Step 1 damage assessment

[BananaBoy]

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I am in an MSTP and recently finished 2nd year of medical school. I just got my usmle step 1 score back today. It is a 229/99 (I know....didn't know "99" went that low). I am wondering:

1. When I am applying for residency, do competitive MEDICINE and PEDS programs screen out applicants for scores that low?

2. Does this mean I need to work extra hard preparing for step 2?

3. Is it likely that the average score will continue to rise in the coming 6 years such that this score will become a weakness of my residency application?

 

[nomogram3]

I am in an MSTP and recently finished 2nd year of medical school. I just got my usmle step 1 score back today. It is a 229/99 (I know....didn't know "99" went that low). I am wondering:

1. When I am applying for residency, do competitive MEDICINE and PEDS programs screen out applicants for scores that low?

For competitive medicine residencies: in a word, yes. Your score is still above the national Step 1 average for IM in 2009 which was 225 so you will get interviews, but if you want to go to MGH or Hopkins a 229 is going to hurt you. I'm not as familiar with the Peds process, I can tell you that mean Peds score was 219 in 2009.

2. Does this mean I need to work extra hard preparing for step 2?

This is the good news. Step 2 CK is an easier exam, and gives you another chance to post a good score. There is now a trend of IM programs wanting Step 2 CK (and CS) before rank lists are due in February whereas before you could just take it after the match and it wasn't a big deal. This may or may not continue, and could mean you would have to study hard for Step 2 regardless.

3. Is it likely that the average score will continue to rise in the coming 6 years such that this score will become a weakness of my residency application?

I feel this has been true for the last 6 years. When I took Step I in 2004 getting a 240 was a great score, and I only knew of two people who hit 250 in my class. This was pre-USMLE World. Now, there are a lot more very high board scores posted, and I suspect it is because of the better test prep materials. I used USMLE World for Step 2 myself last year and posted a very high score, it made test prep notably easier. Whether or not there will be a correction of scores or whether test prep materials have reached their maximal effectiveness is anyone's guess.

 

[dl2dp2]

While I think a bit of fire on your butt isn't such a bad idea, 229 is NOT a bad score by any means. I think a lot of these "top" programs care a great deal about lineage, i.e. if you went to a "top" MDPHD, and your advisor is well known, a 229 is not going to hurt you that much. You won't get "screened" out. Furthermore a good clinical eval is also important (if not more important.) In these "traditional" specialties, the MDPhD gives you a lot of street cred at the top programs--since they want to make their match list glitter with PhDs--and it's not like board scores are public information. Furthermore, they prefer future academics.

Even for relatively competitive specialties I think you have a good shot, as long as you are flexible about geography.

This is not gonna matter for 3 more years at least, so I think for now you should just relaxx and think about the PhD.

 

[StartingLine3]

I have asked this question in the past and below is the general consensus I have sort of compiled (advice from MD/PhD fellows, faculty and clinical department chairs)

I am a student in a top 20 MD,PhD program and received a very similar score that you received

- It is not a red flag, for those two specialties that is by no means a bad score

- If you are looking to go into a IM or Peds at a top institution, alot of these places are looking to train people that are looking to go into academics -
they will take people with lower board scores if that person better fits their mission

- Work hard 3rd year and do well on Step 2, by the time you are ready to
apply to residency your Step 1 score will probably be 5 or more years old

 

[Shifty B]

It's not so bad. I have been through the match and if your other credentials are good you should have no problem matching at a top 25 program. Of course, it would be better to have 250, but then again, it would be better to be rich too!

You'll be fine.

 

[BananaBoy]

Thanks for your responses. Helpful as always