Need advice on USMLE score!

[Chillz]

Hey guys I need advice. I received my score today and got a 228. I'm also an MD-PhD at a mediocre allopathic medical school. I was wondering if with that score the doors are still open for fields such as radiation oncology or ophthamology? Thanks.

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[PeepshowJohnny]

You're right at the average for radiation oncology step 1 scores and I'm not sure about ophthalmogy but I think you're in the ballpark.

What does that mean?

You're going to be considred a competitive adequate. You're going to have a better score than some, worse than others.

Best thing you can do is make yourself look good on multiple facets. Your Step 1 score shows your smart, get a LOR from a 3rd/4th year attending stating how hard a worker you are, or how you'd be the kind of guy he'd want to be a colleague.

Also, show you have interest in the field. These fields are thought of as fields that reimburse well and have good lifestyle. If you can show no other interest in the field other than the those aspects, you're going to get burned. Make sure you know what the job actually entails, what the advances in the field are, etc.

 

[UT_mikie]

The MD/PhD's at my school all tend to match well (big name schools), high step scores or not. I think the PhD will go a long way as long as you do what you are supposed to be doing and publishing. Its the MD's that have a little more riding on it. Just my opinion.

 

[Chillz]

thanks guys! Anymore input?

 

[sga814]

If your dissertation/lab work coincides with the field you want to go into, and you have a a lot of publications (which I'm assuming you do/will), you should have little trouble.. that score is 10 points above average and competitive.

 

[lord_jeebus]

Rad Onc is not tough to match in because it requires astronomical scores (although they are always helpful), but because they place a relatively high emphasis on things like publications that not every med student has.

I imagine that having PhD work relevant to the field of your application will help immensely.

There's also a chance that by the time you graduate, Step I will be Pass/Fail.

 

[Chillz]

Rad Onc is not tough to match in because it requires astronomical scores (although they are always helpful), but because they place a relatively high emphasis on things like publications that not every med student has.

I imagine that having PhD work relevant to the field of your application will help immensely.

There's also a chance that by the time you graduate, Step I will be Pass/Fail.

Is this true?

 

[pdz]

I know an MD-PhD who had very very low step 1 scores (just passing) and got in a very competitive rad-onc program. He had an stellar record of publications during his PhD, and during his interviews all he was asked about was his research.

 

[Arctic Char]

Rad Onc is not tough to match in because it requires astronomical scores (although they are always helpful), but because they place a relatively high emphasis on things like publications that not every med student has.

I imagine that having PhD work relevant to the field of your application will help immensely.

There's also a chance that by the time you graduate, Step I will be Pass/Fail.

Whoa Whoa Whoa . .. . stop the train . . . whats that you say? step 1 going to pass/fail? this is the first i've heard of this. are you pulling our leg, or is there in fact some grain of truth in that speculation? i'm interested to know what makes you think/consider the notion of it going P/F.

i look forward to hearing back . . .

 

[PeepshowJohnny]

Whoa Whoa Whoa . .. . stop the train . . . whats that you say? step 1 going to pass/fail? this is the first i've heard of this. are you pulling our leg, or is there in fact some grain of truth in that speculation? i'm interested to know what makes you think/consider the notion of it going P/F.

i look forward to hearing back . . .

The word through the grape vine is that NBME is exploring a few options of shaking up Step 1. I believe at one of their conferences they give participants a questionaire to ask about the possibility of combining Steps one and two and de-emphasizing the "score" aspect of it. Supposedly, they did the same thing before they instituted Step 2 CS (and went ahead with it, even though it was unpopular on questionaire).

It all stems from how the NBME just hates how some programs use Step 1 to screen applicants as it's designed to be a pass/fail, not empirically scale you.
I believe a student representative of the NBME posted on this thread that the NBME was exploring the options where Step 1 would still be an objective measure to compare school to school, but not put so much focus on a 218 vs. a 220 vs. 230 vs. a 250.

 

[Arctic Char]

thanks for explaning that.

 

[bmcgilligan]

I don't think whether the NBME goes Pass/Fail will affect us though, seeing as we already took Step 1 and got numerical scores.

 

[Law2Doc]

I believe a student representative of the NBME posted on this thread that the NBME was exploring the options where Step 1 would still be an objective measure to compare school to school, but not put so much focus on a 218 vs. a 220 vs. 230 vs. a 250.

If I'm remembering the same post, I think s/he also said that at this point they were just floating ideas and that any change was not going to happen for like at least 7 years though (if ever) so don't anybody get too excited. The current system will stay in place for all of us (unless you want to take 5 years off to research or something).

 

[vtucci]

I think the steps should go pass/fail.

That is what they do for the bar exam. Granted, they give us a number for the multistate portion of the exam but no law firms are deciding whether to hire lawyers or law students based on the score (%).

 

[exmike]

I think the steps should go pass/fail.

That is what they do for the bar exam. Granted, they give us a number for the multistate portion of the exam but no law firms are deciding whether to hire lawyers or law students based on the score (%).

If the steps went pass fail, imagine the fratricide that would go on in the wards since you will be evaluated by residencies almost SOLELY on the clerkships which are SO ARBITRARY. We still need a standardized objective measure of performance. As flawed as a step 1/2 score may be, it is still the best we have. Kinda like the BCS i guess.

Vtucci, perhaps after a year of wards, you'll feel differently about having that year count as 90% of your residency app. Imagine your app being marred by a clinical score given to you by some clerkship director you may have seen for two minutes your entire rotation.

 

[Law2Doc]

I think the steps should go pass/fail.

That is what they do for the bar exam. Granted, they give us a number for the multistate portion of the exam but no law firms are deciding whether to hire lawyers or law students based on the score (%).

Well, the bar exam is a test in which in most states 25-35% of takers won't pass, so passing becomes more meaningful. I don't know that many board takers want that kind of risk. The systems are different in that for the most part the USMLE doesn't decide whether US med students actually become doctors (they pretty much all do, eventually), but influences what kind. The bar, by contrast, is the gateway to the profession altogether and a fair number of people never make it in. It's a bigger deal in some ways, because you can lose a job by failing the bar; failing the boards usually just results in delay (and closes the door for some specialties).

 

[SeventhSon]

if you have a good publication record, I imagine pretty much any field is still open.... although the research is most helpful for getting into high-class IM and peds programs, from what i understand.

 

[AmoryBlaine]

If the steps went pass fail, imagine the fratricide that would go on in the wards since you will be evaluated by residencies almost SOLELY on the clerkships which are SO ARBITRARY. We still need a standardized objective measure of performance. As flawed as a step 1/2 score may be, it is still the best we have. Kinda like the BCS i guess.

Vtucci, perhaps after a year of wards, you'll feel differently about having that year count as 90% of your residency app. Imagine your app being marred by a clinical score given to you by some clerkship director you may have seen for two minutes your entire rotation.

Totally agree. The Steps are an imperfect system but something has to be standard. I will brace for flames as I say this but I would imagine that you don't have very many 240+ students who suck at clinical medicine. SDN is famously hostile towards the attitude that objective measurements of knowledge matter. If you don't believe this just go over to pre-allo and look at all the "I got a 26/2.8, but I know I'll be a great doctor!" threads.

Clerkship grades are so subjective. If they were to rise above Step1 in general importance then exmike's prophecy would probably come true. Plus, alot of clerkship grades come from exam scores anyway. Would we need to do away with those too?

 

[PeepshowJohnny]

Personally, I'd like a happy medium. Instead of the being totaly pass fail, I'd like to see the boards move toward a tiered system.

So you'd have (old system: new system)
Below 185: Fail
185-200: Sufficient
200-220: Pass
220-240: High Pass
240+: Exceptional Pass

That way there's some objectivity of where your score placed you in competitiveness, but it eliminates the "I got a 244 but I wish I got a 270" whining that drives people crazy. Also, programs would haev a lot more variability in who they except. For example, if they only want "high pass" or better, they're still allowing students who may ahve only got a few points above the national average.

 

[indo]

Whoa Whoa Whoa . .. . stop the train . . . whats that you say? step 1 going to pass/fail? this is the first i've heard of this. are you pulling our leg, or is there in fact some grain of truth in that speculation? i'm interested to know what makes you think/consider the notion of it going P/F.

i look forward to hearing back . . .

I've heard this from my school's administration too. They said the class of '11 will probably be the last class to take the current Step I.

 

[Law2Doc]

I've heard this from my school's administration too. They said the class of '11 will probably be the last class to take the current Step I.

From what I've heard, I would put money against that soon a timeframe. I'll try and find the thread a few months back where the rep indicated something like at least 7 years before anything was going to happen, if at all.