How competitive am I for Peds? Having a Crisis of identity

[ohmanwaddup]

Hey all,

I was orignally planning on applying Med-Peds but have been having a bit of a crisis lately. I did a second peds rotation with a doc I've worked with previously, and he basically had me be his intern. I wrote all his notes, submitted orders, had a TON of independence and I loved every second of it, no matter how exhausting it was.

My IM rotation was alright. I liked outpatient care, but my IM was pretty meh, mostly though I believe because administration hamstringed us and it was not that different from shadowing with the occasional note writing. I was planning on doing an away in IM before applications go out and using that to decide, but it seems unlikely I will get one. Couple that with the fact that I was just rejected from a Med-Peds elective at my top choice for residency, and well I am just feeling like maybe I should just apply peds, but I'm worried I will be unhappy the rest of my life. I truly do not know what to do. I really really really want to do Med/Peds but it feels like the stars are aligned against me.

Stats:
DO Student with a 2.5 GPA
step 1 of 231, complex 1 of 523
No honors in any rotation, but COMAT scores are all 70th percentile+. Ironically Peds was my lowest score
I take step2 in a month.

I know I have good stats for peds overall, but what about good programs? I am eyeing places likes Case Western UH and I have heard they are pretty selective. Residency explorer says I'm "average", but I have heard whispers that it isn't a good metric to use.

Just feeling really lost over here

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[Redpancreas]

Hey all,

I was orignally planning on applying Med-Peds but have been having a bit of a crisis lately. I did a second peds rotation with a doc I've worked with previously, and he basically had me be his intern. I wrote all his notes, submitted orders, had a TON of independence and I loved every second of it, no matter how exhausting it was.

My IM rotation was alright. I liked outpatient care, but my IM was pretty meh, mostly though I believe because administration hamstringed us and it was not that different from shadowing with the occasional note writing. I was planning on doing an away in IM before applications go out and using that to decide, but it seems unlikely I will get one. Couple that with the fact that I was just rejected from a Med-Peds elective at my top choice for residency, and well I am just feeling like maybe I should just apply peds, but I'm worried I will be unhappy the rest of my life. I truly do not know what to do. I really really really want to do Med/Peds but it feels like the stars are aligned against me.

Stats:
DO Student with a 2.5 GPA
step 1 of 231, complex 1 of 523
No honors in any rotation, but COMAT scores are all 70th percentile+. Ironically Peds was my lowest score
I take step2 in a month.

I know I have good stats for peds overall, but what about good programs? I am eyeing places likes Case Western UH and I have heard they are pretty selective. Residency explorer says I'm "average", but I have heard whispers that it isn't a good metric to use.

Just feeling really lost over here

You are letting your panic about the rejection from the away get the best of you. Nothing you mentioned comes off as a red flag for IM. Remind yourself of why you're applying Med-Peds and move forward...unless you realized you hated IM and only want to do peds. Then I guess apply Peds then.

Med-Peds is not much more competitive than Peds or IM partly because of a lack of demand given that you do more training for no additional financial compensation.

Case/UH IM-Peds is probably one of the more competitive IM-Peds (I'm completely guessing - 230+ Step 1, 240+ Step 2CK, good class standing, good clinical grades). I don't think you'll hear back from them for Med/Peds, but you may hear back from Case/Metrohealth if location's important for you. They had to SOAP a few years back for a spot. Not to rub salt in the wound but besides your 231 your profile is consistently below average. Your clinical grades aren't good, your grades aren't either at a DO school, and you don't have a Step 2CK in hand. Also, and unfortunately most importantly, 16/17 residents on their class profile are US MDs. Hate the game, not the players :/ Don't fixate on name/location. You have a good chance of matching Meds/Peds if that's what you want to do, but it may not be at Case/UH. Also, just because Med/Peds has limited supply (it also has limited demand) you are best off applying to Peds or IM as back ups just in case.

@tantacles @The Med-Peds Dude thoughts?

 

[ohmanwaddup]

You are letting your panic about the rejection from the away get the best of you. Nothing you mentioned comes off as a red flag for IM. Remind yourself of why you're applying Med-Peds and move forward...unless you realized you hated IM and only want to do peds. Then I guess apply Peds then.

Med-Peds is not much more competitive than Peds or IM partly because of a lack of demand given that you do more training for no additional financial compensation.

Case/UH IM-Peds is probably one of the more competitive IM-Peds (I'm completely guessing - 230+ Step 1, 240+ Step 2CK, good class standing, good clinical grades). I don't think you'll hear back from them for Med/Peds, but you may hear back from Case/Metrohealth if location's important for you. They had to SOAP a few years back for a spot. Not to rub salt in the wound but besides your 231 your profile is consistently below average. Your clinical grades aren't good, your grades aren't either, and you don't have a Step 2CK in hand. Also, and unfortunately most importantly, 16/17 residents on their class profile are US MDs. Hate the game, not the players :/ Don't fixate on name/location. You have a good chance of matching Meds/Peds if that's what you want to do, but it may not be at Case/UH. Also, just because Med/Peds has limited supply (it also has limited demand) you are best off applying to Peds or IM as back ups just in case.

@tantacles @The Med-Peds Dude thoughts?

I've heard that dual applying at the same program can be a bad idea, do you think it would be bad to apply to peds and med-peds at UH if it's already a long shot?

I was already planning on dual apply peds. Geo is pretty important to me, I considered it to be a top priority to match in cleveland/akron.

was hoping my step score would make up for my preclinical struggles. I suppose my clinical grades might be a nail in the coffin. Tried hard for honors but my school wanted 90th percentile and evals had no weight at all in the honors process (got two 4/4 evals for peds)

 

[Redpancreas]

I've heard that dual applying at the same program can be a bad idea, do you think it would be bad to apply to peds and med-peds at UH if it's already a long shot?

I mean that's a better question for a med-peds person @The Med-Peds Dude. What I can say in general is that I wouldn't interpret the dual applying as a sign of bad character or someone trying to play the system. If you do Peds and Med/Peds I don't see that ruffling any Peds feathers. Just don't apply to IM alone specifically at Case/UH. It will be low yield.

Focus on the several places you already have aways at.

 

[Phloston]

Hey all,

I was orignally planning on applying Med-Peds but have been having a bit of a crisis lately. I did a second peds rotation with a doc I've worked with previously, and he basically had me be his intern. I wrote all his notes, submitted orders, had a TON of independence and I loved every second of it, no matter how exhausting it was.

My IM rotation was alright. I liked outpatient care, but my IM was pretty meh, mostly though I believe because administration hamstringed us and it was not that different from shadowing with the occasional note writing. I was planning on doing an away in IM before applications go out and using that to decide, but it seems unlikely I will get one. Couple that with the fact that I was just rejected from a Med-Peds elective at my top choice for residency, and well I am just feeling like maybe I should just apply peds, but I'm worried I will be unhappy the rest of my life. I truly do not know what to do. I really really really want to do Med/Peds but it feels like the stars are aligned against me.

Stats:
DO Student with a 2.5 GPA
step 1 of 231, complex 1 of 523
No honors in any rotation, but COMAT scores are all 70th percentile+. Ironically Peds was my lowest score
I take step2 in a month.

I know I have good stats for peds overall, but what about good programs? I am eyeing places likes Case Western UH and I have heard they are pretty selective. Residency explorer says I'm "average", but I have heard whispers that it isn't a good metric to use.

Just feeling really lost over here

Looking at your 231 in isolation, you're fine for peds in general. However, you have zero room to be selective/picky whatsoever.

If you want to be competitive, you'd need at least 250s on Step 2.

No one's really looking at your COMLEX scores.

Your GPA is low, but a strong 2CK will help override it.

Med-Peds is a stretch. Do well on 2CK.

 

[Redpancreas]

Looking at your 231 in isolation, you're fine for peds in general. However, you have zero room to be selective/picky whatsoever.

If you want to be competitive, you'd need at least 250s on Step 2.

No one's really looking at your COMLEX scores.

Your GPA is low, but a strong 2CK will help override it.

Med-Peds is a stretch. Do well on 2CK.

Assuming 231/250+ profile OP, I would think Case Med/Peds may possibly offer you an interview as I agree the consistent Step scores may outweigh the grades, but in general I also agree that with your profile overall, you can't really be picky on places. Med/Peds may or may not be a stretch as many programs struggle to fill. Focus on the places that you have heard from.

 

[ohmanwaddup]

Looking at your 231 in isolation, you're fine for peds in general. However, you have zero room to be selective/picky whatsoever.

If you want to be competitive, you'd need at least 250s on Step 2.

No one's really looking at your COMLEX scores.

Your GPA is low, but a strong 2CK will help override it.

Med-Peds is a stretch. Do well on 2CK.

Damn, glad I asked the question then. I thought I was in a much better place competitiveness wise but what I am hearing so far is that is not really the case (pun kinda intended)

 

[ohmanwaddup]

I was under the impression that med-peds is less competitive because of the added year, and that most end up practicing in one or the other.
A friend of mine recently matched low-tier univ w/480, no usmle or ECs. He wanted just peds but was advised that it would be too risky.
I guess OP is shooting for competitive programs which definitely complicates things.

Competitiveness is not a must-have for me, I just know that UH is one of the bigger/more competitive names in the area and I am trying to maximize/trying to understand what programs I can realistically apply to in that area.

The situation is apparently more dire than I realized lol

 

[Phloston]

Assuming 231/250+ profile OP, I would think Case Med/Peds may possibly offer you an interview as I agree the consistent Step scores may outweigh the grades, but in general I also agree that with your profile overall, you can't really be picky on places. Med/Peds may or may not be a stretch as many programs struggle to fill. Focus on the places that you have heard from.

Until the OP has a 2CK it's all just speculation. It's like trying to assess med school competitiveness without an MCAT.

 

[ohmanwaddup]

Until the OP has a 2CK it's all just speculation. It's like trying to assess med school competitiveness without an MCAT.

Ill be sure to update y'all in 6 weeks with regards to that

 

[Phloston]

Damn, glad I asked the question then. I thought I was in a much better place competitiveness wise but what I am hearing so far is that is not really the case (pun kinda intended)

231 is basically 50th percentile for Step 1. You need leverage with a strong 2CK before you're calling any shots.

 

[Phloston]

I was under the impression that med-peds is less competitive because of the added year, and that most end up practicing in one or the other.
A friend of mine recently matched low-tier univ w/480, no usmle or ECs. He wanted just peds but was advised that it would be too risky.
I guess OP is shooting for competitive programs which definitely complicates things.

There are pdfs on the actual objective competitiveness with raw numbers.

 

[Redpancreas]

Until the OP has a 2CK it's all just speculation. It's like trying to assess med school competitiveness without an MCAT.

Completely agree. I said it just to emphasize that even with an above average CK, Case/UH Med-Peds may still be a stretch.

 

[ohmanwaddup]

So it sounds like a lot is riding on step 2CK. I've had a pretty strong performance on my shelf exams and Uworld has been going well. Hopefully I can achieve a good score

Looks like it's really time to just grind and get that bread. As I said before, I'm really glad I brought this up, It's looking like I was a little overconfident in my chances and may have misinterpreted some data

 

[Redpancreas]

So it sounds like a lot is riding on step 2CK. I've had a pretty strong performance on my shelf exams and Uworld has been going well. Hopefully I can achieve a good score

Looks like it's really time to just grind and get that bread. As I said before, I'm really glad I brought this up, It's looking like I was a little overconfident in my chances and may have misinterpreted some data

Not the mentality I would recommend you go into it with. Just do your best. Also don’t delay the exam because your NBMEs don’t match a target score or else the exam is never going to get done. A lot of your USMLE performance is out of your control even weeks out from the exam. Would a 250+ get you an interview at competitive places? Maybe...but your grades/class rank are not the best and you’re a DO. I just don’t want you to get that score and be disappointed if you achieve that and don’t get an interview...or worse psyche yourself out and do poorly. The most likely scenario is you’re going to score in the mid 240s on Step 2 CK which would be in line with your current performance and be a net neutral and you still are more than likely going to match Med-Peds somewhere as demonstrated by the number of away acceptances you have received and the fact that it’s not uber-competitive. The point is don’t psyche yourself out about CK. It’s not 250 or bust.

 

[Redpancreas]

I was under the impression that med-peds is less competitive because of the added year, and that most end up practicing in one or the other.
A friend of mine recently matched low-tier univ w/480, no usmle or ECs. He wanted just peds but was advised that it would be too risky.
I guess OP is shooting for competitive programs which definitely complicates things.

It’s complicated. OP was asking about a bunch of things combined. IM for example vs. Med-Peds. Are we talking matching IM in general? Then IM is easier because there’s tons of programs. Matching a competitive med-peds vs competitive IM? IM wins out there. Peds is similar to IM with maybe IM being a bit more competitive again likely due to future earning potential.

I completely agree that OP should a way into Med Peds in general.

 

[mrbreakfast]

I was under the impression that med-peds is less competitive because of the added year, and that most end up practicing in one or the other.

Averages for accepted US seniors (not as applicable to OP, but more data):

Peds: Steps 228/245, overall match rate 98.4%
IM: Steps 235/248, overall match rate 97.4%
Med/peds: Steps 236/250, overall match rate 90.4%

Med/peds had a larger absolute number of unmatched applicants than peds despite having only 20% of the number of applicants.

 

[mrbreakfast]

If I understand correctly, there's lots of fluctuation in scores depending on the prestige of the program, right? For example, EM average is ~232 but I know a handful of people who matched community programs with ~510/<210. So if OP applied to such programs surely they will rank him/her very highly?

Generally speaking, this is true of the larger specialties. You can have an application littered with red flags and still match FM, for example, because there are programs who essentially rely on those applicants to fill. This is also the case with EM, which is expanding so rapidly that its competitiveness is plummeting. I'm not sure whether this is a true for a smaller specialty like IM/Peds, though.

I'd assume OP would match, just maybe not at the top programs.

 

[Redpancreas]

Med/peds had a larger absolute number of unmatched applicants than peds despite having only 20% of the number of applicants.

And like you’ve said it’s because people will always be able to find a FM or IM program willing to take them besides red flags and they can blend into a larger program. There are hundred of programs and every applicant goes on 15+ interviews.

If I’m not mistake there are under 100 Med-Peds programs with most being pretty small class sizes. There are going to be people who are left out.

 

[The Med-Peds Dude]

Let's see if I can sort through the comments

First, for the OP, this is by far not the weakest application I've ever ranked (assuming Step/Level 2 is similar to 1, letters are ok, and no other skeletons. Keep in mind, while Step 1 has averaged around 235, there is a similar number of scores above and below that number. M-P's PD (MPPDA) have been concerned that our Avg matched applicant board scores are so high as discourage perfectly good average-ish applicants from applying or ranking.

Unpublished MPPDA data covering 2008-2020

While applicants seem to labor over the issue of community vs academic medical center location, there are probably no "bad" programs. Metrohealth in particular is a very well established program with a track record. Med-Peds programs need a lot of institutional support to remain viable, board pass rates are similar, and the PD's are a pretty close knit group of talented karaoke singers (true), so word gets around if a program is in trouble.

One consistent predictor of matching is the "mean number of contiguous ranks" - the number of uninterrupted ranks in a row. for 2018-2020, this was 9.2, MDs 11

Averages for accepted US seniors (not as applicable to OP, but more data):

Peds: Steps 228/245, overall match rate 98.4%
IM: Steps 235/248, overall match rate 97.4%
Med/peds: Steps 236/250, overall match rate 90.4%

Med/peds had a larger absolute number of unmatched applicants than peds despite having only 20% of the number of applicants.

I'm not sure where these "match rate" figures come from, or their context. These are not fill rates, nor are they % matched applicants that are MD. Med-Peds certainly does not have a larger number of unmatched applicants compared to Peds (2020, 73 [DOs] vs 212 [MDs]). Being a small number of positions, there has been some volatility in match rates in Med-Peds, the important variable being the number of US MDs who interview at but do not rank a Med-Peds program.

Mine is not the only program that accepts COMLEX - the number of programs isn't known with certainty, but 1/2 seems likely.

I've probably missed something in this thread, so please remind me and I'll try to tackle it.

 

[ohmanwaddup]

Let's see if I can sort through the comments

First, for the OP, this is by far not the weakest application I've ever ranked (assuming Step/Level 2 is similar to 1, letters are ok, and no other skeletons. Keep in mind, while Step 1 has averaged around 235, there is a similar number of scores above and below that number. M-P's PD (MPPDA) have been concerned that our Avg matched applicant board scores are so high as discourage perfectly good average-ish applicants from applying or ranking.

Unpublished MPPDA data covering 2008-2020
View attachment 336769

While applicants seem to labor over the issue of community vs academic medical center location, there are probably no "bad" programs. Metrohealth in particular is a very well established program with a track record. Med-Peds programs need a lot of institutional support to remain viable, board pass rates are similar, and the PD's are a pretty close knit group of talented karaoke singers (true), so word gets around if a program is in trouble.

One consistent predictor of matching is the "mean number of contiguous ranks" - the number of uninterrupted ranks in a row. for 2018-2020, this was 9.2, MDs 11

I'm not sure where these "match rate" figures come from, or their context. These are not fill rates, nor are they % matched applicants that are MD. Med-Peds certainly does not have a larger number of unmatched applicants compared to Peds (2020, 73 [DOs] vs 212 [MDs]). Being a small number of positions, there has been some volatility in match rates in Med-Peds, the important variable being the number of US MDs who interview at but do not rank a Med-Peds program.

Mine is not the only program that accepts COMLEX - the number of programs isn't known with certainty, but 1/2 seems likely.

I've probably missed something in this thread, so please remind me and I'll try to tackle it.

Do you feel that a Med-Peds rotation is essential, or detrimental not to have? I'm getting more and more offers for my 4 year rotations (school does not provide a core site so I have to set up everything as aways) and I'm worried I'll have to cancel an already accepted rotation somewhere else, which I've heard looks bad.

While I have heard that a Med-Peds rotation is not typically required, I am wondering if my strict geographical goals (Cleveland or 2 hours of Cleveland) makes it a more pressing thing to try and obtain.

 

[Redpancreas]

Do you feel that a Med-Peds rotation is essential, or detrimental not to have? I'm getting more and more offers for my 4 year rotations (school does not provide a core site so I have to set up everything as aways) and I'm worried I'll have to cancel an already accepted rotation somewhere else, which I've heard looks bad.

While I have heard that a Med-Peds rotation is not typically required, I am wondering if my strict geographical goals (Cleveland or 2 hours of Cleveland) makes it a more pressing thing to try and obtain.

UH Metrohealth, Wayne State, and Beaumont are some possible targets. Apply to Case UH, Indiana, UPMC, and Michigan just to see as well.

 

[ohmanwaddup]

UH Metrohealth, Wayne State, and Beaumont are some possible targets. Apply to Case UH, Indiana, UPMC, and Michigan just to see as well.

Makes sense.

May biggest concern right now is if I should potentially burn some bridges by canceling an already accepted rotation in order to accept an away from one of my desired Med peds programs. I’d love to leave a slot open for them, but at some point my school will want to know what I’m doing for 4th year.

 

[Lawpy]

UH Metrohealth, Wayne State, and Beaumont are some possible targets. Apply to Case UH, Indiana, UPMC, and Michigan just to see as well.

UPMC, Case and Michigan look like reaches though

 

[ohmanwaddup]

UPMC, Case and Michigan look like reaches though

Imma still apply. No reason not too. Especially with things being virtual again

 

[The Med-Peds Dude]

I mean that's a better question for a med-peds person @The Med-Peds Dude. What I can say in general is that I wouldn't interpret the dual applying as a sign of bad character or someone trying to play the system. If you do Peds and Med/Peds I don't see that ruffling any Peds feathers. Just don't apply to IM alone specifically at Case/UH. It will be low yield.

Focus on the several places you already have aways at.

I've heard that dual applying at the same program can be a bad idea, do you think it would be bad to apply to peds and med-peds at UH if it's already a long shot?

I was already planning on dual apply peds. Geo is pretty important to me, I considered it to be a top priority to match in cleveland/akron.

was hoping my step score would make up for my preclinical struggles. I suppose my clinical grades might be a nail in the coffin. Tried hard for honors but my school wanted 90th percentile and evals had no weight at all in the honors process (got two 4/4 evals for peds)

Realized I didn't answer this question about dual applying. Personally, I have mixed feeling about this. I'm not sure my feelings have made a big difference in making our rank list, since our faculty and residents have a lot to say about the final rank. In addition, I have no idea if applicants have applied to other specialties, elsewhere (and cannot ask), so why pick on someone that I do know about? I don't know for certain how other Med-Peds PD's feel about this, but if forced to guess, suspect most don't make a big deal over it.

 

[YCAGA]

I didn't read the entire thread but from just the OP...my thought process: US grad not on the terrorist watch list = you good for peds.

If you still don't feel relieved, the match rate for peds from 2016-2020 for DO seniors with a Step 1 of 230-239 was 99%...but that doesn't even sell it fully. 136 out of 137 applicants matched. For Step 1 220-229, the match rate for DO seniors was technically higher: 182/183 matched.

Remember this is already selecting for DO grads which is your main weakness, OP. If below average students had serious trouble matching, the match rate wouldn't be 98-99.5% in fields like IM, peds, and FM.