The Gateway to Your Orthopaedic Career.
  Thursday, 10 March 2011
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any insight as to how competitive i am would be appreciated. ie will i match? at a good program? in california? should i bother doing cali aways or will my step 1 score keep me out of them regardless?

originally from cali (would like to return), med school out of state at a school ranked in the 50's i think, step 1: 225, step 2: 263. Did well in 1st-3rd year though not junior AOA and doubtful for senior AOA (prob top quartile of class though), currently doing a research year (in between 3rd and 4th year) with a few publications.

other than my weak step 1 score i think my application would be pretty solid as i'm a hard worker and have gotten good evals/letters of rec. how much of a disadvantage does a 225 put me at? i would hope that a 263 on step 2 would negate/balance the step 1 score but you always hear of the importance of step 1 and the downplay of step 2.

thanks a lot
15 years ago
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#57159
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I am not exactly sure how competitive you are (as I am just a 3rd year med student). However, I am curious how you made so much of a jump from Step I to Step II?
15 years ago
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#57160
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I went from low 230s to mid 270s with less dedicated studying than for Step 1. I think that if you go to a school where you take shelf exams after each core rotation and you study hard for each of them, with a decent review at the end of 3rd year you can really do well on Step 2 no matter how well you did on step 1.
15 years ago
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#57161
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first of all, step 2 is easier or at least the mean is higher (230) with an SD of 23. i didn't mind studying for step 2 like i did step 1--you synthesize a lot of the material you've learned over the past 3-4 years and the material is applicable to patient care (much more so than memorizing biochem pathways). i studied while doing full days of research and took the last week before my test off from research to only study. you could prob do everything in 3 weeks (+/- 1 week) if only studying. this is what i wrote to a couple buddies studying for the test now:

this is what i did: took about a month to lazily go through step 2 secrets (about 10 pages a day--wasn't really studying). then, come (5 weeks out) i started my buckle down. 3 sets of usmle world per day. that's 132 q's per day for 21 days or so to get through the 2200 q's. not sure if that math works out but it's close to that (didn't do all three sets each day obviously but that was my goal and i definitely stuck to it the first week). took decent notes on the q's i got wrong. ended with overall 71% correct. then went over my marked q's (mostly ones i got right but thought it was sorta a fluke and that i should have a second look) and also the q's i got wrong (a total of around 800-1000 q's). ended that with 75% correct overall (which averages in your other early exams). then read secrets again the week before the test. it goes much quicker the second time and i highly recommend the second pass. also read my notes--amazing how many times i would get the same q wrong. took nbme 4 which tells you the q's you get wrong but doesn't give you the right answers. took that one 17 days out after i had finished qworld the first time through (244). took USMLEworld self assessment about a week out (261) which i thought was good test cuz i felt it was more similar to the real thing for some reason. took a few solid pearls from that test. then about 2 days out i took nbme 1 (256). scores are just for reference btw.

what i would do if i had to do it all over again: mostly the same really. except, i would get through step 2 secrets the first time really fast. like a skim. then do the q's, then redo the wrong and marked ones, then reread step 2 when you now have context and can recognize what's really important to know. i would try and do all 4 nbme's and take it self paced timer and look up the answers but don't change yours--essentially, do the test in blocks of one hour and then go back and look up the q's you weren't sure about. i find q's are the best way to learn though i can't really tell you how many concepts or questions on the real thing came from previous nbme exams. though i'm sure there is a reason that it's highly sensitive material that they say they will kill you if you share. i didn't even look at first aid but some ppl use that. i think it's too detailed.

my 2 cents. good luck!
15 years ago
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#57162
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Wow! Thanks for the detailed reply! Will definitely be using Step 2 Secrets and UWorld for Step 2. Did you do UWorld for any of your shelves during 3rd year?
15 years ago
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#57163
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I'll give a slightly different approach (although I'm sure there are many ways of going about this). I studied relatively hard for each shelf exam scoring somewhere around the 90th percentile on average for all of them. Medicine is the biggest subject of Step 2 with maybe 75% of the test being like a huge IM shelf I thought. I read Step Up To Medicine during my IM clerkship (which I took at the very beginning of 3rd year) and liked it for that shelf. With that said I re-read Step Up to Medicine while studying for Step 2 as well as reading all of the non-medicine chapters of First Aid for Step 2 which ends up not being that much of the book at all. I also read Step 2 secrets after this basically as a checklist almost because I figured all the high-yield points should be in there and it took very little time at all after reading Step Up and FA. Throughout the time I was doing all of this reading I was also doing USMLE World which I had done once already during 3rd year. It was a fresh subscription however, so I could go back and do wrong/marked questions during my dedicated Step 2 study time. I basically marked any questions that I got wrong as well as any questions where there was some salient point in the explanation or answer choices that I thought I wanted to read again. So I did the whole question bank one time and then maybe 25% of it again. This was about 3 weeks of "dedicated" study. I didn't study as hard each day like I did for Step 1 - i.e. I went to the gym for a long time, I went out some nights, I took lots of breaks, etc. Anyways if you are diligent during 3rd year with your studies a few weeks of good review will help you kill this thing. My step 1 score was nothing to brag about but my step 2 score literally got brought up at every single interview multiple times.
15 years ago
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#57164
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yeah i forgot to mention that. i did use usmleworld for shelves. not sure how helpful they were for shelves (got mostly 80's) but i was hoping that if by the time step 2 roles around i knew the usmleworld q's cold, i would do well on step 2. there's also tons of info on studentdoctor.net for step 2.
15 years ago
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#57165
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Thanks man!
15 years ago
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#57166
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congrats on match!

if anyone has any advice on the original question of figuring out how competitive you are i would greatly appreciate it. i plan on asking my deans but i think the people on this forum probably know better. or if you know of a resource for regional statistics of applicants and those accepted. ie are the stats known for each individual program or just the overall nrmp match data for ortho ().

thanks a lot
15 years ago
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#57167
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I scored in 220s for Step 1 and also had a significant increase in Step 2 - 254. I was also not senior AOA but got top quartile. At the end, I ended up matching but it was definitely a grind. The Step 1 will hurt you in that you will get screened out at many of the top tier schools. The Step 2 improvement will definitely be asked about in many of your interviews. I applied very broadly, ~70 in any city that I recognized the name of: NYC, ATL, Cincinnati. Did 3 away rotations + home rotation. I ended up receiving 15 offers (2/3 community programs) and interviewed at 12 and ended up matching. I would have only had about 10 offers but used my connections with attendings, had phone calls made, to increase that to 15. It's definitely possible to match with a Step 1 in the 220s, and I think your extra year in research will definitely help. I'm just going to encourage you to maximize all your connections that you've made in ortho and that you will make in your sub-is.
15 years ago
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#57168
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great advice. thanks for the tips and congrats!
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