Are Board Scores Important When Applying for Residency?

Sarah Bernstein, MD


February 02, 2009

Do residency programs really use cut-offs when reviewing applicants' board scores? Are board scores especially important for international medical graduates?

Response from Sarah Bernstein, MD
Resident, Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital, New York, NY

When I was a medical student, I remember having palpitations and breaking out in a cold sweat every time I thought about the Step 1 exam. As a foreign medical graduate, I believed a good score was the key to my future and the only way I could attain a decent residency position. Looking back, I would still agree that board scores are important, but I realize now that they are only one of many components that residency programs consider in the admissions process.

Residency programs receive numerous applications each year, and board scores are the easiest way to limit the number of people they will interview. Some of the more competitive residency programs reportedly do use cut-offs for board scores, not because they believe that "a good score equals a good resident," but because they have too many applications to sort through and need a simple and fair means of limiting their interview numbers.

Residency programs that interview international applicants may place even more emphasis on board scores. The logic is that they have a better idea of how US medical students are educated and what skills they will possess from the start, while the international applicant's level of preparation may be unknown. With a strong board score, a program will feel more confident that the international applicant will perform at the same level as his or her US counterpart.

If you have already taken Step 1 and finished your core clerkships but are afraid you just won't measure up... there is still hope! An away elective (a rotation at an institution other than those affiliated with your school) may be the best way to achieve your goal, especially if you do it at a hospital where you hope to do your residency. Low board scores may be overlooked if you impress the faculty and residents with your hard work, intelligence, and exceptional interpersonal skills.

Many program directors think that the most important factor in resident success is compatibility with the other residents. The away elective can be compared to a first date and should be taken very seriously. Each resident you meet is thinking of the future and considering what it would be like to spend 80 hours a week, in sickness and in health, by your side. Keep in mind that performance on the job is a better indicator of future success than a test score.

In summary, there is no need to take a beta-blocker as you study for Step 1. Take a deep breath, let the palpitations subside, and remember that if your score is low, you will just have to spend some time strengthening the other aspects of your application.

For more information about applying for a US residency as a foreign medical graduate, I recommend the following Web sites:


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