probably wouldn't get an interview there anyway (unless you really screwed up).

Away rotations aren't just for audition purposes. It gives you a chance to see if you like the program as well. You can get letters from different faculty and see how anesthesia is done somewhere else. A strong letter from an attending at another institution is worth a lot because they have no stake in you succeeding and it is more objective, especially if that attending is well known. At your home institution the faculty have a vested interest in your success because it indirectly reflects on them.

I didn't do any away rotations. I went to a good state school, had a strong record (not AOA), interviewed at all the top places on the East Coast, and matched into my first choice. My classmates with similar academic standing did away rotations at great places and matched at them. Some people are all freaked out saying that anesthesia is so competitive, but it's just because a number of years ago they couldn't find people to take the spots. Now, it's competitive to a healthy degree (program directors are excited about the renewed interest in anesthesia, so teaching is reinvigorated, yet there are spots for qualified applicants). Students from average schools with average records should be fine. If in doubt read the ASA newsletter article posted on another thread.

-New M.D.