Step2CK of 230-240 for IM residencies

[TheMCATWorther112]

If one was to theoretically score a 230 on Step2 CK, how much would this hurt their chances at an academic IM residency program? Let's say they attend a mid-tier USMD program (class rank = middle of the pack), passed step1, have average clerkship grades but with improvement through the clerkships, good MSPE comments, strong LORs, and a strong PS? How much would getting a 230 hurt this person vs a 235 vs a 240 - do programs tend to filter by filtering in applicants with scores "greater than or equal to" or "greater than," or filter out by "less than" for step2? This could, in theory, impact someone with a 230 more than a 231 if the filter was set at filtering in applicants at ">230" vs ">=230."

Any insights appreciated.

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[voxveritatisetlucis]

Depends on what you mean by academic IM. My school for example technically has an “academic IM” program but they have never sent somebody to cards or GI fellowship. I would say the top 30ish programs are reaches for sure and you should signal the low-mid tier on the Reddit spreadsheets as well as some community programs

 

[GoSpursGo]

It will not hurt. That’s a good score. May not go to Hopkins but you’re not gonna get screened out basically anywhere based on a 230 for academic IM

 

[voxveritatisetlucis]

It will not hurt. That’s a good score. May not go to Hopkins but you’re not gonna get screened out basically anywhere based on a 230 for academic IM

230 is a 12th percentile according to the latest data. Median is like 250. I don’t know the screens and maybe they’re lower than that but I don’t think a 230 is neutral for the purposes of interviews/rankings

 

[TheMCATWorther112]

230 is a 12th percentile according to the latest data. Median is like 250. I don’t know the screens and maybe they’re lower than that but I don’t think a 230 is neutral for the purposes of interviews/rankings

The question becomes what thresholds programs are using to screen for interviews I think (including USMD vs DO vs IMG and how the filters are combined), because getting the application looked at is likely the biggest barrier. If an interview occurs, what I've heard is that the interview often becomes the most important factor in ranking

 

[voxveritatisetlucis]

an interview occurs, what I've heard is that the interview often becomes the most important factor in ranking

I don’t think that this is true in specialties with big classes such as IM. A lot of people from my low tier MD school get interviews at top programs but then when the programs go to rank they clearly value school prestige (and possibly other factors as well) just as much as the interview when ranking. Most people don’t bomb their interview so it’s likely not enough to differentiate most candidates

 

[GoSpursGo]

230 is a 12th percentile according to the latest data. Median is like 250. I don’t know the screens and maybe they’re lower than that but I don’t think a 230 is neutral for the purposes of interviews/rankings

Fair enough, maybe it's not "good." But academic IM is a wide swath of programs with large classes, so I still think that most US MD grads with a 230 and no red flags is more likely than not to match somewhere academic. If there is some other red flag, then all bets are off.

The question becomes what thresholds programs are using to screen for interviews I think (including USMD vs DO vs IMG and how the filters are combined), because getting the application looked at is likely the biggest barrier. If an interview occurs, what I've heard is that the interview often becomes the most important factor in ranking

I disagree--while yes, the interview is often the deciding factor once you reach that stage, just because you pass a screen does not mean you're likely to get an interview.

 

[TheMCATWorther112]

230 is a 12th percentile according to the latest data. Median is like 250. I don’t know the screens and maybe they’re lower than that but I don’t think a 230 is neutral for the purposes of interviews/rankings

Not necessarily to defend my own honor, but people at different schools (particularly international) get many extra months to study. In my opinion that's something to keep in mind when looking at a 230 vs 250 - what if the second individual had an entire year to prepare? That doesn't happen often at USMD schools, which also tend to have more rigorous clerkship grading systems unfortunately... As an aside, I scored around 230, after scoring around 250 on my last practice exam... So, surprising and unexpected. Sometimes (often times) life ain't fair...
Also what is with the insane score inflation? A 250 used to be 90th+ percentile. It's ridiculous.

I disagree--while yes, the interview is often the deciding factor once you reach that stage, just because you pass a screen does not mean you're likely to get an interview.

I wasn't trying to say one is likely to get an interview just because one passes a screen. I was saying that getting the application looked at is (of course) the first and essential step before an interview can happen. And, if you're filtered out just by score, that's unfortunately not possible. What I'm wondering is the specific score thresholds that programs might use (in combination with other filters, such as boards failures or IMG vs DO vs MD). Common thresholds I've seen talked about are 220 and 225. I've also heard that it's fluid and can change from day to day at any program - maybe that's why these data aren't made publicly available...

 

[GoSpursGo]

Not necessarily to defend my own honor, but people at different schools (particularly international) get many extra months to study. In my opinion that's something to keep in mind when looking at a 230 vs 250 - what if the second individual had an entire year to prepare? That doesn't happen often at USMD schools, which also tend to have more rigorous clerkship grading systems unfortunately... As an aside, I scored around 230, after scoring around 250 on my last practice exam... So, surprising and unexpected. Sometimes (often times) life ain't fair...
Also what is with the insane score inflation? A 250 used to be 90th+ percentile. It's ridiculous.

I wasn't trying to say one is likely to get an interview just because one passes a screen. I was saying that getting the application looked at is (of course) the first and essential step before an interview can happen. And, if you're filtered out just by score, that's unfortunately not possible. What I'm wondering is the specific score thresholds that programs might use (in combination with other filters, such as boards failures or IMG vs DO vs MD). Common thresholds I've seen talked about are 220 and 225. I've also heard that it's fluid and can change from day to day at any program - maybe that's why these data aren't made publicly available...

I don’t think anyone was saying anything negative about you personally, just trying to objectively answer your question. Clearly IMGs have plenty of other drawbacks to their applications; so I don’t think it makes a ton of sense to complain that you didn’t get a year to study. It’s a bummer your actual test day didn’t go as well as your practice though.

If a program has a filter and you just barely clear it, I would assume the rest of your app needs to be stellar to get a chance to get an interview. So unless you’ve got an otherwise stellar app I just wouldn’t worry too much about getting over a filter. If conversely you have a red flag elsewhere, getting a 235 and barely clearing the filter would likely not help much in terms of getting an interview.

 

[Med Ed]

Common thresholds I've seen talked about are 220 and 225. I've also heard that it's fluid and can change from day to day at any program - maybe that's why these data aren't made publicly available...

You seem to be asking multiple interrelated questions, so let's tease them out.

Q1. How do IM programs treat Step 2 scores?
A1. In the 2024 match there were 707 IM programs offering 10,261 categorical IM positions. You can therefore expect about 707 different approaches. This can range from high and very rigid thresholds to places that have no threshold and will spend time looking for diamonds in the rough.

Q2. Will a higher Step 2 score provide benefit in the match?
A2. Absolutely. While programs look for different things, the higher the score the more likely it will be that an application survives any type of raw metric screen that is applied.

Q3. Can a US MD senior with a 230-240 Step 2 score match well in IM?
A3. Absolutely. While there are super-competitive programs in IM, overall it is not a competitive specialty. If every US MD senior who applied to IM this year matched in IM, there would still be over 6,000 leftover positions. An average applicant from a mid-tier US MD school with no red flags starts out in a very favorable position relative to much of the IM applicant pool.

A3a. To head off the inevitable pushback on A3, no, just looking at the number of IM applicants to positions obviously does not tell the whole story. IM programs can range from historic, high power, heavily academic, urban tertiary referal centers with 95 fellowships, to small community programs in isolated parts of the country. However, the fact remains that US MD seniors with no Step failures or other red flags can do quite well in the match, assuming they apply sensibly.

Q4. What is the best course of action for a US MD senior applying to IM with a subpar Step 2 score?
A4. Get advice from your school's speciality advisor(s) and in-house IM PD, then apply broadly to a mixture of academic and community programs. The upper midwest has some very solid academic IM programs that are not terribly competitive because most people don't want to live there.