Third year applying OB

[LW12345]

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I am a third year applying to OBGYN this coming year. I go to a private, average ranked school in the midwest. All this talk about a rough OB match this year kind of has me anxious.

I really would like to go to Texas but plan on staying in the midwest/southeast. Any chance at places like Baylor, UTSW, UTMB, UT-Austin, Miami?

Summary:
Male
Step 1: 214, Step 2: TBA
P in OB, H in surgery, P/NH in other clerkships
3 first author publications, 4 other non first authors (2 more on way). (Mix of ENT and Endocrinology papers)
Started on a preeclampsia chart review this year. Unlikely publication.

Questions:
1) What are my chances at matching to an above average program? I want to do fellowship after, and want to continue doing research and would like to be at a big university program. I have a low step 1 score (scored 220-230s on 4 NBMEs so I know I'm capable of better). I did well on shelfs and plan on a strong step 2 score based on my UWorld


2) I am planning to take Step 2 CK on July 27 or 29. Is that too late? I'm confident I will improve significantly from my Step 1 so will taking it then be in time for schools to take it into account before handing out interviews?


3) I do not have any aways scheduled.
Should I plan on doing an away at a reach program like Baylor/UTSW/Emory? Would it be a waste of time since I'm not a superstar clinically but I'm easy to get along with and I'm not super weird or incompetent. Or should I aim for a more average program for a letter and experience somewhere different?


4) Do people generally do their aways in something outpatient or inpatient like MFM/L&D or surgical? What is the best way to impress and learn the most about the program?


5) I will have 3 OB letters at least. Should I aim for another outside of OB as well? That won't be as easy to obtain but definitely doable


Thanks in advance everyone.

 

[MindyLahiri]

I am a third year applying to OBGYN this coming year. I go to a private, average ranked school in the midwest. All this talk about a rough OB match this year kind of has me anxious.

I really would like to go to Texas but plan on staying in the midwest/southeast. Any chance at places like Baylor, UTSW, UTMB, UT-Austin, Miami?

Summary:
Male
Step 1: 214, Step 2: TBA
P in OB, H in surgery, P/NH in other clerkships
3 first author publications, 4 other non first authors (2 more on way). (Mix of ENT and Endocrinology papers)
Started on a preeclampsia chart review this year. Unlikely publication.

Questions:
1) What are my chances at matching to an above average program? I want to do fellowship after, and want to continue doing research and would like to be at a big university program. I have a low step 1 score (scored 220-230s on 4 NBMEs so I know I'm capable of better). I did well on shelfs and plan on a strong step 2 score based on my UWorld


2) I am planning to take Step 2 CK on July 27 or 29. Is that too late? I'm confident I will improve significantly from my Step 1 so will taking it then be in time for schools to take it into account before handing out interviews?


3) I do not have any aways scheduled.
Should I plan on doing an away at a reach program like Baylor/UTSW/Emory? Would it be a waste of time since I'm not a superstar clinically but I'm easy to get along with and I'm not super weird or incompetent. Or should I aim for a more average program for a letter and experience somewhere different?


4) Do people generally do their aways in something outpatient or inpatient like MFM/L&D or surgical? What is the best way to impress and learn the most about the program?


5) I will have 3 OB letters at least. Should I aim for another outside of OB as well? That won't be as easy to obtain but definitely doable


Thanks in advance everyone.

Hey I was somewhat similar in that I felt I underperformed on my Step 1. I did have a huge jump in my Step 2 score and I think that helped significantly in "weeding out." Many programs will just look at your highest score of the two. I would encourage your to have your Step 2 completed in time to be part of your application. Once you have an interview however the Steps scores will not matter as much.

Just having a "Pass" in ObGyn may be a bit of a red flag. Begin your 4th year doing a few ObGyn sub-Is and make sure you do whatever it takes to honor.

I would suggest doing an away rotation at a program that you would most like to match to. Choose an away in a rotation similar to one you've already done at your home institution so that you're not overwhelmed trying to learn the specialty at the same time you are trying to impress the attendings and residents. So much about ObGyn match is "fit" with the program so just be a friendly hard worker and you'll be more likely to be ranked high. Hope this helps.

 

[HumbleMD]

Addressing your application concerns, at this point most of this you can't change:
- You're male (which is a slight plus but don't rely or put too much weight on it despite what others may tell you).
- Your Step 1 score stinks for top programs; this year 240 seemed to be the new 220.
- 3 first author publications is great and definitely ahead of the field. Play up the endocrinology crossover to OBGYN (we have REI, we deal with gestational diabetes, etc.), and the surgical part of ENT could crossover to surgical skills in GYN.
- Try to get something done on the pre-eclampsia chart review - a quick abstract and try to submit to SMFM, ACOG, or a local OBGYN conference - anything to get another line on your application, and can be a nice "update email" to program late fall.
- That Pass in OBGYN is a big scary red flag, but again you can't change it now. Be prepared to talk about it in your interview. I'd do 2 Sub-Is in OBGYN (don't do too many, we want you to diversify), and work your bum off - you NEED to get an honors in these.

Your questions:
1) You're a pretty average, middle of the road applicant from the sounds of it, which is still probably fine. To give you a best estimate of "what are my chances" - the numbers that matter to you are found here, which will tell you that in 2014 67/877 or 7.1% of US senior applicants did not match in the primary match. This is actually improved from 2013 where 74/866 or 7.9% of US seniors went unmatched. They haven't released this crosstab in the 2015 data yet, but we do know that there were 1,002 US senior who matched into OBGYN and 1,173 US senior applicants. All 171 of them didn't necessarily go unmatched, as they likely matched into another program.

2) Step 2 will help, but the best predictor of a Step 2 score is your Step 1 score, so strive to knock it out of the park, but I'm afraid this may not help as much as you believe. A better score will likely assist in getting some interviews. July is on the later side but will be fine as invites dont' go out until late August/September

3) You seem fixated on a flashy Southern program. For one of those Sub-Is we suggested, I'd consider doing it as an away rotation. Pick the program you really want to go to and think you have a shot at, and work your bum off and prepare to wow them. There's some risk here, as we've had applicants go both ways - their sub-I performance launched them to the top of our rank list, or practically made them DNR. Question- what do you mean "not a superstar clinically?" Is there just a lack of knowledge? Do you need to study more about the field? Maybe go pick up Williams.

4) Very program dependent, and depends on what you're looking for, but I'd stick to inpatient for the best exposure. Our go-to aways are GYN-Oncology which is a mix of floor work and surgery, and you work very closely with a core group of residents. MFM is the other we tend to host, where you get a larger exposure but probably shallower to more residents and faculty, as we're an MFM heavy program. Totally depends on what you're looking for, but also where you think your strongsuits are.

5) 3 OB letters is perfect. Will your OB/GYN chairperson be writing you a letter? I would attempt 1 letter from a non-OB/GYN field, preferable internal medicine. Out program requests 2 letters from OBGYN, 1 from another field, preferably something more medical. Look at specific program websites for what kind of letters they want.

Finally for a little personal info, I'm male, moderate Steps (230, 240), moderately high grades, top 5 East coast med school, no publications just a bunch of abstracts, had a master's degree that no one cared about. Applied to 20 programs, offers at 18, interviewed at 16, ranked them all, matched at #5 back in 2012

You never know until you try. Competitive programs are exactly that, competitive, which is why everyone will tell you to apply widely (20-30 programs) and broadly to a diverse range of programs - WashU, Northwestern, Baylor, UTSW, Alabama as well as lesser programs and everything in between. Don't be too anxious. What we seem to be subjectively noticing is that applicants are going deeper on their rank lists. It used to me more typical for folks to get their first or second choice in OBGYN, but now we're regularly dipping down to #5 or 6 for even top candidates (guess I started a trend back in 2012). Who should really be nervous are international and independent applicants, as they are the ones who are going to be edged out slowly.

 

[22031 Alum]

Letters are good, and any research is good, but that 214 + a pass in OB may get your application set aside at some top programs, even with a 250+ Step 2 score. Honestly, I'm not sure you should use up an away rotation on a reach program unless 1) you were certain you could look like nothing short of a superstar, and 2) you could get reasonable intel about how likely that program is to take someone who is mediocre on paper but a superstar in person. Some places might take you on as a rotator with little to no intention to rank you. To get that intel, it helps if people in your home department have connections from old jobs, residency, etc.

I'd advise you to study your face off for Step 2, work like a fiend on your ob/gyn research, and rock your Sub-I: honors or bust. Apply broadly to university programs, and consider doing an away at say, a South Alabama rather than UAB or UT Houston rather than UTSW.