Minimum passing STEP 1 score and psychiatry residency?

[schimel04]

So I'm sorry to say that I recently found out that I got the minimum passing score on STEP 1, that is 188 which is a 75 2 digit score. Looking back on it I think I wasn't well informed about what the percentage scores on UWORLD and practice NBME test correlated for STEP 1 real scores. I should have delayed my exam, but due to lack of fore sight, information, and energy (I was burned out after my dedicated study time), I did not.

I've been interested in psych residencies since the start of med school. US med school, allopathic, mid-tier. No class failures. Probably in the bottom quartile of the class but I can't check it yet because we are on pass/fail. Poster project in psych. No other red flags that I can think of. Third year just started so I don't have any info about clerkship performance or STEP 2.

So tell me, can I still even apply to psychiatry? How do I even find out which programs will take my application? What can I do now?

Please PM with personal experiences, advice or anecdotes if you don't want to post on the thread.

thanks.

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[splik]

you have everything to play for. no one gives a toss about how you did in your pre-clinicals. your step 1 is important, but the main thing is you passed. something like 1/4 programs will filter you out, which means most will not. no automatically anyway. you need to do well on your clinical clerkships - obviously make an impression on your psych rotation, but even more important i would argue is how you do on medicine (or peds if you like child psych) as these are harder rotations and thus a chance to shine. also you need to do well on step 2 (as well as you can anyway) and have passed this prior to applying.

will this hurt your application? of course it will. even where you get interviews it will still come into play. but it's only ONE factor in your application. we look at the whole application (personally i skip the personal statement but ymmv) so strong letters of recommendation, good clinical grades and a solid pass on step 2 will help salvage you. less important but helpful are other things that show a commitment to psychiatry (as opposed to 'i scored to **** to do anything else'), community experiences, volunteering, leadership, teaching. if you're interested in research then you can do some and get some publications but don't bother if you're not. these things are secondary to the objectives of clinical grades, board scores, and letters of recommendation.

 

[notdeadyet]

So tell me, can I still even apply to psychiatry? How do I even find out which programs will take my application? What can I do now? .

Of course you should apply to psychiatry. It's one of the least competitive specialties out there. It's the specialty people who have worse red flags than you are encouraged to apply.

Few programs automatically screen based on Step I (in fact, some programs send a secondary to all comers to elicit fees before rejecting). You will be rejected by programs that screen based on Step I. You will also have an uphill battle at programs that don't. But you'll still be in the game.

Psychiatry is a different specialty than most. Unless you're looking to find a cure for OCD and such, your main skills will be your ability to relate to people compassionately and articulately, to take a lot of seemingly unrelated factors into account to formulate a realistic plan, and be a professional who takes pride in his or her work. That is what most programs are going to be looking for.

So if you work hard during 3rd and 4th year and demonstrate those qualities to faculty who capture it in your evals and LORs and you come to your interviews showing interest in the program, passion for the field, humility, and a good sense of humor, you'll be fine if you apply early and broadly. You will have to be open-minded geographically and may match further down on your list than some, but you'll match someplace. And about 80% of residency is the work you put into it, not where you do the work. Great psychiatrists coming out of Yale would have been great psychiatrists regardless of where they trained.

You'll be fine if you're willing to do the work in 3rd year...

 

[JamesPhilly]

I failed step 1 once. I did much better on step 2. Had lots of publications, good clinical evals, did one audition rotation at a big place

I knew I would not be competitive at top tier places, but I did interview at awesome programs that would be considered name places. come rank time I stayed mid/lower tier based on my preference and required geography for my family, and I matched where i wanted.

Not to mention that I'm a DO and being a US MD will give you a great advantage. You'll have no problems matching for sure, just rank every place you interview, which is good advice for everyone really. And all the comments above are spot on

Good luck!

 

[NYCMS2]

Of course you should apply to psychiatry. It's one of the least competitive specialties out there. It's the specialty people who have worse red flags than you are encouraged to apply.

Few programs automatically screen based on Step I (in fact, some programs send a secondary to all comers to elicit fees before rejecting). You will be rejected by programs that screen based on Step I. You will also have an uphill battle at programs that don't. But you'll still be in the game.

Psychiatry is a different specialty than most. Unless you're looking to find a cure for OCD and such, your main skills will be your ability to relate to people compassionately and articulately, to take a lot of seemingly unrelated factors into account to formulate a realistic plan, and be a professional who takes pride in his or her work. That is what most programs are going to be looking for.

So if you work hard during 3rd and 4th year and demonstrate those qualities to faculty who capture it in your evals and LORs and you come to your interviews showing interest in the program, passion for the field, humility, and a good sense of humor, you'll be fine if you apply early and broadly. You will have to be open-minded geographically and may match further down on your list than some, but you'll match someplace. And about 80% of residency is the work you put into it, not where you do the work. Great psychiatrists coming out of Yale would have been great psychiatrists regardless of where they trained.

You'll be fine if you're willing to do the work in 3rd year...

Whoa! Secondaries? Jeez, this is the first I have heard about secondaries.

Say it ain't so...

 

[J ROD]

Look at it this way. At least you passed on your first attempt.

It is the best thing to have.......no.

But, it does not kill your chances. Just make sure to do well in Psy, IM, and FM. Maybe do some Psy 4th yr. And do at least average on Step 2.

And appear to be a normal person on interviews.

 

[Waldeinsamkeit]

So how important is your quartile for psych?

 

[mass1]

So how important is your quartile for psych?

At our program, we use quartile as a filter for IMG/FMGs - so anyone below 2nd quartile is automatically ruled out.

 

[Psychotic]

At our program, we use quartile as a filter for IMG/FMGs - so anyone below 2nd quartile is automatically ruled out.

What percentage of the residents at your program are IMG/FMG? And does your program have a cutoff for DOs, or AMGs - like maybe below 3rd quartile?

These programs have to draw the line somewhere, to get a manageable list to invite.

 

[mass1]

About 20-30%. We have a minimum cut off score of both step 1 and COMLEX for MDs and DOs respectively but none for quartile

 

[shan564]

As a US MD, you're likely to match somewhere as long as you pass everything on the first try. But yeah, definitely do better on Step 2. Your Step 1 score will obviously be a detriment to your application, but it's definitely not as bad as you seem to think it is.

 

[Doctor Bagel]

Yeah, definitely take Step 2 earlier because programs might reasonably worry about your ability to pass it as you barely passed Step 1. I'm not really trying to be rude, but how did you miss this information about the scoring of Step 1? Step 1 is kind of a big deal that medical students generally obsess over -- I'm puzzled by not looking into details about the scoring more. Some places probably will screen you out, so that's that, but there's nothing you can do about it now aside from making the rest of your application as strong as it can be. The people above me have mentioned all the ways to do that.

 

[masterofmonkeys]

Rock Step 2 CK EARLY. Fess up to your misjudgments on Step 1 in your personal statement. Match, and move on with life.

If your interest is legit, you won't have much problem and with a good balancing set of attributes, could get into a mid-tier program without it being too much of an issue.

 

[Waldeinsamkeit]

At our program, we use quartile as a filter for IMG/FMGs - so anyone below 2nd quartile is automatically ruled out.

What about for US allopathic?

 

[mass1]

US allopathic at our program need to pass Step 1 with minimum of 200

 

[Psychotic]

US allopathic at our program need to pass Step 1 with minimum of 200

I don't remember the percentiles, but 200 is hardly a tough hurdle, right?

In reality, while that is an official program cut off, I am sure that some programs have their pick of applicants and the "average" Step 1 score of all invitees is probably closer to the specialty average - a few years ago it seems like that was around 220 or so, not sure what it is now, but probably inching upwards.

In terms of stats, grades, and test scores, I was an extremely average applicant 2 years ago. I think I had some other things going for me that helped me standout from the crowd, including strong letters from all writers, a very strong PS, a Fulbright experience related to mental health, and attendance at a Top 20 med school. In other words, Step scores aren't everything, but everything matters in this process.

 

[mass1]

I don't remember the percentiles, but 200 is hardly a tough hurdle, right?

In reality, while that is an official program cut off, I am sure that some programs have their pick of applicants and the "average" Step 1 score of all invitees is probably closer to the specialty average - a few years ago it seems like that was around 220 or so, not sure what it is now, but probably inching upwards.

In terms of stats, grades, and test scores, I was an extremely average applicant 2 years ago. I think I had some other things going for me that helped me standout from the crowd, including strong letters from all writers, a very strong PS, a Fulbright experience related to mental health, and attendance at a Top 20 med school. In other words, Step scores aren't everything, but everything matters in this process.

Agreed. Getting a score of at least 200 on step 1 (for US MDs) or 210 (for IMGs) at our program is only one part of our initial screening process.