MS3 Needs Advice

First of all take a deep breath.  You are in fine shape with a 250 and 2nd quartile.  What you should do now is try to get some clinical research done this spring in uro.  Home rotation first, then a minimum of 2 aways.  Aways are to your advantage, unless you can't perform well on them.  It gives you a chance to get some letters from big names, find out about a program, and increase your chances at that program.  You need to analyze why you are getting a B in surgery and make sure that you correct whatever shortcoming you have BEFORE your uro rotations.  Take step II later rather than sooner.  Do not apply to every program.  Huge waste of money.  You should get plenty of interviews with your stats.  Apply to 30 or 40 you are really interested in.

You sound like a very solid candidate, wouldn't sweat the B in surgery too much (your excellent board score and some good letters of Rec will probably make up for that).  If I were you I wouldn't fret over taking Step II too much--with your Step I score you can take Step II whenever.  Keep in mind you'll have a ton of interviews in November and will not want to take it then.   As for how many aways you want to do, that is going to hinge a lot on your goals actually.  I would recommend talking to your home chairman or PD and see what most students at your school do for aways (how many and where) and get their opinion on programs that you are interested in or programs they think are strong.  The chair will be very honest with you and can even make phone calls on your behalf to get you an away set up if need be.  In my case he was able to recommend two away programs for me based on where he thought I would fit in well personality wise, goal wise, and geographically and he really nailed it--and I matched at one of them.  One last bit of advice, I couldn't tell if you were joking about applying to every program unless otherwise advised.  I wouldn't--you'll likely get plenty of interview invites if you finish your third year strong and do you well in your away rotation(s).  Pick out all the programs you are genuinely interested in, then throw in some that appeal to you for personal reasons (geographic, family, cost of living,  etc) and you'll likely find you've put together a sizeable list that will net you all the interview invites you'll reasonably be able to accept.  Don't only apply to elite programs, add in some "middle and lower" tier programs as well.  You really don't need to apply to every program in the country to match.  You don't need to apply to half, even.  Be aware of your financial and time constraints for interview season...you'll likely turn down several interviews.  I know I did and i had a 237 with no publications and I applied to <50 programs. 

look, I matched at a top 10 program with a step 1 score of 228 and all Bs in my third year rotations.  Your score is great.  don't worry, you will match!  I did 2 away rotations and got really good ROLs. 

Anonymous User wrote:

look, I matched at a top 10 program with a step 1 score of 228 and all Bs in my third year rotations.  Your score is great.  don't worry, you will match!  I did 2 away rotations and got really good ROLs. 

any advice on how you personally felt you got good ROLs? I have this tendency to not interact with attendings as much because they seem so darn busy, plus any question they ask i never know the answer to because uro is just way too broad of a topic to pick up in a few weeks. but i do work hard, try to know the patient, and i ask the residents a ton of "dumb, basic" questions to lay a foundation. sorry for the thread hijack :/

Anonymous User wrote:

Anonymous User wrote:

look, I matched at a top 10 program with a step 1 score of 228 and all Bs in my third year rotations.  Your score is great.  don't worry, you will match!  I did 2 away rotations and got really good ROLs. 

any advice on how you personally felt you got good ROLs? I have this tendency to not interact with attendings as much because they seem so darn busy, plus any question they ask i never know the answer to because uro is just way too broad of a topic to pick up in a few weeks. but i do work hard, try to know the patient, and i ask the residents a ton of "dumb, basic" questions to lay a foundation. sorry for the thread hijack :/

I would read more.  No one is expecting you to know all of the intricacies of urology as a med student.  They do expect you to have read about the basics.  Avoid asking the residents dumb, basic questions.  The basics come from books.  Get Smith's textbook and read the chapters that cover:  Stone Disease, Hematuria, Prostate CA, BPH, Infection, Bladder CA.  Learn them cold.  That will be an excellent foundation for any rotation, covering about 70% of the stuff you will see.  Find out what cases are going on the next day.  Review the pathophys for the dx and more importantly go over the procedure and relevant anatomy in a surgical manual.  Glenn's is pretty good.  Most of the pimping you get during cases will be about anatomy, so focus on that.  Your school library probably has Glenn's and Smith's online for free.  Buy pocket urology and keep it in your pocket.  It provides excellent and brief information on the go.Once you are prepared knowledge wise, you need to come off as a good future resident to get good LOR's.  The way you do that is by being generally enthusiastic and helpful.  Personality is actually a lot more important than knowledge level to succeed on these rotations.  Avoid annoying questions (see above).  Avoid being annoying in general actually.  Show up early and stay late.  Never ask to take meals, leave early, take a day off.  Always volunteer to do more.  Carry supplies in your white coat (lube, 10cc syringes, Coude catheters, tape, 4x4's).  Anticipate the team's needs.  You know you are going to flush a Foley for the next patient, so you be the one who grabs the irrigation kit and a liter of sterile saline on the way into the ward.  Know the patients cold.  Be the one that has all their vitals and lab results written down.  Follow up on studies. If you aren't scrub in write the postop note and orders toward the end of the case (*if acceptable at that institution).Befriend the residents.  If you get invited out for drinks or to a party, go.  If you are someone they like and want to work with they will help you shine.  I had residents feed me the attendings' favorite pimp questions before every case on some rotations.   At some programs their endorsement can go a long way to getting you a spot too.  Hope this helps.

Anonymous User wrote:

look, I matched at a top 10 program with a step 1 score of 228 and all Bs in my third year rotations.  Your score is great.  don't worry, you will match!  I did 2 away rotations and got really good ROLs. 

 When did you apply?

uroj wrote:

Thanks for all the advice.  I was serious about applying to all the programs IF not advised otherwise, but pretty much realize that everybody would advise me otherwise.I only brought up Step 2 because of the logistics.  With 4th year starting in July, my doing a Home Uro + 2 aways, AND my school requiring Step 2 to be done before Dec, pretty much leaves Oct + Nov.  If Nov is full of Urology interviews (and I've read there are even some in October) I was trying to figure out the best time to take it.  Sounds like Oct, maybe early Nov?Again, thanks a lot for all the advice.

You don't necessarily have to take Step 2 in the fall. Unless you want to go to UCSF, you can even take Step 2 after the match. I know a number of students who matched who are taking Step 2 in February and March. A legitimate argument is that if you take it after match, it will have been several months since third year and the material will not be fresh in your mind. The counter to that is once you've matched, all you have to do is pass.

Looks like I didn't read your previous post carefully enough. I totally glossed over the fact that your school requires Step 2 by December. My fault.Hoepfully what I said will still be of some value to strong candidates like you whose schools don't require Step 2 by December,

Anonymous User wrote:

Looks like I didn't read your previous post carefully enough. I totally glossed over the fact that your school requires Step 2 by December. My fault.Hoepfully what I said will still be of some value to strong candidates like you whose schools don't require Step 2 by December,

So, your post is actually more helpful to me than you might've realized.  Basically, is what you are saying that only UCSF requires Step 2 to rank?  Therefore, although I have to take my Step 2 before Dec. because of my school's policy, I could choose not to release the scores until after match day and suffer no ill consequences? (except at UCSF.)  Thus, all I have to do is pass in Oct/Nov whenever I decide to take it? (which relieves some stress)Am I thinking about that correctly?