a known is better than and unknown any day

you should do both. you will want to do your ortho rotations early to get letters of rec. if your score is such that it concerns you, you should take it earlier in the year. if you do three total ortho rotations (two away, one home). one strategy might be to take july off to study only and take the boards (or take an easy elective like radiology so you can get a credit for school out of the way) and then do your three months of ortho. you'll still get your LoRs in time and your score will come back in time for you to get it on your apps. good luck

Everyone's got good input for the question, but the answer lies within you.

Do you think you can improve your Step 1 without taking 2 months to study or do you & standardized exams not get along? Or are you the guy who Honors every rotation during 3rd year, b/c you seem to get along with everyone, know the difference between when to step up & chip in and when to sit back & read up on something? Just be warned...studying after 3 or 4 rotations of Ortho just wouldn't have happened for me. I took 2 weeks of the 1st month of 4th year & got it out of the way (even with a solid Step 1 score, I went up 14 pts.), then did 3 1/2 months of Ortho...boy was I drained after that.

I agree that rotating helps your chances at that place (and even other places if you get a great letter), but if you think you did the best you could on Step 1, then you may want to recognize your strengths & weaknesses & put your best foot forward. Worst case is you take time off, don't do as well, & miss an Ortho rotation. It's up to you.

Whatever you do, NEVER complain about anything (even if it's about the lunch - which is awful & every resident in the room is vomiting - just mention at least it's free). It's all about perception.

Good luck.

I'll chime in on this because I had a terrible day on step 1 for some reason and barely scored in the 200's. I knew that I was screwed without boosting step 2, but I also knew that my strengths were on rotations, working hard and working with people. So, I took July off and studied for three weeks, took step two and scored in the mid 240's. I did an ortho month at my home place in aug. and aways in oct and nov. I only got 13 interview invites and could only make it to 9, but I matched. I am not sure where yet, but I am quite confident I won't go below my top 3 (the three places I rotated). So, you know yourself best. For me, I knew that without a decent step 2 I would get screened out of every place except where I rotated, so my focus early was step 2. After that, I knew that my overall best chance of matching somewhere good was by rotating there. For some people with great numbers but not the greatest personal skills, rotating can hurt them. You know yourself best. So as long as your application has other things that make you stand out, step 2 probably isn't the deal maker, but otherwise I'd take it early. As the previous post said, do you think you can improve? If you do better with clinically oriented topics then you'll probably improved on step 2 since it is a clinically oriented test. However, no doubt the sure way to earn a spot is by rotating with a program and getting the residents and attendings that you work with to like you and to see that you are going to work hard and do a good job. They'll go to bat for you. Hope this helps.