What do average students get to go into?

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triptans128

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If only the top students get to go into competitive specialties (ie. derm, plastics, ENT, ortho, urology, etc.) and into good residency programs for other specialties like IM, what do average or below-average medical students get to go into?

I've been thinking a lot about this. I'm a current MS3 at a top 10 institution. Sure, I attend a good medical school (which I am very thankful for and proud of), but I've come to realize that no matter how hard I work and how much effort I put into studying, I am just a very average/slightly below average student at my institution. My step 1 score is below the average based on the 2016 charting outcome for any of the competitive specialties that I desire, and I may very well go through 3rd year without a single honors on core rotations (only the top 20-30% of students for each rotation gets honors). I don't have any significant research/pubs to make myself stand out either. So what does that leave me with?

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The majority go into internal medicine or general practice. What are the competitive specialties that you desire? Don't let your scores keep you from trying to get into what you want. There's more than one way to skin a cat, as the saying goes.
 
20-30% is a lot, so I certainly wouldn't say "only." Starts to make you wonder how much of an honor "Honors" really is when you start handing it out to a third of the class.
Exactly. Ours is about 10% and we just have Honors and Pass so its extra stressful.
 
According to MSAR, I'd say it's "anything they want to, except the uber specialties".

That's because about 60% of MD grads go into non-Primary Care fields for PGY1 choices. Unfortunately, MSAR only lists "Internal Medicine" as a choice, and thus we don't know if people will subspecialize.

Only 5% of Einstein grads go into Psych, for example.

If only the top students get to go into competitive specialties (ie. derm, plastics, ENT, ortho, urology, etc.) and into good residency programs for other specialties like IM, what do average or below-average medical students get to go into?

I've been thinking a lot about this. I'm a current MS3 at a top 10 institution. Sure, I attend a good medical school (which I am very thankful for and proud of), but I've come to realize that no matter how hard I work and how much effort I put into studying, I am just a very average/slightly below average student at my institution. My step 1 score is below the average based on the 2016 charting outcome for any of the competitive specialties that I desire, and I may very well go through 3rd year without a single honors on core rotations (only the top 20-30% of students for each rotation gets honors). I don't have any significant research/pubs to make myself stand out either. So what does that leave me with?
 
If only the top students get to go into competitive specialties (ie. derm, plastics, ENT, ortho, urology, etc.) and into good residency programs for other specialties like IM, what do average or below-average medical students get to go into?

I've been thinking a lot about this. I'm a current MS3 at a top 10 institution. Sure, I attend a good medical school (which I am very thankful for and proud of), but I've come to realize that no matter how hard I work and how much effort I put into studying, I am just a very average/slightly below average student at my institution. My step 1 score is below the average based on the 2016 charting outcome for any of the competitive specialties that I desire, and I may very well go through 3rd year without a single honors on core rotations (only the top 20-30% of students for each rotation gets honors). I don't have any significant research/pubs to make myself stand out either. So what does that leave me with?

I agree with Goro's post on this thread,

Anything that is not
-Derm
-Ophtho
-Rad Onc
-Interventional Rads (when it becomes its own specialty)
-Surgical Subspecialties
(I may have forgotten another competitive specialty, so correct me if I did)

I'm pretty confident most people can match to literally almost any other specialty with an average or slightly below average step 1 assuming they apply broadly.
 
There's this weird phenomenon that happens with medical students; they think because they've had to be in the top ~5% their entire lives that all of a sudden because they're in the 50th percentile of medical students that they're destined for a bottom tier career.

Let's assume all Step 1 test takers become physicians (not accurate, but close enough), and you scored the median. That means you scored higher than ~half of all doctors in the US. That's not the same as scoring the median on the MCAT, which would mean you scored higher than roughly zero doctors in the US.

Being average, or even below average, amongst a group of the best students in the country is something you should be proud of. You may not be competitive for a few very selective specialties available to only the top ~10% or so, but matching a "good" residency does not mean you need to be in the top of your class -- or really anywhere close to it. Most ACGME residencies are "good," and while it's impossible to really do an objective analysis on this, the distribution is a lot closer to 80-15-5 (good-ok-bad) than the 20-20-60 that most students seem to think.
 
I could be completely missing something obvious here, but I thought ophtho is a surgical subspecialty?

I think a lot of people categorize it as surgical, but I know a lot of others who consider it medicine as well since you have a good mix of both medicine and surgery.

I also tend to categorize it more as medicine because its probably the only surgical field (and maybe Mohs) without the brutal residency and hours.

I think you can call ophtho a surgical or medical specialty and not be wrong.
 
Thanks everybody for the response. I don't mean to rub anyone the wrong way. I guess I am just feeling frustrated and a little down after going through another core clerkship without pulling off an Honors even after busting my ass of. I absolutely killed it clinically on the wards but performed a very mediocre job on the shelf. Makes me wonder I might very well go through this entire year without getting a single honors.

And the thing is, I get a sense that many people here on SDN and at my institution somehow makes getting anything "non-honors" seem so terrible, which adds to more frustration/anxiety on my end.


If you're at a top 10 place, you might still be able to get into a decent place or a more competitive specialty (probably not the most competitive places or specialties though) despite average scores as long as you're geographically flexible. Meet with the relevant people at your school, ask them to make calls for you, etc.

Also, there are plenty of "average" specialties that are still good for average students. For example IM is a great specialty and you can potentially subspecialize in a "competitive" subspecialty like GI or cards. You don't have to be at a top academic program to have a chance at competitive subspecialties like GI or cards either. If you do well at a decent enough academic IM program, you could have a shot.

The majority go into internal medicine or general practice. What are the competitive specialties that you desire? Don't let your scores keep you from trying to get into what you want. There's more than one way to skin a cat, as the saying goes.

I suppose. To be honest, I am extremely interested in Ortho and Urology. I rotated through those services during my surgery rotation, and that was the moment I felt like I finally found something I love and something I can see myself doing for the rest of my life. I wish I had came into med school knowing I'd like to go into something super competitive like that so I can start networking, doing research, and etc. If I were to go into IM, I'd definitely want to go into Cards or GI or Pulm/crit., something hands on.

20-30% is a lot, so I certainly wouldn't say "only." Starts to make you wonder how much of an honor "Honors" really is when you start handing it out to a third of the class.

Exactly. Ours is about 10% and we just have Honors and Pass so its extra stressful.

The % is closer to 20 than to 30, as it varies from rotation to rotation. I don't have a problem w/ the % of honors at my institution because I've heard a few institutions that barely gives out any honors (like yours 10%), but I've also heard of many institutions that give out way more honors than my institution.

@NWwildcat2013, so if only 10% of students get honors and the other 90% (you at Michigan?) gets pass, does that mean there's a significant number of people who are going into surgical specialties like plastics, neurosurg, ortho, urology, ENT, ophtho, Gen Surg who ends up getting just a "pass" on Surgery rotation? Because based on the 10% honors, hypothetically in a class of 150, there should be around 15 people who gets honors on the Surgery rotation. But there has to be more than 15 people who ends up going into those specialties. And that's not even including geniuses who are going into IM and other non-surgical specialties who gets honors on surgery rotation.

If you browse around SDN long enough, you'll find plenty of threads saying "You must get honors on surgery" to go into one of those specialties or "If you get a High Pass, you need to explain to the residency programs why you didn't get honors", which sounds a little absurd to me but hey, it's probably true.

Average students go into IM, FM, Peds, Psych, Anesthesia, Radiology, EM, GS, PM&R, and OB/GYN.

The pickings sure are slim.

Yeah. you are right. Except I don't want to go into FM, peds, psych, anesthesia, radiology, PM&R, or ObGyn. I'd consider IM, EM, or maybe GS (probably not).

According to MSAR, I'd say it's "anything they want to, except the uber specialties".

That's because about 60% of MD grads go into non-Primary Care fields for PGY1 choices. Unfortunately, MSAR only lists "Internal Medicine" as a choice, and thus we don't know if people will subspecialize.

Only 5% of Einstein grads go into Psych, for example.

Thanks for providing the stats!

There's this weird phenomenon that happens with medical students; they think because they've had to be in the top ~5% their entire lives that all of a sudden because they're in the 50th percentile of medical students that they're destined for a bottom tier career.

Let's assume all Step 1 test takers become physicians (not accurate, but close enough), and you scored the median. That means you scored higher than ~half of all doctors in the US. That's not the same as scoring the median on the MCAT, which would mean you scored higher than roughly zero doctors in the US.

Being average, or even below average, amongst a group of the best students in the country is something you should be proud of. You may not be competitive for a few very selective specialties available to only the top ~10% or so, but matching a "good" residency does not mean you need to be in the top of your class -- or really anywhere close to it. Most ACGME residencies are "good," and while it's impossible to really do an objective analysis on this, the distribution is a lot closer to 80-15-5 (good-ok-bad) than the 20-20-60 that most students seem to think.

This. This is what every medical students should know. It's easier said than to actually accept it. I've told myself this over and over again, but I always let SDN and other people influence how I feel about my performance in medical school, which is very frustrating.
 
If so, then I would think it's also arguable for OB/GYN, ENT, urology.

By the way, IM and many medical subspecialties can and do have pretty brutal residencies and hours.

I guess its hard to quantify whether each field is primarily medicine or surgery especially when there is so much variability. I've known/heard of ENTs and Ophto that only do clinic and refer surgeries elsewhere while I know other doctors will try to book as much surgery as possible while minimizing clinic.

As for the other fields you mentioned I'd place OB/GYN in medicine and Urology and ENT in surgery. Again this is just an opinion and where I draw the line, but I'm sure other people will have different classifications, which is fine.

And yes, hours are brutal in a lot of specialties, but I think the surgical specialties are on a level of their own. Most surgery residents I know mention that the 80 hour limit is laughable and the work they do it physically exhausting as well.
 
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On the subject of residency hours.... are there any fields with good hours; i.e. 40-50 hour weeks?
 
On the subject of residency hours.... are there any fields with good hours; i.e. 40-50 hour weeks?
Psych. Some people say psych is "three years of learning stretched out to four years of residency".

This makes psych relatively easy to switch into from other residencies. It also provides a lot of moonlighting opportunities third year and especially fourth year.
 
I guess its hard to quantify whether each field is primarily medicine or surgery especially when there is so much variability. I've known/heard of ENTs and Ophto that only do clinic and refer surgeries elsewhere while I know other doctors will try to book as much surgery as possible while minimizing clinic.

As for the other fields you mentioned I'd place OB/GYN in medicine and Urology and ENT in surgery. Again this is just an opinion and where I draw the line, but I'm sure other people will have different classifications, which is fine.

And yes, hours are brutal in a lot of specialties, but I think the surgical specialties are on a level of their own. Most surgery residents I know mention that the 80 hour limit is laughable and the work they do it physically exhausting as well.
I don't mean to get all pedantic or anything. For whatever it's worth though, if anything, the American College of Surgeons does classify ophtho, ENT, OB/GYN, and urology as surgical specialties (please see here).

Yeah, no doubt surgical specialties are brutal, physically exhausting, don't always abide by the 80 hour rule, etc., but I don't know man, the same or similar could be said about many IM programs and many IM subspecialties too. It's not as if being on ICU or cardiology is exactly easy. To be fair, I suppose one difference is almost all surgical specialties could be said to be brutal whereas there are some IM programs that have more cush hours and don't see as much diverse pathology as anything super crazy gets transferred out etc (e.g., some community programs), although these tend to not offer as good training or so some would argue. Also in IM it depends on your rotation, some are more cush than others, whereas I imagine for surgery it's usually not like that.
 
I don't mean to get all pedantic or anything. For whatever it's worth though, if anything, the American College of Surgeons does classify ophtho, ENT, OB/GYN, and urology as surgical specialties (please see here).

Yeah, no doubt surgical specialties are brutal, physically exhausting, don't always abide by the 80 hour rule, etc., but I don't know man, the same or similar could be said about many IM programs and many IM subspecialties too. It's not as if being on ICU or cardiology is exactly easy. To be fair, I suppose one difference is almost all surgical specialties could be said to be brutal whereas there are some IM programs that have more cush hours and don't see as much diverse pathology as anything super crazy gets transferred out etc (e.g., some community programs), although these tend to not offer as good training or so some would argue. Also in IM it depends on your rotation, some are more cush than others, whereas I imagine for surgery it's usually not like that.

Fair enough! I definitely can't argue with the technical classification, but for me personally it's hard to group ophtho and neurosurgery in the same category.

I think you hit the nail on the head with your second paragraph.
 
What do above average but lazy students go into? My ideal specialty would have the following features:
  • formulaic job
  • relatively low stress
  • minimal/straightforward paperwork
  • preferably shift work
  • little or no call
  • no weekend, night, or holiday shifts
  • ~40 hours per week

inb4 dentistry
inb4 you picked the wrong profession
 
What do above average but lazy students go into? My ideal specialty would have the following features:
  • formulaic job
  • relatively low stress
  • minimal/straightforward paperwork
  • preferably shift work
  • little or no call
  • no weekend, night, or holiday shifts
  • ~40 hours per week

inb4 dentistry
inb4 you picked the wrong profession
Judging by the foot fetish, perhaps podiatry? 😉
 
@NWwildcat2013, so if only 10% of students get honors and the other 90% (you at Michigan?) gets pass, does that mean there's a significant number of people who are going into surgical specialties like plastics, neurosurg, ortho, urology, ENT, ophtho, Gen Surg who ends up getting just a "pass" on Surgery rotation? Because based on the 10% honors, hypothetically in a class of 150, there should be around 15 people who gets honors on the Surgery rotation. But there has to be more than 15 people who ends up going into those specialties. And that's not even including geniuses who are going into IM and other non-surgical specialties who gets honors on surgery rotation.

If you browse around SDN long enough, you'll find plenty of threads saying "You must get honors on surgery" to go into one of those specialties or "If you get a High Pass, you need to explain to the residency programs why you didn't get honors", which sounds a little absurd to me but hey, it's probably true.
Indeed, in a class of ~100 we had more people go into surgical subspecialties like ophtho, uro, ENT, ortho, plastics, neurosurg (~15) than would theoretically honor (~10). That isn't even counting the people who do general surgery, OB/GYN, or something like derm, radiology, or rad onc. If you include the latter group you have another 15-20 people for whom honoring surgery would have been beneficial. You also have to assume that some of the people doing something not so competitive like IM, neuro, gas etc. somehow honored surgery, so that leads me to believe many people are successfully matching into surgery and surgical subspecialties without honors in surgery. Some of the class seems to have matched a bit down their rank list in specialties like ortho, but at least they are still matching successfully.

You don't need to honor surgery to do surgery if you have good scores. You might need to honor your sub i if you dont honor your core rotation, though.
 
What do above average but lazy students go into? My ideal specialty would have the following features:
  • formulaic job
  • relatively low stress
  • minimal/straightforward paperwork
  • preferably shift work
  • little or no call
  • no weekend, night, or holiday shifts
  • ~40 hours per week

inb4 dentistry
inb4 you picked the wrong profession
Im going to still tell you that you picked that wrong profession but for different reasons than others. I dont have the "medicine is a calling" belief and won't shame you, but as someone who has spent a lot of time thinking about how to achieve the stuff on your list I have come to the conclusion that it does not exist.

Summary: There is nothing wrong with wanting what you list, but it doesn't seem to exist in medicine.
 
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What do above average but lazy students go into? My ideal specialty would have the following features:
  • formulaic job
  • relatively low stress
  • minimal/straightforward paperwork
  • preferably shift work
  • little or no call
  • no weekend, night, or holiday shifts
  • ~40 hours per week

inb4 dentistry
inb4 you picked the wrong profession

Easiest way to accomplish this is with a specialty you enjoy that is also conducive to private practice. Even this would require more stress and more hours initially, but once you've established yourself you can be as busy or free as you desire. My best friend for 20+ years now is a family physician with his own concierge-style practice; it took him a bit of time and actually he lost money his first two years, but now he routinely brings in $400k annually for 50 hour weeks. He has several associates that work part time (25-30 hrs/week) for ~$130-$150k. In the right market with some business acumen, you can make what you want out of this profession.
 
Im going to still tell you that you picked that wrong profession but for different reasons than others. I dont have the "medicine is a calling" belief and won't shame you, but as someone who has spent a lot of time thinking about how to achieve the stuff on your list I have come to the conclusion that it does not exist.

Summary: There is nothing wrong with wanting what you list, but it doesn't seem to exist in medicine.


Not even done with first semester of M1, and I'm like:

getting-too-old-for-this.jpg
 
Not even done with first semester of M1, and I'm like:

getting-too-old-for-this.jpg
M1 and already broached this topic at least five times including starting a few threads about it:
What do above average but lazy students go into? My ideal specialty would have the following features:
  • formulaic job
  • relatively low stress
  • minimal/straightforward paperwork
  • preferably shift work
  • little or no call
  • no weekend, night, or holiday shifts
  • ~40 hours per week

inb4 dentistry
inb4 you picked the wrong profession

http://forums.studentdoctor.net/thr...tudents-get-to-go-into.1227438/#post-18260462
Do they exist?

Can I work 30-40 hours/week with no call, no weekends, no overnights, no holidays with the trade-off being a significantly lower salary, i.e. ~$180-250K/year ?

I know jobs like this exist in other specialties (like anesthesiology), but what about rads?

http://forums.studentdoctor.net/threads/mommy-track-radiology-jobs.1222958
Traditionally, the lifestyle specialties were R.O.A.D. (radiology, ophthalmology, anesthesiology, and dermatology), but, based on what I've read on sdn, that has changed nowadays. Radiology is suffering from decreasing reimbursements / increasing case volumes and is no longer considered a lifestyle specialty. The job security of anesthesiology is lower than ever with nurse anesthetist encroachment. I haven't read much on optho, but it seems pretty boring, basically a dentist for the eyes...Derm is still king of lifestyle, but it's impossble to match into...

What are some of the modern lifestyle specialties? (High pay, less hours, lower stress, good job security)

http://forums.studentdoctor.net/threads/cushiest-specialties.1214703
Do lifestyle specialties still exist besides derm? By "lifestyle," I mean high salary, good hours, and good job market (job security). Anesthesiology is suffering from mid-level encroachment by CRNA's. Volume is going way up in radiology, and you're expected to read super fast all day with almost no breaks (not to mention sitting all day, which is "the new smoking" in terms of health effects). Anything surgical is automatically not lifestyle because the hours blow. What's left?

http://forums.studentdoctor.net/threads/are-there-still-lifestyle-specialties-besides-derm.1221583/
Does any specialty fit this description?

-shift work
-no call
-no overnight, weekend, or holidays shifts
-minimal paperwork (i.e. short, formulaic notes)
-possibility to work 30-40 hours per week (I'm willing to accept the trade-off of significantly lower pay)

http://forums.studentdoctor.net/thr...hings-but-love-nothing.1223048/#post-18160716
 
Average students go into IM, FM, Peds, Psych, Anesthesia, Radiology, EM, GS, PM&R, and OB/GYN.

The pickings sure are slim.

wow times have changed, when I applied the ROAD (rads, opth, anesth, derm) were all super-competitive...regardless, lets assume that average means middle third of your class. You can still potentially match into a competitive specialty but not at an upper-tier place. One of my classmates who was "average" did average on step 1, kicked ass on step 2, did research, kissed some a$$, and matched derm at our home institute
 
wow times have changed, when I applied the ROAD (rads, opth, anesth, derm) were all super-competitive...regardless, lets assume that average means middle third of your class. You can still potentially match into a competitive specialty but not at an upper-tier place. One of my classmates who was "average" did average on step 1, kicked ass on step 2, did research, kissed some a$$, and matched derm at our home institute
Never underestimate the power of a well placed kiss on the buttcheek
 
Hospitalist.

My cousin is making $350K doing 7 days on and 7 days off. Occasional call which is taken over the phone.
 
Just to add another example (not the rule.. I know.. these are individual cases) but my buddy just snagged a Anesthesia job on the coast of Cali.

It's not one of those jobs that were advertised and he is NOT overseeing CRNAs making $550,000. Does ~50 hours a week. Takes call every other month. Huge group practice.

Has 8 weeks of vacation too.

So yeah.. there is money out there.
 
I think a lot of people categorize it as surgical, but I know a lot of others who consider it medicine as well since you have a good mix of both medicine and surgery.

I also tend to categorize it more as medicine because its probably the only surgical field (and maybe Mohs) without the brutal residency and hours.

I think you can call ophtho a surgical or medical specialty and not be wrong.

Not that I really care all that much what my field is "technically" considered one way or the other (different people will have different opinions), at least the American College of Surgeons considers ophthalmology a surgical subspecialty: https://www.facs.org/education/resources/residency-search/specialties/ophthal

There will always be people that don't consider certain specialists (ophthalmologists, OBGYNs) "real" surgeons. It's not something to get too worked up over, in my opinion. Doing an enucleation or peeling an epiretinal membrane is surgery as is resecting a leiomyoma or removing a uterus. To think otherwise is just plain silly.

Also, all surgeons have outpatient "clinic". Yes, some fields more than others, but no one is in the OR every day cutting to my knowledge.
 
Not that I really care all that much what my field is "technically" considered one way or the other (different people will have different opinions), at least the American College of Surgeons considers ophthalmology a surgical subspecialty: https://www.facs.org/education/resources/residency-search/specialties/ophthal

There will always be people that don't consider certain specialists (ophthalmologists, OBGYNs) "real" surgeons. It's not something to get too worked up over, in my opinion. Doing an enucleation or peeling an epiretinal membrane is surgery as is resecting a leiomyoma or removing a uterus. To think otherwise is just plain silly.

Also, all surgeons have outpatient "clinic". Yes, some fields more than others, but no one is in the OR every day cutting to my knowledge.
Well said! I pointed out the American College of Surgeons thing above as well (see here).
 
Not that I really care all that much what my field is "technically" considered one way or the other (different people will have different opinions), at least the American College of Surgeons considers ophthalmology a surgical subspecialty: https://www.facs.org/education/resources/residency-search/specialties/ophthal

There will always be people that don't consider certain specialists (ophthalmologists, OBGYNs) "real" surgeons. It's not something to get too worked up over, in my opinion. Doing an enucleation or peeling an epiretinal membrane is surgery as is resecting a leiomyoma or removing a uterus. To think otherwise is just plain silly.

Also, all surgeons have outpatient "clinic". Yes, some fields more than others, but no one is in the OR every day cutting to my knowledge.
I totally agree with you.

After rotating through OBGYN and seeing gyn onc, urogyn, etc. I don't understand why OBGYN has so many haters.
 
Not that I really care all that much what my field is "technically" considered one way or the other (different people will have different opinions), at least the American College of Surgeons considers ophthalmology a surgical subspecialty: https://www.facs.org/education/resources/residency-search/specialties/ophthal

There will always be people that don't consider certain specialists (ophthalmologists, OBGYNs) "real" surgeons. It's not something to get too worked up over, in my opinion. Doing an enucleation or peeling an epiretinal membrane is surgery as is resecting a leiomyoma or removing a uterus. To think otherwise is just plain silly.

Also, all surgeons have outpatient "clinic". Yes, some fields more than others, but no one is in the OR every day cutting to my knowledge.

Well said,

To clarify, I never meant that OB/GYNs and Ophthalmologists aren't surgeons as they clearly are (If you're cutting into someone I think it's fair to call yourself a surgeon). I was saying that because of the ratio of surgery to medicine in these fields, I would personally classify the specialty under medicine.

For example, laparoscopic removal of the uterus vs laparoscopic appendectomy/cholecystectomy are both somewhat similar operations and it would be silly to say one person wasn't a surgeon and the other is. However when you look at how much time is spent in surgery for an average OB/GYN vs General Surgeon, I would say the field of OB/GYN is closer to medicine than surgery, but both doctors are still surgeons. Same for Ophtho.

Didn't mean to start any sort of debate or even hint at disrespect towards any field.
 
If only the top students get to go into competitive specialties (ie. derm, plastics, ENT, ortho, urology, etc.) and into good residency programs for other specialties like IM, what do average or below-average medical students get to go into?

I've been thinking a lot about this. I'm a current MS3 at a top 10 institution. Sure, I attend a good medical school (which I am very thankful for and proud of), but I've come to realize that no matter how hard I work and how much effort I put into studying, I am just a very average/slightly below average student at my institution. My step 1 score is below the average based on the 2016 charting outcome for any of the competitive specialties that I desire, and I may very well go through 3rd year without a single honors on core rotations (only the top 20-30% of students for each rotation gets honors). I don't have any significant research/pubs to make myself stand out either. So what does that leave me with?
That's crazy- only 10% of our students are allowed honors on rotations.
 
If you're decidedly average/below average but are in love with a particular competitive field you could always take a research year.
 
If you're decidedly average/below average but are in love with a particular competitive field you could always take a research year.
This combined with reevaluating geographic preferences can really help. I think that if you eliminate that factor from the match your options open up. I would say that most of the people in the class ahead of me who failed to match did so because they ranked programs clustered on a certain coast.
 
What do above average but lazy students go into? My ideal specialty would have the following features:
  • formulaic job
  • relatively low stress
  • minimal/straightforward paperwork
  • preferably shift work
  • little or no call
  • no weekend, night, or holiday shifts
  • ~40 hours per week

inb4 dentistry
inb4 you picked the wrong profession

I really hope i don't have to work with you.
 
That's crazy- only 10% of our students are allowed honors on rotations.

My school bases honors on our score compared to national scores. It varies based on what rotation, but you have to score around the 80th percentile to honor a rotation (our entire grade is based on our shelf exam). So for some sections we could have half the class getting honors and for others no one could get it. It's nice because getting honors actually has a concrete and tangible meaning.
 
My school bases honors on our score compared to national scores. It varies based on what rotation, but you have to score around the 80th percentile to honor a rotation (our entire grade is based on our shelf exam). So for some sections we could have half the class getting honors and for others no one could get it. It's nice because getting honors actually has a concrete and tangible meaning.

So none of it is based on evals? Just the shelf score?


Sent from my iPhone using SDN mobile
 

Interesting. I would have honored everything then. Nothing more frustrating to crush a shelf and get one average evaluation that pulls you down. At my school we need a great shelf score and awesome evals.

Just goes to show you how much variability there is and how little clerkship grades mean.


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Easiest way to accomplish this is with a specialty you enjoy that is also conducive to private practice. Even this would require more stress and more hours initially, but once you've established yourself you can be as busy or free as you desire. My best friend for 20+ years now is a family physician with his own concierge-style practice; it took him a bit of time and actually he lost money his first two years, but now he routinely brings in $400k annually for 50 hour weeks. He has several associates that work part time (25-30 hrs/week) for ~$130-$150k. In the right market with some business acumen, you can make what you want out of this profession.
That sounds really awesome, regardless of the money! (For me anyway, there's sort of a baseline cut-off to make my time worthwhile, but then I wouldn't care. I would love the autonomy of that kind of practice.)
 
If only the top students get to go into competitive specialties (ie. derm, plastics, ENT, ortho, urology, etc.) and into good residency programs for other specialties like IM, what do average or below-average medical students get to go into?

I've been thinking a lot about this. I'm a current MS3 at a top 10 institution. Sure, I attend a good medical school (which I am very thankful for and proud of), but I've come to realize that no matter how hard I work and how much effort I put into studying, I am just a very average/slightly below average student at my institution. My step 1 score is below the average based on the 2016 charting outcome for any of the competitive specialties that I desire, and I may very well go through 3rd year without a single honors on core rotations (only the top 20-30% of students for each rotation gets honors). I don't have any significant research/pubs to make myself stand out either. So what does that leave me with?

I only know of one person at my school who changed their specialty choice based on board scores or AOA status. Even the 260+/AOA folk who were into IM from the beginning stayed with IM (granted they're good bets to go to Harvard, JH, Stanford etc.).
 
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