Jason is taking a big test in one month.
Scratch that.
A huge test.
The USMLE Step 1.
Or just Step 1.
Or just Step.
{It's also called boards}
It's been on his mind since he started school basically,
and studying for it began at the beginning of second year.
USMLE stands for United States Medical Licensing Exam.
It's a three step exam for medical licensure in the U.S.
Step 1 is taken between second and third year of medical school.
It's a one day, 8 hour test.
Seven 60-minute blocks.
And the score determines a lot.
Like, a whole lot.
In fourth year,
Jason will start applying for residency programs,
and it is known that the score is what the residency program directors say is their most important criterion in selecting graduating medical students for their program.
(Because it is the only standardized measure of all applicants)
And sure,
there are other factors that hold weight on the application.
Letters of recommendation.
Grades on rotations.
Research.
But for the most part,
there is an "average" step 1 score for most specialties,
and if you score below that average,
you may have to do some other things to beef up your application.
If you're TOO far below the average for that specific specialty,
well... you're sorta out of luck.
It's time to find interest in another field of medicine.
Several months ago,
we hosted an internal medicine resident
interviewing in Arizona for gastroenterology fellowships.
He said he went into medical school KNOWING he wanted to pursue orthopedic surgery.
But because he didn't score high enough on Step 1,
he had to choose something else.
It took him a long time to come to terms with giving up his dream of orthopedics,
and of being a surgeon in general.
And that he still has moments where he wishes he could spend his days in the O.R.
It's kind of crappy that so much weight is put on this ONE test,
especially if you're initially drawn to a specialty that tends to be more competitive.
However,
the good thing about taking the test now,
is that Jason will know his score before he starts rotations.
If there are specialties that would maybe be a stretch to match into,
he will know that beforehand,
and be able to keep his mind open when being exposed to other fields of medicine.
Okay, back to Step.
The more competitive the specialty, the higher the averages:
Orthopedic surgery (245)
Urology (243)
Plastic surgery (245)
Dermatology (247)
Neurosurgery (244)
And I'm sure there are others I am missing.
{A passing score for Step 1 is a 194 by the way,
and the national average is 228.}
Most of the competitive fields are surgical.
Most, but not all.
(i.e. dermatology)
And Jason,
like the gunner he is,
wants to pursue surgery.
And at the moment,
is semi-considering urology.
He is open to other surgical fields,
and even non-surgical fields if he finds what he loves outside of the O.R.,
but he says he is making urology his goal because it is competitive,
and he would need a stellar step score.
So he's setting the bar high for himself.
Jason takes Step 1 on March 6th.
A little less than 4 weeks from now.
He studies 9-10 hours a day away from home,
comes homes and spends a little time with the family,
and once the kids are in bed,
it's more flashcards and videos and review.
We are in full study mode over here.
A even I'm starting to feel the stress of it all.
It's very hard to be in a place of no control.
I honestly would be okay with whatever field of medicine he chooses,
surgery included,
if that's what made him really happy.
My hope is that his score will give him the ability
My hope is that his score will give him the ability
to choose what he loves- no matter how competitive.
25 days and counting!
(a normal sight around here)
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