USMLE Step 2 CK confusion

Discussion in 'Radiation Oncology' started by rad0nc, Jun 10, 2011.

  1. rad0nc

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    I have searched all over this forum, and I am having a real problem coming up with an answer for when to take step 2. I keep reading that some programs will not interview you without a step 2 score, but then others say no one cares.

    My step 1 is just barely above the radiation oncology average (241/99), and I am wondering if taking it late would make a negative impact on my application. I would need to drop an away in order to take it in time for interview season. I would like to get in 3 away electives, but obviously if I need my step 2 score early than that would take precedence.
     
  2. Neuronix

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    The opinion from someone who just matched (so grain of salt)...

    Where are you reading this? I've seen some seriously successful applicants without step 2 scores. There is one program (UCSF) that needs step 2 to RANK, but you may not get an interview there even with a high step 2 score pre-interview season.

    On the one hand, three away electives is a lot. Two plus your home rotation is kind of the typical maximum. On the other hand, a 241/99 isn't exactly bad, and you are gambling that you'll improve on that by at least 10 (preferably 20 points). So in the end, I think you could do either choice. Is there another elective instead of the three aways that might benefit you even more? I don't think any of those paths are necessarily wrong.
     
  3. OP
    OP
    rad0nc

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    The reason I am doing 3 away rotations is that I don't have a home program. A couple of the general match threads talk about students not getting interviews because they didn't have step 2 in. Also, my dean's office is telling us that if we don't get it done early we will be excluding ourselves from a bunch of programs (not rad onc specifically)

    I would vastly prefer to take it later if possible so I can do 3 total rotations.
     
  4. Totem

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    Does anyone have evidence that an improved Step 2 score makes a big difference? In talking to people at my home program, Step 2 scores aren't looked at much in general, and Step 2 scores don't "make up" for below average Step 1 scores. So I'm not sure why anyone would take Step 2 early, especially if studying for it conflicted with important away rotations. If others have heard differently, I'd love to know. thanks
     
  5. KarmaDoc

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    If UCSF requires Step 2 CS scores in order to rank, does that mean they will still interview you without Step 2 scores and not hold it against you if you don't have Step 2 completed yet? When is the latest you can possibly take Step 2 for UCSF and other programs?
     
  6. napoleondynamite

    napoleondynamite Keepin' it real yo
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    Don't worry about step 2 - your step 1 score is high enough that no doors should be closed completely based on your test score.

    I had a low step 1 score, but even still, delayed my step 2 until the last possible moment (January of my 4th year) so that I could focus all of my time and attention on radonc rotations and research. In retrospect, this was the right move for me and I would do it again.

    I do not agree that 3 away rotations is too many. My philosophy is the more the better. You greatly enhance your odds of matching at a program if you are a known quantity. Anything you can do to boost your odds of matching is worth it. I spent all of my elective time doing away rotations, and I would do that again as well. I not only got more interviews out of it, but I networked like crazy and many of the relationships I made as a medical student 5 years ago are still thriving today.

    You only want to go through this process ONCE. Many will think you are crazy for applying to every single program, for traveling all over the country do away rotations, for spending all of your weekend time doing research, etc. In the end, it is all worth it if you open up that sweet letter on match day :D
     
  7. wagy27

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    I think Step II is very dependent on your situation. To the OP: I was in a similar position coming from a school with no home program. I felt that getting a solid Step II score was a big factor in the interviews I got. If you have a lot of other things going for you it might not be as important but if you are borderline on other things it can help in my experience.
     
  8. VisualBasic

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    It's hard to say with step II and a lot of programs just ignore it because they don't have anything to compare it to (maybe 3 out of 50 applicants have a step II score in, what do you do with the other 47)?

    Plus, step II is known to be easier and if you scored a 241 on I, a 251 on II won't overly impress anyone. However, if you got a 271, then that's a different story I think.
     
  9. nothingman

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    Karmadoc and others:

    In my experience and that of others applying this past year, no program required a Step II result for an interview invite, UCSF included. The only rad onc program I am aware of with a stated requirement of Step II CK and CS scores complete in order to rank was UCSF.

    In general, most programs seem to finalize rank lists in late January/early February, so I would recommend taking CK by end of December at the latest; CS by whatever the reporting schedule that year is to be on time (probably take exam in mid-fall).
     
    #9 nothingman, Jun 11, 2011
    Last edited: Jun 11, 2011
  10. Sheldor

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    Some specific follow up questions:

    1) So if I understand this correctly, if you did well on Step 1 it is best to take Step 2 CK "later." One poster said January? It sounds like most interviews fall in the December/January time frame so do you just study as you can during those couple months then take it in late January?

    2) What about Step 2 CS? Is that required to go into Match week? A good portion of people from my school take it during spring break of their third year, and I'm curious what everyone thinks about that...
     
  11. hot sauce

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    For most programs just take CS (UCSF requires that you pass but I don't think other programs care) whenever is convenient for you. The chance that you will fail it is very low as along as you don't completely blow it off.

    As for CK, the conventional wisdom is if you did well on step I you can delay it but most of us don't really know how much programs care about your CK score. I suspect that it doesn't make a huge difference in general because a lot of applicants haven't taken it so it is difficult to use to differentiate candidates. (my CK was ~25 points higher than my step I but I don't feel like it had a major impact - on the other hand that is just my gut feeling)

    I took CK early in my 4th year even though I had a fairly strong step I because I felt like all the material from 3rd year was still fresh and I had done fairly well on my shelf exams 3rd year. Most of your 4th year rotations are not going to help you with CK. Later is safer if you think you aren't going to do well but most people get a higher score on CK than step I so if you are prepared I don't think you need to wait just to be safe. Sure there is a risk but in theory if the other applicants they are considering all have taken it with good scores and you haven't that may hurt (or it may not).

    I don't think interview season is a very good time to be studying for CK as I found it to be a pretty stressful time. If you can study effectively in hotel rooms, airports, and airplanes before and after major interviews then it might work out for you. I went to a beach house for a lot of my studying so I could be away in a relaxing environment.

    Bottom line. I suggest taking it when it works best for you to preform your best.
     
  12. CyberKnife19

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    Despite a strong Step 1 score, I opted to take Step 2 early (July). Why?

    If you felt like you were crushing your NBME shelf exams throughout the course of the year (> 90th percentile or so), then you are very likely to get a great Step 2 score. Ergo...

    If you can confirm a great step 1 score with a great Step 2 score, why not take it early?

    I still had enough time to do three rotations, research and do everything that I felt like I needed to do to make myself the best applicant that I could be. Best of luck to all of you. :thumbup:
     
  13. nothingman

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    Generally speaking, this is correct. It does seem that the definition of doing "well" on Step I has been creeping upwards recently. I would say that if you're >250, this certainly applies. 240-250, depends on the rest of the app. <240, and early Step 2 is advised especially for the more competitive programs.

    I took Step 2 CK "late" because of the aforementioned criteria, but early enough for rank list because I was highly interested in a program that required this result to be ranked. Thus, I took it around Christmas time of interview season. Studying for it in the midst of frequent interviews, airports blaring carols, cross-country plane travel with time zone changes, etc. was rather hellish and I would generally not recommend doing what I did, though I ended up happy w/my score.

    If programs requiring this score are high on your interest list and you intend to take it "late," I recommend taking Step 2 CK before interview season is in full swing (September/October/early November) so that you have control over your score release but are not studying in the midst of heavy travel and interviews. If these programs are not high on your list, defer to post-interview time when you are more relaxed and the score doesn't really matter providing you do ok.

    Again, depends on the specific program, but with only one exception that I'm aware of, the answer is no it is not required. This one I would take early just to get out of the way, because the amount of studying is minimal, you're fresh off your third year rotations and can do an H+P efficiently, and if you do fail by some fluke, there is enough time to retake. Also, the scores take a much longer time to come back. As I understand it, programs tend to care the least about this score, though it is advised for financial and other reasons to pass on the first try.

    If you do take this after match and fail, your time to remediate prior to internship is more limited - though again, as I understand it, in many states you can start PGY-1 without passing CK.
     
  14. Sheldor

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    So would it look at all odd to programs to have a Step 1 score and a Step 2 CS Pass when you apply but no CK?
     
  15. radtothebone

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    No nothing odd as far as I can tell. I applied last year and had the Step I and CS pass in hand during interviews but did not take CK until February. Nobody mentioned it at all on the trail. Many other applicants were in the same boat as me and also seemed to have no ill-effects of adhering to this strategy.
     
  16. Sheldor

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    Thank you!
     
  17. Aphtalyfe

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    Sorry if I should've just made a new thread!

    ...was just wondering if anyone had any new impressions about when to take Step 2? Did anyone encounter any programs that required Step 2 to interview/rank?
     
  18. ramsesthenice

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    Has anyone ever seen any evidence that a good step 2 score can "make up" for anything unless youreally tank step 1? So few people have a ck score and so many programs openly tell you during interviews that they dont care. The top programs have so many perfect applicants they can afford to be super choosey. The mid teir programs have no prob with "avg" rad onc boards in the 230s-240s. Anyone have experience that says otherwise? It could be there, just havnt met anyone with it yet. This topic comes up again and again and it would be nice to know how well conventional wisdom to other feilds applies. Could be anywhere on the map.
     
  19. Gfunk6

    Gfunk6 And to think . . . I hesitated
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    The problem is that programs use Step I scores in their initial automated screens. Therefore you may be rejected out of hand, rendering your Step IICK score irrelevant. However, if a program offers to interview you despite a below average Step I score, you could take Step IICK early, do well, update the program, and it could possibly positively impact your position on their rank list. Obviously, you run the risk of doing the same or worse than your Step I score so it's a calculated risk.
     
  20. Totem

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    My experience (n=2) is that my home program doesn't care at all about step 2 and it plays no role in the application process. My friend crushed step 2 after an average step 1 and it was never mentioned on any interviews. So my impression is that step 2 doesn't help, let alone makes up for a below average step 1.
     
  21. hot sauce

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    A couple interviews mentioned my CK score. I don't know if it played a role in the rank process or not but they had obviously noticed it.

    In general step I scores seem to be important than step II; probably because everyone has taken step I so it is easier to use as a benchmark. However, like pretty much every metric, it varies significantly from program to program.
     
  22. Sheldor

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    Just curious about other peoples experiences.

    If you didn't had the the score at the time of submission were you often asked if you had taken it yet?
     
  23. ramsesthenice

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    Not once. I actually had a pretty good one about half way through the season, but never bothered to upload it to ERAS because I forgot to do it. The subject never came up. Pretty confident USMLE scores are 99% for screening and to a good degree, but less so, for ranking. Once you are interviewed they just don't care.
     
  24. Aphtalyfe

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    I was reading through the residency director survey and it says that only 23% of radiation oncology program directors said they do not require Step 2 CK to interview?? :eek:

    I'm having a minor panic attack at the moment since I just scheduled my Step 2 CK for Nov 15th...

    Source: http://www.nrmp.org/data/programresultsbyspecialty2010v3.pdf
     
  25. Sheldor

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    That certainly stands in sharp contrast to the advice I've received. I'll be curious to what others say.
     
  26. radiadouken

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    I applied last cycle. I took Step II CK in February (after interviews). I had no problems getting interviews, no one asked about it, no one cared (including UCSF).
     
  27. Seldon1985

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    Agreed. I didn't get my score back until a couple of days before rank lists were due, and it made absolutely no difference.
     
  28. neo87

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    just matched -- took it November 23rd, nobody cared -- and even though I released the score, all the programs I interviewed at didn't even look at it, just casually asked what I got.
     
  29. Aphtalyfe

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    Thank you for the replies!
     
  30. Sheldor

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    So you going to keep your date in November then?
     
  31. mheat3

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    I'm applying for this cycle and my plan is to take it early/mid December... just as an FYI hopefully won't come back to bite me...
     
  32. Sheldor

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    I'm with you, I'll likely take it around then as well (perhaps slightly earlier in November like Aphta) Either way, it will definitely be later in the season!
     
    #32 Sheldor, Jun 21, 2012
    Last edited: Jun 21, 2012
  33. Aphtalyfe

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    Yea I really don't have much of a choice... I have away rotations and required electives up until the end of Oct...

    Good luck to everyone!
     
  34. baculum1

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    Yo yo yo people can anyone please provide some recent reliable feedback on the necessity to take step 2 by the time ranking lists are about to come about? I am in 240s STEP1 and i honestly don't think it's good for me to take it considering the chance to break a 250-260+ is probably low for me. I studied very hard for step1 and gave it my all and thats' what i ended up with. I'm doing three away rotations and my home program. I'm currently being pressured by my school hard to try to take my StepII. I have zero time right now to actually study for it being on aways and trying to pound out research and with interviews coming up it just sounds like such a bad idea. The evidence that is being cited is the residency program director survey http://www.nrmp.org/wp-content/uploads/2013/08/programresultsbyspecialty2012.pdf where at least 50% of rad onc PDs responded saying they do use STEP2 in their decision to invite an applicant to interview so I'm in a big panic right now; my entire schedule is taken up by away electives. can someone with some direct knowledge please answer. I would appreciate someone who is preferably a senior resident or an attending and not another student giving me what they have "heard". Please advice. thank you very much.
     
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  35. Aphtalyfe

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    I'm only a PGY2 so ignore my post if you would like. I think if you're really low on time I would probably not take it. Due to your time crunch there's always the chance that you might do worse on Step 2.

    That being said... after I got my Step 2 report (late in the interview invite season) I sent my score in an email to nearly every program that hadn't replied to my match application. I got 1 interview invite the very next day, and 1 more a couple days later. Coincidence? Maybe... maybe not?
     
  36. TheMV

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    Don't let your school fool you, my said something a long the similar lines. It just doesn't really matter in RadOnc. Since pretty much everyone has to do aways, most people just do not have the time to take it until winter time. Thus, in this field, things like letters of recommendations are worth so much. On the interview trail most people probably took theirs in Nov or Dec (I would say 80%), really the people who took a year of research were the only ones who had it to submit with application.

    I will even give you the advice my RadOnc adviser told me (pretty knowledgeable dude). He said don't submit your Step 2 score unless its 15+ above your Step 1. He said that even if it is a standard 10 over your Step 1, it will not help you and maybe just limit you on how smart they perceive you to be. My score was also in the 240s, so very applicable to you. This is pretty extreme end of the spectrum of the advice though. I took mine in December and got the standard 10 over my Step 1 and never submitted it. It didn't hurt me one bit, at least I never felt like it did. I got into a great program that I am super super happy with.

    Hope that helps and lessens your fears. Focus on being a fun, hardworking medical student on your aways instead.
     
  37. revaldo29

    revaldo29 New Member
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    If anyone could please clarify: I understand that having Step 2 CK is not necessary for interview invites, but is having Step 2 CK scores before programs submit their rank list important? I would like to schedule it in February when I will have time to study, but my score would not be back in time for rank lists. I know some of the California schools require it early, but I am not particularly interested in any of the California programs. My step 1 is low 240s.
     
  38. Sheldor

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    Don't worry about it, as far as I know only UCSF "requires" it to rank. Many people wait and take it much later. I would just take it when its convenient.
     
  39. revaldo29

    revaldo29 New Member
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    Thanks. Is this the case for CS as well?
     
  40. Sheldor

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    Yup. My only caution about CS is to take it earlier enough so that if you were to fail, you could have time to retake it and get the scores back before graduation. It has a 95+% pass rate for US students, but still, 5% is 5%. I personally knew a couple people who ran into trouble with that. I believe it takes 3 months to sign up, take and wait for scores, more or less.
     
  41. itom37

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    I had a mini freak out that programs wouldn't invite without a step 2 score. I am applying this cycle and have gotten interviews at about 55% of the places I applied, weighted more heavily towards the higher ranked programs. I know I am a very strong applicant overall (260 step 1, MD/PhD, lots of pubs, lots of community service), but at least in principle not having step 2 score doesn't mean you won't get interviews.

    I'd say pretty clearly if other parts of your app aren't as strong, you may get fewer invites if you don't have it.

    Take it when you can best prepare and when it is convenient. This is your best chance for a good score.
     
  42. cwrig14

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    I apologize for bringing back an old thread, but I am hoping for reassurance of my decision of when to take step 2 ck.

    I scored 250+ on step 1 and opted to focus on research at the end of third year rather than step 2. I was originally planning on taking ck towards the end of October, giving myself 4-6w to prepare and score well. A recent research opportunity came up over the same timeframe and I am hoping to explore that, alternatively. I could then either take ck soon (feel confident I would pass) or defer to February. Either way, I don't feel that I would do as well.

    More worried about releasing before rank lists than interviews. Could I take it at either time point and choose not to release my score before rank lists?
     
  43. scarbrtj

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    Allow me to ask a dumb question. What does "241/99" mean?
     
  44. Neuronix

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    Step scores used to have a 3 digit score and a 2 digit score. The 2 digit score was not a percentile and only went up to 99. They stopped giving out 2 digit scores a few years ago.
     
  45. Ankianki

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    I'm curious about this as well. I currently have it scheduled for the end of October, but that only gives me 3 weeks of dedicated study time. Does Step 2 automatically get released and taken into account for rank lists?
     
  46. evilbooyaa

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    250+ on step 1 means you should do the research project. Defer Step 2, otherwise a score < 260 (at bare minimum < 250) will hurt your application when programs are looking for interviewees.

    To answer the bolded - Yes. Anytime you take it now going forward, you will have the option of choosing when to release scores.

    General consensus was that if programs see that you have a high enough step 1 to interview, they generally don't care about Step 2 at time of rank lists.

    Perhaps a PD can back me up on this, but I don't think many (or any) PDs would see somebody they were excited about get a 220 on Step 2 in February of 4th year, and change their ranking significantly, especially if that person had a previously high Step 1.

    In-short - Defer Step 2 till the new year. You will have to send it to almost every program to be eligible for rank, but they primarily want to know you passed at that point (as opposed to if you had say a 230 Step 1, you'd want to take Step 2 early to try to show improvement, and it's controversial whether even that matters to PDs.

    Does not get automatically released unless the results are back prior to Sept. 15th. However, you will want to make sure it's released prior to rank lists, as most, if not all, programs require a Step 2 to rank.
     
  47. WimbledonCumbermatch

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    Status:
    Medical Student

    I didn't know that most if not all programs required a step 2 CK score to rank. Is this really true? I thought it was just UCSF.

    For what it's worth, I matched without submitting my score, and according to the newest charting outcomes, I'm not completely alone.
     

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