USMLE Step II b/f or after interviews?

[suckerfree]

Hi,

I had 214 on my Step I (right at the national median) and straight passes on all coursework/clerkships at my MD program. All I'm interested in is entry into pathology somewhere. With good letters of rec, do you think that I should do Step II before or after interviews? If I do step II afterwards, then I will be able to do 2 more path electives before the interviews instead. Currently, i'm signed on for a hematopath elective and an academic path elective before interviews, as well as an AI in medicine and an ambulatory peds block (these last 2 are requirements by my school). I figured that I'll be the smartest if I am fresh off my clerkships and step II, and I'll be able to put my best foot forward into path electives if I take Step II first.

Any advice would be much appreciated.

Thanks!

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[deleted113029]

just take step 2 early. you already stated you'd be fresh in your clinical knowledge.

chances are that you will not get much lower than your step 1. most likely you'll improve a little bit on step 2...but most importantly, you will do better on your path rotations with step 2 out of the way, as you said.

 

[veo1]

I agree. Just go ahead and take it. Most of the people I know improved from Step I (some quite substantially..I went up 15+points). Besides its nice to have it out of the way. Also, you might as well take CS while you're at it.

 

[b&ierstiefel]

214 isn't a great score. I know that people on this board tend to sugarcoat things a bit but I would seriously consider preparing for and taking Step 2 early.

The USMLE's are graded on a curve...and most people don't give a rats ass about preparing from Step 2 or Step 3 so if you prepare well for Step 2, your chances for getting a much better score on your Step 2 is reasonable.

 

[suckerfree]

Thanks for the responses thus far. Well, 214 certainly isn't a great score, however it is a score at the 50th percentile. By no means do I anticipate it will get me into a "great" program like Johns Hopkins from where I might then be able to move on to "great" positions like program director for the satellite division in Uganda, but I'm pretty sure that pathology is not so prohibitively competitive that I won't be able to get into a decent residency somewhere that will ensure I don't kill anyone via wrong diagnoses upon entrance into the workforce.

I will definitely go ahead and get the step II out of the way. I bought all my books the other day. I figure that the majority of people will be studying 2-4 weeks. I have a little more time budgeted. Wish me luck!

 

[2121115]

Pathology is getting more competitive, but it is still not extremely competitive by any means. A Step 1 of 214 might not get you "big name" interviews but if you have good letters and a genuine interest in pathology you will be able to find a solid program and become a good pathologist. So, my advice would be to take Step 2 early, you likely won't do worse and doing better can only help you.

 

[deleted113029]

good luck suckerfree! (interesting name btw)

i am so glad to be done with everything except step 3.

 

[VijayEM]

I say take Step 2 now and enjoy 4th year. And 214 is not a bad score, although I don't know what "quality" of programs you plan to apply to. Everyone keeps saying Path is "getting more competitive" but those are for the upper range of programs. There are many Path programs that are super difficult to get into. BUT....looking at recent friends who entered path, there still seems to be a wide range of programs for everyone, and wide range of Step1/2 scores.

Kill that Step 2! you'll do great.

 

[suckerfree]

I saw the dvd for the BBC documentary "planet earth" recently. There is a part of the desert episode where they enlist the help of a local mongolian camel/llama tracker who has spent so many years tracking these elusive camels or llamas. I was so struck by the way how he would say in his limited english, "...patterns changing" when he would describe the image of the most distant horizon distorted by the heat to indicate that the camels were on the move and the team needed to act. I thought..."hmmm...pathology is a lot like that." I am almost finished with OB though, and there is also something very special about saving people's lives via your proper assessment and planning. I like both actually. Well, my first career relevant elective will be an AI in medicine, followed by a month of hematopath as my first path elective. I will make my decision then. Thanks!

 

[alimarie81]

214 isn't a great score. I know that people on this board tend to sugarcoat things a bit but I would seriously consider preparing for and taking Step 2 early.


Is 227 Step I good enough to avoid taking step 2 till later in the year? I want to wait until after I've had my ICU, GI, ID rotations to take step 2 December-ish.

 

[CameronFrye]

214 isn't a great score. I know that people on this board tend to sugarcoat things a bit but I would seriously consider preparing for and taking Step 2 early.


Is 227 Step I good enough to avoid taking step 2 till later in the year? I want to wait until after I've had my ICU, GI, ID rotations to take step 2 December-ish.

227 is alright and won't hurt you, but it's also not going to help distinguish you from the pack.

Also, I see that you are an osteopathic student, so you already have less room for error with some programs. Therefore, I would strongly recommend taking step 2 early.

 

[mlw03]

227 is alright and won't hurt you, but it's also not going to help distinguish you from the pack.

Also, I see that you are an osteopathic student, so you already have less room for error with some programs. Therefore, I would strongly recommend taking step 2 early.

any thoughts about what step 1 score does distinguish a candidate from the pack? 235? 240? 250?

also, any thoughts about whether anyone's gonna look at a step 2 score and say, "wow" one way or the other short of being below 190 or above 260?

 

[deleted113029]

any thoughts about what step 1 score does distinguish a candidate from the pack? 235? 240? 250?

also, any thoughts about whether anyone's gonna look at a step 2 score and say, "wow" one way or the other short of being below 190 or above 260?

depends on what program you're looking at. 235 is a good score for most programs and will make you competitive. obviously, the higher the better.

people do look at step 2. scores above 240 should elicit a hearty "wow." (i had very high step 1 and step 2 scores, BUT not a single program mentioned it. )

 

[CameronFrye]

depends on what program you're looking at. 235 is a good score for most programs and will make you competitive. obviously, the higher the better.

people do look at step 2. scores above 240 should elicit a hearty "wow." (i had very high step 1 and step 2 scores, BUT not a single program mentioned it. )

Yes, I agree on both counts. Some of it's kind of silly. A 230 "looks" better than a 227, but the two scores fall within the margin of error, so they're statistically the same. And I'm certainly not saying that a 227 will necessarily keep you out of places, but it really is better to have at least something that sets you apart. Whether it's a killer LOR from some path god, great boards scores, a 1st author publication, a great personal story, etc. You just want something to make you memorable and not just a faceless statistic. I reviewed some of our applications this past year and there were definitely people who just jumped out at me and I was interested in meeting them. All that being said, once you've scored the interview, most of that stuff becomes much less important and your likability, sanity, etc. takes precedence. If you're a a giant douche, I don't give a rat's ass if you're Juan Rosai Jr., are published extensively, scored 280+, and lived with monks for a year.

So, what can you do if you just happen to be an average Joe? I would strongly recommend trying to do some aways at your favorite places. If people like you, you're reliable, seem interested, and not an idiot, you can really separate yourself. That being said, you can also sink yourself with a poor performance.

 

[yaah]

There is something to be said for just being a nice, conscientious, hardworking individual who can work well with others. If you can combine these traits it is absolutely astounding to me how many people you can vault over who have deficiencies in any or all of these areas. It is also amazing to me how many candidates discount this and think that their scores are going to get them in.

Of course, it is also amazing to me when programs occasionally look the other way in terms of these traits when a certain candidate fits a particular interest they are trying to fill (like research). So what do I know.

Short summary: Be well rounded and don't be a douche.

 

[DarksideAllstar]

don't be a douche.

Probably can't be emphasized enough. OP, if I had your Step 1 score, i'd just take Step 2 next month and be done with it. Unless you completely slacked off during M3 and didn't learn anything, you won't score lower and an score jump can only help you. While you're at it, take CS as well. I took mine in March and I'm still waiting for the results.

 

[mlw03]

Of course, it is also amazing to me when programs occasionally look the other way in terms of these traits when a certain candidate fits a particular interest they are trying to fill (like research). So what do I know.

and once these programs make their beds they have to lie in them for 4 years. as i go into the MS4 year i think about the few douchebags in my class and realize they'll all easily land residency spots because they have solid numbers. but then those programs and the other residents are going to have to deal with them for 3+ years.

darkside: our school doesn't let us wait until spring to take CS because they don't want us to end up like alex on grey's (for those of you who don't watch, he found out he failed CS after starting internship). i hope you're right about step 2 CK scores not going down - i got mine tomorrow

 

[DarksideAllstar]

darkside: our school doesn't let us wait until spring to take CS because they don't want us to end up like alex on grey's (for those of you who don't watch, he found out he failed CS after starting internship). i hope you're right about step 2 CK scores not going down - i got mine tomorrow

yeah, my school just requires that we take it prior to graduation, which wouldn't be so bad if the turn-around time wasn't so f*cked up. Good luck on your CK. I took mine a year and a half after my 3rd year ended and I still improved 10 points over my Step 1, so I think you'll be fine.

 

[CameronFrye]

For my CS, I took it in Atlanta the day after my Emory interview. That way I killed two birds with one stone and didn't have to make a second trip somewhere. I then had my score back long before I graduated.

 

[pathbound]

Hey Suckerfree:

I hope you don't mind my emailing you directly, but I was browsing the posts and came across the thread that you posted. I'm in the same boat now that you were in before (average Step I), and was wondering how everything worked out for you?

Any info you have would be appreciated. If not possible, I hope things went well.

Thanks
J