Help!! Very low step 1 score 193 :-(

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Dr. DG

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Hi guys,
So I received back my score report and It was just the worst day of my life. I was only a point away from failing. I just wanted to see if I can get any advice.
I am a 3rd year US medical Student interested in doing IM residency. Do you guys think I will have a chance?Haven't taken step2 yet. I know I will have to also consider FM. Any input will be appreciated.
 
How did a USMD do so poorly? Not trying to be mean just genuinely wondering, did you fail any of the first years?
 
sorry that this happened man
i think having grades for the step exams is silly if you're using it for licensing purposes
just have to do well in third year and crush step 2 which is harder than it sounds
 
@Oo Cipher oO

I thought people have to complete step 2 to get a residency spot... Isn't only step3 required for licensing after that? Since I was told step3 is the easiest of all the steps, so why PD are so concerned about residents not passing step 3? Are there any 'internal' exams during residency that I don't know about?
 
skiier54 said:
This is my biggest fear in life. Nothing else (getting rejected by women, getting robbed, breaking bones) compares. I'd give up a kidney for a 250+ guaranteed score.
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I am starting MS2 next month and I am already terrified about step1. I think they put too much weight on that exam...
 
W19 said:
@Oo Cipher oO

I thought people have to complete step 2 to get a residency spot... Isn't only step3 required for licensing after that? Since I was told step3 is the easiest of all the steps, so why PD are so concerned about residents passing step 3? Are there any 'internal' exams during residency that I don't know about?
Click to expand...

Since I am a fourth year I don't have first hand knowledge of residency exams so anyone feel free to correct me. So you do have Step 3 for licensing in residency but there are usually internal exams and then Board certification exams. These passing rates of these exams reflect on the residency and a high failure rate can be a red flag that can cause an entire residency to be put on probation. That is why PDs want students who have proven then can at least pass these standardized exams and not cause them headaches down the road.
 
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Are there any 'internal' exams during residency that I don't know about?
Click to expand...

You have to pass a written exam to be board certified in (all ? ) the specialties. Many specialties have oral exams that you take after you pass the written exams (eg anesthesia and surgical specialties) .
Programs are judged on the exam pass rates of their residents. You also have "in service" exams every year by which your program can judge your progress. There are percentile scores so you can be compared to your peers in your PG year level. After you pass your exams and become board certified, most specialties currently require that you take another exam every 10 years to re-certify.
 
skiier54 said:
This is my biggest fear in life. Nothing else (getting rejected by women, getting robbed, breaking bones) compares. I'd give up a kidney for a 250+ guaranteed score.
Click to expand...

You're an idiot. You've obviously never done a renal rotation or been on a dialysis ward. I'd give up a 250 to make sure I never became a hemodialysis zombie
 
Dr. DG said:
Hi guys,
So I received back my score report and It was just the worst day of my life. I was only a point away from failing. I just wanted to see if I can get any advice.
I am a 3rd year US medical Student interested in doing IM residency. Do you guys think I will have a chance?Haven't taken step2 yet. I know I will have to also consider FM. Any input will be appreciated.
Click to expand...
 
You passed, which is better than failing. Do well on your clinical rotations and you'll match into IM somewhere. Not necessarily your first choice or top programs
 
Life is about how you look at things. Yes, you have a low Step 1 score. Barely passed and it is not competitive.

BUT, you passed! Ask those that failed would they take that 193 Step 1 score. So, my advice is handle what is done and be happy you passed. It could have easily went the other way.

Do solid work 3rd year and work on taking standardized exams with the shelves through the year. And prepare as much as possible for Step 2. If that means, you have to delay it a tad to get a better score, then do that. Just have the score back in time for interviewing.

Find that silver lining in things and life will not suck as bad. Write that down! And sticky that bitch!
 
correct me if im wrong but isnt failing in some instances better than passing? for example if you pass you cant take the exam again. but if you fail you can still take it again. so if someone fails they have a chance to get a much higher score where if you pass with a low score you cant take it again.
 
doc-Oc said:
correct me if im wrong but isnt failing in some instances better than passing? for example if you pass you cant take the exam again. but if you fail you can still take it again. so if someone fails they have a chance to get a much higher score where if you pass with a low score you cant take it again.
Click to expand...
Probably depends on the circumstances. If you think you can score a 250 next time (unrealistic if you've failed once) you'll probably be better off failing the first time, but more realistically you're going to fail and then barely slide by the next time. You're better off with a 193 and a first time pass than you are with a 210 and a fail.
 
skiier54 said:
This is my biggest fear in life. Nothing else (getting rejected by women, getting robbed, breaking bones) compares. I'd give up a kidney for a 250+ guaranteed score.
Click to expand...
F yah.
1. Give away kidney
2. Get 250+
3. Match surgical subspeciality
4. $$$
5. Buy kidney back for $300k

I don't even need "???" in this plan as step 3. It's fool proof.
 
Try to think of how tough it would be to fail, get pulled from rotations (likely taking time away from your 4th year electives or vacations), and to have to re-study for this beast again.
A low score can be tough, but you have only forward to look. You are literally and figuratively passed this test. Look ahead, think of how awesome you can do on your clerkships and step 2. Use this as motivation to give your next two years all you have and prove everyone you do have what it takes to do well. I hope all works out for you OP. I know such a low score can be demoralizing, but try to think of what it could of been like if that score were just a few points lower. And see this as a chance to make your next two years better. Wishing you all the best!
Sorry I can't offer real advice regarding residency, I haven't done that process either. But, I hope I can offer a morale boost at least. 🙂

P.s. I'm writing this as someone who struggled to pass NBMEs throughout dedicated and would be very thankful for any passing score right now (scores come out next week *fingers crossed*).
 
A first-time pass, even with a low score, is better than a failure and retake. But if I saw your app, I'd be concerned that you will continue to struggle with in-service exams and written boards- which then causes problems for the residency program you end up in. It's really important for you to figure out why you got a low score, and fix it. Poor test-taking skills? Severe test anxiety? Decided you weren't going to use question banks? People will tell you that you need to "crush" your shelf exams and Step 2, but it probably won't be easy as just declaring that as your goal.
 
Doctor Bob said:
I might have given up my spleen for a great step score.

I settled for studying instead.

In retrospect I'd rather have the time back and a scar from a splenectomy.
Click to expand...

Those encapsulated bacteria tho
 
jw3600 said:
F yah.
1. Give away kidney
2. Get 250+
3. Match surgical subspeciality
4. $$$
5. Buy kidney back for $300k

I don't even need "???" in this plan as step 3. It's fool proof.
Click to expand...
No kidding. You're pretty much just renting one kidney and still have the other in the meantime.
 
W19 said:
@Oo Cipher oO

I thought people have to complete step 2 to get a residency spot... Isn't only step3 required for licensing after that? Since I was told step3 is the easiest of all the steps, so why PD are so concerned about residents not passing step 3? Are there any 'internal' exams during residency that I don't know about?
Click to expand...
USMLE stands for United States Medical Licensing Exam. You must pass all 3 to get licensed.

Now, schools and residencies use these as benchmarks of your knowledge base, but that wasn't their original purpose.
 
i wonder how would his circumstances would change if he was an international medical student.
 
jqueb29 said:
Those encapsulated bacteria tho
Click to expand...

vanilla-ice.jpg
 
doc-Oc said:
i wonder how would his circumstances would change if he was an international medical student.
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His prospect of finding any residency at all would be slim... He can be picky a little bit about the non competitive specialties since he is an AMG... I know people at my school who matched into university IM programs with <200 in step1, but I was told they have good ECs...

I know FMG with score like OP's that never matched and had to go back to school to become NP...
 
doc-Oc said:
i wonder how would his circumstances would change if he was an international medical student.
Click to expand...

OP will still have the privilege of choosing a specialty, probably even location with smart applying. An IMG with that score would be pretty much stuck with whatever they could take.
 
Your letters of recommendation are the most important part of your application. There's no debating that. I've sat on multiple admission's committees for both medical school and residency programs, and a good LOR from the right person can go a very long way. Your STEP 1 score is low for sure, but you didn't fail. To give you an example of a worse score, I know someone who failed their STEP 1 and she went on to match into a very competitive residency (dermatology) and went on to gain leadership positions in her national association and is laughing all the way to the bank (she's ridiculously good at what she does and very successful in practice). This is the beginning of your journey, not the end.

Head up, smile on your face, march forward. Start thinking about your application and the its other components, so you put together an outstanding application. You are certainly in the running for IM residency. Do better on STEP 2 and take it early, so that score is available for your application.
 
doc-Oc said:
correct me if im wrong but isnt failing in some instances better than passing? for example if you pass you cant take the exam again. but if you fail you can still take it again. so if someone fails they have a chance to get a much higher score where if you pass with a low score you cant take it again.
Click to expand...
No
 
Residency programs see all of your scores. If you failed, they see that. Then, if you crush the exam the next time, they see that, too. Problem is: they'll assume you were lazy or just too disorganized to study properly the first time you failed, because you just proved that you're capable of acing the exam. The other more realistic problem is that if you failed step 1, you're not going to turn around a ace it all of a sudden. That's not how learning/studying for this kind of exam works. It's not that simple

And, finally, good luck finding the time to study AGAIN for Step 1 if you've not passed it the first time around. You'll be thrown into clinical rotations as a med student where there are no work hour restrictions and you can be exhausted all the time. And Step 1 material quickly exits your brain once you are in the thick of clinical rotations. Take Step 1 once, prepare like you've got one shot at it, and know that if you fail, it's still a salvageable mistake. BUT, you've got to be realistic about the fact that certain competitive specialties are just not a realistic goal anymore (not impossible, just not something you should bet all your money on). Go be happy doing something else and don't beat yourself up about it. Everything happens for a reason, and you may very well be happier and better following a different direction. You can't expect to know what's best for you at this stage--it's all part of the self-discovery process during your training.
 
There's always Step 2 to prove your worth to the residencies. Many of the less competitive residencies will only screen out people who failed the first time, so you should be fine. Then, if they'll see you dramatically improved Step 2 score they will probably take the Step 1 score less seriously. Do you know why you did so poorly on Step 1? What were you getting on your practice tests? What study resources did you use? How long did you study for? How did you do in your pre-clinical classes (were you at the very bottom, or failed any classes)?
 
I want to thank everyone who commented. I really appreciate it
 
Oo Cipher oO said:
Since I am a fourth year I don't have first hand knowledge of residency exams so anyone feel free to correct me. So you do have Step 3 for licensing in residency but there are usually internal exams and then Board certification exams. These passing rates of these exams reflect on the residency and a high failure rate can be a red flag that can cause an entire residency to be put on probation. That is why PDs want students who have proven then can at least pass these standardized exams and not cause them headaches down the road.
Click to expand...

Most specialties have nationwide in-service examinations, which essentially track your progress in acquiring knowledge/clinical judgment through residency. Residency directors do care about this. These exams are typically not internal to any program.
 
coreytayloris said:
You're an idiot. You've obviously never done a renal rotation or been on a dialysis ward. I'd give up a 250 to make sure I never became a hemodialysis zombie
Click to expand...

Clearly your "renal" rotation failed to teach you that someone with normal kidney function can donate a kidney with no increase in risk of needing dialysis down the road.

Maybe you need to do a nephrology rotation.
 
lazymed said:
Clearly your "renal" rotation failed to teach you that someone with normal kidney function can donate a kidney with no increase in risk of needing dialysis down the road.

Maybe you need to do a nephrology rotation.
Click to expand...
Yeah but what about Step 2?
 
Okay,
It's official. Allo has become pre allo.
The first comments were great and helpful. But now I'm seeing the regurgitatant remaints of pre allo with the new comments.
No one is being helpful.
OP, You passed. You're not happy with the score, but you can improve and you will become a doctor. Don't let your score discourage you.
 
W19 said:
I am starting MS2 next month and I am already terrified about step1. I think they put too much weight on that exam...
Click to expand...

Me too man! I got a month of summer left before MS2 and I'm already freaking out about this stupid beast.
 
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Hey OP relax. Theres a ton of IM FMGs and IMGs working as hospitalists in community hospitals making 200,00+. If they found a spot then so can you with your shiny American MD.
 
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