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Step 1 scores for good IM Residency

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lyticstar

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Hi guys,

I'm finishing up year II at Wayne State in MI and getting ready for USMLE Step 1. I'm in the top half of my class and would like to get into a competitive IM residency so I can go on to Cards. I was wondering what score to shoot for. I saw that Mayo wants a 91.5... what do you think?
 
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orientedtoself

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the higher the better. 230+
however, step 1 is not what's going to get you into a competitive residency. third year clinical clerkship performance is much more important, particularly how you do in your im clerkship and sub-i's.
 

DOCTORSAIB

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the higher the better. 230+
however, step 1 is not what's going to get you into a competitive residency. third year clinical clerkship performance is much more important, particularly how you do in your im clerkship and sub-i's.

Really?

That's a first...
 

TheDuke2K

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the higher the better. 230+
however, step 1 is not what's going to get you into a competitive residency. third year clinical clerkship performance is much more important, particularly how you do in your im clerkship and sub-i's.

I think the only way PDs dont care about step1s as much is if you went to a big-time med school.

Otherwise, I think its a top 5 factor easily.

I agree that 230+ gets you in the door at most places, and if youre looking at the top 5 programs (and you didnt go to one of those places for med school) 240+
 

orientedtoself

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imo step 1/2 scores are more of a weed out factor- a low one could make you miss the cut for an interview, but a sky high score won't necessarily get you in. 230-240+ should get you past the usmle cutoff. however, i still believe clinical grades are the most important. who do you want working beside you- somebody who got 266 on their step 1 or somebody who consistently performed well on the wards?
 

PublicEnemy

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everything matters. what school you go to, your grades, your step 1 score, your research, publications, your letters... i don't think there's any real trick or formula, but overall the more good things you have going for you, the more choices you get.
 

SabinoCanyon

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imo step 1/2 scores are more of a weed out factor- a low one could make you miss the cut for an interview, but a sky high score won't necessarily get you in. 230-240+ should get you past the usmle cutoff. however, i still believe clinical grades are the most important. who do you want working beside you- somebody who got 266 on their step 1 or somebody who consistently performed well on the wards?

Sometimes excellent clinical grades must not correlate with how good someone is to work with, we have all seen obnoxious residents, some in pretty prestigious programs which you would assume require an honors even for an interview, therefore, I think everyone pushes really hard for honors in Medicine if they are going into IM, but I don't think that it correlates with how amiable a person is, a person who just "passed" honors might be more nice, maybe because they were humbled by the whole process.

Secondly, the job of a medical student is not the same as the job of a resident, i.e. responsibility and making management decisions come into play rather than "Where are the vitals" and "Who invented the IVC filter". . . And the motivation is different, i.e. someone who is working their [email protected] off to get an honors in a clerkship maybe would slide once they get their residency, whereas someone who cares about patients will go strong, if you are a "player" you can do very well on medicine clerkships by smoozing everyone without really knowing what you are doing, I have seen and been told this by medical students who do this.

Obviously there is some translation from good med student -> good resident -> good attending, but a lot of it gets lost in translation and sometimes a good med student -> average resident -> mediocre attending
 

orientedtoself

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i agree. the perfect applicant would have an all over fantastic application. however, i don't know about you, but i'm not perfect. it's worthwhile for the op to try and get the best step 1 score possible, however, imo step 1/2 scores are not as important as good evals during the clinical years. however, i'm not a program director. just a resident. my 2 cents. maybe we can send out the bat signal for aprogdirector?

everything matters. what school you go to, your grades, your step 1 score, your research, publications, your letters... i don't think there's any real trick or formula, but overall the more good things you have going for you, the more choices you get.
 

juicebox

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i agree. the perfect applicant would have an all over fantastic application. however, i don't know about you, but i'm not perfect. it's worthwhile for the op to try and get the best step 1 score possible, however, imo step 1/2 scores are not as important as good evals during the clinical years. however, i'm not a program director. just a resident. my 2 cents. maybe we can send out the bat signal for aprogdirector?

I couldn't agree more -- step 1 and 2 scores get your foot in the door but what I think really matters is your performance on the wards and what comes across in the letters. Ultimately program directors are interested in how well such and a such an applicant is going to do the job, and nothing speaks more than what your attendings/residents thought of your performance.
 

TheDuke2K

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I think Step 1 standardizes performance across the board which is why PDs seem to value it.

That said, doing well on wards, subI (which most medicine applicants tend to do) its hard to standardize that performance considering how variable everyones school's are.

I think both are important, but I do believe that there is way more subjectiveness in the latter which is why I think you do need to consider both.
 

NotAProgDirector

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I'm not sure that I have much more to add to this discussion. Different programs may be looking for different things.

Step scores are clearly important. I agree with the above that above some cutoff, it really doesn't matter how well you've done. That cutoff will differ between programs, but I agree that >240 prob doesn;t matter much anymore.

Third year clerkship grades are critical. Most important are Medicine, Surgery, and whatever field you are applying to.

LOR's are pretty useless. They all tell me that you're in the "top 5% of all students I've ever worked with." That gets old after awhile.

Research is nice, but probably only key for top research directed programs.

Extracurriculars and personal statement are nice, and are good fodder for your interview, but are not very important.

The less well known your medical school is, the more important USMLE's are. For IMG's and DO's, USMLE's (or perhaps COMLEX) scores become critical.
 

orientedtoself

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thanks for weighing in, aprogdirector. it's nice to have a program director on tap.
 
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Bito42

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On the other hand, what if i have very average step 1 score (220) but am from a great (top 3) med school, have good extracurriculars, and honors in medicine. Do you think my 220 still 'closes doors' at some top programs like columbia, Brigham, ucsf?
 

jiy76

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If your school has a weird grading system so thats its almost impossible to get honors but u have great evaluations (evaluation only count for like 35% of the clinical grade in this crap school)....does it make a difference? Lets say u get high pass in your im clerkship but your evaluations were honors but because of the grading system u only get a high pass how bad does it look?
 

velo

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imo step 1/2 scores are more of a weed out factor- a low one could make you miss the cut for an interview, but a sky high score won't necessarily get you in. 230-240+ should get you past the usmle cutoff. however, i still believe clinical grades are the most important. who do you want working beside you- somebody who got 266 on their step 1 or somebody who consistently performed well on the wards?

Yeah, this rings true with everything I've heard from PDs, faculty advisers, and with the little PD questionaire study they reference in the from of First Aid. Especially for IM (which as a field doesn't seem obsessed with the Step 1 score) the only thing you want to worry about is the possibility of not getting through some initial screening due to your Step 1 score. For most IM programs that bar is probably not really sky high, and for the very elite programs it would still be no higher than 230-240.

I agree with O2S that clinical grades are the most important part of the package. Not only do your 3rd year grades determine class rank and largely determine AOA (unless your school has Jr AOA I guess), the comments from faculty in your evals make up your Dean's Letter and your LOR writers reference your performance in their letters. Whatsmore, PDs cite 'grades and evals in specialty of choice' as the #1 most important factor in their ranking decisions.
 

velo

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On the other hand, what if i have very average step 1 score (220) but am from a great (top 3) med school, have good extracurriculars, and honors in medicine. Do you think my 220 still 'closes doors' at some top programs like columbia, Brigham, ucsf?

On a program to program basis it may, the problem with screening 'cut-offs' is that the rest of your application doesn't get much attention if you don't make it past the screen. But if I were you I would just study hard for Step II CK, take and release it early during your 4th year (So that the scores get released before they'd be reviewing your application), and do well enough on that to get past any screen. good luck!
 

orientedtoself

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unless you have burned bridges, i think most programs take their own for im. your best bet may be to stay at your home program for residency.


On the other hand, what if i have very average step 1 score (220) but am from a great (top 3) med school, have good extracurriculars, and honors in medicine. Do you think my 220 still 'closes doors' at some top programs like columbia, Brigham, ucsf?
 

Seed

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I'm not sure that I have much more to add to this discussion. Different programs may be looking for different things.

Step scores are clearly important. I agree with the above that above some cutoff, it really doesn't matter how well you've done. That cutoff will differ between programs, but I agree that >240 prob doesn;t matter much anymore.

Third year clerkship grades are critical. Most important are Medicine, Surgery, and whatever field you are applying to.

LOR's are pretty useless. They all tell me that you're in the "top 5% of all students I've ever worked with." That gets old after awhile.

Research is nice, but probably only key for top research directed programs.

Extracurriculars and personal statement are nice, and are good fodder for your interview, but are not very important.

The less well known your medical school is, the more important USMLE's are. For IMG's and DO's, USMLE's (or perhaps COMLEX) scores become critical.


I know I'm straying slightly from the topic of discussion but since it's related I'd appreciate some help from aProgDirector....
I'm a foreign med student, I recently did a sub i rotation which I honored while I was a visiting student at a reasonably good med school in the US. How important do you think this grade and the attending's letter of recommendation will be when I apply, given that I'll be an IMG?
 

Freakingout

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What about a student right in the middle of their class at a top 40 school with almost no honors and a 250+ step1. Do they have a chance at the top residency programs?
 

dadr

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What about a student right in the middle of their class at a top 40 school with almost no honors and a 250+ step1. Do they have a chance at the top residency programs?

Repeating what was said before, a high Step 1 will probably merely prevent you from being eliminated by the ERAS screening tool. Programs who get 2000 applicants will have to set some parameters to winnow the list down for manual evaluation. However, for top programs I don't think this cutoff would be more than 230-235.

In that sense, Step 1 score can make or break your chances of getting an interview at a Top 10. After that, it probably matters not, although a > 250 may turn some heads.

To specifically address your question, I was a middle of the class student at a #30-40 med school with a few honors, but not in medicine or sub-I, and had mid-230s Step 1/2. I got interviews at basically all but Top 5 programs. I think my Step scores had nothing to do with it. What you need are honors in medicine and sub-I, and often AOA, to make the cut at Top 5 programs.
 

muscles

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I agree with the above post with one exception: I think the step I score being above 230 has a lot to do with getting interviews at strong programs; many programs use step I scores as screening tools; just because you are above 230 doesn't guarantee you an interview, but a score above 230 means you are AT LEAST considered for one, whereas a score<230 means you are not, barring an exception...
 

johnnywalker

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I remember hearing Northwestern used 240 as their cutoff...
 
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NotAProgDirector

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I know I'm straying slightly from the topic of discussion but since it's related I'd appreciate some help from aProgDirector....
I'm a foreign med student, I recently did a sub i rotation which I honored while I was a visiting student at a reasonably good med school in the US. How important do you think this grade and the attending's letter of recommendation will be when I apply, given that I'll be an IMG?

That letter and your USMLE scores will be the most important parts of your application.
 

orientedtoself

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aprogdirector, in your experience, have high step scores correlated with good residents? it seems like a high score on a test identifies people who do well on tests. there is so much more to medicine than just being able to pick the right answer out of a-e.
 

muscles

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I certainly agree with the above post; what really bothers me is how they say people who do the best on the MCAT make the best doctors...
 

NotAGunner

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Hi, I just want to say that I matched into a "top 10" program for medicine next year and did not score above 230 on Step 1. For everyone about to apply, I would just encourage you not to take what you read on here too seriously. It doesn't hurt you to apply everywhere, and since it's medicine, you're much more likely to get some really good interviews.
 

koma

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I agree with the above post with one exception: I think the step I score being above 230 has a lot to do with getting interviews at strong programs; many programs use step I scores as screening tools; just because you are above 230 doesn't guarantee you an interview, but a score above 230 means you are AT LEAST considered for one, whereas a score<230 means you are not, barring an exception...

I think step 2 is pretty important and can compensate for average to low step1, at least from my experience.
 

lemonade02

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This is my opinion after going through it this year and talking to other classmates. I agree, Step 1 is extremely important but a distinction needs to be made for top 10 and the rest. This obviously doesn't apply to FMGs, caribs, or MD/PHDS. And also doesn't necessarily apply to people who did an away rotation. people with connections, or some very distinguishing life experience.

To make it into the truly elite residencies: AOA>med school reputation>clinical grades>overall rank>step 1>research>step 2>letters

To make it into good but not elite: AOA>med school reputation>step 1>clinical grades>overall grades>step 2>letters>research
 

NotAProgDirector

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aprogdirector, in your experience, have high step scores correlated with good residents? it seems like a high score on a test identifies people who do well on tests. there is so much more to medicine than just being able to pick the right answer out of a-e.

Not exactly. Residents with high test scores tend to be my better residents, but it's not perfect and I've had some with lower scores end up being superstars.

The question to which this quote is from was asking for an IMG -- in that case, USMLE scores are vital since the MSPE is often useless.
 

dragonfly99

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I doubt that even the top IM residencies like UCSF and Harvard use 240+ as the cutoff for looking at people to interview. They might do that for IMG/FMG's, or something. I think 230 or 235 would probably be the lowest they'd set the filter...probably 230. And if you don't make it but have a great application in other ways, they are probably ways to get around the filter (i.e. full professor at your school emails or calls someone at that school and requests they review your file).
 
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Wendy26

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It seems like step 1 scores/cut offs are going up- anyone have any more recent ideas about this topic? For example, will a 239 get you cut from UCSF, etc these days?
 

sooku

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That letter and your USMLE scores will be the most important parts of your application.

I have 216 in step1 and 235 in step2, lower half class rank, US allo senior. and I'm wondering if I will get past the top tier IM programs' automatic cutoffs? Also, does step2 score compensate for step1 in any way? Thanks!
 

Instatewaiter

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First of all- what's the deal with dragging up old threads?

It seems like step 1 scores/cut offs are going up- anyone have any more recent ideas about this topic? For example, will a 239 get you cut from UCSF, etc these days?

Probably not. You should get past the initial screen if everything else on the app is similar to that 239.

I have 216 in step1 and 235 in step2, lower half class rank, US allo senior. and I'm wondering if I will get past the top tier IM programs' automatic cutoffs? Also, does step2 score compensate for step1 in any way? Thanks!

Are you trolling?

10 points below the average step 1 score for medicine and lower half of the class- will you make it for an interview in the top tier? Not to be mean but I seriously doubt it. Your step 2 will help but it is only just above average. You're gonna match but probably not to the top tier. The top tier of medicine is just as competitive as the most competitive specialties.
 

fuzzywuz

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I have 216 in step1 and 235 in step2, lower half class rank, US allo senior. and I'm wondering if I will get past the top tier IM programs' automatic cutoffs? Also, does step2 score compensate for step1 in any way? Thanks!

Okay I'm in a similar situation (same step 1 score), but I'm a third year. I'm definitely being realistic with myself and not going for the top tier programs. What are the odds of getting into a mid- to low- tier program in the NY?
 

francisco84

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Okay I'm in a similar situation (same step 1 score), but I'm a third year. I'm definitely being realistic with myself and not going for the top tier programs. What are the odds of getting into a mid- to low- tier program in the NY?

US Allo grad? If yes, then VERY good... but you could probably get a better program outside of the city
 

dd128

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I have 216 in step1 and 235 in step2, lower half class rank, US allo senior. and I'm wondering if I will get past the top tier IM programs' automatic cutoffs? Also, does step2 score compensate for step1 in any way? Thanks!

I'm just curious as to what schools are defined as top tier? Doesn't this vary somewhat? I'm aware that mass gen, colombia, beth israel, etc. just to name a few, but how do most people define top tier?
 

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From what I've heard, step scores are important. Without them how do you differentiate among applicants on paper? Supposedly IM is becoming more competitive too, so step scores may matter more for mid-tier places too. Mine was enough to get interviews, we'll see how those go soon!
 

Instatewaiter

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I'm just curious as to what schools are defined as top tier? Doesn't this vary somewhat? I'm aware that mass gen, colombia, beth israel, etc. just to name a few, but how do most people define top tier?

Depends on who you ask and how deep you consider the top tier. Here's the top 8 (arguable of course)

Top 8:
JHH
MGH
B&W
UCSF
Columbia
Duke
Penn
Michigan

Here's a good thread that talks about the top 30 or so
http://forums.studentdoctor.net/showthread.php?t=751250
 

jdh71

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Depends on who you ask and how deep you consider the top tier. Here's the top 8 (arguable of course)

Top 8:
JHH
MGH
B&W
UCSF
Columbia
Duke
Penn
Michigan

Here's a good thread that talks about the top 30 or so
http://forums.studentdoctor.net/showthread.php?t=751250

I'd quibble about michigan, but not much. Everything above Michigan on that list almost everyone posting in here would agree are the top 7 programs.

I'd also say that the order of the above list is also arguable, but those 7 programs are always in the top 7 when we talk about this stuff.
 

gold&black2005

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I'd quibble about michigan, but not much. Everything above Michigan on that list almost everyone posting in here would agree are the top 7 programs.

I'd also say that the order of the above list is also arguable, but those 7 programs are always in the top 7 when we talk about this stuff.

Agree c jdh whole-heartedly. As for instatewaiter...no bias to that order, eh? jokes, jokes ;)
 
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