Yes, Step 2-CS is definitely the test being discussed. Passing is critical, but unlike Step 1 or Step 2CK there is no numerical score, it is literally pass/fail with no distinction between barely passing and perfect score. The pass rate is extremely high for US MD students (98% on the first try, of that 2% who fail, 91% of them will pass on the 2nd try), and med schools typically administer their own versions essentially and those are usually graded more harshly than CS. In fact, there was an article in the NEJM (http://www.nejm.org/doi/full/10.1056/NEJMp1213760) that argued that US MD students should be exempt from step 2 CS while still requiring it of FMGs who have a first time pass rate of 79%. I have also seen it argued that since many medical schools offer their own (often harder) version of step 2 CS as part of the requirement to move on to MS4 and the very high correlation between failing that and failing 2-CS that 2-CS is simply redundant for US med students and the schools themselves are more than equipped to identify inadequate students.
With regard to program size, I have definitely heard that bigger programs provide more flexibility. Not just in terms of being able to find other residents to cover for you but also the programs offer more opportunities to the residents since the program doesnât need all of them working on the floors as much as possible to handle the hospitalâs daily operations. As MD/PhD students for example, we are told to very much target the larger programs - I think that would be true for anyone considering anything outside of pure 100% patient care. If 100% patient care is the goal, then program size is probably more a matter of quality of life (e.g. how hard is it to take a sick day, how hard is it to find someone to cover your shift so you can go to your friendâs wedding etc) than anything else.
Thanks for the information! He apparently survived the test yesterday and felt pretty good about his performance. As always, this knowledgable group was very helpful!
âcomplained more about cost (test fee, travel costs) than actual test.â - yes. My D. was frustrated (despite the fact that we paid for everything), she mentioned that CS test is primarily test to see the language skills and really should be only for non-native English speakers. But I guess, since they cannot discriminate like this, then everybody has to take it.
She is waiting for the result of her Step 3. She just needs to pass it. First time in her life she could not study as much as she usually does for the test because of her absolutely horrific schedule. Because of the test (2 days, 7 hours every day), she has been also working without days off, including nights, 30 hrs shifts,âŠetc. She used up 2 days off for taking the Step 3 exam.
I am still surprised that she is not complaining about her schedule at all, just merely stating the fact as we asked to have her schedule. I am really shocked by her schedule, she is just staying cool and doing the job and right now she has hospital shifts on her favorite IM floor. The tiny complaint that she has is that this schedule does not allow her to go to gym, but she said that she walks so much during her shifts that she probably is compensating for the lack of gym time.
Dadof3,
So program size, particularly in pediatrics (as an aside, Iâm a board certified pediatrician and just finished a peds critical care fellowship in June so Iâm just now done with my 6 years of training), in my opinion tends to be a marker of diversity of clinical opportunities and how busy a place is. If the hospital can cover all of their patients with just 24 residents total (3 years with 8 residents in a class), then you can be sure the patient load in the entire hospital is not as significant as the place that takes 24 interns a year. Now this does not mean that the person at the program with only 8 interns in a class wonât have the same number of patients per intern, just that the hospital volume is not the same.
Hospital volume tends to drive things like subspecialty exposure. A smaller hospital may lack all the subspecialties, and in particular lack pediatric surgical subspecialties like Neurosurgery, ENT, or Ortho which, if patients need those specialists they will be transferred somewhere else that has them. That may or may not matter to pediatric residents depending on their future goalsâŠif youâre a general pediatrician in a rural community, taking care of an post-op advanced airway reconstruction patient in the PICU probably isnât a missed opportunity, but if youâre thinking of becoming a pediatric intensivist, that patient may have value. Likewise if a childrensâ hospital lacks something like a pediatric nephrologist or pediatric rheumatologist.
There are quality programs of all sizes but a lot of time applicants find comfort in one size and thatâs where they cluster their rank list. The person who loves the huge programs at a place like Texas Childrenâs is unlikely to feel at home at a small place like Kentucky, while the person who is turned off by the fact that a resident doesnât âknowâ all the people in their residency class would be unlikely to enjoy a program with 30+ interns a year.
A big program will certainly provide a lot more flexibility in terms of finding coverage. I know when I was going through the process as a decidedly single male, going to a really tiny program would have likely found me picking up a lot more shifts for colleagues than what ended up happening by going to a program that took 26/yr. And forget about it if someone ends up pregnant! As it was, there were lots of pregnancies in my program and it never once felt like a burden, which would have never been the case in a smaller program.
Thanks for your insight Bigred. DD has said that at least for now, she is looking at going further than general peds, and doesnât yet have a firm idea of where. So perhaps too small a place may be an issue if sheâs looking to experience a variety of subspecialties.
Continuing the saga of BFFâs DS (MS4) who is madly scheduling interviews for an ortho residency. She and I were having coffee today when he called her to share heâd gotten an email today (3 PM) offering him an interview this Saturday at a school heâs quite interested in. (Seems pretty short notice, in my view.) He already has an interview scheduled for that day at another school 3 states away! Heâd probably prefer the ânewâ school but thinks itâd be rude (and might backfire) to cancel the original interview on such short notice. He called and asked for an alternate day but there werenât any openings on another day. Whatâs this kid (ha! Heâs 27 years old!) to do??
Seems crazy that they canât spread these interview dates out rather than have the same interview weekends. Iâm gaining a whole new respect for what theyâre going through.
Ortho used to be known for having competing programs purposefully scheduling interviews on the same date to force applicants to choose one program over another early on. Not sure if itâs still trueâŠ
Also the ortho interview season is almost done; your friendâs son likely got off the interview waitlist due to last minute cancellation by another student. It happens.
PDs know exactly how many applicants they need to interview to fill their residency slots slots. Since interviewing is expensive and time-consuming for programs too, PDs donât want to interview more applicants than they absolutely have to to.
Some programs do this intentionally to force you to choose one program over the other prior to the interview. Totally unfair but the programs (especially in specialties like ortho) hold all the power at that stage of the game.
WayOutWestMom, the interview season canât be almost done! He has interviews scheduled out through the middle of January! Scares his mom, given the dreadful weather conditions that can exist along the east coast during the winter months. His interviews only start this coming weekend. He has a dozen or so scheduled from early Dec thru mid Jan. He has 4 planned for 5 days later this month!
What I meant is all interview slots have been filled already, not that all actual interview have happened. D1 interviewed from mid-November thru mid-January last year. Her first 3 interviews were the week before Thanksgiving.
Yeah, I know about the potential for winter bad weather. My kidlet had an interview in western upstate NY last fall during the historic Buffalo Snowmageddon. (For the record she made her interview in a trip straight out of Plane, Trains and Automobiles. Her flight to western NY ended up grounded due to weather in Camden; the airlines lost her suitcase [with her new interview suit!]; there were no rental cars available at the airport. She ended up taking a cab to different airport, renting a car there, then driving 400 miles during a raging snowstorm, literally following the snow plow along I-81 and I-90 to get to her interview. )
Oh, my! Canât help but think there has to be a better way?! I suppose they just throw caution to the wind and get there the best way possible! I canât imagine how much the interview process costs these poor (literally, poor!) kids. WOWM, was your kidlet applying for ortho as well? Are programs understanding when students cancel interviews to opt for another school? Is it accurate that itâs one of the most competitive specialities? Is there light at the end of the tunnel?
BFF tells me her son hasnât heard from probably 30 programs yet. (He applied to 70!) In your experience, is that unusual? Sheâs a nervous wreck on her sonâs behalf!
Iâd rather not say what D1âs specialty is. (She considers my discussing it on a public forum a violation of her privacy and I canât really disagree with her.)
The residency interview process is expensive. $10,000 isnât unusual, but it partly depends where the applicant lives and how many interview one attends. Some locations require more travel and more expensive travel to get to interviews.
Competitive programs really donât get too bent out of shape about applicants cancelling interviews (unless itâs at the last minute) since there is always someone willing to take their place.
Ortho is very competitive. So are the other surgical subspecialties (ENT, uro, optho) and derm. More applicants than positions available.
Not getting any response from the majority of the programs is the norm.
And thereâs a lightâitâs called Match Day. (March 18, 2016 for this residency application cycle.)
Not looking to intrude, WOWM. Iâm not really interested in your Dâs speciality, just wondered if you had first-hand knowledge of the ortho residency process since it is, apparently, somewhat unique. They seem to start the process considerably later than most others and they seem to play games with the applicants by choosing the same interview dates as other competitive programs, forcing applicants to choose from the onset.
BFF tells me there will be ortho hopefuls who donât match because there arenât enough slots available.
Am I understanding you correctly? The majority of the programs donât even reply to some of the applicants?! Sounds very unprofessional and rude to me! Canât imagine an automated email is too much to ask!
Yes that date is marked on my calendar. BFF plans to attend the match ceremonyâsays itâs often more meaningful than graduation.
Yep. In 2015, 25% of 4th year US med students and 77% of the rest of the applicants applying to ortho did not get a spot in an ortho residency. (http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf)
I donât know about âmajorityâ but itâs definitely not uncommon. Also until you reject someone, you can always give them a spot later on. Especially with SOAP occurring after the match, thereâs a fair number of applicants you would be willing to accept vs. the ones youâd interview/rank. Additionally, most med students got at least 1 silent rejection during the medical school application process so weâre used to it already.
I agree
Both ceremonies had a different vibe about them, but looking back if I had to pick one it would be Match Day. The excitement at Match Day was palpable whereas at graduation I thought a lot of kids had mentally moved on.
The majority of med schools donât reply to applicants either. Itâs called a silent rejection. For both residency and med school admission, applicants may get a email or portal notice of official rejection at the very end the cycle, but itâs quite common to keep he majority of applicants âon holdâ until all final, official decisions have been made and ROL have been submitted, if not indefinitely. (I think thereâs still a med school or two which hasnât sent D1 an official rejection yet⊠
)
Yes, about 20% of ortho hopefuls wonât match into orthoâwhich doesnât mean they wonât match at all. (If ortho applicants are smart about it and had good advising from their programs, they applied & interviewed to a back-up specialty, are willing to go thru SOAP to find a prelim spot or permanent spot in another specialty, or are able to arrange a research year in case of a non-Match.)
A parent attending Match ceremonies can be an iffy thing. Besides the joy of matching, there can be lots of disappointments too. People who didnât match into their chosen specialty and ended up in back-up choice, who didnât match at a program or location they wanted, who matched to the bottom half of their rank list, who matched far away from their SO/familyâŠsometimes Match isnât happy. Not everyone wants their parents there.
Also, from what I understand, there are a number of students who simply donât attend their Match ceremonies because they arenât fans of all the artificial hoopla surrounding it and want their privacy when opening their envelope regardless of whether the news is good or not so good.
RE: match vs graduation. Iâd pick graduation since there was a whole community of family & close friends who attended together to support D1 and wish her well. For D1 it was a very long road to med school with many, many detours along the way and she would not have ended up as a doctor without the support & encouragement of these people. D1 also asked me to hood her. I only wish her dad had still been alive to see her graduation; he would have been the one hooding her. For D2, graduation will be special because her older sister will be the one hooding her little sis.
As a parent I was very, very proud to have hooded my S at his graduation ceremony, but the students just seemed more excited, bigger grins at Match day. But yes there were definitely some not so happy seniors at Match Day.
@rutgersmamma
my specialty is very similar to ortho in terms of competitiveness and lateness of interview cycle. There are still about 30 programs in my specialty that havent sent out invites yet. Bulk of interviews occur in Dec and Jan, most in Jan.
If my kid had the potential of NOT matching, Iâd say thatâd be reason enough for me to attend. Somebody needs to be there to âpick up the piecesâ!
Thanks, bigreddawgie! I like that thereâs still hope for my friendâs DS. Iâd hate to think the cycle is over for him!
Wasnât aware students needed to ask somebody to âhoodâ them! Very special, indeed!
Iâm guessing this varies from school to school. At mine for example, itâs either an associate dean of the medical school or an âimmediate relativeâ (defined as spouse, parent, sibling, son or daughter) and they must have an MD (or maybe a PhD/JD is allowed, it just says âmust be a doctorâ) themselves in order to do so. At Brown I donât believe anyone other than the schoolâs designated âhoodersâ are allowed to hood you (at least Iâve never seen a photo of someone who went to Brown being hooded by a family member like I do for my med school). Iâm sure the school lets the students know if they allow others to hood you, and I doubt any school requires students to find people to hood them.