step 1 scores for top IM programs:

[Biffer]

chances at great "great programs?"

thanks

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[dream2008]

low

 

[Int Med 2008]

240 with AOA and honors in every clerkship 3rd year should get you interviews at Hopkins, Penn, Duke and maybe MGH. Most lilkely not the Brigham or UCSF. Without AOA and mostly honors your 3rd year unlikely for any of the above mentioned programs.

 

[ocean11]

I have your exact stats! but am AOA (Senior) and have pretty much all honors in third year. Got interviews at some big names like MGH, BID, Cornell, U of Chicago etc... but not at BWH, Hopkins. I think though that the reason for this was due to four factors: personal statement (and interest in primary care) as well as NOT doing electives there, not having alot of research/publications and finally not being a US citizen.

That being said, still got 29 interview invites, went to 18, many were very prestigious.... it can be done!

good luck

 

[souljah1]

Your board score is definitely high enough. Board scores help more then hurt. What is more important is honors, AOA or not, who's writing your letters and what they say, and where you go to school. A board score of 240 definitely won't hurt you as most programs have cut offs that help to create a composite score

 

[CJamblooze]

At many of the top places, I believe they have either a cut off for a certain board score, which I can't imagine is higher than 235 at the absolute highest, probably 230 or so (but this is just a guess).

For the most part, as I am sure is echoed multple times in these postings, the application process is multifactorial. Certainly included in this is the reputation of the school, thus coming from Harvard or Yale Medical School, you may not have to be as impressive as someone from a different school (although this is a smaller factor).

Objectively (ish), you 3rd year grades and letters of recommendations are going to be a huge factor. Otherwise, it is how you envision your career in medicine and what you have done thus far to show that you are commited to developing that vision. If a program feels that they would be a good fit in helping you realize your vision, they will most likely interview/rank you.

My recommendation is to start thinking about what it is you think you'd like to be doing in 10 years. It does not have to be that specific (althought it certainly can be with the caveat that it is guaranteed to change). But have an idea of what kind of career you would like to have and how you think you can get there.

If you are thinking you'd like to do EP and make a ton of cash because you think that would make you happy, you don't necessarily need to spend your time or anyone else's in a high-powered academic center in which the culture is largely of those interested in some combination of teaching, research, and clinical medicine.

The beautiful thing is that you will end up exactly where you are supposed to be. Good luck!

240 from unranked private school, chances at great "great programs?"

thanks

 

[CJamblooze]

My Step 1 was below 240 and I was not AOA and I got interviews at Brigham, MGH, Hopkins, and Penn. Not Duke.

I am now at MGH.

There is no exact science to this, my friends. It is an important lesson to learn in medicine in general.

240 with AOA and honors in every clerkship 3rd year should get you interviews at Hopkins, Penn, Duke and maybe MGH. Most lilkely not the Brigham or UCSF. Without AOA and mostly honors your 3rd year unlikely for any of the above mentioned programs.

 

[dream2008]

My Step 1 was below 240 and I was not AOA and I got interviews at Brigham, MGH, Hopkins, and Penn. Not Duke.

I am now at MGH.

There is no exact science to this, my friends. It is an important lesson to learn in medicine in general.

there is definitely something else about you that make you attractive, research/school reputation/away rotation etc...

 

[lemonade02]

yeah the single biggest factor in determining where you get interviews is medical school reputation. undeniably the biggest factor.

 

[Raisins]

yeah the single biggest factor in determining where you get interviews is medical school reputation. undeniably the biggest factor.

From what I have heard, it seems like school rep is most important in the field of internal medicine. Would you agree with this?

 

[jdh71]

From what I have heard, it seems like school rep is most important in the field of internal medicine. Would you agree with this?

That's what he said. Do you agree with this?

 

[Rasengan]

yeah the single biggest factor in determining where you get interviews is medical school reputation. undeniably the biggest factor.

Bingo. Internal medicine is notoriously elitist, especially in the northeast, and prefer what otherwise would be inferior applicants from top-name schools over likely better applicants from lesser-named institutions. Its quite sad really.

 

[Raisins]

That's what he said. Do you agree with this?

Allright, allright. What I meant is that in terms of different fields (IM vs. Surgery vs. lots of other stuff) that school reputation carries the most weight in the field of IM. (Not talking about factors within IM)

 

[Mental Gymnast]

Lemonade,

Do you have any evidence whatsoever to support any claims regarding this incredible significance of med school repution? Is this your own personal experience that you want to generalize across thousands of med students? So the standardized 8 hour USMLE exam administered all across the world, and your consistent performance clinically in medical school are universally less significant than the school you went to? I would be very careful making swamping generalizations and statements like "undeniably the biggest factor" in these posts. I am sure your school name plays some significance in terms of reputation, networking, impression of previous residents who came from your school, research at your institution, etc.... but to make claims like it is "undeniably the biggest factor" is unsupported and hasty. This study on thousands of med students and program directors showed that statistically med students tend to undervalue USMLE score, clinical honors, class rank, and AOA.

http://www.med-ed-online.org/pdf/res00138.pdf

 

[lemonade02]

i'm sorry, i should have prefaced my comments with 'in my opinion...'

i obviously don't have a pdf document to support my point (i really don't like evidence based-medicine anyway). of course this is based on personal experience. and based on the people that seem to agree with this as well as the fact that someone posts every year on the relative unimportance of step 1 for IM.

unless you're AOA, from a middle tier medical school without any freakish research experience or life experience, you're not going to break into the elite programs (JHU, MGH, Penn, BWH, UCSF, etc.) i'd bet that a person from a top 5 medical school with a 225/middle class ranking has a better shot at an elite program than a 250/non-aoa from an unranked medical school. if you haven't gone through the app process, you'll see for yourself next year.

 

[cardsboy08]

Lemonade,

Do you have any evidence whatsoever to support any claims regarding this incredible significance of med school repution? Is this your own personal experience that you want to generalize across thousands of med students? So the standardized 8 hour USMLE exam administered all across the world, and your consistent performance clinically in medical school are universally less significant than the school you went to? I would be very careful making swamping generalizations and statements like "undeniably the biggest factor" in these posts. I am sure your school name plays some significance in terms of reputation, networking, impression of previous residents who came from your school, research at your institution, etc.... but to make claims like it is "undeniably the biggest factor" is unsupported and hasty. This study on thousands of med students and program directors showed that statistically med students tend to undervalue USMLE score, clinical honors, class rank, and AOA.

http://www.med-ed-online.org/pdf/res00138.pdf

I think the limitations of this study are clear. When we talk about the "importance of where you went," this most often applies to the more competitive programs, not to the majority of programs. Most people don't deny that the top 5 students at an average state med school are just as good as (and will often get equally competitive interviews to) the top 5 in a top 10 med school. However, not all students who end up at "top" residency programs are AOA with honors across the board and USMLE scores >230-240. The problem is when a residency program is faced with 2 students, not at the "top" of their class, both receiving scattered honors, high passes, etc., and one has a 220-230 on their Step 1 and the other has a 200-210, how do they make their decision. Say the person at the state school has, on average, higher scores and maybe has done a bit more as far as extracurriculars than the person at the top 10 school in this situation. Then smaller factors like where you went to med school, undergrad, etc. do enter the equation. The problem is this happens a LOT in talking to program directors and they are forced to make several such difficult decisions. The "simple" decisions based on your stated factors likely make up about half their interview pool.

A better comparison is the bottom 5 at a top 10 med school who are probably just as good as the bottom 5 at an average state school. However, they will likely get better nods from modestly higher level programs, though they will get a number of rejections as well, particularly from the upper tier.

The studies you describe aren't representative of "what people want" on this board which is a narrow focus on upper middle tier to upper tier residencies which are the minority of available residencies. Also, I agree that everything you mention from that article matter, however as you proceed down a class rank, the importance of where you happened to go for med school and other nonspecific factors start to matter more and distinguish you from other candidates at lesser known schools.

The problem is that study says little more than what the perceptions are. It's easy for any program to say "we want the student with the highest USMLE score, AOA, are in the top 5 of their class, etc." But this does not differentiate the fine decisions (of which there are MANY every year) that occur in choosing to interview one candidate over another. It's hard to differentiate 2 upper middle-of-their-class students whose board scores are separated by 10 points on the USMLE and may or may not be AOA. Many decisions like this need to be made, and the deciding factor is often "non-numeric" criteria such as where you went to med school. So to ask "what do you care about?" is a very different question from "who do you end up interviewing?" A more interesting study would involve looking at programs, dividing by tier, and then looking at the percentage of interviewees from different schools, their average USMLE's, the number that are AOA from each place, etc. However, there being a perceived greater importance by program directors on the stated factors is not surprising and in fact expected.

 

[Fexofenadine]

Solid score! Likely will get lots of great interviews including Penn, Cornell, Brown, UTSW, UCSD, BID...maybe even Stanford. Unlikely will get MGH or BWH or UCSF unless you're AOA w/ good research also.

 

[golytlely]

It is a fact that where you went to med school it the single most important factor in applying for residency. Most residencies rank schools in tiers ie

Tier A - Harvard, Stanford, Hopkins, UCLA
Tier B - UTSW, Wash U, Yale
Tier C - Loyola, Vanderbilt, NYU
Tier D - Everyone else

The top student from a tier C school is competing with middle class tier B and middle to lower class tier A.

That is the reality, fair or not. I went to a C tier school and still got into a competitive program, so there is hope!!!

 

[indiamacbean]

I am not sure if I agree with this. The truth is that the top programs should they wish could fill themselves with top students from top schools. They don't have to scrape the barrel for "middle to lower tier students." At UCSF, the program seldom accepts more than 5 people from any one school including their own and this year there are around 40 UCSF students applying for medicine according to the 4th years I have talked with. Therefore, it is extremely competitive for the UCSF students to match at the program and the students know it. I often feel like this line of reasoning is advanced by students at less fancy medical schools who do not receive interviews/match at top programs. At my n=1 of a good program the residents from "tier A" schools are universally awesome and I happen to know that many of them were at the top of their class. I am not saying that the school you come from plays no role but I disagree with the assertion that poor to middle range students at great schools are matching at the top programs.

 

[Woatalk]

I agree that certain residency programs do rank applicants based on the medical school they are from. I go to a middle of the road program, and several of my classmates who had 250+, with research, and other accolades i.e AOA, Gold Humanism, did not get interview offers at MGH, Penn, UCSF, JHU and so on. This idea is also supported by looking at where residents of these respective programs went to for medical school...(>95% from top 10 med schools). There is definitely some "in-breeding" happening.

 

[indiamacbean]

I guess it varies from program to program how much weight they put on the school of the applicant. It seemed like from when I was interviewing the east coast programs cared about this slightly more but it is certainly possible to interview/match at your choice of program be it MGH/JHU/UCLA, whatever not coming from a "top ten" medical school. The sad truth is 250/AOA is no guarantee and there are plenty of those people around who have also published substantial research, worked in other countries, MPH, founded clinics, etc. Also, just to put some data behind this at least at UCSF, if you look at the classes by school it is NOT correct to say that 95% are from top ten schools:
http://medicine.ucsf.edu/education/residency/current/interns.html

I think that this is an important point for several reasons:1) if you go to a top medical school I think it is important to realize that you won't just be able to walk into the residency program of your choice and if it is important for you to get into a top program you are going to have to work at it 2) the residents at top programs are usually very talented regardless of where they went to school 3) if you don't go to a really fancy medical school it is certainly possible to match at any program in the country if you play your cards right.

all that being said, there is certainly still some in-breeding going on.

 

[Int Med 2008]

>250 stepI, >260step II. AOA, Lots of research, no pubs. Unranked school.

Interviews Penn, Hopkins, BID

Rejects Columbia, MGH, Brigham, Duke, UCSF

Others in my school with similar stats did get MGH.

I guess if I went to a tier A-C school these stats would have gotten me these interviews. However, not so sure.