Above what Step 1 score doesn't it matter any more?

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Whitney

Whitney

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Just curious what you all thought....
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Above 184 studying to retake the exam doesnt matter anymore
Above 200 drinking gallons of pepto bismol out of fear of not getting a residency doesnt matter anymore.
Above 220- posting "am i competitive?" on various student forums doesnt matter anymore.
Above 240- Rubbing it in the faces of people doesnt matter anymore-- (but people still do)

Above 260- G-d doesn't matter anymore and u should start ure own religion.
 
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To set a number would imply that everyone involved in the residency process at every program approaches the scores the same way. Obviously they don't.

Some guy might consider all passing scores equivalent and base decisions entirely on other factors.

Some guy might be obsessed with numbers and prefer the 272 to the 270.

The important question is, "how will the people who will be looking at my application interpret my score?" Still, beyond asking them all (and getting an honest answer somehow) it's impossible to say.
 
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lord_jeebus said:
To set a number would imply that everyone involved in the residency process at every program approaches the scores the same way. Obviously they don't.

Some guy might consider all passing scores equivalent and base decisions entirely on other factors.

Some guy might be obsessed with numbers and prefer the 272 to the 270.

The important question is, "how will the people who will be looking at my application interpret my score?" Still, beyond asking them all (and getting an honest answer somehow) it's impossible to say.
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A point well taken, but I still think there is a score above which the vast majority of residency directors would not make any further distinction. For instance (and I know your example was simply to make your point), any residency director that actually makes any decision based on the difference between a 270 and 272 would have to fall in the extreme minority, and so too, I think, would those who distinguish between a 268 and a 272, etc...So I guess i was wondering at what score people felt that this "extreme" minority starts to become a "reasonable" minority of residency directors.
 
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just to point out... the latest nbme analysis plots the match rate as a function of step1 score. there's diminishing marginal returns but it continues to increase for every score range up to "260+." this plot sweeps all of the specialties together, so you can't assume much for any given specialty.
 
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I think the best way to look at it is this. At 240+ (assuming a decent application and a workable personality) you can reasonably expect 10+ interviews in any field without having to apply to 100 programs.

After the interview, most places are going to be ranking based on "hmm, do I think I can work with this person?" rather than, "hmm, John Smith was 5 points higher than Jane Brown on Step1..."
 
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AmoryBlaine said:
I think the best way to look at it is this. At 240+ (assuming a decent application and a workable personality) you can reasonably expect 10+ interviews in any field without having to apply to 100 programs.

After the interview, most places are going to be ranking based on "hmm, do I think I can work with this person?" rather than, "hmm, John Smith was 5 points higher than Jane Brown on Step1..."
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Agree w/entire post. Above 240 and you should make it past most the competitive fields or big name location cut offs.
 
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Long Dong said:
Agree w/entire post. Above 240 and you should make it past most the competitive fields or big name location cut offs.
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I too agree the original post named it.

Let's say you interview two candidates for an ENT position.

Guy A 245 Step 1, Guy B 262 Step 1.

What does Guy B know that A doesn't? It may just amount to a buncha biochem and molecular and cellular biology questions. How relevent is that to the field? And if Guy A cracks some funny jokes in the interview, and has a glowing recommendation from an ENT doc, that may be enough to cover a ~17 point difference.
 
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PeepshowJohnny said:
I too agree the original post named it.

Let's say you interview two candidates for an ENT position.

Guy A 245 Step 1, Guy B 262 Step 1.

What does Guy B know that A doesn't? It may just amount to a buncha biochem and molecular and cellular biology questions. How relevent is that to the field? And if Guy A cracks some funny jokes in the interview, and has a glowing recommendation from an ENT doc, that may be enough to cover a ~17 point difference.
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What does someone with 245 know that someone with 228 doesn't? It may just amount to some useless stuff. How relevant is that? And so forth onward and onward down to 185 and failing.
 
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PeepshowJohnny said:
I too agree the original post named it.

Let's say you interview two candidates for an ENT position.

Guy A 245 Step 1, Guy B 262 Step 1.

What does Guy B know that A doesn't? It may just amount to a buncha biochem and molecular and cellular biology questions. How relevent is that to the field? And if Guy A cracks some funny jokes in the interview, and has a glowing recommendation from an ENT doc, that may be enough to cover a ~17 point difference.
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it's a good point you're making. the argument seems to be that scores aren't everything, and is certainly true. however, implicit in your argument is that 262 is considered better than 245; ie the precise score still matters in the 240's range.
 
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werd said:
it's a good point you're making. the argument seems to be that scores aren't everything, and is certainly true. however, implicit in your argument is that 262 is considered better than 245; ie the precise score still matters in the 240's range.
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I see what you're saying.

In fact, I don't agree that a 262 "better" than a 245 necessarilly. By points correct and scaled, of course it's better. But I personally believe that the USMLE system breaks down around the 240 level (my own hunch, no evidence) and inter-test variability determines too large a part of your score thus aren't fair representatives of knowledge. Thus, as Pinkertinkle said, I think definetely a 240 is better than a 220 is better than a 200 is better than a 185 because I think the test is representative in that range. It's when you get to the extremes I feel it falls apart.

But what I was trying to argue is even if you accept that the 262 guys knows "17 more points of knowledge" or whatever than a 245 guy and that's a fair representative, programs don't care. You're clay to be shaped by them. Sure they want some basic knowledge, of course, but a huge part of their decision is "How dedicated is this guy?" and "How easy is this guy going to be to work with". Dedication is somewhat tested by Step 1, but personality isn't (You can easily memorize the "correct" answer to patient interaction questions). So even if you believe a flawed assumption that 262 > 245, it's only in one category, while those doing admissions look a lot broader than that.
 
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this whole discussion is ******ed because all the big guns around here are going to say a 260 matters while all the other people are going to say it doesn't make a difference. from my experience though, the 260ers at my school are light years above the 240ers in my school in every respect. honestly though, its not too difficult to hit a 240, but its a lot harder to hit a 260+. thats the reality of it and it does make a difference.
 
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I was talking to the PD at my school for my chosen specialty (rather competitive program in moderately competitive field). He asked me two questions.

1. Who's writing your letters?
2. "What's your score?"

In response to the second (260+), he whistled and said "you can write your own ticket." He also started talking up his program.

So I'd guess that the big numbers mean something, even if there are diminishing returns at the top. It will be interesting to see what the response is at interviews, if it comes up at all.

Nonetheless I agree that the most important feature of high scores is getting past fixed cut-offs, which probably never go above 240.
 
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Okay so since I just went threw the match last year I'll gives you guys my 2 cents.

All things being equal 2 applicants with the same everything on their CV, then yes a few points higher on step 1 might get the person with the higher boards ranked higher. But how often does this really happen.

I've seen programs take a 230s applicant, who has worked with the program for years, over a 260+ applicant they don't know at all. I've seen programs take the 240+ MD/PhD over the the 260+ applicant. I've seen programs take the 240+ published applicant over the the 260+ non published one. I've seen some applicants come off as arrogant arses, (I'm sure they were top dogs at there school w/great boards and all) during the dinners the day before interviews and the day of interviews, not match. In derm there are so many great applicants, programs would rather take the humble, easy to work with great applicant over the arrogant, entitled applicant who scored 5-10 points higher on step 1.

At alot of my interviews the interviewers didn't even have my board scores in front of them. Most of the interviews the PD would tell the applicants that if you made it to be invited to the interview that you were pretty much top notch and the interview was to get to know us cause we had all already meet their academic criteria. Only at one interview did an interviewer ask my board score (at my own school), cuz the file that the interviewers get of the applicants doesn't include board scores. And according to a faculty member on the residency committee at my school the cut off for derm interviews was 230 a few years back. At alot of my interviews they would just ask about my hobbies, life outside of medicine and my research.

I posted this advice on the derm forum to a someone with 270s asking there chances, I'll repost it below:

I couldn't say what your chances are, because you really haven't decided what field you want yet. I think if you where to apply that it could go ether way. Like going to a club and hitting on 2 girls at the same time, both of these girls might see threw what you are doing and you might end up going home alone. In dating good looks (i.e. hi boards) can only go so far. Especially at the more elite clubs there well be other more well rounded suitors, ie hi boards maybe not as high as yours, but with derm research, connections, and a an application that shows a commitment to derm. I'd recommend doing a derm rotation or some shadowing and seeing if derm is for you, and then maybe you could commit to one or the other. Or maybe your game is so tight you could hook up with both girls at the club if you wanted, us mear mortals just don't have it like that.

According to the match outcomes there are those with 260+ who don't match, I don't know about those with 270+. But do you want to be one of these statistics. Don't underestimate how important connnections are in this small field. One poster on the dermboard said this "Like all small groups of professionals, personal connections can make or break you. It's a political game. Play it or risk not matching."
 
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blz said:
honestly though, its not too difficult to hit a 240, but its a lot harder to hit a 260+.thats the reality of it and it does make a difference.
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I spose that's why <33% of the intelligent people who even make it into medical school get that score. Cuz, you know, it's not too difficult...😱

That's one heckuva perspective.
 
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This thread upsets me because of the CRAZY speculation. If you look at the latest (2007) NRMP report, you will see that the HIGHEST mean step 1 score is that of plastic surgery.. which is 241. I am also upset about that " it is easy to get a 240" comment... no it is not easy... that's why less than 16% of people achieve that score (based on last mean/standard deviation). So basically, if you have a score above a 230, you are either within or above the 25-75 percentile range matching for all NRMP specialties. To go out on a limb, I guess non-NRMP specialties like Neurosurgery, Urology, Optho mean scores are probably high, but I doubt they are higher than direct Plastic Surgery (241) or Derm (238). In summary, that is my argument for 230 as being the answer to the OP's question, because, given that you show interest (via research, letters of rec, etc) in your specialty of choice and don't mess up your interview, you WILL match SOMEWHERE.
 
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sga814 said:
This thread upsets me because of the CRAZY speculation. If you look at the latest (2007) NRMP report, you will see that the HIGHEST mean step 1 score is that of plastic surgery.. which is 241. I am also upset about that " it is easy to get a 240" comment... no it is not easy... that's why less than 16% of people achieve that score (based on last mean/standard deviation). So basically, if you have a score above a 230, you are either within or above the 25-75 percentile range matching for all NRMP specialties. To go out on a limb, I guess non-NRMP specialties like Neurosurgery, Urology, Optho mean scores are probably high, but I doubt they are higher than direct Plastic Surgery (241) or Derm (238). In summary, that is my argument for 230 as being the answer to the OP's question, because, given that you show interest (via research, letters of rec, etc) in your specialty of choice and don't mess up your interview, you WILL match SOMEWHERE.
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Probably less than 15% of US medical students achieve 240, since there is anecdotal evidence of the USMLE normal curve being slightly leftward skewed.

If you don't honor most of your clerkships, kiss a competitive residency goodbye.
 
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sga814 said:
To go out on a limb, I guess non-NRMP specialties like Neurosurgery, Urology, Optho mean scores are probably high, but I doubt they are higher than direct Plastic Surgery (241) or Derm (238).
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Neuro surge mean was at 236 and optho was at 231.
 
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sga814 said:
This thread upsets me because of the CRAZY speculation. If you look at the latest (2007) NRMP report, you will see that the HIGHEST mean step 1 score is that of plastic surgery.. which is 241. I am also upset about that " it is easy to get a 240" comment... no it is not easy... that's why less than 16% of people achieve that score (based on last mean/standard deviation). So basically, if you have a score above a 230, you are either within or above the 25-75 percentile range matching for all NRMP specialties. To go out on a limb, I guess non-NRMP specialties like Neurosurgery, Urology, Optho mean scores are probably high, but I doubt they are higher than direct Plastic Surgery (241) or Derm (238). In summary, that is my argument for 230 as being the answer to the OP's question, because, given that you show interest (via research, letters of rec, etc) in your specialty of choice and don't mess up your interview, you WILL match SOMEWHERE.
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i don't know about you but i sure dont want to just match SOMEWHERE. most people take other factors into account such as location and program training. so in my eyes, because i actually care about where im going to spend the next hellish years of my life, i think a 230 will NOT suffice. so you go ahead and enjoy your derm residency in alaska.
 
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blz said:
i don't know about you but i sure dont want to just match SOMEWHERE. most people take other factors into account such as location and program training. so in my eyes, because i actually care about where im going to spend the next hellish years of my life, i think a 230 will NOT suffice. so you go ahead and enjoy your derm residency in alaska.
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I agree with this. Just matching anywhere is not the ideal. I hear there's pretty much a 250 cut off for radiology at UCSF.
 
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Pinkertinkle said:
I agree with this. Just matching anywhere is not the ideal. I hear there's pretty much a 250 cut off for radiology at UCSF.
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Actually from their website "in recent years, most of our interviewees have had three-digit scores of 240 or higher on Step 1. The small number of our interviewees with Step 1 scores between 200 and 239 have had offsetting factors such as a combination of top clinical grades at a competitive medical school and extraordinary research experience and academic promise."

So it appears ucsf rads cut off is 240, and this is the highest cut off that I know of. Thats why I said above 240 and you should make it past most cut offs.
 
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Pinkertinkle said:
I agree with this. Just matching anywhere is not the ideal. I hear there's pretty much a 250 cut off for radiology at UCSF.
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I don't what to say... but "good for you!!!" :0 especially because 250 would be something like 95th percentile, if not higher- and radiology, although competitive is not the most competitive.. So hey hey hey.. let's speculate some more!!!
 
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sga814 said:
I don't what to say... but "good for you!!!" :0 especially because 250 would be something like 95th percentile, if not higher- and radiology, although competitive is not the most competitive.. So hey hey hey.. let's speculate some more!!!
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what are you crying about? is it because i dont think 230 is the magic number? id like some options, so i set the bar higher. i'm sure others would as well.
 
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sga814 said:
I don't what to say... but "good for you!!!" :0 especially because 250 would be something like 95th percentile, if not higher- and radiology, although competitive is not the most competitive.. So hey hey hey.. let's speculate some more!!!
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Yeah but this isnt just rads. This is rads at UCSF. I know killer applicants who didn't match there. I really think you do have to sell a kidney or win a nobel prize to match there.
 
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blz said:
what are you crying about? is it because i dont think 230 is the magic number? id like some options, so i set the bar higher. i'm sure others would as well.
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what you think and what the facts are don't quite correspond. if you score above 230-235, have shown interest in the field via a number of modalities, and perform well on interview, you should have no problem matching into any program of your choice. Even higher tier programs stop looking at exact scores after a certain point, and I highly doubt there are programs that set their absolute cut-offs anywhere near 250. I have heard of 240 for top programs, but once again, that's only what I've heard, so I do not want to add to this sespool of speculation. If you know something I don't, please share. However, I am going by the most recent NRMP match data.
 
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http://www.radiology.ucsf.edu/residents/application.shtml

wow, great website. thanks longdong. it really does demystify a lot of things. not only does it cement that the cutoff for ucsf rads is pretty much 240 (NOT 250), but this line shines true: "Most of our interviewees are members of AOA and have received "A" or "honors" grades in most or all of their core clerkships." read: competitive programs do not want idiot savant test-takers with only high Step I scores in their program. they can afford to be selective enough to select applicants with the entire package. so we can extrapolate that the guy with the 245 who did well third year will match over the 265 so-so candidate, at least for ucsf rads.

it has been repeated OVER AND OVER that step I is almost unilaterally an interview cutoff and little else. "Once an applicant is selected for an interview, USMLE scores have little bearing on the final rank." pwned.
 
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Long Dong said:
Actually from their website "in recent years, most of our interviewees have had three-digit scores of 240 or higher on Step 1. The small number of our interviewees with Step 1 scores between 200 and 239 have had offsetting factors such as a combination of top clinical grades at a competitive medical school and extraordinary research experience and academic promise."

So it appears ucsf rads cut off is 240, and this is the highest cut off that I know of. Thats why I said above 240 and you should make it past most cut offs.
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Well they say their cut off is 240 for interview, but from what I've heard all the actual residents there have 250+. Most people with 250+ don't just have a high step score. They tend to be the real gunners with high step scores, publications and good clerkships. Being UCSF they have the freedom of picking people who have top everything, including step 1.
 
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Pinkertinkle said:
Well they say their cut off is 240 for interview, but from what I've heard all the actual residents there have 250+. Most people with 250+ don't just have a high step score. They tend to be the real gunners with high step scores, publications and good clerkships. Being UCSF they have the freedom of picking people who have top everything, including step 1.
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Agreed, I've heard most of their residents average in the 250s as well. It seems that rads at big name places are big on numbers.
 
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I talked to an orthopedic surgeon (at Columbia) today, and he basically said that 230+ should be considered competitive for tough specialties/good programs. I definitely think that at 240+, the distinctions don't matter much.

A few months ago, I also talked to a Harvard pediatrician who assured me that Step 1 scores matter very little for peds, even in the top programs, compared with clinical performance in years 3 and 4.
 
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i clicked on 240 and i think it should be enuf. but... try to make the goal to 99 percentile so that you get a better morale i guess
 
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