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Low USMLE scores

July 29, 2011

A question that I was sent via email. What are my chances in Internal Medicine with scores below 85?  What can I do to improve my chances?

Not great and not much I’m afraid.  Lets look at the numbers.  From a prior post you know that 26.8% of all non-US IMG applicants will match.  Also remember that 34% of non-US IMG applicants do not interview in any field.

In internal medicine, the NRMP published data from 2009 on USMLE scores and matching for IMGs (starting on page 96).  This is a very helpful resource in determining where you fit into the matching game.

For starters, lets use the three digit score as the two digit scores are being phased out.  Now, the mean step 1 score of all IMGs (non-US and US IMGs) who match in internal medicine is 222 and the mean step 2 is in the 226 range.  (For conversion from 2 digit to 3 digit see here)

For those with a step 1 score of 200 and below, only 13.0% of IMG applicants who interview match in internal medicine.  Remember there are a lot of people who apply with step 1 scores under 200 and don’t interview so if we take those into account, the match numbers in IM for step 1 scores under 200 are terrible.  Looking at those with a step 1 score of 210 or less, only 25.6% of those who interview match in IM.  Still not great.

Lets look at step 2 scores. For those with a step 2 score of 200 and below, only 19.9% of IMG applicants who interview match in internal medicine.  Remember there are a lot of people who apply with step 2 scores under 200 and don’t interview so if we take those into account, the match numbers in IM for step 2 scores under 200 are not good.  Looking at those with a step 1 score of 210 or less, only 23.2% of those who interview match in IM.  Again not great.

I don’t interview for Family Medicine but if you look at the mean step 1 score of IMGs who match is 201 and the mean step 2 is 205.  For those of you with lower scores, Family Medicine may be “easier” to match in but has fewer residency spots.  Similar to Internal Medicine, Family Medicine is saturated with applicants.

No amount of research, publications, MPHs, or observer experiences will rescue poor step 1 and 2 scores.  Good friends of mine had great research, student clerkships, observer experiences, perfect English and connections but did not match due to low scores.

The message is that poor scores are very difficult to overcome.

The views expressed in this post are those of Kenneth Christopher, MD and do not necessarily reflect the views of Dr. Christopher’s employer Partners HealthCare.

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