Stupid Question - Step 1 score for competitive residency

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red7

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I've tried searching different keywords and haven't really found an answer to this question, but maybe I'm just bad at it (or maybe it's just proof that I shouldn't be worried about this type of useless stuff before I'm even in med school). Anyway:

What Step 1 score is necessary/competitive for "top tier" academic programs in the difficult-to-match residencies? I've seen lots of threads like "you'll need about xxx to be in the ballpark for orthopedics or yyy for dermatology," but what do you need to be considered competitive for something like ... Orthopedics at HSS, or neurosurgery at Mayo, or radiology at UCSF, or other super competitive programs like that? Is it a lot higher for the elite programs, or is it more like once you're high enough, then it will be more about other stuff (like clinical grades, research, etc.)

I know that these types of programs look for much more than Step 1, but my understanding is that your score is what will get your foot in the door.
 
IslandStyle808 said:
Here is what I have:

Look at page 9 for median scores (even ranges!) for each program acceptance

http://www.nrmp.org/data/chartingoutcomes2011.pdf

Look at whole document of what each residency values

http://www.nrmp.org/data/programresultsbyspecialty2012.pdf

Have fun with all that...
Click to expand...

Actually, I think I've seen those documents before, and please correct me if I'm wrong, but those seem to be aggregates for each specialty. e.g. For all people matched in _____ specialty, the mean Step 1 score was ____. That's not exactly what I am looking for.

What I mean to ask is, within ONE generally competitive specialty, what would be a Step 1 score that wouldn't exclude you from consideration at the most competitive academic programs?

So for example:
- in the case of orthopedics - what Step 1 score do you need to remain competitive at HSS?
- in the case of ENT - what Step 1 score would keep you competitive for at Hopkins?
- in the case of radiology - what Step 1 score would keep you competitive at UCSF?

[Just so it's clear, I'm just naming random specialties that I understand to be very tough to match, and picking hospitals that I've heard have very good training programs in that specialty - I'm not trying to start a war about what is the most competitive field, or which hospital is the best, etc.]
 
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red7 said:
Actually, I think I've seen those documents before, and please correct me if I'm wrong, but those seem to be aggregates for each specialty. e.g. For all people matched in _____ specialty, the mean Step 1 score was ____. That's not exactly what I am looking for.

What I mean to ask is, within ONE generally competitive specialty - let's take orthopedics as the example - what would be a Step 1 score that wouldn't exclude you from consideration at the most competitive academic orthopedics programs? ... if that makes any sense.
Click to expand...
It's hard to say what the real basement score for a given specialty is, a there may be a few certain program out there that will accept much lower-than-average-for-the-specialty step1 scores, though these are likely to be less regarded and/or in less desirable locations. But other factors can come into play as well (did a lot of major research in the field, got to know some important people) and no one can really say to what extent one thing offsets another. But if you wanna be on the safe side, I'd say 240, cuz ya never really know, and things may get more competitive in the future. There's another chart on NRMP that gives more info as to step scores per each specialty, but that still won't quite answer than question.

Edit: oh, you mean for a specific program in a specific specialty? Well, for one, there are a lot of programs, so you'd have to pick just a few you care about first. But even then, it's still hard to say what the absolute basement is, but the more on the low side you go, the more you will need other unusually beneficial factors in your favor.
 
red7 said:
Actually, I think I've seen those documents before, and please correct me if I'm wrong, but those seem to be aggregates for each specialty. e.g. For all people matched in _____ specialty, the mean Step 1 score was ____. That's not exactly what I am looking for.

What I mean to ask is, within ONE generally competitive specialty, what would be a Step 1 score that wouldn't exclude you from consideration at the most competitive academic programs?

So for example:
- in the case of orthopedics - what Step 1 score do you need to remain competitive at HSS?
- in the case of ENT - what Step 1 score would keep you competitive for at Hopkins?
- in the case of radiology - what Step 1 score would keep you competitive at UCSF?

[Just so it's clear, I'm just naming random specialties that I understand to be very tough to match, and picking hospitals that I've heard have very good training programs in that specialty - I'm not trying to start a war about what is the most competitive field, or which hospital is the best, etc.]
Click to expand...

I see what you mean, sorry about that. This is a difficult thing to know as to "what is a competitive score for each school?" You could try and contact the programs (hopefully one of the medical students on the forums may have an exact answer).

Sephiroth said:
It's hard to say what the real basement score for a given specialty is, a there may be a few certain program out there that will accept much lower-than-average-for-the-specialty step1 scores, though these are likely to be less regarded and/or in less desirable locations. But other factors can come into play as well (did a lot of major research in the field, got to know some important people) and no one can really say to what extent one thing offsets another. But if you wanna be on the safe side, I'd say 240, cuz ya never really know, and things may get more competitive in the future. There's another chart on NRMP that gives more info as to step scores per each specialty, but that still won't quite answer than question.

Edit: oh, you mean for a specific program in a specific specialty? Well, for one, there are a lot of programs, so you'd have to pick just a few you care about first. But even then, it's still hard to say what the absolute basement is, but the more on the low side you go, the more you will need other unusually beneficial factors in your favor.
Click to expand...

+1

The main thing is to have a USMLE step I score that is competitive for the residency you want. No matter what you will be going into this specialty whether it be in a top-tier school or low-tier program. With that said you will apply through the match program with your 15 or so residency choices. So you will be shooting for your reach school as number one and have your safeties at the bottom. In the end, the USMLE stats (if they are competitive on average) may not change your decision to apply for the top-tier schools anyway.
 
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red7 said:
Actually, I think I've seen those documents before, and please correct me if I'm wrong, but those seem to be aggregates for each specialty. e.g. For all people matched in _____ specialty, the mean Step 1 score was ____. That's not exactly what I am looking for.

What I mean to ask is, within ONE generally competitive specialty, what would be a Step 1 score that wouldn't exclude you from consideration at the most competitive academic programs?

So for example:
- in the case of orthopedics - what Step 1 score do you need to remain competitive at HSS?
- in the case of ENT - what Step 1 score would keep you competitive for at Hopkins?
- in the case of radiology - what Step 1 score would keep you competitive at UCSF?

[Just so it's clear, I'm just naming random specialties that I understand to be very tough to match, and picking hospitals that I've heard have very good training programs in that specialty - I'm not trying to start a war about what is the most competitive field, or which hospital is the best, etc.]
Click to expand...

There aren't hard and fast rules, only averages. Programs change in competitiveness, program directors with different biases come and go, places regard graduates of certain med schools more or less positively over the years. You absolutely don't want to pick a specific residency you want to end up at because odds are you won't get it. People end up deeper in their rank let all the time and that's just in the places they get interviews at, not that they applied to. So this line of questioning is fruitless. Go all out and get the highest score you can get. Then see what your options are, and do away rotations where you want to end up and network like crazy. But no point looking at this in pre-allo.
 
Love that no one answered the question. Anyways, 250.
 
My girlfriend got a 257 and is comfortable that she'll be able to match to most any specialty/program. And if she doesn't match, it won't be because her Step 1 was inadequate.
 
Also, know that to get a top program in (basically) any specialty, you need not only a stellar step 1 score, but also great grades, research, strong LORs, solid away evals, etc. I would think 250/260 would be pretty standard for the top programs in almost any specialty.
 
I thought the USMLE was going to be changed within the next few years, something about condensing 3 steps into 2 steps with a completely different scoring system.
 
circulus vitios said:
I thought the USMLE was going to be changed within the next few years, something about condensing 3 steps into 2 steps with a completely different scoring system.
Click to expand...

How about we just get rid of step2 cs for us med students? That is where we should start...
 
>270.

Source: sdn Step 1 forums.
 
Trying to write out the complete answer to your question, others have partial and/or incorrect info.

1) So there is no confusion, Step 1 scores matter, a lot.
2) Residency applications depend on a lot of things and after a certain point those other things matter a hell of a lot more than your Step 1 score.
3) If you get a 250+, you will never not match at a program because your score wasn't high enough.
4) One can have a high probability of matching into a particular specialty with a very high Step 1 score, but particular program is much more difficult. This depends primarily on the size of the program and the number of applicants that want to go there. If there is only 1 slot and 5 people with 250+ apply, 4 people are not matching there.
 
red7 said:
I've tried searching different keywords and haven't really found an answer to this question, but maybe I'm just bad at it (or maybe it's just proof that I shouldn't be worried about this type of useless stuff before I'm even in med school). Anyway:

What Step 1 score is necessary/competitive for "top tier" academic programs in the difficult-to-match residencies? I've seen lots of threads like "you'll need about xxx to be in the ballpark for orthopedics or yyy for dermatology," but what do you need to be considered competitive for something like ... Orthopedics at HSS, or neurosurgery at Mayo, or radiology at UCSF, or other super competitive programs like that? Is it a lot higher for the elite programs, or is it more like once you're high enough, then it will be more about other stuff (like clinical grades, research, etc.)

I know that these types of programs look for much more than Step 1, but my understanding is that your score is what will get your foot in the door.
Click to expand...


I'm happy to see my fellow premed to be so concerned about Step 1 and residency, when he/she didn't start medical school yet. That's like saying a high school student bring worried about the MCAT. Stop being too ambitious OP.
 
Thanks everyone for the great responses - I have a much better idea now. It's a stupid thing to worry about, I know, but it was bugging me so I thought I'd just ask. Now, back to applying for med school ....
 
mimelim said:
3) If you get a 250+, you will never not match at a program because your score wasn't high enough.
Click to expand...

Not to pick nits, because this is almost universally the case, but one Dermatology program of which I am aware used 260 as their Step I cut off this year for offering interviews.
 
Agent B said:
I'm happy to see my fellow premed to be so concerned about Step 1 and residency, when he/she didn't start medical school yet. That's like saying a high school student bring worried about the MCAT. Stop being too ambitious OP.
Click to expand...

oh relax. who cares. i'm curious about this question. nobody is taking it too seriously.
 
GuyWhoDoesStuff said:
Not to pick nits, because this is almost universally the case, but one Dermatology program of which I am aware used 260 as their Step I cut off this year for offering interviews.
Click to expand...

Which program? There were 31 applicants with 260+ Step 1 scores that applied Derm last year. I would find it surprising that a program would limit their interview pool to only 30 applicants. And then they would be literally be interviewing people based on Step 1 score alone which is a pretty bad way of doing things.

So... Which program? Kinda wanna look into this...
 
mimelim said:
Which program? There were 31 applicants with 260+ Step 1 scores that applied Derm last year. I would find it surprising that a program would limit their interview pool to only 30 applicants. And then they would be literally be interviewing people based on Step 1 score alone which is a pretty bad way of doing things.

So... Which program? Kinda wanna look into this...
Click to expand...

Won't name names but it was a small-ish program out west. The 31 figure was from two years ago, although I doubt it increased that much last year. That said, most derm applicants apply to almost every program, and most programs interview 7-10 people per spot. So, for example, a program with 3 spots will often interview 20-30 people total.

When you've got the pick of the litter, you can choose to be as elitist as you want when it comes to Step I, regardless of how silly that actually is.
 
I don't get it. Is this hidden knowledge? Do they just take application fees from people and not tell them that they don't consider them if they are below 260?

I'm not going to pretend to know a lot about Derm programs, but it is illogical to not consider more applications given how few they are are reviewing. They will get inferior residents by auto-interviewing people based on Step score because they are the only ones they are considering. Something just doesn't quite fit here.
 
mmmcdowe said:
Yeah, I'm inclined to agree that 250+ is money for basically all top programs except maybe plastics/derm where a 260 might be a smidgeon more ideal.
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I know I'm a noob for asking this, but why is dermatology the most difficult speciality to get into (with the highest Step 1 score)?
 
Lanolin said:
When I was interested in Radiology I was told by our chair of the department that my ~3.9/255+/270+ was higher than the guy that matched the previous year at UCSF and the other who match BWH/MGH.

Take that for what it's worth. I think anyone with 250+/260+ and good letters/grades will have a good chance of interviewing at any program around.
Click to expand...

:wow:

Hoping we're not applying to a lot of the same programs......
 
mmmcdowe said:
Yeah, I'm inclined to agree that 250+ is money for basically all top programs except maybe plastics/derm where a 260 might be a smidgeon more ideal.
Click to expand...

I'd throw rad-onc into that mix. Plus plastics and rad-onc are research heavy as well.
 
Agent B said:
I know I'm a noob for asking this, but why is dermatology the most difficult speciality to get into (with the highest Step 1 score)?
Click to expand...

Plastics has the highest step 1 avg.
 
Btw the premise of this post is stupid. IMO Step 1 is one of the least important factors once you have reached a set level, which IMO is about 250. Yes perhaps it'd be nicer to have a higher step for certain specialties, but my classmate matched mayo derm last year with a 245, so it's not absolutely essential to have high step scores even for the better programs. Anyways, I think the non- step 1 factors are what are going to set your application apart for the top programs in competitive specialties; you have to be good at everything.
 
drizzt3117 said:
Btw the premise of this post is stupid. IMO Step 1 is one of the least important factors once you have reached a set level, which IMO is about 250. Yes perhaps it'd be nicer to have a higher step for certain specialties, but my classmate matched mayo derm last year with a 245, so it's not absolutely essential to have high step scores even for the better programs. Anyways, I think the non- step 1 factors are what are going to set your application apart for the top programs in competitive specialties; you have to be good at everything.
Click to expand...

Where should I put my ability to pick up chicks? I feel like that is an important part of my application as it might contrast my academic accolades and showcase that I'm a "well rounded" applicant.

Hmm..
 
Lanolin said:
Your ~250/265+ will do just fine 🙂.
Click to expand...

Don't get me wrong - I'm happy with my scores - I couldda done better on Step 1, but I think at that that level it's just kind of bragging rights, but HOLY COW - >270 on step 2! Nice work. I don't know anyone who broke the 270 mark (or at least anyone who will admit it in public, lol). Saw you put up Carolinas and BWH/MGH on the interview thread - I'll be there too, hopefully I'll catch you sometime on the trail.
 
FSU2013 said:
but HOLY COW - >270 on step 2! Nice work. I don't know anyone who broke the 270 mark (or at least anyone who will admit it in public, lol).
Click to expand...

Honestly, it happens on Step 2 more often than you think.
 
Lanolin said:
Where should I put my ability to pick up chicks? I feel like that is an important part of my application as it might contrast my academic accolades and showcase that I'm a "well rounded" applicant.

Hmm..
Click to expand...

I put it under honors.
 
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