Very low step 1

[DOaz]

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Scored 20 plus lower on my step one usmle than practice exams, 198 actual. Haven't gotten COMLEX back yet but was wondering if I am out of running for MD EM spots. I am hoping for mid 500 on COMLEX. Not real concerned about where I go, prefer to stay Midwest area and avoid east coast. I know my work is cut out for me and I need to nail step 2, but with EM competitiveness increasing my coordinator advised me to look into something else. Interested in anesthesia also so that's not any easier, just thought I would gauge someone else's opinion. Thanks for the advise

 

[zinjanthropus]

was it your first time taking the exam? if so, at least you passed on first attempt and you are going a bit above and beyond by taking it as a DO anyway.

 

[DOaz]

Yeah was the first time, took it for the increased opportunities of MD and DO residencies.

 

[Chakrabs]

Hate to say it, but a DO applicant with a 198 step 1? You'd be hard pressed to find any decent MD program that'd show you the time of day unless you've rotated there and blew the rotation out of the water. focus on Comlex, if you do well on that submit to both DO and MD programs. If you can ace Step 2, you'll have an argument that the Step 1 score was a fluke. Be sure to rotate at a variety of programs.

 

[dotcb]

You might have trouble matching in EM with that score. Need a back up plan of what you'll do if you fail to match. Rock your clerkships. Take Step 2 ASAP and need it to be very high. Do some aways and knock their socks off. Good luck

 

[OccupyTheED]

It'll be tough but not impossible, I matched last year with a 201. Agree with above, being a rockstar on your clerkships can go a long way towards making up for the Step 1. Make sure your application is complete by September 15th and follow up with the programs you're really interested in. Apply for some medicine prelim years as a backup.

 

[DOaz]

Thanks everyone for here your responses, I know I have uphill battle ahead of me. If anyone would rather pm me for advice or similar situation I would greatly appreciate it.

 

[Pigg-O-Stat]

My Step 1 was a 202, and I got a solid MD spot. I got 231 on Step 2, and worked my ass off on my audition rotation. So obviously those things were crucial. But you aren't out of the running. You can still get a solid spot. That being said, I remember attending a few lectures at med student symposia, where they told us about cut-off scores at various programs. They ranged from around 185-230 depending on the program. Many of them had cut-off around 200. So many of those programs won't look at your application. I think the key for you is to focus on DO friendly MD programs (just look at their current and past residents), and audition widely - a good audition rotation will overcome a single low score. Also kick ass on Step 2. Good luck.

 

[Groove]

All this type of data is online, easy to analyze and gives you a good idea of where you stand. It's much more accurate information than asking us "what are my chances???" when some of us matched years ago. I would have told you.... probably can't do it, but then again if you look at the match data... 118/146 matched within that range of Step 1 score. Seems high, but the numbers don't lie. Hey that rhymed.

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

It will be more difficult matching as a DO, but easier than an IMG/FMG. Apply widely and have back ups. I don't know if you plan on taking Step 2 or not, or if you're required, but I would recommend it with that low score. I remember that several programs had cut offs around 205.

 

[justaregularmed]

My Step 1 was a 202, and I got a solid MD spot. I got 231 on Step 2, and worked my ass off on my audition rotation. So obviously those things were crucial. But you aren't out of the running. You can still get a solid spot. That being said, I remember attending a few lectures at med student symposia, where they told us about cut-off scores at various programs. They ranged from around 185-230 depending on the program. Many of them had cut-off around 200. So many of those programs won't look at your application. I think the key for you is to focus on DO friendly MD programs (just look at their current and past residents), and audition widely - a good audition rotation will overcome a single low score. Also kick ass on Step 2. Good luck.

LOL @ an emed program cutting off at 230, they must have confused themselves with the orthopods. I for one am happy with pride in ones specialty but specialty snobbery needs to take a hike.

 

[DaBears77]

Scored 20 plus lower on my step one usmle than practice exams, 198 actual. Haven't gotten COMLEX back yet but was wondering if I am out of running for MD EM spots. I am hoping for mid 500 on COMLEX. Not real concerned about where I go, prefer to stay Midwest area and avoid east coast. I know my work is cut out for me and I need to nail step 2, but with EM competitiveness increasing my coordinator advised me to look into something else. Interested in anesthesia also so that's not any easier, just thought I would gauge someone else's opinion. Thanks for the advise

Greetings,

Don't give up on EM. I matched to my top program with a 200 on step one. I did 2 away rotations, got 3 SLORs. The program I matched is not somewhere I rotated but just somewhere I fit really well with. I did massively improve on step 2 (high 240s) which I'm sure helped a lot. Be sure to apply ASAP because many programs will give out interviews long before all SLORs are out, and I had all of my interview offers before the dean's letter was released.

All that being said. Have a backup plan.

 

[John146]

It is definitely possible to overcome a low step 1 score. Obviously you have put yourself in a bad position. Hopefully, the rest of your CV (class rank, extracurriculars, volunteer, etc.) is strong so far and adds value to your application.

As others have stated, you basically need to buckle down and kick butt on your M3 rotations (lots of honors/high passes). Start studying now for Step 2, go into "loser mode," take it early and show everyone that you're a stud.

Simply, don't worry about the past, because what's done is done. Just do the best you possibly can moving forward and best of luck.

[Worked for me. DO with low step 1 due to some family stuff. Got basically all honors during 3rd year, nice SLORs early in 4th year, and scored 50 points higher on Step 2. I ended up getting loads of interviews and matched at a respectable allopathic program in the NE.]

 

[tofuman14]

Here is some number evidence to get an idea of your chances.

They just published the results from the 2011 Match. Click on the link below and scroll to page 62 to see the breakdown of matches by score:

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

This past year, 118 US students with scores like yours (191-200) successfully matched into an EM residency. I don't know the breakdown of Allopathic vs. DO, but hopefully it's nice to know the numbers.

 

[DOaz]

Anybody this year match with similar number as me? 198 USMLE and 526 Comlex, trying to figure out audition rotations and my chances. Feel free to PM, I would greatly appreciate any feedback. Thanks

 

[SeekerOfTheTree]

Here is some number evidence to get an idea of your chances.

They just published the results from the 2011 Match. Click on the link below and scroll to page 62 to see the breakdown of matches by score:

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

This past year, 118 US students with scores like yours (191-200) successfully matched into an EM residency. I don't know the breakdown of Allopathic vs. DO, but hopefully it's nice to know the numbers.

See I think they extrapolate data because it says 7 people matched with less than a 180. How does that even work?

 

[SserPrun95]

Glanced through it quickly and although I didn't see it stated explictly (like I said I glanced through quickly) I can only assume that those scores are for first time test takers aka they were able to retake it and pass but that score isn't what's reported.

 

[K31]

See I think they extrapolate data because it says 7 people matched with less than a 180. How does that even work?

I'm pretty sure that Charting Outcomes only takes first attempts at each Step into account.

 

[Siggy]

I'm pretty sure that Charting Outcomes only takes first attempts at each Step into account.

Also DOs since USMLE isn't required for licensure.

 

[K31]

Also DOs since USMLE isn't required for licensure.

A good point, except that statistic is only US MD seniors.

 

[Old_Mil]

Your best option is to rotate at osteopathic EM residencies and try and use that experience to get a spot. While nothing is impossible matching to an allopathic md program with that step 1 score will be very difficult. There will be many applicants with step 1 scores that are 30, 40, even 50 points above yours.

 

[Siggy]

A good point, except that statistic is only US MD seniors.

Touche.

 

[valkener]

Your best option is to rotate at osteopathic EM residencies and try and use that experience to get a spot. While nothing is impossible matching to an allopathic md program with that step 1 score will be very difficult. There will be many applicants with step 1 scores that are 30, 40, even 50 points above yours.

You're forgetting that he will need to learn OMM if he wants to match AOA.

 

[Siggy]

You're forgetting that he will need to learn OMM if he wants to match AOA.

Considering that the OP mentioned that he has a COMLEX Level 2 score of 526, I think it's safe to say that he learned OMM over the past 4 years.

 

[diphenyl]

Do's aren't required to report their USMLE scores even if they have taken them since it isn't required for licensing purposes as I recall.

 

[SserPrun95]

I know of a guy who failed step 1 and matched at his #1. Don't know what his retake or step 2 scores were though. Anything is possible, your road is just more difficult.

 

[sylvanthus]

Do's aren't required to report their USMLE scores even if they have taken them since it isn't required for licensing purposes as I recall.

If they apply AOA they dont have to report USMLE scores. If they apply MD they have to report that they took it. Its unclear if they have to actually report the score or just that they took it. But obviously if a student says they took it and didnt release the score it isnt a good sign.

 

[The White Coat Investor]

Be sure you tailor your applications to your score. The places that most consider "back-up programs" should be the only type you apply to, and you probably want to shell out to apply to 40-60 of those. You've got to get yourself 5-10 interviews. Taking Step 2 early and rocking it (which is much easier than rocking step I - trust me on this, I had to study for it unlike most of my classmates due to the military match and scored 12 points higher than an already great score) would also go a long way.

 

[randodoc]

Anecdotally, the EM match is getting more and more competitive every year. Being a DO puts you at a big disadvantage right off the bat. You really need to rise ABOVE the competition to have a good shot at matching.

Good thing is, it seems the AOA and ACGME match will have combined by the time you apply. So, you may not have to make the decision to drop out of the AOA match in order to try your luck at ACGME. Honestly, without stellar 3rd year grades, amazing SLORs, and a huge increase in step 2 (like 250s), I doubt you'll get much, if any, play on the ACGME side. If I were you, I would start working on the above, while simultaneously investigating DO programs that you might be interested in attending. Be sure to rotate at some DO programs, as you are still in the running for them.

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