Give up Hope?

[any hope]

I met with the chair of my department, and my assessment is that he thinks I am a very weak candidate basically because of my step 1 score.  He told me that to be competitive I need to take Step 2 early and do well and do 4 away rotations.  This is an impossible task to do before Sept 15 though as we don't finish third year until June 30th.  Is it time to look at other options?

Step 1: 226 (I've know since the day I got this score that I wrecked my chances of matching, but I've just moved on and forgot about it until my chair basically belittled me over this)

Grades: Mostly Hs in everything

Research: tons, 10 NSG publications, mostly 1st and 2nd author.  Presented nationally and internationally.  Several research grants

Letters: relying on getting 2 from aways, and will have 2 home letters that should be very strong (long relationships)

Aways: ? I was thinking home, top caliber, and lower caliber.  Chair said I need 4 though.

School: Top 40

[Guest]

According to NRMP Match Data, 11 of the 22 applicants who had Step 1 scores of 221 to 230 matched. That is a 50% rate of success. You appear to have strong research and grades and Recs. Even stronger candidates do home and 3 aways, not unusual. Concentrate at least two of your aways on "lower caliber" if there is such a thing. A great Sub-I performance will offset the Step score. Also, try to really endear yourself to your home program as much as possible. Aside from the opportunity to match there, you need a strong rec from the chair and hopefully a few calls on your behalf after the interviews. If you are a personable person, willing to cast a wide net, not get too ambitious, accept any program that comes your way, and do a lot of hard work and hard schmoozing then stay the course. Good Step 2 will be helpful but not nearly as much as great Sub-Is.

[Guest]

APD here: if you were my student I'd reassure you that all will be fine. Plenty of people match with those stats, especially with that research record. Board scores seem to matter a great deal on websites filled with students applying to neurosurgery and seem to matter much much less if the real world. Seriously.

My advice: take step 2 ASAP and do as well as you possibly can. Do two away rotations (not three, because that is not necessary and you will burnout and suck at the last one.) Pick places that are solid all around but not the most competitive. Note: I did not mention the "tier." There is a big difference between solid training programs and places mystically referred to as "top tier." Get advice from residents and other faculty at your home institution to choose these programs.

Finally: my take on your post is that your chair is not your biggest fan. That's fine. Do your best to improve your standing in his eyes and move on to bigger and better things.

[Guest]

Yes, step 1 scores below 250 should be screened out and never read.