step 3 avg score for path?

[cellmatrix]

What is the average step 3 score / score trends for pathology residents who take the USMLE step 3 exam? Are there any average scores for each fellowship? I'm under the impression that fellowships don't care at all what your score is if you're an American grad in good standing with your residency and have good letters of recommendation, all they will want to see is that you passed the step 3 on the first try, get a few case reports or USCAP presentations, then you should be okay to get a moderately competitive fellowship...

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[Patho2009]

For Step 3 in particular, just passing is enough and it doesn't matter..whether you are American or foreign graduate. They all look for passing Step 3 on your CV before they decide considering your application. You have to know that many States Medical Boards require having a license to join your fellowship. Step 3 is an essential part of the licensing process. Therefore, Step 3 requirement is not always related to the program itself but also related to the State Medical board governing the State where the program is located. NY State, for example, does not require a license while you are in training and therefore you might see fellows without Step 3. This is not true in the vast majority of the rest of the States.

From my past experience in applying for fellowships, the most two important factors -besides Step 3 - were (1) the name of your residency program, and (2) LoR. The most reputable fellowships won't take residents of weak or average programs...Fellowships in University hospitals are interested in residents of university programs, in contrast to community-based hospital programs. Letters of recommendation are also not less critical than your residency name.
This is just a general impression I had during my fellowship applications and I was even told these things by fellowship directors during my interviews. Experiences between people vary.

Know that if you don't have Step 3 in hand at the time of your application, all other factors won't be of value. After passing Step 3, other factors such as scholarly activities, LoR, residency name differentiate between applicants- Step 3 score was not among them (at least in my own individual experience). Also know that not passing Step 3 will ruin your entire career: won't be able to get license to practice, to sit for your specialty board exams, to get a fellowship (still possible but very tough) and will render all the years spent in training in vain. Therefore, if you pass with 75, you own the world!!. if you fail with one point (74), you will have a gloomy future!!!. i.e. one point in this exam might take you into either way!!!! In other words, Step 1 and 2 get you into the residency and Step 3 controls the rest!!

 

[cellmatrix]

Luckily I found out I passed a few weeks ago (score 199). Not the greatest score, but a comfortable margin nonetheless and I was just wondering if that really meant anything. I'm leaning towards thinking now I'm over that hurdle, and I'm glad that I can focus on studying nothing except for pathology now.

 

[coroner]

Also know that not passing Step 3 will ruin your entire career: won't be able to get license to practice, to sit for your specialty board exams, to get a fellowship (still possible but very tough) and will render all the years spent in training in vain. Therefore, if you pass with 75, you own the world!!. if you fail with one point (74), you will have a gloomy future!!!.

Not to sound apocalyptic, but this is true. If for whatever reason Pathology (or any other field of medicine) doesn't work out, as long as one has been accepted into a residency program and completed at least one or more years of postgraduate training, passage of Step 3 makes one eligible for licensure by a given state medical board. This licensure is independent from being board certified but keeps doors open career-wise if one doesn't complete Path, etc.
The last few years, programs across the country have been cracking down on making sure residents pass Step 3 midway thru training before renewing contracts. We've had residents at our hospital who were forced to be on a leave of absence until they completed the exam. This can be very stressful since it pushes back training, causes people to graduate off-cycle and they can't start fellowship in July if they do eventually pass, and worst of all have bills to pay with no income.
Some people say it's tough, others easy. My guess is this correlates with how well people did on Step 1 & 2, i.e. those who aced both exams with 260+ probably didn't sweat too much during Step 3, and vice-versa. Congrats on passing though. Next up is Pathology boards which most everybody says is tougher than any of the USMLE's...

 

[Necromonger]

I passed Step3 before going into residency but my graduation timing was funny due to my PhD shifting my clerkship schedule. I passed by 1 point, you needed a 187, I got a 188. Interviewers had fun with this.

 

[deleted314957]

What is the average step 3 score / score trends for pathology residents who take the USMLE step 3 exam? Are there any average scores for each fellowship? I'm under the impression that fellowships don't care at all what your score is if you're an American grad in good standing with your residency and have good letters of recommendation, all they will want to see is that you passed the step 3 on the first try, get a few case reports or USCAP presentations, then you should be okay to get a moderately competitive fellowship...

I am REALLY remote from this (1977 med school grad), but it sounds like the USMLE exam that so many reference here is what we used to call National Board of Medical Examiners #3. If that is the case, to my recollection we never got a score and no one ever asked for one. You passed or you didn't. Same for parts 1 or 2 which were taken in med school. We all took part 3 after internship. I had never heard of anyone failing part 3. Is this the same basic exam? It really measured fundamental medical skills and if someone could not pass it they must have been asleep in med school and internship or whatever PGY1 is. Am I off base on this? If this is a problem for early trainees maybe the American Board of Path should go back to requiring a clinical year (and not some subtrefuge "clinical research" year escape hatch) of training. After all, we do function as consultants to clinical practioners and there is nothing like walking a mile in their shoes to help in our effectiveness. I know from experience that they appreciate it and it sure as hell helped me. Also, it may help with all the bitching about how tough the job market is if we added a year (as before) and turned out more doctors who have had to hold a few more patients hands and wait for a path report while the patient suffers.

 

[zao275]

Took step 3 at beginning of PGY-1 year. Passed with average score (but 20 point drop from step 1 and 2 scores). I used "Crush Step 3" to study. Studied for 2-3 weeks off and on and then for 2-3 days solid. Also used USMLE world (it was worth the cost I thought). And make sure you do those clinical computer simulation practice cases from the USMLE before the exam. They are not terrribly hard but you MUST be comfortable with working the software.

 

[zao275]

More info on Step 3 preparation is available here:

http://pathinfo.wikia.com/wiki/USMLE_Step_3_Exam

 

[Traveler08]

You say that "know that not passing Step 3 will ruin your entire career". I failed Step 3 after passing Step 1 and 2 with solid but average scores. I retook Step 3, and passed with a score similar to my previous Step 1 and 2 scores. I really don't know what happened or how I failed. I made some big errors on CCS not knowing how the time worked on the system. Now I am about to apply for fellowship, and I am very concerned about obtaining a fellowship with a failed Step 3 attempt on my USMLE transcript despite having passed the exam on the second try. Is my future career as gloomy as you said in your post? Any comments or advice?

For Step 3 in particular, just passing is enough and it doesn't matter..whether you are American or foreign graduate. They all look for passing Step 3 on your CV before they decide considering your application. You have to know that many States Medical Boards require having a license to join your fellowship. Step 3 is an essential part of the licensing process. Therefore, Step 3 requirement is not always related to the program itself but also related to the State Medical board governing the State where the program is located. NY State, for example, does not require a license while you are in training and therefore you might see fellows without Step 3. This is not true in the vast majority of the rest of the States.

From my past experience in applying for fellowships, the most two important factors -besides Step 3 - were (1) the name of your residency program, and (2) LoR. The most reputable fellowships won't take residents of weak or average programs...Fellowships in University hospitals are interested in residents of university programs, in contrast to community-based hospital programs. Letters of recommendation are also not less critical than your residency name.
This is just a general impression I had during my fellowship applications and I was even told these things by fellowship directors during my interviews. Experiences between people vary.

Know that if you don't have Step 3 in hand at the time of your application, all other factors won't be of value. After passing Step 3, other factors such as scholarly activities, LoR, residency name differentiate between applicants- Step 3 score was not among them (at least in my own individual experience). Also know that not passing Step 3 will ruin your entire career: won't be able to get license to practice, to sit for your specialty board exams, to get a fellowship (still possible but very tough) and will render all the years spent in training in vain. Therefore, if you pass with 75, you own the world!!. if you fail with one point (74), you will have a gloomy future!!!. i.e. one point in this exam might take you into either way!!!! In other words, Step 1 and 2 get you into the residency and Step 3 controls the rest!!

 

[KCShaw]

I suspect it's more about never passing, than eventually passing. I don't recall anyone wanting my Step 3 scores at any point. It's pretty gloomy if one simply never passes because, well, you can't really get licensed to practice medicine. However if you pass at some point, even if you never finish a residency anywhere or never pass boards, you can still technically practice medicine -- just not market yourself as board certified or whatever-specialty-trained...which is limiting and bad, but not necessarily apocalyptic.

As far as I know, yes, the USMLE steps correlate to the NBME's -- the NBME now runs the USMLE. I don't know the exact history, but it sounds like the exams basically gained traction post WWII as states transitioned away from administering their own exams and having to deal with agreements with other states that those exams would or wouldn't be accepted in certain other states -- i.e., a nationally accepted exam. When name changes occurred and what kind of content changes occurred over the years, I don't know.

 

[mlw03]

I've never heard of anyone caring about a step 3 score. It's just important to have passed it.

 

[lipomas]

You say that "know that not passing Step 3 will ruin your entire career". I failed Step 3 after passing Step 1 and 2 with solid but average scores. I retook Step 3, and passed with a score similar to my previous Step 1 and 2 scores. I really don't know what happened or how I failed. I made some big errors on CCS not knowing how the time worked on the system. Now I am about to apply for fellowship, and I am very concerned about obtaining a fellowship with a failed Step 3 attempt on my USMLE transcript despite having passed the exam on the second try. Is my future career as gloomy as you said in your post? Any comments or advice?

I doubt it matters. When people say "not passing step 3 will ruin your entire career" they are probably referring to people who never pass it. Or for those who don't pass it before the timeframe for taking it expires. Don't you have to re do residency or something if you don't pass it in the right time frame?

Anyone who has ever asked me about step 3 I have given them this advice:
1) Take it as soon as you can. It only gets harder to fit it in and study for it later on. Especially if you fail.
2) Don't worry about your score as long as it is passing.
3) If you don't pass, take it seriously and take it again soon.

If you're an IMG it is even more important for residency purposes.

 

[Torsed]

I passed Step3 before going into residency but my graduation timing was funny due to my PhD shifting my clerkship schedule. I passed by 1 point, you needed a 187, I got a 188. Interviewers had fun with this.

At the end of the day you passed! Who cares how pathology people do on Step 3? Not like I am ever going to write orders for anything or consult patients on wearing seat belts or writing orders for nurse Edna to wipe patient X's rear end q 3 hours.

 

[Path or bust]

I am REALLY remote from this (1977 med school grad), but it sounds like the USMLE exam that so many reference here is what we used to call National Board of Medical Examiners #3. If that is the case, to my recollection we never got a score and no one ever asked for one. You passed or you didn't. Same for parts 1 or 2 which were taken in med school. We all took part 3 after internship. I had never heard of anyone failing part 3. Is this the same basic exam? It really measured fundamental medical skills and if someone could not pass it they must have been asleep in med school and internship or whatever PGY1 is. Am I off base on this? If this is a problem for early trainees maybe the American Board of Path should go back to requiring a clinical year (and not some subtrefuge "clinical research" year escape hatch) of training. After all, we do function as consultants to clinical practioners and there is nothing like walking a mile in their shoes to help in our effectiveness. I know from experience that they appreciate it and it sure as hell helped me. Also, it may help with all the bitching about how tough the job market is if we added a year (as before) and turned out more doctors who have had to hold a few more patients hands and wait for a path report while the patient suffers.

Medical training does not need to be longer. It needs more efficiency and doing a year of internship is one of the most inefficient ways, in my opinion, for a pathologist to spend their time. Good communication skills and clinical correlation definitely beats any internship. I've seen people switch out of surgery and internal medicine for pathology. I see no difference in their training or in the training of 50 year old pathologists who did a year of internship. It must be a rite of passage that older pathologists want to push on the younger, "greedy" generation of pathologists.