wooh! I hate life.
Anyone else getting interview invites yet and freaking out at just how much it's going to cost? And how to still manage to do rtoations while interviewing instead of wasting vacation on it? Because I am.
Random thoughts
Step 2 CK - Used Qbank and Crush mostly, started using First Aid about 5 days before the test. I was very happy with qbank and was not impressed by USMLEworld either for step 1 or for step 2. That's just me though. Crush is NOT ENOUGH if you want to blow the top off this exam. It is enough to be below average to maybe slightly above average. If you are the kind who can learn off questions, it would probably be workable to first study crush and then go to questions. I was very vocally not a fan of First Aid for Step 1. On the other hand I thought First Aid for Step 2CK was brilliant. I would wager I got a 10-15 point bump in my score because I started using that book. Possibly could've been more if I started studying with it earlier. I can't complain about my score though, which was a lot better than I feared.
Use the NBME practice tests. They are a far better indicator of how you're doing than the qbanks (although qbanks are invaluable learning aids).
Plan on studying for a month or so. This will not need to be dedicated studying a la step 1, but a few hours every night. Do questions while watching TV every night. This will prevent burnout while letting you eke out a bit more study time.
If you weren't happy with your step 1 score, plan on taking the test no later than mid-August. It takes 3 weeks to get your scores in. Interview decisions will start being made 2nd week of September. You do the math.
Step 2 is much more intuitive and based on problem solving than Step 1. For many this will help you out tons. If you didn't do very well on Step 1, you can save yourself with Step 2. PDs have said that a significantly higher Step 2 score can all but erase a poor Step 1 showing. They understand that medical school is a growing process, and that a high step 2 and good clinical evals show you are in fact a different person than the step 1 results indicate. They also realize step 2 is about 90000000 times more relevant to clinical medicine.
what you want to do - People will tell you that it's ok to take your time in figuring things out. That is both true and not true. It is certainly ok not to know what you want to do early in third year. Not so ok by the end. This is especially true if you plan on either a) getting into a highly competitive specialty b) going to a top tier program in any residency (I'm going psych, at some of these places, the competitive applicants look no different from competitive ROAD applicants) c) being very selective in geographical location.
It is hard to know if you like something before you've gotten a taste of it, but there are good ways of getting an idea. First Aid for the Match has synopses of various specialties. Iserson's Getting into a Residency is an even better handbook and I'd recommend all third years get a copy as soon as possible. A little pricey at 35 bucks, but covers EVERY question you might have and especially invaluable for people at the 'i don't have a f***ing clue' stage.
Talk to residents, show up for grand rounds, etc. of any specialty you're interested in. The clinical mentor program we have is also useful as the physicians who volunteer are more than happy to discuss their specialties with you and setup shadowing opportunities that you can often do DURING your rotations (the weight of a faculty member often helps you get an excuse from showing up to afternoon activities etc).
research - Some people don't want to research. I'm not one of them, so I did a fair amount of research during med school. I needed to prove that I really was committed to research since I claimed to be. At the same time, research will really strengthen your application especially if you are applying for hospital-based specialties and have less than stellar GPA, scores or CV. This goes double for those of you applying for specialties that command beaucoup NIH dollars.
For those of you who abhor research and are really wondering if you need it, or if it would improve your chances, look at it this way. Being successful in residency doesn't really correlate that well to test scores, pre-clinical grades, or much of anything that is objectively measured. A successful resident is a hard worker (i.e. will help a team be efficient) who isn't afraid to study to do what needs to be done (i.e. pass step 3 and professional boards).
Research experience, and especially completed research projects that have been submitted, presented, and/or pubished prove that you are a hard enough worker to take on the responsibilities of 3rd year AND research at the same time, that you have the dedication to see a project through to completion, and that since you'll be the lowest dude or dudette on the totem pole, you will put up with scut. As an added bonus, if your research is in the field that you are applying to, it means that the PD knows you have some education in the specialty that many other applicants may lack if that specialty is not a part of the core curriculum.
letters - make your prospective letter writer decisions as early as possible. And seek to make as strong a relationship with these people as possible. You want at the very least one letter from your specialty, but the more the merrier.
Another thing to keep in mind is that some specialties want letters from the chair of the department. Meet with them as early as possible, and have something on your CV that indicates you are actually interested in that specialty.
Finally, many competitive specialties want a letter from the dept of medicine, regardless of the actual specialty. This could've been an issue for me if i'd applied to one of those specialties, for reasons I won't detail, but suffice to say that you can't pick your attendings, and some are less than ideal when it comes to evaluating you. For you guys, you need to do something in Medicine or an IM specialty your very first month or two of 4th year. a medicine sub-I or some other rotation like cardiac critical care or GI is pretty much mandatory. Get out there, prove you know your crap and get that letter. That way you can still have that all-important medicine letter ready in time for the ERAS opening date on Septemer 1st.
Good luck everyone and feel free to PM me if you got questions.
Egads that's a lot of money. Where the heck are we supposed to come up with that? As far as I remember, they don't really give us extra money for 4th year expenses, right?
Or am I taking this too seriously?
courses! 
. I did think 2nd year was noticeably more challenging because the degree of rote memorization goes up considerably which was never an easy skill for me - we just never did such a thing in business school, even at the graduate level. However, you're right on track, Jwax - the degree of difficulty goes up second year, but so does the degree of interesting - so, all things considered, I enjoyed second year much more than I did first year. Actually, right now, I'm starting to think of those long days of homeschooling with breaks to watch Oprah as "the good old days." God, do I miss afternoon naps.
