Disappointed with Step 1 outcome

[Fatalis]

So I'm making this post at the risk of sounding very ungrateful, and that's not my intention. I've just had lingering disappointment since I got my score back recently. I was really aiming for a 260, and all of my practice tests within the last few weeks of my prep period were in that range. 275 on UW1 (over predict I know), 265 on NBME 18, and 264 on UWSA2. I don't get test taking anxiety, and my real exam honestly felt like the easiest set of questions I'd encountered for a long time. In hindsight, that was probably a red flag because the curve was probably brutal.

Anyway, I scored a 250, which is at the absolute bottom of my confidence interval of 250-267 (predicted 260). I know that objectively this is a good score, but I was really disappointed to not meet my goal. I poured my heart and soul into this test and it just feels bad not hitting your goal. I'm in clerkships now which are going fine and going to apply for the match next year. I go to a medical school with a good reputation but it's no John Harvard. I'm interested in academic IM at a top 20 program to be competitive for fellowship, but honestly with how competitive top programs in IM have become, I'm skeptical this will help me stand out much.

Anyway, if anyone happens to be reading this post and hasn't taken Step yet, I'd advise that they mentally prepare themselves to be happy with any score within the confidence interval. I know some people even end up scoring below that which is really disheartening. I really wasn't prepared for anything below a 255 and that was my own fault. I just hope the strong foundation I've developed helps me score higher for Step 2.

O-M-G what a Greek tragedy! Seriously you better be trolling, if not, honestly get over yourself

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[ChopinLiszt]

Ok.. yes most us would love that score but I do know how you feel. I had 250s-260s on nbmes and UWSAs and really wanted a 260 but would have been happy with a 250+ (applying for a super competitive specialty so wanted that safety factor). Just *barely* missed 250, below all practice tests I took my last few weeks of dedicated. I think that’s what gets us - getting so far below practice tests that are supposedly really predictive for so many people.. and the worry that we’ll close doors to a program we might like. But honestly we’ll all end up fine so we just need to chill. Does suck to come in way below practice tests even if you know it’s a ‘good’ score in general. not one of life’s great trials or anything, but disappointing..

 

[usmd2022]

Yeah man, if that's the game you want to play, one where you are concerned about reputation and the place you go to, then yeah. You should be prepared for moments like this where you feel like crap when you get only a 250. Striving for the top doesn't necessarily mean destroying a board exam. But you can pick your battles - just be prepared for the emotional toll and consequences.

You don't have to follow into the trap of medicine's classical method of stratifying applicants based on test scores. People repeatedly tell you that you can achieve your goals with your board exam score and attending a reputable IM program but it doesn't matter to you. You choose this life of suffering by making these posts. You've done that in college with your MCAT, and that is why you aren't actually thankful or take any pride in the fact that you got scholarship money from your "cheaper but reputable" school, something that the majority of med school students can't even get and are thus in enormous debt after their medical training. You're concerned about how your score can't get you into a top 10-20 residency. Again, you pick your battles.

I think that's a fair response. And also a perspective I need to hear.

Just to clarify, I recognize this is by no means the end of the world. I am just sharing my disappointment. More so than the score even, it was the fact that I didn't break the 90th percentile when I have scored greater than the 95th percentile on my practice exams and MCAT. Again, very much 'first world problems,' but it just goes back to my desire to match into a top program.

I know several people have posted that I don't 'need' a top IM program to get a fellowship. But honestly I'm just having major deja vu from when people told me I don't need a top med school to get into a top residency program. And I don't want to find myself in a similar situation down the line.

 

[usmd2022]

Ok.. yes most us would love that score but I do know how you feel. I had 250s-260s on nbmes and UWSAs and really wanted a 260 but would have been happy with a 250+ (applying for a super competitive specialty so wanted that safety factor). Just *barely* missed 250, below all practice tests I took my last few weeks of dedicated. I think that’s what gets us - getting so far below practice tests that are supposedly really predictive for so many people.. and the worry that we’ll close doors to a program we might like. But honestly we’ll all end up fine so we just need to chill. Does suck to come in way below practice tests even if you know it’s a ‘good’ score in general. not one of life’s great trials or anything, but disappointing..

Really reassuring to hear similar stories. Especially when people with same or lower practice scores as you end up posting about their 265 triumphs.

 

[efle]

Really reassuring to hear similar stories. Especially when people with same or lower practice scores as you end up posting about their 265 triumphs.

If your true spot is high 250s, then a 265 vs 250 is statistical noise within 66% CI (e.g. 257 plus or minus 8). You can literally chalk it up to good vs bad luck on your form.

 

[Splenda88]

I can see why OP is disappointed. 85th (250) vs. 94th (260) percentile probably look different in the eyes of top 20 IM program directors. Remember guys that top 20 IM programs are extremely competitive. And almost everyone applying to these programs will have 250+ and great research background. A 260+ can give one a slight advantage over another applicant who score 250-255 for instance.

 

[Splenda88]

If your true spot is high 250s, then a 265 vs 250 is statistical noise within 66% CI (e.g. 257 plus or minus 8). You can literally chalk it up to good vs bad luck on your form.

True but PD don't get into these gritty nitty details unfortunately.

 

[Dwan]

Top 20 IM is very competitive but it doesn't make a difference in most people's ultimate careers vs the top 40. Most people say "fellowship" or "academics" vaguely as their reason for wanting a top 20, but prestige is the main driver. Fellowships are not that hard to get even from top 40s (including cards/GI/onc), the US-MD match rates are high and most who don't match have some "flag" (applied or ranked one program for geography reasons, switched last minute and couldn't get good letters). Most academic positions are not competitive if you are coming from a top 40 IM program (prepare to make far less money vs PP), the exceptions being grant-funded research faculty positions. Only a select few go in that even from top IM - I'm one of a handful in my entire program who wants serious academics and has an appropriate background (dabbling in research on the side is not competitive as that won't require funding). If that is truly your interest, you can find PI's at mid tier academic programs that are equally productive to the PI's at top programs, you would just need to be more picky on institution as the breadth of elite PI's will not be as large.

I know several people have posted that I don't 'need' a top IM program to get a fellowship. But honestly I'm just having major deja vu from when people told me I don't need a top med school to get into a top residency program. And I don't want to find myself in a similar situation down the line.

It is very true that prestigious med school helps a ton for prestigious IM which helps a ton for prestigious fellowship, but all this matters much less for final career positions. Competition differences are large between the top 40'ish institutions, but the final career opportunities do not differ significantly.

 

[DrStephenStrange]

I think that's a fair response. And also a perspective I need to hear.

Just to clarify, I recognize this is by no means the end of the world. I am just sharing my disappointment. More so than the score even, it was the fact that I didn't break the 90th percentile when I have scored greater than the 95th percentile on my practice exams and MCAT. Again, very much 'first world problems,' but it just goes back to my desire to match into a top program.

I know several people have posted that I don't 'need' a top IM program to get a fellowship. But honestly I'm just having major deja vu from when people told me I don't need a top med school to get into a top residency program. And I don't want to find myself in a similar situation down the line.

If a top 20 IM residency was required to get into GI or Cardio fellowships, then people in DO schools like me would be screwed. Just imagine how DO students with 260s must feel when they realize they can't even land a top 50 IM program.

 

[usmd2022]

Top 20 IM is very competitive but it doesn't make a difference in most people's ultimate careers vs the top 40. Most people say "fellowship" or "academics" vaguely as their reason for wanting a top 20, but prestige is the main driver. Fellowships are not that hard to get even from top 40s (including cards/GI/onc), the US-MD match rates are high and most who don't match have some "flag" (applied or ranked one program for geography reasons, switched last minute and couldn't get good letters). Most academic positions are not competitive if you are coming from a top 40 IM program (prepare to make far less money vs PP), the exceptions being grant-funded research faculty positions. Only a select few go in that even from top IM - I'm one of a handful in my entire program who wants serious academics and has an appropriate background (dabbling in research on the side is not competitive as that won't require funding). If that is truly your interest, you can find PI's at mid tier academic programs that are equally productive to the PI's at top programs, you would just need to be more picky on institution as the breadth of elite PI's will not be as large.


It is very true that prestigious med school helps a ton for prestigious IM which helps a ton for prestigious fellowship, but all this matters much less for final career positions. Competition differences are large between the top 40'ish institutions, but the final career opportunities do not differ significantly.

I think this depends on your career goals. If you want to become the medicine chair of a prestigious hospital, your training pedigree will only do you favors. And I want to keep my options open.

And so ultimately my question boils down to how much does a 250 vs. 260 affect my chances for a top 20 IM programs all other things being equal. This is something I haven't been able to find any good information about at all. If it's true JHH IM average is 251, it seems like my disappointment is justified given my goals. But on the other hand if it really does not make a significant difference, then that would be reassuring to know.

 

[usmd2022]

If a top 20 IM residency was required to get into GI or Cardio fellowships, then people in DO schools like me would be screwed. Just imagine how DO students with 260s must feel when they realize they can't even land a top 50 IM program.

I'm sure it's not required to get any fellowship, but I'm sure it helps you to get a competitive fellowship.

It's funny because when I chose to forego the T10 school, people said it doesn't matter because the quality of the residency and fellowship is more important. So I'm just trying to set myself up accordingly.

 

[DrStephenStrange]

I think this depends on your career goals. If you want to become the medicine chair of a prestigious hospital, your training pedigree will only do you favors. And I want to keep my options open.

And so ultimately my question boils down to how much does a 250 vs. 260 affect my chances for a top 20 IM programs all other things being equal. This is something I haven't been able to find any good information about at all. If it's true JHH IM average is 251, it seems like my disappointment is justified given my goals. But on the other hand if it really does not make a significant difference, then that would be reassuring to know.

If their average is 251, your disappointment isn't justified at all. An average of 251 means plenty of people in the 240s have also matched in their program.

 

[usmd2022]

If their average is 251, your disappointment isn't justified at all. An average of 251 means plenty of people in the 240s have also matched in their program.

That's a good point, but are the people below the average the kids from the T10 schools (aka not me)? Again, this is an issue of lack of data. These programs are not very transparent with their numbers.

 

[Ho0v-man]

Assuming this is not a troll post, I think I counted it up last year. There’s not enough USMDs with 250+ applying IM to fill the top 20 programs. In 2018, there were about 880 people who applied IM with 250+ scores. Only about 500 of them were USMDs. If you count the research tracks, there’s about 915 spots in the top 20 IM programs.

That score won’t hold you back.

 

[FindersFee5]

So I'm making this post at the risk of sounding very ungrateful, and that's not my intention. I've just had lingering disappointment since I got my score back recently. I was really aiming for a 260, and all of my practice tests within the last few weeks of my prep period were in that range. 275 on UW1 (over predict I know), 265 on NBME 18, and 264 on UWSA2. I don't get test taking anxiety, and my real exam honestly felt like the easiest set of questions I'd encountered for a long time. In hindsight, that was probably a red flag because the curve was probably brutal.

Anyway, I scored a 250, which is at the absolute bottom of my confidence interval of 250-267 (predicted 260). I know that objectively this is a good score, but I was really disappointed to not meet my goal. I poured my heart and soul into this test and it just feels bad not hitting your goal. I'm in clerkships now which are going fine and going to apply for the match next year. I go to a medical school with a good reputation but it's no John Harvard. I'm interested in academic IM at a top 20 program to be competitive for fellowship, but honestly with how competitive top programs in IM have become, I'm skeptical this will help me stand out much.

Anyway, if anyone happens to be reading this post and hasn't taken Step yet, I'd advise that they mentally prepare themselves to be happy with any score within the confidence interval. I know some people even end up scoring below that which is really disheartening. I really wasn't prepared for anything below a 255 and that was my own fault. I just hope the strong foundation I've developed helps me score higher for Step 2.

Honestly dude, you're getting crucified here but I totally understand. Doing worse than you expect to do is painful. If you were scoring a predicted 250 and you got a 240, people would be much more sympathetic. But a 250 isn't going to hold you out of anywhere. AOA seems more important for IM anyways - go out and crush 3rd year and you've still got a great chance!

 

[efle]

Assuming this is not a troll post, I think I counted it up last year. There’s not enough USMDs with 250+ applying IM to fill the top 20 programs. In 2018, there were about 880 people who applied IM with 250+ scores. Only about 500 of them were USMDs. If you count the research tracks, there’s about 915 spots in the top 20 IM programs.

That score won’t hold you back.

Yep. This is true in many of the larger specialties. For example in DR, the Top 20 programs alone have enough spots for about 1/3rd of US MD rads applicants.

The hyper-competitive niche specialties like derm, ENT, plastics are only so absurdly rough to match because they're so small

 

[usmd2022]

Assuming this is not a troll post, I think I counted it up last year. There’s not enough USMDs with 250+ applying IM to fill the top 20 programs. In 2018, there were about 880 people who applied IM with 250+ scores. Only about 500 of them were USMDs. If you count the research tracks, there’s about 915 spots in the top 20 IM programs.

That score won’t hold you back.

This is very reassuring to hear. Do you mind sharing where you got this data from?

Honestly dude, you're getting crucified here but I totally understand. Doing worse than you expect to do is painful. If you were scoring a predicted 250 and you got a 240, people would be much more sympathetic. But a 250 isn't going to hold you out of anywhere. AOA seems more important for IM anyways - go out and crush 3rd year and you've still got a great chance!

Thanks, really appreciate it. And honestly maybe I do deserve some of the responses here, but I was disappointed and perhaps just wanted to hear some reassurance after not meeting my goals after so much effort.

 

[slowthai]

This is very reassuring to hear. Do you mind sharing where you got this data from?

He got it from Charting the Outcomes (2018)

 

[Ho0v-man]

This is very reassuring to hear. Do you mind sharing where you got this data from?



Thanks, really appreciate it. And honestly maybe I do deserve some of the responses here, but I was disappointed and perhaps just wanted to hear some reassurance after not meeting my goals after so much effort.

I counted the number of spots at the top 20 schools. And then I looked at the interactive charting outcomes and applied filters for applicant status (usmd, do, img).

Edit: I really can’t remember what list I used for “top 20”. Could’ve been top 20 med schools or top 20 IM programs and there are multiple lists out there by doximity, US news, etc. So if someone else does this and numbers are slightly different, we likely had slightly different lists. That said, the point still stands that if these programs that almost exclusively accept USMDs want to fill exclusively with USMDs (and they do), they can’t screen anywhere near your score. Furthermore, it’s not like every 250+ applicant to IM even wants to attend a top 20 program. So as far as scores go, you’re in a great position.

 

[TelemarketingEnigma]

@usmd2022, I definitely suggest checking out Residency Explorer (I think a few others have mentioned it upthread), as it might help alleviate some of your fears, and show you other areas you can focus on. Residency Explorer™ Tool: Home

I plugged my own score (1 point away from yours) in for the top 20ish IM residencies out of curiosity and it's in the middle 50% or top 25% for matched applicants at all of those institutions for which they have data. As others have said, there are more spots in top IM programs than IM applicants with 250+ scores. And some of those 250+ applicants will inevitably end up at non-top 20 insitutions (weaker apps in other ways, geographical preference, specific interests better suited to other programs, bad luck...)

Also important to remember that a high step score is in no way a guarantee of top residency. I have no first hand knowledge of this, but my feeling is that once you're past 250ish it's likely that the other parts of your application matter more now. You've passed most of the score cutoffs (except for maybe some crazy programs), now you need to make sure you stand out in other ways.

 

[studentdocftw]

Bruh...I scored 244 on step 2 when my UW range was 257-270...I got over it quickly when I realized there was nothing I could do, and that ultimately, everything would be fine.

 

[sella.turcica]

You should quit med school while you can.

 

[usmd2022]

Thank you to everyone for the reassurance and reality check.

 

[deleted804295]

So I'm making this post at the risk of sounding very ungrateful, and that's not my intention. I've just had lingering disappointment since I got my score back recently. I was really aiming for a 260, and all of my practice tests within the last few weeks of my prep period were in that range. 275 on UW1 (over predict I know), 265 on NBME 18, and 264 on UWSA2. I don't get test taking anxiety, and my real exam honestly felt like the easiest set of questions I'd encountered for a long time. In hindsight, that was probably a red flag because the curve was probably brutal.

Anyway, I scored a 250, which is at the absolute bottom of my confidence interval of 250-267 (predicted 260). I know that objectively this is a good score, but I was really disappointed to not meet my goal. I poured my heart and soul into this test and it just feels bad not hitting your goal. I'm in clerkships now which are going fine and going to apply for the match next year. I go to a medical school with a good reputation but it's no John Harvard. I'm interested in academic IM at a top 20 program to be competitive for fellowship, but honestly with how competitive top programs in IM have become, I'm skeptical this will help me stand out much.

Anyway, if anyone happens to be reading this post and hasn't taken Step yet, I'd advise that they mentally prepare themselves to be happy with any score within the confidence interval. I know some people even end up scoring below that which is really disheartening. I really wasn't prepared for anything below a 255 and that was my own fault. I just hope the strong foundation I've developed helps me score higher for Step 2.

Congrats you can match into any specialty of your choosing.

 

[deleted804295]

You should've told us that you got a 222 and you wanted ENT, then you could've continued @failedatlife's legacy

I miss him. Did he match ENT?

 

[deleted804295]

Nothing out of the ordinary. Anki, UWORLD, Amboss, Rx, Sketchy -- the works. Finished over 6000 unique questions before test day. I scored 90% on the free 120 (actually found the real exam to be easier which is unusual). Honestly my assessment is I got unlucky on a few guesses and perhaps a higher % of my incorrect answers were not experimental questions.

And to answer your question if I've talked to Harvard and Hopkins residents -- I have not (I don't know any lol). I really wish there was a tool like the MSAR that gave you a mean Step 1 score per program, but I have not found one. When I looked into what scores are competitive for the top 10 IM programs, I was seeing 260+ from posts on SDN and reddit.

It doesn't matter if you scored 270, if you don't have connections to top residency programs then you're unlikely to get in. Work on connections, doing stellar during rotations, and you should get into a top program.

 

[deleted804295]

Yeah man, if that's the game you want to play, one where you are concerned about reputation and the place you go to, then yeah. You should be prepared for moments like this where you feel like crap when you get only a 250. Striving for the top doesn't necessarily mean destroying a board exam. But you can pick your battles - just be prepared for the emotional toll and consequences.

You don't have to follow into the trap of medicine's classical method of stratifying applicants based on test scores. People repeatedly tell you that you can achieve your goals with your board exam score and attending a reputable IM program but it doesn't matter to you. You choose this life of suffering by making these posts. You've done that in college with your MCAT, and that is why you aren't actually thankful or take any pride in the fact that you got scholarship money from your "cheaper but reputable" school, something that the majority of med school students can't even get and are thus in enormous debt after their medical training. You're concerned about how your score can't get you into a top 10-20 residency. Again, you pick your battles.

Pick your battles. I love this.

It has helped me preserve my mental health and make me feel proud even during my shortcomings.

What will lessening your lifespan via stress achieve? An extra 2 points? How will that drastically change your life in the long run? Being an academic physician at BU instead of Harvard?

Was it really worth it all in the end?

 

[slowthai]

I miss him. Did he match ENT?

No one really knows. Legend says he died and reincarnated into one of the most well known posters on here. He could be one post above you or one post below you on any given thread...ooOOooh *scary music*

One thing is for sure, no one will ever blur the line between trolling and self-flagellation like he did

 

[Ganon]

If OP is serious, this kind of lack of self-awareness will sink him on the interview trail faster than a much, much lower score would. Cheers

 

[M&L]

@usmd2022 my close friend was an IMG (not caribs, just another country), step 1 below 230. No pubs. Got into only one residency, small community program (Internal medicine). This summer he is starting a very juicy critical care fellowship in one of the top hospitals in new york. How, you ask me? Just hard work during residency.

 

[usmd2022]

@usmd2022 my close friend was an IMG (not caribs, just another country), step 1 below 230. No pubs. Got into only one residency, small community program (Internal medicine). This summer he is starting a very juicy critical care fellowship in one of the top hospitals in new york. How, you ask me? Just hard work during residency.

No doubt hard work can make up for not starting with a 100 yard lead to begin with.

 

[efle]

No doubt hard work can make up for not starting with a 100 yard lead to begin with.

Yes! You'll hear constantly on SDN how much of a disadvantage it is to go to DO school, but in just the last few years I've met academic GI fellows, deans, and department leadership that have DOs. Cream always rises. A 250 isn't even a stumbling block in the first place, you'll be fine!

 

[deleted804295]

Yes! You'll hear constantly on SDN how much of a disadvantage it is to go to DO school, but in just the last few years I've met academic GI fellows, deans, and department leadership that have DOs. Cream always rises. A 250 isn't even a stumbling block in the first place, you'll be fine!

I'd be more understanding if it was a 220 but it's a 250

I'll probably get nowhere near that score

 

[usmd2022]

I'd be more understanding if it was a 220 but it's a 250

I'll probably get nowhere near that score

I think the responses here have given me some much needed perspective for sure. When I was looking into what Step scores are competitive for top IM programs, seeing threads like the one linked below gave me a lot of anxiety. Not sure how much truth there is to the responses in that thread.

 

[deleted804295]

I think the responses here have given me some much needed perspective for sure. When I was looking into what Step scores are competitive for top IM programs, seeing threads like the one linked below gave me a lot of anxiety. Not sure how much truth there is to the responses in that thread.

Did you read the thread? They said 250+ is fine. You have not closed any doors. Just focus on research clerkships and connections now

 

[usmd2022]

Did you read the thread? They said 250+ is fine. You have not closed any doors. Just focus on research clerkships and connections now

A few posts mentioning 260+.

 

[deleted1038938]

@DrStephenStrange : 236-245 seems way too low for Mass Gen, are you sure that's not 25th / 75th or something

my upperclassmen matched there with a 236 lol. and from a very mid-tier school.

 

[deleted1038938]

I said it before, it is okay to be disappointed. That is fine. Again though, OP, you will match. You dont need T10 IM to get a fellowship, you just don’t.

I was CRUSHED after I got my step 1 score (hint: it was 39 points lower than your’s). I felt like a failure. My practice scores were higher. I felt like I was going nowhere and that I was doomed.

Here’s the thing: you‘re a very competitive applicant. A 250 sure isn’t closing doors for you. You can’t change it. You’ve just gotta work on what you can change. Get an equally impressive CK score. Get more research. Network. Nail your rotations.

same. I got a score that was 20 points below my practice scores and felt like the exam didn't go that bad. i was absolutely devastated.

 

[usmd2022]

same. I got a score that was 20 points below my practice scores and felt like the exam didn't go that bad. i was absolutely devastated.

This was definitely what contributed most to my disappointment, especially when you see people who had similar practice scores as you scoring in the 260s. How easy the exam felt seems to definitely be the red flag -- wouldn't be surprised if it required almost 95% correct to break into the 260s like NBME 18.

 

[Tenk]

Wtf kinda worm hole did I enter where someone is worried about IM with a 250?

 

[usmd2022]

Wtf kinda worm hole did I enter where someone is worried about IM with a 250?

Yeah, I knew that I'd be more than ok for IM in general. But I am really interested in academic IM at a top 20 program to get into a good fellowship. If I were at a T10 school I don't think I'd have been as concerned.

 

[deleted1038938]

This was definitely what contributed most to my disappointment, especially when you see people who had similar practice scores as you scoring in the 260s. How easy the exam felt seems to definitely be the red flag -- wouldn't be surprised if it required almost 95% correct to break into the 260s like NBME 18.

the difference is I got a 233... from scores in the 253s on NBMEs and a 260 on UWSA lol so the two cannot be compared. you still got in your range and did well. i don't see why you're so upset. my friend in an upper class matched MGH with a 236 in a specialty more competitive than IM. you'll end up fine.

 

[Dwan]

Yeah, I knew that I'd be more than ok for IM in general. But I am really interested in academic IM at a top 20 program to get into a good fellowship. If I were at a T10 school I don't think I'd have been as concerned.

The reason top IM is competitive isn't because of the step requirements. AOA is by far the largest factor (outside of school name). For reference, I went to a low-tier med school, and every single AOA I knew applying IM had top 20 invites (the lowest being ~220 but with a 260+ step 2). I had them with a step far worse than yours. I think BU and NW IM had listed their step averages, and they were very similar (243ish), but NW is definitely more competitive and has a lot more AOAs.

 

[M&L]

The reason top IM is competitive isn't because of the step requirements. AOA is by far the largest factor (outside of school name). For reference, I went to a low-tier med school, and every single AOA I knew applying IM had top 20 invites (the lowest being ~220 but with a 260+ step 2). I had them with a step far worse than yours. I think BU and NW IM had listed their step averages, and they were very similar (243ish), but NW is definitely more competitive and has a lot more AOAs.

What if you didn’t get AOA?

 

[Dwan]

What if you didn’t get AOA?

Then you'll want other factors to stand out, including step scores, clinical grades, letters, and research publications or other impressive ECs. But there are great diminishing returns past 250 which is already an excellent step for any IM program.

 

[slowthai]

The reason top IM is competitive isn't because of the step requirements. AOA is by far the largest factor (outside of school name). For reference, I went to a low-tier med school, and every single AOA I knew applying IM had top 20 invites (the lowest being ~220 but with a 260+ step 2). I had them with a step far worse than yours. I think BU and NW IM had listed their step averages, and they were very similar (243ish), but NW is definitely more competitive and has a lot more AOAs.

Wonder what percentage of applicants matching into the top 20 have AOA. Probably 90%, lol

 

[M&L]

Does anyone know how many pubs is considered good enough ? Also what about poster presentations ?

 

[Frogger27]

Wonder what percentage of applicants matching into the top 20 have AOA. Probably 90%, lol

nah, probably like 40%.

 

[Mass Effect]

So I'm making this post at the risk of sounding very ungrateful, and that's not my intention. I've just had lingering disappointment since I got my score back recently. I was really aiming for a 260, and all of my practice tests within the last few weeks of my prep period were in that range. 275 on UW1 (over predict I know), 265 on NBME 18, and 264 on UWSA2. I don't get test taking anxiety, and my real exam honestly felt like the easiest set of questions I'd encountered for a long time. In hindsight, that was probably a red flag because the curve was probably brutal.

Anyway, I scored a 250, which is at the absolute bottom of my confidence interval of 250-267 (predicted 260). I know that objectively this is a good score, but I was really disappointed to not meet my goal. I poured my heart and soul into this test and it just feels bad not hitting your goal. I'm in clerkships now which are going fine and going to apply for the match next year. I go to a medical school with a good reputation but it's no John Harvard. I'm interested in academic IM at a top 20 program to be competitive for fellowship, but honestly with how competitive top programs in IM have become, I'm skeptical this will help me stand out much.

Anyway, if anyone happens to be reading this post and hasn't taken Step yet, I'd advise that they mentally prepare themselves to be happy with any score within the confidence interval. I know some people even end up scoring below that which is really disheartening. I really wasn't prepared for anything below a 255 and that was my own fault. I just hope the strong foundation I've developed helps me score higher for Step 2.

This is why future generations will navigate a pass/fail Step system.

 

[NotAProgDirector]

Honestly I think one of the worst things to happen to the steps are "practice exams" that give you a predicted score.