Upset and confused

[sp9]

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Lets say you don't clear you step 1 on the first try but do so on the second. Does that automatically mean that your chances of entering into a general surgical residency will are close to 0%? Secondly if you can enter into a general surgical residency what if any, chance are there that you can specialize? From what I have been told: in both cases the chance are low or 0!!! So I guess I should give up and go into internal medicine. Thanks for the help in advance.

 

[boston]

Lets say you don't clear you step 1 on the first try but do so on the second. Does that automatically mean that your chances of entering into a general surgical residency will are close to 0%? Secondly if you can enter into a general surgical residency what if any, chance are there that you can specialize? From what I have been told: in both cases the chance are low or 0!!! So I guess I should give up and go into internal medicine. Thanks for the help in advance.

Not necessarily -- it really depends on the details of your individual situation, for example:

What was the reason you did poorly the first time? (family/personal illness?)
How poorly did you do? How much of an improvement did you demonstrate the second time? I mean, if you rocked it the second time, I think you clearly demonstrate that you have the aptitute to do well and that perhaps the first time was a fluke. It also matters how you explain your first score to programs / interviewers.

Step I score is just one factor that they weigh among many (clinical evals, letters, interview), and sometimes I think it gets over-emphasized.

Also, how committed are you to pursuing surgery? For example, would you be willing to do a prelim surgery intern year in the hopes of getting a categorical spot when someone drops out? The national attrition rate for general surgery residents is 20% over 5 years.

I wouldn't rule out general surgery simply based on Step I. It really depends on your individual situation. Care to elaborate?

 

[Pilot Doc]

Lets say you don't clear you step 1 on the first try but do so on the second. Does that automatically mean that your chances of entering into a general surgical residency will are close to 0%?

See this thread

 

[imalwayshungry]

Not necessarily -- it really depends on the details of your individual situation, for example:

What was the reason you did poorly the first time? (family/personal illness?)

i talked to a program director, explained to him my situation (acutely critically ill parent, i'm talking GCS<8) ... and he said "whatever, everyone has excuses"
i almost punched him.😡

 

[SLUser11]

i talked to a program director, explained to him my situation (acutely critically ill parent, i'm talking GCS<8) ... and he said "whatever, everyone has excuses"
i almost punched him.😡

Alot of PDs will have a similar stance......fair or unfair. If your retake score is drastically better than 180, then maybe they'll buy into "he/she had a bad day," but Step 1 is a test designed for 95% of US allopathic students to pass, with the other 5% weeded out for some remedial instruction.

Still, I definitely don't think that by failing step 1 once, you are 100% out of the competition. Maybe this would be true for Ortho/derm, but while high step 1 scores might guarantee you a spot in Gen Surg, low step 1 scores don't prevent you from getting a spot.

Your application will have a big red flag on it....the same way that DOs and IMGs have big red flags on their applications. Still, you can do what they do: work hard, do your best on step 2, and cast a BIG NET when you are applying. Just try your best to pad your CV with lots of great things to divert attention away from your big red flag.

 

[Pilot Doc]

1) regarding specialization after surgery, if your standardized test scores subsequent to your Step I failure are OK, the step 1 score will have no impact on getting a fellowship

2) Actively cultivate mentors in your department of surgery. If the attendings aren't approachable, get a senior resident first who can pave the way for you. Don't go about it with the "My scores suck, how can you help me" approach, but a "I love surgery, help me learn about it" approach. A couple of well placed phone calls from someone who likes you and has connections will get you a residency.

 

[imalwayshungry]

Your application will have a big red flag on it....the same way that DOs and IMGs have big red flags on their applications. Still, you can do what they do: work hard, do your best on step 2, and cast a BIG NET when you are applying. Just try your best to pad your CV with lots of great things to divert attention away from your big red flag.

it's a good thing i didnt fail step 1 then.

 

[tooshorttoolong]

If you want something bad enough, then you will make it happen. Ask your mentors what it will take to make surgery happen for you. Be blunt and ask the hard question -- it will get you the answer that you need.

😎 tooshorttoolong

 

[SLUser11]

it's a good thing i didnt fail step 1 then.

Oops, I thought you were the OP. Nevermind, good for you....you passed a test designed for you to pass.👍

 

[mcindoe]

Lets say you don't clear you step 1 on the first try but do so on the second. Does that automatically mean that your chances of entering into a general surgical residency will are close to 0%?

huh? why would passing the second time around automatically make your chances close to 0%? as opposed to having better chances not passing it the second time around? maybe i misinterpreted the question.

Secondly if you can enter into a general surgical residency what if any, chance are there that you can specialize? From what I have been told: in both cases the chance are low or 0!!! So I guess I should give up and go into internal medicine. Thanks for the help in advance.

if you're going to just give up and throw in the towel basd on what a few people have told you, then it sounds like you don't have the passion and motivation to do surgery in the first place, so maybe it's for the better that this happened.

And what makes you think internal medicine programs are all going to welcome you with open arms after you've failed the boards? maybe family practice programs won't care so much, but i wouldn't underestimate any other residency program or specialty when it comes to assuming that only surgeons care about step 1 scores.

I can understand your fear and I would be scared too not knowing how this will affect my application. but chances are, this is probably not an isolated incident and i would bet there are other parts of your application that are consistent with how you performed on the test. is the rest of your application weak too? or is it strong and this is just an anomaly? if it's the latter, i wouldn't assume that your chances of matching are hopeless.

Now for one minute put yourself in the seat of the program directors out there sifting through applications. You failed the boards. And it's no secret that this is an important test to do well on when it comes to residency applications. You know this, they know this, and they see that despite this you were unable to successfully pass the test. Is it thus any surprise to you that if you had a stack of apps in front of you and you had to whittle it down to pick who you wanted to interview, do you blame the PD or anyone for that matter for picking someone else to interview who did pass the test than you? It doesn't mean you're not capable of succeeding in residency, but it's not the most reassuring thing to find in an application when you're searching for prospective residents. I agree with the above posters in just wanting to know why you think you failed and if the rest of your app is consistent or not with this. but more importantly, i'm more concerned about your flippancy towards a career in surgery in that you'd just give it up in a minute and pursue something you perceive as safer because of your step 1 performance. if you REALLY wanted to be a surgeon, you wouldn't give up so easily.

good luck.

 

[njbmd]

Lets say you don't clear you step 1 on the first try but do so on the second. Does that automatically mean that your chances of entering into a general surgical residency will are close to 0%? Secondly if you can enter into a general surgical residency what if any, chance are there that you can specialize? From what I have been told: in both cases the chance are low or 0!!! So I guess I should give up and go into internal medicine. Thanks for the help in advance.

Failing USMLE Step I does not automatically place General Surgery out of reach. It will make getting a categorical slot at a university program an uphill battle but there are solid community programs out there and you have the option of scrambling into a non-designated prelim slot (working your rear-end off and doing well on ABSITE) which would greatly enhance your chances of getting a categorical slot the next year.

Make sure you do well on Step II (no failures here) and make sure that your grades (especially your General Surgery clerkship grade) are very good. Internal Medicine is not for people who fail Step I and can't match into General Surgery.

Enlist the help of your medical school's Surgery Department chairman. If you have a strong letter from the chairman, you can greatly increase your chances of a Match. Choose enough programs to get 15 solid interviews and rank your programs carefully. Good luck!

 

[imalwayshungry]

i'm wondering how safe it is to rely on community programs... i heard some of them taking people with 240s... and them not interviewing people with <215... i feel like if 240s are falling back on community programs, where does the average (215ish) student go? it's getting scary!

Failing USMLE Step I does not automatically place General Surgery out of reach. It will make getting a categorical slot at a university program an uphill battle but there are solid community programs out there and you have the option of scrambling into a non-designated prelim slot (working your rear-end off and doing well on ABSITE) which would greatly enhance your chances of getting a categorical slot the next year.

Make sure you do well on Step II (no failures here) and make sure that your grades (especially your General Surgery clerkship grade) are very good. Internal Medicine is not for people who fail Step I and can't match into General Surgery.

Enlist the help of your medical school's Surgery Department chairman. If you have a strong letter from the chairman, you can greatly increase your chances of a Match. Choose enough programs to get 15 solid interviews and rank your programs carefully. Good luck!

 

[tooshorttoolong]

Good point. Many of the more numerically qualified applicants are choosing community programs over the academic because they are more lifestyle friendly.

😎 tooshorttoolong

 

[Pilot Doc]

Good point. Many of the more numerically qualified applicants are choosing community programs over the academic because they are more lifestyle friendly.

😎 tooshorttoolong

There is a wide range of community programs. Some are in posh hospitals in desirable locations and have a semi-academic core of attendings (Virginia Mason, Carolinas) they get a robust group of applicants. There are others that are in run down hospitals with a purely indigent clientele and run by community surgeons who exploit the residents as much as they can. And there are many in between. Most community programs are less competitive than most university programs.

And by the way, last year US Seniors with Step I in the 210's had an 85% match rate. It's not THAT bad.