I'm a 4th year medical student going into IM and hoping to eventually do a heme-onc fellowship. I made a 236 on Step 1 - however, at the time I was going through a lot of personal and family problems (my sister died a month before I took the test, which obviously shook me up). My question is: with that score, how important is it for me to take step 2 early? I realize it's a solid but not stellar score, and I think I could do better now that my head is a little clearer. I am scheduled now to take it in late November - is it worth it for me to try to reschedule and take it early enough so that programs can take it into account for interviewing decisions? Or will my score be back in time for them to see it?

I'm a 4th year medical student going into IM and hoping to eventually do a heme-onc fellowship. I made a 236 on Step 1 - however, at the time I was going through a lot of personal and family problems (my sister died a month before I took the test, which obviously shook me up). My question is: with that score, how important is it for me to take step 2 early? I realize it's a solid but not stellar score, and I think I could do better now that my head is a little clearer. I am scheduled now to take it in late November - is it worth it for me to try to reschedule and take it early enough so that programs can take it into account for interviewing decisions? Or will my score be back in time for them to see it?

Are you seriously apologizing for a 236?! (What the hell is the world coming too . . .)

Look, step 2 will only help you. Take it early, make sure it's on your app. More and more programs are paying attention to the score as it's the only step score that correlates with success in residency, plus it's really bad form to accept an applicant who then goes onto fail step 2.

Agree and disagree with jdh.

First, a 236 is a great score and nothing to be concerned about. According to the 2007 data, the average Step 1 score for US allo's matching into OB was 214 and the 75th percentile was 228. You're well above this, placing you into the 90+ percentile.

Disagree, in that I don't think that taking step 2 early is necessarily needed. If you do as well on it or better, great. In fact, as long as you get >220, there's no problem at all. Should you get a score <220, then you've hurt your chances. So, I would not rush to take Step 2 if you're not ready.

thanks for the feedback! It seems like everyone posting on SDN has a score >250, so it's hard not to feel intimidated! I've also heard the rumor floating around that programs who use cutoffs for interviews generally make it around 230....so I'm not really sure how much it would even matter if I study my rear off and bring my score up 10-15 points...

Disagree, in that I don't think that taking step 2 early is necessarily needed. If you do as well on it or better, great. In fact, as long as you get >220, there's no problem at all. Should you get a score <220, then you've hurt your chances. So, I would not rush to take Step 2 if you're not ready.

Dammit I hate it when I get my advice skewed . . . but it seems that more and more places are noticing step 2. It's a known indicator of residency success, so would you at least say that it is becoming more preferred to have the score on hand. For instance, everything be equal, one applicant has a step 2 of satisfactory level and one does not have a score, I think the fight goes to the applicant with the score, and the small margins make a difference the higher up the food chain you apply. I would say that MOST of the posters on here are interested in ranking at the BEST place on their list, right?

Of course, if one if not ready, don't take the test . . .

I completely agree that a good Step 2 score is a positive.

Hard to know what to do with Step 2. Assuming all else is equal (which never happens, but for the sake of argument):

Applicant #1: Step 1 255, no Step 2
Applicant #2: Step 1 220, Step 2 220

Who to rank higher? Hard to say.

A good Step 2 score can go a long way to negating a poor Step 1 score.

I personally feel that Step 2 tends to predict residency performance better than step 1. Most published data tends to suggest that neither is really predictive.

I personally feel that Step 2 tends to predict residency performance better than step 1. Most published data tends to suggest that neither is really predictive.

I'm sure you more up on this data than I am, but a couple of guys at my home institution were looking at this and we were told their numbers showed statistical significance for step 2 score, but I do not know their end points . . .

In my opinion/experience, a Step 1 of 236 is a great score for IM, and would likely not exclude you from any program by itself. If your other credentials are equal to or greater than the Step 1 score than you need to go no further. Unless you crush Step 2 (apologies to the book author) it will not help you one bit.

The strategy I employed, which I think is a good one, was to take Step 2 just before Christmas, which was late enough that interviewers wouldn't wonder about it, but early enough that if I did well, I could still report my score before programs finalized rank lists. I ended up doing well, and it served as a positive note to go out on with review committees.

First off, I am sorry about your sister. This must have been a sad time for you.

Your step I score is quite good. Not off the charts, but for internal medicine this is quite a high score. Even for the higher tier programs your step score should not be the limiting factor in getting you an interview vs. not.

I totally disagree with taking the Step 2 early. If you somehow did significantly worse (unlikely if you are generally a good test taker, but it could happen) it might hurt your application. Even if you do better and get a 245 or something, the vast majority of IM programs are not going to use that to give you an interview vs. not. I think you are overestimating the important of step scores in picking IM residents also. It is important to do well, but a 236 is doing "well" for IM anyhow. I hear you on wanting to do "better" on Step 2, because standardized test taking is all relative anyway. If you know you are normally a great standardized test taker, then you may not be totally happy with the 236, but trust me, it is good for IM. We're not talking about derm or ortho here, where there are so many people with 230+ board scores and so few residency spots...

I'd vote for keeping the November test date. If you rock the test you will still get your scores early enough to submit to the residency programs (I think...it's been 5 years since I was an IM residency applicant). If you somehow don't get the score you want (god forbid you get a 220's or something...trust me that still ain't that bad) you can just not forward them to the residency program. I doubt they will ask...I was never asked for these during my medicine residency interviews.

I would focus now on doing an IM subinternship and getting a good letter of recommendation from that. That is going to count as much or more as a high step score, at this point. I think you are safe in assuming that if any programs are screening out people by test scores, your >230 Step I score should get you through their filter.

To the original OP, I pm'd you.

I am in a similar situation. I got a very similar score and want to do IM. I finished off 3rd year with IM and thought since I had the shelf studying fresh in my head, I would study and take Step 2. I had heard, as has been mentioned in this thread, that Step 2 is being looked at more and asked about in interviews for IM.

I am a bit worried though. I took a NBME exam last week and got only a few points higher than my Step 1 score. After I took the NBME exam, my aunt passed away, so needless to be said the past couple of days I have not been studying hard. My exam is in 6 days. I am not sure what to do. I have been asking others what to do, and they have said to just take the test because I have already put in the time to study and "everyone does better than what they did on NBME". I'm not too sure about it, because from other threads, it seems like NBME (the test I took) was a good marker for what you really do on the real exam. I am just worried about doing worse than my Step 1.

Any thoughts would be greatly appreciated. Thanks in advance.

Why the big rush to take Step II? You can easily take it in September and the places you apply would probably have the results by the time they are even thinking of inviting people to interview, right? I mean, unless they've changed things a lot in the last 4-5 years, they don't even send out invites until they have gotten the Dean's letter for the applicants, which doesn't even come out until November.
It doesn't sound like you have much to worry about testwise if you got 230's on Step I, but if you aren't feeling confident then why not give yourself a few more months to study?

Why the big rush to take Step II? You can easily take it in September and the places you apply would probably have the results by the time they are even thinking of inviting people to interview, right? I mean, unless they've changed things a lot in the last 4-5 years, they don't even send out invites until they have gotten the Dean's letter for the applicants, which doesn't even come out until November.
It doesn't sound like you have much to worry about testwise if you got 230's on Step I, but if you aren't feeling confident then why not give yourself a few more months to study?

Thanks for the reply. I guess my reasoning for taking the test now rather than later are...
1) I just finished medicine rotation, and everythign is fresh. If I took it later, it would probably would have meant more reviewing and time to study.
2) I've already been studying for the past 3 weeks.
3) I'm doing an away elective in August, and Sub-I in September, and another away in mid October --- won't have much time to study later.
4) Initially I foolishly thought if I could do really well on Step 2 then it would look good for applications.

If I pushed it off, I'd probably not take it until much later, maybe even November. I guess then it goes back to the same argument of whether Step2 is important or not if you did well on Step1 for IM residency, etc..

oh OK bbt now I understand. It sounds like you take the test now or wait until November. I'd say do whatever you feel comfortable with. Now is fine, and so is November, in my opinion.

I would say if you got a 230+ on Step I, then your step 2 score is not very important for IM. If you had bombed step I then it would be important to try and do better on Step 2, if you want to get in to a well known IM program. My situation was that I only got a mid 220's (only very slightly above average) on Step 1, which I wasn't happy with, normally being a good standardized test taker. I actually delayed taking Step 2 - I think it was December even? I was thinking I needed to be sure and study enough. Then I got a 242 on Step 2, which I was happier with. I was at a well known med school, with average grades but some nice comments in my letters of recommendation. I still got in to a well known internal medicine residency program, and it actually seemed they were recruiting me at my interviews. These places weren't in NYC or Boston or something, though.

I think with a 230's on Step I I'd be sorely tempted to sit on the score, and take my step 2 in November or December. That way if you rock it you can still submit your scores to the residency programs, but if you somehow did worse than you wanted, just don't do it.