US IMG low step 1 score. Any hope left?

[stresstest06]

I'm a US-IMG, I graduated in 2017. I planned on taking Step 1 in 2019, but due to some family issues I went into depression and couldn't study for few months. Then scheduled to take the exam in March, but that got delayed due to covid. Finally, took the exam in Sept and did worse than I expected. I was expecting to get something in the 225-235 range based on my NBME performances, but ended up in the 205-215 range. I'm just trying to figure out if there's any hope left for me or if I should give up and pursue something else. I'm willing to put in the work if I still have any chance left. As far as US experience goes, I have volunteer experience at a hospital, but I'm currently looking for research positions to bolster my resume.

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[ciestar]

Probably not. You have no USCE, you graduated over 3 years ago, and have a low step 1 score.

 

[Small Cell Carcinoma]

I'm a US-IMG, I graduated in 2017. I planned on taking Step 1 in 2019, but due to some family issues I went into depression and couldn't study for few months. Then scheduled to take the exam in March, but that got delayed due to covid. Finally, took the exam in Sept and did worse than I expected. I was expecting to get something in the 225-235 range based on my NBME performances, but ended up in the 205-215 range. I'm just trying to figure out if there's any hope left for me or if I should give up and pursue something else. I'm willing to put in the work if I still have any chance left. As far as US experience goes, I have volunteer experience at a hospital, but I'm currently looking for research positions to bolster my resume.

How can you be a US-IMG and have no US clinical experience? Don't all Caribbean programs rotate their students in the states?

The 3 years out from graduation hurts you far more than the low 200s score. You could match in at least FM with with that if you were to apply broadly and otherwise play your cards right.

 

[stresstest06]

How can you be a US-IMG and have no US clinical experience? Don't all Caribbean programs rotate their students in the states?

The 3 years out from graduation hurts you far more than the low 200s score. You could match in at least FM with with that if you were to apply broadly and otherwise play your cards right.

I completed my MBBS in Asia and became citizen after getting married. So I guess I'm not US-IMG in "traditional" sense. I'm calling myself US-IMG simply because I will not be needing any visa while applying to residency programs

 

[stresstest06]

Does anyone know how the change to pass/fail score reporting for Step 1 impact my chances? Looks like more emphasis will be given to Step 2. Will I have a shot if I can score 240+ in Step 2 CK?

 

[ciestar]

Does anyone know how the change to pass/fail score reporting for Step 1 impact my chances? Looks like more emphasis will be given to Step 2. Will I have a shot if I can score 240+ in Step 2 CK?

Your time from graduation is still going to hurt you a lot

 

[Tangerine123]

How can you be a US-IMG and have no US clinical experience? Don't all Caribbean programs rotate their students in the states?

US-IMG and Caribbean aren't synonyms

 

[stresstest06]

Your time from graduation is still going to hurt you a lot

Setting that aside, will a high Step 2 CK score somewhat compensate for lower Step 1 score?

 

[DO2015CA]

Just stay in Asia and undergo residency/practice there.

 

[Goro]

I completed my MBBS in Asia and became citizen after getting married. So I guess I'm not US-IMG in "traditional" sense. I'm calling myself US-IMG simply because I will not be needing any visa while applying to residency programs

So you're an FMG who later became a citizen. As mentioned above, the YOG is going to hurt you.

 

[jurassicpark]

How can you be a US-IMG and have no US clinical experience? Don't all Caribbean programs rotate their students in the states?

The 3 years out from graduation hurts you far more than the low 200s score. You could match in at least FM with with that if you were to apply broadly and otherwise play your cards right.

Not all USIMG are Caribbean. They can go to Asia, India, Europe, etc. US-IMG just means you are US citizen that went to a foreign school, it is not caribbean specific.

 

[Florentine]

Hi OP. There is always hope of course. If you take a look at the NRMP data here https://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-IMGs.pdf you will see that in some cases there are handfuls of international students who matched despite having scores in the 201-210 range, and 211-220 range. So the score will probably make it harder but it's not impossible. I agree with the others that the time from graduation is probably going to hurt you, however.

 

[stresstest06]

So you're an FMG who later became a citizen. As mentioned above, the YOG is going to hurt you.

Correct, I'm a FMG who became citizen. Thank you for your feedback

 

[stresstest06]

Hi OP. There is always hope of course. If you take a look at the NRMP data here https://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-IMGs.pdf you will see that in some cases there are handfuls of international students who matched despite having scores in the 201-210 range, and 211-220 range. So the score will probably make it harder but it's not impossible. I agree with the others that the time from graduation is probably going to hurt you, however.

Thank you for the information. I wonder if having a low step 1 score and high (240+) step 2 CK score put someone closer to overall "mean". Is there anything that says that the programs put more emphasis on step 1 vs step 2 or vice versa?

 

[ciestar]

Thank you for the information. I wonder if having a low step 1 score and high (240+) step 2 CK score put someone closer to overall "mean". Is there anything that says that the programs put more emphasis on step 1 vs step 2 or vice versa?

Keep in mind the average step 2 score is like a 244.

Either way, it will be an uphill battle.

 

[DO2015CA]

Have you been in residency/practicing medicine in the country you went to school?

 

[Medisaint]

I am going to make a few guesses about your situation.

#1 that you are young(ish) (mid 20's) and #2 you don't have much in the way of debt. I say that based on you having earned an MBBS and how you casually mentioned switching careers if medicine doesn't pan out. For many US-IMGs changing careers is not a viable option as they are in late 20's/early 30's with hundreds of thousands in undergrad and Caribbean student debt. They are like overeducated sharecroppers who spiral deeper into debt hoping to break the cycle with each application season. I am sure some of these folks wish they had gone into something (or anything) else. In your case, if you are not tethered to medicine and are lukewarm about continuing this may be a good time to reflect on your options. To pull off matching into residency you're going to have to be "all-in".


A few thoughts on applying ...
-3 years out of graduation was the limit at my program but other places may be more lenient.

-If I may ask, what have you done with your life over this time? If you worked as a junior doctor abroad then that will help, if you were unproductive then you basically have to major time gap to explain away.

-While there may be biases toward your MBBS, being a US citizen will help a lot when applying broadly to smaller programs who couldn't otherwise sponsor a J1 or H1 visa. I would make sure you find a way to mention "US Citizen" into the opening paragraph of your personal statement in case the MBBS throws them off.

-Traditionally, the step 1 was more heavily weighted but that shouldn't really matter. You will need to do excellent on CK, regardless.

 

[Small Cell Carcinoma]

Setting that aside, will a high Step 2 CK score somewhat compensate for lower Step 1 score?

Like others have said, your YOG is the biggest obstacle here. I totally understand how crippling it must have been to go through a depressive episode, but why not take these exams in 2017 around the time you graduated and avoid this circumstance entirely?