270 vs 250, Screen for Competitive Specialties

[greentealeaves]

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I keep hearing that many competitive specialties have a screen that they put on applicants usually in the 240 range. If you wanted to do something like derm, is there any advantage to having a Step 1 score that is considerably higher than the screen? Let's say the screen is a 245 for a specific program, is there any advantage to having a 270 vs. say having a 250? Thanks in advance for your input!

 

[OnePunchBiopsy]

Probably not.

 

[greentealeaves]

Probably not.

What makes you say that?

 

[OnePunchBiopsy]

What makes you say that?

Because the Step 1 score screen is just one check box on the list of items needed to get an interview. Your background, volunteering, research, grades, etc. have to check the other boxes.

 

[greentealeaves]

Because the Step 1 score screen is just one check box on the list of items needed to get an interview. Your background, volunteering, research, grades, etc. have to check the other boxes.

If you look at the 2018 NRMP survey of dermatology program directors, 83% of them assigned an importance of 4.0 / 5.0 to Step 1 scores when ranking applicants (post-interview). It seems like the metric isn't just used for an interview screen then, but also factors into ranking decisions. Any thoughts on this?

 

[OnePunchBiopsy]

If you look at the 2018 NRMP survey of dermatology program directors, 83% of them assigned an importance of 4.0 / 5.0 to Step 1 scores when ranking applicants (post-interview). It seems like the metric isn't just used for an interview screen then, but also factors into ranking decisions. Any thoughts on this?

I'm not a PD, or a dermatologist, but during the applicant ranking meetings I've attended, I've never seen an applicant get ranked higher just because of their step score. It's a package deal. Just my experience. It sounds like you're answering your own question.

 

[Amba]

Yes, all other things equal, a 270 will most definitely get you more interviews in dermatology than a 250. Don't let anyone tell you different.

 

[Ttubule]

I think a 250 probably helps not just with interviews but even come ranking time at a lot of programs vs a 240 but I genuinely don’t think a 270 vs a 250 makes a ton of difference. No one is going to overlook social awkwardness for a 270 step 1 score.

 

[efle]

Probs gets you a few more interviews, especially in the surgical subspecialty fields that have a huge emphasis on board score (like Ortho).

But for actually getting ranked highly, your interview impression and who vouches for you (letters, phone calls) are 10x more important.

 

[Ttubule]

Probs gets you a few more interviews, especially in the surgical subspecialty fields that have a huge emphasis on board score (like Ortho).

But for actually getting ranked highly, your interview impression and who vouches for you (letters, phone calls) are 10x more important.

agreed. Score in the low 250s. Matched into a top ortho program. Had 14 invites, went on 12 so pretty average I guess for those numbers so maybe missed out on more than I would have with a 270. Never had my score come up as anything but a positive though.

 

[piii]

RadiologyPD said he assigns everyone with a 250+ with the same grade in the step 1 category on his ranking scoring system meaning he treats 250+ as the same. I bet many PDs do this.

 

[libertyyne]

In scouring boards, and looking at the data it seems like its more binary , step 1 >250 good enough for interview i dont think there are actually many programs with screens that high, and that there are marginal returns for increasing step 1 scores after a certain threshold. Also the premise is kind of flawed, its not like you are going to adjust your studying to get a 250 instead of a 270. You should be trying to get the 270 regardless and see where you end up.

If you look at the 251+ category vs the 260+ category the difference in match <5%.

Higher scores are good, but after you get an interview , other things become more important like fit and interview performance, research productivity etc. As the chart shows there are people with 260+ who fail to match as well.

 

[efle]

Gotta keep in mind that PDs are flying through these apps, there's a mountain of them. We pontificate for hours about minor differences on SDN but in reality you're getting a few minutes of glance-through.

"Boards? Good, >250. Where are they applying from...U of X, good program, our last couple residents from there were solid. Let's see these grades...Honors in surgery, good, honored their SubI, good, and their audition at Big Hospital...mostly Honors in other clerkships, no low passes, good. Let's see whose recommending them...oh I know Joe at Big Hospital. Letters look strong. Research? Looks like a few middle authorships...first authored a chart review, so that's all fine. Let's interview him. Next."

That's how I think each of our fates and futures is really determined, right there. I left out the personal statement and ECs on purpose.

 

[operaman]

Gotta keep in mind that PDs are flying through these apps, there's a mountain of them. We pontificate for hours about minor differences on SDN but in reality you're getting a few minutes of glance-through.

"Boards? Good, >250. Where are they applying from...U of X, good program, our last couple residents from there were solid. Let's see these grades...Honors in surgery, good, honored their SubI, good, and their audition at Big Hospital...mostly Honors in other clerkships, no low passes, good. Let's see whose recommending them...oh I know Joe at Big Hospital. Letters look strong. Research? Looks like a few middle authorships...first authored a chart review, so that's all fine. Let's interview him. Next."

That's how I think each of our fates and futures is really determined, right there. I left out the personal statement and ECs on purpose.

yeah I think you nailed it. At least for the initial pass that’s basically all you have time to do. They get reviewed in more detail when trying to decide who on the short list to interview and then reviewed in even more depth at the interviews, but youve hit the nail on the head for the first few passes.

 

[gatorsbruh]

I keep hearing that many competitive specialties have a screen that they put on applicants usually in the 240 range. If you wanted to do something like derm, is there any advantage to having a Step 1 score that is considerably higher than the screen? Let's say the screen is a 245 for a specific program, is there any advantage to having a 270 vs. say having a 250? Thanks in advance for your input!

I agree with previous posts that 250 vs. 270 will either have no effect or might get you a few more invites from programs that are super fixated on step score.

I want to add that a step 1 of 270 is beginning to enter the "woah wtf" range, and at that score and higher people will actually start wondering if you're weird or not

 

[Frogger27]

I have heard my schools GS program won’t interview anyone over a 270 because they matched a resident one time with a 272 and they were the worst resident they’ve ever had lol

 

[slowthai]

I have heard my schools GS program won’t interview anyone over a 270 because they matched a resident one time with a 272 and they were the worst resident they’ve ever had lol

Haha. Some programs have these strange rules. This reminds me of that one ortho program that does the exact same thing. No 270+ allowed

 

[Yankees27]

^ I highly doubt that ortho programs will disallow a 270 Step 1. The only reason if they did so, would be because they know that the person is likely only applying as a so-called "safety" program, otherwise, the statement is inaccurate.

 

[slowthai]

^ I highly doubt that ortho programs will disallow a 270 Step 1. The only reason if they did so, would be because they know that the person is likely only applying as a so-called "safety" program, otherwise, the statement is inaccurate.

For sure. That program was most likely yield protecting.

Edit: What I said is based on data; I'm not just pulling it out of nowhere, just to clarify.

 

[Skindoc83]

No. Step 1 is gating, after that no one cares. Unlike med school where they publish their average MCAT score, no one publishes their average step one score. If you’re in the top 10 percent thats all that matters