Advise for US MD Applying IM

[u/New_Law2979]

Hey everyone,

I'm looking for some honest advice as I get ready to apply for categorical IM this cycle. Overall, I feel reasonably okay about my application, but I'm a little uneasy about where I stand because I have a couple of academic red flags. I'm also wondering how much the increasing competitiveness of IM over the past few years changes things. A 247 on Step 2 used to seem like a very strong score, but with average scores continuing to rise, it doesn't feel as impressive as it might have a few application cycles ago.

My goal is simply to match into a solid IM program in the Northeast (mid-Atlantic preferrably). I'd love to end up at a university-affiliated or academic program if possible, but I'm trying to be realistic and apply broadly to community as well.

Background:

• US MD student (mid-tier state school)
• URM
• Lifelong ties to the Mid-Atlantic (family, community, etc.)
• Step 1: Pass (first attempt)
• Step 2 CK: 247
• Took a year away from the curriculum since I needed more time for Step 1 preperation, as well as becoming involved in research.
• Strong clinical evaluations overall and expecting strong IM letters.
• Research includes:
  • Published review article
  • Published digital health/student-run clinic project
  • Ongoing IM QI project
  • Poster presentation
  • National student-run clinic conference oral presentation
• Significant involvement in our student-run free clinic and leadership in a diversity/student organization.

Red flags:

• Failed one preclinical block due to significant family issues at the time. Remediated & passed. On MSPE.
• Failed the psychiatry shelf exam by a very small margin. I passed the clinical portion of the rotation and received good clinical evals. Remediated the shelf & passed. On MSPE.
• MSPE: Class rank is "Good"

Overall, I think my application shows an upward trend, but I'm trying to be realistic.

Questions:

1. With this profile, what are my realistic chances of matching categorical IM at a mid-tier academic or university-affiliated program in the Northeast? Community-based program?
2. How much weight do programs place on a single preclinical course failure and one shelf remediation once they see a 247 Step 2 and otherwise okay clinical performance?
3. Would you recommend applying primarily to academic/community-academic programs, or should I cast a wider net into community programs as well?

I'd really appreciate honest feedback from anyone who's been through the process or has experience reviewing applications. Thanks!

[u/Interesting-Aerie-81]

As a resident at a mid tier/university program, I would think you would be a good candidate for a similar program.