Low Step1 score is better than no Step1 score

[drducky.]

I noticed a lot of DO students talking about hiding their step score because they scored poorly, but in most specialties, it seems like it's better to have a low step score than no score at all.

For example, in IM, anyone that took step1 and passed has a better match rate than "Score unknown", even those that scored 191 to 200 matched better than people without a Step1 score

Even in more competitive specialties like gas, having a 210-220 (still below average) almost doubles your chances compared to having no score

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[DrStephenStrange]

You're right if you passed step 1, I think you should release your score unless you're applying to the very competitive specialties like N.surg or Ortho or something, and your comlex score is already super high while having a low step 1, and you are targeting old DO programs. Other than that I can't think of a good reason why someone should not release their score if they at least passed.

 

[BorntobeDO?]

You're right if you passed step 1, I think you should release your score unless you're applying to the very competitive specialties like N.surg or Ortho or something, and your comlex score is already super high while having a low step 1, and you are targeting old DO programs. Other than that I can't think of a good reason why someone should not release their score if they at least passed.

Well if your over 600 on comlex and got a 201 on step, it might be better to just roll with the comlex. That said the scores usually aren’t that much different.

 

[Royale with Cheese]

Well if your over 600 on comlex and got a 201 on step, it might be better to just roll with the comlex. That said the scores usually aren’t that much different.

As someone with a 230+ step and 650+ COMLEX (current M3), this is where I'm at. Current gameplan is to take step 2, knock it out of the park, and *hope* that PDs recognize that maybe I just had a bad day or a wicked curve on my USMLE form.

Or just not report USMLE. Still haven't decided yet as I'm not 100% sure what field I want to get in.

 

[drducky.]

As someone with a 230+ step and 650+ COMLEX (current M3), this is where I'm at. Current gameplan is to take step 2, knock it out of the park, and *hope* that PDs recognize that maybe I just had a bad day or a wicked curve on my USMLE form.

Or just not report USMLE. Still haven't decided yet as I'm not 100% sure what field I want to get in.

You’d be crazy to not report a 230+ no matter what field. While a 230 is lower than a 650 percentile wise, it still doesn’t matter if program directors don’t care about your comlex at all. Many might not even look at your app without step.

 

[FindersFee5]

You’d be crazy to not report a 230+ no matter what field. While a 230 is lower than a 650 percentile wise, it still doesn’t matter if program directors don’t care about your comlex at all. Many might not even look at your app without step.

Is a 230 even that different from a 650 when you consider the different testing pools? Sure, I'd say 90th percentile is actually more equivalent to a 240, but a 240 - 230 swing is easily within the margin of a single days testing error.

 

[Lawpy]

Is a 230 even that different from a 650 when you consider the different testing pools? Sure, I'd say 90th percentile is actually more equivalent to a 240, but a 240 - 230 swing is easily within the margin of a single days testing error.

Yeah the percentiles can't be directly compared like that. I believe they'd need to be taken into account separately and evaluated as such, but even then if anything, the greater weight (and likely expectation) placed on Step might mean a 230 is better than a 650

 

[Azmkv]

I got step 1 222 and comlex 630 lol.. idk if its worth to report step 1 for my case?

 

[DrStephenStrange]

I got step 1 222 and comlex 630 lol.. idk if its worth to report step 1 for my case?

It's never not worth it if you passed. I guess it also depends on what you're applying for, but still I don't think 222 is that terribly low to not report it even for super competitive specialties. You should also focus on improving on step 2.

 

[Azmkv]

It's never not worth it if you passed. I guess it also depends on what you're applying for, but still I don't think 222 is that terribly low to not report it even for super competitive specialties. You should also focus on improving on step 2.

I just wanna do IM or anesthesiology at a decent city haha. I do believe I underperformed significantly but oh well :/ I am hoping to improve a lot on step 2 (hopefully 250+) and see if my goal is reasonable.. Also willing to take a research year if that means I can add more pubs to my CV and form a connection with someone who can write me a good, personalized letter of rec.

 

[Ho0v-man]

Anyone who scored 220+ should report without even thinking. There’s only a few rare scenarios where reporting any step score is a bad idea.

 

[DrStephenStrange]

I just wanna do IM or anesthesiology at a decent city haha. I do believe I underperformed significantly but oh well :/ I am hoping to improve a lot on step 2 (hopefully 250+) and see if my goal is reasonable.. Also willing to take a research year if that means I can add more pubs to my CV and form a connection with someone who can write me a good, personalized letter of rec.

You should be able to match IM in a decent size city with that score. Not so sure about gas. But I don't think you need a research year for either of those 2 specialties.

 

[Kerosene Hat]

Yep, I'm ultimately glad I reported USMLE, despite my Step 1 and Step 2CK scores being not even 220. (I passed both the first time.)

*Internal medicine, for what it's worth.

 

[DOVinciRobot]

As someone with a 230+ step and 650+ COMLEX (current M3), this is where I'm at. Current gameplan is to take step 2, knock it out of the park, and *hope* that PDs recognize that maybe I just had a bad day or a wicked curve on my USMLE form.

Or just not report USMLE. Still haven't decided yet as I'm not 100% sure what field I want to get in.

That would be a supremely bad decision.
D

I got step 1 222 and comlex 630 lol.. idk if its worth to report step 1 for my case?

Programs will care far more about the 222 than the 630. No one cares about COMLEX.

Is a 230 even that different from a 650 when you consider the different testing pools? Sure, I'd say 90th percentile is actually more equivalent to a 240, but a 240 - 230 swing is easily within the margin of a single days testing error.

Yeah definitely not very different. A 230s score is the most common Step paired with a 600s COMLEX.

 

[BorntobeDO?]

I got step 1 222 and comlex 630 lol.. idk if its worth to report step 1 for my case?

I likely would. If you interest is gas that step is a little low, but at the same time, many anesthesia programs will exclude you anyway without it. For IM you will have options at uni's. Actually even with just the 630 you would have options in IM, but I still think the step will open doors. Just do the best you can on step 2 and let it rip.

If you really want to be practmatic, you could email programs your interested in and see if they require/strongly recommend step. Its a lot of leg work. Someone who did it more recently can speak, but I think you might be able to assign the scores to individual programs in ERAs. I know that I had to assign them and they were not automatically release, but I don't recall if the only option was to assign all.

 

[Azmkv]

I likely would. If you interest is gas that step is a little low, but at the same time, many anesthesia programs will exclude you anyway without it. For IM you will have options at uni's. Actually even with just the 630 you would have options in IM, but I still think the step will open doors. Just do the best you can on step 2 and let it rip.

If you really want to be practmatic, you could email programs your interested in and see if they require/strongly recommend step. Its a lot of leg work. Someone who did it more recently can speak, but I think you might be able to assign the scores to individual programs in ERAs. I know that I had to assign them and they were not automatically release, but I don't recall if the only option was to assign all.

Do you think if I, say hypothetically, score 250+ on step2 and take a research year (for pub + letter) and apply with c/o 2024 where majority of the applicants won't have their step1 scores, I will stand a better chance with matching? I am trying to avoid being screened from many programs because of my step 1 score

 

[DOVinciRobot]

Do you think if I, say hypothetically, score 250+ on step2 and take a research year (for pub + letter) and apply with c/o 2024 where majority of the applicants won't have their step1 scores, I will stand a better chance with matching? I am trying to avoid being screened from many programs because of my step 1 score

No matter the specialty, more programs will screen you for not having a Step score than will for having a 222.

 

[deleted1081396]

What if we have a high step 1 score but no step 2 score.

 

[BorntobeDO?]

Do you think if I, say hypothetically, score 250+ on step2 and take a research year (for pub + letter) and apply with c/o 2024 where majority of the applicants won't have their step1 scores, I will stand a better chance with matching? I am trying to avoid being screened from many programs because of my step 1 score

Interesting strategy. Yes that would help you get past the screens for step 1. As long as that research year prints (i.e. actually publishes), I think that could help. Honestly tho, if you get a 250 and find a program you think you are being screened at, you can email and ask them to consider anyway. Many will do this.

 

[FutureDoctor5000]

As someone with a 230+ step and 650+ COMLEX (current M3), this is where I'm at. Current gameplan is to take step 2, knock it out of the park, and *hope* that PDs recognize that maybe I just had a bad day or a wicked curve on my USMLE form.

Or just not report USMLE. Still haven't decided yet as I'm not 100% sure what field I want to get in.

Lol bro a 230 step 1 is much better than a 650 comlex, no PD(aside from former aoa programs ) even know what a 650 comlex is.. a 230 step 1 is a good score. Congrats!

 

[FutureDoctor5000]

Do you think if I, say hypothetically, score 250+ on step2 and take a research year (for pub + letter) and apply with c/o 2024 where majority of the applicants won't have their step1 scores, I will stand a better chance with matching? I am trying to avoid being screened from many programs because of my step 1 score

For anesthesia??? A research year in anesthesia is unheard of and also a complete waste for IM and anesthesia since it’s not a big factor in residency selection per PD survey. A 222 step 1 according to 2020 charting outcomes gives you a decent shot at matching and if you improve on step 2(240+) your chances will improve even more. Step scores are prbly the most important thing in matching anesthesia and IM. While anesthesia is getting competitive, it’s not impossible to match with a >220 step 1. You will have to apply broadly and definitely do a few away rotations but it’s not like matching ENT or derm which would be close to impossible with a 220 step 1and no research year or serious connections.

 

[Cornfed101]

Yeah the percentiles can't be directly compared like that. I believe they'd need to be taken into account separately and evaluated as such, but even then if anything, the greater weight (and likely expectation) placed on Step might mean a 230 is better than a 650

Well unless they decide to directly compare them by putting them in a single slot on ERAS.

the world is literally falling apart when it makes more sense to directly compare COMLEX with USMLE instead of just scrapping COMLEX

 

[MDMechEngr]

Well unless they decide to directly compare them by putting them in a single slot on ERAS.
View attachment 342927
the world is literally falling apart when it makes more sense to directly compare COMLEX with USMLE instead of just scrapping COMLEX

Nah! get rid COMLEX and go with USMLE for ALL.

 

[FutureDoctor5000]

Well unless they decide to directly compare them by putting them in a single slot on ERAS.
View attachment 342927
the world is literally falling apart when it makes more sense to directly compare COMLEX with USMLE instead of just scrapping COMLEX

This is a futile recommendation and won’t be implemented. I do see the usmle having an omm portion sometime in the future, the nbome can say they designed the omm for DO’s portion so they are still relevant lol

 

[Neopolymath]

It would be far worse to have an OMM only exam honestly. You can pass all 3 exams without studying OMM more than enough to pass your in-house OMM exams. I'm living proof of that concept.

With an OMM only exam you have to actually study OMM and can't just use the real medicine to get your score.

Ideally, NBOME doesn't exist but the in-between option honestly sounds worse. Taking Comlex was dumb and costly but was not a big deal. It was an annoyance and not the real reason DO schools are terrible.

 

[KirksvilleKrunk]

It would be far worse to have an OMM only exam honestly. You can pass all 3 exams without studying OMM more than enough to pass your in-house OMM exams. I'm living proof of that concept.

With an OMM only exam you have to actually study OMM and can't just use the real medicine to get your score.

Ideally, NBOME doesn't exist but the in-between option honestly sounds worse. Taking Comlex was dumb and costly but was not a big deal. It was an annoyance and not the real reason DO schools are terrible.

Are you saying if we're passing in-house OMM exams we shouldn't worry about failing the COMLEX? (As long as our real medicine knowledge is up to par)

 

[Neopolymath]

Are you saying if we're passing in-house OMM exams we shouldn't worry about failing the COMLEX? (As long as our real medicine knowledge is up to par)

This is one random person's opinion/experience on the internet: Correct.

 

[Ho0v-man]

Are you saying if we're passing in-house OMM exams we shouldn't worry about failing the COMLEX? (As long as our real medicine knowledge is up to par)

Just another piece of anecdata: ~25th percentile on omm both times but still comfortably above 600 on level 1&2.

 

[FutureDoctor5000]

It would be far worse to have an OMM only exam honestly. You can pass all 3 exams without studying OMM more than enough to pass your in-house OMM exams. I'm living proof of that concept.

With an OMM only exam you have to actually study OMM and can't just use the real medicine to get your score.

Ideally, NBOME doesn't exist but the in-between option honestly sounds worse. Taking Comlex was dumb and costly but was not a big deal. It was an annoyance and not the real reason DO schools are terrible.

No I don’t mean entire exam for omm that you have to pass on its own, I mean DO’s have to take an omm section during thier usmle that factors into their overall score simmilar to how it is currently on the comlex… that portion can be scored based on how other DO students performed but is still a small portion of the entire exam.

 

[Deecee2DO]

What if we have a high step 1 score but no step 2 score.

Dont do that lol thats what i did and im sitting on zero invites rn bc i waited to take CK smh

 

[DrStephenStrange]

Dont do that lol thats what i did and im sitting on zero invites rn bc i waited to take CK smh

Lol dude stop panicking. I know ppl with step 2 scores applying IM with zero invites rn too.

 

[FutureDoctor5000]

Dont do that lol thats what i did and im sitting on zero invites rn bc i waited to take CK smh

hahaha quit panicking, your invites will come

 

[JimBone905]

How hard it is to match at some of the uni programs in NY like SUNY upstate/downstate or not super competitive programs like maimonides or lenox hill as a DO with a step 1 in the upper 22x and comlex in the mid 5xx? Should be doable as long as step 2 scores are somewhat in line with similar percentiles I assume? (Internal medicine or psych level competitiveness specifically)

 

[Ho0v-man]

How hard it is to match at some of the uni programs in NY like SUNY upstate/downstate or not super competitive programs like maimonides or lenox hill as a DO with a step 1 in the upper 22x and comlex in the mid 5xx? Should be doable as long as step 2 scores are somewhat in line with similar percentiles I assume? (Internal medicine or psych level competitiveness specifically)

No one can really know for sure. Just apply. See what happens.

 

[ohmanwaddup]

As someone with a 230+ step and 650+ COMLEX (current M3), this is where I'm at. Current gameplan is to take step 2, knock it out of the park, and *hope* that PDs recognize that maybe I just had a bad day or a wicked curve on my USMLE form.

Or just not report USMLE. Still haven't decided yet as I'm not 100% sure what field I want to get in.

you scored 50th+ percentile on step and are considering not reporting it? Are you insane?

 

[Royale with Cheese]

you scored 50th+ percentile on step and are considering not reporting it? Are you insane?

While I understand the general rhetoric from your reply (and previous replies), I still see some benefit depending on what specialty and geographic location I'd prefer to match.

For example: if I find my niche in less competitive specialties (see: FM, IM), find a former AOA program that knows how to interpret COMLEX, and the program is in a desirable location (as well as the program being desirable itself) then I would think it's worth consideration to report my 90th+ percentile COMLEX over my 50th+ percentile step to hedge my bets.

Of course that comes with risks as that would be putting my eggs in one basket while potentially closing doors on programs in specialties/areas outside of my hypothetical top choices; therefore the ambiguity of my original post.

 

[FutureDoctor5000]

While I understand the general rhetoric from your reply (and previous replies), I still see some benefit depending on what specialty and geographic location I'd prefer to match.

For example: if I find my niche in less competitive specialties (see: FM, IM), find a former AOA program that knows how to interpret COMLEX, and the program is in a desirable location (as well as the program being desirable itself) then I would think it's worth consideration to report my 90th+ percentile COMLEX over my 50th+ percentile step to hedge my bets.

Of course that comes with risks as that would be putting my eggs in one basket while potentially closing doors on programs in specialties/areas outside of my hypothetical top choices; therefore the ambiguity of my original post.

News flash, even the former aoa programs now value the usmle way more than comlex, lots of them have MD faculty and PD's

 

[DOVinciRobot]

While I understand the general rhetoric from your reply (and previous replies), I still see some benefit depending on what specialty and geographic location I'd prefer to match.

For example: if I find my niche in less competitive specialties (see: FM, IM), find a former AOA program that knows how to interpret COMLEX, and the program is in a desirable location (as well as the program being desirable itself) then I would think it's worth consideration to report my 90th+ percentile COMLEX over my 50th+ percentile step to hedge my bets.

Of course that comes with risks as that would be putting my eggs in one basket while potentially closing doors on programs in specialties/areas outside of my hypothetical top choices; therefore the ambiguity of my original post.

There is no situation where not reporting your Step score would benefit you.

 

[JimBone905]

When will people understand that you can't compare COMLEX and USMLE percentiles? Predicting Osteopathic Medical Students' Performance on the United States Medical Licensing Examination From Results of the Comprehensive Osteopathic Medical Licensing Examination
Scroll down to the graph. At best your COMLEX correlates with a 235-ish step 1 score.

In the DO world, you're already a rockstar considering anywhere from 30-70% of DOs don't take USMLE (depending on the schools, a handful mandate it). And of those who take it most average <220. IIRC the highest average is KCOM with ~228 (2/3 take it), and even other "top" DO schools like MSUCOM only average a 217.

Now you can attribute that to time wasted learning OMM, poor instruction/guidance or what have you, but generally speaking, lower ACT/SAT tends to correlate with lower MCAT and lower Step/COMLEX scores. (yes IK a lot of it is due to socioeconomic factors).

At the end of the day having a USMLE score is better than even a high comlex score. One of my mentors is a former PD and even to this day she will refer to DOs as "osteopaths" and unconsciously speak about them as if they're somehow less-than MDs, even if she believes them to be equal.

I have many DO friends and I believe DO = MD but if I were in a position to rate applicants I'd always pick the DO with a USMLE over the one without, no matter how much higher of a COMLEX score the latter has. I don't know what all goes into the COMLEX nor do I have any interest in finding out. Now I have some classmates who straight-up talk smack on DO and I can only imagine they'd throw out every DO app no matter what. You don't want to give them any more reasons to do that by not reporting USMLE.

How do you feel about programs rating an MD 230 higher than a DO 230? I've seen people on the interwebs say that we need to get HIGHER scores than our MD counterparts to override our title discrimination

 

[Royale with Cheese]

10-4 to all the above.

It was a strategy to maximize an excellent comlex and minimize a mediocre step score while keeping an open mind going through 3rd year. I didn't realize that there's virtually no scenario where a comlex score would hold more weight against a step score, even at the extremes.

I still have all of 3rd year to complete anyhow, and should focus on what specialty to purse and go from there rather than create strategies for hypothetical match scenarios.

 

[DOVinciRobot]

How do you feel about programs rating an MD 230 higher than a DO 230? I've seen people on the interwebs say that we need to get HIGHER scores than our MD counterparts to override our title discrimination

You do. A DO 230 applicant will interview with 210-220 MDs at the same program.

 

[FutureDoctor5000]

Why is this an argument where another DO vs MD thing is brought up again lol, actually about 50-60% of DO's now take usmle and most will report it even if it's a below average score. Not reporting a 222 which is a just below average score is foolish, you did will well on comlex and did well on usmle, no PD at former aoa program or any program is going to look down on your 222 step 1 lol

 

[YCAGA]

man... a 230+ is NOT mediocre. Anything >225 is pretty solid and can get you into semi-competitive specialties as long as you're geographically flexible. My friends had no trouble matching various specialties with sub 220 & sub 550 comlex.

To put it in another perspective, most of your older attendings in their 50s and 60s didn't have to score as high or know as much as we do nowadays, and they're all doing just fine in practice.

No. A 225 is 34th percentile for US and Canadian MD's (no DO's or IMG's) and 230 is not much better at 43th percentile. Now of course the vast majority of those bottom 43% of MD students still match, but it is not into "semi-competitive" specialities, it is almost all peds, IM and FM.

It is not 2010 anymore...240+ is "only" 62nd percentile to put thing further into perspective.

 

[YCAGA]

How do you feel about programs rating an MD 230 higher than a DO 230? I've seen people on the interwebs say that we need to get HIGHER scores than our MD counterparts to override our title discrimination

That has been the case for decades, and definitely was common and often talked about knowledge when you start medical school 3 years ago (if your flair is correct).

Also anyone who thinks COMLEX and USMLE are in any way comparable is delusional. The median MCAT for MD students is almost 1 SD higher than DO students.

 

[FutureDoctor5000]

No. A 225 is 34th percentile for US and Canadian MD's (no DO's or IMG's) and 230 is not much better at 43th percentile. Now of course the vast majority of those bottom 43% of MD students still match, but it is not into "semi-competitive" specialities, it is almost all peds, IM and FM.

It is not 2010 anymore...240+ is "only" 62nd percentile to put thing further into perspective.

Just out of curiosity, when I took step 1 a year ago, the average score on it was 230, it said so on my score report, so that would be 50th percentile, I got a 235 so I would be above the 50th percentile, now this year the average seems to have crept up to 233 or whatever, will my score be considered to the original 230 average from 1 year ago(what it says on my score report) or what the step 1 average is now in 2021? Like do programs see the score report and see what the average was when you took it?

 

[FutureDoctor5000]

No. A 225 is 34th percentile for US and Canadian MD's (no DO's or IMG's) and 230 is not much better at 43th percentile. Now of course the vast majority of those bottom 43% of MD students still match, but it is not into "semi-competitive" specialities, it is almost all peds, IM and FM.

It is not 2010 anymore...240+ is "only" 62nd percentile to put thing further into perspective.

also your statement makes zero sense because there are plenty of USMD's and DO's per charting outcomes getting into "semi competitive" stuff like Gas, rads, PMR, psych?, OB, EM and even gen surgery with step scores in the 220's, so no people with 220 step 1 aren't limited to peds, IM and FM(especially not USMD and even DO's actually), the charting outcomes makes that very clear. A 220 step score wont destroy your app and keep you from matching the above mentioned specialties, if you have no red flags and are an AMG. I don't understand why you have this notion that the specialties I mentioned are like plastics, derm or neurosurgery.

 

[JimBone905]

That has been the case for decades, and definitely was common and often talked about knowledge when you start medical school 3 years ago (if your flair is correct).

Also anyone who thinks COMLEX and USMLE are in any way comparable is delusional. The median MCAT for MD students is almost 1 SD higher than DO students.

Bruh 220 to 229 step 1 for DR and anesthesia is in the 80% range for DO how is getting a 22x limiting u to primary care. Yes my flair is correct and I'm not questioning the existence of the stigma.

 

[Feelgood MD]

For anyone interested in COMLEX and USMLE comparisons: Predicting Osteopathic Medical Students' Performance on the United States Medical Licensing Examination From Results of the Comprehensive Osteopathic Medical Licensing Examination

 

[BobbyKoch]

For anyone interested in COMLEX and USMLE comparisons: Predicting Osteopathic Medical Students' Performance on the United States Medical Licensing Examination From Results of the Comprehensive Osteopathic Medical Licensing Examination

very interesting. thank you for sharing!!!

 

[Schwifty]

For anyone interested in COMLEX and USMLE comparisons: Predicting Osteopathic Medical Students' Performance on the United States Medical Licensing Examination From Results of the Comprehensive Osteopathic Medical Licensing Examination

“On average, students scored 30 percentile points lower on USMLE Step 1 than on COMLEX-USA”
Meanwhile I scored 10 percentile points higher on Step than COMLEX lol