USMLE scores myths versus facts

[envivany1]

Ok so the whole time i have been at sgu, people have been telling me of the three digit and two digit scores, and they always tell the their percentile. I got my scores back and I am very happy, i performed very well. But there was no percentile, then i assumed that the two digit score was the percentile, but no its not. According to this link USMLE - United States Medical Licensing Examination (http://www.usmle.org/Scores/percentiles.htm) ecfmg no longer attaches percentile to the score report because it causes confusion, and the two and three digit scores are equivalent.
So if someone tells you they were 75 percentile, they mean their 2 digit score was 75. (you need a two digit of 75 or three digit of 185 to pass respectively, these scores are equivalent, its up to the hospital or program director which to use)
I did better than i expected, and I am really glad that I attended the Atlanta Kaplan retreat.

[swimguy23]

people refer to it as a precentile all the time, including PD's.....its best just to smile and nod and not correct because then it just gets too confusing for people

i think its also bc people like to pat themselves on the back.....so they can say "I got 90% correct on my usmle, i'm God's gift to medicine....."

[Never Mind the Bollocks]

I'm under the impression that 75 is set to the minimum 3-digit passing score and 100 [or 99 I suppose] is set to the highest 3-digit score and all scores in between are proportionally laid out between 75 & 99. I think saying XY percentile is just easier than saying the above.

[stateofequilibrium]

The two digit score I think occurs as a result of normalization of the scores. In comparison with others, the two digit scores fluctuate actually quite dramatically when compared with similar three digit scores.

[misscanada]

I think when people say what percentile they got, they're not refering to the two digit score per se. We know very well that the exam has a mean of 200 and a standard deviation of 10 or 15...i'm not sure. So based on your 3 digit score, you can calculate which percentile for yourself i guess.

[stateofequilibrium]

I think when people say what percentile they got, they're not refering to the two digit score per se. We know very well that the exam has a mean of 200 and a standard deviation of 10 or 15...i'm not sure. So based on your 3 digit score, you can calculate which percentile for yourself i guess.

The US Average is 217. Those rascally Canadians have an average of 223. I don't know what the mean is for IMGs/FMGs. Though according to First Aid, only 59% pass.

[CANeh]

The US Average is 217. Those rascally Canadians have an average of 223. I don't know what the mean is for IMGs/FMGs. Though according to First Aid, only 59% pass.

Those guys always screwing things up!!!
I hope that continues when I write USMLE I

[stateofequilibrium]

Those guys always screwing things up!!!
I hope that continues when I write USMLE I

Canadians educated in Canada I believe.

[RussianJoo]

why are canadaians who were educated in canada meaning went to med school in canada taking the USMLEs? aren't there residencies in Canada? Or do most canadians want to move and practice med in the states?

[stateofequilibrium]

why are canadaians who were educated in canada meaning went to med school in canada taking the USMLEs? aren't there residencies in Canada? Or do most canadians want to move and practice med in the states?

Well, Canada IS the 51st State.

[swimguy23]

maybe someone can correct me if im wrong but in the pre-usmle years scores were reported as 2 digits. Then when the usmles were created to normalize testing programs were having a hard time dealing with the 3 digit score so an equivalent 2 digit score was kept so the old time PD's didnt freak out

[super2]

maybe someone can correct me if im wrong but in the pre-usmle years scores were reported as 2 digits. Then when the usmles were created to normalize testing programs were having a hard time dealing with the 3 digit score so an equivalent 2 digit score was kept so the old time PD's didnt freak out

From what I heard some state medical boards have the minimum score required for a licence in 2 digit scale. Thus it was kept so as these boards would not have to change the documents.

[RussianJoo]

saving some paper is always a good thing!

[swimguy23]

From what I heard some state medical boards have the minimum score required for a licence in 2 digit scale. Thus it was kept so as these boards would not have to change the documents.

which would be a leftover from pre-usmle ;)

[envivany1]

My score sure would look a lot better if it was just in two digit. But oh well, there are somethings I will never understand

[misscanada]

it seems like the current class that just took step one are getting amazing scores or people are just flat out telling lies. So far most people i've heard from who got their scores back got either 240 or above that. Also some people took the exam three weeks ago and yet claim they have their scores back already!!!!!! Maybe they used OASIS to find out they passed and they're making up scores. Hmmm fishy!!! But oh well, the more people who get above 240 the better for sgu

[stateofequilibrium]

it seems like the current class that just took step one are getting amazing scores or people are just flat out telling lies. So far most people i've heard from who got their scores back got either 240 or above that. Also some people took the exam three weeks ago and yet claim they have their scores back already!!!!!! Maybe they used OASIS to find out they passed and they're making up scores. Hmmm fishy!!! But oh well, the more people who get above 240 the better for sgu

I got my Oasis within 3 weeks, and my score two days afterwards. I think it all depends on the volume of people taking the test.

From my own perception of the test, most people who study will get 220-230, anything above that is kind of luck as to which 50 were experimental, and how much detail you remembered from class and REAL textbooks. When I was taking it, I found myself recalling back to lecture and lecture material, not Kraplan, BRS, or anything like that. So lesson? PAY ATTENTION IN CLASS.

[rokshana]

it seems like the current class that just took step one are getting amazing scores or people are just flat out telling lies. So far most people i've heard from who got their scores back got either 240 or above that. Also some people took the exam three weeks ago and yet claim they have their scores back already!!!!!! Maybe they used OASIS to find out they passed and they're making up scores. Hmmm fishy!!! But oh well, the more people who get above 240 the better for sgu

well i don't know about the 240 part, but depending on when you take step I you can get them back in ~3 weeks. If you take in may and june, the scores get a little delayed, because that's when most of the US students take it and the volume is a little high. Last year i know people who took it in June had to wait almost 8 weeks to get it. I took mine at the end of march last year and had my score back mid april.

[envivany1]

True that coz I got my score exactly 3wks and 2days after, most probably coz i took it in march

[domino9]

From my own perception of the test, most people who study will get 220-230, anything above that is kind of luck as to which 50 were experimental, and how much detail you remembered from class and REAL textbooks. When I was taking it, I found myself recalling back to lecture and lecture material, not Kraplan, BRS, or anything like that. So lesson? PAY ATTENTION IN CLASS.

Anybody else agree?

[stateofequilibrium]

Anybody else agree?

That's just my opinion from taking it. I have a good memory for questions that freak me out. And most of them were the "straight-shooter" questions that ask you to recall a particular factoid I learned way back when. So I'm saying those may or may not have been experimental questions.

A lot of the pharm stuff I knew I got wrong were evidently experimental because my pharm was way up there. Anyways, I left a lengthy review here in the usmle forums. And things like cell bio, immuno, and everything else that gets dumped out of your brain first year was HEAVY to where I was trying to recall class material, not review material.

[stephew]

as stated many times, the 2 digit score is not a percentile and those who brag about it as such really are great source of irony related humor.

[misscanada]

as stated many times, the 2 digit score is not a percentile and those who brag about it as such really are great source of irony related humor.


if the highest two digit score you can get is a 99 then you damn sure should brag about it whether its a percentile or a percent or a score or just a number!

[swimguy23]

if the highest two digit score you can get is a 99 then you damn sure should brag about it whether its a percentile or a percent or a score or just a number!

its like having a kid and calling it a girl when its really a boy or vice versa.....doesn't take away from the fact that you had a kid and that rocks but more so because they're too thickheaded to know which

[Beebopash]

Lol this is purely for curiosity and i understand these are fictional charecters. Anyway I wonder what J.D from 'scrubs' got in his USMLE or what about Todd and that guy from House. :p

[swimguy23]

Lol this is purely for curiosity and i understand these are fictional charecters. Anyway I wonder what J.D from 'scrubs' got in his USMLE or what about Todd and that guy from House. :p

finally a thread worth posting in!

I would think JD got a fair 220

Todd is one of those people who acts like an idiot but really spanked a 240+

the blonde one from house was definitely a <200

[stateofequilibrium]

I think everyone from House got a 182 on their second try. How many times can you diagnose wegner's for something, really.

[Beebopash]

Lol this sure adds new flavour to the thread. By the way looks like dr cox from scrubs must be one of those freaks from the nature with 260+. Lol the girl from house has to be a 182-185 !

[jaywalk81]

I think everyone from House got a 182 on their second try. How many times can you diagnose wegner's for something, really.

and sarcoidosis

[rokshana]

Anybody else agree?

i do agree- the best preparation you can do for the boards is LEARN the material as you go along in the basic sciences, not cram in a 6 week kaplan class. And like SOE said, there were questions (mine were biochem though) that were staight forward factoids- you knew it or you didn't, but i do remember thinking to myself - I know I heard this in class!! ( i could, in my mind's eye, see the page and even WHERE on the page of lecture notes, but just couldn't read it!!!).

And misscanada, while a 99 is a great 2 digit score, that could range anywhere from a 245 to a 275- its the same 2 digit score- if you ARE gonna brag, its done with the THREE digit score, cause that is much more precise.

[misscanada]

i do agree- the best preparation you can do for the boards is LEARN the material as you go along in the basic sciences, not cram in a 6 week kaplan class. And like SOE said, there were questions (mine were biochem though) that were staight forward factoids- you knew it or you didn't, but i do remember thinking to myself - I know I heard this in class!! ( i could, in my mind's eye, see the page and even WHERE on the page of lecture notes, but just couldn't read it!!!).

And misscanada, while a 99 is a great 2 digit score, that could range anywhere from a 245 to a 275- its the same 2 digit score- if you ARE gonna brag, its done with the THREE digit score, cause that is much more precise.

There must have been a reason why 245-275 range equal 99. so whether you get 245 or 275, those are pretty high scores which equal 99 and you have every right to brag...don't hate..haha:bored:

[stateofequilibrium]

and sarcoidosis

And for some reason, they enjoy sticking probes up people's butts quite often!! :shock::shock:

[sammy123]

Is it true that if you pass the USMLE Step 1, you cannot retake it?

[stateofequilibrium]

Is it true that if you pass the USMLE Step 1, you cannot retake it?

Nope. You're stuck with what you got.

[summerwind]

why are canadaians who were educated in canada meaning went to med school in canada taking the USMLEs? aren't there residencies in Canada? Or do most canadians want to move and practice med in the states?

I would assume, because Canada has socialized medicine, doctors can make more money working in the states. Canadians correct me if I am wrong.

[RussianJoo]

so all canadain docs want to move to the US? Well I hope the US makes it hard from them to get a visa. So much for canadian pride.

[stateofequilibrium]

so all canadain docs want to move to the US? Well I hope the US makes it hard from them to get a visa. So much for canadian pride.

Right now getting into Canada from the US is difficult, if you're planning on visiting Canada, make sure you have no criminal record. Even a shoplifting offense decades ago can prevent you from entering Canada.

[FragileX]

i do agree- the best preparation you can do for the boards is LEARN the material as you go along in the basic sciences, not cram in a 6 week kaplan class. And like SOE said, there were questions (mine were biochem though) that were staight forward factoids- you knew it or you didn't, but i do remember thinking to myself - I know I heard this in class!! ( i could, in my mind's eye, see the page and even WHERE on the page of lecture notes, but just couldn't read it!!!).

And misscanada, while a 99 is a great 2 digit score, that could range anywhere from a 245 to a 275- its the same 2 digit score- if you ARE gonna brag, its done with the THREE digit score, cause that is much more precise.

Not true. The three digit score is not normalized and varies according to the mean and standard deviation of your test group. It is not an accurate scale to compare two candidates. It is possible to get anywhere from a 230/92 to a 230/96 depending on your test group. The two digit number is not a percentile, but it is normalized meaning a 96 is the same category as any other 96 regardless if you got a 230 or a 240.

Even of those who received 99s and got a 260 vs. 275, there isn't really a true 15 point difference. We'll never really know who was "better" because the 260/99 might have had a mean of 217 and then 275/99 might have had a mean of 220 in addition to any number of varying standard deviations. As such any "99" is only in the same realm of the other 99s. Anyone who says, "My 275/99 is better than your 260/99" doesn't really know what they're talking about. We as medical students talk about our three digit score because we like to talk about bigger numbers, but Program Directors look at the two digit score because that is what really matters.

People like to use the 275 vs. 260 thing as bragging rights, but they technically can't. Of course, if you have a 240/99 and someone took it the same day as you and got a 275/99... well then, he might have a case for being "better" because you'd most likely be part of the same group with the same mean and SD.

Either way, these scores are just numbers and don't say anything about how good of a doctor you'll be. House is a depicted as a lazy genius, so in his fictional world he probably got somewhere below the mean because he doesn't care and would say "these questions aren't interesting enough." Just my two cents.

-fragilex

[jameslynton]

Is it true that if you pass the USMLE Step 1, you cannot retake it?Who would want to retake it??? It is important to get it right the first time. People have suffered major depression knowing they have to retake it....

[RussianJoo]

Right now getting into Canada from the US is difficult, if you're planning on visiting Canada, make sure you have no criminal record. Even a shoplifting offense decades ago can prevent you from entering Canada.

who said anything about US citizens going to canada? to me it seems like it's the other way around. And I have been to canada many times when i was a teen since the drinking age is 18 in canada, I have never had any problems at the border no one really cared and just asked the general q's they ask everyone.

[envivany1]

I thought drinking age was 19 in canada.
Anywho, USMLE is not supposed to be used to guage your performance as a doctor or to select persons for residency. It it supposed to measure if you can apply medicine, the major factor is passing. Unlike the MCAT which is used to measure who is smarter or whatever, and for which there is no actual pass mark. Hence if you have already passed Usmle, it doesnt make sense to take it again to obtain a higher score. I think your score is good for 7 years or something like that, so if you really want a higher score, you can just wait 7 years, lol. But Passing is Key!!!!

[stateofequilibrium]

in 7 years though they'll probably be asking questions on atomic structure. So best to nail it the first time around as quickly as possible.

[ScubaVa]

I thought drinking age was 19 in canada.
Anywho, USMLE is not supposed to be used to guage your performance as a doctor or to select persons for residency. It it supposed to measure if you can apply medicine, the major factor is passing. Unlike the MCAT which is used to measure who is smarter or whatever, and for which there is no actual pass mark. Hence if you have already passed Usmle, it doesnt make sense to take it again to obtain a higher score. I think your score is good for 7 years or something like that, so if you really want a higher score, you can just wait 7 years, lol. But Passing is Key!!!!

You're only half right. Yes, ensuring that all medical students have a certain degree of competency applying the basic sciences to medicine is the point of the USMLE Step I. However, beyond that your score is extremely important, especially as an IMG. Many residency programs use scores the way medical schools use MCATs. Thus, you should approach the exam the same way you approached the MCAT: Score as high as possible. If you just set your sites on passing Step I you're short changing yourself. Remember, this isn't the bar exam.

[rokshana]

Not true. The three digit score is not normalized and varies according to the mean and standard deviation of your test group. It is not an accurate scale to compare two candidates. It is possible to get anywhere from a 230/92 to a 230/96 depending on your test group. The two digit number is not a percentile, but it is normalized meaning a 96 is the same category as any other 96 regardless if you got a 230 or a 240.

Even of those who received 99s and got a 260 vs. 275, there isn't really a true 15 point difference. We'll never really know who was "better" because the 260/99 might have had a mean of 217 and then 275/99 might have had a mean of 220 in addition to any number of varying standard deviations. As such any "99" is only in the same realm of the other 99s. Anyone who says, "My 275/99 is better than your 260/99" doesn't really know what they're talking about. We as medical students talk about our three digit score because we like to talk about bigger numbers, but Program Directors look at the two digit score because that is what really matters.

People like to use the 275 vs. 260 thing as bragging rights, but they technically can't. Of course, if you have a 240/99 and someone took it the same day as you and got a 275/99... well then, he might have a case for being "better" because you'd most likely be part of the same group with the same mean and SD.

Either way, these scores are just numbers and don't say anything about how good of a doctor you'll be. House is a depicted as a lazy genius, so in his fictional world he probably got somewhere below the mean because he doesn't care and would say "these questions aren't interesting enough." Just my two cents.

-fragilex

my point was not about comparing across years, because you're right, there is actually no way to compare across years, even across different test taking periods-but you put too much store in the 2 digit score- some PDs look at, some PDs look at the 3 digit- it just depends. When you start looking at programs, you need to ask the different programs what their cutoffs are. Like it was mentioned before, the 2 digit is a holdover from when licensure in various states had a 75 as the pass for the ECFMG (pre USMLE) exam and and if only a 3 digit was reported, there could be licensure issue for FMGs.

as for a 245 and a 265 being the same thing, misscanada, if you start to look at any ubercompetitive residencies when you get to that point in your med school career- you will see that there IS a difference!

[rokshana]

Anywho, USMLE is not supposed to be used to guage your performance as a doctor or to select persons for residency.

even if this wasn't the intention, it has become the way persons ARE selected for residency- well the interview at least and since you really can't rank a program that hasn't interviewed you, it amounts to the same thing.

really IMHO, the steps are a way to separate us from $2600 during med school!!:D

[envivany1]

really IMHO, the steps are a way to separate us from $2600 during med school!
No one can disagree with you there, haha, I spent a lot more, coz i paid for bloody kaplan
But yes, the intention for usmle was not to stratify students, and yes unfortunately this still happens. Its no coincidence that the average step 1 score in derm is 232 or something like that. But we all know that usmle scores are only one small factor amongst so many.
My post was mainly for people who had already passed step 1 versus those still studying for it. The way i see it, there aint no point crying over spilled milk. But yeah, when studying, gun for the highest score possible. But if you have already passed, be grateful that you made it past that hurdle, and work on more important things like Networking, coz we all know that its the way to secure a residency

[misscanada]

my point was not about comparing across years, because you're right, there is actually no way to compare across years, even across different test taking periods-but you put too much store in the 2 digit score- some PDs look at, some PDs look at the 3 digit- it just depends. When you start looking at programs, you need to ask the different programs what their cutoffs are. Like it was mentioned before, the 2 digit is a holdover from when licensure in various states had a 75 as the pass for the ECFMG (pre USMLE) exam and and if only a 3 digit was reported, there could be licensure issue for FMGs.

as for a 245 and a 265 being the same thing, misscanada, if you start to look at any ubercompetitive residencies when you get to that point in your med school career- you will see that there IS a difference!

Rokshana girl, you must have a lot of time on your hands going back and forth with this score stuff, especially if you're doing rotations or maybe nothing much to do during free time. As for me I'm waiting for my scores so I have all day. Well I guess I'll have time to do my extracurricular stuff during my rotations...there's prolly more time to spare than I thought

[rokshana]

Rokshana girl, you must have a lot of time on your hands going back and forth with this score stuff, especially if you're doing rotations or maybe nothing much to do during free time. As for me I'm waiting for my scores so I have all day. Well I guess I'll have time to do my extracurricular stuff during my rotations...there's prolly more time to spare than I thought

some of are just better at time management

plus who ever told you it was always busy, busy, busy during clinicals it lying...i'm on call now and waiting (and waiting, and waiting...) for my 1st admission!!!

vmd is usually my break while i'm reading harrison's (hard to sit and read more that 3 or 4 pages at a time- need to let my brain cool off!!!).

nice to see that you are still idealistic (though trust me...it will get beaten out of you soon enough!!)

[FragileX]

my point was not about comparing across years, because you're right, there is actually no way to compare across years, even across different test taking periods-but you put too much store in the 2 digit score- some PDs look at, some PDs look at the 3 digit- it just depends. When you start looking at programs, you need to ask the different programs what their cutoffs are. Like it was mentioned before, the 2 digit is a holdover from when licensure in various states had a 75 as the pass for the ECFMG (pre USMLE) exam and and if only a 3 digit was reported, there could be licensure issue for FMGs.

as for a 245 and a 265 being the same thing, misscanada, if you start to look at any ubercompetitive residencies when you get to that point in your med school career- you will see that there IS a difference!

That is your opinion and you are entitled to it. However, I don't want everyone to get scared that their particular score "isn't enough".

I already matched this year. My opinion is that scores will get you in the door, but the interview is what gets you into residency. The difference between a 245/99 vs. a 265/99 is marginal at best. The cutoffs you may have heard of are arbitrary and usually just put in place so a program can make a dent in their stack of applications. 230 is usually the nice round number competitive residencies use while 240 is the nice round number competitive upper tier residencies use. The reason these "cutoffs" stop around 240 is because a 240 correlates to a 99. A cutoff any higher than this would cut into the upper echelon of candidates.

Example: UCSF Radiology Residency
Arguably one of the most competitive if not the most competitive radiology residency out there. (Stellar academics along with the ultra competitive west coast)

UCSF - Radiology - Residency - Application (http://www.radiology.ucsf.edu/residents/application.shtml)

Excerpt:

"Performance on the USMLE is only one of several factors that we consider when choosing candidates whom we would like to interview. We review each application as a whole, and we do not have a threshold value for USMLE scores. However, in recent years, most of our interviewees have had three-digit scores of 240 or higher on Step 1. The small number of our interviewees with Step 1 scores between 200 and 239 have had offsetting factors such as a combination of top clinical grades at a competitive medical school and extraordinary research experience and academic promise. Once an applicant is selected for an interview, USMLE scores have little bearing on the final rank."

The IMG version is:

UCSF - Radiology - IMGs (http://www.radiology.ucsf.edu/residents/IMGs.shtml)

Excerpt:

"Please note that because of the large number of applications and the difficulty of evaluating the records of IMGs, we can offer interviews only to those IMGs who have all of the following qualifications: a strong record of research (usually in a department of radiology in the United States) with multiple first-authored publications in peer-reviewed journals; outstanding letters of recommendation, including at least one written by someone who is known to our selection committee; and high scores on both Steps 1 and 2 of the United States Medical Licensing Examination (USMLE) -- at least 240 on the three-digit scale (usually corresponding to 99 on the two-digit scale). Please bear in mind that we cannot consider IMGs who do not meet all of these criteria and that high USMLE scores are not sufficient for an interview."

I sincerely doubt a top tier residency would exclude you simply because you were a seemingly "lower 99". To do so would be a fallacy. Anecdotally, during my interviews only my two digit score was ever quoted if at all.

Summary: I believe that a Caribbean graduate with 245/99 vs. 265/99 should get the same amount of interviews assuming that the program even interviews IMGs. The biggest hurdle in getting a competitive residency is getting a program to interview you. After that it's up to you.

-fragilex

[stateofequilibrium]

Well, to be fair though, c'mon, UCSF? :-P

[FragileX]

Well, to be fair though, c'mon, UCSF? :-P

I chose UCSF because it is the most competitive and thus would be most likely to show a preference for a 245/99 vs. a 265/99. And it does not.

That was my point.

[envivany1]

Well said FragileX, i must say, you make a lot of sense

[metatemujin]

Not true. The three digit score is not normalized and varies according to the mean and standard deviation of your test group. It is not an accurate scale to compare two candidates. It is possible to get anywhere from a 230/92 to a 230/96 depending on your test group. The two digit number is not a percentile, but it is normalized meaning a 96 is the same category as any other 96 regardless if you got a 230 or a 240.

Even of those who received 99s and got a 260 vs. 275, there isn't really a true 15 point difference. We'll never really know who was "better" because the 260/99 might have had a mean of 217 and then 275/99 might have had a mean of 220 in addition to any number of varying standard deviations. As such any "99" is only in the same realm of the other 99s. Anyone who says, "My 275/99 is better than your 260/99" doesn't really know what they're talking about. We as medical students talk about our three digit score because we like to talk about bigger numbers, but Program Directors look at the two digit score because that is what really matters.

People like to use the 275 vs. 260 thing as bragging rights, but they technically can't. Of course, if you have a 240/99 and someone took it the same day as you and got a 275/99... well then, he might have a case for being "better" because you'd most likely be part of the same group with the same mean and SD.

Either way, these scores are just numbers and don't say anything about how good of a doctor you'll be. House is a depicted as a lazy genius, so in his fictional world he probably got somewhere below the mean because he doesn't care and would say "these questions aren't interesting enough." Just my two cents.

-fragilex

I realize this is an old thread, but it seems that the final conclusion of this thread regarding the nature of the three digit score is incorrect. If you read what is posted on the USMLE website, specifically at this link: USMLE - United States Medical Licensing Examination (http://www.usmle.org/Scores/percentiles.htm) , you would see that three digit scores do entail differences in performance. The 3 digit scores are fixed and not subjected to change with regard to the nature/capabilities of the pool of test takers. This is to say that a score of 240 in 2001 implies equivalent performance as a score of 240 in 2007. Even though the averages and/or standard deviations may be different for the two years. This also means that a score of 260 implies greater performance than a score of 240 no matter what years these scores were obtained in. As for why two different three digit scores may have the same two digit scores. This has to do with simple fact that if you were asked to describe 3 feet and 5 inches strictly in terms of feet, without any decimals, you would say 3 feet. But in terms of inches, you would be able to say it is 41 inches. Simply put, larger range in the number allows a finer description.