Minimum score on USMLE Step 1 as an Osteopath

[DrZed]

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So I'm curious. What is a minimum score on practice NBME, UWorld, etc. that would make taking Step 1 worth it. I feel like an average or below average score will only hurt an osteopath. Therefore there's no reason to take it unless you can break a certain threshold. What would that be? A competitive score seems to start around 230+. So if you can't break 230 on practice test, should you even bother taking Step 1? Wouldn't it just look bad?

 

[GUH]

So I'm curious. What is a minimum score on practice NBME, UWorld, etc. that would make taking Step 1 worth it. I feel like an average or below average score will only hurt an osteopath. Therefore there's no reason to take it unless you can break a certain threshold. What would that be? A competitive score seems to start around 230+. So if you can't break 230 on practice test, should you even bother taking Step 1? Wouldn't it just look bad?

Fair question, and one I'd like to know the answer to as well. I suspect that a lot of it has to do with what kind of residency you want.
230+ seems a bit high though unless you're shooting for something competitice since most students get below a 230, including allopathic students.

 

[SLC]

I think the general wisdom is if you think you can get anywhere near or above the average you should take it.

Most of the fields that DO's have a good chance of matching in have averages USMLE scores that are below the national average. Many primary care fields have published USMLE cutoff scores of ~200 for IMG's, so a DO applicant with a 225 should have no trouble with being "score screened" at a place like that.

I would think that if you feel confident that you can land at or above a 220 it would be advisable to take it. Though I have no idea what the average is these days, it was 227 for my year.

 

[preDoGuy24]

I know quite a few people who were kicking themselves because they did not take the USMLE due to only scoring average on practice exams. If you can get in that range just go for it.

 

[lal4life]

USMLE score is going to be one of the best, and sometimes one of the only, ways to compare DO and MD students. As usual, there are so many different aspects to an applicant that you can't just say Step 1 score is a make or break, but if you're applying to an ACGME residency and you scored, say, 575 on COMLEX to a program or residency that averages a 230 on Step 1, they may not be familiar with that score. Some people may be better than others, but some people still think it's an inferior test than USMLE.

If you have a specialty in mind, shoot for the average for that specialty. I don't think that simply because you have a DO degree makes you vastly inferior to MD applicants as a whole. There are definitely certain programs that feel that way, but I think the general opinion is that you don't want to be at those programs anyway. In my opinion, you obviously don't want to fail, and scoring in the low 200's would make it more difficult to match, no matter what your degree is or what school you went to. If you're near the failing mark, don't take it. Also, you may end up finding out that you are interested in specialties that have below average board scores. There are still a lot of specialties with average board scores that are below the national average.

In the end, do what you feel is best. I know my school recommended that if you failed a class or averaged below 80% in most of your classes, then you should consider not taking the USMLE. I'm really glad I took both tests because I don't have to worry about program directors looking at my scores and thinking, "How does this compare to MD students?"

 

[abolt18]

For me, my personal cutoff was 230 (last year's average being 229 I believe). Told myself if I'm not breaking that on practice tests I'm not taking it. 220 may honestly be a better limit. Either way, I felt like it's not worth taking of I don't at least hit the average. My school basically told my class they shouldn't and don't need to take it. Worst advice I think you could ever give an entire class. I think it's good advice for individuals not doing well in school in the first place, but if you're performing well all around in school, it shouldn't be discouraged.

 

[arewethereyet...]

I found this question to be very hard. I was supposed to take the usmle tomorrow but 2 weeks ago I got a 215 on nbme 16 and last week I got a 209 on nbme 17. I had told myself that if I didn't get a 220 I would cancel, so I did.

Honestly I don't know if it was the right choice, but I keep telling myself that there are few places that I'd be better off with a 210/215 and 500 than just a 500. And like someone said, I probably don't want to go to those places anyway. I do think that what you want to do and where you want to do it are determining factors- I'm interested in neurology, pm&r, or geriatrics, so while the top residencies likely require a usmle, I still have a good shot at plenty of places. It's tough because I've definitely closed at least a few doors, but how many is hard to know. The what ifs keep running through my head but at this point it's cancelled, so that's that.

A few people have told me that you can always just take step 2 to make yourself comparable to mds, but I haven't looked into it yet.

 

[RadsonRads]

please don't ever use the term 'Osteopath' again

 

[preDoGuy24]

please don't ever use the term 'Osteopath' again

Just read that again. Yeah no one refers to themselves as Osteopaths unless they are OMT nutjobs. We are Physicians.

 

[DrZed]

please don't ever use the term 'Osteopath' again

Just read that again. Yeah no one refers to themselves as Osteopaths unless they are OMT nutjobs. We are Physicians.

I see your point, but I politely disagree. We're osteopathic physicians. Even if you hate OMT and will never use it again, your original training began at a DO school. I don't think this topic would be addressing the same issue if it was "What's the minimum score as a Physician."

 

[RadsonRads]

I see your point, but I politely disagree. We're osteopathic physicians. Even if you hate OMT and will never use it again, your original training began at a DO school. I don't think this topic would be addressing the same issue if it was "What's the minimum score as a Physician."

Osteopath does not equal Osteopathic physician. Please don't drink anymore kool-aid and help advance our profession rather than prevent the progress

 

[Mad Jack]

I see your point, but I politely disagree. We're osteopathic physicians. Even if you hate OMT and will never use it again, your original training began at a DO school. I don't think this topic would be addressing the same issue if it was "What's the minimum score as a Physician."

There is a difference between an osteopath and an osteopathic physician. Osteopaths are what are licensed in other countries- Australia, the UK, etc.- and are only trained in OMT, while osteopathic physicians practice with a full physician's scope of practice and also learn OMT. The "physician" is what sets us apart from the OMT-only crowd that is trained everywhere else in the world, and the reason no self-respecting DO refers to themselves as an "osteopath," because we're so much more than that.

 

[DrZed]

There is a difference between an osteopath and an osteopathic physician. Osteopaths are what are licensed in other countries- Australia, the UK, etc.- and are only trained in OMT, while osteopathic physicians practice with a full physician's scope of practice and also learn OMT. The "physician" is what sets us apart from the OMT-only crowd that is trained everywhere else in the world, and the reason no self-respecting DO refers to themselves as an "osteopath," because we're so much more than that.

Well... in that case. Oops. Today I learned. 🙂

 

[preDoGuy24]

I see your point, but I politely disagree. We're osteopathic physicians. Even if you hate OMT and will never use it again, your original training began at a DO school. I don't think this topic would be addressing the same issue if it was "What's the minimum score as a Physician."

How many Allopaths have you met? How many MDs refer to themselves as such? Zero. Osteopath has a negative connotation, especially among those docs/ from Europe, it's an outdated term for DOs and really does not encompass what we do or who we are.

 

[preDoGuy24]

Well... in that case. Oops. Today I learned. 🙂

Yeah probably best not to lecture those ahead of you in the Physician game...good thing to keep on mind as you move along.

 

[TheFuture_22]

I think 220 is a good cutoff. Don't forget that even among the residencies that accept COMLEX they still don't usually consider an average COMLEX score to be equal to an average USMLE score.

 

[DrZed]

Yeah probably best not to lecture those ahead of you in the Physician game...good thing to keep on mind as you move along.

Good point. I haven't been on here since the pre-med days. Last I remember was the volatile DOvsMD debates so I guess it was a knee-jerk reaction. =P My apologies.

Now, back to the OT.

 

[a runner]

It's totally dependent on the specialty and if you plan on applying ACGME only, ACGME and AOA, or AOA only (in which case you probably wouldn't take the USMLE).

For example, in family medicine, a step 1 in the 200-210 range will open more doors for you than it shuts on the ACGME side, although if your level 1 is 500+, those same programs might accept that score with no step 1.

Radiology, for example, you need a step 1 for MOST programs, so a 210-220 is better than no step 1 with a 600+ level 1. I think a 210 will get you past the cutoff for about half of programs, whereas only about 10% or less of programs will accept a level 1 only. Even a 200-210 is better than a comlex only because you will make the cutoff for approximately a third of programs.

I think for most DO students, the threshold should be low to take step 1. Most students will be better off with a 210+ than no step 1 unless it's a very DO friendly field (PM&R, psych, FM) or they plan to match AOA.

On a related note, most pre-clinical students put a bit too much importance on the actual score. Many programs just want to see you have a minimum level of competence in standardized exams and won't fail specialty boards and other factors are more important such as the interview, dean's letter, LORs, personality and fit. For different specialties that minimum level of competence can mean different things because each specialty's exams are different... some specialties/programs just want a pass on all attempts, some want a 200+, others a 220+ etc.

 

[arewethereyet...]

It's totally dependent on the specialty and if you plan on applying ACGME only, ACGME and AOA, or AOA only (in which case you probably wouldn't take the USMLE).

For example, in family medicine, a step 1 in the 200-210 range will open more doors for you than it shuts on the ACGME side, although if your level 1 is 500+, those same programs might accept that score with no step 1.

Radiology, for example, you need a step 1 for MOST programs, so a 210-220 is better than no step 1 with a 600+ level 1. I think a 210 will get you past the cutoff for about half of programs, whereas only about 10% or less of programs will accept a level 1 only. Even a 200-210 is better than a comlex only because you will make the cutoff for approximately a third of programs.

I think for most DO students, the threshold should be low to take step 1. Most students will be better off with a 210+ than no step 1 unless it's a very DO friendly field (PM&R, psych, FM) or they plan to match AOA.

On a related note, most pre-clinical students put a bit too much importance on the actual score. Many programs just want to see you have a minimum level of competence in standardized exams and won't fail specialty boards and other factors are more important such as the interview, dean's letter, LORs, personality and fit. For different specialties that minimum level of competence can mean different things because each specialty's exams are different... some specialties/programs just want a pass on all attempts, some want a 200+, others a 220+ etc.

That's a good point. Is there one place where I can read about all of this, or is this just stuff you've picked up as you've gone along?

 

[hallowmann]

OP, my cutoff for taking it is 220. Honestly, I've heard people say if you are going to score >215 its worth taking, but it really depends on what you're interested.

The only time I would recommend not even registering/planning to take the Step is if you are sure you're going to apply AOA. That's an option that will likely disappear come 2020, so I imagine as long as you can get a score within 1 SD of the mean, you're probably better off taking the USMLE Step 1.

By the way, the only time I've heard of people regretting that they took Step 1 is for people who failed it, so that may provide some insight.

 

[DrSoup]

Here's a list of average USLME step 1 scores per specialty:

http://www.doctorsintraining.com/blog/usmle-step-1-average-match-scores-by-specialty/

Not sure how to gauge the value of a DO student taking it...what they would need to score to make them equally competitive, especially with a COMLEX of _______.

My question though, is how does this all change with the merger of osteopathic/allopathy residencies in 2020? I've read that there is no movement to combine the COMLEX/USMLE, so what does that imply for DO students who are now unequivocally competing with MD students for all residency spots? Still trying to understand the implications of all of this...

 

[TheBoneDoctah]

I cringe when I heard osteopath

 

[Mr Kenobi]

osteopath

osteopath

osteopath

haha. Seriously though, I used to be just like you. You'll get used to it. At this point, 2 years in, I feel like it is an unwinable battle. Wait til OMM starts and all the faculty in that department start preaching...It's their favorite word.

I was like

 

[TheBoneDoctah]

haha. Seriously though, I used to be just like you. You'll get used to it. At this point, 2 years in, I feel like it is an unwinable battle. Wait til OMM starts and all the faculty in that department start preaching...It's their favorite word.

I was like

It just sounds so bad. People who don't know what a DO is will look up osteopath and then draw conclusions off that when that's not even what an osteopathic physician is. It's so annoying. Especially when we have the same + more training and they say it's not even science based. The public is just so ignorant.

 

[kenjixshadow]

That word annoyed me so much that I had to make this meme.

 

[JustaDO]

The minimum score is the same the allopathics aim for: as high as possible.

 

[fingerscrossedpremed]

The minimum score is the same the allopathics aim for: as high as possible.

I wonder if you should take the USMLE irregardless of what you think you'll make (within reason). Would AOA programs care if you bombed the USMLE? If not, I'd just take the USMLE and hope for the best. If your test scores for the USMLE don't pan out the way you'd like, you could just stick with AOA programs.

 

[abolt18]

I wonder if you should take the USMLE irregardless of what you think you'll make (within reason). Would AOA programs care if you bombed the USMLE? If not, I'd just take the USMLE and hope for the best. If your test scores for the USMLE don't pan out the way you'd like, you could just stick with AOA programs.

A lot of MD programs accept the COMLEX. I believe at those programs, a failed USMLE is going to be a greater detriment to you than not taking the test at all. You close more doors with a failed test than you do not taking it.

 

[JustaDO]

You should take it if you feel confident in your ability to do well on it. If so, my advice stands, aim as high as possible