218 Step 1 Score Emergency Medicine?

[AromaticOreo]

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Hi all,

I'm a current M3 at a US MD school and I just got my Step 1 score back today. Ended up with a 218, which I'm really disappointed with. I've gotten mostly honors and some high pass during my preclinical years, and I was hitting my goal on practice tests, so I'm not sure what happened on test day. Anyway, I know I can't change what I have, so I know I just have to keep moving forward, but I was just wondering if anyone had any advice for me or if anyone has any experience applying to EM programs with a similar score. I know there are other threads about this, but they seemed a little outdated, so I wanted to get a more current perspective.

Having worked as an EMT for a while before medical school, I've been pretty set on EM for some time. I'm just trying to gauge what I need to do to stay in the running. Thanks in advance!

 

[akinetopsia]

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

Chart EM-3 in the Emergency Medicine section shows 180 US allopathic seniors scoring between 211 and 220 on Step 1 matched into EM, and 20 US allopathic seniors scoring between 211 and 220 didn't match.

The data is from 2016 but that isn't that long ago. I would say don't rule it out, I'm sure it's more competitive as the years go on, but you still have a solid chance.

 

[TeddyBoomBoom]

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

Chart EM-3 in the Emergency Medicine section shows 180 US allopathic seniors scoring between 211 and 220 on Step 1 matched into EM, and 20 US allopathic seniors scoring between 211 and 220 didn't match.

The data is from 2016 but that isn't that long ago. I would say don't rule it out, I'm sure it's more competitive as the years go on, but you still have a solid chance.

A program director (at a super solid program) specifically told us that step 2 was more important than step 1 for EM.

His exact words were "I'd rather see a 215 on step one and 230 on step two, than vice versa."

 

[AromaticOreo]

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

Chart EM-3 in the Emergency Medicine section shows 180 US allopathic seniors scoring between 211 and 220 on Step 1 matched into EM, and 20 US allopathic seniors scoring between 211 and 220 didn't match.

The data is from 2016 but that isn't that long ago. I would say don't rule it out, I'm sure it's more competitive as the years go on, but you still have a solid chance.

A program director (at a super solid program) specifically told us that step 2 was more important than step 1 for EM.

His exact words were "I'd rather see a 215 on step one and 230 on step two, than vice versa."

Thanks! Those tables are very helpful. From what I'm seeing on the line graph, looks like roughly an 88% chance of matching somewhere with my step score. Guess I just need to focus on honoring rotations, getting good SLORs, and redeeming myself on step 2 over the next year. I've also heard some people mention taking Step 2 early. Is that generally recommended for people in my position?

 

[sliceofbread136]

A program director (at a super solid program) specifically told us that step 2 was more important than step 1 for EM.

His exact words were "I'd rather see a 215 on step one and 230 on step two, than vice versa."

Keep in mid that a 215 on step 2 is a significantly lower percentile than a 215 on step 1. A 215 on step 2 is quite poor.

 

[W19]

Thanks! Those tables are very helpful. From what I'm seeing on the line graph, looks like roughly an 88% chance of matching somewhere with my step score. Guess I just need to focus on honoring rotations, getting good SLORs, and redeeming myself on step 2 over the next year. I've also heard some people mention taking Step 2 early. Is that generally recommended for people in my position?

Yes! Start getting ready for step2 by crushing the shelf exams...

 

[TeddyBoomBoom]

Keep in mid that a 215 on step 2 is a significantly lower percentile than a 215 on step 1. A 215 on step 2 is quite poor.

Oh, absolutely. I was just making the point that he shouldn't be dead in the water for EM providing he improves a lot for step two.

 

[Osteoth]

Thanks! Those tables are very helpful. From what I'm seeing on the line graph, looks like roughly an 88% chance of matching somewhere with my step score. Guess I just need to focus on honoring rotations, getting good SLORs, and redeeming myself on step 2 over the next year. I've also heard some people mention taking Step 2 early. Is that generally recommended for people in my position?

SLOEs are of supreme importance. Had a friend match at a top 3 program this year with a 220 STEP 1, 240 STEP 2.

He told me that in order of how important everything is: SLOE > STEP2 > 3rd year grades > STEP 1.

Obviously you're going to get screened out some places, but thats the nature of the game.

Take it for what its worth, n=1.

 

[Goro]

Hi all,

I'm a current M3 at a US MD school and I just got my Step 1 score back today. Ended up with a 218, which I'm really disappointed with. I've gotten mostly honors and some high pass during my preclinical years, and I was hitting my goal on practice tests, so I'm not sure what happened on test day. Anyway, I know I can't change what I have, so I know I just have to keep moving forward, but I was just wondering if anyone had any advice for me or if anyone has any experience applying to EM programs with a similar score. I know there are other threads about this, but they seemed a little outdated, so I wanted to get a more current perspective.

Having worked as an EMT for a while before medical school, I've been pretty set on EM for some time. I'm just trying to gauge what I need to do to stay in the running. Thanks in advance!

I recommend looking at:

 

[Tenk]

A program director (at a super solid program) specifically told us that step 2 was more important than step 1 for EM.

His exact words were "I'd rather see a 215 on step one and 230 on step two, than vice versa."

I would not bet on this. I know plenty of PDs who care far more about step 1 than step 2. Also, I know plenty of PDs who will blow smoke up applicants asses in the same way applicants do to them. They may have been telling the truth but for the most part step 1 > step 2 just like all other specialties. A great step 2 can help but a great step 1 is always better. I'm not saying this to be a downer, I'm just being realistic. Your n=1 is nowhere near the amount of applicants/PDs I have seen over the years.

Op: you are not dead in the water but you now need to work on all other parts of your application in addition to doing well on step 2. This includes good clinical grades, good SLOES, good aways, applying broadly, maybe some research and more importantly, networking. Good luck.

 

[LostinLift]

I would not bet on this. I know plenty of PDs who care far more about step 1 than step 2. Also, I know plenty of PDs who will blow smoke up applicants asses in the same way applicants do to them. They may have been telling the truth but for the most part step 1 > step 2 just like all other specialties. A great step 2 can help but a great step 1 is always better. I'm not saying this to be a downer, I'm just being realistic. Your n=1 is nowhere near the amount of applicants/PDs I have seen over the years.

Op: you are not dead in the water but you now need to work on all other parts of your application in addition to doing well on step 2. This includes good clinical grades, good SLOES, good aways, applying broadly, maybe some research and more importantly, networking. Good luck.

I've heard step 1 is important to a point. Would you consider a great step 1 (250s) and good step 2 (240s) better than a good step 1 (230/240) and great step 2 (260s)?

 

[AromaticOreo]

I would not bet on this. I know plenty of PDs who care far more about step 1 than step 2. Also, I know plenty of PDs who will blow smoke up applicants asses in the same way applicants do to them. They may have been telling the truth but for the most part step 1 > step 2 just like all other specialties. A great step 2 can help but a great step 1 is always better. I'm not saying this to be a downer, I'm just being realistic. Your n=1 is nowhere near the amount of applicants/PDs I have seen over the years.

Op: you are not dead in the water but you now need to work on all other parts of your application in addition to doing well on step 2. This includes good clinical grades, good SLOES, good aways, applying broadly, maybe some research and more importantly, networking. Good luck.

I have been involved in 2 research projects at my home institution emergency department. One is definitely being published and the other is in the process of being written. So, I already have some connections to my home program. I was also the president of our school's emergency medicine interest groups for the last year. So hopefully, those two things should show PDs that I have a genuine interest in the specialty. I'll also be taking an third year EM rotation in December this year after my medicine rotation.

I am by no means doubting the importance of a good step 1 score. I know I messed up, so I'm just looking for ways to get myself back on track.

 

[TeddyBoomBoom]

I would not bet on this. I know plenty of PDs who care far more about step 1 than step 2. Also, I know plenty of PDs who will blow smoke up applicants asses in the same way applicants do to them. They may have been telling the truth but for the most part step 1 > step 2 just like all other specialties. A great step 2 can help but a great step 1 is always better. I'm not saying this to be a downer, I'm just being realistic. Your n=1 is nowhere near the amount of applicants/PDs I have seen over the years.
.

Hey, fair enough, man. Just relaying what I heard.

 

[Tenk]

I have been involved in 2 research projects at my home institution emergency department. One is definitely being published and the other is in the process of being written. So, I already have some connections to my home program. I was also the president of our school's emergency medicine interest groups for the last year. So hopefully, those two things should show PDs that I have a genuine interest in the specialty. I'll also be taking an third year EM rotation in December this year after my medicine rotation.

I am by no means doubting the importance of a good step 1 score. I know I messed up, so I'm just looking for ways to get myself back on track.

Yup. Sounds like you are doing all the right things. Just continue to make friends and do your best on step 2. Good luck!

 

[Tenk]

I've heard step 1 is important to a point. Would you consider a great step 1 (250s) and good step 2 (240s) better than a good step 1 (230/240) and great step 2 (260s)?

All those scores are great and would have no problem matching EM. Once you get to the 240s, it starts to having diminishing returns, so it really depends on the rest of the application, how you interview, and what the faculty/residents think of you at that point.

I was trying to make few points though:
1) You aren't completely out of the game with an ok-lowish step 1 score if you bolster every other part of your application and do great on step 2.
2) You shouldn't put all your eggs into either step 1 or step 2. You need a balanced application.
3) Step 1 > step 2 for most but not by a whole lot.

 

[Jabbed]

I've heard step 1 is important to a point. Would you consider a great step 1 (250s) and good step 2 (240s) better than a good step 1 (230/240) and great step 2 (260s)?

260s on both Step 1 and 2 would be better.

Seriously though, I feel that your Step 1 puts you in a bracket, and then your Step 2 moves you within that bracket. How big that move can be is specialty-dependent. 210/260 isn't a coveted score and probably raises more question than anything else.

By sheer statistics, the average person will perform better on their Step 2 (230 -> 240), but their percentile rank won't be wildly different (both are ~50th).

 

[Sherlock Holmes123]

Guys, can someone comment on my stats and tell how I am looking for this year match...

Step 1:222 Step 2CK:235 Step 2CS: Passed and Step 3:212 (No attempts), Visa requiring IMG, 2013 Graduate, 6 months of observership (4 months in Teaching Hospitals with residency and 2 months in a small community Hospital), I have 6 US lor's 3 are recent and 3 are like 1 year back, No publications but contributed to some Qbanks....APPLYING IN IM...

Last year applied and had 1 interview...Didn't quite make it...The changes I did are: Took step 3 and passed with 212, added 4 months of observership to my applications with 2 good LOR's (one is from a program PD and one is from Associate PD)...

Can you guys give me your honest opinion? What are the things I need to remember going into the season and changes that I should make?

Thank you so much guys..

 

[Sherlock Holmes123]

And to add, I am also actively looking for any Research positions...

 

[Osteoth]

I've heard step 1 is important to a point. Would you consider a great step 1 (250s) and good step 2 (240s) better than a good step 1 (230/240) and great step 2 (260s)?

It also comes down to strategy at that point as well, because with a STEP1 of 250 you probably wouldn't take STEP2 until after applications are already in since you will pass any and all screens, even for the best programs.

 

[Sherlock Holmes123]

Guys, can someone comment on my stats and tell how I am looking for this year match...

Step 1:222 Step 2CK:235 Step 2CS: Passed and Step 3:212 (No attempts), Visa requiring IMG, 2013 Graduate, 6 months of observership (4 months in Teaching Hospitals with residency and 2 months in a small community Hospital), I have 6 US lor's 3 are recent and 3 are like 1 year back, No publications but contributed to some Qbanks....APPLYING IN IM...

Last year applied and had 1 interview...Didn't quite make it...The changes I did are: Took step 3 and passed with 212, added 4 months of observership to my applications with 2 good LOR's (one is from a program PD and one is from Associate PD)...

Can you guys give me your honest opinion? What are the things I need to remember going into the season and changes that I should make?

Thank you so much guys..

Guys anyone that can comment on this?

 

[jw3600]

SLOEs are of supreme importance. Had a friend match at a top 3 program this year with a 220 STEP 1, 240 STEP 2.

He told me that in order of how important everything is: SLOE > STEP2 > 3rd year grades > STEP 1.

Obviously you're going to get screened out some places, but thats the nature of the game.

Take it for what its worth, n=1.

Would you mind listing the top 3 programs for us?

 

[Osteoth]

Would you mind listing the top 3 programs for us?

Bud you're not one of those triggered people who like to be mad are you?

Based on what he told me and our (w/b)est coast bias, top 3 would be: USC, Cincinnati, Denver, not necessarily in that order.

 

[Lexdiamondz]

SLOEs are of supreme importance. Had a friend match at a top 3 program this year with a 220 STEP 1, 240 STEP 2.

He told me that in order of how important everything is: SLOE > STEP2 > 3rd year grades > STEP 1.

Obviously you're going to get screened out some places, but thats the nature of the game.

Take it for what its worth, n=1.

This isn't quite true. In general it's more like SLOE>Step2=Step1>>>>>3rd Year Grades

Would you mind listing the top 3 programs for us?

Bud you're not one of those triggered people who like to be mad are you?

Based on what he told me and our (w/b)est coast bias, top 3 would be: USC, Cincinnati, Denver, not necessarily in that order.

There aren't any "top 3 programs" in EM. There are top-tier programs, certainly, but there isn't any strict ranking

 

[caramelbear]

This isn't quite true. In general it's more like SLOE>Step2=Step1>>>>>3rd Year Grades

Step 1 > 3rd year grades would be kind of a relief. Still on my first rotation and was told we get graded based off how well we do scutwork since there's no way to really help the team except for that. Don't get me wrong, I am more than willing to do it since it can be so helpful, but having parts of my future influenced by how well I call for records from outside hospitals is a little concerning.

 

[W19]

Step 1 > 3rd year grades would be kind of a relief. Still on my first rotation and was told we get graded based off how well we do scutwork since there's no way to really help the team except for that. Don't get me wrong, I am more than willing to do it since it can be so helpful, but having parts of my future influenced by how well I call for records from outside hospitals is a little concerning.

Welcome to 3rd year! where residents will send you out to get them coffee...

 

[Osteoth]

This isn't quite true. In general it's more like SLOE>Step2=Step1>>>>>3rd Year Grades






There aren't any "top 3 programs" in EM. There are top-tier programs, certainly, but there isn't any strict ranking

Yeah, but from what I understand if you have a good STEP1 score you can just take STEP2 after applications are over, so realistically its more important to have a good STEP1 than it is to have a good STEP2 if you play your cards right.

And yeah of course, but when I was talking to him it was at the end of my M1 year and you get used to parroting what your seniors tell you as gospel.

 

[jw3600]

Bud you're not one of those triggered people who like to be mad are you?

Based on what he told me and our (w/b)est coast bias, top 3 would be: USC, Cincinnati, Denver, not necessarily in that order.

I hate people like you. You make a ridiculous, unanimously agreed upon to be wrong claim. I call you out. You accuse me of being "triggered." You're literally a Facebook comments troll.

 

[caramelbear]

Welcome to 3rd year! where residents will send you out to get them coffee...

And I stress over getting them the hottest, most caffeinated coffee with the best flavor profile faster than any 3rd year has brought it to them before.

 

[IslandStyle808]

This isn't quite true. In general it's more like SLOE>Step2=Step1>>>>>3rd Year Grades

I know an EM doc who was a PD, I can confirm that boards and SLOE are at the top of the selection, while 3rd year grades didn't mean much (since it was variable and he couldn't use a filter on them was his reasoning).

 

[Osteoth]

I hate people like you. You make a ridiculous, unanimously agreed upon to be wrong claim. I call you out. You accuse me of being "triggered." You're literally a Facebook comments troll.

You know I wouldn't mind having a clear, open-minded discussion about what constitutes a top-3 program in EM, but I could tell based on your phrasing you were looking for a fight.

Someone says something based on a premise that you don't agree with, and instead of asking them to define or clarify their idea, you ask a question with no right answers.

Of course what I said was subjective, there's obviously no top 1 or 3 or 5 programs considering the variety of factors that go into choosing a residency, but what you're doing is attacking the straw man instead of clarifying the concept and pushing the discussion, which I admittedly pushed in the wrong direction with my claim, further into oblivion.