IM Residency Competitiveness?

[StraightOuttaBrooklyn]

Aloha,

I'm a middle of the pack 2nd year, and I anticipate I will be middle of the pack in 3rd year too. I'm trying to be realistic about my residency prospects on this basis, but I do have the lofty goal of eventually pursuing a cardiology fellowship. I'm not exactly expecting that I will "crush" Step 1 either, maybe somewhere in the window of 230-240? I'm wondering, and I hope anyone who is apprised to these kinds of things might chime in here, but would an IM program, say, Vanderbilt or Northwestern or Georgetown or Methodist (Houston), be within my reach with those kinds of estimates? I've got the "leadership" card covered, and hopefully I'll have a poster (solid organ transplantation research) or something by the time I submit my ERAS.

Sincerely,

Aimless.

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[mimelim]

Aloha,

I'm a middle of the pack 2nd year, and I anticipate I will be middle of the pack in 3rd year too. I'm trying to be realistic about my residency prospects on this basis, but I do have the lofty goal of eventually pursuing a cardiology fellowship. I'm not exactly expecting that I will "crush" Step 1 either, maybe somewhere in the window of 230-240? I'm wondering, and I hope anyone who is apprised to these kinds of things might chime in here, but would an IM program, say, Vanderbilt or Northwestern or Georgetown or Methodist (Houston), be within my reach with those kinds of estimates? I've got the "leadership" card covered, and hopefully I'll have a poster (solid organ transplantation research) or something by the time I submit my ERAS.

Sincerely,

Aimless.

What exactly do Vanderbilt, Northwestern, Georgetown and Houston Methodist have in common that you are lumping them together? A 230 step 1 score will put you in range of all of them. I am not going to pretend to know the inner workings of IM programs, but you would be average or above average scores wise...

 

[StraightOuttaBrooklyn]

What exactly do Vanderbilt, Northwestern, Georgetown and Houston Methodist have in common that you are lumping them together? A 230 step 1 score will put you in range of all of them. I am not going to pretend to know the inner workings of IM programs, but you would be average or above average scores wise...

Locations and programs that I am interested in. Some are more "name" than others in the list obviously, but for instance in Chicago I'd prefer to be at a larger institution in the city than say a community program just outside the city. Name recognition of these programs I guess would also be helpful somewhat further down the road when readying for a fellowship match.

 

[TBV]

Oh great another competitiveness of IM thread. Wonder if this one will be identical to the other 46,378

 

[Cytarabine]

What exactly do Vanderbilt, Northwestern, Georgetown and Houston Methodist have in common that you are lumping them together? A 230 step 1 score will put you in range of all of them. I am not going to pretend to know the inner workings of IM programs, but you would be average or above average scores wise...

would be below average for vandy

 

[mimelim]

would be below average for vandy

How far below?

 

[Cytarabine]

How far below?

Hard to say, frieda says vandy's average is >240, but ">240" is the highest step category frieda has. I wouldn't imagine it's a whole lot greater than 240

 

[mimelim]

Hard to say, frieda says vandy's average is >240, but ">240" is the highest step category frieda has. I wouldn't imagine it's a whole lot greater than 240

Never used Frieda before, just made an account, checked out my program, half of the numbers/stats are incorrect for us. Trying to figure out where they get their information from since it is AMA, ie a 3rd party lobbyist organization rather than a part of the actual system. Is this like US news?

Edit: checked 2 other programs that I know the scores of residents who are at them, also off as well. Maybe it is just vascular surgery, but it seems like everything I've looked at is just made up...

Edit2: Not going to pretend to know Vandy's step scores or even guess at their range. Just didn't know this thing existed.

 

[midwestm2]

@mimelim ... incorrect like the reported step scores are too high, or incorrect like too low?

 

[mimelim]

@mimelim ... incorrect like the reported step scores are too high, or incorrect like too low?

I've gone through 4 programs so far. Every single one of them has had something incorrect.

Dates are wrong, web addresses are wrong/old, minimum step scores for interview are wrong, "Average Step 1 score (range) of current residents/fellows" are wrong, Visa Status accepted wrong.

I'm also not sure what "Average Step 1 score (range) of current residents/fellows" means. My guess is that the average falls within pre-specified ranges, ie <220, 221-240, 240>. I don't know why you would report information that way. Unless you were depending on self reporting (ie unverifiable) or you were just making it up.

 

[midwestm2]

Are there any legitimate resources to view your competitiveness to a residency program's averages? (It might save a lot of new redundant threads in the future)

 

[Cytarabine]

Never used Frieda before, just made an account, checked out my program, half of the numbers/stats are incorrect for us. Trying to figure out where they get their information from since it is AMA, ie a 3rd party lobbyist organization rather than a part of the actual system. Is this like US news?

Edit: checked 2 other programs that I know the scores of residents who are at them, also off as well. Maybe it is just vascular surgery, but it seems like everything I've looked at is just made up...

Edit2: Not going to pretend to know Vandy's step scores or even guess at their range. Just didn't know this thing existed.

My understanding is programs pay to list their information with frieda (if they want to include more than just, like, their program website link) and then self report their information. I'm not a big Vandy fan, they're just the only program of that list I decided to check as I had a feeling they might have a higher reported step average

 

[Psai]

I've gone through 4 programs so far. Every single one of them has had something incorrect.

Dates are wrong, web addresses are wrong/old, minimum step scores for interview are wrong, "Average Step 1 score (range) of current residents/fellows" are wrong, Visa Status accepted wrong.

I'm also not sure what "Average Step 1 score (range) of current residents/fellows" means. My guess is that the average falls within pre-specified ranges, ie <220, 221-240, 240>. I don't know why you would report information that way. Unless you were depending on self reporting (ie unverifiable) or you were just making it up.

I put it slightly above doximity in reliability

 

[Danbo1957]

A 240 Step 1 score is in the 70 percentile. Average; considered the minimum for IM. And Vanderbilt IM is competitive.

 

[Psai]

A 240 Step 1 score is in the 70 percentile. Average; considered the minimum for IM. And Vanderbilt IM is competitive.

Rofl what are you talking about? Average is the average for im

 

[TBV]

Rofl what are you talking about? Average is the average for im

Psai don't you know that above average is the minimum for all specialties quit it

 

[J ROD]

You get a 240 for IM and you will be ok. Whether or not they even decide to interview you is random too.

It's random. That simple.

 

[Danbo1957]

I guess that I need to spell it out. 240 denotes an average student, at least at first glance. Our program is unbelievably competitive, so we're looking 250 - 260 for a full half of our residents. I believe in the Step 1 numbers...

 

[Dave89]

FREIDA Step 1 averages are unreliable - as is virtually everything else on that site apart from program street addresses.

 

[22031 Alum]

FREIDA Step 1 averages are unreliable - as is virtually everything else on that site apart from program street addresses.

After a move, my program's address was wrong for more than a year on FREIDA.

 

[Dave89]

After a move, my program's address was wrong for more than a year on FREIDA.

Lol. Maybe they got the # of residency positions right.

Hope springs eternal.

 

[J ROD]

I guess that I need to spell it out. 240 denotes an average student, at least at first glance. Our program is unbelievably competitive, so we're looking 250 - 260 for a full half of our residents. I believe in the Step 1 numbers...

I believe in patients who say their doctors are passionate and provide great care. I know plenty of 250+ guys that are just great test takers and not clinicians.
I guess we all have a different definition.

 

[Psai]

I guess that I need to spell it out. 240 denotes an average student, at least at first glance. Our program is unbelievably competitive, so we're looking 250 - 260 for a full half of our residents. I believe in the Step 1 numbers...

230 is the average doe

 

[psychMDhopefully]

I love how every program in every specialty thinks they're going to get the "above average" students, 98% of American MDs match so somebody has to take the below average students. One of the secretaries from the IM department here told me about how the program ranked a bunch of AOA and 250+ people and ultimately ended up with a bunch of IMGs, like they do every year.

 

[StraightOuttaBrooklyn]

A 240 Step 1 score is in the 70 percentile. Average; considered the minimum for IM. And Vanderbilt IM is competitive.

See, I didn't know Vanderbilt was a competitive IM program.

When it comes to an IM program being competitive, what kind of scores on Step I are we talking about? My general understanding is that the Big 4 can be as competitive as say any Ortho or Derm residency application, commanding 255+'s for their IM programs. When you describe Vandy as competitive, what is the threshold to be considered competitive? 240?

 

[Cytarabine]

See, I didn't know Vandenot grbilt was a competitive IM program.

When it comes to an IM program being competitive, what kind of scores on Step I are we talking about? My general understanding is that the Big 4 can be as competitive as say any Ortho or Derm residency application, commanding 255+'s for their IM programs. When you describe Vandy as competitive, what is the threshold to be considered competitive? 240?

Just based on my experience / discussions. I doubt there are more than a handful (if any) medicine programs that actually screen out based on a step cutoff much higher than 240, but that doesn't necessarily mean a given program won't look at a 260 more favorably than a 240 come to interview invites or rank. Everything matters though. If you look at vandy's resident list, more than a third are AOA, and they're not generally considered top tier. I think as you get to the competitive programs, research, pedigree, and whatnot matter more. But my hunch is, stepwise, >240 gets your app looked at vast majority of places

 

[the argus]

See, I didn't know Vanderbilt was a competitive IM program.

When it comes to an IM program being competitive, what kind of scores on Step I are we talking about? My general understanding is that the Big 4 can be as competitive as say any Ortho or Derm residency application, commanding 255+'s for their IM programs. When you describe Vandy as competitive, what is the threshold to be considered competitive? 240?

First off, while derm and ortho are 2 of the more competitive specialties, they in no way "command 255+'s."
http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf
If you look at the most recent NRMP Charting Outcomes document from 2014, you can see the Step 1 score for people who matched in each specialty.

Derm
221-230 ----- 20/29 (69%) matched
231-240 ----- 50/72 (69%) matched
241-250 ----- 98/125 (78%) matched
251-260 ----- 106/128 (83%) matched
261+ ----- 45/51 (88%) matched

Ortho
221-230 ----- 47/90 (52%) matched
231-240 ----- 136/180 (75%) matched
241-250 ----- 206/248 (83%) matched
251-260 ----- 158/171 (92%) matched
261+ ----- 58/59 (98%)

So as others have said, getting a 255+ on Step 1 is definitely helpful, but it is in no way necessary to match into even the most competitive specialties. And in fact, the majority of people that match into those specialties have scores <250. The same goes for the most competitive IM programs. Yes, a higher Step 1 score is better, but it's in no way necessary to match there. I'm sure you have to hit a minimum (240 I would guess), but after that it's more about the rest of your application.

The best advice for Step 1 is to try for the absolute highest score you can get. Aiming for a particular number is stupid. And after you have your score, worrying about how you compare to others is also worthless. 70% people who applied to derm with scores in the 220s matched in 2014. Just figure out what you want to do, and make the rest of your application as strong as it can possibly be.

And to @Danbo1957, if you do in fact live in Austin, TX, there's only one IM residency program in Austin. And I know for a fact that that program is not "unbelievably competitive." It probably doesn't even qualify for "moderately competitive." I know this because they offered me, a Caribbean grad with ~220 on Step 1 (granted a much higher Step 2 score), an interview last year. And as others have pointed out, 240 is not average.
http://www.usmle.org/pdfs/transcripts/USMLE_Step_Examination_Score_Interpretation_Guidelines.pdf
Average for people applying this year was 229 with a SD of 20. That leaves only ~25% of USMD students with a score >240 on Step 1.

 

[StraightOuttaBrooklyn]

Wow, thank you for taking the time to put together such a thoughtful and insightful response.

I think I saw something about pedigree, somewhere. I have an Ivy undergrad, did a 2 year M.S. with a thesis at an "okay" program, and I attend medical school at The []_[] (Miami). So, that's my pedigree. I don't anticipate that AOA will be a cherry on top of that though. If anyone wants to chime in on pedigree, that'd be great

First off, while derm and ortho are 2 of the more competitive specialties, they in no way "command 255+'s."
http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf
If you look at the most recent NRMP Charting Outcomes document from 2014, you can see the Step 1 score for people who matched in each specialty.

Derm
221-230 ----- 20/29 (69%) matched
231-240 ----- 50/72 (69%) matched
241-250 ----- 98/125 (78%) matched
251-260 ----- 106/128 (83%) matched
261+ ----- 45/51 (88%) matched

Ortho
221-230 ----- 47/90 (52%) matched
231-240 ----- 136/180 (75%) matched
241-250 ----- 206/248 (83%) matched
251-260 ----- 158/171 (92%) matched
261+ ----- 58/59 (98%)

So as others have said, getting a 255+ on Step 1 is definitely helpful, but it is in no way necessary to match into even the most competitive specialties. And in fact, the majority of people that match into those specialties have scores <250. The same goes for the most competitive IM programs. Yes, a higher Step 1 score is better, but it's in no way necessary to match there. I'm sure you have to hit a minimum (240 I would guess), but after that it's more about the rest of your application.

The best advice for Step 1 is to try for the absolute highest score you can get. Aiming for a particular number is stupid. And after you have your score, worrying about how you compare to others is also worthless. 70% people who applied to derm with scores in the 220s matched in 2014. Just figure out what you want to do, and make the rest of your application as strong as it can possibly be.

And to @Danbo1957, if you do in fact live in Austin, TX, there's only one IM residency program in Austin. And I know for a fact that that program is not "unbelievably competitive." It probably doesn't even qualify for "moderately competitive." I know this because they offered me, a Caribbean grad with ~220 on Step 1 (granted a much higher Step 2 score), an interview last year. And as others have pointed out, 240 is not average.
http://www.usmle.org/pdfs/transcripts/USMLE_Step_Examination_Score_Interpretation_Guidelines.pdf
Average for people applying this year was 229 with a SD of 20. That leaves only ~25% of USMD students with a score >240 on Step 1.

 

[Cytarabine]

Wow, thank you for taking the time to put together such a thoughtful and insightful response.

I think I saw something about pedigree, somewhere. I have an Ivy undergrad, did a 2 year M.S. with a thesis at an "okay" program, and I attend medical school at The []_[] (Miami). So, that's my pedigree. I don't anticipate that AOA will be a cherry on top of that though. If anyone wants to chime in on pedigree, that'd be great

Again, this is just the feeling I've gotten - don't have any data to back it up. Top 10 med school > top 30 med school > others. Of course, certain programs will have had certain experiences with students coming from "x" med school which could color their perception as well. I won't comment on undergrad pedigree, already well into the realm of speculation - I'll just say it's something that isn't even asked about in the nrmp program director survey

 

[Danbo1957]

And to @Danbo1957, if you do in fact live in Austin, TX, there's only one IM residency program in Austin. And I know for a fact that that program is not "unbelievably competitive."

I live in Austin, but the program that I work with is in another Texas city, not the Austin IM program. Also, and you'd have to live here (or in some other very liberal city) to understand this: excellence is subordinate to social issues, such as diversity and equal access. I'd be blown away if the new Dell medical academic leadership ever drew a cutoff in any test scores.

In general though, the trend in IM residencies is to strengthen the overall program, Step 1 scores do matter. I am not saying that Step 1 is a cutoff completely, there are plenty of outliers in every program, accepted for other reasons and qualifications.

 

[Slack3r]

A 240 Step 1 score is in the 70 percentile. Average; considered the minimum for IM. And Vanderbilt IM is competitive.

This must be news to the 1000+ applicants who matched with scores well below 240. But don't let facts stand in your way, you never have in the past.

Matched average Step 1: 231
http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

 

[Jimberlane]

Aloha,

I'm a middle of the pack 2nd year, and I anticipate I will be middle of the pack in 3rd year too. I'm trying to be realistic about my residency prospects on this basis, but I do have the lofty goal of eventually pursuing a cardiology fellowship. I'm not exactly expecting that I will "crush" Step 1 either, maybe somewhere in the window of 230-240? I'm wondering, and I hope anyone who is apprised to these kinds of things might chime in here, but would an IM program, say, Vanderbilt or Northwestern or Georgetown or Methodist (Houston), be within my reach with those kinds of estimates? I've got the "leadership" card covered, and hopefully I'll have a poster (solid organ transplantation research) or something by the time I submit my ERAS.

Sincerely,

Aimless.

Hi,

I'm a third year IM resident who will be pursuing a cardiology fellowship in the future. I got a 250 on step 1 when I took it and am at a fairly competitive residency program now. I know northwesterns program is also competitive but I don't know their average.
Good luck

 

[Mad Jack]

Never used Frieda before, just made an account, checked out my program, half of the numbers/stats are incorrect for us. Trying to figure out where they get their information from since it is AMA, ie a 3rd party lobbyist organization rather than a part of the actual system. Is this like US news?

Edit: checked 2 other programs that I know the scores of residents who are at them, also off as well. Maybe it is just vascular surgery, but it seems like everything I've looked at is just made up...

Edit2: Not going to pretend to know Vandy's step scores or even guess at their range. Just didn't know this thing existed.

Supposedly the data is provided by the programs themselves, but much of it is out of date or limited, so it could be that the info for your program is many years old or was provided by someone who didn't know wtf they were talking about.

 

[Danbo1957]

This must be news to the 1000+ applicants who matched with scores well below 240. But don't let facts stand in your way, you never have in the past.

Matched average Step 1: 231
http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

What part of "average" don't you understand? Like talking to children in here sometimes...

 

[Psai]

What part of "average" don't you understand? Like talking to children in here sometimes...

Wtf are you talking about
Do you understand what average means?

 

[Merely]

What part of "average" don't you understand? Like talking to children in here sometimes...

Are you a brilliant troll...?

 

[Slack3r]

What part of "average" don't you understand? Like talking to children in here sometimes...

What part don't YOU understand? You called the minimum for IM a 240, which is ~10 points above the average matched. So you'll understand my confusion.

 

[Señor S]

What part of "average" don't you understand? Like talking to children in here sometimes...

Are you high?

 

[charmiedermie]

First off, while derm and ortho are 2 of the more competitive specialties, they in no way "command 255+'s."
http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf
If you look at the most recent NRMP Charting Outcomes document from 2014, you can see the Step 1 score for people who matched in each specialty.

Derm
221-230 ----- 20/29 (69%) matched
231-240 ----- 50/72 (69%) matched
241-250 ----- 98/125 (78%) matched
251-260 ----- 106/128 (83%) matched
261+ ----- 45/51 (88%) matched

Ortho
221-230 ----- 47/90 (52%) matched
231-240 ----- 136/180 (75%) matched
241-250 ----- 206/248 (83%) matched
251-260 ----- 158/171 (92%) matched
261+ ----- 58/59 (98%)

So as others have said, getting a 255+ on Step 1 is definitely helpful, but it is in no way necessary to match into even the most competitive specialties. And in fact, the majority of people that match into those specialties have scores <250. The same goes for the most competitive IM programs. Yes, a higher Step 1 score is better, but it's in no way necessary to match there. I'm sure you have to hit a minimum (240 I would guess), but after that it's more about the rest of your application.

The best advice for Step 1 is to try for the absolute highest score you can get. Aiming for a particular number is stupid. And after you have your score, worrying about how you compare to others is also worthless. 70% people who applied to derm with scores in the 220s matched in 2014. Just figure out what you want to do, and make the rest of your application as strong as it can possibly be.

And to @Danbo1957, if you do in fact live in Austin, TX, there's only one IM residency program in Austin. And I know for a fact that that program is not "unbelievably competitive." It probably doesn't even qualify for "moderately competitive." I know this because they offered me, a Caribbean grad with ~220 on Step 1 (granted a much higher Step 2 score), an interview last year. And as others have pointed out, 240 is not average.
http://www.usmle.org/pdfs/transcripts/USMLE_Step_Examination_Score_Interpretation_Guidelines.pdf
Average for people applying this year was 229 with a SD of 20. That leaves only ~25% of USMD students with a score >240 on Step 1.

Apply with a 221-231 on Step 1 and see if you'll match into Derm or Ortho, not being from a top-tier school. Hint: You won't.

This must be news to the 1000+ applicants who matched with scores well below 240. But don't let facts stand in your way, you never have in the past.

Matched average Step 1: 231
http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

I think you misread what @Danbo1957 said because of his weird semi-colon usage. He said a 240 Step 1 score is the 70th percentile unlike the 230 average which is 50th percentile. There is no way you're going to match into Vanderbilt, even if it is IM, with an average 230 without another hook. I think that was his point.

 

[StraightOuttaBrooklyn]

Supposedly the data is provided by the programs themselves, but much of it is out of date or limited, so it could be that the info for your program is many years old or was provided by someone who didn't know wtf they were talking about.

Sounds like much of SDN; this thread excluded of course, many of the responses have been insightful and helpful

 

[Señor S]

I think you misread what @Danbo1957 said because of his weird semi-colon usage. He said a 240 Step 1 score is the 70th percentile unlike the 230 average which is 50th percentile. There is no way you're going to match into Vanderbilt, even if it is IM, with an average 230 without another hook. I think that was his point.

If that's what he meant it was one of the most confusingly-worded (and punctuated) posts in SDN history.

 

[christmasindr]

Only in SDN, if you score below average on Step 1, you will only be good for family medicine...

 

[evilbooyaa]

I'm really glad I didn't read SDN to figure out what I wanted to do. Everyone would have told me that I would've never matched in my selected field lol.

 

[Merely]

Apply with a 221-231 on Step 1 and see if you'll match into Derm or Ortho, not being from a top-tier school. Hint: You won't.

I think you misread what @Danbo1957 said because of his weird semi-colon usage. He said a 240 Step 1 score is the 70th percentile unlike the 230 average which is 50th percentile. There is no way you're going to match into Vanderbilt, even if it is IM, with an average 230 without another hook. I think that was his point.

Yet 70 percent of those who applied did match...