Step 1 scores, GPA, and Residency

[Snuka]

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Hi-

I'm a 2nd year and new to SDN. I was wondering how important is GPA when you are being considered for residency? I want to do IM then a fellowship in nephrology. I know this is not one of the super competitive residencies (i.e. Radiology, Opthamology, Dermatology) but know you still have to perform well. My med school is probably rated in the middle to bottom in terms of education value and I want to know what kind of Step 1 scores and GPA do I need to get a good residency in the northeast, excluding the Boston and NYC areas? Every time I look on residency websites there is no specific information about scores. If anyone can give me some insight I would greatly appreciate it.

Thanks

 

[doc05]

study a lot, get as high a score as possible. as an ms2, you're in no position to choose a specialty, and a high score will keep your options open.

as for IM, it's not competitive overall, but you'll need AOA/230-240+ for the top academic programs.

 

[8744]

I think if you get a 182 on Step 1, a 184 on Step 2 and repeat a year in the process you can pretty much kiss that dermatology residency goodbye.

Glad I could help.

 

[Snuka]

So Step 1 scores and recommendations from 3rd year clinicals are the best indicators for residency selection? I'm just wondering how important grades can be if 1/2 of the medical schools are on pass/fail and don't have a system in place for class rank.

 

[WatchingWaiting]

study a lot, get as high a score as possible. as an ms2, you're in no position to choose a specialty, and a high score will keep your options open.

as for IM, it's not competitive overall, but you'll need AOA/230-240+ for the top academic programs.

You're stoned if you think those are the stats of the average IM resident at Hopkins or UCSF. AOA plus a 240 Step 1 will make you competitive for radiology or othopedic surgery at top places.

 

[WatchingWaiting]

So Step 1 scores and recommendations from 3rd year clinicals are the best indicators for residency selection? I'm just wondering how important grades can be if 1/2 of the medical schools are on pass/fail and don't have a system in place for class rank.

Step I scores are not very important for internal medicine. In fact, most programs (including many top places) won't even look at them (other than to make sure you passed). IM at top academic programs is going to be primarily interested in the strength of your letters, your research experiences, and your clinical performance (grades/Dean's letter bucketing of your performance) in med school. Given the very large number of slots medicine residencies have to fill (for example, 29 medicine residents per year at Stanford, as compared to 2 for derm, 8 or 9 for radiology, 5 or 6 for orthopedic surgery) coupled with the fact that uber-competitive applicants generally don't go for medicine, medicine will, even at top academic places, always be relatively easy to match into.

Coming from a middle-to-bottom school, you will want to be in the top 1/3 of your graduating class (AOA would be even better), have good letters, do some audition rotations at the top places you want to match, and, ideally, have some kind of research.

 

[Snuka]

What about scores in the 220-230's for a middle to upper middle IM residency, below the Ivy's, Stanford, Duke etc.? I'm just trying to get a sense of what I should be aiming for when I take Step 1 this summer. Although it would be nice to score higher, I'm trying to be realistic in the score I think I can attain. I have a graduate degree, am published, and have presented at national conferences so I'm hoping that will help narrow the gap b/t other candidates that might have better grades than me.

 

[WatchingWaiting]

What about scores in the 220-230's for a middle to upper middle IM residency, below the Ivy's, Stanford, Duke etc.? I'm just trying to get a sense of what I should be aiming for when I take Step 1 this summer. Although it would be nice to score higher, I'm trying to be realistic in the score I think I can attain. I have a graduate degree, am published, and have presented at national conferences so I'm hoping that will help narrow the gap b/t other candidates that might have better grades than me.

Step I just isn't going to be that important a factor. If you can get the national average or above, you should be fine. In addition, even if you have a 250 Step 1, if your clinical evals aren't stellar, you're going to have a hard time placing into top academic Medicine programs. The fact that you have a research background will definitely be positive for your candidacy at top academic programs. To re-iterate, prestigious academic medicine programs just aren't going to care all that much about your Step I, but will care a lot about your clinical grades and letters and whether they have seen you during an audition rotation.

Step 1 is generally used by competitive fields as a weeding tool. It's not like radiology programs sit and write their rank-list based on their interviewees' Step I scores. They, instead, use Step I as a screening tool to get rid of applicants and narrow down the candidates under consideration for interview to a more reasonable size. Since Medicine generally doesn't need to weed because it is not being deluged by applicants, they go straight to the evaluation phase, which is mostly based on how good a clinical practitioner you are going to be, with some consideration to your potential for being a leader in internal medicine.

 

[RustNeverSleeps]

So Step 1 scores and recommendations from 3rd year clinicals are the best indicators for residency selection? I'm just wondering how important grades can be if 1/2 of the medical schools are on pass/fail and don't have a system in place for class rank.

Just because a school is pass/fail, don't assume that they do not calculate class rank. At many schools (including mine which is Honors/Pass/Fail), even though they record the letter grade on your transcript, they keep records of your numerical grades for calculating class rank.

 

[Snuka]

This may be a naive question coming from a 2nd year, but what is an audition rotation?

Thanks for your advice about this whole process. I feel like I've worked my a** off and have a good grasp of the material but unfortunately, my grades don't quite reflect a 4.0! What you said takes a little of the pressure off about Step 1 but I guess just makes my 3rd year evaluations that much more important. Another year of high stress, can't wait !?!?

 

[WatchingWaiting]

This may be a naive question coming from a 2nd year, but what is an audition rotation?

Thanks for your advice about this whole process. I feel like I've worked my a** off and have a good grasp of the material but unfortunately, my grades don't quite reflect a 4.0! What you said takes a little of the pressure off about Step 1 but I guess just makes my 3rd year evaluations that much more important. Another year of high stress, can't wait !?!?

Your fourth year is pretty flexible at most med schools. You can do clerkships/clinical rotations at schools that you are interested in attending for residency. They get a month to sniff you out and see if you smell palatable. It's often helpful if you aren't coming from a great school because you get a month to impress a few attendings/get a good letter from someone at this school. You, obviously, have to give a strong performance during that month (or, at least one of those months, assuming you rotate into different programs at different places).

Also, it's always nice to have a high Step 1 in case you decide you want to do a more competitive field during the third year and because there is a lot of pimping during the third year, a decent chunk of which is based on how well you have learned the pre-clinical material. It's just a lot more important to do well in the third-year!

 

[bigfrank]

You're stoned if you think those are the stats of the average IM resident at Hopkins or UCSF. AOA plus a 240 MCAT will make you competitive for radiology or othopedic surgery at top places.

A 240 MCAT will make you competitive, you're damn right!

 

[Skichic56]

I was wondering if mcat scores and ugrad gpa are ever factors in residency applications. I wouldn't think so, but I ask only because I was shocked to have to report my high school rank, gpa, and sat scores on the washu secondary for med school.

 

[Snuka]

Your fourth year is pretty flexible at most med schools. You can do clerkships/clinical rotations at schools that you are interested in attending for residency. They get a month to sniff you out and see if you smell palatable. It's often helpful if you aren't coming from a great school because you get a month to impress a few attendings/get a good letter from someone at this school. You, obviously, have to give a strong performance during that month (or, at least one of those months, assuming you rotate into different programs at different places).

Also, it's always nice to have a high Step 1 in case you decide you want to do a more competitive field during the third year and because there is a lot of pimping during the third year, a decent chunk of which is based on how well you have learned the pre-clinical material. It's just a lot more important to do well in the third-year!

So I'm guessing from what you said that these audition rotations would have to be done early in the 4th year so that any letters of recommendation could be included b/f the residency application is submitted. I think at my school we get a month off to study for Step 2 and then another month for interviews so any away rotations will have to be in b/t those months.

Also, I would love to have your input about 3rd year rotation schedule. I've heard that it's best to do the rotation in your field of interest some time in the middle of the year, when you have a couple of other rotations under your belt. But I've also heard and read that doing the IM rotation first gives you a great base to succeed in the other rotations. What are your thoughts? And.. do you think there is a strong correlation between scoring high on Step 1 and how you perform in 3rd year? Just wondering...

 

[WatchingWaiting]

I was wondering if mcat scores and ugrad gpa are ever factors in residency applications. I wouldn't think so, but I ask only because I was shocked to have to report my high school rank, gpa, and sat scores on the washu secondary for med school.

Some programs do ask for an undergrad transcript (neurosurgery, for example), but the vast majority do not. I assume that of those that do (again, very rare), the impact on the final decision would be very low.

 

[WatchingWaiting]

A 240 MCAT will make you competitive, you're damn right!

Been posting too much on the pre-allopathic board I guess.

 

[exmike]

Just because a school is pass/fail, don't assume that they do not calculate class rank. At many schools (including mine which is Honors/Pass/Fail), even though they record the letter grade on your transcript, they keep records of your numerical grades for calculating class rank.

there are some schools that truly dont rank their students during M1/M2 years.. like case western 😀 all we get is a P on our transcripts if we pass.. no numerical rankings of any kind