Very low class rank...do I still have a shot?

[blah2274]

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I just got back my class rank so far, and it turns out I've been doing a lot worse than I thought. I'm in the bottom quartile for sure, and I'm not sure I really have a chance to climb back out of the hole I've put myself in. I'm currently a third year at an MD school (top 25 if that matters). Step 1 was 230 with mostly passes and some high passes in clerkships, and I don't have my medicine grade back yet. Preclinical grades are technically pass/fail, but they go into our rank and I did really poorly (not failing, but not good either). I have a little bit of research and volunteering, but not very much.

I go to school in the Northeast, but definitely wouldn't mind going back home to Texas. How bad is my current situation? I was really interested in eventually doing pulmonary/cc or endocrinology, and I know getting into an academic program is important, but are those mostly out of reach now?

 

[rd31]

I just got back my class rank so far, and it turns out I've been doing a lot worse than I thought. I'm in the bottom quartile for sure, and I'm not sure I really have a chance to climb back out of the hole I've put myself in. I'm currently a third year at an MD school (top 25 if that matters). Step 1 was 230 with mostly passes and some high passes in clerkships, and I don't have my medicine grade back yet. Preclinical grades are technically pass/fail, but they go into our rank and I did really poorly (not failing, but not good either). I have a little bit of research and volunteering, but not very much.

I go to school in the Northeast, but definitely wouldn't mind going back home to Texas. How bad is my current situation? I was really interested in eventually doing pulmonary/cc or endocrinology, and I know getting into an academic program is important, but are those mostly out of reach now?

Do you still have a decent shot at an academic program coming from a top 25 allopathic med school? Uh, yes. This is IM, not plastics.

 

[bashwell]

Still much better chances than most IMGs or US-IMGs! 🙂

I don't think your med school performance will matter as much for fellowship. What they'll look at more is where you did your IM residency, how well you did during your IM residency, any research, etc. Besides, apart from SDN, a 230 on Step 1 (for IM then fellowship) is still respectable. Just keep showing upward progression, and geographic flexibility, and you'll likely be fine.

As for fellowship, endocrinology you really shouldn't have a problem getting into at all. Pulm/cc wasn't as hard to get into in past years, but in the last year or two it's been very competitive (approximately alongside hem/onc, though not as hard as GI or cards). It's hard to say what future trends will be like for pulm/cc in 3-4 yrs if/when you'll probably be applying to pulm/cc, so probably no need to worry too much about it now. Focus more on getting into as good of an IM academic program as you can.

Hopefully an IM PD will weigh in and give you better advice.

 

[ArkansasMed]

Blah, you have an excellent shot at matching. Coming from a top 25 MD program helps a lot and your Step 1 score is good as well. You may have trouble matching at some of the top 20 programs, but you still may have a chance depending on what school you come from on the Northeast.

I would try to work on the following:
1) Secure strong letters of rec if possible.
2) Schedule your Sub-Internship in medicine early (and nail it).
3) Consider scheduling step 2 early if you are confident you can nail it.
4) Meet with an adviser at school to see where applicants like yourself have matched in previous years.

You will easily get into an academic medicine program (if you apply broadly to a range of academic programs) and should be fine to match in either Endo or Pulm/CC.

 

[rokshana]

how you will do for fellowship (any fellowship) will depend more one how you do in residency so its a it premature to say how you competitive you are for any fellowship.

pulm/cc is becoming more and more competitive (now that intensivist are working shifts and more like a hospitalists schedule with good money, the lifestyle/money component is making it more competitive) so who knows what it will look like in the next 3-5 yrs. Endo overall is not competitive so if you do well in your residency, your shouldn't have an issue...but the fill rate is decent, so getting into a competitive program (as with all competitive programs) may be difficult if you don't perform well in residency.

 

[blah2274]

Thanks for all the advice! I was under the impression that the low class rank was considered a big red flag, even outside of top programs and regardless of what school I attend. I understand that I'm not shooting for the top tier residencies or anything, but I just want to be in a situation where getting into fellowships afterwards is a good possibility.

Either way, I'll start thinking about LORs/Step 2/Sub-I's and hopefully everything works out. Thanks.

 

[sluggs]

You will get interviews at every Texas program, except that UTSW may be close. Other than Duke, UVA and maybe UNC and Vandy you should get looks anywhere in the southeast too.
You are fine. Keep working hard and don't piss off too many important folks at your school

 

[bashwell]

You will get interviews at every Texas program, except that UTSW may be close. Other than Duke, UVA and maybe UNC and Vandy you should get looks anywhere in the southeast too.
You are fine. Keep working hard and don't piss off too many important folks at your school

I agree with this. Although Baylor (Houston) might be tough to get an interview from too. But maybe still within reach. Other places in the Southeast which might be tough are Emory and UAB. Maybe Wake Forest? Not sure.

 

[tom10]

I am a DO student, class rank 8th from the bottom, slightly lower step 1 score than you and I got enough interviews at university programs to feel comfortable that I will match into one. You got it man, don't worry.

 

[DoctaDee]

I am a DO student, class rank 8th from the bottom, slightly lower step 1 score than you and I got enough interviews at university programs to feel comfortable that I will match into one. You got it man, don't worry.

Did you end up matching?

 

[jdh71]

Yes. And we do have a "what are my chances thread".

 

[tom10]

Did you end up matching?

Yes, my #4 spot out of 10 or 11 I think. I'm kind of shocked I didn't get my top 3 since I felt I had strong interviews there, but I am happy nonetheless.