Should I give up on my Ophtho dreams?

[Konkurro]

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[NotAProgDirector]

The SF match doesn't provide data like this. But the Ophthal Applicant spreadsheet does (although it's voluntary, and the data may be incomplete. Some people who matched may not have indicated such, for example). Pulling what data there is from that:

USMD DO IMG	Step 1	Step 2 CK	Matched
USMD	21x	250	FALSE
USMD	22x	23x	TRUE
USMD	22X	249	TRUE
USMD	22X	24X	TRUE
DO	224	253	FALSE
USMD	226	247	TRUE
USMD	228	242	TRUE
USMD	229	274	TRUE
USMD	232	N/A	FALSE
DO	232	NA	FALSE
USMD	233	235	TRUE
DO	234	258	FALSE
USMD	236	238	FALSE
USMD	237	262	FALSE
USMD	239	n/a	FALSE
USMD	239	253	FALSE
USMD	239	252	FALSE
USMD	239	261	TRUE

As you can see, many people with 22x on S1 ultimately matched, and many with 23x did not. Many possible explanations: There's more to apps than scores, people with 230's didn't come back to update the sheet, people with 220's lied and said they matched....

Link to the spreadsheet is here: Ophthal Spreadsheet

 

[Konkurro]

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[Phloston]

I am a MS3 at a medical school ranked 23-28 (lol anonymity) who unfortunately only scored a 229 on step 1. I am planning on taking a research year and applying to residencies in 2024 (in which most applicants will have a p/f step 1 score). Do you guys think its possible to match with a much better step 2 score and a research year? Anyone have any success matching ophtho with a similar step 1 score? Any advice is much appreciated.

229 isn't "that low." It's decent. Do well on rotations. Do well on 2CK. Get some ostensible publications and good letters. Simple.

 

[aaronrodgers]

229 isn't "that low." It's decent. Do well on rotations. Do well on 2CK. Get some ostensible publications and good letters. Simple.

Out of curiousity, are you practicing in Osaka as a US physician?

 

[brownman23]

If ophtho is your absolute dream career, then you should do everything possible to achieve it. Ace M3, ace Step2CK, produce tons of pubs in the gap year, network well within your home program and during your away rotations, apply to every program, and hope for the best during the app cycle.

It might be wise to apply to a back up specialty as well.

 

[xenzymaticx]

No don't give up on it. If your stats were way out there that's one thing, but I agree with others on here.

 

[collegestud2013]

Still possible, but definitely far from certain. It's still unclear right now how programs will view Step 1 scores during the transition period to P/F Step 1 for those who have a Step 1 scores when compared to those who just have a Pass. But I suspect most ophtho programs won't outright screen out based on a 229 Step 1 alone when most applicants just have a Pass.

If possible I would try to at least take and get your Step 2 CK score and M3 grades/ranking back before committing to a research year (which in itself is a big decision as you would essentially be losing a year of a future attending salary) so you can commit to the research year knowing that your Step 2 score or med school grades won't hold you back. But I would be prepared for the possibility that even with the research year, there is a still a reasonably high enough chance you may not match and so in the meantime would also prepare an application for a less competitive back-up specialty. For example, you may also apply to Neurology and then do a neuro-ophthalmology fellowship afterwards.

 

[Konkurro]

229 isn't "that low." It's decent. Do well on rotations. Do well on 2CK. Get some ostensible publications and good letters. Simple.

Thank you for the kind words sir/madam, definitely makes me feel a lot better. Like I said, I am prepared to fail but would at least want to think I had some sort of shot!

 

[Konkurro]

If ophtho is your absolute dream career, then you should do everything possible to achieve it. Ace M3, ace Step2CK, produce tons of pubs in the gap year, network well within your home program and during your away rotations, apply to every program, and hope for the best during the app cycle.

It might be wise to apply to a back up specialty as well.

Thank you for the advice, the time you took to type that is much appreciated!

 

[Konkurro]

No don't give up on it. If your stats were way out there that's one thing, but I agree with others on here.

Thank you, your words are appreciated as is the time you took to reply!

 

[Konkurro]

Still possible, but definitely far from certain. It's still unclear right now how programs will view Step 1 scores during the transition period to P/F Step 1 for those who have a Step 1 scores when compared to those who just have a Pass. But I suspect most ophtho programs won't outright screen out based on a 229 Step 1 alone when most applicants just have a Pass.

If possible I would try to at least take and get your Step 2 CK score and M3 grades/ranking back before committing to a research year (which in itself is a big decision as you would essentially be losing a year of a future attending salary) so you can commit to the research year knowing that your Step 2 score or med school grades won't hold you back. But I would be prepared for the possibility that even with the research year, there is a still a reasonably high enough chance you may not match and so in the meantime would also prepare an application for a less competitive back-up specialty. For example, you may also apply to Neurology and then do a neuro-ophthalmology fellowship afterwards.

Ahh ok, that is good advice. I will try my hardest to get that S2CK grade and am trying hard on my rotations right now. I really appreciate the time you took to write out your perspective and for the advice!

 

[dabears505]

Please don't waste a year doing research to try and get into optho. You will not match with that score. Just pick something else and move on with life. Repeat, Do not waste a year of your life. You will also not be as good of a candidate applying non traditionally against regular M4s.

 

[Eye-eye]

As someone who failed to match this past year with a 239, decent M3 scores, some pubs, etc... It could be a very tough road, and I would dual apply, but do everything you can to strengthen your app for ophtho in the meantime. The biggest things for that will probably be an ophtho-related pub or two if you can, and most importantly, getting in the good graces of someone important in the field. Ophtho is still an old boys club to a very depressing degree. I didn't really have an opportunity to get in good with someone important last year, and now working for a "big name" in the field, I see how that can be the absolute most important part of your application in many cases, outside your performance on interview day.

Unless you had strong support from a really big name, I'd say 220s are going to get you screened out a lot and make it REALLY tough. But I think you'll be at a huge advantage against those with only a pass. Unless of course programs just require a step 2 score and focus on that. If you can improve your step 2 score and make that really competitive with other applicants, it would certainly help. But take all of this with the caveat that none of us know what'll happen that year. Maybe a huge number of other reapps/IMGs/etc who have a low-ish step 1 for the field will see this as their opportunity to shine, against all the passes. It's hard to say, but I think a backup plan is really important. If you think a further year of research could help if you don't match, to hopefully give time for the craziness of it being the first year most people won't have step 1 scores to settle down, if nothing else, then go for it. If you think there's another specialty you'd also enjoy a lot, though, consider dual applying. I truly believe most people could be happy in one of at least a few, if not many, different fields. Don't give up on your dream too quick, but be realistic and plan accordingly.

Good luck! Trust me, I know some of what you're feeling, and I really hope the best for those in such situations. It's a ****ty system, to go through all this and have one number make or break things to the extent it can. But it's life, unfortunately.

 

[StressfulMD]

Please don't waste a year doing research to try and get into optho. You will not match with that score. Just pick something else and move on with life. Repeat, Do not waste a year of your life. You will also not be as good of a candidate applying non traditionally against regular M4s.

Way to be encouraging pal. Offers no advice on how to move on either.

 

[nerve zapper]

Please don't waste a year doing research to try and get into optho. You will not match with that score. Just pick something else and move on with life. Repeat, Do not waste a year of your life. You will also not be as good of a candidate applying non traditionally against regular M4s.

Totally agree. OP, I had a similar step 1 as you and was devastated. Despite multiple pubs, nat’l ophtho conference presentations and the support of my home program’s chair, I took a step back and re-evaluated. I had multiple friends with stellar scores and research who failed to match or matched in small undesirable towns. Also, remember that a research year is a year of lost peak income. There are many advantages to ophtho but also some important drawbacks/disadvantages as well. Think about what you really want out of your career as an MD.

I carefully considered my options and ultimatey pivoted away from ophtho. I didn’t dual apply as I felt that would detract from my chances in my new chosen field. I’m now a pgy-2 in a specialty I love with great quality of life, strong job market, specialist and procedural care (no primary care), potential for inpt work and leadership opportunities, and a relatively brief and painless residency. Living in my dream city and in a very supportive, well regarded program. In other words I am happy to have given up on ophtho, and you could be too. Think about it. Happy to answer any questions!

 

[snooper]

optho is a small field, so research with someone well known or well connected will go a long way to matching.

 

[dabears505]

Way to be encouraging pal. Offers no advice on how to move on either.

Yea I'd rather give good advice instead of sow false hopes and waste a year of someone's life and make it harder for them to match in some other field. The truth is if you don't have 240s, you are not likely going to match in optho. Just face the facts, move on and live your life.

 

[Konkurro]

Please don't waste a year doing research to try and get into optho. You will not match with that score. Just pick something else and move on with life. Repeat, Do not waste a year of your life. You will also not be as good of a candidate applying non traditionally against regular M4s.

The diversity of opinion and the time you took to write out your answer is quite appreciated. Definitely good to see some other perspectives. Do you not think that applying with others who are p/f step 1 will take off some weight from step 1 for me too?

 

[NotAProgDirector]

The diversity of opinion and the time you took to write out your answer is quite appreciated. Definitely good to see some other perspectives. Do you not think that applying with others who are p/f step 1 will take off some weight from step 1 for me too?

Many people with stellar apps do a research year for ophthal. I expect a good number of people will have scores, and I doubt programs will somehow ignore them.

The advice you've received in this thread is solid. Your step 1 score is going to be a problem, the only way you'll get a spot in ophthal is by maximizing the rest of your app. You'll need outstanding clinical grades, a well connected ophthal mentor, and a productive research year. Even with all of that, you may not match.

Dual applying is an option, but is not without risk also. Whatever other field you apply to will see the ophthal research year. If you try to state in your PS that you've "changed your mind", I doubt programs will believe you. Some, if not many, backup programs may decline to interview you at all as it's obvious you're applying to ophthal. There's a reasonable chance you'll end up in SOAP.

 

[Konkurro]

Totally agree. OP, I had a similar step 1 as you and was devastated. Despite multiple pubs, nat’l ophtho conference presentations and the support of my home program’s chair, I took a step back and re-evaluated. I had multiple friends with stellar scores and research who failed to match or matched in small undesirable towns. Also, remember that a research year is a year of lost peak income. There are many advantages to ophtho but also some important drawbacks/disadvantages as well. Think about what you really want out of your career as an MD.

I carefully considered my options and ultimatey pivoted away from ophtho. I didn’t dual apply as I felt that would detract from my chances in my new chosen field. I’m now a pgy-2 in a specialty I love with great quality of life, strong job market, specialist and procedural care (no primary care), potential for inpt work and leadership opportunities, and a relatively brief and painless residency. Living in my dream city and in a very supportive, well regarded program. In other words I am happy to have given up on ophtho, and you could be too. Think about it. Happy to answer any questions!

Thank you for the perspective, appreciate you own story and explanation of your reasoning!

 

[Konkurro]

Many people with stellar apps do a research year for ophthal. I expect a good number of people will have scores, and I doubt programs will somehow ignore them.

The advice you've received in this thread is solid. Your step 1 score is going to be a problem, the only way you'll get a spot in ophthal is by maximizing the rest of your app. You'll need outstanding clinical grades, a well connected ophthal mentor, and a productive research year. Even with all of that, you may not match.

Dual applying is an option, but is not without risk also. Whatever other field you apply to will see the ophthal research year. If you try to state in your PS that you've "changed your mind", I doubt programs will believe you. Some, if not many, backup programs may decline to interview you at all as it's obvious you're applying to ophthal. There's a reasonable chance you'll end up in SOAP.

Yes, this certainly sounds risky, but I've always been brash a bit too risk-tolerant for my own good. It will be a hard decision to make for sure, I have a meeting with a potential mentor coming up, hopefully they can also shed some light before I make my final decision

 

[Eye-eye]

Also, remember that a research year is a year of lost peak income. There are many advantages to ophtho but also some important drawbacks/disadvantages as well. Think about what you really want out of your career as an MD.

This is true, but only if you work the same or more years in another field than in ophtho, and the pay gap should also be factored in.

Who does better financially and personally, the pediatrician that loves her job and works it for 40 years despite making $200k/year; or the ortho doc making $800k/year who burns out after 8 years because she didn't really follow her passion? The pediatrician, for many reasons. Or the ophthalmologists who had a year or two taken out in the beginning in order to match in an uphill battle but has an average income of $400k/year, versus the IM subspecialist making $350? Even if they work a few years less, the ophtho doc wins. And it's a short residency (4 y) compared to most that make any significant income. In short, money is a consideration, but it shouldn't be a big one - and one year more of training is just not a huge factor compared with choices like how much you enjoy the specialty (who would've thought?), how long you can thus practice it / how many hours, the specialty's average pay, practice setting, location, etc.

If ophtho will make you significantly happier than another field, I'd think about going for it, for at least one cycle (while keeping in mind the point made by @NotAProgDirector that it can be tricky to dual apply and that failing to match can make things much harder the next time around).

 

[Konkurro]

This is true, but only if you work the same or more years in another field than in ophtho, and the pay gap should also be factored in.

Who does better financially and personally, the pediatrician that loves her job and works it for 40 years despite making $200k/year; or the ortho doc making $800k/year who burns out after 8 years because she didn't really follow her passion? The pediatrician, for many reasons. Or the ophthalmologists who had a year or two taken out in the beginning in order to match in an uphill battle but has an average income of $400k/year, versus the IM subspecialist making $350? Even if they work a few years less, the ophtho doc wins. And it's a short residency (4 y) compared to most that make any significant income. In short, money is a consideration, but it shouldn't be a big one - and one year more of training is just not a huge factor compared with choices like how much you enjoy the specialty (who would've thought?), how long you can thus practice it / how many hours, the specialty's average pay, practice setting, location, etc.

If ophtho will make you significantly happier than another field, I'd think about going for it, for at least one cycle (while keeping in mind the point made by @NotAProgDirector that it can be tricky to dual apply and that failing to match can make things much harder the next time around).

Thanks for the detailed perspective. I didn't think about all that in terms of the money stuff. To be honest, I don't think about money too much, and a year of lost attending income (even though I'll have 400k of loans after accrued interest by the time of paying off) doesn't really phase me. I live pretty minimally, and other than having to pay for a house and family stuff (im still single rn), I don't think I'd need to spend much to be happy. I really how you match this cycle my friend

 

[Lawpy]

I am a MS3 at a medical school ranked 30 (lol anonymity) who unfortunately only scored a 22x on step 1. I am planning on taking a research year and applying to residencies in 2024 (in which most applicants will have a p/f step 1 score). Do you guys think its possible to match with a much better step 2 score and a research year? Anyone have any success matching ophtho with a similar step 1 score? Any advice is much appreciated.

Contrary to the doomsday posts, i don't think a 220 is a red flag in a mostly P/F Step 1 world, because at that point, Step 1 becomes nearly meaningless and much of the weight is placed on Step 2. Make sure you study very hard for a 250-260 on Step 2. That's critical

 

[Lawpy]

Many people with stellar apps do a research year for ophthal. I expect a good number of people will have scores, and I doubt programs will somehow ignore them.

The advice you've received in this thread is solid. Your step 1 score is going to be a problem, the only way you'll get a spot in ophthal is by maximizing the rest of your app. You'll need outstanding clinical grades, a well connected ophthal mentor, and a productive research year. Even with all of that, you may not match.

Dual applying is an option, but is not without risk also. Whatever other field you apply to will see the ophthal research year. If you try to state in your PS that you've "changed your mind", I doubt programs will believe you. Some, if not many, backup programs may decline to interview you at all as it's obvious you're applying to ophthal. There's a reasonable chance you'll end up in SOAP.

You really think a 220 Step 1 will be a problem in 2024 with mostly P/F Step 1 in place? Because a 220 is exactly what i'd expect to be comparable to a pass, so unless ophtho PDs think a pass on Step 1 is a red flag, i don't see why a 220 would doom OP. Especially by then, much weight will be placed on Step 2

 

[Eye-eye]

You really think a 220 Step 1 will be a problem in 2024 with mostly P/F Step 1 in place? Because a 220 is exactly what i'd expect to be comparable to a pass, so unless ophtho PDs think a pass on Step 1 is a red flag, i don't see why a 220 would doom OP. Especially by then, much weight will be placed on Step 2

Well, the PDs will still have the ingrained association of scores they're used to seeing with how they would've seen them at the time. So some will see 220 and instinctively think "bad" on at least a subconscious level. Now they may see "Pass" and think "bad" instinctively as well... or their mind might inherently assume it's equivalent to an "average" score until proven otherwise (again, on at least a subconscious level). Unfortunately, "average" for an ophtho application who matches has been above 235 for over a decade and 245 for the past few years, and even the unmatched mean has been above 220 since 2012. So yes, by comparison, it could still hurt you. Should it, logically? No. But that's not how the human mind works.

On the flipside, I think some PDs will see ANY step 1 score that's not just Pass (well, maybe not a 195, but you get the idea) as very good and helpful.

 

[Lawpy]

Well, the PDs will still have the ingrained association of scores they're used to seeing with how they would've seen them at the time. So some will see 220 and instinctively think "bad" on at least a subconscious level. Now they may see "Pass" and think "bad" instinctively as well... or their mind might inherently assume it's equivalent to an "average" score until proven otherwise (again, on at least a subconscious level). Unfortunately, "average" for an ophtho application who matches has been above 235 for over a decade and 245 for the past few years, and even the unmatched mean has been above 220 since 2012. So yes, by comparison, it could still hurt you. Should it, logically? No. But that's not how the human mind works.

On the flipside, I think some PDs will see ANY step 1 score that's not just Pass (well, maybe not a 195, but you get the idea) as very good and helpful.

This is why retroactively converting all Step 1 scores to P/F for ERAS 2023 onwards is the best, simplest and fairest move

 

[Captain_Falcon]

This is why retroactively converting all Step 1 scores to P/F for ERAS 2023 onwards is the best, simplest and fairest move

How is it fair to any student that did well on Step 1?

 

[Lawpy]

How is it fair to any student that did well on Step 1?

It's fairer than all the other alternatives. Obviously some people are going to lose out in any change, but doing well on an exam that's going to change anyways has less meaning (because the focus is shifted to an exam that's still scored) compared to an exam that's always going to remain scored. Retroactively converting to P/F benefits the vast majority of Step 1 takers because by definition, the people who did score well on Step 1 is necessarily in the minority

 

[Dave1980]

I am a MS3 at a medical school ranked 30 (lol anonymity) who unfortunately only scored a 22x on step 1. I am planning on taking a research year and applying to residencies in 2024 (in which most applicants will have a p/f step 1 score). Do you guys think its possible to match with a much better step 2 score and a research year? Anyone have any success matching ophtho with a similar step 1 score? Any advice is much appreciated.

https://www.usnews.com/best-graduate-schools/top-medical-schools/research-rankings

There is no school ranked at 30 lol

 

[Dave1980]

Way to be encouraging pal. Offers no advice on how to move on either.

Obviously moving on means chose a different specialty. Don't be purposefully dense. What else could it possibly mean?!

 

[Captain_Falcon]

It's fairer than all the other alternatives. Obviously some people are going to lose out in any change, but doing well on an exam that's going to change anyways has less meaning (because the focus is shifted to an exam that's still scored) compared to an exam that's always going to remain scored. Retroactively converting to P/F benefits the vast majority of Step 1 takers because by definition, the people who did score well on Step 1 is necessarily in the minority

I don't necessarily agree with the bolded . It's much more of a sliding scale (i.e. low Step 1 scores will have a great benefit, middle of the pack Step 1 scorers won't really benefit, and higher scorers will be effectively punished). You're also assuming all step 1 scores are created equal. Someone with a 205 will have an uphill battle regardless of field. Someone with a 230 will be fine for most fields (excluding Derm, neurosurg, etc.).

I don't see how this is fair at all. There doesn't need to be an alternative. Why not just let Program Directors decide for themselves? Say if 33% of PDs only look at Step 2 now, it's their choice to "level the playing field." Say 33% will still screen if a student has a Step 1 score, again their choice. And the remaining third will do it on a case-to-case basis. Retroactively doing something is a bad idea because it forces a choice on not just program directors, but effectively messes up those students that studied their asses off for Step 1 when they could have done other things to benefit themselves in the long run.

 

[Lawpy]

I don't necessarily agree with the bolded . It's much more of a sliding scale (i.e. low Step 1 scores will have a great benefit, middle of the pack Step 1 scorers won't really benefit, and higher scorers will be effectively punished). You're also assuming all step 1 scores are created equal. Someone with a 205 will have an uphill battle regardless of field. Someone with a 230 will be fine for most fields (excluding Derm, neurosurg, etc.).

I don't see how this is fair at all. There doesn't need to be an alternative. Why not just let Program Directors decide for themselves? Say if 33% of PDs only look at Step 2 now, it's their choice to "level the playing field." Say 33% will still screen if a student has a Step 1 score, again their choice. And the remaining third will do it on a case-to-case basis. Retroactively doing something is a bad idea because it forces a choice on not just program directors, but effectively messes up those students that studied their asses off for Step 1 when they could have done other things to benefit themselves in the long run.

A pass benefits everyone who didn't (or wouldn't have to) score high because they don't have to invest a sheer amount of effort stressing over an exam where the score matters (and can also mask their scores if they feel it's below average if retroactive conversion is in place). A pass also by definition is at least greater than the minimum passing score (so i think 190), so pass > 205 doesn't really make sense. The Step 1 creep across specialties would also immediately disappear.

Again i'm talking comparatively. There is no alternative other than the vague subjective interpretation on how to compare a pass to a score, which frankly just looks like an attempt to avoid the unpleasant reality of accepting the demise of Step 1 scores.

Also Step 1 change was announced a long time ago. You're worried about a small fraction of people hastily studying for a 250+ before Step 1 collapses to P/F. Many programs already switched over to Step 2 emphasis so the game has already changed

All this is a side discussion to the underlying issue that OP's chances for ophtho are needlessly getting impacted because some PDs apparently can't let go of their obsession of Step 1 and will still count that heavily even with the overall shift away from Step 1 to Step 2

 

[Captain_Falcon]

A pass benefits everyone who didn't (or wouldn't have to) score high because they don't have to invest a sheer amount of effort stressing over an exam where the score matters (and can also mask their scores if they feel it's below average if retroactive conversion is in place). A pass also by definition is at least greater than the minimum passing score (so i think 190), so pass > 205 doesn't really make sense. The Step 1 creep across specialties would also immediately disappear.

Again i'm talking comparatively. There is no alternative other than the vague subjective interpretation on how to compare a pass to a score, which frankly just looks like an attempt to avoid the unpleasant reality of accepting the demise of Step 1 scores.

Also Step 1 change was announced a long time ago. You're worried about a small fraction of people hastily studying for a 250+ before Step 1 collapses to P/F. Many programs already switched over to Step 2 emphasis so the game has already changed

All this is a side discussion to the underlying issue that OP's chances for ophtho are needlessly getting impacted because some PDs apparently can't let go of their obsession of Step 1 and will still count that heavily even with the overall shift away from Step 1 to Step 2

You're advocating for retroactively changing scored Step 1 exams to P/F --> the "sheer amount of effort" has already been applied for people like me (an M3 who took Step 1 after M2) who is applying next year with M3s who will be taking a P/F exam. If programs have already switched to a Step 2 emphasis, then that is their decision to make. This whole idea of yours that we should retroactively change an already scored exam where students already put in X amount of effort is stupid

 

[Lawpy]

You're advocating for retroactively changing scored Step 1 exams to P/F --> the "sheer amount of effort" has already been applied for people like me (an M3 who took Step 1 after M2) who is applying next year with M3s who will be taking a P/F exam. If programs have already switched to a Step 2 emphasis, then that is their decision to make. This whole idea of yours that we should retroactively change an already scored exam where students already put in X amount of effort is stupid

I was accounting for all cases including those currently studying for Step. A 230+ and lower doesn't lose out with conversion to P/F even with effort used for studying (it's not a waste of effort when the benefits of Step 1 transfer over to MS3/Step 2). You're focusing on the small minority who lose out by studying all the way to 250+. We need to account for everyone, not the SDN obsession of high scorers, so the change is anything but stupid

 

[Captain_Falcon]

I was accounting for all cases including those currently studying for Step. A 230+ and lower doesn't lose out with conversion to P/F even with effort used for studying (it's not a waste of effort when the benefits of Step 1 transfer over to MS3/Step 2). You're focusing on the small minority who lose out by studying all the way to 250+. We need to account for everyone, not the SDN obsession of high scorers, so the change is anything but stupid

But you see you are not accounting for everyone. And it isn't just the top 20% of scorers either. Say a student from low tier MD or even DO took Step 1 and got a 238 and they want to apply to academic institutions for medicine or neuro, or even general surgery. You think now having a pass is beneficial to them after they KNOW they put in that work and got that score?

Your argument is flawed and is trying to uniformly fix something that doesn't need to be fixed. Let program directors decide individually what they want to do

 

[Lawpy]

But you see you are not accounting for everyone. And it isn't just the top 20% of scorers either. Say a student from low tier MD or even DO took Step 1 and got a 238 and they want to apply to academic institutions for medicine or neuro, or even general surgery. You think now having a pass is beneficial to them after they KNOW they put in that work and got that score?

Your argument is flawed and is trying to uniformly fix something that doesn't need to be fixed. Let program directors decide individually what they want to do

The effort into the score transfers over to everything else. It's not a waste of effort even with retroactive conversion to P/F. That's the thing.

And of course it needs to be fixed. My point in this discussion is i strongly disagree with OP's Step 1 being held against them with ophtho when Step 1 is increasingly transitioned to P/F. Letting PDs decide makes ERAS cycle 2023 and 2024 extremely unpredictable and chaotic. It's not a good thing which is why i'm proposing a controversially uniform fix

 

[Captain_Falcon]

The effort into the score transfers over to everything else. It's not a waste of effort even with retroactive conversion to P/F. That's the thing.

And of course it needs to be fixed. My point in this discussion is i strongly disagree with OP's Step 1 being held against them with ophtho when Step 1 is increasingly transitioned to P/F. Letting PDs decide makes ERAS cycle 2023 and 2024 extremely unpredictable and chaotic. It's not a good thing which is why i'm proposing a controversially uniform fix

Sure the effort isn't completely lost, but that time spent could have been on research or whatever other activity the student wants to do. It does not need to be fixed, we're just in complete disagreement.

So because PDs will weigh Step 1 differently we should force them all to not have a choice but see Pass/Fail. Why stop there? Why not just uniformly make it easy for them with "This student has Research- Pass?" I mean, some PDs value research more than others and and makes it really confusing, unpredictable, and chaotic... right?

 

[Lawpy]

Sure the effort isn't completely lost, but that time spent could have been on research or whatever other activity the student wants to do. It does not need to be fixed, we're just in complete disagreement.

So because PDs will weigh Step 1 differently we should force them all to not have a choice but see Pass/Fail. Why stop there? Why not just uniformly make it easy for them with "This student has Research- Pass?" I mean, some PDs value research more than others and and makes it really confusing, unpredictable, and chaotic... right?

Comparing between scored Steps and P/F is the biggest variability because what score is equal to a Pass varies from program to program and low or even average scores can be a red flag. A 230 can be "above Pass" for one program and "below Pass" for another, which is problematic.

If a Pass is treated like 190 (the score needed to pass Step) everywhere, i wouldn't be this strong on retroactively converting everything, because even in OP's case, a 220+ is better than a Pass (but not good enough for the average).

That said, this is all hypothetical because ERAS 2023 will have a mix of scores anyways and won't retroactively convert any score so OP should plan the next steps of doing well on clinicals and acing Step 2

 

[Captain_Falcon]

Comparing between scored Steps and P/F is the biggest variability because what score is equal to a Pass varies from program to program and low or even average scores can be a red flag. A 230 can be "above Pass" for one program and "below Pass" for another, which is problematic.

If a Pass is treated like 190 (the score needed to pass Step) everywhere, i wouldn't be this strong on retroactively converting everything, because even in OP's case, a 220+ is better than a Pass (but not good enough for the average).

That said, this is all hypothetical because ERAS 2023 will have a mix of scores anyways and won't retroactively convert any score so OP should plan the next steps of doing well on clinicals and acing Step 2

The thing is though, this is all conjecture and the exact reason why it would be a stupid idea.


Back to the OP, if you get the research, have connections, and come back with a kick-ass Step 2 score > 250 you may match. Idk what the odds would be, but even with a strong Step 1, Step 2, AND research it is hard to match ophthalmology. If I were you, I'd try and find exposure to other fields and see if you could fall in love with something else where your step 1 isn't much of a problem. And then decide at the end of M3 if a research year is still what you want to do

 

[Lawpy]

The thing is though, this is all conjecture and the exact reason why it would be a stupid idea.


Back to the OP, if you get the research, have connections, and come back with a kick-ass Step 2 score > 250 you may match. Idk what the odds would be, but even with a strong Step 1, Step 2, AND research it is hard to match ophthalmology. If I were you, I'd try and find exposure to other fields and see if you could fall in love with something else where your step 1 isn't much of a problem. And then decide at the end of M3 if a research year is still what you want to do

It's not stupid. It's controversial and people don't like losing out when unpleasant changes happen (that's the whole reason why Step 1 change was so controversial and really created this domino effect). I think Step 2 is heading in direction of P/F very soon and app caps are going to happen, and none of this is pure conjecture.

I agree with the rest of your post