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231 on USMLE Step 1
#1
Hello everyone. I would appreciate any input regarding my chances of matching into neurosurgery. I'll keep it short and sweet:

  1. I scored a 231 on the USMLE Step 1 exam.
  2. I had a family emergency that delayed my entry into 3rd year, as a result, my SubI/Aways time will be cut short. 
  3. The family emergency also affected my step prep and mental focus, so I am anticipating/hoping for a higher Step 2 score.
  4. I will have ~20 publications in the field of neurosurgery at the time of application, including 5 first-author manuscripts.
  5. I do not have a home neurosurgery program, but I have networked with several neurosurgeons who may write me letters, assuming they aren't turned off by my Step 1 score.
Thank you!
-ShireTater
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#2
No excuses. What happens when you are distracted in the OR? If it’s a bad outcome that is unacceptable. What will tell the patient if they live or the family? Sorry I was distracted for whatever reason. Come on man or woman.
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#3
I would've phrased it differently, but I agree. Never start with excuses. Step 2 is your chance to shine. People may then ask you what happened with step1, and you can then tell them or not.
231 is not necessarily a dealbreaker, and your scientific output is above average, which is especially great without a home program. You could think about a research year, which could elevate you into very competitive territories if done right and with the right people. I think you should be fine, however, if step 2 will be stellar. Best of luck
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#4
Thank you for the replies. I appreciate your input. Please allow me to clarify, I was not making any excuses - I realize it looks like that because the formatting of the post distorted upon publishing and points 1 and 2 merged together. 

Instead, I intended to communicate the family emergency as a reason I will be missing a few SubI’s, not as a reason I performed poorly on Step 1. The time/energy it took away from Step preparation certainly may have impacted my score, but I’m not using that as an excuse so much as a justification for why I am expecting a more consistent performance on Step 2. And at no point in the application/interview would I use it to explain a poor Step 1 performance. Please accept my apologies for the miscommunication. 

Thanks again for the replies!
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#5
You are completely fucked
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#6
assuming it was a real emergency i feel sorry for you. looks like you got fucked pretty bad
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#7
you will be fine. Even 200s can match, if there is no hole.
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#8
This is my perspective as a senior resident at a top 10 program, where there are multiple residents with step 1 scores < 215. Step scores rarely are given significant weight during applicant rankings post-interview.

Focus now on what you can control. Excel clinically on your subI. Don’t be annoying or needy. Be courteous to everyone. Continue publishing as much as possible. Develop good relationships with your letter writers. Play the post-interview game intelligently. Have your closest mentor contact your top program.

Most importantly, cherish the time post-match before intern year begins.
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