Just got my score back and it's terrible 221.. I was in shock when I saw this. I know that it's not far below average but it pretty much just destroyed all of my hopes and dreams. This is way below my average on nbme. my lowest score was 245 and just the week before I scored a 262. I studied way more than average 3 full months pretty much doing all 3 questions banks twice each, first aid, everything. I am also between high pass and honors in all of my courses. The reason I am so upset is because I have my heart set on surgery since day one. I don't know what to do at this point. Is it even worth rescoring. I really felt fairly confident leaving the testing center. No idea how I could have done so poorly but this is a huge blow to my future.
Step 1 has me saying wtf!
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From what I can tell most schools dont even look at step 2(and with the amount of studying I did for step 1 it was something I can not repeat physically. it was my best). I had my heart set on surgery and I don't see any hope for that. Even gen surg average step 1 is over 230... I was ultimately hoping to do ortho or plastics but now I don't know what I'm going to do. I have so much experience shadowing surgeons, interest groups, research... but all of that is just wasted now.
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AFAIK this somewhat depends on the field. Some expect step 2 of pretty much all applicants, others don't really care either way. Regardless, it will be a chance for you to settle some of those questions if you kill step 2.
Also, the match rate in general surgery for US med school grad applicants (are you USMD or IMG?) with Step 1 between 221-230 was 85% per Charting Outcomes 2014. Not exactly hopeless.
Thanks that is reassuring. I am still unfortunately completely hopeless for ortho or plastics. Even with Gen surg I will probably be looking at a low tier at best. The other issue is that I've gotten this far via test scores. I'm not one to schmoooze and really stand out so I probably wont be doing fantastic in 3rd year considering it is based on ability to achieve high ratings from attending physicians. Its just not looking good for me.
The only people who spend their time smelling trolls are trolls . . .
I understand that you probably mean well by this post, but I just wanted to point out that it comes off as dismissive. People have different expectations and different goals. They are not required to calibrate their emotions against your standards.
To the OP:
I can see that you're frustrated by your score, and that feeling is totally valid. I would probably feel the same way if I were in your situation. If you were planning on one of the more competitive surgical subspecialties, I can only imagine how much it would suck to feel like your future has been in some way decided based on one exam. This system is not perfect and there are bound to be hard-working, bright medical students who by chance or circumstance post scores that are not reflective of their dedication and aptitude. All I can say about this is that I'm genuinely sorry that you are one of them.
Lamenting the change in your situation is completely understandable, but I just want to caution you about letting your score on this test define you. You are not less of a person and you are no less bright, motivated or proficient than you were the moment before you took that test. It might change your expectations, but it should not change the way you think of yourself.
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In 2014, just under 1100 US seniors matched into surgical fields or fields with a significant number of surgical procedures.
Gen Surg: 374, Neuro surg: 29, OB/Gyn: 536, Derm: 34, Ortho: 72, ENT: 20, Plastics: 20, Vascular: 10
An average matching score is an average matching score because around half of the people scored below it.
I'm sure it's disappointing, but you can either keep crying about it, or you can work your a$$ off and be one of those 1100.
(Not trying to sound harsh, just being realistic. How bad do you want it?)
Gen Surg: 374, Neuro surg: 29, OB/Gyn: 536, Derm: 34, Ortho: 72, ENT: 20, Plastics: 20, Vascular: 10
An average matching score is an average matching score because around half of the people scored below it.
I'm sure it's disappointing, but you can either keep crying about it, or you can work your a$$ off and be one of those 1100.
(Not trying to sound harsh, just being realistic. How bad do you want it?)
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I don't know about the various routes for ortho, but if your goal really is plastics I believe you can do a transfer from gen surg to plastics. It might be a 5+2 (albeit longer) but you still have a chance. You'll be fine for gen surg, but if you have the choice, I'd rank programs higher that may have a plastics program. It might increase your chances of getting in if you bust your balls at your gen surg. residency. Just food for thought.
Just curious, because you threw out numbers like 245 and 262 on NBMEs, were you doing these under real testing conditions (e.g. adhering to the timer and not pausing your way through them)? Are you talking just NBMEs or UWSAs as well? Did something happen on test day, like did you freak out or get sick? I ask because in order to hit a 262 on an NBME, you pretty much have to be on point for each block (the typical conversion would have a 262 at about a 93-94% raw score...not really room for any mistakes here)? The thought of underperforming by 40 points is frightening when I'm waiting another month for my score to get back. Reassure me by telling me something tragic happened.
Yes I always used strict testing conditions on NBMEs (timed with 45 minutes of break time throughout) on average I may have missed between 3-6 questions per section at most. On the test day I felt fairly confident as I did while taking the practice NBME(even more confident because of higher energy levels and lots of sleep beforehand). There were only a few questions I wasn't sure about. At the end of the exam I had totaled up 32 questions that I had to take an educated guess on which I should have about 25-50% chance of getting correct. The rest I was fairly certain I had gotten correct. Time was not an issue. I always finished with about 5 mins left per section to go back to the questions I wasn't uncertain of.
I really have no idea how I could have been scored so low unless the questions I missed just happened to be the ones that were worth a greater percentage of my score. I'm not sure ,but I would expect that a 220 is somewhere around 75-80% correct which would mean I missed about 80 questions and that is just absurd. thats almost 12 questions wrong per section. Even on my first day of studying UWORLD i never missed that many questions per section not even close....
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I feel for you man, I'd be pissed if that happened especially if I were that confident after the test. Something sounds really off is there any way they could have messed up grading? I've taken like 10 nbmes and even when I felt like I guessed on half of them I somehow still end up within 5 points from my average. Can't imagine being that far off.
It's pretty ridiculous the most important test in your life you only get one shot at. Random migraine or something during the test = screwed for life.
It's pretty ridiculous the most important test in your life you only get one shot at. Random migraine or something during the test = screwed for life.
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Here's the deal. Even with a 221 you WILL match into General surgery especially if you get honors and high passes during 3rd year. According to 2014 match outcomes your chances of getting into General surgery are > 80 %
Things that you will most likely not match to (but not impossible) are Plastic surgery, ENT, Dermatology, Orthopedic Surgery, Neurosurgery, Rad/Onc, Opthamology (maybe?), Urology stuff like that.
Just take USMLE step 2 and kill it. General surgery (almost everybody honestly) really care about 3rd year grades so make sure to try your very best to get honors.
In terms of regrading most likely you'll have a 0.0000000000001 % chance of having that score changed and even if it is changed I would put a hundred pennies saying it would be +/- 1 point if even that.
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Lol yeah, I mean, it's so different than being an actual doctor, because you always get multiple chances to diagnose & treat each patient, and a mistake for whatever reason will never screw up his/her life.
Since you seem so intolerant of anything less than total perfection (after all, like you say—look at the consequences of mistakes in our profession), I suppose you are also supportive of high malpractice costs and lawyers constantly trying to recruit patients to file lawsuits on the chance a doctor did something wrong?
It is truly perverse to praise one instance of unfairness for its striking resemblance to other unfairness. Not only is that an uninteresting commentary (Look how similar unfair things are to one another!), but it also represents a position of moral nihilism that is indefensible. Do you not value fairness as a principle?
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You're ranting about something completely pointless. Stop writing a Shakespearian play on SDN trynna impress others.
CALM DOWN.
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It didn't.
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I've read this about 8 times, and I still don't understand what you meant or how you interpreted my post to provoke this response. Who said anything about intolerance of imperfection or praising unfairness? I was making a comparison to say "hey, that's just the way it is in this profession." It doesn't matter if it's fair or unfair. But now that you mention it, step 1 is probably the fairest part of medical school. Everybody gets one shot. That's more than you can say about getting into medical school. The bottom line is you can decide to make the best of it moving forward, figure out what you need to do to get into your dream fields and/or start exploring other fields. Or, you can decide to whine about it & be miserable.
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Just ignore his/her message. When I read it I was like wtf none of this BS makes any sense and it's definitely not worth any bodies time.
My point was that you were basically condoning the fairly messed up fact that people's lives are to a substantial extent determined by their performance on a single day of testing. Whether this is the best way of doing it or not is a different question, but your attitude seems to be "the rest of medicine is messed up and contingent too, so what's the point of complaining about how Step is problematic?" I just don't think that attitude makes sense. That's like saying "why should we complain about X person who got wrongfully convicted of a crime if there's still a ton of other injustice in the world?"
Also, regarding fairness—people have different ways of thinking about this. We could just decide residency by randomly assigning people to residencies and specialties. If your definition of fairness is that everyone has one equal shot, then that would be just as fair if not more. That's not all there is to fairness. Things that give people an equal chance but are to some extent contingent or arbitrary are not necessarily fair.
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I don't agree with this. That just sounds like the typical SDN fear mongering. It can prevent you from passing initial screening for a select few fields. Other than that, it's just a part of the equation. Overall, I guess I just believe in making your own opportunities. If you want to go into x field, you find out the requirements for it & you fill them to give yourself the opportunity. If you can't, then you move on to something else.
Quite literally, in medicine or not, very few people can be who they most desire to be. That's just life. I don't understand complaints about how it should be different. If you wanted to, you could complain about everything every day forever. Lots of people already do, especially now that social media allows them to do it passive aggressively whenever they want. What's the point? Where does it get you? Control what you can control, make opportunities for yourself & move on to the next one when something doesn't go your way.
I would really like to know how my test was scored... I think its pretty lame to come this far and have all of my dreams crushed by 1 exam where I have no idea how well I even performed other than an arbitrary score. I'd like to know how many questions were incorrect and how they calculated such an abysmal score from it.. Honestly I don't see how others can accept this practice. Seriously a private company getting to pick and choose who gets to become doctors with zero transparency is just insane in the 21st century.
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Assuming this isn't a troll job, I would probably go ahead and request a rescore and perhaps write a letter specifically asking them to look for any irregularities such as an entire section unscored or anything else out of the ordinary. If you were on track to score >260 and then an entire section's answers weren't transmitted, then that could easily drop you to 221. It's a very long shot, but probably worth it to have some semblance of closure.
OP was interested in surgery. It seemed like he was disappointed because he was interested in some subspecialties that are very competitive. I am not fear-mongering. For people like the one we are talking about, that mistake does significantly change the equation. This thread is talking about someone who was interested in surgery. There are several surgical subspecialties for which step 1 is damn near "make-or-break."
The reason why it's unfortunate that this is the way medicine works is that in most other fields, even if there is a high barrier to entry, you will not get bottlenecked into a career that is substantially different than the one you intended to enter. To make it more clear, I'll use this example: I want to be a psychiatrist. I have for a very long time and it was the reason I went to medical school. Imagine a world where psych was one of the most competitive fields. People who were in love with psychiatry and passionate about it might well choose something other than medical school if they couldn't see themselves being happy as a medicine doc. By the time you get to the point that you're bottlenecked, you have too much invested for it to really be feasible to go do something else you might be almost as passionate about. The broader implications of this type of system are that med school will attract fewer people with focused passions and more people with passing interests who would be okay with any specialty. I think it's hard to deny that there's social utility in having people with focused passions in the fields they're passionate about, but whatever.
Besides complaining about unfairness being a necessary part of exposing aspects of a system that might need to change, it also serves a function even if nothing does change. At least by recognizing that a situation is not completely fair (even if it may be the best system we have) we do not allow ourselves to just normalize these types of situations. If we lived in a situation where it was inevitable that everyone would develop a cancer and we all had the same level of care (the same "shot" at life, if you will), s0me people would live and some people would die but at least they'd die in the fairest way possible. Just because this situation is inevitable and it's "the best we can do given the circumstances" doesn't make the situation okay. It's still tragic, unfortunate, and worthy of lament.
For various reasons, I think it's important for people to realize this instead of just getting trapped in the learned helplessness of "oh, well this situation sucks but there's no way around it so I have no right to be upset." I think that's a long-term recipe for emotional disaster.
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I agree with a lot of what you're saying, and yes, it's unfortunate & important to recognize that it is, but recognizing it & dwelling on it or blaming it for personal mistakes/faults are completely different. There's never been a guarantee for anyone going into medical school that he/she can go into any field desired, which is unfortunate for some. But IMO, these are fundamental aspects of this process that everyone knows or has the resources to find out. Likewise, we all know or have the resources to know what we need to accomplish to put give ourselves the best chance to get a position in our desired fields. What we do with that is up to us. I guess I just don't think getting into medical school should entitle you to eventually go into whichever specialty you choose, no matter how much interest you have in it.
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If your NBMEs were consistently in the 250+ range and you're this confident about your test-day performance, I would go ahead and request a re-score as it seems statistically plausible that your score is inaccurate. It's not as much of a longshot as you might think.
Let us know how it works out.
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Yeah I don't think you have anything to lose by requesting a rescore.
Waste of money they just emailed the same stock letter as an attachment that says there were no facility issues that day. I could just post the letter here so that no one has to bother ever paying to see it. They will not review the actual test nor will they disclose any information about how they actually arrived at the score. For all I know they could just be arbitrarily giving out scores. The score is only representative of how they feel you would perform across many different assessments with an SE of 6 points.. thus meaning you could have scored much better however their software has interpreted the exam is in the 95% range of your test tries and generates a score for you that is based on the standard deviation in the 65% range instead or even lower who knows..