What Step 1 Score or Level 1 Score Should I Try to Get?

Session 05

USMLE Step 1 and COMLEX Level 1 scores can play a major role in the specialty that you match in to. Let’s talk about the score that you want to shoot for!

We're joined as always by Dr. Andrea Paul from Board Vitals, a testing platform to help you prepare for every step of your journey as a medical student, whether it's Step 1, Level 1, Step 2, Step 3, or all of the Shelf Exams that you have to take as a medical student, and beyond that once you're out in practice. They offer QBanks and everything they have to offer you, you're sure to be prepared for your test when it comes to test day. Save 15% when using the promo code BOARDROUNDS.

[02:12] What Scores to Shoot For

Andrea says that USMLE has a secret recipe that they score with but they don't disclose it but the scores range from 1 to 300. (But they won't officially say that.) Most people score between 140 and 260. The average in 2018 was 229 with a standard deviation of 20. So you're looking at a 209 to 249, which is incredibly high. Andrea thinks the reason for the increase in average is that people recognize competition and the high stakes of this test.

"People recognize the high stakes of this test more than ever before. We haven't been expanding numbers of residency programs but we have expanded in the number of applicants."

[05:40] Average Step 1 Scores for Different Specialties

The landscape of competitiveness of different areas has changed for some of the specialties. Anesthesia used to be one of the most competitive. But this changes over time for a lot of reasons. But specialties that have stayed on the top of the list include Dermatology, Orthopedic Surgery, Oncology, ENT, and Neurosurgery.

For 2018, the average USMLE score for people who matched in Orthopedic Surgery was 248. Dermatology is not too far off with 249 and ENT was 248, Neurosurgery at 245. Even the least competitive specialties had quite high average scores. Family medicine was 220, the highest it's been. Scores are just continuing to increase.

"It's just the sheer number of people competing for these few spots that really require people to study harder and score higher."

[08:07] Beyond Your Scores

Of course, if you want to get in Dermatology, for instance, then you've got to be aiming for something over that 249. That said, other things still matter like the geographic area you're looking at, your experience, letters of recommendation, etc. Hence, the variation of scores and no specific cutoffs. So even if you're not in the range, it's good to still apply.

"It's good to still apply even if you're not in the range. It does not hurt to still try."

The Step 1 score gets you in the door for a lot of these areas. But after that, they're not going to pick a 249 over 248 just based on the score. That being said, it's good to aim high.

[11:29] Breakdown of COMLEX Scores

The scores fall the same way as USMLE does with Dermatology as the highest and Family Medicine as the lowest. Their average score for match candidates was 566 in 2018. For some of the high scoring specialties, Radiology was around 615 while Family Medicine was at 520.

[12:20] Data for Osteopathic Students

There's anecdotal data that osteopathic students in some geographic areas in some specific institutions have a disadvantage but there's no specific data. If you're an osteopathic student and you want to apply to a more traditional MD institution, you may want to consider as this could help in the institution's diversity. But try to make sure your scores are not only competitive but trying to shine so much that they can't ignore your application. There could also be a lack of information in some geographic areas on what background DOs come in with. Andrea believes that as this merger happens, this may start to change.

"Make sure your scores are