I got absolutely bodied on USMLE Step 1 with a low pass of 205. Dear god. I'm interested in FM/IM.

[JudgeIsInTheHouse]

First time posting on SDN since the pre-med days, so I'm sorry if this is the wrong place to post this. I go to a well-respected DO school in the Northeast with a high Boards pass rate/high Match rate. I haven't received my COMLEX scores yet, but I'm pretty sure that went at least a bit better than USMLE.

I'm just freaking out because I didn't expect a score this low. My original plan was to score well enough to get into a residency program on par with IM at Stony Brook University Hospital or Northwell Health. I don't even know what their stats are, but I'll take a shot in the dark in saying that I'm probably much lower. Anyways, a decent program in the Northeast would be nice. I have a knack for Upstate NY too. Is there a website that has data on outcomes? Help a brotha out please. Godspeed.

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[ciestar]

A 205 isnt great, but for FM/IM in the northeast isnt a reach. There are sooo many programs out there.

I will say this, don’t get your heart set on one program. Be open minded, apply in your geographic region and see what happens. It CAN help (especially FM) to get an audition in the program you’re interested in, as they like “fit”. (Im in FM, only reason i can say as much)

 

[PsychHopeful2021]

The best resource for this is residency explorer or Freida. I think residency explorer is more up-to-date, so that's your best bet.

I'll say this - a 205 isn't pretty, but it's only one aspect of your application. You still have Step 2. And you still have auditions. While it may be hard to overcome a low Step 1, I have seen classmates that have matched out of their minds with low scores. While these are anecdotal accounts, just keep keepin' along.

 

[DameJulie]

OP, given you can past USMLE, I think you're already ahead in the DO applicants curve.

A side question, how would a 205 do in CA FM/IM programs?

 

[DO2015CA]

OP, given you can past USMLE, I think you're already ahead in the DO applicants curve.

A side question, how would a 205 do in CA FM/IM programs?

You can get FM at the more inland FM programs in California with a 205. Idk about the coastal. Certainly don’t know about IM

 

[AnatomyGrey12]

You will be fine. Apply broadly and don’t get set on any one program. Honestly the fact you passed USMLE Step 1 is a big accomplishment so keep that in perspective. There will be many FM programs that will be happy to have you.

 

[Sardonix]

Though I did not apply Northeast, I also was not happy with my Step1 score (206). I applied to 30-something FM programs in the Midwest where I am from.

I got far too many interview invites and am very happy with where I matched.

 

[iforget2]

Though I did not apply Northeast, I also was not happy with my Step1 score (206). I applied to 30-something FM programs in the Midwest where I am from.

I got far too many interview invites and am very happy with where I matched.

Always encouraging to see posts like this. I feel like on SDN we get enamored with high numbers and think anything <230 means we won't get into a desired specialty or location.

 

[Sardonix]

Always encouraging to see posts like this. I feel like on SDN we get enamored with high numbers and think anything <230 means we won't get into a desired specialty or location.

PSYCH. I got a 2006 on my Step1. SDNisms strike again!

 

[ritts]

PSYCH. I got a 2006 on my Step1. SDNisms strike again!

to be fair- it's clearly not all a numbers game but let's look at Psych for example. The mean Step 1 for matched DO applicants in 2018 was 224. That means for every person that matches with a 250, there's 1 person who who matches with a 200. It happens but it's still not the best advice to tell someone to go all out for psych. If someone is dead set on psych, they should definitely apply, but needs to also consider backup specialties for risk of not matching. Furthermore, the mean Step 1 of unmatched DO applicants to psych is 217. A person with a 200 is more likely to end up in that category. I guarantee that every year people match in ortho with a Step 1 in the 230s. This is when away rotations, connections, and research really help propel someone who may have a subpar Step 1.

 

[ortnakas]

I know people who matched into ACGME IM in 2018 with scores between 200-210. You probably can’t afford to be very picky when you’re applying in the first place but all hope isn’t lost

 

[JudgeIsInTheHouse]

I would like to thank everyone for their encouraging responses. Overall, I see the appeal of the upcoming P/F change to this exam. I don't think it was representative at all of the content that was emphasized in the past two years. I regret the fact that my score makes me feel like a scrub, after a year of very solid module exam scores. Blahh---can't fix the past though.

I'm just a simple dude who wants to take good care of my patients and live a healthy, strong, family-centered life. A hiccup like a low Step score really seems like a cluster-f*ck, especially when you don't know what it means for your future.

Thanks again.

 

[hungrydoc710]

Does a 205 pretty much count you out of academic IM / programs with fellowships ?

 

[Spectreman]

Good buddy just matched U of Wisconsin FM with a 420 and no Step. They care about interest and first time pass, even second time pass is often okay for FM. You will have a job OP, life is going to be great. Congrats on first time pass of Step. Don’t poo poo your accomplishments. Putting yourself out there with confidence will really help you get some good auditions. Plus look, you have Step 2! Uworld it up all year, also highly recommend taking the first chunk of the year to blast a solid pathology resource like Sketchy Path. SP in particular will be huge for foundational knowledge so you can crush Step 2 and quickly follow/learn Online Med Ed. Bust through that Salt Deck while watching all of SP and then hammer the OME cards in Dorian while you chip through Uworld all year. Come dedicated for Step 2 you’ll be ready to crack a SOLID step 2 and wash away any concerns programs might have.

All will be well!

 

[DO2015CA]

Does a 205 pretty much count you out of academic IM / programs with fellowships ?

no just work on other aspect of the application. Low tiers match 200-210. They also have fellowships

 

[DameJulie]

Uworld it up all year, also highly recommend taking the first chunk of the year to blast a solid pathology resource like Sketchy Path. SP in particular will be huge for foundational knowledge so you can crush Step 2 and quickly follow/learn Online Med Ed.

Would you recommend "saving" SP for clinical years Step 2 instead of Step 1? Rising M2 here already drowning in micro/pharm and aren't sure if I can incorporate SP into classes.

no just work on other aspect of the application. Low tiers match 200-210. They also have fellowships

Can you give some example programs? This sounds really good news.

 

[Spectreman]

Would you recommend "saving" SP for clinical years Step 2 instead of Step 1? Rising M2 here already drowning in micro/pharm and aren't sure if I can incorporate SP into classes.

Can you give some example programs? This sounds really good news.

I tried hard to play the zanki game 2nd year and 100% attribute my weak 225 to putting my stock into 26,000 cards when I could have pounded Pathoma —> Sketchy path —> Salt deck in just a few thousand cards. I woke up at 5am all through 2nd year trying to beat zanki and it kicked my ass. I was reviewing 900+ cards per day all for silly low-yield trash that clogged up my ability to process the important stuff. Many days I didn’t finish my reviews till freaking 2pm and was exhausted while getting wrecked in Uworld. If I had put in those 5am anki sessions toward ~300 HY Salt cards I could have had way more time to properly use Uworld. Zanki GI is like 2500 cards or something insane, you can hit all of GI in sketchy path in A DAY.

My advice is do Sketchy Path and the salt deck, refine the cards as you do them. Don’t rewatch the videos, just focus on snapping in the actual histo slides from Pathoma, take the time to read the FA page that is snapped in with each subdeck and keep adding your own snaps from Pathoma and Uworld (use Gyazo to snap from Uworld). By the time dedicated rolls around you’ll be in a solid place to do well on Step.

would still use Zanki for psych and Lightyear with snaps from Pixorize for Biochem. Trying to use Zanki to review Biochem was a colossal waste of time for me. Obv, grain of salt since I’m a dumb dumb compared to 80% of SDN. Sketchy Path and the Salt deck saved me though.

 

[Ho0v-man]

Does a 205 pretty much count you out of academic IM / programs with fellowships ?

No. There are solid “low-tier” university/strong community programs in undesirable locations that don’t even require step scores but have good fellowship matches/in-house fellowships.

 

[hungrydoc710]

I tried hard to play the zanki game 2nd year and 100% attribute my weak 225 to putting my stock into 26,000 cards when I could have pounded Pathoma —> Sketchy path —> Salt deck in just a few thousand cards. I woke up at 5am all through 2nd year trying to beat zanki and it kicked my ass. I was reviewing 900+ cards per day all for silly low-yield trash that clogged up my ability to process the important stuff. Many days I didn’t finish my reviews till freaking 2pm and was exhausted while getting wrecked in Uworld. If I had put in those 5am anki sessions toward ~300 HY Salt cards I could have had way more time to properly use Uworld. Zanki GI is like 2500 cards or something insane, you can hit all of GI in sketchy path in A DAY.

My advice is do Sketchy Path and the salt deck, refine the cards as you do them. Don’t rewatch the videos, just focus on snapping in the actual histo slides from Pathoma, take the time to read the FA page that is snapped in with each subdeck and keep adding your own snaps from Pathoma and Uworld (use Gyazo to snap from Uworld). By the time dedicated rolls around you’ll be in a solid place to do well on Step.

would still use Zanki for psych and Lightyear with snaps from Pixorize for Biochem. Trying to use Zanki to review Biochem was a colossal waste of time for me. Obv, grain of salt since I’m a dumb dumb compared to 80% of SDN. Sketchy Path and the Salt deck saved me though.

I agree with most of this - I actually favored doing Duke pathoma deck over doing all of Zanki. However I did use parts of Zanki such as bchem and msk. Lolnotacop micro and Zanki pharm are thier own gold standard as well. Made my own anki deck from UW (about 900 cards). Random other deck I used was Dorian's anatomy, which has sky rocketed my anatomy knowledge. Makes me want to use his deck for Step 2!

I prob would have gone down sketchy path route IF there was no direct pathoma deck (Duke's).

 

[FutureDoctor5000]

No. There are solid “low-tier” university/strong community programs in undesirable locations that don’t even require step scores but have good fellowship matches/in-house fellowships.

This is true for matching into those IM programs, but how important would say is your step 1 score as an OMS2 when applying for more competitive sub specialties like GI, Cards, Heme onc and Pum/CC?

 

[Isoval]

This is true for matching into those IM programs, but how important would say is your step 1 score as an OMS2 when applying for more competitive sub specialties like GI, Cards, Heme onc and Pum/CC?

Nobody cares about Step 1 for fellowship. It’s almost entirely dependent on where you went for residency.

 

[Spectreman]

Nobody cares about Step 1 for fellowship. It’s almost entirely dependent on where you went for residency.

Are you certain about this? My buddy is a cardiologist and said his Step 1 score came up constantly, but he had a crazy high score so it might have been a “gee wiz” thing. He feels like it follows you forever. He didn’t go to a fancy program either, just Broward IM. They have a good cards fellowship though.

 

[Ho0v-man]

This is true for matching into those IM programs, but how important would say is your step 1 score as an OMS2 when applying for more competitive sub specialties like GI, Cards, Heme onc and Pum/CC?

I can’t speak with any authority on the matter and won’t pretend to know everything despite this being the norm for the interwebz. I’ve read on here that it is a data point for fellowships in IM and a few other specialties, but is not high on the list of importance. My gut says it’s of little importance, but does exist. Contrary to popular belief on sdn, the vast majority of people in IM don’t have crazy high step scores so it probably only stands out if it’s super duper high or if you failed. But I’ve never known anyone who went through the fellowship match so this is basically conjecture.

 

[Rekt]

Nobody cares about Step 1 for fellowship. It’s almost entirely dependent on where you went for residency.

This is wrong.

 

[Prehealth1011]

Are you certain about this? My buddy is a cardiologist and said his Step 1 score came up constantly, but he had a crazy high score so it might have been a “gee wiz” thing. He feels like it follows you forever. He didn’t go to a fancy program either, just Broward IM. They have a good cards fellowship though.

vs GI

2-3 research projects and/or publications are needed for your odds to be ~80% according to the data. There's a huge disconnect between NRMP data and how sdn portrays competitiveness of these fellowships and i honestly don't know what it is. According to sdn, you need 240+ and 10+ publications to be competitive for these.

 

[JudgeIsInTheHouse]

Good buddy just matched U of Wisconsin FM with a 420 and no Step. They care about interest and first time pass, even second tome pass is often okay for FM. You will have a job OP, life is going to be great. Congrats on first time pass of Step. Don’t poo poo your accomplishments. Putting yourself out there with confidence will really help you get some good auditions. Plus look, you have Step 2! Uworld it up all year, also highly recommend taking the first chunk of the year to blast a solid pathology resource like Sketchy Path. SP in particular will be huge for foundational knowledge so you can crush Step 2 and quickly follow/learn Online Med Ed. Bust through that Salt Deck while watching all of SP and then hammer the OME cards in Dorian while you chip through Uworld all year. Come dedicated for Step 2 you’ll be ready to crack a SOLID step 2 and wash away any concerns programs might have.

All will be well!

Thanks bro. What are your thoughts on Amboss? I cracked it open when I couldn't sleep the night before my Step 1 to review Acid/Base, and it looked pretty solid.

 

[Prehealth1011]

This is wrong.

Reputation of residency and Research are more important factors than step 1 score.

http://www.nrmp.org/wp-content/uploads/2017/02/2016-PD-Survey-Report-SMS.pdf

 

[Neopolymath]

Reputation of residency and Research are more important factors than step 1 score.

http://www.nrmp.org/wp-content/uploads/2017/02/2016-PD-Survey-Report-SMS.pdf

Which come from.... Drumroll please.... Mostly your board scores getting you into a good program lol

 

[Drrrrrr. Celty]

Reputation of residency and Research are more important factors than step 1 score.

http://www.nrmp.org/wp-content/uploads/2017/02/2016-PD-Survey-Report-SMS.pdf

Step scores are a filter just like MD v.s DO.
A program director can very easily set their filters to only look at certain scores above a point on their first passes. For fellowships it's a lot more about who you know, your connections, and the reputation of your residency. However step scores don't go away.

 

[DrStephenStrange]

Which come from.... Drumroll please.... Mostly your board scores getting you into a good program lol

Well, I don't completely agree since some programs in non-desirable locations that average low step 1 scores still have great fellowship matches.

 

[Drrrrrr. Celty]

Are you certain about this? My buddy is a cardiologist and said his Step 1 score came up constantly, but he had a crazy high score so it might have been a “gee wiz” thing. He feels like it follows you forever. He didn’t go to a fancy program either, just Broward IM. They have a good cards fellowship though.

It's a standardized part of your application that you can use to compare people. It's always going to be important. However for a lot of fellowships it's gonna end up being minimally important.

 

[Drrrrrr. Celty]

Well, I don't completely agree since some programs in non-desirable locations that averages low step 1 scores still have great fellowship matches.

Fellowship matching is... complicated. By the time you get there you're all probably very qualified.

 

[Drrrrrr. Celty]

No. There are solid “low-tier” university/strong community programs in undesirable locations that don’t even require step scores but have good fellowship matches/in-house fellowships.

You're not wrong. That being said I'd choose matching at a weaker program in a nicer city than a stronger program where I'd have nothing to do or have 0 chance of wanting to live there after. Like remember that residency is also a large recruiter, your hospital or hospital system will probably be one of your easiest choices for employment after residency.

 

[Spectreman]

Thanks bro. What are your thoughts on Amboss? I cracked it open when I couldn't sleep the night before my Step 1 to review Acid/Base, and it looked pretty solid.

Personally never did it, but for Step 2 man people loved it. Will say AMBOSS is one of my primary google go-to’s for studying. Better than Med Bullets in many cases!

 

[Prehealth1011]

Which come from.... Drumroll please.... Mostly your board scores getting you into a good program lol

Sure that's the logical conclusion. But NRMP data makes it seem like you're still fine with 220 and even 210 for some of these competitive fellowships. I highly doubt all these guys went to good university programs. Cardio is a common pathway for many Indian IMGs who match into community IM programs every year. There's probably a huge spectrum of weak/strong fellowship programs and you aren't out of the running by going to a community IM residency.

 

[Drrrrrr. Celty]

Sure that's the logical conclusion. But NRMP data makes it seem like you're still fine with 220 and even 210 for some of these competitive fellowships. I highly doubt all these guys went to good university programs. Cardio is a common pathway for many Indian IMGs who match into community IM programs every year. There's probably a huge spectrum of weak/strong fellowship programs and you aren't out of the running by going to a community IM residency.

I think going from a non academic community program with no cardio program will make it very hard to match cardio. Those that do will do it because they were extraordinary candidates.

 

[Isoval]

Which come from.... Drumroll please.... Mostly your board scores getting you into a good program lol

I made a pretty explicit point to say it's dependent on your residency, not your Step 1 score.

The fact that Step 1 is related to residency quality is irrelevant. If a person with a 200 matches a university program with fellowships, their chances are much higher to get a fellowship than someone with a 200 who matched a rural, unknown community program.

 

[DO2015CA]

I made a pretty explicit point to say it's dependent on your residency, not your Step 1 score.

The fact that Step 1 is related to residency quality is irrelevant. If a person with a 200 matches a university program with fellowships, their chances are much higher to get a fellowship than someone with a 200 who matched a rural, unknown community program.

Its not irrelevant because a good IM residency is contingent on step. So a competitive fellowship is tangentially important for competitive fellowship.

 

[mathnerd88]

SDN has a mentality that you need USMLE to match into any academic IM program. While generally true (esp if you don't have research), you do not need it to match into a great community IM program with fellowships or even low to mid-tier academic IM program.

OP, if you score well on COMLEX, I would just submit that score instead. AlteredScale and I both matched into university IM programs with COMLEX only. I'm also in the northeast. You can PM me if you wish.

 

[FutureDoctor5000]

SDN has a mentality that you need USMLE to match into any academic IM program. While generally true (esp if you don't have research), you do not need it to match into a great community IM program with fellowships or even low to mid-tier academic IM program.

OP, if you score well on COMLEX, I would just submit that score instead. AlteredScale and I both matched into university IM programs with COMLEX only. I'm also in the northeast. You can PM me if you wish.

This is very true the academic IM programs in the state of my DO school and the surrounding states is open to comlex only applicants and you don’t need a super high step score to match there either

 

[libertyyne]

I tried hard to play the zanki game 2nd year and 100% attribute my weak 225 to putting my stock into 26,000 cards when I could have pounded Pathoma —> Sketchy path —> Salt deck in just a few thousand cards. I woke up at 5am all through 2nd year trying to beat zanki and it kicked my ass. I was reviewing 900+ cards per day all for silly low-yield trash that clogged up my ability to process the important stuff. Many days I didn’t finish my reviews till freaking 2pm and was exhausted while getting wrecked in Uworld. If I had put in those 5am anki sessions toward ~300 HY Salt cards I could have had way more time to properly use Uworld. Zanki GI is like 2500 cards or something insane, you can hit all of GI in sketchy path in A DAY.

My advice is do Sketchy Path and the salt deck, refine the cards as you do them. Don’t rewatch the videos, just focus on snapping in the actual histo slides from Pathoma, take the time to read the FA page that is snapped in with each subdeck and keep adding your own snaps from Pathoma and Uworld (use Gyazo to snap from Uworld). By the time dedicated rolls around you’ll be in a solid place to do well on Step.

would still use Zanki for psych and Lightyear with snaps from Pixorize for Biochem. Trying to use Zanki to review Biochem was a colossal waste of time for me. Obv, grain of salt since I’m a dumb dumb compared to 80% of SDN. Sketchy Path and the Salt deck saved me though.

IDK how you were reviewing, or how you were testing. I did 1k cards per day last six months of m2, 50% kaplan , 50% rx, and then 90% of uworld in dedicated and 250+. This was on the lower end of the scale for me because i had terrible testing anxiety that day and didnt sleep, but the system worked for me.
Sketchy path was awful for me, i never understood any path that required to remember the stuff and answer questions. I did however never rewatch any videos.
I wouldnt get discouraged though, 225 is a solid score, and all your hardwork will not go unrewarded in terms of setting you up for success on the wards and for shelves.

 

[Spectreman]

IDK how you were reviewing, or how you were testing. I did 1k cards per day last six months of m2, 50% kaplan , 50% rx, and then 90% of uworld in dedicated and 250+. This was on the lower end of the scale for me because i had terrible testing anxiety that day and didnt sleep, but the system worked for me.
Sketchy path was awful for me, i never understood any path that required to remember the stuff and answer questions. I did however never rewatch any videos.
I wouldnt get discouraged though, 225 is a solid score, and all your hardwork will not go unrewarded in terms of setting you up for success on the wards and for shelves.

my buddy who did zanki with me and scored well could zip through cards at an avg of 7sec per card. I couldn’t make that happen. I had to stop and read/review every 10-30 cards. That’s why it would take me all freaking day to review. Even then had huge swaths of zanki where I was trying to force my brain to memorize tons of concepts I knew I wasn’t understanding. Maybe it was because I had pounded all that junk before hand but once I finally transitioned to Sketchy Path and personalized the Salt deck to my understanding it felt like all of the Step 1 path finally clicked. Appreciate your comment on my 225. I’m a 4th year now and just took Step 2, 3rd year and shelves went relatively well. Trudging through Sketchy Path before doing OME and such was totally worth it for my Step 2 prep.
I’m obv not happy with the 225, but I worked my butt off for that score so I take some comfort in that. Hopefully Step 2 comes back much better.