USMLE Score and GI Fellowship Match

[Auscultate]

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So I just got back my Step II scores and passed both the CS and CK - BUT unfortunately I did have a significant plunge in my CK score (to right around 200) from my step I (meaning if I had those scores prior to applying I would probably not have gotten interviews at some of my top choices). Anyway, I'm pretty confident I'll match into a highly-regarded IM program but I know I want to do a subspecialty fellowship probably in GI. My question is how much of a factor is Step II CK scores in fellowship applications. The rest of my CV is very strong and my step I score is average. Would a high step 3 score (i'll make sure to devote more time to studying this time!!!) off-set a low step II CK? I would be thinking of top academic programs for fellowship application - assuming I do fine in residency (which I'm sure I will 🙂). Any people gone through the fellowship application process and have any opinions?

 

[tibor75]

Forget GI, dude. It's Rheum or ID in your future. Sorry.

 

[Auscultate]

Forget GI, dude. It's Rheum or ID in your future. Sorry.

or maybe I should start thinking about scrambling for family medicine 🙂

Seriously though, I'm not worried about matching in GI down the road - just wanted to know about how much of a weight fellowships put in the Step 2 score - and due to location issues I would be looking at two very competitive programswhen it comes time to apply. The low step 2 is the main weak link in my CV.

 

[Shah_Patel_PT]

So I just got back my Step II scores and passed both the CS and CK - BUT unfortunately I did have a significant plunge in my CK score (to right around 200) from my step I (meaning if I had those scores prior to applying I would probably not have gotten interviews at some of my top choices). Anyway, I'm pretty confident I'll match into a highly-regarded IM program but I know I want to do a subspecialty fellowship probably in GI. My question is how much of a factor is Step II CK scores in fellowship applications. The rest of my CV is very strong and my step I score is average. Would a high step 3 score (i'll make sure to devote more time to studying this time!!!) off-set a low step II CK? I would be thinking of top academic programs for fellowship application - assuming I do fine in residency (which I'm sure I will 🙂). Any people gone through the fellowship application process and have any opinions?

after u get into a good IM program u are set. If you know people...fellowships will be easy to get.

btw...they dont really take into account the step scores for fellowships. (even the competetive ones)

 

[Fosamax]

I beg to disagree with the previous post! I recently met with my institution's fellowship director. Step 2 scores are looked at, but not given as much weight as your research, letters, quality of IM program. GI is one of the most competitive specialties to match well in. Some programs have explicit cutoffs, and the most competitive programs like to see a 95+ on the Steps.. Also, some programs look at your medical school transcript to determine AOA, pedigree, etc. That being said, there seems to be a huge home field advantage in GI despite the match, and your home program is likely to be the most receptive.

Also, I've heard that despite the reinstitution of the match, the politics are quite dirty and the integrity of the match isnt even close to that of the residency process.

 

[Shah_Patel_PT]

I beg to disagree with the previous post! I recently met with my institution's fellowship director. Step 2 scores are looked at, but not given as much weight as your research, letters, quality of IM program. GI is one of the most competitive specialties to match well in. Some programs have explicit cutoffs, and the most competitive programs like to see a 95+ on the Steps.. Also, some programs look at your medical school transcript to determine AOA, pedigree, etc. That being said, there seems to be a huge home field advantage in GI despite the match, and your home program is likely to be the most receptive.

Also, I've heard that despite the reinstitution of the match, the politics are quite dirty and the integrity of the match isnt even close to that of the residency process.

what are the step cut offs for cardio?

 

[Archie]

after u get into a good IM program u are set. If you know people...fellowships will be easy to get.

btw...they dont really take into account the step scores for fellowships. (even the competetive ones)

Applying this year -- many programs I have interviewed at have said they use certain scores as cut offs for an interview. One place would not give an interview if below the national average. That being said -- things like Med School class rank, residency performance, caliber of residency training, reasearch and letters matter more.

 

[KBoogie311]

I am currently an Internal Medicine Chief Resident (PGY-4) at a University program who matched into GI in 2006. I am starting my Fellowship in July.

My Step scores-Step 1 96/237, Step 2 -87/222, Step 3- 98/237. I got no help with phone calls or the such.

I have been through the process and I understand the nitty gritty. In addition I have held several fellowship workshops (where the panel is fellowship director based). It seems pretty clear that fellowship directors depending on how competitive the fellowship is...use a cut offs of several different types - though there is no one thing that base application on.

The Keys
1). Where did you go to med school and what did you do there? This where things like going to Hopkins or Harvard make difference and can compensate for other down falls on the CV. Being AOA-though this isn't mandatory..it only helps if you are. Being an FMG hurts - It can get your application completely kicked out especially since some GI programs have begun to use filters on ERAS- It automatically kicks out the application from a non-american school regardless of the rest of the application.

2). Where did you go to residency and what did you do there? Coming from a University Programs helps obviously, though again not madatory. While in residency did you win any awards? Were you named the greatest resident ever? Did you obtain a chief residency? Anything that can set you apart from the next application (in a positive light)?

3) Lettors of Rec - HUGE! This can make or break an fellowship application. Generally you need to have the program director and chair of medicine plus 1 or 2 additional letters of your choice depending on the program. Very important part. BE A SOLID MEDICINE RESIDENT!!! EVERY DAY COUNTS AND NEVER SLACK OFF!

4). Research - Did you publish? Did you present? It doesnt have to be first author on a paper - it can be an abstract or two. Case reports are generally not sufficient unless you have a million of them or something. This part of the application can really compensate for the other weak parts. The Program Directors LOVE research. They feel that it shows that someone can follow a goal through to the end and it shows dedication to the subspeciality of interest.

5). Board Scores - It tends to be a screening tool - and in some cases will kill an application if you don't meet a minimum (either as an avg of the exams or on each individual part. That being said - The GI dept at my program uses it as an avg. score. Obviously the higher the better. But if you don't do well on one exam or the avg isn't great you can make up for it with the previous sections that i mentioned. The cardio program here won't look at the application unless you have 90s on all the boards.

6). Secondary Factors - Phone calls, Personal Statement, What you did in college...etc etc. etc.

For a 3 spots in the GI fellowship that I matched into. They received 500+ applications. They interviewed 30--esentially 1 in 10 chance. The interview is critical at this point. Don't be a numb nuts--cause the job isn't yours just cause you got the interview. You still have to beat out the best 30 people of the 500 that applied.

BOTTOM LINE
The bottom line is that it all counts, except that application selection is much more fluid than your prior experiences (with college, med school and residency). They are forgiving of blemishes on the CV as long as you make up for it in a different area of the application. The overall body of the application is what ends up mattering.

This is generally speaking for the non-competitive and competitive fellowships.

In the Ultra-competitive fellowships - i.e. GI and Cardio, some programs may not be as forgiving of these blemishes only because they have such a high volume of applicants and they need some way to weed people out.


Hope this Helps
-KBoogie

 

[VCMM414]

Kboogie311, that was a very helpful post.

A couple of questions if you don't mind. First, how competitive do you think you would have been at your home cardiology program? You mentioned that they wouldn't look at anyone with a score of <90 on any of the steps, and you had a 87 on your step II. Yet, it's hard to believe that you would be so easily shrugged off when you are a chief resident, with presumably full backing from your PD/chairman. Is your cardiology deparment's score criterion that much set in stone?

Also, the OP has had 1 bad showing on step II down to around 200. However, I think he has interviewed at MGH/Brigham/Stanford/Penn-caliber programs for IM. Assuming that he matches at one of these top places (good luck to you, Auscultate), and he does a solid job there with full PD/chairman support + some research, will he really be filtered out so easily? Applicants who match at one of these top programs usually have good step I scores, so it's actually not too uncommon for them to post a less-than-spectacular step II CK score (usually taken late in the year, or during interview season, with somewhat less preparation).

Thank you for your help in clarifying this matter.

 

[KBoogie311]

Kboogie311, that was a very helpful post.

A couple of questions if you don't mind. First, how competitive do you think you would have been at your home cardiology program? You mentioned that they wouldn't look at anyone with a score of <90 on any of the steps, and you had a 87 on your step II. Yet, it's hard to believe that you would be so easily shrugged off when you are a chief resident, with presumably full backing from your PD/chairman. Is your cardiology deparment's score criterion that much set in stone?

Also, the OP has had 1 bad showing on step II down to around 200. However, I think he has interviewed at MGH/Brigham/Stanford/Penn-caliber programs for IM. Assuming that he matches at one of these top places (good luck to you, Auscultate), and he does a solid job there with full PD/chairman support + some research, will he really be filtered out so easily? Applicants who match at one of these top programs usually have good step I scores, so it's actually not too uncommon for them to post a less-than-spectacular step II CK score (usually taken late in the year, or during interview season, with somewhat less preparation).

Thank you for your help in clarifying this matter.

Yeah I can see where I might have sounded absolute...Yeah I think I woulda been competitive, for exactly the reasons that you said. When applying from an outside program, they may not be as generous (but again this particular PD is kinda anal).

Auscultate is going to be fine in the grand scheme. He/She is going to have some work to do to make up for the slip (next exam and with research), but it might be enough just to match into a solid residency. Again this is where the fluidity of the application process comes into play...weaker parts will be compensated by the stronger ones.

I am going to re-emphasize the importance of being a STAR RESIDENT. That will win major points across the board and can bridge you into a fellowship with a strong Lettor of Rec. no questions asked. There were kids in my program who didnt get GI....but then again they were idiots. They expected to walk into a fellowship simply based on educational pedigree and entitlement. They did just enough work to get by or be average. Not wise.

-KBoogie.

 

[Auscultate]

Hey Kboogie,
Thanks for your posts - they are very helpful.
I definitely plan on aiming for a really high step 3 and doing my best during IM residency. The other parts of my CV are very solid - almost all honors third year, very strong letters and lots of research with publications - but I know I'll be screened out at some places due to the step 2 score. Hopefully, I'll make a good enough impression with the GI people in my program to be able to get someone to make a call on my behalf at places that screen me out.
Anyway, I'm going to stop thinking about now - I still have to match into IM first (13 more days!)...and then worry about fellowship match when the time comes.
Now, I can't chill out the rest of 4th year - I need to study to prepare to be a star resident 😡

 

[KBoogie311]

Hey Kboogie,
Thanks for your posts - they are very helpful.
I definitely plan on aiming for a really high step 3 and doing my best during IM residency. The other parts of my CV are very solid - almost all honors third year, very strong letters and lots of research with publications - but I know I'll be screened out at some places due to the step 2 score. Hopefully, I'll make a good enough impression with the GI people in my program to be able to get someone to make a call on my behalf at places that screen me out.
Anyway, I'm going to stop thinking about now - I still have to match into IM first (13 more days!)...and then worry about fellowship match when the time comes.
Now, I can't chill out the rest of 4th year - I need to study to prepare to be a star resident 😡

Good Luck Buddy.
-KBoogie

 

[GasDaddy]

haha, match results arent even out yet and people are freaking out about fellowships.... insane. enjoy this time while it lasts man, once residency starts are life will change completely.... live it up, dude!!!

 

[Studebug]

Yeah I can see where I might have sounded absolute...Yeah I think I woulda been competitive, for exactly the reasons that you said. When applying from an outside program, they may not be as generous (but again this particular PD is kinda anal).

Auscultate is going to be fine in the grand scheme. He/She is going to have some work to do to make up for the slip (next exam and with research), but it might be enough just to match into a solid residency. Again this is where the fluidity of the application process comes into play...weaker parts will be compensated by the stronger ones.

I am going to re-emphasize the importance of being a STAR RESIDENT. That will win major points across the board and can bridge you into a fellowship with a strong Lettor of Rec. no questions asked. There were kids in my program who didnt get GI....but then again they were idiots. They expected to walk into a fellowship simply based on educational pedigree and entitlement. They did just enough work to get by or be average. Not wise.

-KBoogie.

For those of us that have not entered that phase (residency), can you outline what quailities a "Star Resident" would have?

 

[nycscope]

So I just got back my Step II scores and passed both the CS and CK - BUT unfortunately I did have a significant plunge in my CK score (to right around 200) from my step I (meaning if I had those scores prior to applying I would probably not have gotten interviews at some of my top choices). Anyway, I'm pretty confident I'll match into a highly-regarded IM program but I know I want to do a subspecialty fellowship probably in GI. My question is how much of a factor is Step II CK scores in fellowship applications. The rest of my CV is very strong and my step I score is average. Would a high step 3 score (i'll make sure to devote more time to studying this time!!!) off-set a low step II CK? I would be thinking of top academic programs for fellowship application - assuming I do fine in residency (which I'm sure I will 🙂). Any people gone through the fellowship application process and have any opinions?

Just curious, did you end up matching into GI?

 

[Raryn]

Just curious, did you end up matching into GI?

Give you 50:50 odds the OP ended up changing his mind about applying GI and ended up becoming a hospitalist 😛

 

[nycscope]

Give you 50:50 odds the OP ended up changing his mind about applying GI and ended up becoming a hospitalist 😛

Ha, well played 😀
With all the perks, why the heck not?!