Can I get into Heme-Onc with a step 1 of 215?

[MrMimeGuy]

I'm currently an M4 student at a low-tier MD school hoping to get into Oncology. I'd initially been on the path of Rad Onc (still may do it), but considering the disarray that the field is currently in I'm going to do a rotation in Heme-Onc in a couple months to see how I like it and will likely dual apply to IM and Rad Onc.

Thing is, my step 1 is poor (215). I really enjoyed IM during my 3rd year and for a long time thought that's what I was going to do, but ultimately I think I've decided I'd be unhappy remaining a hospitalist, so I want to do everything I can to ensure I get into Heme-Onc if I choose to go down this path. If I go into IM, I will be 100% intent on applying for Heme-Onc and I'd really appreciate any and all advice to make sure I'll match.

Will my step 1 filter me out of too many programs? I see for MDs the match rates are discouraging for my test scores (~70% match). I do have 4 publications already with numerous poster/oral presentations at state conferences and strong extracurriculars (student leader of a free low income clinic our school sponsors for a couple years), and I expect to continue getting more throughout residency. My step 1 was sorta a fluke since I had to take it during rotations because of COVID, and I've been an above average student for M3 year, but I'd like to assume for the sake of the argument that my step 2 is also below average.

I'm willing to attend any IM or Heme-Onc program in the nation so long as it sets me up for success. I'd prefer to stay in the pacific western region if possible, but I have no intent on going into academics and would probably prefer community programs honestly. I can get the letters, schmooze the Heme-Oncs associated with my IM program, and I'll work hard to get multiple pubs during residency.

So...do I have a chance? What else do I need to do to nearly guarantee my success of matching? Is that even a possibility or will it be a massive uphill battle? Any and all advice would be greatly appreciated.

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[collegestud2013]

Try to get into an IM program with an in-house heme-onc fellowship. This may be more difficult given your step 1 score but still possible as a 215 places you more in the realm of mid to lower tier community IM programs and many of them do not have an in-house program. Then try get chief and do a chief resident year since chiefs are almost guaranteed to have a spot at their in-house fellowship (unless the program is really malignant).

If that doesn't work out just go with rad onc which basically has a near 100% match rate right now with essentially more spots than applicants. But if the job market is still as bad is at it is now 5 years down the line expect to make the same or less than doing primary care and having more geographic limitations.

 

[HemeOncHopeful19]

I matched with a 220 (Current PGY4). Make sure your step 2-3 is improved. Agree with the above to do a chief year I don’t recall when Step 1 goes P/F but if you could end up applying with that cohort then they may even ignore your step 1, who knows?

If Heme/Onc is the #1 goal then try for a university IM program with in-house fellowship even if out of region. Don’t do a community IM program just to stay in the Pacific NW, imo, but only you can choose your priorities.

 

[MrMimeGuy]

Then try get chief and do a chief resident year since chiefs are almost guaranteed to have a spot at their in-house fellowship (unless the program is really malignant).

This is really good advice thank you. Is it possible to apply to Heme-Onc before I do a chief year, and then if things don't work out I just reapply as a chief with I'm assuming better odds? Or is that a taboo at programs to accept being a chief but then apply for a fellowship?

If that doesn't work out just go with rad onc which basically has a near 100% match rate right now with essentially more spots than applicants. But if the job market is still as bad is at it is now 5 years down the line expect to make the same or less than doing primary care and having more geographic limitations.

Yepp, and it's a real shame because this is ideally what I would do, but it's hard to predict the future and it's terrifying to accrue nearly half a million of debt with potentially no job on the horizon. Thanks for the advice.

I matched with a 220 (Current PGY4). Make sure your step 2-3 is improved.

Did you feel like the app cycle was particularly hard for you? Were you MD? What do you think made your app stand out to get matched above higher stat applicants? I do expect to do average-above average on step 2 based off of my current performance (245-255), so hopefully I can secure that. It's really unfortunate I had to take step 1 in the middle of my 3rd year. I was averaging 240s before step 1 was cancelled...ugh.

 

[lulu09]

I matched in 2019. I have an even lower step 1 score than yours.

Try to match this year at an academic IM program with an in-house fellowship. You will be weeded out at the elite programs based on step 1 score alone (don't hold your breath for Hopkins, DFCI, NIH...etc.) but you will be competitive at the other programs. Above all else, getting good research will set you apart on interview day. Get the interview, then blow them away there. I wouldn't care too much about chief etc. You don't need to be chief. I wasn't one and was fine. I did a heck of a lot of research though in residency to set me apart, though. It worked well, and I didn't even start until intern year ended. You'll be fine as long as you keep your eyes on the prize.

Good luck!

 

[Heplayer92]

Step 1 of 222 here, and then able to bump it to 240+ on Step 2 which really helped. Ended up matching in a top 20 academic medicine residency. Once you're at a solid residency program they definitely do everything they can to set you up for success. Continue to work hard through M3 and M4 year and you will be fine!

 

[IMres85]

208 step 1.


Bust your tail on step 2 and it won’t matter (as much)

 

[CluvK]

Yes you definitely have a chance. I am DO, Step 1 < 220, doing IM residency at a small community hospital. Initially thought about doing hospitalist vs. Endo or ID fellowship but found my interests in Hem/onc later in the PGY-2. Have been doing research throughout residency (case report, QI project etc.). Was looking for a hospitalist job before the fellowship match day as I didn't think I would match with my profile. Matched a solid Hem/onc program this year.

A huge improvement of Step 2 may help. Research helps. Also, you may change your mind in residency. In my intern year, half of my class wanted to do cards and the other half wanted to do GI, but now many of them have changed mind. You never know.

 

[WhiteCoatWonder]

yeah my step was in the same neighborhood - i agree w/ many others here, rounding out the rest of your application can only help. at some point, i decided that the programs that would "filter" my application based on a step score were likely places i would not fit in well (this sentiment began before med school). im a career changer and community involver and multi-committee member and junior researcher, etc. i dont consider myself academically strong, but i have a track record of good relationships with my patients and teams, evidence of interest in the field and a strong mentor network of people smarter than me who can tell me what to do next. i matched at my #1 this year.