Step 1 score as "the single most important factor" for residency programs...with 2016 Match data

Sep 9, 2013
38
8
Puerto Rico
Status
Medical Student
Hello, forums. I am Bryan, a 4th year medical student at the University of Puerto Rico (UPR) applying to Internal Medicine residencies. I would like to entertain the saying, "the Step 1 score is the single most important factor for residency programs deciding who to invite to interview."

For example, an IM residency program receives an application with the following test scores (compare with 2016 matching outcomes):
Step 1: 205
(Matched, all specialties 233. Matched, IM 233. Unmatched, IM 210.)
Step 2: 239
(Matched, all specialties 245. Matched, IM 246. Unmatched, IM 225.)
These are my scores.

I would like to hear about your knowledge and experiences, if any, with regard to residency programs and their evaluation of candidates based on their Step scores. I am particularly interested in the ways a program might evaluate the combination of "low Step 1, decent Step 2"—or vice versa, "decent Step 1, low Step 2." For the sake of discussion, let's imagine the Step scores meet "target score" cutoffs and are not screened out. I have more experiences and Match outcomes data to share with those who are interested.
 

bashwell

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Mar 20, 2013
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Hello, forums. I am Bryan, a 4th year medical student at the University of Puerto Rico (UPR) applying to Internal Medicine residencies. I would like to entertain the saying, "the Step 1 score is the single most important factor for residency programs deciding who to invite to interview."

For example, an IM residency program receives an application with the following test scores (compare with 2016 matching outcomes):
Step 1: 205
(Matched, all specialties 233. Matched, IM 233. Unmatched, IM 210.)
Step 2: 239
(Matched, all specialties 245. Matched, IM 246. Unmatched, IM 225.)
These are my scores.

I would like to hear about your knowledge and experiences, if any, with regard to residency programs and their evaluation of candidates based on their Step scores. I am particularly interested in the ways a program might evaluate the combination of "low Step 1, decent Step 2"—or vice versa, "decent Step 1, low Step 2." For the sake of discussion, let's imagine the Step scores meet "target score" cutoffs and are not screened out. I have more experiences and Match outcomes data to share with those who are interested.
Is this a purely academic discussion about how IM programs screen, interview, and match potential residents that you're "entertaining," or are you actually wondering about your own chances matching into an IM residency because you had a low Step 1 but improved a lot on Step 2? If the former, every program is different. If the latter, there's a WAMC thread in the IM forum. By the way, you have a great name!
 
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Boricua27
Sep 9, 2013
38
8
Puerto Rico
Status
Medical Student
Is this a purely academic discussion about how IM programs screen, interview, and match potential residents that you're "entertaining," or are you actually wondering about your own chances matching into an IM residency because you had a low Step 1 but improved a lot on Step 2? If the former, every program is different. If the latter, there's a WAMC thread in the IM forum. By the way, you have a great name!
Hey Bryan thanks for writing. I'd like to know more about how programs think when they see a low step 1 score. If the "step 1 is the most important thing for getting interviews," do programs basically put aside these applications, do they actively look for other strong points...? What is the effect of a decent step 2 score considering a low step 1 score, and does anyone have experiences they can share? We can use my step scores as an example. Thanks for linking me to the other thread, it looks good.
 
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Lexdiamondz

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Dec 16, 2011
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The simplest answer is that it depends.

Your USMLE scores are the "most important" part of your application because it's the least subjective part - every MD student in the country applying for residency takes this exam, and there's a standard body of knowledge you're expected to master.

With that said, how your board scores are viewed will always be in context of the rest of your application, and how you fit in with the program's goals. If you're an MD-PhD from a top 20 school and you're applying for research-track IM, your Step 1 score is gonna matter alot less compared to your research and letters. If you're a USMD applying to community IM programs in unpopular regions like suburban south, rural midwest, etc then your Step 1 score isn't gonna matter so much so long as you pass a certain threshold. On the other hand, if you're a mid or low tier MD grad gunning for a spot at Hopkins or Penn IM, your step score is your foot in the door above everything else. So it all depends.

FWIW, almost everyone who applied IM and passed Step 1 on the first try matched. So as long as you apply broadly you will match somewhere. The question is where.
 
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Boricua27
Sep 9, 2013
38
8
Puerto Rico
Status
Medical Student
The simplest answer is that it depends.

Your USMLE scores are the "most important" part of your application because it's the least subjective part - every MD student in the country applying for residency takes this exam, and there's a standard body of knowledge you're expected to master.

With that said, how your board scores are viewed will always be in context of the rest of your application, and how you fit in with the program's goals. If you're an MD-PhD from a top 20 school and you're applying for research-track IM, your Step 1 score is gonna matter alot less compared to your research and letters. If you're a USMD applying to community IM programs in unpopular regions like suburban south, rural midwest, etc then your Step 1 score isn't gonna matter so much so long as you pass a certain threshold. On the other hand, if you're a mid or low tier MD grad gunning for a spot at Hopkins or Penn IM, your step score is your foot in the door above everything else. So it all depends.

FWIW, almost everyone who applied IM and passed Step 1 on the first try matched. So as long as you apply broadly you will match somewhere. The question is where.
Thanks for sharing, Lex. What do you think about a 205 step 1 and a 239 step 2, in particular? To what extent would you "overlook" the step 1 score?
 

iceman55

7+ Year Member
May 9, 2010
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Hello, forums. I am Bryan, a 4th year medical student at the University of Puerto Rico (UPR) applying to Internal Medicine residencies. I would like to entertain the saying, "the Step 1 score is the single most important factor for residency programs deciding who to invite to interview."

For example, an IM residency program receives an application with the following test scores (compare with 2016 matching outcomes):
Step 1: 205
(Matched, all specialties 233. Matched, IM 233. Unmatched, IM 210.)
Step 2: 239
(Matched, all specialties 245. Matched, IM 246. Unmatched, IM 225.)
These are my scores.

I would like to hear about your knowledge and experiences, if any, with regard to residency programs and their evaluation of candidates based on their Step scores. I am particularly interested in the ways a program might evaluate the combination of "low Step 1, decent Step 2"—or vice versa, "decent Step 1, low Step 2." For the sake of discussion, let's imagine the Step scores meet "target score" cutoffs and are not screened out. I have more experiences and Match outcomes data to share with those who are interested.
I would say you can assume that programs that give you an interview have "overlooked" your step 1 score.

However you step one score will keep you from getting a decent amount of interviews .

If you had above 220 on step 1 i would say you were in great shape. Or even above 215.

Nonetheless, since you say you go to in PR I'm assuming you are hispanic, which may help you at programs that are looking for diversity, as you would be considered underrepresented. However, this would only come into play if you are already qualified.



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bashwell

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Mar 20, 2013
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Hey Bryan thanks for writing. I'd like to know more about how programs think when they see a low step 1 score. If the "step 1 is the most important thing for getting interviews," do programs basically put aside these applications, do they actively look for other strong points...? What is the effect of a decent step 2 score considering a low step 1 score, and does anyone have experiences they can share? We can use my step scores as an example. Thanks for linking me to the other thread, it looks good.
Hey Bryan! :) I think others already answered your question. But just to reiterate, as far as I understand, it varies from program to program. Some programs might apply a filter on Step 1, and for example if their filter is 230, then you'll be screened out, and won't get a chance to go further. However, other programs might not do this. That's a very broad and general rule but that's sort of how it works, I guess. If you ask on the WAMC thread, there are PDs and other attendings who have sat on admissions committees who could probably tell you much more.
 
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Boricua27
Sep 9, 2013
38
8
Puerto Rico
Status
Medical Student
Hey Bryan! :) I think others already answered your question. But just to reiterate, as far as I understand, it varies from program to program. Some programs might apply a filter on Step 1, and for example if their filter is 230, then you'll be screened out, and won't get a chance to go further. However, other programs might not do this. That's a very broad and general rule but that's sort of how it works, I guess. If you ask on the WAMC thread, there are PDs and other attendings who have sat on admissions committees who could probably tell you much more.
You've convinced me to participate in the WAMC thread. Happy? haha Thanks for the info.
 
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