How low is too low?

anythings possible dude!...if you have something else going for you that helps-good grades, great letters, research-that may help mitigate that low step 1. i know a guy at washu with a 204 step 1....i reiterate, anything is possible!

I was told by many reliable sources including PDs that for most competitive ortho programs have cutoff at 220. Once in awhile, they'll consider a candidate with lower scores, but I wouldn't count on it.

Having said that I do know of people who got in with scores around 200, although it's difficult. You have to prove yourself in other areas like clinical rotations, away rotations and research publications.

Taking step II early and acing it certainly helps, but not as important as acing step I the first time around.

I posted this before. But I think the general algorithm should be:
1. If you bombed step I (around 200), take step II early and ace it.
2. If you bombed step I AND step II, ace your clinical rotations and away rotations and research.
3. If you bombed everything, take the year off do research and make some political connections early on.

There are always some exceptions, but if your score is below 200 you have a tall mountain to climb. 220 is aite, but probably have to do well in other areas. 230s is solid. 240 is probably good enough to be considered by many programs.

Also, ortho is not the only road to happiness. I think people should keep an open mind and consider other very, very respectable surgical specialties such as vascular, CT, plastics, colorectal which can be all done via general surgery route. From what I hear, general surgery is very doable these days because of such a low demand. Something to think about.

Hope this helps.

I am sure your ortho PD will be able to tell you more than I can, but I would bet no. The worst thing a ortho program can have (outside of multiple people leaving the program) is to have people fail the OTIE's. If I am a PD, I would have extremely severe doubts that someone with a 200 on step one can pass the OTIEs, unless you have a good MCAT and had a really good reason for having a bad step one day with a good step 2.....

Your best bet is your home program. Really lay it out when you meet with the PD. Don't make excuses for the past. You have that score and you have to live with it and move forward. Ask him/her what you will have to do over the next year to set you apart from other applicants with better scores and do more than he/she expects. This can go a long way at your home program and may even spill into other programs if the PD and other faculty are impressed and go to bat for you. You have nothing to lose and a ton of ground to gain, so go for it. I had a lower score on Step 1, did tons better on step 2, did some pretty big research, and worked my ass off in all of my ortho rotations, both home and away. I was complimented by many faculty and residents about my drive and work ethic, so I think that will go a long way when match day comes. Now, I haven't matched yet and nothing is guaranteed, but I have put myself in a much better position than if I had just lived up to expectations. If I don't match, I will know that I did everything that I could in the time that I had and will work harder to match next year.

Bottom line, work your ass off. Show them that your score is not the defining aspect of your application. And although I agree that other surgical specialties are great, if you really want to do ortho you have to give it a shot. Don't settle in this process because you have to live with that for a long time.

Good luck!

great post, chopper, i wholeheartedly agree.

blah, blah, step 2. we've all said it a gazillion times. you have to rock it. period. and it may still be a longshot.

but... if you want ortho that bad, you have to try. if you are not sure you want to do it, don't. it's too hard to go after half-as$ed.
your PD may tell you you have no shot. if you still want to try, tell him "i know this is an uphill battle, but there is nothing i'd rather do with my life, so i would appreciate any help you can offer to make me as competitive as possible..."
my PD worked with my personal statement, suggested order for my rotations, kept in touch throughout the process, and helped me choose programs who might me more open minded with regard to blemishes on my transcript.
if your PD is not as student-oriented or helpful, try other attendings in your dept. it helps to have someone really understand you. you also get a much better letter out of it, as they can truly speak to your commitment to ortho.
good luck.

cheers.
firegirl

So my question is, what happens if you come from a school with no ortho department? No PD to help you out with all this?

(I'm seriously knocking on wood that this isn't me, since I take Step 1 in May, I've got enough of an uphill battle with no ortho department)

i don't think most programs are going to hold it against if you don't have a home program. the biggest disadv for you is that home programs take their best students - but plenty of people match outside of their home program. as far as the connections through your home program to other places - it definately helps if you are in good with somebody, BUT, its not the be all end all. i think if you go on your rotations and make it known to the PDs and chairmen early that you come from a place without a home program and you would appreciate advice/mentoring they may take a special interest in you (i.e. make a connection for other programs) especially if they like you/want to keep you because they know your coming from somewhere where you can't stay because you don't have a program (possibly a slight + for you). just try to get as many good letters of recs from nationally recognized names.

it is to your advantage that you are still early in this process. i would find a PD (in ortho) to be a mentor. if you are in a city with another med school go do some research there and get to know their department PD and get adopted. go to a meeting somewhere and try to meet somebody if you can. good luck.