What specialties can I match into?

[mrphysique]

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Just curious if anyone has any idea on what I might be able to match into?
Step 1: 221
Step 2: 250
Mix of honors/pass during third year
I got to a top 10 US medical school. My step 1 score is low, so I know I'm ****ed for all the competitive ones. I don't want to do EM, Psych, Family Medicine. Probably not Radiology or Anes either. I know that already crosses a lot off already but I guess I shouldn't be too picky with my low step score. I like procedures and medicine. I was thinking of doing PM&R with maybe a fellowship in pain or sports medicine but not sure how that would work. My school doesn't even really have a PM&R program. I came in wanting to do Ortho but I'm afraid that's off the table given my scores. I have published research in Ortho and Neurology (2 first author papers and some case reports). How limited am I? Can I consider applying to maybe 2 specialties or is that unrealistic. My school advising sucks so that's why I'm asking here.

 

[sinombre]

Check out the NRMP data. For US allopathic seniors there were 42 applicants who matched and 27 applicants who didn't match into ortho with a step 1 of 221-230 in 2016. So based off of your step 1 score it's not automatically off the table (although there is no way of knowing what else those applicants had on their application to help).

Applying to ortho with PM&R as a backup might be a great idea for you, as long as PM&R is something you think you would actually enjoy. Realistically matching ortho is going to be a huge uphill battle for you, but if it's something you're interested in there is no reason not to try as long as you have a solid backup plan.

https://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

 

[AcademicNeurosurgery]

Just curious if anyone has any idea on what I might be able to match into?
Step 1: 221
Step 2: 250
Mix of honors/pass during third year
I got to a top 10 US medical school. My step 1 score is low, so I know I'm ****ed for all the competitive ones. I don't want to do EM, Psych, Family Medicine. Probably not Radiology or Anes either. I know that already crosses a lot off already but I guess I shouldn't be too picky with my low step score. I like procedures and medicine. I was thinking of doing PM&R with maybe a fellowship in pain or sports medicine but not sure how that would work. My school doesn't even really have a PM&R program. I came in wanting to do Ortho but I'm afraid that's off the table given my scores. I have published research in Ortho and Neurology (2 first author papers and some case reports). How limited am I? Can I consider applying to maybe 2 specialties or is that unrealistic. My school advising sucks so that's why I'm asking here.

Can you provide more information about what your interests are/what you enjoy? You said you like procedures and medicine and wanted to go into ortho...that covers pretty much all specialties - medicine, procedure-heavy, and surgical specialties.

It also depends on your priorities. Are you ortho or bust (doesn't sound like you are)? Are you willing to take a risk for a specialty you love or are you more concerned about matching at all and moving on with your life?

For ortho, 42/69 US seniors matched with a Step 1 score in your range according to 2016 Charting Outcomes. Thus, you're not out of the race but it will be an uphill battle and the risk of not matching is very real. If you decide to shoot for ortho, it's time to bolster your research, think about a research year, start networking, etc. Consider applying to general surgery as well or go all in with ortho and come to terms with the idea of not matching and have a plan ready (scramble, pre-lim year).

If you aren't comfortable with that risk, look at Charting Outcomes and find all the specialties where you fall around the Step 1 average. Cross off what you don't want to do and see what's left. There's more to your app than Step 1 but it may be a good starting place to get yourself organized.

Be realistic (which it seems like you are), but don't settle if you don't have to.

Edit: Congrats on the Step 2 score, way to battle back.

 

[DrWhozits]

If you are interested in Neurology (based on your research...), neuro seems like a good field for you. It doesn't seem too procedural, but it would definitely be doable based on your stats. Otherwise, I would say Internal Med --> cards/GI/CC, etc. fellowship or PM&R.

 

[mrphysique]

Check out the NRMP data. For US allopathic seniors there were 42 applicants who matched and 27 applicants who didn't match into ortho with a step 1 of 221-230 in 2016. So based off of your step 1 score it's not automatically off the table (although there is no way of knowing what else those applicants had on their application to help).

Applying to ortho with PM&R as a backup might be a great idea for you, as long as PM&R is something you think you would actually enjoy. Realistically matching ortho is going to be a huge uphill battle for you, but if it's something you're interested in there is no reason not to try as long as you have a solid backup plan.

https://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

My main issue with that range is that because I have a 221, I just assumed most of those people had 230 and not the lower end of that range. Would I need to take a year off and do some more research or something to match ortho that way? I think I might enjoy PM&R if I could do procedures with maybe a pain fellowship. From what I have read though there is a huge difference between top PM&R programs and lower ones in terms of training. I think If I could still do a mix of procedures I could be happy in PM&R. Do you think it's realistic to apply to both? How does one do their rank list if they are applying to both?

 

[sinombre]

My main issue with that range is that because I have a 221, I just assumed most of those people had 230 and not the lower end of that range. Would I need to take a year off and do some more research or something to match ortho that way?

The scores are probably skewed towards 230, but the range still gives you a good idea of outcomes.

I have no idea how common it is to take a year to do research for ortho (I'm an ms4 heading into a general surgery residency). I have two close friends in my class interested in ortho (I'm not as close with the other students). One matched (pretty much the smartest guy in my class with high scores) and the other took a gap year to do research and is applying next year.

I think I might enjoy PM&R if I could do procedures with maybe a pain fellowship. From what I have read though there is a huge difference between top PM&R programs and lower ones in terms of training. I think If I could still do a mix of procedures I could be happy in PM&R. Do you think it's realistic to apply to both? How does one do their rank list if they are applying to both?

Yes, it is realistic to apply to both. Many (if not most) people applying to competitive residencies apply to backup specialties. When making a rank list you rank programs in the order you would want to match. So if you interview at 10 ortho programs and 10 pm&r programs, you would rank the 10 ortho programs first and then the 10 pm&r programs.

 

[mrphysique]

Can you provide more information about what your interests are/what you enjoy? You said you like procedures and medicine and wanted to go into ortho...that covers pretty much all specialties - medicine, procedure-heavy, and surgical specialties.

It also depends on your priorities. Are you ortho or bust (doesn't sound like you are)? Are you willing to take a risk for a specialty you love or are you more concerned about matching at all and moving on with your life?

For ortho, 42/69 US seniors matched with a Step 1 score in your range according to 2016 Charting Outcomes. Thus, you're not out of the race but it will be an uphill battle and the risk of not matching is very real. If you decide to shoot for ortho, it's time to bolster your research, think about a research year, start networking, etc. Consider applying to general surgery as well or go all in with ortho and come to terms with the idea of not matching and have a plan ready (scramble, pre-lim year).

If you aren't comfortable with that risk, look at Charting Outcomes and find all the specialties where you fall around the Step 1 average. Cross off what you don't want to do and see what's left. There's more to your app than Step 1 but it may be a good starting place to get yourself organized.

Be realistic (which it seems like you are), but don't settle if you don't have to.

Edit: Congrats on the Step 2 score, way to battle back.

1. I like procedures and clinic. I like improving the quality of life for patients. I'm not super crazy about life and death situations (I know ortho has trauma but I would have probably gone the sports med or hand route). I like making people feel better. I know it's vague but I don't care for the EM type doctors (saving lives acutely) I'm not an adrenaline junky. I know surgery tends to have that but for ortho I have found that it's the right balance for me. I'm open minded and I'm not Ortho or bust. I don't feel super confident that I would match ortho so I'm looking for other ways I can do something I love. I'm willing to take some risks but I don't want to not match at all.

2. I don't want to be flammed or hated for this but I have lots of loans. I know salaries go up and down and I never liked ortho for the money (i've always been interested in the matter) but I just don't see myself going into a specialty where I'm making peanuts and I can't afford to ever pay off my loans.

So I guess my big question is. Unfortunately my step 1 score sucks. I felt like I didn't have enough dedicated time (3 weeks) and I wasn't allowed to push it back that late...what's done is done. My step 2 score I was more prepared and did better but It seems like step 1 matters more. When I look at the charting outcome I'm below average for like every specialty except maybe some of the primary care ones. Can I cross off all the surgical sub-specialties? Or can I apply to ortho and PM&R? Can someone explain to me how that works? Like if I somehow got invited to some ortho invites could I rank my list like

ortho 1?
ortho 2?
PM&R 1
PM&R 2
etc?

This is all so confusing for me.

 

[mrphysique]

If you are interested in Neurology (based on your research...), neuro seems like a good field for you. It doesn't seem too procedural, but it would definitely be doable based on your stats. Otherwise, I would say Internal Med --> cards/GI/CC, etc. fellowship or PM&R.

I like neurology but I can't see myself being a neurologist. I feel like the procedures aren't there. Also if I did internal med I imagine I wouldn't match at the best internal med program so would that limit my chance at fellowship? Also is it realistic to go through internal med residency if my mentality then would be to specialize or bust?

 

[mrphysique]

Also just to throw this out there, what Ortho programs would I even apply to. I see many programs have a 230 cutoff. Do I just throw those ones out? Do I apply to all porgrams and see who invites me?

Edit: And can applying to ortho if I rank those higher sabotage my chance of matching PM&R. Like if I were to rank all my ortho potential but unlikely interviews first and my PM&R interviews lower meaning I wouldn't match into PM&R too?

 

[mrphysique]

The scores are probably skewed towards 230, but the range still gives you a good idea of outcomes.

I have no idea how common it is to take a year to do research for ortho (I'm an ms4 heading into a general surgery residency). I have two close friends in my class interested in ortho (I'm not as close with the other students). One matched (pretty much the smartest guy in my class with high scores) and the other took a gap year to do research and is applying next year.



Yes, it is realistic to apply to both. Many (if not most) people applying to competitive residencies apply to backup specialties. When making a rank list you rank programs in the order you would want to match. So if you interview at 10 ortho programs and 10 pm&r programs, you would rank the 10 ortho programs first and then the 10 pm&r programs.

Thank you so much for explaining that! This past year most of the ortho people didn't take time off but all had like 250+ step 1 scores. I feel like such a failure for ****ing up such an important exam.

 

[sinombre]

Thank you so much for explaining that! This past year most of the ortho people didn't take time off but all had like 250+ step 1 scores. I feel like such a failure for ****ing up such an important exam.

Things happen man. I have very similar scores to you so I understand the frustration (although I was never interested in anything super competitive). Life has a way of working out, so just keep your head up and keep working hard.

For what it's worth I ended up matching at my top choice (although general surgery is obviously less competitive than ortho)

 

[DrfluffyMD]

You need to milk the crap out of that top 10 school. Trust me, you can easily get top 20 if not top 10 residency in medicine, radiology, anesthesia, and possibly match at some of the less competitive surgical subspecialies.

A lot of SDN people don't understand or grossly undersestimate how much pedigree helps

in my opinion AND experience a top 10 school, especially one with good brand like Penn or Stanford, open doors as much as a 250 would do, if not more.

If you don't believe me, talk to advisors and PDs. Places like Mt sinai or NYU would be thrilled to have you.

 

[DokterMom]

OK - So here's what you do if you think your honest preferences would be Ortho first, them PM&R:

1. Gear your activities toward sports medicine and make that one of the focal points of your statement narrative. You can have two different statements (one for each specialty), but in either case, you should have the activities to back it up.
2. Spend as much time with the ortho folks at your home institution as you can. Let them get to know you and impress the heck out of them. Ask for their feedback and support. If they can honestly write you a strong LOR and are willing to network on your behalf, this will make a big difference. (Edit to add: If they subtly discourage you from applying ortho, then listen to that...)
   
3. Do an away rotation in PM&R with a sports medicine focus since your home program doesn't have one. Makes sense from either perspective.
4. Do an away ortho rotation and a lower-tier ortho program near your medical school where someone at your school knows someone there. Choose this program carefully. (Edit to add: This should be the ortho program you would have the best shot at matching into - one where your home program has contacts and one where your rotation performance will circumvent any Step auto-screen.)
   
5. Apply to both specialties.
   1. Apply to EVERY ortho program except
   2. Those where they also have a PM&R program you'd like to apply to
   3. Attend every interview you are offered
      
   4. Rank every ortho program and any PM&R program you would be willing to attend

Your "top 10 US medical school" will really help you in your quest to be one of the '42/69' seniors who match. Use all of the resources your school can throw at the problem. Sometimes 'who you know' matters and this is one of those times. Use it.

 

[bannie22]

I dont think a 221 is a killer. Lots of people have done worse and matched into competitive specialties.

 

[W19]

I think you should go all-in for ortho... You are from a top 10 school and your step2 shows that step1 score could have been a fluke...

 

[ERDOC555]

Just curious if anyone has any idea on what I might be able to match into?
Step 1: 221
Step 2: 250
Mix of honors/pass during third year
I got to a top 10 US medical school. My step 1 score is low, so I know I'm ****ed for all the competitive ones. I don't want to do EM, Psych, Family Medicine. Probably not Radiology or Anes either. I know that already crosses a lot off already but I guess I shouldn't be too picky with my low step score. I like procedures and medicine. I was thinking of doing PM&R with maybe a fellowship in pain or sports medicine but not sure how that would work. My school doesn't even really have a PM&R program. I came in wanting to do Ortho but I'm afraid that's off the table given my scores. I have published research in Ortho and Neurology (2 first author papers and some case reports). How limited am I? Can I consider applying to maybe 2 specialties or is that unrealistic. My school advising sucks so that's why I'm asking here.

I'm going to be the voice of dissent and tell you not to waste your time and money applying ortho. Step 1 average is just under 250 and a top school name helps a lot but not 30 points on step 1.

Those 42 people who matched likely had an ace up their sleeve, such as heavy research, PhD, a home department that loved them, a family member at a program, or something else that made them stand out.

Don't forget that these #s don't include all the people who applied and didn't gt a single interview. I can't imagine why any program would interview anyone with super low step scores when they have hoards of 250+/Research/AOA applicants to fill those spots.

TL;DR: Don't apply ortho unless you have some super compelling reason that will get you interviews.

 

[DrfluffyMD]

I'm going to be the voice of dissent and tell you not to waste your time and money applying ortho. Step 1 average is just under 250 and a top school name helps a lot but not 30 points on step 1.

Those 42 people who matched likely had an ace up their sleeve, such as heavy research, PhD, a home department that loved them, a family member at a program, or something else that made them stand out.

Don't forget that these #s don't include all the people who applied and didn't gt a single interview. I can't imagine why any program would interview anyone with super low step scores when they have hoards of 250+/Research/AOA applicants to fill those spots.

TL;DR: Don't apply ortho unless you have some super compelling reason that will get you interviews.

Actually a top school name can be equivalent to 30 points in the right circumstances. I know for a fact that top 20 medicine places have taken top 10 school students with 220 and turned down state school kids with 250.

 

[DrWhozits]

I like neurology but I can't see myself being a neurologist. I feel like the procedures aren't there. Also if I did internal med I imagine I wouldn't match at the best internal med program so would that limit my chance at fellowship? Also is it realistic to go through internal med residency if my mentality then would be to specialize or bust?

It is my understanding that in IM, your top 10 school will be worth its weight in gold. While may be a long shot, you can EASILY match a university program for IM, so it's not unreasonable that with a bit of research and hard work you could match something like cardiology, which is very procedure heavy

 

[mrphysique]

OK - So here's what you do if you think your honest preferences would be Ortho first, them PM&R:

1. Gear your activities toward sports medicine and make that one of the focal points of your statement narrative. You can have two different statements (one for each specialty), but in either case, you should have the activities to back it up.
2. Spend as much time with the ortho folks at your home institution as you can. Let them get to know you and impress the heck out of them. Ask for their feedback and support. If they can honestly write you a strong LOR and are willing to network on your behalf, this will make a big difference.
3. Do an away rotation in PM&R with a sports medicine focus since your home program doesn't have one. Makes sense from either perspective.
4. Do an away ortho rotation and a lower-tier ortho program near your medical school where someone at your school knows someone there. Choose this program carefully.
   
5. Apply to both specialties.
   1. Apply to EVERY ortho program except
   2. Those where they also have a PM&R program you'd like to apply to
   3. Attend every interview you are offered
      
   4. Rank every ortho program and any PM&R program you would be willing to attend

Your "top 10 US medical school" will really help you in your quest to be one of the '42/69' seniors who match. Use all of the resources your school can throw at the problem. Sometimes 'who you know' matters and this is one of those times. Use it.

Thank you for your feedback. The paper I'm first author also has the chair of my department on as well. I can ask him to see who he knows as other programs.

 

[mrphysique]

I'm going to be the voice of dissent and tell you not to waste your time and money applying ortho. Step 1 average is just under 250 and a top school name helps a lot but not 30 points on step 1.

Those 42 people who matched likely had an ace up their sleeve, such as heavy research, PhD, a home department that loved them, a family member at a program, or something else that made them stand out.

Don't forget that these #s don't include all the people who applied and didn't gt a single interview. I can't imagine why any program would interview anyone with super low step scores when they have hoards of 250+/Research/AOA applicants to fill those spots.

TL;DR: Don't apply ortho unless you have some super compelling reason that will get you interviews.

Okay. So my question would be, does my research not count? And does my Step 2 not count as well? If I'm just throwing away money applying I don't care since i'd be willing to pay that. On the flip side, do you think there are other competitive specialties that would consider me? If I don't get ortho I won't be too bummed. I didn't post on here because I thought I was competitive or anything. I just wanted to get opinions and I appreciate that you gave an explanation to yours.

 

[mrphysique]

It is my understanding that in IM, your top 10 school will be worth its weight in gold. While may be a long shot, you can EASILY match a university program for IM, so it's not unreasonable that with a bit of research and hard work you could match something like cardiology, which is very procedure heavy

But on the flip side if I don't match a top IM program I'm screwed for cardiology fellowship? I guess I would be unhappy if I was just an IM doc.

 

[mrphysique]

If I can't do ortho, are there any other surgical specialties you guys think I would have a shot matching at? Seems like Ortho is def on the higher end of competitive but I guess so are the other ones?

 

[W19]

If I can't do ortho, are there any other surgical specialties you guys think I would have a shot matching at? Seems like Ortho is def on the higher end of competitive but I guess so are the other ones?

You should be competitive for general surgery... I still think that you will have a decent shot at ortho though..

 

[mrphysique]

You should be competitive for general surgery... I still think that you will have a decent shot at ortho though..

I think I'll speak with some of the department people and see what they say. I have worked with them since I was an MS1 and most of them know me....just not my step 1 score LOL.

 

[ERDOC555]

Okay. So my question would be, does my research not count? And does my Step 2 not count as well? If I'm just throwing away money applying I don't care since i'd be willing to pay that. On the flip side, do you think there are other competitive specialties that would consider me? If I don't get ortho I won't be too bummed. I didn't post on here because I thought I was competitive or anything. I just wanted to get opinions and I appreciate that you gave an explanation to yours.

If you want to roll the dice with ortho AND a back-up (general or PM&R) and don't care about money, then go for it. It can't hurt.

Just don't be rash enough to apply ortho only.

As for research I don't know what you have but you should have well above the average matched applicant to be considered research heavy.

As for step 2, (not to be rude, but) you didn't actually do that great (what is a 250 like 70th percentile? I'm guessing here). You did 10 points above average, and even if you had destroyed step 2, idk if specialties like ortho/derm/plastics actually care that much. A 240 on step 1 followed by a 270 on step 2 would certainly help, but 220 to 250 isn't a super confidence booster.

I think the main issue is getting past the screen, and even then you'd have to have a compelling reason for them to interview you instead of the 300 people with 250/AOA/research that they need to cut down to 50 interviews.

If you do apply both, please come back here on match day and let us know how it worked out and how many interviews you get for ortho! I'm genuinely curious to find out! Best of luck 🙂

 

[W19]

I think I'll speak with some of the department people and see what they say. I have worked with them since I was an MS1 and most of them know me....just not my step 1 score LOL.

Top 10 count for something. Trust me on that. N=1 I know someone from Duke (probably top 20) who was in similar situation and was able to match into a competitive specialty . She was actually surprise at the # of invites she got... Step1 227 and step2 was in the mid 240s (don't remember the exact score).

 

[AcademicNeurosurgery]

1. I like procedures and clinic. I like improving the quality of life for patients. I'm not super crazy about life and death situations (I know ortho has trauma but I would have probably gone the sports med or hand route). I like making people feel better. I know it's vague but I don't care for the EM type doctors (saving lives acutely) I'm not an adrenaline junky. I know surgery tends to have that but for ortho I have found that it's the right balance for me. I'm open minded and I'm not Ortho or bust. I don't feel super confident that I would match ortho so I'm looking for other ways I can do something I love. I'm willing to take some risks but I don't want to not match at all.

2. I don't want to be flammed or hated for this but I have lots of loans. I know salaries go up and down and I never liked ortho for the money (i've always been interested in the matter) but I just don't see myself going into a specialty where I'm making peanuts and I can't afford to ever pay off my loans.

So I guess my big question is. Unfortunately my step 1 score sucks. I felt like I didn't have enough dedicated time (3 weeks) and I wasn't allowed to push it back that late...what's done is done. My step 2 score I was more prepared and did better but It seems like step 1 matters more. When I look at the charting outcome I'm below average for like every specialty except maybe some of the primary care ones. Can I cross off all the surgical sub-specialties? Or can I apply to ortho and PM&R? Can someone explain to me how that works? Like if I somehow got invited to some ortho invites could I rank my list like

ortho 1?
ortho 2?
PM&R 1
PM&R 2
etc?

This is all so confusing for me.

Like you said, what's done is done with regards to Step 1. Time to focus on the rest of your app. With regards to loans - in most cases, you will be able to pay off loans on an attending's salary with some basic financial knowledge and self-control. I don't know too much about applying to multiple specialties so I will let others weigh in.

I think I'll speak with some of the department people and see what they say. I have worked with them since I was an MS1 and most of them know me....just not my step 1 score LOL.

This changes things quite a bit, especially if they think positively of you. I would suggest not being as flexible as you've been on this thread when you speak to them. Tell them you unequivocally see yourself doing ortho and want to know what your chances are and how you can maximize your application. Tell them to be honest with you and not hold back. If they support you, my personal suggestion is to go all in on ortho and make sure your home department is willing to make calls for you. Your home department is your key to an ortho residency at this point. If they don't seem like they'll go to bat for you, then you can re-evaluate.

 

[mrphysique]

If you want to roll the dice with ortho AND a back-up (general or PM&R) and don't care about money, then go for it. It can't hurt.

Just don't be rash enough to apply ortho only.

As for research I don't know what you have but you should have well above the average matched applicant to be considered research heavy.

As for step 2, (not to be rude, but) you didn't actually do that great (what is a 250 like 70th percentile? I'm guessing here). You did 10 points above average, and even if you had destroyed step 2, idk if specialties like ortho/derm/plastics actually care that much. A 240 on step 1 followed by a 270 on step 2 would certainly help, but 220 to 250 isn't a super confidence booster.

I think the main issue is getting past the screen, and even then you'd have to have a compelling reason for them to interview you instead of the 300 people with 250/AOA/research that they need to cut down to 50 interviews.

If you do apply both, please come back here on match day and let us know how it worked out and how many interviews you get for ortho! I'm genuinely curious to find out!

If you read my post I said I WOULD NOT apply to just ortho. I literally made that very very clear early on. Okay and before you flame me for my step 2 score, the average step 2 for ortho is 253. I feel like maybe you are misreading my post...I'm not writing here, hey, I have low stats and am only applying Ortho. Like I said I'm gonna apply to 2 specialties. Anyhow, I will post back later. May not even apply ortho at all. I want to match and I'm not delusional thinking any program will give me an interview. I think I've heard you need like 10 interviews to match.

Anyhow, I think you are right about the screen so that might be the biggest issue and maybe I get zero interviews.

 

[AcademicNeurosurgery]

If you want to roll the dice with ortho AND a back-up (general or PM&R) and don't care about money, then go for it. It can't hurt.

Just don't be rash enough to apply ortho only.

As for research I don't know what you have but you should have well above the average matched applicant to be considered research heavy.

As for step 2, (not to be rude, but) you didn't actually do that great (what is a 250 like 70th percentile? I'm guessing here). You did 10 points above average, and even if you had destroyed step 2, idk if specialties like ortho/derm/plastics actually care that much. A 240 on step 1 followed by a 270 on step 2 would certainly help, but 220 to 250 isn't a super confidence booster.

I think the main issue is getting past the screen, and even then you'd have to have a compelling reason for them to interview you instead of the 300 people with 250/AOA/research that they need to cut down to 50 interviews.

If you do apply both, please come back here on match day and let us know how it worked out and how many interviews you get for ortho! I'm genuinely curious to find out! Best of luck 🙂

240 on Step 1 followed by a 270 on Step 2 "would certainly help"? Is that a joke?

 

[mrphysique]

Like you said, what's done is done with regards to Step 1. Time to focus on the rest of your app. With regards to loans - in most cases, you will be able to pay off loans on an attending's salary with some basic financial knowledge and self-control. I don't know too much about applying to multiple specialties so I will let others weigh in.



This changes things quite a bit, especially if they think positively of you. I would suggest not being as flexible as you've been on this thread when you speak to them. Tell them you unequivocally see yourself doing ortho and want to know what your chances are and how you can maximize your application. Tell them to be honest with you and not hold back. If they support you, my personal suggestion is to go all in on ortho and make sure your home department is willing to make calls for you. Your home department is your key to an ortho residency at this point. If they don't seem like they'll go to bat for you, then you can re-evaluate.

They do think highly of me and I think I'm generally well liked. I did a rotation with them and got honors and I'll get LOR and all...they just don't know my step score. It's like they think I'm intelligent, blah blah blah, but maybe If they knew my step 1 score they would think differently of me. I know my school took someone with a step score similar to mine several years ago but he was a research intern or something like that and he took a year off as well. Idk how I would score something like that unless I met and spoke to some people about my application.

 

[AcademicNeurosurgery]

They do think highly of me and I think I'm generally well liked. I did a rotation with them and got honors and I'll get LOR and all...they just don't know my step score. It's like they think I'm intelligent, blah blah blah, but maybe If they knew my step 1 score they would think differently of me. I know my school took someone with a step score similar to mine several years ago but he was a research intern or something like that and he took a year off as well. Idk how I would score something like that unless I met and spoke to some people about my application.

If you want it, do what you need to do. Only way to find out is to tell them everything about your app and see what they say.

 

[ERDOC555]

If you read my post I said I WOULD NOT apply to just ortho. I literally made that very very clear early on. Okay and before you flame me for my step 2 score, the average step 2 for ortho is 253. I feel like maybe you are misreading my post...I'm not writing here, hey, I have low stats and am only applying Ortho. Like I said I'm gonna apply to 2 specialties. Anyhow, I will post back later. May not even apply ortho at all. I want to match and I'm not delusional thinking any program will give me an interview. I think I've heard you need like 10 interviews to match.

Anyhow, I think you are right about the screen so that might be the biggest issue and maybe I get zero interviews.

Totally agree with you and your mindset going in! I was just concerned at all the people who hyped you up for ortho, in case they changed your mind. I think you have a solid plan, and if you really like ortho it's definitely worth a little extra money to try for that as well.

Edit: also if your home department loves you, nothing else really matters. I've known several people with low step scores that knew the department from day 1. They only got 1 interview, but they matched.

 

[DrfluffyMD]

The OP is absolutely set for whatever he likes to do between top 10 school and his step score.

Take my word, a top 10 residency rather take another person from a top 10 school with 220 than a random state school grad with 250 and no research (the top 10 grad is a known quantity).

 

[Lexicon0]

The OP is absolutely set for whatever he likes to do between top 10 school and his step score.

Take my word, a top 10 residency rather take another person from a top 10 school with 220 than a random state school grad with 250 and no research (the top 10 grad is a known quantity).

I would be wary of going into the application process with this mindset. I can point to just as many students that go unmatched at my school (t10) with better scores into competitive residencies as those who match with subpar scores. It's also important to bear in mind that match lists are of limited value as most schools won't publish how many students go unmatched.

 

[mrphysique]

I would be wary of going into the application process with this mindset. I can point to just as many students that go unmatched at my school (t10) with better scores into competitive residencies as those who match with subpar scores. It's also important to bear in mind that match lists are of limited value as most schools won't publish how many students go unmatched.

Yikes! I never claimed for that to be my mindset. I really appreciate everyone's responses. I'm really level headed about this whole process. I'm applying with a backup if I do in fact decide to apply ortho so no worries 🙂

 

[Lexicon0]

Yikes! I never claimed for that to be my mindset. I really appreciate everyone's responses. I'm really level headed about this whole process. I'm applying with a backup if I do in fact decide to apply ortho so no worries 🙂

Never meant to imply that you did. That post was more of a general statement/directed at the poster I quoted. You've got some sound advice already, but I'd also consider scheduling a meeting with your home PD (since you seem pretty tight with the department) and go over your application for a realistic assessment of your chances.

 

[akwho]

The only people I know who matched ortho with your step 1 score did a year of research, were well published, and loved in the ortho department. Then they came in and crushed their home sub-i. Even then, they only would get 4-5 interviews due to being auto-screened out by step 1, they would be sweating bullets the whole application cycle, and would usually only match their home program/research year program if they matched at all.

You seem like you would be happy in a lot of different specialities and aren't necessarily gung-ho ortho. You would need to be gung-ho ortho to wade through the pile of bullcrap your bad step 1 score is going to make you go through. If I were you and just wanted a procedure based specialty that made a lot of money which appears to be important to you, I would do internal medicine at the best program I could get and gun for cards or GI. You will make just as much as ortho in those two fields and your step 1 score won't hold you back.

 

[mrphysique]

Thank you for everyone's comments. I think to clarify things. Had I had a 250 step 1, I would def applied ortho. It's my top choice for sure but since I don't have that I have been trying to be realistic with other stuff I like too, PM&R, other procedural things. I had my eyes on ortho that I kinda put blinders on everything else. Other stuff I liked as elective, ENT, and OB-GYN, but ENT is I think, even more competitive than ortho and I won't do OB because as much as I liked my rotation, I'm male and I felt awkward being turned away so many times as a medical student. I actually really liked some of the Uro-Gyn surgeries but the other stuff I wasn't too crazy about.

 

[RangerBob]

Two big things to keep in mind if you apply to ortho & PM&R:

1) You will need to apply to pre-lim programs for PM&R (pre-lim surgery, medicine, or TY's are most common). I thought doing PM&R interviews + pre-lim interviews was a lot, but adding ortho adds even more. I guess it's all relative though--I did a total of about 20 interviews (12 PM&R, 8 pre-lim) and I've heard of people doing much more than 20 for a single specialty...

2) If you are applying to PM&R as a back-up, you absolutely cannot let that be known. In the past (up to the 80's, 90's) PM&R was most ortho applicant's backup. As PM&R has gotten much more competitive we don't see that anymore--everyone applying to PM&R is extremely interested and dedicated to the field. Our board scores are still quite low, so you're in good shape there, but you'll need to do a PM&R rotation (ideally get some inpatient exposure too--if you just do sports programs will wonder how much about PM&R you really know). And just keep the ortho stuff quiet.

DockterMom gave some really good advice, so read that over if you haven't already. I agree it would be best to not apply to ortho and PM&R programs at the same institution.

I would add that if you really did enjoy OB, the way male OB-Gyn residents/attendings get treated is very different than male medical students. Most women with male OB's really love them. Almost all my co-residents/co-residents SO's chose the same male OB to deliver their babies.

 

[failedatlife]

Dude, stop asking some random M1 and M2s on this website what their opinions are. They have no f*ing clue. Not saying I do either... You're essentially in a really similar boat that I am (I am applying ENT). YES, research helps big time (especially when you are in the top 10% of applicants to the academic powerhouses). YES, school name helps. YES, letters play a very important role. BUT, YES that stupid f*ing test matters (a lot) to some people. I've had mixed opinions from advisors, and this is because different people (and hence different programs) have different ways of looking at it. Some get boners over high scores and ED from low scores, others don't give a s*** compared to the other components. It's a mixed bag no matter how you look at it. The only way to know about screens is to physically call and ask.

I'm just going to go with it, do the max number of aways and try my best. I might apply to a backup specialty, I might not. There just isn't enough time to dual apply for some specialties. I've been an underdog based on scores before for med school and that ended up working out as best as I could have expected. Here's to hoping the same happens.

 

[ActinicKeratosis]

failedatlife...why don't you study like crazy for step 2ck, rock a stellar score, and then just show all of your dream ENT residencies that the first time was a fluke?

 

[AcademicNeurosurgery]

Dude, stop asking some random M1 and M2s on this website what their opinions are. They have no f*ing clue. Not saying I do either... You're essentially in a really similar boat that I am (I am applying ENT). YES, research helps big time (especially when you are in the top 10% of applicants to the academic powerhouses). YES, school name helps. YES, letters play a very important role. BUT, YES that stupid f*ing test matters (a lot) to some people. I've had mixed opinions from advisors, and this is because different people (and hence different programs) have different ways of looking at it. Some get boners over high scores and ED from low scores, others don't give a s*** compared to the other components. It's a mixed bag no matter how you look at it. The only way to know about screens is to physically call and ask.

I'm just going to go with it, do the max number of aways and try my best. I might apply to a backup specialty, I might not. There just isn't enough time to dual apply for some specialties. I've been an underdog based on scores before for med school and that ended up working out as best as I could have expected. Here's to hoping the same happens.

I really have been rooting for your success and will continue to do so. That said, you have to stop hijacking every thread on this topic with your personal story, especially when your comment contributes little to the discussion other than a summary of your personal story.

 

[failedatlife]

failedatlife...why don't you study like crazy for step 2ck, rock a stellar score, and then just show all of your dream ENT residencies that the first time was a fluke?

Yes, I've been doing that. I'm not the greatest test taker in the world so it's harder than you can imagine.

 

[MSTP18]

The scores are probably skewed towards 230, but the range still gives you a good idea of outcomes.

I have no idea how common it is to take a year to do research for ortho (I'm an ms4 heading into a general surgery residency). I have two close friends in my class interested in ortho (I'm not as close with the other students). One matched (pretty much the smartest guy in my class with high scores) and the other took a gap year to do research and is applying next year.



Yes, it is realistic to apply to both. Many (if not most) people applying to competitive residencies apply to backup specialties. When making a rank list you rank programs in the order you would want to match. So if you interview at 10 ortho programs and 10 pm&r programs, you would rank the 10 ortho programs first and then the 10 pm&r programs.

Have a good friend/former classmate who took a year off and then matched ortho. Don't know for certain the frequency but I don't think it's uncommon.

 

[mrphysique]

Dude, stop asking some random M1 and M2s on this website what their opinions are. They have no f*ing clue. Not saying I do either... You're essentially in a really similar boat that I am (I am applying ENT). YES, research helps big time (especially when you are in the top 10% of applicants to the academic powerhouses). YES, school name helps. YES, letters play a very important role. BUT, YES that stupid f*ing test matters (a lot) to some people. I've had mixed opinions from advisors, and this is because different people (and hence different programs) have different ways of looking at it. Some get boners over high scores and ED from low scores, others don't give a s*** compared to the other components. It's a mixed bag no matter how you look at it. The only way to know about screens is to physically call and ask.

I'm just going to go with it, do the max number of aways and try my best. I might apply to a backup specialty, I might not. There just isn't enough time to dual apply for some specialties. I've been an underdog based on scores before for med school and that ended up working out as best as I could have expected. Here's to hoping the same happens.

Ya you are right. Good luck to you too man! It's a shame one test can make such a difference. I've got AOA going for me, good grades, a better Step 2 CK, great LOR, and solid research but one exam makes me feel like crap. Anyhow, I've only heard really positive things from people in the department at my school. They have told me to apply and that despite what the charting outcomes show, my odds are still good. I'll have some people make some phone calls for me tg. Anyhow, I guess I was just looking to see if others were in my boat and found success.

Edit: I also talked to people in general surgery and apparently I have a great shot at matching into a top Gen surg program despite step 1. I guess going to a top school has a few perks....I don't think I'm going to go this route but it's good to know I have some options

 

[AcademicNeurosurgery]

Ya you are right. Good luck to you too man! It's a shame one test can make such a difference. I've got AOA going for me, good grades, a better Step 2 CK, great LOR, and solid research but one exam makes me feel like crap. Anyhow, I've only heard really positive things from people in the department at my school. They have told me to apply and that despite what the charting outcomes show, my odds are still good. I'll have some people make some phone calls for me tg. Anyhow, I guess I was just looking to see if others were in my boat and found success.

Edit: I also talked to people in general surgery and apparently I have a great shot at matching into a top Gen surg program despite step 1. I guess going to a top school has a few perks....I don't think I'm going to go this route but it's good to know I have some options

Good luck! And please remember to come back and keep us updated.

 

[augeremt]

I'll have some people make some phone calls for me tg.

What's the best way to have people make calls for you?

I'm in a similar boat and was told the same thing as you, but I'm not good at calling in favors or asking people to go to bat for me. Do I ask them to help with getting interviews? Or after interviews but before rank lists? Do I email or meet in person for such requests? Should I be subtle or flat-out say I need help? Or do I hope they offer on their own accord and not bring it up myself?

How does one navigate this delicate dance?

 

[mrphysique]

Good luck! And please remember to come back and keep us updated.

Will do!

 

[mrphysique]

What's the best way to have people make calls for you?

I'm in a similar boat and was told the same thing as you, but I'm not good at calling in favors or asking people to go to bat for me. Do I ask them to help with getting interviews? Or after interviews but before rank lists? Do I email or meet in person for such requests? Should I be subtle or flat-out say I need help? Or do I hope they offer on their own accord and not bring it up myself?

How does one navigate this delicate dance?

Honestly. I should probably give some background. Despite me having a low step 1 score, I have many other things that I did throughout my medical school career. I TAd during the first two years, was very active in the Ortho/Gen surg department, I honored all rotations but two, I was involved in curriculum stuff, and I guess I left a good impression on some people during these past years. I simply emailed the chair and said hey, I'm having trouble deciding how to put my application together, would you be willing to give me a few minutes of your time? I met with them, and I gave them my CV. After 2minutes of looking it over, my chair said that if I wanted a spot at my home program they would love to have me but that they will also call up some of their friends at other programs to put in a word for me. I guess 221 doesn't get screened out at too many places but for the few that do, some phone calls will be made. I did not ask for anyone to make phone calls for me. They offered. I'm not trying to gloat or anything like that but despite my step 1 score being low, I crushed all my shelf exams and I think I was/am generally liked and I feel like that made a difference. My chair also said my step 2 score will definitely help because the improvement shows I can learn from my mistakes and improve.

tlr --> I think you can ask if you want, but I think if you go to your chair if they know you they will offer.

 

[augeremt]

Honestly. I should probably give some background. Despite me having a low step 1 score, I have many other things that I did throughout my medical school career. I TAd during the first two years, was very active in the Ortho/Gen surg department, I honored all rotations but two, I was involved in curriculum stuff, and I guess I left a good impression on some people during these past years. I simply emailed the chair and said hey, I'm having trouble deciding how to put my application together, would you be willing to give me a few minutes of your time? I met with them, and I gave them my CV. After 2minutes of looking it over, my chair said that if I wanted a spot at my home program they would love to have me but that they will also call up some of their friends at other programs to put in a word for me. I guess 221 doesn't get screened out at too many places but for the few that do, some phone calls will be made. I did not ask for anyone to make phone calls for me. They offered. I'm not trying to gloat or anything like that but despite my step 1 score being low, I crushed all my shelf exams and I think I was/am generally liked and I feel like that made a difference. My chair also said my step 2 score will definitely help because the improvement shows I can learn from my mistakes and improve.

tlr --> I think you can ask if you want, but I think if you go to your chair if they know you they will offer.

Awesome. Thanks for the background. Your story sounds very similar to mine even with this addition, with the exception of an outright offer to call on my behalf. A few attendings have implied but haven't quite said those magical words. I'll keep working on them 🙂