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Posts Tagged ‘step 1’

What are my chances?

Let me get out my crystal ball.

The “what are my chances” question is not one that can be answered as I do not have enough data.  One can predict the probability of matching based on Step 1 scores or a combination algorithm.

Remember one can not underestimate the importance of data.  According to the NRMP 2009 data the probability of matching in Internal Medicine (IM) is 35% if you have 3 interviews, 50% if you have 5 interviews, 75% if you have 10 interviews.  That makes sense you have to interview to match.  Many people are lucky to get 1 interview which corresponds to a 25% chance of matching in IM.

Regarding Step 1 scores, for those who do interview in IM, the probability of matching in IM with Step 1 200 is 27%, Step 1 of 220 is 45%, 240 is 63%.  Information on step 2 scores is not present as many AMGs don’t take step 2 prior to applying.

What can I do to improve my chances?  Just over half (1092/2113) of those who match do not have any Abstracts, Presentations, or Publications which suggests that if you are strong enough as a candidate, publications/research don’t matter.

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.

2 digit USMLE scores are going away

August 4, 2011 1 comment

So the two digit score is going away, sort of.

From ECFMG Reporter issue 169 May 2011: “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, 2 CK, 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.”

This doesn’t have any effect on the applicant as most programs use the 3 digit scores in their filters anyway.  What it does mean for the IMG community is a frame shift in the thinking of what the scores mean.    What this means is that “99/99″ will become a thing of the past.  No more “he is a 99/99 so he must be good.”  A 99 two digit score represented about the top 20% of scores, not the 99th percentile.  True 99th percentile is a three digit score of 260 according to a nice analysis by My Dominant Hemisphere. This was a big point of confusion for a lot of people for a long time.  The only people I ever heard mention the two digit score were IMGs.  And the mention bordered on obsession.  The two-digit scores were designed for the state medical boards and will still be reported to the states and to the test taker but not the residency programs.

On the two-digit scale, the minimum passing score is always a 75 but with the 3 digit score it depends on the distribution.  Minimum Passing three digit Scores for last year were Step 1 188, Step 2 CK 189, Step 3 187. My advice is to think of your scores in the three digit form and compare them to the NRMP data to see in which specialties that you might fit.

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.

Categories: USMLE Scores Tags: , , , ,

Even excellent scores are no guarantee

August 2, 2011 2 comments

I previously looked at low USMLE scores and the likelihood of matching.

Lets look at the opposite.  What are the chances of getting a residency in IM with terrific scores?

Again lets look at the NRMP data from 2009.

In general, scores over 230 are considered very good.  Scores over 240 are terrific.

For Step 1, for the 1054 IMGs with scores above 230 who interviewed, only 61.7% matched to internal medicine.  For the 459 IMGs with scores above 240 who interviewed, only 70.6% matched to internal medicine.

For Step 2, for the 1252 IMGs with scores above 230 who interviewed, only 63.3% matched to internal medicine.  For the 650 IMGs with scores above 240 who interviewed, only 71.5% matched to internal medicine.

So, even if your scores are great there is only a moderately strong chance that you will get a residency in internal medicine.  Even with terrific scores you need to have the other parts of the application including clinical experience in the US with US letters.  The most important issue is not expecting to land a residency in a university program.  If you lower your expectations (even if you have terrific scores) and alter your application strategy accordingly, you may be happier in the end.

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.

Low USMLE scores

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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