What if I committed myself to earning a Step 2 score of 290+?

[IntoTheNight]

Theoretically, what if I were to commit myself to earning a 290+ on Step 2?

I just finished first year and am heading into second year in the near future. I've been thinking a bit about some of the people I admire's advice to "play games you're good at" and it got me thinking:

As someone who loves learning --even the obscure-- and is better at testing than I am at some of the other parts of my application I could work on, would there be value to committing myself to a very high step 2 score?

I can anticipate some responses advocating for a well-balanced application>>>Step 2 spike; but at some point, can't an individual "cut their losses" with their weaknesses and lean into their strengths--especially if they are controllable?

Is this inadvisable? How would I go about doing it?

Thanks in advance!

EDIT: I should add that as much as a Step 2 score is nice, I'd be curious to see what the opinion is in terms of how valuable Step 2 knowledge is? For example, would learning the details that gets me such a score make me a better doctor or is it more obscure facts that might not translate like in Step 1?

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[Billiam95]

Can only speak to general surgery, but there's definitely a point of diminishing returns around 260 in terms of application boost

 

[xffan624]

You're likely in a school and an applicant pool full of folks who love learning and are good at test taking. If it were that easy to just commit to getting it, everyone would be getting those scores. It's hard to do. Even the alleged IMG cheaters I think were getting like 280s. It's not that they're just focusing on other aspects. Not sure what the schedule is these days with pass/fail Step 1 but when I went, you used MS3 to study for Step 2 so it actually didn't require too much intensive study to do well on it. Doing well during MS3 was a way to study for Step 2. Not sure if that still applies with new system. By all means, study hard and do well. I used Anki throughout medical school and felt it helped tremendously so I had the memorization downpat and made my dedicated periods less stressful. The conceptual stuff is the part that gets to the higher scores and part that separates the wheat from the chaff with these tests. Expecting a 290 from these efforts though is like expecting to be Simone Biles because you train really hard at gymnastics and you're flexible. Not that likely.

 

[GoSpursGo]

Agree, at a certain level there is no appreciable difference between a 260 and a 290.

A step 2 score alone is not going to get you a highly competitive specialty, and if you do nothing except study for step 2 you won't have the other things.

 

[Goro]

Theoretically, what if I were to commit myself to earning a 290+ on Step 2?

I just finished first year and am heading into second year in the near future. I've been thinking a bit about some of the people I admire's advice to "play games you're good at" and it got me thinking:

As someone who loves learning --even the obscure-- and is better at testing than I am at some of the other parts of my application I could work on, would there be value to committing myself to a very high step 2 score?

I can anticipate some responses advocating for a well-balanced application>>>Step 2 spike; but at some point, can't an individual "cut their losses" with their weaknesses and lean into their strengths--especially if they are controllable?

Is this inadvisable? How would I go about doing it?

Thanks in advance!

EDIT: I should add that as much as a Step 2 score is nice, I'd be curious to see what the opinion is in terms of how valuable Step 2 knowledge is? For example, would learning the details that gets me such a score make me a better doctor or is it more obscure facts that might not translate like in Step 1?

I'm going to my default answer when I see posts like this:
What if you flap your arms and fly to the moon?

 

[operaman]

Yeah not worth the additional effort it would take. Not even close. High step scores don’t open doors, they prevent doors from closing on you. After a certain point, the door is open and doesn’t get any more open.

Your underlying thinking is sound though. Putting that effort into shelf exams should help you earn higher clinical grades which definitely keeps more doors open. If youre capable of a 290, you could study way less and get a 270 and use the extra time to crank out a few papers which would help you far more.

So definitely lean into your strengths, but in ways that will be most helpful. The story I always tell about the step score delusion was a guy at my school who scored a 280 on step 1, thought he was gods gift to residency and tried to coast on his score. Didn’t match - had to scramble to prelim and did match a pgy2 categorical the next year. Be a well rounded strong applicant and you’ll do much better.

 

[voxveritatisetlucis]

Impossible because literally 1 or 2 wrong would prevent it. There’s a limit

 

[MDMechEngr]

I scored a 27* on S2. One inteview that I got from a WL the PD told me he yield protected me because of my 27* S2. It was a relatively high ranked program also. LOL. agreed with poster above, S2 has a deminishing return around 260-265.

 

[Hollow Knight]

This M3’s opinion isn’t worth much, but from my limited experience, no, board scores are not correlated with quality of attending.

Maybe specialty boards? An internist at my school got a 100th % on his IM boards, and he’s basically House MD with great bedside manner. But I know physicians/students with great scores who just somehow suck clinically.

 

[mrbreakfast]

I've posted about this before but residency application evaluation process at most places is set up with multiple categories with a maximum possible score in each category, so while you'd probably impress people, it wouldn't necessarily open doors.

Also, as others have said, getting a 290 is essentially impossible due to the curved grading scale. A 290 would likely require you to miss a maximum of a single question for the entire test.

 

[LunaOri]

You would be better served by aiming for a 260+, and using the time you save to improve the weaknesses in your application. No program director ever said “Hey, I’ll rank this guy with the amazing Step 2 score over the applicants with great LOR, great interview, and publications”.

 

[longhaul3]

It's been a long time since I took Step 2 (used to be called CK) but I would say the knowledge is useful if you're doing into a general-ish specialty like IM, FM, peds, or obgyn. But whatever you learn for the exam you will relearn in residency. I do think you should commit to learning as much as you can in med school, whether for boards or not, because it will make you a better physician regardless of specialty. I'm in a niche subspecialty that values general medical knowledge and I think it's embarrassing when people don't know how to manage uncomplicated inpatient hypertension or diabetes and can't figure out why a young trauma patient has 4 days of vaginal bleeding

You can commit yourself to getting whatever step score you want but I doubt you'll score 290. I'm not as fluent in Step 2 score as I was in Step 1 score back in the day but if they're still relatively equivalent (average Step 2 used to be a few points higher than Step 1), nobody in my specialty would care if you got a 260 vs 290

 

[Captain_Falcon]

Save that extra time and exercise, you’ll be more attractive on those Zoom interviews and that will yield better results

 

[ophthoaspirant]

Agree, at a certain level there is no appreciable difference between a 260 and a 290.

A step 2 score alone is not going to get you a highly competitive specialty, and if you do nothing except study for step 2 you won't have the other things.

I hear research (not just chart reviews and case reports) is becoming very important. People are getting dual degrees or taking research gap years.

 

[voxveritatisetlucis]

I scored a 27* on S2. One inteview that I got from a WL the PD told me he yield protected me because of my 27* S2. It was a relatively high ranked program also. LOL. agreed with poster above, S2 has a deminishing return around 260-265.

Don’t you also go to a top school, probably had more to do with that. People with top grades and scores from my school usually only get trash options

 

[VincentAdultman]

You would be better served by aiming for a 260+, and using the time you save to improve the weaknesses in your application. No program director ever said “Hey, I’ll rank this guy with the amazing Step 2 score over the applicants with great LOR, great interview, and publications”.

I'm not a program director but If an application came accross my desk from someone who scored 290 my first thought would be that that person was sociopathic.

 

[LunaOri]

I'm not a program director but If an application came accross my desk from someone who scored 290 my first thought would be that that person was sociopathic.

My first thought would be that they were super smart. But that’s not necessarily the most important factor in choosing a resident.

 

[VincentAdultman]

My first thought would be that they were super smart. But that’s not necessarily the most important factor in choosing a resident.

It’s not, and point of diminishing returns etc.

There’s better uses of one’s time.

 

[ChordaEpiphany]

Can only speak to general surgery, but there's definitely a point of diminishing returns around 260 in terms of application boost

Does this apply to more competitive programs in desirable cities? I'm an otherwise very competitive applicant from a mid-tier school and I totally surprised myself with a mid-270s score. I was only targeting 250s-260s and thinking I'd go to a solid academic residency, ideally somewhere without a behemoth prestige center sucking up the interesting cases . Things really started to click during dedicated and thankfully I surpassed my expectations. However, my geographical situation recently got complicated due to family matters, and it's looking like being in a specific, highly competitive area/city may be necessary, and being at the behemoth prestige center may be the way to get well-rounded training. I'm thinking big centers like UCSF, Stanford, UCLA, BWH, MGH, Cornell, Columbia, NYU, Sinai, UW, etc... Could the 270+ score push my application in this case, or should I still be looking for a center that manages to keep solid volume in all specialties despite competing with one of the above hospitals? My goal is academics.

I say this having just come off a sub-I where residents cross cover two specialties (and get pretty subpar experience in one of them) because the massive top tier academic center nearby absorbs all the cases and volume is incredibly low in some specialties.

 

[VincentAdultman]

Does this apply to more competitive programs in desirable cities? I'm an otherwise very competitive applicant from a mid-tier school and I totally surprised myself with a mid-270s score. I was only targeting 250s-260s and thinking I'd go to a solid academic residency, ideally somewhere without a behemoth prestige center sucking up the interesting cases . Things really started to click during dedicated and thankfully I surpassed my expectations. However, my geographical situation recently got complicated due to family matters, and it's looking like being in a specific, highly competitive area/city may be necessary, and being at the behemoth prestige center may be the way to get well-rounded training. I'm thinking big centers like UCSF, Stanford, UCLA, BWH, MGH, Cornell, Columbia, NYU, Sinai, UW, etc... Could the 270+ score push my application in this case, or should I still be looking for a center that manages to keep solid volume in all specialties despite competing with one of the above hospitals? My goal is academics.

I say this having just come off a sub-I where residents cross cover two specialties (and get pretty subpar experience in one of them) because the massive top tier academic center nearby absorbs all the cases and volume is incredibly low in some specialties.

I think as a general rule a score like that isn’t going to trump publications, presentations or LORs especially at more prestigious institutions.

 

[operaman]

Does this apply to more competitive programs in desirable cities? I'm an otherwise very competitive applicant from a mid-tier school and I totally surprised myself with a mid-270s score. I was only targeting 250s-260s and thinking I'd go to a solid academic residency, ideally somewhere without a behemoth prestige center sucking up the interesting cases . Things really started to click during dedicated and thankfully I surpassed my expectations. However, my geographical situation recently got complicated due to family matters, and it's looking like being in a specific, highly competitive area/city may be necessary, and being at the behemoth prestige center may be the way to get well-rounded training. I'm thinking big centers like UCSF, Stanford, UCLA, BWH, MGH, Cornell, Columbia, NYU, Sinai, UW, etc... Could the 270+ score push my application in this case, or should I still be looking for a center that manages to keep solid volume in all specialties despite competing with one of the above hospitals? My goal is academics.

I say this having just come off a sub-I where residents cross cover two specialties (and get pretty subpar experience in one of them) because the massive top tier academic center nearby absorbs all the cases and volume is incredibly low in some specialties.

Score like that is definitely worth having. I think diminishing returns just means the incremental difference in effort to go from 240 to 260 is far more meaningful than going from 260 to 280. But hey if you’ve already nailed a super high score, great! It definitely won’t close any doors for you and will get noticed.

Just be sure the rest of the app is strong as well. A nice high score and a strong overall app with solid grades and research and strong letters will put the better programs in play.

If your mentors have any connections to top programs in your desired area, ask them to make calls on your behalf as that too can be a big help.

 

[DOVinciRobot]

I'm thinking big centers like UCSF, Stanford, UCLA, BWH, MGH, Cornell, Columbia, NYU, Sinai, UW, etc... Could the 270+ score push my application in this case

Usually it’s other things that push you over the edge at places like that, such as research/LOR’s/interesting background/etc and not having a few extra points on boards. We’ve had students match at places like that and their scores are typically strong (250s-260s) but not absurdly high. They were simply overall strong applicants in every area and very well liked in the department

 

[FlowRate]

Had a few 280's I was aware of when I was on the residency selection committee (as a resident.) Our program, like many, didn't really care all that much what your scores were, once you were in the post-interview stage of things. And even then I don't think anyone thought of scores over 270 as being appreciably different from each other.