When do people typically take step 2/

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JP2740

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Step 2 CK that is. Halp

I'm thinking between ent or IM. My Step 1 was really high, but if I go into IM I heard they like seeing that Step 2 score, so is there an ideal eligibility period I can sign up for now while I decide which field that will be advantageous to ENT but also allow me to get the scores out in time to IM programs?

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Honestly, I say just take it while the clinical stuff is fresh. I did well on step 1 and well on step 2...all my friends who did well on step one (around 250 and up), did just as well on CK.

If you must wait, you want you eligibility in fall. You will have you IM invites, but scores back by Feb for ranking (if you need to release). If you don't do so hot, just don't release if you go ENT.

ENT is a small field. I can speak on behalf of Derm...also a small field. One to a few interview days. At some places, they were meeting to rank us before we walked out the door.
 
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Step 2 is typically taken right between the end of M3 year and december of M4 year.

If you scored high on step 1 then you probably don't need a step 2 to get IM interviews at most places.

Typically people who have a low step 2 take it immediately after M3 year (to help get interviews) but for your case the ball is in your court. You can take it really anytime you want. Just make you have a score by January....programs will want it before ranking you.
 
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You sure about that?

I didn't apply IM. But I know several classmates who have high step 1s and put off step 2 till october yet were able to get a ton of interviews at many many strong programs.

Maybe it could limit you at a few places....but if you scored a 260 on step 1 then there is an extremely high likeliness you will do well on step 2 also. Programs know this.
 
If you go to the IM forum, you will see comments by a program director that CK is viewed as more important than step 1 because it is more clinically oriented. Traditionally step 1 is seen as more important. But given that virtually everyone does very well on that exam these days, CK is becoming a more important discriminator at least for ranking (maybe step 1 is still used more as a screening metric). But as a fourth year in December now, I will tell you that I am very glad I have CK and CS out of the way back in the spring. You don't want to be trying to deal with CK and CS when clinical stuff is out of your head for 6 months and you are trying to interview. Get them done as early as possible. A high step 1 without a CK is kind of a red flag anyway. It looks like you are trying to hide something (your clinical knowledge) and not risk getting a lower score or having to put forth the effort to get a good score that would be required before the interview. It makes you look kind of lazy. Program directors aren't stupid, they know what you are doing if you intentionally push it back so it's not on your ERAS.

Maybe it could limit you at a few places....but if you scored a 260 on step 1 then there is an extremely high likeliness you will do well on step 2 also. Programs know this.

I would agree with this. It's not as important if you aced step 1 -- just may not look good but shouldn't prevent you from getting interviews. If your step 1 is below average or even just average (which is what, nearly 230 these days), it is crucial to have at least a passing score on CK and CS when you apply. You won't get interviews anywhere if there is concern that you might match and not graduate on time because you failed CK and/or CS.
 
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If you go to the IM forum, you will see comments by a program director that CK is viewed as more important than step 1 because it is more clinically oriented. Traditionally step 1 is seen as more important. But given that virtually everyone does very well on that exam these days, CK is becoming a more important discriminator at least for ranking (maybe step 1 is still used more as a screening metric). But as a fourth year in December now, I will tell you that I am very glad I have CK and CS out of the way back in the spring. You don't want to be trying to deal with CK and CS when clinical stuff is out of your head for 6 months and you are trying to interview. Get them done as early as possible. A high step 1 without a CK is kind of a red flag anyway. It looks like you are trying to hide something (your clinical knowledge) and not risk getting a lower score or having to put forth the effort to get a good score that would be required before the interview. It makes you look kind of lazy. Program directors aren't stupid, they know what you are doing if you intentionally push it back so it's not on your ERAS.



I would agree with this. It's not as important if you aced step 1 -- just may not look good but shouldn't prevent you from getting interviews. If your step 1 is below average or even just average (which is what, nearly 230 these days), it is crucial to have at least a passing score on CK and CS when you apply. You won't get interviews anywhere if there is concern that you might match and not graduate on time because you failed CK and/or CS.
Thanks, so basically since I did really well on Step 1, I can delay this and still get a chance at some very strong programs in IM?
 
Thanks, so basically since I did really well on Step 1, I can delay this and still get a chance at some very strong programs in IM?

Maybe. Check the websites for the programs you are interested in. Some programs may require a Step 2 CK score for interview invites. I know of a few programs in anesthesiology that had such a requirement. And I hear that a score is often required for a program to rank you. Again, check with the programs websites, or even call the program coordinator and ask. But I would suggest taking an ICU rotation early in your fourth year (preferably first thing), then spend the next month studying for Step 2 CK and taking it. That way you are fairly close (temporally) to your 3rd year material, and get some exposure to the ICU stuff that invariably pops up in the exam.
 
Personally, I wanted to get it over with as I knew I would be studying totally different material on my sub-is. I had also done well on prior standardized tests so I wasn't ultra stressed about it. Ended up taking it in June. I really recommend this if feasible: adds another piece to your application, gives you a break from rotations after third year, and best of all I don't have to deal with it while interviewing/vacationing.
 
Traditionally step 1 is seen as more important. But given that virtually everyone does very well on that exam these days, CK is becoming a more important discriminator at least for ranking (maybe step 1 is still used more as a screening metric).

wtf are you talking about? The average has gone up like 3 points in the last 5 years. Not that big of a deal. The 2012 NRMP program director's survey shows step 1 as the single most important criteria for granting IM interviews, and equal to step 2 in importance for ranking (both of which are less important than other factors).

OP: have you been pwning shelf exams? If so, just take step 2 after M3. You will prob do as well on step 2 as on shelves and will look baller with 260+, 260+ on your ERAS app.
 
JP, if you're doing well on shelf exams (80-85%+ consistently) just take the damn thing after 2-4 weeks of independent studying. Check out the Step 2 UWorld QBank to Step2 Score thread in the Step 2 forum. People that got 240-250+ routinely got 260+ on step 2. Obviously biased b/c SDN gonna SDN, but it's definitely doable.

There is an argument for not taking it early, but I think your application looks stronger as a 240+ step 1 and 250+ step 2 than just a 240+ step 1.

I can't speak from personal experience, as I took step 2 early to make up for a sub-par Step 1 (for my residency choice). I can understand delaying Step 2 CK until like Oct. ish but I definitely wouldn't push it back to the Spring. Almost all places will require a Step 2 CK to rank you, so if you barely pass Step 2 after interviewing at Brigham, it's going to hurt your rank position.
 
wtf are you talking about?

I am talking about a post in the IM forum by a program director that explicitly says step 2 is more important than step 1. I have heard this from other PDs as well. Obviously there will be variation as to what is important, with some only inviting people with step 1 240+ and others not caring about step scores at all. It makes sense that step 2, being a more clinically oriented and more recently taken exam, will be more important to many PDs. It's often not available at time of interview offer, therefore making step 1 more important for offering the interview. If it's available, it will play a big role in offering you an interview. I would recommend having it available. Obviously this opinion pisses everyone who has a 250+ step 1 off and doesn't want to study hard/gamble with step 2 before interview season. Don't shoot the messenger.
 
I am talking about a post in the IM forum by a program director that explicitly says step 2 is more important than step 1. I have heard this from other PDs as well. Obviously there will be variation as to what is important, with some only inviting people with step 1 240+ and others not caring about step scores at all. It makes sense that step 2, being a more clinically oriented and more recently taken exam, will be more important to many PDs. It's often not available at time of interview offer, therefore making step 1 more important for offering the interview. If it's available, it will play a big role in offering you an interview. I would recommend having it available. Obviously this opinion pisses everyone who has a 250+ step 1 off and doesn't want to study hard/gamble with step 2 before interview season. Don't shoot the messenger.

Not shooting the messenger or pissed, I have no dog in this fight. But what you said re: step 1 was just inaccurate.

The step 1 mean/median drifting up 3 points in the last 5 years does not equate to "virtually everyone doing well" on the exam, as you put it. I'm too lazy to look up the national average for step 2, but its markedly higher than step 1. If the average for Step 1 is drifting up, you can be pretty damn sure the average for step 2 is drifting up as well. "2 months for step 1, 2 weeks for Step 2, and number 2 pencil for Step 3." Sure, step 2 is more clinically oriented... but is also much easier to do well on.

I've heard ~5 program directors from different fields talk about the numbers game at my institution, and I've never heard anyone saying Step 2 is anywhere close to supplanting step 1 in importance, as you're suggesting. Step 2 is very nice to have (often even required) and shows consistency or improvement in the case of a lower Step 1, but the program director's themselves said in 2012 via the PD survey that Step 1 is more important.
 
Take it whenever it fits your schedule. I wanted to get my away rotation done early so that I would have my grade and letter from that rotation in my ERAS app. Granted I did well on step one, but in the end a lot of my friends ended up saying they wish they had pushed step 2 back a bit to get some key rotations out of the way.
 
This has been asked, and attempted to be answered, a hundred times.

The bottom line is that the "right" time to take it varies by specialty applying to, and by individual applying. There is likely no one best fit. That said, programs are facing increasing pressure from the GME offices at their institution to require Step II to rank. The days of taking it in late april of fourth year (as I did) are dwindling.

My usual advice to students is to take Step II CK early, but just late enough so that the score is not back when you upload your USMLE transcript to ERAS. That way, you take control over the score. Programs only find out about it if you want them to.

Step II CS is another beast. It's become increasingly difficult to schedule, there is a long lag time between taking it and getting the score back, and it is just a pass/fail test. So my advice on that is to take it as early as you can possibly schedule it. It's a box to be checked, and having the pass on your application will just make things easier come ranking time.
 
Applied for a competitive speciality, did well on step 1 and took step 2 ck in April... Got asked zero questions about this during interviews.
 
April as in the end of your MS3 year, or April as in 1 month after you matched?

April as in one month after I matched... If I could do it again I probably wouldn't have waited this late but still would have taken it well after transcripts and scores went out, probably like Dec or Jan. If you did well on Step 1 I don't see what the advantage to taking Step 2 early is unless a program specifically requires it... And like I said, out of 20+ interviews (TY, prelim, specialty) I never had this come up once.
 
April as in one month after I matched... If I could do it again I probably wouldn't have waited this late but still would have taken it well after transcripts and scores went out, probably like Dec or Jan. If you did well on Step 1 I don't see what the advantage to taking Step 2 early is unless a program specifically requires it... And like I said, out of 20+ interviews (TY, prelim, specialty) I never had this come up once.

Most residency programs I've heard of require a passing Step 2 CK in order to rank you at this time. Not sure how long ago you matched.

If your Step 1 is rock solid, you can push back Step 2. However, I would still recommend taking it around Sept./Oct. and only releasing the scores if you did well (as you are likely to if you rocked Step 1).
 
Word, that's a tough strategy to use now as many programs are requiring it to rank. Personally, I think I enjoyed my fall and winter a lot more having step 2 out of the way. If you're doing well on shelf exams throughout third year you should be fine.
 
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