Psychiatry residencies with hard Step 1/2 cutoffs

[Transistor]

I do recognize that there are a plethora of factors that gauge a psychiatry applicant's competitiveness. That said, I'd imagine that there are programs out there with hard numerical score cutoffs given that the field is getting more competitive. Asking if anyone has heard through the grapevine if there are any programs that have hard cutoffs, or weigh the score heavily? Off the top of my head I've read that many of the tippy top (think top 10 on Doximity) programs have 240-250+ cutoffs, and MUSC looks for high scoring applicants as well.

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[theadvocate]

Not a cutoff, but the Stony Brook website says "applicants with multiple failures in the basic or clinical sciences or on the USMLE examinations will not be invited for interviews." This is under their "High Intelligence" requirement.

The most prestigious programs do not have Step cutoffs on their websites and say you only have to pass within 1 or 2 attempts ("we do holistic review"). How true that is, I do not know.

Some recently accredited programs do specify cutoffs. I remember that Ventura and Cleveland Clinic Akron General both have cutoffs of 220 for both exams.

 

[comp1]

I'm surprised anyone would advertise a cutoff beyond "passing."

 

[Taddy Mason]

Off the top of my head I've read that many of the tippy top (think top 10 on Doximity) programs have 240-250+ cutoffs.

Can confirm that this is not true for 6-7 of the "top" 10 programs listed on Doximity based on conversations I've had with graduates from my med school, co-residents, and applicants over the past several years who have interviewed at these programs with Step scores well below 240.

 

[Peonage]

The only one I came across was Wayne State. According to their website "We offer interviews only to applicants whose USMLE or COMLEX 1 & 2 scores average at least 220; multiple attempters are screened out."

 

[Psychresy]

I do recognize that there are a plethora of factors that gauge a psychiatry applicant's competitiveness. That said, I'd imagine that there are programs out there with hard numerical score cutoffs given that the field is getting more competitive. Asking if anyone has heard through the grapevine if there are any programs that have hard cutoffs, or weigh the score heavily? Off the top of my head I've read that many of the tippy top (think top 10 on Doximity) programs have 240-250+ cutoffs, and MUSC looks for high scoring applicants as well.

I interviewed at musc with a high step but know for a fact another fellow interviewee interviewed with only a modestly better than average comlex.

 

[Stagg737]

I do recognize that there are a plethora of factors that gauge a psychiatry applicant's competitiveness. That said, I'd imagine that there are programs out there with hard numerical score cutoffs given that the field is getting more competitive. Asking if anyone has heard through the grapevine if there are any programs that have hard cutoffs, or weigh the score heavily? Off the top of my head I've read that many of the tippy top (think top 10 on Doximity) programs have 240-250+ cutoffs, and MUSC looks for high scoring applicants as well.

FREIDA has some programs with "hard" cutoffs listed, but do not believe them. I got interviews at programs where my boards were below their cutoff. If you really want to go somewhere but you don't meet their cutoffs, apply anyway.

 

[splik]

I have never heard of a program with cut off of 240 or 250 or there wouldn’t be enough applicants! Top 10 programs do not place emphasis on scores only less competitive programs do. The best programs look at everything and can afford not to place so much emphasis on scores. These programs may pass on applicants with 260+ scores and not give them an interview and interview someone with sub 200 score who is stellar in other ways. Cut off scores use to be between 200-220. Most places don’t emphasize this, nor advertise this and I wouldn’t get too fixated on it.

 

[Stagg737]

I have never heard of a program with cut off of 240 or 250 or there wouldn’t be enough applicants! Top 10 programs do not place emphasis on scores only less competitive programs do. The best programs look at everything and can afford not to place so much emphasis on scores. These programs may pass on applicants with 260+ scores and not give them an interview and interview someone with sub 200 score who is stellar in other ways. Cut off scores use to be between 200-220. Most places don’t emphasize this, nor advertise this and I wouldn’t get too fixated on it.

This, I'm a little less removed from the match and the highest cutoff scores I remember were a 220 Step 1 or 550 COMLEX. Seemed like they were used to assure competency, not identify the top applicants.

 

[theadvocate]

I'm surprised anyone would advertise a cutoff beyond "passing."

It'd be nice if more programs were transparent about that, though. It would save applicants a lot of money...

 

[Celexa]

Yeah no idea why you would have heard that top programs use cutoffs. They want the most competitive applicants--they will happily take lower step scores for someone who shines in other ways. Which is not to say scores are meaningless, but they're just one variable among many.

 

[wamc2021psych]

hard cutoffs may not be that common. however, board scores are weighted very heavily when it comes to making rank lists by top academic programs (say top 50ish). so even if you get an interview with low board scores, you probably won't be ranked to match. it's often said that once you land an interview, it's an even playing field, but that's completely untrue for academic programs. maybe it was at some point in time.

 

[Taddy Mason]

...board scores are weighted very heavily when it comes to making rank lists by top academic programs (say top 50ish). so even if you get an interview with low board scores, you probably won't be ranked to match. it's often said that once you land an interview, it's an even playing field, but that's completely untrue for academic programs....

Source? Board scores pretty much never come up in making our rank list. Obviously this isn’t representative of all programs, but in talking with colleagues at other programs board scores are generally a pretty minor factor when ranking applicants after interviews. It may differentiate someone being ranked 21st v. 20th but not 15th v. 70th.

 

[AnonymousXYZ]

What are some of the other factors that programs use to gauge competitiveness? I imagine there's a lot more similarities than differences between applicants, so how do programs decide whom to interview?

 

[TexasPhysician]

Even if you find a “hard cutoff” somewhere, consider it outdated and ignore it. These don’t exist. Programs can create “searches” using a number of criteria and then re- search with other criteria. It happens all the time. Round 1 could be steps > 240. Once reviewed, move to >220 with research and whatever else. Program chairs use the filters in many ways to begin processing apps at different times.

Hard filters in some places may be 0 step failures or 0 failed classes.

 

[FlowRate]

hard cutoffs may not be that common. however, board scores are weighted very heavily when it comes to making rank lists by top academic programs (say top 50ish). so even if you get an interview with low board scores, you probably won't be ranked to match. it's often said that once you land an interview, it's an even playing field, but that's completely untrue for academic programs. maybe it was at some point in time.

I have detailed knowledge of two top academic programs and this is untrue for both of them. The one creates the initial rank list 100% on interview aggregate score then fine tunes by group discussion.

 

[clausewitz2]

I have detailed knowledge of two top academic programs and this is untrue for both of them. The one creates the initial rank list 100% on interview aggregate score then fine tunes by group discussion.

Similar to the highly-ranked program i have firsthand knowledge of.

 

[Celexa]

Similar to the highly-ranked program i have firsthand knowledge of.

Indeed. The only part of that poster's statement that is true is that you aren't necessarily on equal footing just by getting an interview. Programs have different ways they generate and modify their rank lists. But step scores are not main driver of ranking and there is wide variation among the step scores in my 'top' program.

 

[Stagg737]

What are some of the other factors that programs use to gauge competitiveness? I imagine there's a lot more similarities than differences between applicants, so how do programs decide whom to interview?

The interview day itself is almost uniformly the most important factor. Your interactions with staff and residents, ability to communicate, comfort/fit, etc. Other aspects may include areas of interest, past or current research, involvement in the field such as volunteering or working in organizations, etc. I was told by several programs my LORs were a big reason I got interviews and may carry weight in final rankings. Many things can determine competitiveness and criteria can vary significantly between programs.

 

[clausewitz2]

Indeed. The only part of that poster's statement that is true is that you aren't necessarily on equal footing just by getting an interview. Programs have different ways they generate and modify their rank lists. But step scores are not main driver of ranking and there is wide variation among the step scores in my 'top' program.

Honestly the folks for whom getting an interview communicated the least about their chances of actually matching were our home program med students. Every year it seemed like a couple of them were bitterly disappointed, possibly because they assumed they were a shoo-in. Top programs can be choosy about many aspects of an application and the CVs tend to be a bit more varied so it is less of a uniform sea of identi-resumes and vaguely positive recommendation letters that need to be culled with a number.

 

[Celexa]

Honestly the folks for whom getting an interview communicated the least about their chances of actually matching were our home program med students. Every year it seemed like a couple of them were bitterly disappointed, possibly because they assumed they were a shoo-in. Top programs can be choosy about many aspects of an application and the CVs tend to be a bit more varied so it is less of a uniform sea of identi-resumes and vaguely positive recommendation letters that need to be culled with a number.

We see some of this too, people who are at a 'top' medical school with a 'top' psych residency who think they're going to be able to stay because they went to school here, not fully realizing at that this point the program is only going to keep the 'top' applicants from the school.

 

[MacDonaldTriad]

Even if programs do use cut offs, those cut offs vary from year to year based on the distribution of that year's applicants. Even with this, many exceptions are made for talented people.

 

[kopftonmd]

Corollary question: How much do programs care about mediocre grades? Not like straight Ps, but a mix of H/HP/P. Will strong Step scores help offset? Will being spiky (I find the way that college admissions folks use the term delightful) help offset alternatively?

My sense is students worry a lot about Step scores, but that can't be the only thing that's often used to throw applications in the trash.

 

[Stagg737]

Corollary question: How much do programs care about mediocre grades? Not like straight Ps, but a mix of H/HP/P. Will strong Step scores help offset? Will being spiky (I find the way that college admissions folks use the term delightful) help offset alternatively?

My sense is students worry a lot about Step scores, but that can't be the only thing that's often used to throw applications in the trash.

I had straight passes and one failure at the start of second year, and as I said above had no problems matching. The red flag and poor pre-clinical performance certainly didn't help, but I still had no problems getting interviews. Some of it is knowing how to sell yourself in an app (as a disclaimer I think I'm pretty bad at this actually), some of it is being smart about where you apply, and some of it is just luck of the draw that someone was interested enough to offer an ii. Again, it will vary from program to program. But as said above, psych tends to weigh factors other than boards and GPA/class rank more heavily than many other fields.

 

[NickNaylor]

Corollary question: How much do programs care about mediocre grades? Not like straight Ps, but a mix of H/HP/P. Will strong Step scores help offset? Will being spiky (I find the way that college admissions folks use the term delightful) help offset alternatively?

My sense is students worry a lot about Step scores, but that can't be the only thing that's often used to throw applications in the trash.

Every program will approach this differently. I'm sure there are programs that have fairly rigid criteria by which they weed out applicants. That said, at my institution the program does use "objective" cutoffs but they're pretty loose, and nearly all applications get reviewed be program leadership prior to the interview. Step scores are pretty irrelevant to the program's final ROL. Pre-clinical grades are more important, but interviews and clinical grades play a much bigger role. Our applicant rubric doesn't evaluate class rank.

 

[FlowRate]

Hey all,

Bumping this thread again because I was curious if, since the most recent match, there is any intel on whether the relative lack of cutoffs still exist in psych. I've since heard of a program who won't even look at most applicants until after reviewing those who graduated from elite medical schools which is why I ask now.

Not surprising and not the same as a step cutoff. If you're a prestigious program trying to look prestigious then the visible thing on your residents page is alma mater, not step scores.

 

[Dharma]

Not surprising and not the same as a step cutoff. If you're a prestigious program trying to look prestigious then the visible thing on your residents page is alma mater, not step scores.

Curb appeal, all the way. Doesn't always play out well, but it sells.

 

[phonyreal98]

apps at different times.

Not surprising and not the same as a step cutoff. If you're a prestigious program trying to look prestigious then the visible thing on your residents page is alma mater, not step scores.

what are you talking about my 284 on step 1 is listed on my residency's page about me 🤣

 

[J ROD]

MUSC cares about Step scores. They interview lower scores. I know for a fact they only took the one 240+ on Step 1 in my class. They interviewed about 5 from my med school that day of 8 that applied Psych. Felt like we were all there as fill as they only paid attention to her.