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Over and over you hear that the USMLE Step 1 is the most important exam of your life. You hear that your score has drastic implications on which specialties you can apply for and where you can apply. It seems primitive, but in the eyes of a program director sorting through 1000 applications, you may seem like just a USMLE Step 1 score. 

Obviously, a well rounded application is key to obtaining the residency you want. But it is widely known that your USMLE Step 1 score acts as a “filter”( i.e. a program can select a sample of applicants to interview from a desirable range of scores.) Large academic programs receiving an influx of highly qualified applicants (scores >240) will generally select a sample with a higher range to interview.

Additionally, certain specialties have historically received applicants with higher scores. Often times those specialties have desirable lifestyles or are highly specialized. For example, otolaryngology or ENT surgery has a mean USMLE Step 1 score of over 240. It is a highly specialized residency with very few spots; even with a smaller sample of applicants, there are relatively few spots when compared to other specialties. Internal medicine has the most spots in the country. Thus some IM programs accept applicants with a wide range of scores from 200-250.

It is easy to get lost in the numbers. Remember, you are not a number.

Your application says a lot about who you are — so don’t neglect your personal statement and letters of recommendation. If your USMLE Step 1 score is not on par with the mean for the program you are applying to, have a back up plan. Unfortunately at times the program directors don’t even get to see your application if you are filtered out by a mean USMLE Step 1 score. 

Most importantly, realize that your intelligence is not measured by your USMLE Step 1 score. Some of the most brilliant physicians I’ve ever met have told me they were poor test takers. However, their clinical prowess and comprehensive approach gave me full faith in their intelligence and medical abilities. Don’t be discouraged by your score, rather use it as a compass to direct you towards programs and specialties were you have the best chance of matching into residency.

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Samuel Azeze, MD

Samuel Azeze, MD

Samuel Azeze MD, MPH is a graduate of St. George’s University School of Medicine in Grenada. He is currently a resident in Diagnostic Radiology at University Hospitals Cleveland Medical Center. Prior to that he completed a one year internship in Internal Medicine at Staten Island University Hospital where he had the opportunity to work one on one with medical students who have a variety of learning styles. Sam has a firm knowledge of the medical basic sciences that has been tried and tested through his clinical experience. He has impressive USMLE scores that gave him a competitive edge while applying for residency. Sam plans to stay in the academic arena as a physician and has a soft spot for teaching and mentoring.
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