Likelihood?

[DrAwsome]

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What's the likelihood, given the progressive competitiveness of the match, that an average medical student will match in a decent residency other than primary care?

Average student defined as having a passing score on boards (<200), mostly P's in rotation, no failures, Dean's letter with no red flags.

Decent residency defined as something like neurology, PM&R, radiology, psych, anesthesia.

 

[dragonfly99]

very unlikely to match in rads, IMHO.
Anesthesiology...probably depends a lot on if you are willing to go to absolutely any anesthesia program.
PM and R I don't believe is very competitive at all...yes you would get a spot.
Would think that psych you would be able to get.
Neuro...maybe slightly more competitive than IM, the low boards might be an issue...but realistically could probably find a spot.

Some of this depends on your letters of rec, how you did in a subI, also what med school you go to has a little influence too. <200 boards is kind of low, though.

 

[DrAwsome]

very unlikely to match in rads, IMHO.
Anesthesiology...probably depends a lot on if you are willing to go to absolutely any anesthesia program.
PM and R I don't believe is very competitive at all...yes you would get a spot.
Would think that psych you would be able to get.
Neuro...maybe slightly more competitive than IM, the low boards might be an issue...but realistically could probably find a spot.

Some of this depends on your letters of rec, how you did in a subI, also what med school you go to has a little influence too. <200 boards is kind of low, though.

It is, but just like any standarized test, it really doesn't mean anything in the long term. Not everyone is a good test taker, and many people match with scores of 180's even.

 

[danzman]

I would love to see data on this. Perhaps if every program was forced to share the stats of their applicants students could get a true idea about subjectivity vs objectivity. Anybody ever seen anything like this?

 

[DrAwsome]

I would love to see data on this. Perhaps if every program was forced to share the stats of their applicants students could get a true idea about subjectivity vs objectivity. Anybody ever seen anything like this?

I think the data produced from the match lists the USMLE scores of applicants. I guess programs have to choose people somehow, it's just a shame that people who are not good test takers are doomed.

 

[DrAwsome]

While I agree Step scores aren't perfect, I ask you what else? How else do you compare apples to apples. Class rank and med school grades are subjective and your class rank might be very different if you went to State U vs. Super competitive med school. Reserach and other activities are helpful but don't help with looking at fund of knowledge per se. To me that leaves standardized tests. For those who are poor test takers, it's difficult but unfortunately what are those students going to do for their specialty boards? Medicine is made up standardized tests and it's just an accepted part of the road.

On the flip side of the arguement, as someone who went to a very small, less regarded med school, I can say that stellar USMLE scores helped me get interviews and end up at a residency program in a competitive specialty filled with applicants from top tiered schools. So in that respect, I value the leveling of the playing field that the USMLE provides to some degree.

What specialty did you end up at? Just curious. 🙂 I can understand the need for some sort of comparison method, it's just unfortunate that for some of those us who are not good test takers, it really hurts us. English is my third language, so I don't read as fast as I could, which doesn't help. I didn't do terrible, but I didn't do terrific on step 1. At the same time, so far I have received all honors clinically and done very well otherwise. I might not end up where I want after though.

 

[danzman]

While I agree Step scores aren't perfect, I ask you what else? How else do you compare apples to apples. Class rank and med school grades are subjective and your class rank might be very different if you went to State U vs. Super competitive med school. Reserach and other activities are helpful but don't help with looking at fund of knowledge per se. To me that leaves standardized tests. For those who are poor test takers, it's difficult but unfortunately what are those students going to do for their specialty boards? Medicine is made up standardized tests and it's just an accepted part of the road.

On the flip side of the arguement, as someone who went to a very small, less regarded med school, I can say that stellar USMLE scores helped me get interviews and end up at a residency program in a competitive specialty filled with applicants from top tiered schools. So in that respect, I value the leveling of the playing field that the USMLE provides to some degree.

You make a good point and I won’t knock using step 1 scores as an important and standardized method of evaluating candidates; however I can’t see any reason to use them as a cut off for a program. I also don’t know if there is really such a thing as a “bad test taker.” I know some people have issues with stress or general test taking strategies, but many people seem to use this as an excuse. I would like to see step 1 and 2 combined to create one test taken during the 4th year, and a greater emphasis on third year grades as they seem to be more indicative of future performance as a physician. Also, putting all or most of your future on one test seems to be a backwards way of evaluating physicians when you have four years of data to judge from.

 

[danzman]

What specialty did you end up at? Just curious. 🙂 I can understand the need for some sort of comparison method, it's just unfortunate that for some of those us who are not good test takers, it really hurts us. English is my third language, so I don't read as fast as I could, which doesn't help. I didn't do terrible, but I didn't do terrific on step 1. At the same time, so far I have received all honors clinically and done very well otherwise. I might not end up where I want after though.

This is a perfect example of why third year grades should matter more.

 

[Law2Doc]

This is a perfect example of why third year grades should matter more.

Except that they aren't standardized, other than the shelf exams, so it's kind of impossible to compared folks at different schools. Is A better than B, or are the attendings at A more generous than at B, etc.

When the Steps 1 & 2 get merged, expect to see greater weight on things like applicable shelf exams, I think.

 

[Smurfette]

The unfortunate reality is that many programs DO have a board score cutoff for interviews. Average board score is the 215-220 range, so less than 200 is significantly below the mean. Does this mean you cannot match into a competitive specialty? Of course not, there are other factors involved, but it will make it quite difficult (not impossible per se) for radiology. Anesthesia depends on the program, but 'top' programs will likely have score cutoffs. Neuro, PMR, psych will be more program specific--depends on how many of the programs use cutoffs....an advisor at your med school should be able to help you find programs that you are competitive for.

 

[doc4life95]

Does anyone have evidence on any particular state being easier than others to match into Emergency medicince?

 

[gutonc]

Does anyone have evidence on any particular state being easier than others to match into Emergency medicince?

I hear that Montana, the Dakotas and New Hampshire are particularly hard to match into in EM.

 

[scab]

I hear that Montana, the Dakotas and New Hampshire are particularly hard to match into in EM.

something to do with falling off mountains?

 

[dragonfly99]

doc4life,
I would say that programs in places that are not a city and/or have bad weather (some of the Midwest and rural New England, etc.) would likely be easier to match into. Also in general fewer people try for the Midwest and South, vs. the West or Northeast. Personal connections, such as having rotated at a place or having a LOR writer who knows someone at the program, are important.

I think if the OP wants rads,the OP should consider trying for it if the only problem is the board scores. The OP can also gun for a higher score on Step 2 because that might help. Maybe post on the rads forum (if there is one?) to see if there are people on there who matched despite 200's on Step 1. I would guess there might be.

I think it is fair to use USMLE scores. My Step 1 score was just all right so I don't think it helped me a lot to get into residency, but I think that grading among various med schools is EXTREMELY variable and it would not be fair to base everything on just grades. It's not going to happen, either. If they are barred from using USMLE scores, the programs are just going to use shelf exams, and perhaps ask for MCAT scores. They have to have SOME objective measure to consider in this process. That said, whenever I look at things like test scores, I always consider mitigating factors...I think it is definitely true that for someone who has English as a 2nd or 3rd language it must definitely be difficult to do these exams. I have a friend in a similar situation who had to go abroad for med school b/c of a slightly lower MCAT score, but he is VERY smart...I just think he couldn't read fast enough on the MCAT to get a really high score.

I think as a residency applicant, you have to use whatever strong points there are in your application, and just sell yourself. If you know you're going to get screened out by some programs in rads due to your test scores, then apply to some more mid and lower tier programs, and also ask a faculty member(s) to call up certain schools and ask them to pull your application and look at it, despite the lower USMLE score. If they see other things they like, such as high clinical grades and maybe some relevant research, they might very well ignore the lower test score.

 

[dacrocytic]

doc4life,
I would say that programs in places that are not a city and/or have bad weather (some of the Midwest and rural New England, etc.) would likely be easier to match into. Also in general fewer people try for the Midwest and South, vs. the West or Northeast. Personal connections, such as having rotated at a place or having a LOR writer who knows someone at the program, are important.

I think if the OP wants rads,the OP should consider trying for it if the only problem is the board scores. The OP can also gun for a higher score on Step 2 because that might help. Maybe post on the rads forum (if there is one?) to see if there are people on there who matched despite 200's on Step 1. I would guess there might be.

I think it is fair to use USMLE scores. My Step 1 score was just all right so I don't think it helped me a lot to get into residency, but I think that grading among various med schools is EXTREMELY variable and it would not be fair to base everything on just grades. It's not going to happen, either. If they are barred from using USMLE scores, the programs are just going to use shelf exams, and perhaps ask for MCAT scores. They have to have SOME objective measure to consider in this process. That said, whenever I look at things like test scores, I always consider mitigating factors...I think it is definitely true that for someone who has English as a 2nd or 3rd language it must definitely be difficult to do these exams. I have a friend in a similar situation who had to go abroad for med school b/c of a slightly lower MCAT score, but he is VERY smart...I just think he couldn't read fast enough on the MCAT to get a really high score.

I think as a residency applicant, you have to use whatever strong points there are in your application, and just sell yourself. If you know you're going to get screened out by some programs in rads due to your test scores, then apply to some more mid and lower tier programs, and also ask a faculty member(s) to call up certain schools and ask them to pull your application and look at it, despite the lower USMLE score. If they see other things they like, such as high clinical grades and maybe some relevant research, they might very well ignore the lower test score.

Unfortunately my school does not have regular shelf exams, making tthat much harder 🙁