[add1]

I just came across a post on a different site and was wondering if any part of it is true??

hi all,

all the best to all of you preparing for step1. I am trying to explain how important step1 score is
for getting a GOOD residency especially for NON-US IMGs who need visa - H1/J1. When I gave my step1, I thought I knew this, but I now realize and I didn't quite know how important step1 score really is.

I am applying for residency this year - in fact this is my second year of applying. I got some interviews, but I might not be able to get into a program I had initially hoped for.

I have good scores (99-237/99-243), lot of clinical experience and even research experience and excellent LORs from US doctors. However, I got only a couple of interviews from University programs which are my top priorities.

this info is for IM - internal medicine.

when I compared myself with other non-us IMGs who got several university IVs, I found only one main difference - their step1 scores were higher.

If you want good university programs, make no mistake a low 99 is NOT going too cut it - you need HIGH 99s. In fact the higher the better.

If you want top university programs (top 10, top 20 programs), 270+ scores are almost necessary. I have not seen any non-US IMG get into top 20 programs without a super high score.

For a top 50 / top 100 program, you'll need 260+ for sure.

And to get into any good univ program with a fellowship, you'll need 250+.

If you don't have a 250 and are a non-US IMG and need visa, you have very low chances of getting into a university program with a fellowship, which is what I aimed for.

I had thought a double 99 would get me a university program, but I can't believe how wrong I was. If I were to do it again, I would not settle for low 99s. even if I had to put several months more of preparation, I would sure work for high 99s.

Please don't make the mistake I made in underestimating the imp of step 1 score - even if you have to prepare for a few months more.

Please, please, get high score - step1 score is the Single MOST important credential in getting a GOOD residency. of course, clinical experience, us lors are important too, but step1 score is by far the most imp.

good luck to all of you..

 

[chardoc]

Total crap. unworthy of comment.

 

[steps]

 

[dr tee]

pls if an IMG writes this we have to look into this critically. I am an IMG and I hope we all are writing USMLE because we believe we would have a fair chance in getting a residency unlike what is happening in the europead union now.
Can we please get some response from people who know better, even if they want us to get a 290 before we get a good residency let us be aware.
thanks.
waiting for your replies.:scared:

 

[add1]

I do not think any of this is true though...

 

[drarnab]

This is absolute BS - I have seen the "match outcomes for 2009" file and MANY MANY IMGs are matching in Internal medicine at scores less than 220.

Also, There were only 10 or 12 people who have scored greater than 260 and about 150 who have scored more than 250 in step 1 - this number can at most increase by 30% in 2 years. No dent at all.

I really think such people are sick to be creating these stories.
There are others about being "super prepared" but "failed miserably". Totally frustu people.

 

[kundra]

never heard a crap worst than this..i know a lot many people who matched last year to good university programme and none of them had 99 in either step what to say of having 99 in both!!
these are people who have either failed or could not match due to several reasons and are just trying to take out their frustrations on those like us who are still preparing..
just think it through even if we dont intend to match in top 20 universities we still need 260+..total BS!!

don't let any of these rubbish talks affect you guys,give your best shot and with proper planning you will be able to get into your specialities of choice and definitely in universities programmes even if you are scoring in early 90's.

 

[StepTaker]

My opinion on this

I just came across a post on a different site and was wondering if any part of it is true?? .....

Several points are true but they are exaggerated a little bit.

First, the importance of Step 1 Score is absolutely correct and I have discussed that more than year ago in our USMLE articles section, here's the link http://www.usmle-forums.com/usmle-a...e-more-important-than-usmle-step-2-score.html

Second, you need to pay attention to what he's saying. He said (top 10/20 University programs). He's not saying any University Program, he's pointing to those prestigious programs such as Harvard, Mayo, Cleveland, and others. These programs are very very competitive specially for the IMG.

However, I think the numbers are quite exaggerated. I don't think you absolutely need 270+ to get an IV. Also, there are other factors that play role in addition to the score. These factors are mentioned here http://www.usmle-forums.com/residency-match-recommended-threads/40-matching-filters.html

I will be moving this thread to the Residency Match Forum for better categorization.

 

[tkourkou]

"Controlling" is one of the low yield defense mechanisms in step 2CK in which, certain people gain control over their lives if they "control" other peoples minds and behaviors. The writer of this post probably has employed such a mechanism... (And I am actually intellectualizing right now!!!))), sorry guys I am revising psychiatry right now!)

Don't give up guys, these are total BULLSHIT!

Give your best shot and everything will take it's course in life

 

[sherief]

what about importance of step 2 scores

what about importance of step 2 scores

 

[aagupta2]

A warning worth heeding

I do admit that some of the points of the original poster are a bit overstated, but he does bring up some really good points. For me the take home message is that getting a 99 is not what it used to be. With the steady increase of averages of usmle scores, and the unexplained reasons why a 99 now can correlate with a 3 digit score as low as 229, makes getting a 99 on the 2 digit scale less elite. Especially since the Scores are negatively skewed (mean<median<mode), which means that the average student (the median) scores higher than the stated average.

Competition is rising every year, and as an IMG we would be less likely to be chosen, unless we really stand out. While I don't think any real people get a 270, it makes sense that we should make this the new target, since the target of getting a 99 is not going to be the magic ticket to make all of our dreams come true.

Thanks for the warning dali89, since I am sure most of thing that if we get back to back 99s we will have our choice of any program we want, which is not true. I hope you the best luck in matching in the following year, and think it is prudent for you to apply to programs that do give you interviews, even if they arent on your initial list of desired university programs.

In reference to the outcomes for 2009 we need to keep in mind that the people who matched in 2009 must have taken step 1 in 2007. Scores go up every year, so we need to plan to be competitive with the rising standards of the future. According to Kaplan only 42% of IMGs matched in 2010 for a first year residency. Of course IMGs on average score much lower than AMGs but still our scores will be the main thing that will give us a fighting chance. Also as far as step 2 goes, the mean is right around 230/99, so scoring higher there will be imperative.

Best of luck to everyone, and Thanks dali for the insight. If it is a rough job market out there, I would rather know about it while i can still do something about it.

 

[drarnab]

I do admit that some of the points of the original poster are a bit overstated, but he does bring up some really good points. For me the take home message is that getting a 99 is not what it used to be. With the steady increase of averages of usmle scores, and the unexplained reasons why a 99 now can correlate with a 3 digit score as low as 229, makes getting a 99 on the 2 digit scale less elite. Especially since the Scores are negatively skewed (mean<median<mode), which means that the average student (the median) scores higher than the stated average.

Competition is rising every year, and as an IMG we would be less likely to be chosen, unless we really stand out. While I don't think any real people get a 270, it makes sense that we should make this the new target, since the target of getting a 99 is not going to be the magic ticket to make all of our dreams come true.

Thanks for the warning dali89, since I am sure most of thing that if we get back to back 99s we will have our choice of any program we want, which is not true. I hope you the best luck in matching in the following year, and think it is prudent for you to apply to programs that do give you interviews, even if they arent on your initial list of desired university programs.

In reference to the outcomes for 2009 we need to keep in mind that the people who matched in 2009 must have taken step 1 in 2007. Scores go up every year, so we need to plan to be competitive with the rising standards of the future. According to Kaplan only 42% of IMGs matched in 2010 for a first year residency. Of course IMGs on average score much lower than AMGs but still our scores will be the main thing that will give us a fighting chance. Also as far as step 2 goes, the mean is right around 230/99, so scoring higher there will be imperative.

Best of luck to everyone, and Thanks dali for the insight. If it is a rough job market out there, I would rather know about it while i can still do something about it.

If you look a that file you will find that IMGs across ALL sorts of score ranges get accepted into the programs. Dont take my word for it, there were many people with >250 on S1 who did NOT match into Family medicine as well. While an IMGs with a score less than 210 matched into plastic surgery.

On my score report, it is clealy mentioned that the median for USMLE administrations in the recent past (2011) has been 221 with a standard deviation of 24.

The distribution is NOT negatively skewed, although there is what we call in epidemiology a strong "reporting bias" in favor of positive scores.

I agree that a "99" is no longer amazing, and its quite simple. if the mean is 221 (which is 4 points lesser now than in 2009) , and SD is a HUGE 24, then 229 is a mere 0.33SD greater than the mean.. a lowly 58th Percentile.... assuming 17,000 IMG applicants taking the exam you will clearly see that 99-ers are obviously going to be lying around like stray pennies.

However trying to score 270 is just pure nonsense and neither should such a score be a "target" - imagine postponing ones NBME everytime one got a mere 250... lol..

The real deal is that scores are not ONLY issue - ones intelligence, technical knowledge, communication skills, research and clinical experience make for a complete package.

However, the unfortunate truth is that "average scores" will simply number too many to be reveiwed "in depth" by the programs and so your good points are likely to be missed if you dont score well.

how well ? Estimates say that 25% of the top IMG applications are reviewed by moderate to top programs - this should correspond to a 240 on the test... FAR way from a 270.

my two rupees worth.

 

[drarnab]

http://davidmlane.com/hyperstat/z_table.html

put in the median as 221 and SD as 24, you will see the percentiles.. correction a 99 now is 63rd percentile , not 58th. .. whatever...

 

[aagupta2]

Stats


click image to enlarge

Sorry for nitpicking, but this seems to be turning into a stats discussion.

First off, The distribution for the USMLE is indeed a negative skew. Think about it, there will be far more people who will take the test and score 50 points below the mean then there will be people who will score 50 above the mean. (Since about 20% of people who take the test will not pass). The more extreme values effect the mean more.

Let me give a hypothetical scenario:
If the average is 220, 4 people scoring 230 will be cancelled out by one person scoring a 180 if looking at the mean. However the median of this group has moved to 230, since the guy in the middle of the pack scored a 230. This is how the usmle scores are, with tons of people clumped in the middle, and much more outliers on the negative end of the spectrum. The image at the top illustrates how the distribution looks. To sum up negative and postive skew, the skinny end points to the skewed side.

Also as far as the exact percentile of what is a 99, it really cant be done with a high level of precision since it is not a normal Gaussian curve.

As a slight non-sequitur, it seems like scoring a 270 would be close to the 99th percentile, which is so commonly misused in place of the two digit score of 99.

 

[evavar]

I just don't like people who get into this forum to try to scare everybody.
More than 270, what?????? BSBSBSBSBSBSBSBSBS.
I never heard or seen anyone having that kind of scores. In the other hand I've seen people with 95 getting into good university programs.
Maybe some people with good grades and everything don't have good interview skills.

 

[drarnab]

Sorry for nitpicking, ........which is so commonly misused in place of the two digit score of 99.

I am really sorry but you are using the wrong graph here - clearly this is the "Doctors in training " students graph of THIER students , please have a look and see the MEAN for this curve... a freaking 235.... Can you please provide a picture of the real distribution so we may have a discussion? Im attaching one from usmlestep.com

Im sorry about the stats, its a subject i love.. something about numbers and statistics is related to the pure truth.... something we are all searching for here dont u think .. )


click image to enlarge

 

[drarnab]

And a wonderful example of reporting bias here... blue lines are what is REPORTED and red line is the TRUE distribution...


click image to enlarge

 

[Haisook]

May be the article's writer is partly true about those few prestigious universities like Harvard and Yale, and clinics like Mayo. I've heard they just filter IMGs out altogether. So even super high scores won't help.

Other than those few locations, you don't really need those crazy high scores especially for internal medicine (even 95/220 is enough).

And by the way, a 99 is still a 99. If you have this score, you stand out. Low or high 99 only matters if you're aiming for a competitive specialty like a specialized surgery.