Should I wait for my step 2 score to apply?

QUESTION:

I am an IMG with a 90 on step 1 and pass on CS. I am applying in anesthesiology. Should I wait for the resultys of my step 2 exam to apply?

ANSWER

NO, I do not think you have to wait. I think that with a 90 on step 1 it is unlikely that they will inactivate you because of this. If you have a LOW step 1 score, then I would wait.

How will failing step 2 CS hurt me?

QUESTION: I am an IMG with scores of 94 and 95,passed cs on second attempt,1 month observership in a community hospital.I graduated 2 years ago.I have applied for IM.From your above post it looks like the cs attempt is going to be very bad.So do you mean that nothing can compensate for my failure in cs once?What about average programs? I would be grateful if you could share your thoughts on my case.  ANSWER: WIth GOOD step 1 nad 2 scores, I would simply say you had explosive diarrhea on the day of the exam. You will still have a good chance. I think a great step 3 score will help as well.

Public Option: Abandoning principles

16% of a 40 trillion dollar economy is a bit more than car fare. It is not surprising that the insurance companies would support reform ONLY as long as it did not include a public option which would be more efficient, less expensive and less corrupt.

I am sure there will be a healthcare reform bill, I do NOT however think that the public option will surivive and that is a profound defeat for the American People. It iwll be a huge payoff for the insureres. Extra funding and mandatory insurance for healthy youg people so that corporations will become richer.

Hope, The Facts and Heroism

I have been thinking of shortening my presentation on ‘Routine Miracles”.  I am doing an interview on Sirius Satelite radio on ‘The Doctor Show” at 6am on Channel 114 on tuesday and need to encapsulate the ideas.

I will be looking at shrinking it down to these three points.

Evidence for the superiority of the current medical student compared to the past

Every bit of objective evidence should convince you that a current medical student is superior to students of the past.

• USMLE Scores 15 years ago were an average of 200, now it is 222
• IQ rises by three points per decade
• Passing rates on Internal Medicine Boards have risen from 75% to over 90%
• Attending Re-certification rates on boards are LOWER than for fresh residents

Would you consider that you, the current student, is the beauty of the world? the ‘Flower’ of your generation? Perhaps there is no one else to save the world, except you. You are intelligent, qualified and capable. You have only to realize that there is NO ONE else who will do these great things such as the cure of autism or diabetes EXCEPT you!

Taking Care of a prisoner in the Emergency Department today

He is lying in a bed in the emergency department with his hands cuffed behind his back. He has a bandage on his head. Two men with nine millimeter guns at his side read the paper and wait. “Tell me what happened?”  “The cops beat me up!” says the man.

I do not want to get involved in that squabble. I do not want to enter into a litigious battle. There is an injured human being in front of me. The cause, who is right and who is wrong are not the point.

He is safe? Is he in pain? How can I help? Does he need surgery? Sutures? Drainage of a hematoma? That is my concern.

The cops, calmly, without defensiveness tell me “He fought several officers and made a grab for a gun. He could have killed someone”

I don’t want to hear this either.

What are the facts? Is he in need of help? I do the exam, I order the CT of the Maxilla.

Would the world be better if I had treated him as right or wrong in the cause? Is the civilization better if I treat a prisoner toughly? or villify the cops?

A human is injured. He needs help. That is all of my concern.

Start reform from the result and work backwards

I have made a career out of going to hospitals and programs that want to change, to improve and to grow. One program had the lowest board pass rate in the United States, another was on probation, another could not keep any graduates of their own medical school, another simply was thought of as a dump.

In every case, you walk in with a clear vision of the result. What do we want it to look like at the end?

Never, ever, ever, ever start with “How do we pay for this?” or ” Can we afford it?” Start with  “THIS IS WHERE WE ARE GOING. now tell me how you want to get there”

In this great land of ours, with the eyes of the world upon us, we are called to create a Great Civilization.  Do we agree on the end product?

Then let us begin. Start now. And I promise you, we shall achieve this end. And the heart and mind of this Great Civilization will expand to fill the grandeur that is our destiny.

How important are Step 3 scores?

QUESTION:Congratulations on your new book and i hope to meet you soon in the bay area! I was wondering though.how important are the step 3 scores? I mean, do PDs look for a pass or is there any optimum range of scores? I have 99 in both step1 & 2, and 85 on step3

ANSWER

When you have all three steps prior to applying, they are, more or less, averaged.

When you have a 99 on step 1 and 2 then a step 3 score of 85 may hurt you just a little.

If you have step 1 and 2 score of 79 and 79 or a failure on step 1 or 2 then a step 3 score of 85 will help you.

One and ONLY presentation with Patients of Routine Miracles is Tonight!

At 7pm tonight, September 10 is the ONE and ONLY presentation with the Patients in the stories of ‘Routine Miracles”. 59th street and 9th avenue in New York City!

I will co-present with the priest who conceived the idea of the book and set the vision for helping relieve the suffering of this world!

 

Hope you will join us!

“What’s in it for me?”

Here I am listening to details of the healthcare reform battle.  I hear a new point. A senator from Nebraska says :” My people who HAVE insurance what to know ‘What’s in it for them?”

Nebraska, interestingly, is a state that identifies itself as 95% believing Christian. I would like to know philosophical system starts with ‘What’s in it for me?”.  HOw about “WHatsoever you do unto the least of these my brethren, you do unto me?”

Look, I don’t want anyone to touch my health insurance, I don’t want to lose anything, and if there are any higher taxes, there is a 100 to 1 chance that I am the one who will have to pay, not you. I don’t understand that really, there is a military that is >$700 billion more than it was 8 years ago and I don’t know why we can’t use some of that. We have troops stationed in OVER one HUNDRED countries, did you know that? Did you know that?

I am going to go okay no matter what. But I have ideals and beliefs that need to live. My belief is that sick people need to be taken care of. Period. 

I don’t use an cruel and insensitive argument of ‘take responsibility for yourself” as an excuse to disregard people.

There are MANY MANY working people who do not get insurance from their jobs,a nd they need to be taken care of. This is a civilization definining moment.

 

How will you like to look at your country in the future? Will we allow forces of hatred and negativity to allow a ‘Screw them! I got mine! Let them get theirs!!”  Now is the time to stand up for goodness, and kindness.  I do NOT believe this is a matter of “I must make my helalthcare worse, to get you yours” Wrong!!

 

There IS enough for everyone.

Let’s live in a country where we take care of each other. Where Goodness and mercy are teh watchwords that define our culture. Where payment for kindness is unlimited and fear is neutralized.

Come to see me on Thursday night at 7pm at StPaul the APostle church in NYC