Would you rather get a 187 or a 189 on your Step 1?

[LovelyBRass]

Knowing that a 188 is the minimum passing score and you can't retake a passing score, which would you prefer?

"Neither" doesn't count!

---

Members don't see this ad.

 

[Law2Doc]

Knowing that a 188 is the minimum passing score and you can't retake a passing score, which would you prefer?

"Neither" doesn't count!

It's better to have a lousy score but have passed the thing on one try. Getting a 240 on your second try does not outweigh having failed it. And you generally can't hide that you took it multiple times. Programs all ask.

 

[J ROD]

this is one time where experience will hurt you....

 

[gravitywave]

many programs will send you straight to the circular file if you failed the first attempt, regardless of how well you might have done the second time around.

OTOH, many won't, and i could see a way for someone to do better in the Match with a fail/240 than with a 189. i'm sure that there would be a few ROADs that would at least look at you with the former that wouldn't with the latter.

of course, the trick would be to know who those programs are. and TBH, the odds of something like that happening are pretty ridiculous (unless you were messed up by personal issues when you failed). the rate for retakers to simply pass is still pretty bad, 60% or so.

 

[Lokhtar]

many programs will send you straight to the circular file if you failed the first attempt, regardless of how well you might have done the second time around.

OTOH, many won't, and i could see a way for someone to do better in the Match with a fail/240 than with a 189. i'm sure that there would be a few ROADs that would at least look at you with the former that wouldn't with the latter.

of course, the trick would be to know who those programs are. and TBH, the odds of something like that happening are pretty ridiculous (unless you were messed up by personal issues when you failed). the rate for retakers to simply pass is still pretty bad, 60% or so.

I would guess it'd be higher for those who were that close to passing though (I doubt there're many stats released regarding that though).

Although 60% is pretty brutal overall.

 

[Droopy Snoopy]

It's better to have a lousy score but have passed the thing on one try. Getting a 240 on your second try does not outweigh having failed it. And you generally can't hide that you took it multiple times. Programs all ask.

If I saw an applicant who went 180 -> 240 I'd just assume that the person cheated.

 

[Bartelby]

If I saw an applicant who went 180 -> 240 I'd just assume that the person cheated.

It's hard to cheat on the Steps and MCAT, I would assume the person had something bad going on in their life the first time around (depression, death in the family, etc). That said I would rather have 189 first time than fail/240.

 

[Lokhtar]

I guess it's different than the MCAT? In the MCAT, you'd much rather have a 23 (a 'failure' if you want a MD acceptance) and then improve to a 37, rather than a 28 (borderline too low for MD schools) the first time and not take it again.

 

[greg1184]

I guess it's different than the MCAT? In the MCAT, you'd much rather have a 23 (a 'failure' if you want a MD acceptance) and then improve to a 37, rather than a 28 (borderline too low for MD schools) the first time and not take it again.

The MCAT is not a pass fail exam. You can take it as many times as you want until you get the score you want. With Step 1, its one and done unless you fail.... another rant for another day.

As for the original question... Neither.

 

[LovelyBRass]

I'm really surprised by your answers! I absolutely would have chosen to get the 187 the first time... at least you can retake it! I looked at these two scores as being just as bad as each other, so why not prefer the one where at least you can retake? I guess I didn't consider that there would be residency programs that would actually throw your file away if you failed the first time but did well the second time. On the other hand, wouldn't those same programs throw away your file if they saw your meager 189?

 

[da8s0859q]

I guess it's different than the MCAT? In the MCAT, you'd much rather have a 23 (a 'failure' if you want a MD acceptance) and then improve to a 37, rather than a 28 (borderline too low for MD schools) the first time and not take it again.

The only way the MCAT and Step 1 are comparable is that they are both standardized exams. Also, I'd much rather have a 28 on the MCAT, because the magical 30 means that lots of people get in with a 26-29, but your odds still decrease the lower you go. And with some solid prep, there's a very good chance you can tack on a few points to that 28 if it becomes necessary.

I'd rather have a 189, only because I remember seeing a very, very low bar on the NRMP's PD survey when they were talking about considering applicants with a Step 1 failure.

 

[tkim]

On the other hand, wouldn't those same programs throw away your file if they saw your meager 189?

Failing a step and barely passing are red flags, but failing is much worse. You only have step II to redeem yourself, rather than killing step I on retake *and* killing step II.

 

[gravitywave]

The only way the MCAT and Step 1 are comparable is that they are both standardized exams. Also, I'd much rather have a 28 on the MCAT, because the magical 30 means that lots of people get in with a 26-29, but your odds still decrease the lower you go. And with some solid prep, there's a very good chance you can tack on a few points to that 28 if it becomes necessary.

I'd rather have a 189, only because I remember seeing a very, very low bar on the NRMP's PD survey when they were talking about considering applicants with a Step 1 failure.

only 56% of rads programs "never" consider apps with a Step I failure.

only 52% of ortho programs "never" consider apps with a Step I failure.

only 16% of EM programs "never" consider apps with a Step I failure.

now granted they aren't considering these apps "often" very much either - but it means these folks still have a chance.

the bigger issue i think was already covered above, namely that going from fail -> 240 is damn near unheard of.

 

[Law2Doc]

...
the bigger issue i think was already covered above, namely that going from fail -> 240 is damn near unheard of.

Agreed. More often the person who got that 187 will retake and snag that 189.

 

[Brigade4Radiant]

I guess it's different than the MCAT? In the MCAT, you'd much rather have a 23 (a 'failure' if you want a MD acceptance) and then improve to a 37, rather than a 28 (borderline too low for MD schools) the first time and not take it again.

A 28 is not really too low for MD schools several people get accepted into MD schools with 28s. The avg is 30 so a good % of the class got below 30. A lot of people on SDN believe that if you don't get a 30 you are doomed but looking at the MCAT and GPA grid for acceptances there are plenty of people with 27-29 or all GPA ranges who get accepted.

 

[Mr hawkings]

It's better to have a lousy score but have passed the thing on one try. Getting a 240 on your second try does not outweigh having failed it. And you generally can't hide that you took it multiple times. Programs all ask.

I disagree. I would rather fail the first time than apply for residency with 1 point over passing.
I would rather be asked about having taken it multiple times in an interview than not get in interview invite at all because of a sub-par passing score.
Thats just me

 

[Law2Doc]

I disagree. I would rather fail the first time than apply for residency with 1 point over passing.
I would rather be asked about having taken it multiple times in an interview than not get in interview invite at all because of a sub-par passing score.
Thats just me

Um, you aren't going to get that interview invite at all if you failed either. It's not like a fail and retake opens a potential interview door that would be closed with a low passing score. So yeah, that's just you... I think that's the point of everyone else on this thread. The places that have trouble with a low score have even more trouble with a fail.

 

[Mr hawkings]

Um, you aren't going to get that interview invite at all if you failed either. It's not like a fail and retake opens a potential interview door that would be closed with a low passing score. So yeah, that's just you... I think that's the point of everyone else on this thread. The places that have trouble with a low score have even more trouble with a fail.

You're probably right. I'm basing my opinion on personal knowledge of two people in those two situations and the guy with the failure and a 233 the second time after taking a year off, matched whereas the one with the 199 the first time did not and had to scramble transitional year only to not match the following year and scramble again. These two people could very well be the exception but those are the two experiences that i have to draw on.
I know its anecdotal and cannot be generalized but seeing that left a huge impression on me. No matter how logical your argument is and how much sense it makes, but i still feel like its an opinion based on what we expect should happen or even what we've been told would happen.

I wonder if there are any residency directors on this borad that could shed some light on what they would actually do.

 

[naus]

If you studied your butt off (and most people do for the Step 1) and still failed, I doubt you can get 240 on the second attempt short of a severe personal event (illness, death in family, divorce etc).

Strategic failing just sounds like such a stupid and potentially suicidal plan.

 

[Depakote]

keep in mind that if you fail Step I, it's not like you just get a few consequence free months to study for a re-take.

You're probably half-way through your first 3rd year clerkship when you find out your score. If you fail, you've got to finish that clerkship (and study for a shelf exam... knowing you've got Step I looming over your head AGAIN). Then you pop out of clinical mode to study. But all that info is stale b/c you've been doing Surgery or Psych or Family or whatever and suddenly you have to remember Biochem.

Then you're suddenly 4 weeks behind the rest of your class. That 4 weeks comes out of time you were going to use for interviews, 4th year electives, vacation.

People do it every year at every school, but it blows with the force of a thousand hurricanes. I'd be shocked if that environment managed to move someone with a 187 to a killer score.

 

[ACSurgeon]

It's better to have a lousy score but have passed the thing on one try. Getting a 240 on your second try does not outweigh having failed it. And you generally can't hide that you took it multiple times. Programs all ask.

And most people getting a 187 on the first pass probably won't be getting a 240 on the second pass! More likely, you'll get a 187 followed by a sub-200 repeat, in which case, a 189 on the first try is a much, much better choice!

 

[Doctor4Life1769]

It's always best to fail, bitches!

 

[Brigade4Radiant]

Um, you aren't going to get that interview invite at all if you failed either. It's not like a fail and retake opens a potential interview door that would be closed with a low passing score. So yeah, that's just you... I think that's the point of everyone else on this thread. The places that have trouble with a low score have even more trouble with a fail.

Um, Assuming you could get 220-240 it would be better to fail it. 189 Doesn't really open the flood gates in terms of matching at least if you do really well on the second time you could still be a good candidate for some residencies. It doesn't matter if programs ask about it because you can tell them why you did bad the very fact that you are talking to them is because of your high second score. Your advice doesn't apply to all residency programs and a 189 isn't going to get you many more opportunities.

 

[womp]

Assuming you could get 220-240 it would be better to fail it. 189 Doesn't really open the flood gates in terms of matching at least if you do really well on the second time you could still be a good candidate for some residencies. It doesn't matter if programs ask about it because you can tell them why you did bad the very fact that you are talking to them is because of your high second score.

That's a stupid and worthless assumption. If you could get 220-240, you wouldn't fail anyway. If something happened in your life that made you not prepare as well as you should, then you should delay the test, not bomb it first. This is a basic question of judgment. Would you want a surgeon committing to a surgery that he thinks he may bomb?

The logistics of failing is horrible. 3rd year grades MATTER. How do you expect to get good clinical grades while studying for the Step 1?

 

[ar2388]

i cant believe i have to start getting used to worrying about grades again.. pass/fail was so sweet.

 

[Doctor4Life1769]

Um, Assuming you could get 220-240 it would be better to fail it. 189 Doesn't really open the flood gates in terms of matching at least if you do really well on the second time you could still be a good candidate for some residencies. It doesn't matter if programs ask about it because you can tell them why you did bad the very fact that you are talking to them is because of your high second score. Your advice doesn't apply to all residency programs and a 189 isn't going to get you many more opportunities.

Go for the fail, dude.....

 

[Brigade4Radiant]

That's a stupid and worthless assumption. If you could get 220-240, you wouldn't fail anyway. If something happened in your life that made you not prepare as well as you should, then you should delay the test, not bomb it first. This is a basic question of judgment. Would you want a surgeon committing to a surgery that he thinks he may bomb?

The logistics of failing is horrible. 3rd year grades MATTER. How do you expect to get good clinical grades while studying for the Step 1?

This is for the purposes of the OP's question not a real life scenario. You either get a predetermined 187 or a 189. Also depending on your 2nd year grades some schools may force you to retake the 2nd year. This is a hypothetical question anyway you could give the same argument for getting a 189.

 

[Seven of Nine]

keep in mind that if you fail Step I, it's not like you just get a few consequence free months to study for a re-take.

You're probably half-way through your first 3rd year clerkship when you find out your score. If you fail, you've got to finish that clerkship (and study for a shelf exam... knowing you've got Step I looming over your head AGAIN). Then you pop out of clinical mode to study. But all that info is stale b/c you've been doing Surgery or Psych or Family or whatever and suddenly you have to remember Biochem.

Then you're suddenly 4 weeks behind the rest of your class. That 4 weeks comes out of time you were going to use for interviews, 4th year electives, vacation.

People do it every year at every school, but it blows with the force of a thousand hurricanes. I'd be shocked if that environment managed to move someone with a 187 to a killer score.

i actually thought that everything comes to a screeching halt and your school pulls you out of your clerkship... that if you didn't pass step 1, you shouldn't be seeing patients on rotation and have to focus on passing that test. i could (and most likely am) totally wrong though. this would be an unfortunate position to be in regardless.

 

[Seven of Nine]

That's a stupid and worthless assumption. If you could get 220-240, you wouldn't fail anyway. If something happened in your life that made you not prepare as well as you should, then you should delay the test, not bomb it first. This is a basic question of judgment. Would you want a surgeon committing to a surgery that he thinks he may bomb?

The logistics of failing is horrible. 3rd year grades MATTER. How do you expect to get good clinical grades while studying for the Step 1?

i think the poor judgement comes into play when you decide whether to score your exam or void it. unforeseen circumstances/sudden illness could tank your test, and under the pressure of the exam, one may not be able to correctly judge their performance.

if i was not adequately prepared for the exam, i might take the pass and aim for taking step 2 early (and blowing it out of the water) in time for application season/interviews. i don't think i would have a long enough window between the first sitting/score report and the second to re-study and get a high score.

 

[gravitywave]

i actually thought that everything comes to a screeching halt and your school pulls you out of your clerkship... that if you didn't pass step 1, you shouldn't be seeing patients on rotation and have to focus on passing that test. i could (and most likely am) totally wrong though. this would be an unfortunate position to be in regardless.

depends on the school. some do as you describe, some as Depakote says, still others don't care when or even if you pass Step I.

 

[Law2Doc]

...Your advice doesn't apply to all residency programs and a 189 isn't going to get you many more opportunities.

I'm saying that having that "fail" isn't going to get you the kind of opportunities you seem to think regardless of how you subsequently did. You don't get do-overs. You fail, lots of places simply won't consider you. You get 189, lots of places still won't consider you, but at least you didn't fail.

 

[clinicallabguy]

Knowing that a 188 is the minimum passing score and you can't retake a passing score, which would you prefer?

"Neither" doesn't count!

I suppose it's an interesting question. But I hope you're not obsessing about it too much, and I hope you're in neither camp. This is not generally something that too many students should have to worry about.

 

[Brigade4Radiant]

I'm saying that having that "fail" isn't going to get you the kind of opportunities you seem to think regardless of how you subsequently did. You don't get do-overs. You fail, lots of places simply won't consider you. You get 189, lots of places still won't consider you, but at least you didn't fail.

No while some programs will not consider you retaking STEP 1 and doing significantly better as a US MD doesn't doom you. This is from the IM director at our school. Many people do do-overs. A 189 is not a good score at all and would be lucky to match. The person who failed the step failed one exam but still has 3rd year grades and many other things. If you barely passed sure you didn't fail but your score is not even in the mid 90s if you fail you retake it show you did better and do well on all the other things residency directors look for. In real life retakers only have a 65% chance of passing on subsequent retakes which hurts their chances. This is a hypothetical scenario.

It hurts with specialties but non competitive stuff is very possible.

 

[Miscbrah]

are there any non-residency options available for med students with such low Step1 scores? are there any administration positions that don't require a residency?

 

[Raryn]

There's residency options for such med students.

Family med, Internal Med, Psych... You won't get into a good program, and you may have to scramble to get a spot, but even the people who barely pass almost all get in *somewhere*

 

[boobelle]

It's better to have a lousy score but have passed the thing on one try. Getting a 240 on your second try does not outweigh having failed it. And you generally can't hide that you took it multiple times. Programs all ask.

...as do lawyers during malpractice trials.

Legit or not, it's a common early question with the goal to influence the jury if you have a history of failed board exams.

 

[MossPoh]

It is very very unlikely that if you failed the first time, you'd all of a sudden jump 40+ points the second. Most people who fail the first time pass the second, but just barely.

As far as the lawsuit thing, it is much harder lawyers to win these suits than people think, especially if you were practicing within accepted standards. An exceedingly small amount of cases actually progress to courtroom and out of those, only about half will actually rule against the doctor. Out of THOSE cases, only about half truly met the qualifications of malpractice.

Moral of the story is to just not be a d-bag to your patients and to practice within accepted standards.

 

[Law2Doc]

...as do lawyers during malpractice trials.

Legit or not, it's a common early question with the goal to influence the jury if you have a history of failed board exams.

Actually this doesn't typically happen, although it could be a smart maneuver for a lawyer, but it probably involves too much homework. So no, not common at all. Also most physicians will have board certification exams that come after the step exams which would be much better fodder for attacking credentials anyhow, if you were going to go this route. Also enough lawyers live in glass houses since the bar pass rate tends to be lower than the step passage rates, that few want to open their doors to this.

 

[boobelle]

Actually this doesn't typically happen, although it could be a smart maneuver for a lawyer, but it probably involves too much homework. So no, not common at all. Also most physicians will have board certification exams that come after the step exams which would be much better fodder for attacking credentials anyhow, if you were going to go this route. Also enough lawyers live in glass houses since the bar pass rate tends to be lower than the step passage rates, that few want to open their doors to this.

That info came from a panel of practicing physicians and lawyers who defend against these suits...although they were all practicing in the same state where I was a premed, so perhaps it's a regional practice then? It's also frankly uncommon to fail, so if you include all they physicians with all passing scores then I imagine being asked about your past failed boards is uncommon.

 

[quepatho]

I would rather get the 187 and write a note to all of my residencies explaining how I had a panic attack at the site.

Then I would retake it and get my 240+! Or not, but at any rate, I'm doing a lot better than 189 right now, so yeah, I would rather fail it.