Undecided specialty, need advice

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Your S2 is not at par for Ophtho or Derm. Rest all is ok. People matching in these speciality have over 260 (exceptions exists) . Program keep soft cut off for 260 now. If you plan applying either of them, go ahead. You deserve to take that chance. But dual apply IM.
 
medschoolaspirant said:
Your S2 is not at par for Ophtho or Derm. Rest all is ok. People matching in these speciality have over 260 (exceptions exists) . Program keep soft cut off for 260 now. If you plan applying either of them, go ahead. You deserve to take that chance. But dual apply IM.
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This is patently false. Look up the charting outcomes of the match. Plenty of students match in OPs score range in derm in 2024. Not sure about 2024, but the average step 2 in 2022 for ophtho was 247.

It's not a guaranteed score by any means and OP would be best to dual apply either way, but you're just straight up spreading disinformation.

For OP, I do think derm and ophtho are probably best for you if your heart is truly set on a mix of procedures and medicine, but it sounds like cards, GI, and anesthesia might also be reasonable. I do think you should revisit neuro, as it's not all just stroke call and that's only a fraction of what neurologists do.
 
“Patently false” ? “Spreading disinformation” ? Very strong words buddy.
Are you mistaking Step 1 score When it was scored? Now step 1 is pass or fail. Step 2 score average is touching 260 for speciality like derm or Ophtho. For your reference charting outcome for 2024 link here. Please review page 10 dermatology matched applicant for step 2. It’s touching near 260.


For Ophtho sfmatch don’t publish it, look at poll taken on Ophtho discord matched applicant 2025, results were out this week. 80% of Matched applicant score for step 2 was above 260.
 
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So you like peds, and IM, and optho, and derm. And maybe neuro.

What if there is more than one specialty in which you will be happy and find the work interesting? And if that is the case, maybe deciding comes down to other factors?

For example, maybe you don't want to be stressed during the match, and therefore you want to lean towards IM over derm. Just food for thought.

If you go the IM route you could always do cards or GI if you want to scratch the procedure itch. But sometimes I think people think they have a "dream specialty" and I don't think that's really true for everyone. I'd be happy in FM, IM, or peds. I'm doing FM simply because it's A) easy easy to match and B) better for being an outpatient PCP which I plan on doing. But I don't think I'd be unhappy as an internist at all. If that makes sense. Maybe you're the same way.
 
The data does not imply any soft
medschoolaspirant said:
“Patently false” ? “Spreading disinformation” ? Very strong words buddy.
Are you mistaking Step 1 score When it was scored? Now step 1 is pass or fail. Step 2 score average is touching 260 for speciality like derm or Ophtho. For your reference charting outcome for 2024 link here. Please review page 10 dermatology matched applicant for step 2. It’s touching near 260.


For Ophtho sfmatch don’t publish it, look at poll taken on Ophtho discord matched applicant 2025, results were out this week. 80% of Matched applicant score for step 2 was above 260.
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The data does not remotely imply there is a "Soft cut off" for 260. Per your own source, I attached screenshots. And yes, I looked at this before I made my original comment.

Just looking at OPs Step score, that puts them at a 65% chance of matching derm. That is independent of their GHHS status, top quartile, good research output, and possible AOA status, which will provide a reasonable boost in odds.

Saying anyone below a 260 is an exception to the rule is indeed patently false. You can tell applicants to be cautious and apply smartly without being a doomer about it.


Screenshot_20250207-084510.png
Screenshot_20250207-084453.png
 
Yes. You have valid point. OP does have that chance to match. But so does someone between 201-210 S2 score has 30% chance to match. Your first chart is saying it. Result is showing zero match in that category. 240-250 is showing 58 people matched from total of 300+ matched applicants. Above chart posted by you is only showing that. What is probability? 15-20% not (65% as first chart is showing). May be you don’t call it as “exception” so be it, call it whatever you want to call. If I were OP, I will apply , as all of us deserve the chance to go for our dream. And also dual apply. As reality is it’s steep.
 
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Look at above screenshot. Sfmatch for Ophtho doesn’t post S2 average like nrmp. So you have to derive reality from posted data by applicants. This is discord screenshot from this week. Poll was taken from matched applicants only. 200 matched applicant have taken poll and replied. Which is very large poll, you can derive some % from it. 32 of 200 said they matched with S2 score of less than 250. Which is 15% of matched applicants only matched with that type of score. Is it possible. Sure it is. For 15%. You don’t want to call it exception, then ok. But definitely not a norm. I feel Op deserves a chance to apply both highly competitive speciality. However both are steep and should dual apply IM.
 
I also agree for me to mention there is soft cut off of 260 may be not accurate (not patently false). As there is no such documented evidence for it, But below 260, it definitely is iffy, that is definitely can be derived. For competitive matches speciality like derm or Ophtho.
 
“Plenty of students match in OPs score range in derm in 2024. Not sure about 2024, but the average step 2 in 2022 for ophtho was 247.”

How accurate is your statement here, is it patently false? 58 out of 300 for derm. 32 out of 200 for Ophtho. Is that plenty? Also does Ophtho average looks like 247 to you here?
 
1738984721293.png


Please look at 3rd bar. It’s for derm. Please read wording below. Blue Horizontal bar is median, for matched applicants which is touching 260 for derm. Blue vertical bar is range for matched applicants for derm.. Which is shwoing range of 250- 270 ish. You can now make judgement whether “plenty” are matching derm below 250.
 
1738985964811.png

Clearly mentioned here line 4. Mean S2 derm- 257 for matched ones. Mean S2 derm UNMATCHED IS 250. . OP at 249 S2 has to be realistic. Definitely apply and go for dream. Also dual apply. Also look at line 2. Mean speciality ranked by even matched applicant is at 2.2. Given that most people dual or triple apply specialities for ones applying derm.
 
You’re not dead in the water for competitive specialties, though statistically you’re going to have a harder time.

Do you have home programs? Do you have some kind of faculty mentoring in them if so? Are those national research mentors connected clinically or just in research? If your research program isn’t giving you some connections in a field specifically, then while it’s nice that it scratches an academic itch, I see it as time that could/can be used to network since small fields are small worlds (hey, I got a derm and eye reference in). A PhD letter has minimal impact compared to one from someone I know or know of clinically.

I’m a little surprised that my relatively recently matched colleague is sort of writing you off after previously making several posts about how connections are crucial. Your hard numbers are doable. It helps a lot to have someone who knows a guy/gal and goes to bat for you.

Bioinformatics, health equity, and immunology have a pretty good size footprint in ophtho research. If you’re really into research and like trainwreck cases, you could potentially do well in academics with an a uveitis or oncology fellowship, with the possible addition of a surgical retina one to manage everything. Some people just do retina and dabble more than average. Do note that would be up to a 7 year track, there aren’t a big number of these cases, and there are hurdles in infrastructure/coordination/productivity.
 
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Agree with the others, you aren’t DOA but you’ve got a tough road ahead. I would also remember that we will likely see some additional shift in S2 as these data were from the transition period of scored S1. As applicants focus more on S2 we may see a little more score creep just as we did back in the S1 days.

The big issue with the outcomes data is that you can’t see the rest of the applications or where they matched. For every low scored match I would wager they matched home program or had some other really stellar items on their application. It also doesn’t show family connections which pop up more than you’d think.

Sounds like OP has a pretty solid app other than the score. Competitive fields will be a bit tougher but if you’re tied in with a program that likes you then you may have a good shot. Definitely consider a dual match or at least preparing for one. It’s much easier to do this ahead of time than waiting til last minute during soap or after a failed early match. Since you’ve already done a research year you’re going to want to end up doing something clinical after graduation. You will have the most best options if you apply early.
 
Thank you for the advice! I know I underperformed on Step 2- my shelf exams were high all year so I was very shocked. I was upset for months and put in a lot to reflect on what went wrong. I was caring for a parent w/ cancer and also a health care proxy for a family member who passed during that period so I think that may have had something to do it. But at this point, I can't change anything or dwell in the past.

Ultimately, I love both clinical care and research, and want to be in a career that is fulfilling and lets me make an impact on others. It sounds like unfortunately my step will make most things out of reach. I am curious if I would be ok for academic IM? I loved my IM rotation too and could see myself perhaps doing a subspecialty within IM that has procedural aspects. But I know that most of those fellowships are also competitive and am curious how important step 2 may be for those applications as well.

In terms of my research fellowship - all my mentors are MDs and are very well connected clinically and research-wise. All of them are very well known in their fields by name. They have offered to write me letters and reach out to programs on my behalf.

That said, I did meet with an advisor at my home institution who is a family med physician couple days ago. He was quite worried about me matching IM with my score and recommended I even look for opportunities post grad that don't involve applying to residency. I absolutely love patient care and so this was very disheartening to hear. If anyone has insight/advice, please let me know. I do feel quite upset/embarrassed about my score but ultimately, there is not much I can do going forward.
 
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I realize my comments may have been pessimistic due to your S2. Which is my bad. I want to reiterate you DO have a chance to match surgical speciality like Ophtho or derm. I can speak more about Ophtho (being PGY 1 right now). It is all about whom you know (more than what you know). If you do some solid always 2-3 and build relationship with residents and PD. You have better chance. Build relationship at home program, you have better chance, 2025 Ophtho match is indicative from polls taken that 6 out of 10 people have matched at places they know people (home, away, research). As they may take you as they know you, If you dual apply IM , academic IM is definitely doable. I again can speak for myself. I was a dual applicant IM ( as I was middle of the pack stats for Ophtho). and had applied very select high academic IM program only in my regions. I did well with number of IV with academic IM program. Had it come to match (which didn’t happen, as matched Ophtho), I think I would have matched, Dual applicantion does give huge peace of mind. My suggestion is don’t give up on dreams due to lower S2 score , build relationships and it’s possible. Hedge bet by dual application IM, as we have seen even best of best fall thru cracks, after having all check boxes checked , what top applicants have.
 
frazzledmeatball said:
That said, I did meet with an advisor at my home institution who is a family med physician couple days ago. He was quite worried about me matching IM with my score and recommended I even look for opportunities post grad that don't involve applying to residency. I absolutely love patient care and so this was very disheartening to hear. If anyone has insight/advice, please let me know. I do feel quite upset/embarrassed about my score but ultimately, there is not much I can do going forward.
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Wait what? Your score is nothing to be ashamed of. I'm assuming you mean he was worried about you having a hard time matching at Brigham for IM or do you mean he was worried you'd match IM as a fallback specialty when dual applying?

You sound like someone who probably interviews well, who has connections in the fields you're interested in, who likely crushed clinical rotations/is likely AOA, and whose S2 score is likely not going to get you screened out of interviews. In fact, I'd wager you do end up getting offered a good number of interviews, as long as you apply broadly. I can't speak for other specialties, but at my (top 10) residency in psych, interview was like 90% of where you'd land on the rank list. I think you should definitely apply to derm and/or ophtho, whichever feels like a better fit for you.
 
FlowRate said:
Wait what? Your score is nothing to be ashamed of. I'm assuming you mean he was worried about you having a hard time matching at Brigham for IM or do you mean he was worried you'd match IM as a fallback specialty when dual applying?

You sound like someone who probably interviews well, who has connections in the fields you're interested in, who likely crushed clinical rotations/is likely AOA, and whose S2 score is likely not going to get you screened out of interviews. In fact, I'd wager you do end up getting offered a good number of interviews, as long as you apply broadly. I can't speak for other specialties, but at my (top 10) residency in psych, interview was like 90% of where you'd land on the rank list. I think you should definitely apply to derm and/or ophtho, whichever feels like a better fit for you.
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I appreciate this advice. I think he was mainly worried because I have a lot of derm related skin of color research (though it is looking at disparities in cutaneous oncology) and he's worried IM will see that as a negative or that I am applying to IM as a back up. Additionally, I go to school in the NE area, so his concern was that the programs in the area are just very hyper-competitive.
 
frazzledmeatball said:
I appreciate this advice. I think he was mainly worried because I have a lot of derm related skin of color research (though it is looking at disparities in cutaneous oncology) and he's worried IM will see that as a negative or that I am applying to IM as a back up. Additionally, I go to school in the NE area, so his concern was that the programs in the area are just very hyper-competitive.
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I'm not familiar enough with IM competitiveness enough to know whether the non-Harvard/Columbia/NYU programs are all that competitive, but my sense was that they're not nearly as competitive as those programs. Similarly, I can't speak with any authority as to what IM program directors think, but I would imagine that they're quite used to derm dual-appliers. The nature of those hyper-competitive specialties is that a good portion of applicants don't match into their preferred specialty and IM is often the default backup. I think psych programs care a little more about dual applying only insofar as psych is not necessarily like most other fields of medicine, so actually wanting to do psych matters a little more to how they think a candidate will do as a resident.
 
the 2024 match data shows chances of matching dermatology with a s2 of 249 is roughly above 60%. That doesnt take into account all the other aspects of these students applications. Unless I am misinterpreting the data, I think it would be a mistake to let that be the sole reason to not apply given all your other strengths
 
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