Will getting a top Step score make it worse if you want to get in a rural peds residency?

[zaztong]

As title. Will residency programs take you less seriously and assume there was an error?

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[Staphylococcus Aureus]

Define rural peds residency. The programs I see are in 100k+ cities, other than Dartmouth, Maine, and Dakota, where else?

 

[AcademicNeurosurgery]

...no.

 

[673441]

I'd say maybe... I brought this put up on a different thread. 260+ step scores apply to IV programs or top rural programs if they want PC. The PD thinks of it like this, rank 1 = person we like who is most likely to rank us (the Kobe Bryant). If they see you with such a high step score, it means you have more options and unless you explicitly state you want the program, they may interpret you as a long shot. Not saying you wouldn't get ranked, just not as high as an avg joe for that PC specialty

 

[AcademicNeurosurgery]

I'd say maybe... I brought this put up on a different thread. 260+ step scores apply to IV programs or top rural programs if they want PC. The PD thinks of it like this, rank 1 = person we like who is most likely to rank us (the Kobe Bryant). If they see you with such a high step score, it means you have more options and unless you explicitly state you want the program, they may interpret you as a long shot. Not saying you wouldn't get ranked, just not as high as an avg joe for that PC specialty

This may have some merit but I doubt they would think your score was an error...

 

[673441]

This may have some merit but I doubt they would think your score was an error...

Lol, ya that's unlikely! I think the OP is referring to the error in undershooting based on score.

 

[BigRedBeta]

If the PD follows the rules of the match as prescribed, and isn't one to brag about yield or "we only went down to X spot on our rank list" mularkey, then no your step score shouldn't matter. If a PD is trying to read tea leaves about applicants preferences and predict the people most likely to rank them, they are a fool and missing out on presumably quality applicants.

Given the number of intern spots most programs have to fill in pediatrics, most peds programs are used to going pretty far down their list, and most are interviewing 8-10x the number of spots they have (eg, if they have 25 spots, not uncommon to interview 200-250 people, sometimes more). This is an extremely different paradigm than almost any other field except IM because of intern class size. It's just a different thought process than for a "big" ENT program that takes only 6 residents a year.

Bottom line, everything works better if everyone ranks the programs and applicants they like best, end of story. Any deviation from creates problems.

 

[Azete]

I think the better question is why would someone put in the amount of work necessary for a 260 if they only want a rural peds residency? Nobody is so smart that they walk in and get a 260 without studying for it.

Even if you insist on working hard all the time, your time would be better spent on peds research than studying for a step score you don't need.

 

[mcloaf]

I think the better question is why would someone put in the amount of work necessary for a 260 if they only want a rural peds residency? Nobody is so smart that they walk in and get a 260 without studying for it.

Even if you insist on working hard all the time, your time would be better spent on peds research than studying for a step score you don't need.

This is insulting. Working hard to be a well-educated physician isn't an activity reserved for people who want to do derm or plastics in coastal cities.

 

[Azete]

This is insulting. Working hard to be a well-educated physician isn't an activity reserved for people who want to do derm or plastics in coastal cities.

Well-educated physician =/= step 1 score. If somebody truly wants to become an expert on a topic, they'd be far better off doing research than memorizing boards minutiae.

 

[mcloaf]

Well-educated physician =/= step 1 score. If somebody truly wants to become an expert on a topic, they'd be far better off doing research than memorizing boards minutiae.

Who said anything about becoming an expert in a topic? Just because someone is smart doesn't mean they necessarily care about research (I'd imagine if you're shooting for rural peds research is not going to be a point of emphasis).

Your argument that a capable, driven student should voluntarily do more poorly on Step 1 just because they're "only" interested in rural peds is insulting. That a high step doesn't necessarily make one a well-educated physician is irrelevant; a high step score reflects ability and hard work which, again, are not limited to people who want to do competitive fields in high-demand areas.

 

[Azete]

Who said anything about becoming an expert in a topic? Just because someone is smart doesn't mean they necessarily care about research (I'd imagine if you're shooting for rural peds research is not going to be a point of emphasis).

Your argument that a capable, driven student should voluntarily do more poorly on Step 1 just because they're "only" interested in rural peds is insulting. That a high step doesn't necessarily make one a well-educated physician is irrelevant; a high step score reflects ability and hard work which, again, are not limited to people who want to do competitive fields in high-demand areas.

????

I never said anything about voluntarily doing poorly on Step 1. I said instead of going for a 260, which has vastly different time requirements than a 230, they should utilize that time to study things they're interested in and passionate about. I don't understand how any of that seems outrageous.

 

[AcademicNeurosurgery]

????

I never said anything about voluntarily doing poorly on Step 1. I said instead of going for a 260, which has vastly different time requirements than a 230, they should utilize that time to study things they're interested in and passionate about. I don't understand how any of that seems outrageous.

It's outrageous because you are implying that they are mutually exclusive. Often, the students who score that high are capable of having a well-rounded application if they so choose. Your claim that they should've spent less time studying for Step 1 and more time doing research is impractical, insulting, and your personal opinion that you shouldn't project onto others.

1) Research will always be there. Conducting research is an endless endeavor so they can easily get involved in research later on.

2) You are assuming that since you can generally match peds with a lower score, people interested in peds shouldn't work as hard during the first two years. Top peds residencies are competitive, period. Even rural residencies can be very competitive (UWash for example).

3) Maybe the person just wanted to crush Step 1 as a sense of achievement? Again, there will always be research opportunities later on down the line.

 

[mcloaf]

????

I never said anything about voluntarily doing poorly on Step 1. I said instead of going for a 260, which has vastly different time requirements than a 230, they should utilize that time to study things they're interested in and passionate about. I don't understand how any of that seems outrageous.

What do you think you're arguing for when you say somebody shouldn't bother to study as hard? It is saying someone should voluntarily do more poorly than they would otherwise.

What you're arguing only makes sense if you're of the opinion that one should only do the minimum required in order to match, which is not a universal attitude.

 

[Azete]

It's outrageous because you are implying that they are mutually exclusive. Often, the students who score that high are capable of having a well-rounded application if they so choose. Your claim that they should've spent less time studying for Step 1 and more time doing research is impractical, insulting, and your personal opinion that you shouldn't project onto others.

1) Research will always be there. Conducting research is an endless endeavor so they can easily get involved in research later on.

2) You are assuming that since you can generally match peds with a lower score, people interested in peds shouldn't work as hard during the first two years. Top peds residencies are competitive, period. Even rural residencies can be very competitive (UWash for example).

3) Maybe the person just wanted to crush Step 1 as a sense of achievement? Again, there will always be research opportunities later on down the line.

Ok guy

 

[Amba]

Ok guy

He's not your guy, friend.

 

[sliceofbread136]

Articulate your interests well in your ps and don't be afraid to send love letters. I think you will do very well

 

[HereWeGo17]

You might not get interview offers initially from these rural programs, because they assume you aren't interested in them.

Similar thing happened to me - not urban vs. rural but uber academic vs. less academic. I had very good stats and got tons of interview offers from places like Hopkins/Harvard/Mayo/UCLA/Vandy/UW etc etc. On the other hand I was passed over or rejected by programs like Temple, Wayne State, UC Irvine, Tulane etc - all very good programs but less focus on academia. My PD said it's probably because these programs didn't think I would be interested in them based on my grades/scores/research.

With that said, there's an easy solution. If you get passed over by a program, and you think it's because the program didn't think you were interested in them (as opposed to the program thinking you weren't qualified enough), just send them an email explaining why you are very interested in their program, and if you sound sincere enough they will likely extend you an interview. You can get your home department to call/email on your behalf too, which lends extra credence.


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[OnePunchBiopsy]

He's not your guy, friend.

He's not your friend, buddy!

 

[bannie22]

Absolutely not. Do not be stupid.

All you have to do is write a PS that is all about rural peds. Call those programs or get your mentors to call.
And you will be golden.

If you have a poor step score it just means you have to work that much harder in the other areas.

 

[Tesselate]

So no problem applying to IM with a 265? It actually had crossed my mind that I might get ranked lower. ^I guess I just have to express my interest more?

 

[ChordaEpiphany]

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[educ8r]

There are two different possibilities here. If you haven't yet taken step 1, and know you want to go into a non-competitive area, are you going to try to titrate your performance to a lower score than your max performance? This seems dangerous and ill-advised. On the other hand, perhaps you already have the score and you're concerned about how your 260+ will be viewed by programs. Seems reasonable to let the programs you're interviewing at know that you're really into them, that they aren't just your safety. Lots of ways you could do that. Programs know that you are more than just your step score.

 

[MSTP18]

I would say depends on the rest of your app. If everything about you says rural peds (or at least peds) then definitely not. If everything about you says big city derm then you'll probably have some issues. Had an MD/PhD student at my school who did his research in ortho and had the stats to get into ortho apply to gen surg programs only (because after MS3, decided he liked gen surg more) and he was frequently asked if he was really interested in gen surg or just using it as a backup.

 

[Tesselate]

A 265 is probably right in line for top IM programs. In fact, depending on the rest of your application and which school you attend, you might not even get interviews at the top 10 or so. There's a few reasons for this.

1) Top tier IM values med school over almost any other metric. I've personally seen students with 225 and no AOA match at top 10 IM places from a top tier med school while a 250/AOA w/ great research from a top 50 doesn't get an interview. So realistically, unless you're from a brand name school, you're effectively competing for fewer spots in a far larger applicant pool.

2) While IM is less competitive, it still has the largest applicant pool. So if 1/2 of the spots at top 10 IM programs are going to students from "normal" med schools, you're competing with a ton of people, and statistically plenty of them will have 260+.

3) Step score isn't everything in IM. Most people say it's a cutoff and then they don't care. This is sort of true. I say this basically to say that top tier IM programs place that "cutoff" for students from normal med schools very, very high. You need amazing everything unless you already go to a top school. So effectively you need that 260+ regardless of cutoff mentality, because your competition will be equally amazing in all other aspects of the competition.

My school is in the Caribbean and I'm not aiming for any of the top programs lol. Rural works too as long as they sponsor visas

 

[ChordaEpiphany]

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