the difference between 1 point

[dodobird1]

i.e. 234 vs 235
239 vs 240
244 vs 245
249 vs 250

may this be the most type A post ever on SDN. I hear residency cutoffs always ending in 5's or 0's. The averages of Step 1 for most competitive specialties is usually 235-249, is the difference between a plastic surgeon being perceived as so knowledgeable his/her 1st 2 years of med school versus an IM really attributed to only 12 points on the exam? I imagine the difference between 1 point is at most 2-3 questions. I find it hard to believe that the scoring guidelines are that linear.

Anyone finding the importance of every question on NBMEs nerve wracking? Hard to focus on that much on the real deal.

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[MedicineMike]

This is a very Type A post. And yes, I may be just a brand new 3rd year but I have a business degree and worked in corporate America before med school. Medicine is no different. Yes, your step 1 is very important, but i PROMISE that if you score a 238 and are not an absolute ****** like most med students, and you shine on rotations, and make connections, and impress people, and people like you - you will have a better chance of getting that all important surgical spot over someone who scored a 245. That's just the way the world works. Medicine is no different. Nepitism, connections, and being likeable and intelligent go a looooooong way over a 3 digit number on paper

 

[carddoc33]

This is a very Type A post. And yes, I may be just a brand new 3rd year but I have a business degree and worked in corporate America before med school. Medicine is no different. Yes, your step 1 is very important, but i PROMISE that if you score a 238 and are not an absolute ****** like most med students, and you shine on rotations, and make connections, and impress people, and people like you - you will have a better chance of getting that all important surgical spot over someone who scored a 245. That's just the way the world works. Medicine is no different. Nepitism, connections, and being likeable and intelligent go a looooooong way over a 3 digit number on paper

Word.

 

[Stellar Clouds]

This is a very Type A post. And yes, I may be just a brand new 3rd year but I have a business degree and worked in corporate America before med school. Medicine is no different. Yes, your step 1 is very important, but i PROMISE that if you score a 238 and are not an absolute ****** like most med students, and you shine on rotations, and make connections, and impress people, and people like you - you will have a better chance of getting that all important surgical spot over someone who scored a 245. That's just the way the world works. Medicine is no different. Nepitism, connections, and being likeable and intelligent go a looooooong way over a 3 digit number on paper

While I agree with you that connections and likeability both help you match, it is your step score that initially opens the door.

 

[MedicineMike]

While I agree with you that connections and likeability both help you match, it is your step score that initially opens the door.

Not if you did an audition rotation...

 

[Stellar Clouds]

Not if you did an audition rotation...

True that an away rotation may help someone with a less favorable step score score match to a nearly out of reach program, but this is few and far between. An audition rotation doesn't guarantee anything. Not even an interview. If you are banking on away rotations to land you in a program that generally takes people with higher step scores, prepare to be disappointed.

 

[coolforschool]

True that an away rotation may help someone with a less favorable step score score match to a nearly out of reach program, but this is few and far between. An audition rotation doesn't guarantee anything. Not even an interview. If you are banking on away rotations to land you in a program that generally takes people with higher step scores, prepare to be disappointed.

Agreed. I heard from very trusty anonymous internet sources that some programs have cutoffs as insane as 240 + AOA (a top ortho program). This post isn't meant to be sarcastic either.

 

[MedicineMike]

True that an away rotation may help someone with a less favorable step score score match to a nearly out of reach program, but this is few and far between. An audition rotation doesn't guarantee anything. Not even an interview. If you are banking on away rotations to land you in a program that generally takes people with higher step scores, prepare to be disappointed.

An away rotation is helpful to anyone regardless (again, as long as you are not ******ed). Obviously I know that I'm not going to match at Harvard surgery so a rotation there would be in vain. That wasn't the point of all of this. Rotations are away to prove yourself and your worth to a hospital/program and there is no denying that.

 

[MedicineMike]

Agreed. I heard from very trusty anonymous internet sources that some programs have cutoffs as insane as 240 + AOA (a top ortho program). This post isn't meant to be sarcastic either.

Yes. This is where I agree with you guys. Your score confines you to a certain standard deviation depending on what else you can bring to the table. I can be the best doc ever, but a 188 step 1 will get screened out

 

[coolforschool]

An away rotation is helpful to anyone regardless (again, as long as you are not ******ed). Obviously I know that I'm not going to match at Harvard surgery so a rotation there would be in vain. That wasn't the point of all of this. Rotations are away to prove yourself and your worth to a hospital/program and there is no denying that.

Yes. This is where I agree with you guys. Your score confines you to a certain standard deviation depending on what else you can bring to the table. I can be the best doc ever, but a 188 step 1 will get screened out

Haha. I think we're in agreement here. Let's shake hands and call each other "doctor" while nodding in approval.

 

[MedicineMike]

Haha. I think we're in agreement here. Let's shake hands and call each other "doctor" while nodding in approval.

Deal. Doctor

 

[John Lannister]

This is a very Type A post. And yes, I may be just a brand new 3rd year but I have a business degree and worked in corporate America before med school. Medicine is no different. Yes, your step 1 is very important, but i PROMISE that if you score a 238 and are not an absolute ****** like most med students, and you shine on rotations, and make connections, and impress people, and people like you - you will have a better chance of getting that all important surgical spot over someone who scored a 245. That's just the way the world works. Medicine is no different. Nepitism, connections, and being likeable and intelligent go a looooooong way over a 3 digit number on paper

Agree here.

I have some outside experience also. People in academics go overboard on test scores. A lot of people will realize once they start working that a few points here or there on an MCAT or Step 1 are the absolute least important factors in a great career. But right now, people like to freak out and it's the only thing they can work on.

 

[dodobird1]

I guess I feel better looking at match outcomes. Some MS1-2 myths were debunked for me after looking at matching outcomes from 2011. You can look at hundreds of anecdotes on forums where people with 230 got into derm, but what I find more surprising is how many naive younger classmen think non-competitive residency = low step 1. Myths (data from US students):

1. Most people in family medicine or psych chose so because they got a low step 1 score.
#applicants with Step 1 scores >250: Family med = 36, Psych = 19
That's a lot more people than I expected.

2. People chose general surgery over ENT, ortho, neurosurg, or plastics because they didn't score high enough on step 1.
General surg applicants with Step 1 > 241 = 207, > 251 = 81

3. Higher step 1 is always better:
ENT acceptance rate for 251 < Step 1 < 260 = 98%, acceptance rate for >260 = 91%
Ortho acceptance rate for 251 < Step 1 < 260 = 93%, acceptance rate for >260 = 86%
Granted the noise in the #rejected is probably high making these inferences not significant, perhaps these may represent specialties where the whole package mattered more than wasting 1-3 months to go from a 255 to a 265. By contrast, Dx Rads, Rad Onc, Neurosurgery and Derm had 100% acceptance rate for Step 1 > 260, so maybe they care less about red flags so long as u remember p. 253 paragraph 2 line 1 word 1 of Goljan RR. I highly doubt between those 4 competitive specialties there wasn't 1 person with a red flag in the 260+ range.

Since the Step 1 > 260 score = 100% match in rads, neurosurg, and derm, there has to be some magic number every year, is it 252, 253, 254 etc..? That's where the Type A'ing kicks in.

 

[coolforschool]

That's definitely type A stuff. Would it satisfy you to know that magic number? Probably not, because then you'll start analyzing which rotations you need to honor or who's got the biggest D that needs a good jerkin' or which attending to bow down to... control what you can control, brah. We're all gonna make it...

 

[Stellar Clouds]

Yes. This is where I agree with you guys. Your score confines you to a certain standard deviation depending on what else you can bring to the table. I can be the best doc ever, but a 188 step 1 will get screened out

I agree, doctor.

Agree here.

I have some outside experience also. People in academics go overboard on test scores. A lot of people will realize once they start working that a few points here or there on an MCAT or Step 1 are the absolute least important factors in a great career. But right now, people like to freak out and it's the only thing they can work on.

I do agree that people tend to go overboard about test scores, but it is just as easy to say that people with "outside experience" undervalue step 1 scores. The outside world doesn't typically have a standardized application system that enables the employer to easily filter applicants by something that EVERY SINGLE applicant has by requirement. You can be the greatest student physician in the entire world, with oodles and oodles of 1st author papers (1 including the cure for cancer--unless you are shooting for ortho, then it's a paper demonstrating an easier way than using the heart to get Ancef to the bones), LORs from the best physicians in the entire world beaming about how wonderful you are and how your touch can heal those on death's door, and honors on everything (including under water basket weaving), but if your step score fails to meet the cut off, you can kiss that program good-bye.

Hyperboles make it more fun to read.

 

[dodobird1]

That's definitely type A stuff. Would it satisfy you to know that magic number? Probably not, because then you'll start analyzing which rotations you need to honor or who's got the biggest D that needs a good jerkin' or which attending to bow down to... control what you can control, brah. We're all gonna make it...

the funny thing is that men have tried time and time again to increase both, but in the end we're all limited by the potential we are born with