# What does a score of Double 99 mean?

#### Shoushu

5+ Year Member
I read on various forums people referring to IMGs scoring double 99s and not accepted at any program.

What's double 99? since step I has average score in 200 range and perfect theoretical score of 300. I thought 99 means percentile. ??

#### Instatewaiter

##### But... there's a troponin
10+ Year Member
I read on various forums people referring to IMGs scoring double 99s and not accepted at any program.

What's double 99? since step I has average score in 200 range and perfect theoretical score of 300. I thought 99 means percentile. ??
There is a 2 digit score and a 3 digit score. The 3 digit score is the one people actually use (unless they are an IMG) because the 2 digit score tells you very little. A 99 can be a 3 digit score from 235- 280. Those are very different scores.

The 2 digit score IS NOT A PERCENTILE. IMGs think it is. Hell a 75 is the lowest possible passing score.

A 99 currently means you got above about a 235 on the real deal (roughly 75th percentile). While a good score, it is not 99th percentile (which would be in the 270-280s).

When you hear someone say, "I got a 99 on step 1" you can basically gaurrantee they did not go to school in the US.

#### defcon8

##### Information ≠ Knowledge
10+ Year Member
I read on various forums people referring to IMGs scoring double 99s and not accepted at any program.

What's double 99? since step I has average score in 200 range and perfect theoretical score of 300. I thought 99 means percentile. ??
Double 99 means a 2-digit score of 99 in both step 1 and step 2 ck. The 2 digit score is neither a percent nor a percentile, just a score correlating with 3-digit performance up to a point mainly for use by residencies.

#### illixir

##### One
10+ Year Member
Double 99 means a 2-digit score of 99 in both step 1 and step 2 ck. The 2 digit score is neither a percent nor a percentile, just a score correlating with 3-digit performance up to a point mainly for use by residencies.
Residencies use the 3-digit score to judge. The 2 digit score is an artifact from several years ago when the IMG exam(was scored in only 2 digits) and US exam(was scored in only 3 digits) combined.

#### kryptik

10+ Year Member
they need to get rid of the double digit score, serves no purpose

#### Shoushu

5+ Year Member
they need to get rid of the double digit score, serves no purpose
yeah it only confuses. Double digit score, triple digit, gimme a break, arent they the same step I exam?

If a US-IMG scored double 99 on step I and step II, that means he ranks 75th precentile in all med students. With IMG bias, still not quite making to good programs. If he scored into the 90-percentile range, does he still have only 99 or 129, 139 or what? it's confusing.

It should be like the SATs or MCAT, 2-digit or 4-digit only, (up to 45 mcat, or 1600 to 2400 for old/new SAT).

#### mochief2000

10+ Year Member
There is a 2 digit score and a 3 digit score. The 3 digit score is the one people actually use (unless they are an IMG) because the 2 digit score tells you very little. A 99 can be a 3 digit score from 235- 280. Those are very different scores.

The 2 digit score IS NOT A PERCENTILE. IMGs think it is. Hell a 75 is the lowest possible passing score.

A 99 currently means you got above about a 235 on the real deal (roughly 75th percentile). While a good score, it is not 99th percentile (which would be in the 270-280s).

When you hear someone say, "I got a 99 on step 1" you can basically gaurrantee they did not go to school in the US.

I have no idea why you just singled out IMG's. Alot of students get this wrong. But you are right though..

#### defcon8

##### Information ≠ Knowledge
10+ Year Member
Residencies use the 3-digit score to judge. The 2 digit score is an artifact from several years ago when the IMG exam(was scored in only 2 digits) and US exam(was scored in only 3 digits) combined.
Residencies with cut-off scores use the 2-digit score, not the 3-digit score. The 3-digit becomes important when looking at the applicants who made it through the filter.

#### tideleonheart

10+ Year Member
Residencies with cut-off scores use the 2-digit score, not the 3-digit score. The 3-digit becomes important when looking at the applicants who made it through the filter.
Some cutoff with 2 digit scores, true, but others have their cutoffs with 3-digit scores. I obviously don't have any statistics to back this up, but I suspect more tend to have cutoffs of the 3-digit score.

#### myocyte

I read on various forums people referring to IMGs scoring double 99s and not accepted at any program.

What's double 99? since step I has average score in 200 range and perfect theoretical score of 300. I thought 99 means percentile. ??
Double 99 = 235+ on Step I, 240+ on Step II. I find it hard to believe that someone with those numbers didn't get accepted to any programs unless they chose to send out only 4 apps (MGH, Yale, JHU, and UCSF).

#### deuce

##### New Member
7+ Year Member
15+ Year Member
USMLE site is very recondite about this - their web site says mean is 210-230 depending on the year and SD is 20 - so does that mean a 240 is 75th percentile and a 260 means you scored higher than 95 % of those taking step 1 ?

#### McGillGrad

##### Building Mind and Body
10+ Year Member
15+ Year Member
It means that you are more competitive than people without a double 99.

It is used by program directors to more easily differentiate candidates. Instead of setting an arbitrary 3-digit score, the two digit score allows a group of similar candidates to be filtered through. Since the exam has a roughly 6 point margin of error, it is easier to set 99 as a cut-off (since a 236 could be 242 on a good day or vice versa) than 240, because it covers a larger group within the margin of error.

#### kjamess

7+ Year Member
what is the significance of two digit score now that 99 is being given to those with a score of 228 or 229? And how is this two digit score calculated anyway?

#### hrandani

7+ Year Member
2 digit score is being phased out. I've never heard of a program director using it over the three digit anyway. There is no significance.

I heard it originated as a percentile, but it most definitely is no longer calculated that way.

#### ArcGurren

##### only one will survive
what is the significance of two digit score now that 99 is being given to those with a score of 228 or 229? And how is this two digit score calculated anyway?
Residencies no longer get your 2 digit score on ERAS, they filter purely by 3 digit score. I think it's more or less a remnant of an old scoring system, along with the fact that some programs used to use it just for IMGs. My parents were also confused when I was explaining this to them, as I have an IMG cousin who got a 99 and I had to explain to them (to their consternation) that 99 =/= 99th percentile.

#### lord_jeebus

##### 和魂洋才
Moderator
15+ Year Member
The only reason the 2 digit score exists is that a few state medical boards are required by their state laws to only issue licenses to applicants with USMLE scores of "75" or greater on a two-digit scale.

This also means that while the passing 3-digit score can be changed, 75 will always be a minimum pass.

#### Siverhideo1985

10+ Year Member
7+ Year Member
What's the mathematical difference between the two scores?

#### ArcGurren

##### only one will survive
What's the mathematical difference between the two scores?
Not sure what you mean by that... the 2 digit score isn't related directly to the 3 digit score except that 188 normalizes to 75

#### HalladayWeekend

7+ Year Member
Do programs take into account the standard error of measurement when doing score cutoffs (i.e. if score cutoff is 250 and SEM of 6, would those with 244+ make the cutoff?)

#### SmokD

5+ Year Member
I tend to use the two digit scores when talking to people not familiar with the test. Too many questions when you give em the 3 digit score =/

#### MeatTornado

##### On Sabbatical
10+ Year Member
I tend to use the two digit scores when talking to people not familiar with the test. Too many questions when you give em the 3 digit score =/
you mean you use the 2 digit score because it makes your score sound more impressive

its pretty easy to say "i got 2xx" and the national average is 222 with a sd of 24

#### SmokD

5+ Year Member
you mean you use the 2 digit score because it makes your score sound more impressive

its pretty easy to say "i got 2xx" and the national average is 222 with a sd of 24
Well, I'm technically not lying. Not my fault they assume its better than it is

#### ArcGurren

##### only one will survive
you mean you use the 2 digit score because it makes your score sound more impressive

its pretty easy to say "i got 2xx" and the national average is 222 with a sd of 24
Yeah and it's not entirely a normal distribution either... a 250 is around 94th percentile for example, where on the normal curve it should be closer to the 85th percentile (my math sucks though, this is just an approximation)

#### hrandani

7+ Year Member
you mean you use the 2 digit score because it makes your score sound more impressive

its pretty easy to say "i got 2xx" and the national average is 222 with a sd of 24
Well, maybe you can tell people that. I'm not entirely sure anyone in my family even knows what a standard deviation is.

#### MeatTornado

##### On Sabbatical
10+ Year Member
Well, maybe you can tell people that. I'm not entirely sure anyone in my family even knows what a standard deviation is.
sd isn't really that important ...when i told my parents the score i just told them the mean. on the other hand you can tell them the approximate percentile which many have talked about on here. but telling someone you got a "99" is really silly

#### iceman87

10+ Year Member
5+ Year Member
From usmle . org annoucements page:

Changes to USMLE Procedures for Reporting Scores

Starting July 1, 2011, USMLE transcripts reported through the ERAS reporting system will no longer include score results on the two-digit score scale. USMLE results will continue to be reported on the three-digit scale. This affects the Step 1, 2CK, and 3 examinations only; Step 2 CS will continue to be reported as pass or fail. These changes do not alter the score required to pass or the difficulty of any of the USMLE Step examinations.

Posted May 04, 2011 [-] Click HERE to close announcement
Since its beginning in the 1990s, the USMLE program has reported two numeric scores for the Step 1, Step 2 CK, and Step 3 examinations, one on a three-digit scale and one on a two-digit scale. The three-digit score scale is considered the primary reporting scale; it is developed in a manner that allows reasonable comparisons across time. The two-digit scale is intended to meet statutory requirements of some state medical boards that rely on a score scale that has 75 as the minimum passing score. The process used to convert three-digit scores to two-digit scores is designed in such a way that the three-digit minimum passing score in effect when the examinee tests is associated with a two-digit score of 75.

The USMLE program requires its governing committees to reevaluate the minimum passing score every three to four years. This process has, at times, resulted in changes in the minimum passing score, expressed on the three-digit scale, and an accompanying change in the score conversion process, to ensure that a two-digit score of 75 is associated with the new minimum passing requirement. A by-product of the adjustment of the score conversion system over time has been a shift in the relationship between the two score scales. This shift has no impact for USMLE score users who use the three-digit scoring scale or for those using the two-digit scale with a primary interest in whether the examinee has a passing two-digit score of at least 75. However, it may create challenges in interpretation for score users who are focusing on two-digit scores, other than 75, and are doing so for purposes of comparing USMLE scores that span several years.

To simplify matters and make interpretation of USMLE information more convenient for score users, the USMLE Composite Committee has asked staff to report two-digit scores only to those score users for whom the scale is intended, i.e., the state medical boards. The Committee also asked that examinees continue to receive scores on both scales so that they are fully informed about the information that will be reported when they ask that results be sent to a state medical board. When examinees request that their results be sent to other score users, only the three-digit score will be reported. Current plans call for these changes to begin with the elimination of the two-digit score from USMLE transcripts reported through the ERAS reporting system starting July 1, 2011. Other systems and procedures for reporting results will be similarly modified as soon as possible after the July 1, 2011 date.

#### lord_jeebus

##### 和魂洋才
Moderator
15+ Year Member
Do programs take into account the standard error of measurement when doing score cutoffs (i.e. if score cutoff is 250 and SEM of 6, would those with 244+ make the cutoff?)
No

I suppose you could say that that program has an actual cutoff of 256, with 6 points of leeway given

#### MeatTornado

##### On Sabbatical
10+ Year Member
From usmle . org annoucements page:

Changes to USMLE Procedures for Reporting Scores

Starting July 1, 2011, USMLE transcripts reported through the ERAS reporting system will no longer include score results on the two-digit score scale. USMLE results will continue to be reported on the three-digit scale. This affects the Step 1, 2CK, and 3 examinations only; Step 2 CS will continue to be reported as pass or fail. These changes do not alter the score required to pass or the difficulty of any of the USMLE Step examinations.
interesting. thanks for sharing

#### Tig2575

When you hear someone say, "I got a 99 on step 1" you can basically gaurrantee they did not go to school in the US.

ROFL. Too true.

#### luluxiu

It is the use of program directors to more easily distinguish candidate. Rather than set an arbitrary three-digit score, double-digit scores can be screened by a group of similar candidates...