Step 1 Scores vs. Grades

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AK_MD2BE

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I have a question for those of you who may know about how residency directors may choose their residents. What is the importance of grades as it compares to Step 1 scores? Are grades equally weighed against Step 1 scores or are Step 1 scores more important? My understanding is that your grades in MS III and MS IV are much more important than the grades you earn in MS I and MS II. In order to get into a difficult residency (ortho, for example), would it be good enough to just pass your classes as long as you scored well (say 240) on Step 1? Any knowledge from those who know what they are talking about would be greatly appreciated. :cool:

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AK_MD2BE said:
I have a question for those of you who may know about how residency directors may choose their residents. What is the importance of grades as it compares to Step 1 scores? Are grades equally weighed against Step 1 scores or are Step 1 scores more important? My understanding is that your grades in MS III and MS IV are much more important than the grades you earn in MS I and MS II. In order to get into a difficult residency (ortho, for example), would it be good enough to just pass your classes as long as you scored well (say 240) on Step 1? Any knowledge from those who know what they are talking about would be greatly appreciated. :cool:


Just like the process for getting into med school, the residency process is multi-faceted. Generally board scores and rough GPAs or class ranks are used as interview invite cut-offs. After that it's up to the interview and your Dean's letter comments/LOR.

I would think that being a star in the clinic and barely passing Step 1 vs. sliding by on grades but acing Step 1 is about the same. Either one isn't going to be great for residency applications to very competitive programs.

As far as III/IV grades vs. preclinical that is very much true. Keep in mind a number of schools don't even have grades in the preclinical years. For us we're told our entire 1st year counts less towards our GPA than our Medicine clerkship.

When I was a 1st year I was shadowing my mentor while he was going through residency apps (hundreds of apps for 2 spots). There was just a checklist where he scored them 0-3 on several categories:
Board Score
Grades
Research
Comments on clerkship performance at home insitution
Comments on clership performance at this institution
Personal Statement
LOR

He spent maybe 2 minutes on each app, scored them, and the top 20 or whatever got interviews. That's just one method at one hospital but I bet similar systems are used elsewhere.
 
AK_MD2BE said:
I have a question for those of you who may know about how residency directors may choose their residents. What is the importance of grades as it compares to Step 1 scores? Are grades equally weighed against Step 1 scores or are Step 1 scores more important? My understanding is that your grades in MS III and MS IV are much more important than the grades you earn in MS I and MS II. In order to get into a difficult residency (ortho, for example), would it be good enough to just pass your classes as long as you scored well (say 240) on Step 1? Any knowledge from those who know what they are talking about would be greatly appreciated. :cool:

Let me preface by saying that I'm an incoming MSII, so it's not like I have a bunch of unique insight; all I can do is reiterate hearsay. BUT, from what I've heard, there's no way you can get into ortho by just passing your classes. I've definitely heard that Step I scores are MORE important than grades, but for those ultracompetitive residencies like ortho and derm, you've really got to have the whole package. You can't make a C in anatomy and be an orthopedic surgeon (lucky I don't want to be one!). Although, definitely for specialties that are less competitive, a 240's going to carry you a long way.
 
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Scraping by the first 2yrs and getting a 240+ don't go together. I'm sure someone will come out and be the exception, but MS1/2 grades (especially the NBME's) tend to predict board performance. As a matter of fact, you are more likely to do well MS1/2 and end up with an average step1 than the other way around..... of course this doesn't apply to top 10 schools where avg students regularly score well.

Many institutions no longer have categorical grades for MS1/2, which is why the step is so important now. If you do have preclinical grades, then it would be in your best interest to as well as you can. During MS3, your letters from each department can mean more than your actual grade. Most students who try hard will get at least high pass, but if you ace the shelf and are a jackass, it will show in your letter.

Just do your best while maintaining ballance in your life. Right now you are worrying about things that for the most part are out of your control.
 
AK_MD2BE said:
I have a question for those of you who may know about how residency directors may choose their residents. What is the importance of grades as it compares to Step 1 scores? Are grades equally weighed against Step 1 scores or are Step 1 scores more important? My understanding is that your grades in MS III and MS IV are much more important than the grades you earn in MS I and MS II. In order to get into a difficult residency (ortho, for example), would it be good enough to just pass your classes as long as you scored well (say 240) on Step 1? Any knowledge from those who know what they are talking about would be greatly appreciated. :cool:

Grades in the first two years are not all that important compared to Step 1. They are far from weighted equally -- we are talking about the weight of a mouse versus an elephant here. And first year grades are less important than second year grades (so more like a small vole). You theoretically can just pass everything, get an extremely high board score, and match very well. But I agree with the prior poster that if you are just squeaking by in your science years, you are significantly less likely to knock the roof off the boards. (Although I guess it's possible, if you studied toward the boards throughout, at the expense of your course grades -- i.e. notwithstanding your professors' test subject focus. But usually these things are fairly well alligned).
 
Law2Doc said:
Grades in the first two years are not all that important compared to Step 1. They are far from weighted equally -- we are talking about the weight of a mouse versus an elephant here. And first year grades are less important than second year grades (so more like a small vole). You theoretically can just pass everything, get an extremely high board score, and match very well. But I agree with the prior poster that if you are just squeaking by in your science years, you are significantly less likely to knock the roof off the boards. (Although I guess it's possible, if you studied toward the boards throughout, at the expense of your course grades -- i.e. notwithstanding your professors' test subject focus. But usually these things are fairly well alligned).

Most true. You can't forget that when time comes to take Step1 there is no substitute for having done well your first 2 years. No insanely vigorous study schedule can make up for 2 years of slacking or squeaking by for whatever reason.
 
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