Which one to take first? CK or CS?

[MairaO]

Hi! I was planning to take step 2 early next year and was wondering which one to take first? Or does it even make a difference? any advice will be really appreciated. thanks!

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[14022]

For each person it varies. I took them both early for these reasons. I did well third year and figured I would do well on step 2 as well. I wanted to take at as close to third year as possible so I studied for 2.5 weeks after third year and took step 2 ck. I took step 2 cs one week after because of lot of knowledge needed for step 2 cs (ie, differential dx for certain complaints) was learned for step 2 cs. Also, I am going into peds and will not be seeing adults at all during fourth year so I wanted to take step 2 cs as close to third year as possible while I still was comfortable doing an exam on an adult.

It probably doesnt matter which you take first. I liked taking cs second because studying for step 2 cs was much easier after spending 2 weeks doing intense studying for ck.

People that do really well on step 1 and want to go into derm, ortho, rads, etc often push step 2 ck back until after interviews so they do not risk getting a bad score that could hurt their chances of matching. I think this is pretty stupid because I have been told that once you start interviews, you lose all academic motivation and it is pretty hard to sit for 2 weeks and study for step 2 ck in January.

So you have to decide what is right for you. Good luck.

 

[MairaO]

For each person it varies. I took them both early for these reasons. I did well third year and figured I would do well on step 2 as well. I wanted to take at as close to third year as possible so I studied for 2.5 weeks after third year and took step 2 ck. I took step 2 cs one week after because of lot of knowledge needed for step 2 cs (ie, differential dx for certain complaints) was learned for step 2 cs. Also, I am going into peds and will not be seeing adults at all during fourth year so I wanted to take step 2 cs as close to third year as possible while I still was comfortable doing an exam on an adult.

It probably doesnt matter which you take first. I liked taking cs second because studying for step 2 cs was much easier after spending 2 weeks doing intense studying for ck.

People that do really well on step 1 and want to go into derm, ortho, rads, etc often push step 2 ck back until after interviews so they do not risk getting a bad score that could hurt their chances of matching. I think this is pretty stupid because I have been told that once you start interviews, you lose all academic motivation and it is pretty hard to sit for 2 weeks and study for step 2 ck in January.

So you have to decide what is right for you. Good luck.

thanks scholes...i guess i'll take ck first then...

 

[bigfrank]

However, our dean told us that some schools in some specialties will NOT rank individuals who have not taken & passed Step II CS in time for rank-order lists to be submitted. Something to consider.

 

[p53]

People that do really well on step 1 and want to go into derm, ortho, rads, etc often push step 2 ck back until after interviews so they do not risk getting a bad score that could hurt their chances of matching. I think this is pretty stupid because I have been told that once you start interviews, you lose all academic motivation and it is pretty hard to sit for 2 weeks and study for step 2 ck in January.

So you have to decide what is right for you. Good luck.

What a stupid response. Motivation is beside the point. The point is to not fight a battle that DOESN'T have to be fought.

Think about it... A person that did well on Step 1 will PASS Step 2. Passing Step 2 is all that is needed.

Does it really matter if one scores a 200 Step 2 if they have already matched in Dermatology?

 

[14022]

What a stupid response. Motivation is beside the point. The point is to not fight a battle that DOESN'T have to be fought.

Think about it... A person that did well on Step 1 will PASS Step 2. Passing Step 2 is all that is needed.

Does it really matter if one scores a 200 Step 2 if they have already matched in Dermatology?

Stupid resonse? Ha.

Step 2 may matter (depending on the program) if you plan on doing a fellowship, such as Mohs. Some programs will look at step scores while others will only look at only your performance in residency. Personally, if I were a program director and I saw a 200 step 2 score after a 240 step 1 score, I would seriously question that person's integrity and how their effort is so reward dependent. But I am not a residency director, so I have no idea how this would hold up.

Why don't you wait a few months before giving advice. You have no idea how you are going to feel a year from now. Usually, it is best for those who have experience in something to give advice regarding the matter.

And by the way p53, you did not score that well on step 1. There are plenty of people who scored much better on step 1 that had a really hard time third year and struggled to beat the mean on many of their shelves. Clinical knowledge is much different than memorizing a First Aid book and regurgitating that crap. Regardless of your step 1 score, poor clinical performance can hurt your chances in fields like Derm, ENT, urology, etc. Taking and doing well on step 2 early may be a saving grace for these people.

 

[daisygirl]

However, our dean told us that some schools in some specialties will NOT rank individuals who have not taken & passed Step II CS in time for rank-order lists to be submitted. Something to consider.

Sorry for the diversion.....

We were told the same thing. I'm a bit confused though- why would this happen considering that med students often take step II CK well after rank lists are finalized? I'm sure this is highly dependent on specialities (which was already pointed out in the messages that students are receiving from their dean's).

The fact that programs would defer ranking someone until they've received a P from the NBME seems so silly.

 

[14022]

Sorry for the diversion.....

We were told the same thing. I'm a bit confused though- why would this happen considering that med students often take step II CK well after rank lists are finalized? I'm sure this is highly dependent on specialities (which was already pointed out in the messages that students are receiving from their dean's).

The fact that programs would defer ranking someone until they've received a P from the NBME seems so silly.

What I think may have happened, but I do not know for sure, is that too many people waited until the spring to take or schedule the exam and were not able to get their scores back in time for the start of their residency. Or people failed, and could not reschedule their exam until after residency started. Since you cannot start residency until you pass both step 2 exams, programs were short residents for the first month or two. This may be why programs are pushing for applicants to take step 2 cs exam prior to rank list time. It is much easier to schedule step 2 ck on short term notice and scores come back more quickly.

 

[p53]

And by the way p53, you did not score that well on step 1. There are plenty of people who scored much better on step 1 that had a really hard time third year and struggled to beat the mean on many of their shelves. Clinical knowledge is much different than memorizing a First Aid book and regurgitating that crap. Regardless of your step 1 score, poor clinical performance can hurt your chances in fields like Derm, ENT, urology, etc. Taking and doing well on step 2 early may be a saving grace for these people.

Shooting from the hip, hey costanza. Actions speak louder than words, georgey. You took Step 2 before ERAS.

Hmmmmm.....I wonder why?

I guess it is time to consider your boldened statement above.

There is nothing to be ashamed of costanza. I'm sure you will be one of the finest PEDIATRICIANS in your world. Don't let your poor clinical performance keep you down.

 

[Pox in a box]

Stupid resonse? Ha.

Step 2 may matter (depending on the program) if you plan on doing a fellowship, such as Mohs. Some programs will look at step scores while others will only look at only your performance in residency. Personally, if I were a program director and I saw a 200 step 2 score after a 240 step 1 score, I would seriously question that person's integrity and how their effort is so reward dependent. But I am not a residency director, so I have no idea how this would hold up.

Why don't you wait a few months before giving advice. You have no idea how you are going to feel a year from now. Usually, it is best for those who have experience in something to give advice regarding the matter.

And by the way p53, you did not score that well on step 1. There are plenty of people who scored much better on step 1 that had a really hard time third year and struggled to beat the mean on many of their shelves. Clinical knowledge is much different than memorizing a First Aid book and regurgitating that crap. Regardless of your step 1 score, poor clinical performance can hurt your chances in fields like Derm, ENT, urology, etc. Taking and doing well on step 2 early may be a saving grace for these people.

Why are you being so defensive? What is the advantage of being lazy and delaying if you're trying to make your application look solid by rocking both Steps? Do you know p53 by the way? You seem to act like you know about his or her score that hasn't been announced. Seems like you have more interest in arguing than in actually looking at the facts presented in the argument.

 

[Aubrey]

All aspersions on people's motivations and personalities aside, there is a certain amount of strategy in applying for residencies, and potentially postponing your step 2 until post-ranking is just one component of that. For the vast majority of people, I truly doubt it makes much difference. For uber-competitive specialties like Derm, where even a microscopic bit of difference between applicants is the make or break, it can be a legitimate, honorable way to maximize your chances.

That being said, back to the original topic.. Step 2 CS is really a joke, more exhausting physically than anything else, involving considerable travel for lots of people.. I would do it after CK for that reason alone. You do not need any additional preparation for CS after you are ready for CK. Just my $0.02.

 

[omores]

However, our dean told us that some schools in some specialties will NOT rank individuals who have not taken & passed Step II CS in time for rank-order lists to be submitted. Something to consider.

For what it's worth:

Evidently the NBME folks e-mailed medical school advisory deans to pass this on to their students. My advisory dean, who is of a highly skeptical disposition, thought that this sounded implausible. She actually e-mailed program directors from a whole bunch of residency programs to ask them whether they would not rank or otherwise "look down upon" folks who hadn't yet taken CS. The answer was a unanimous "no." I aslo e-mailed program directors of the programs to which I'm applying; they all me the same thing.

My advisory dean also reported that CS has an unanticipatedly high failure rate, and that some excellent students at our school have failed it without explanation. She advised us that it might be in our best interest not to take it too early.

 

[14022]

My advisory dean also reported that CS has an unanticipatedly high failure rate, and that some excellent students at our school have failed it without explanation. She advised us that it might be in our best interest not to take it too early.

I don't know if I agree with this advice. I have come across several programs that have said you cannot be a resident if you fail step 2 cs on the first attempt. If they truly stick with this rule, it would mean that you could match at a program and fail step 2 cs after the match and be out of a residency. If I were to fail, I would want to fail prior to the match or even interviews so that I wouldnt match into a place that would eventually withdraw my position. So I guess it all depends on if a program would truely withdraw your contract if you failed after the match. Also, if you did fail later in the year, you cannot start residency without passing. This may delay your residency start position by a few months which would mean no income during that time and extending your residency by a few months which may delay your ability to apply for fellowship since you would not be on the same time frame with finishing your residency as the other fellowship applicants. Just my thoughts on the matter.

 

[omores]

I don't know if I agree with this advice. I have come across several programs that have said you cannot be a resident if you fail step 2 cs on the first attempt.

Well that's interesting. Have you actually contacted programs and confirmed that they're talking about CS?

I know that some programs specify things like "taken Step 1 and 2 with no failures," but then when you ask them about CS, they backpedal. In fact, most of the PDs I've contacted seem to have a very flexible attitude about Step 2 (far more so than their websites would suggest.) From what I understand, none of the people who failed CS at my school ended up being de-matched.

But if you've heard differently, please divulge! Perhaps it's field-dependent.

 

[14022]

From the U of Chicago pediatrics residency website....

USMLE STEP I AND STEP II EXAMS MUST BE PASSED ON THE FIRST ATTEMPT. Due to recent alterations in the USMLE step II CS process, we no longer require its completion at time of application. However, we still require that step II CS is passed on the first attempt prior to admission to our program.

I have not contacted this program to verify this, but this statement seems fairly explicit to me.

It would be horrible if you ranked this program #1 and matched, but failed step 2 in April, and not being able to matriculate into the program. You could have ranked other programs-- ones that do not have this policy-- higher on the list and matched without a problem.

Personally, I think the policy sucks since there have been so many cases of strong students failing this exam. The grading process is fairly subjective; it seems that the assessment of each student is primarily from trained standardized patients without any medical background. Also, the test does not really do a good job detecting the so-called "high risk" doctors, since most of these people are sensible enough to fake kindness for the afternoon.

 

[omores]

From the U of Chicago pediatrics residency website....

USMLE STEP I AND STEP II EXAMS MUST BE PASSED ON THE FIRST ATTEMPT. Due to recent alterations in the USMLE step II CS process, we no longer require its completion at time of application. However, we still require that step II CS is passed on the first attempt prior to admission to our program.

I have not contacted this program to verify this, but this statement seems fairly explicit to me.

Yep, it does. If I were interested in that program, I'd probably write them to ask about what they'd do if someone matched to their program but ended up failing CS (and hope my inquiry didn't make it sound as if I was expecting to fail!)

In my (admitedly limited) experience, most programs' CS policies are works in progress (in fact, one classmate e-mailed a program that didn't seem to be aware of the two separate components of Step 2.) I'd hope that U of Chicago would work with an applicant in that unfortunate situation, rather than throwing them overboard. And I'd hope to be able to get a sense of that beforehand -- if a program really were that inflexible about something as unreliable as CS, I don't think I'd be happy there.

Any other programs you ran into that mentioned that explicitly?

 

[14022]

Yep, it does. If I were interested in that program, I'd probably write them to ask about what they'd do if someone matched to their program but ended up failing CS (and hope my inquiry didn't make it sound as if I was expecting to fail!)

Any other programs you ran into that mentioned that explicitly?

I saw maybe 2 or 3 others that mention it, but do not remember which ones off the top of my head. They were programs I did not have much of an interest in anyways. I took and passed step 2 cs already so I haven't been too diligent about finding this information.

 

[bigfrank]

Why are you being so defensive? What is the advantage of being lazy and delaying if you're trying to make your application look solid by rocking both Steps? Do you know p53 by the way? You seem to act like you know about his or her score that hasn't been announced. Seems like you have more interest in arguing than in actually looking at the facts presented in the argument.

Scholes, don't let Pox's infantile comments get to you. He's made a nasty little habit the last few weeks (check his posts) of harrassing other SDN-ers who have done well. In other words, Pox has a green-eyed monster on his back. Your fabulous 269 falls into the JEALOUS category. "BF" out.