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I scored below my goal…can I still get into the specialty I want?

Activity Forums USMLE Step 1 Forum I scored below my goal…can I still get into the specialty I want?

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    Dan S., MST USMLE Tutor
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    USMLE ExpertMD or DO

    First of all, I love data and generally find more data better than less data. Second of all, let data inform you, but don’t be afraid to be the outlier.

    Here are three documents I find myself turning to often when helping students answer the question, “I scored *** on Step 1. Do I still have a chance to match in ***?”
    For US MDs: https://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Seniors.pdf
    For US DOs: https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Osteo.pdf
    For US and Non-US IMGS: https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-IMGs.pdf

    Here is a specific example of how I use this info:
    A US IMG scored 213 on Step 1 and wants to know whether or not this means the end of their hopes of becoming a Neurologist. Page 9 of the third document above shows us that the interquartile range (IQR) for US-IMGs who matched in neurology was about 218-238.The IQR for those who did not match was about 206-222. It is worth thinking about what this does and does not tell us.
    1) What it does tell us: a score of 213 is more central to the curve of those who did not match in neurology than to the curve of those who did match, i.e. more people who scored at or below 213 didn’t match than did.
    2) What it does not tell us: whether this particular person is more likely to fall on the curve of those who matched or the curve of those who did not.
    The IQR, by definition, includes 50 percent of people. Another 25% scored above the range presented, and 25% scored below the range presented. Put another way, if you matched in neurology, you were as likely to have a Step 1 score below 218 as you were to have a step 1 score between 218 and 228.

    My take aways from this type of thinking are as follows: Step 1 scores matter, but they aren’t the end all be all. There is clearly lots of overlap in Step 1 scores between those who do and do not match, so there are lots of other factors at play. If your Step 1 score is below the IQR of matched students, it is worth acknowledging that your score will be working against you, but that doesn’t mean it will outweigh the factors working for you.

    To come back to our example, if you are US-IMG who scored a 213 on Step 1, the answer is no, it is not necessarily time to give up on your goals. That said, if your number 1 goal is to match in a US residency program, and this is more important to you than matching in neurology, the same figure on page 9 might provide you with other specialty options in which your Step 1 score would be more central to the curve.

    Feel free to post questions below!

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