You Got a Poor USMLE Step 1 Score: Now What?

Marlene Busko


April 24, 2018

What Happens After a Failing Score?

Most students who fail USMLE Step 1 eventually graduate, according to a national study of more than 129,000 medical students who took the USLME Step 1 exam for the first time in 1993 to 2000. More than 7800 students (6%) failed on their first try, but 90% of these students ultimately graduated from medical school.

Another study of medical students in the classes of 1997 to 2002 in six Midwestern medical schools found that the 50 students (2.5%) who failed USLME Step 1 on their first attempt were more likely to be minorities, from lower-income families, or older when they graduated from university. Compared with students who had initially passed, a higher proportion of those who initially failed became primary care physicians (53% vs 41%).

According to Signer, some applicants who fail to be matched to a residency position, "apply to and rank specialties for which they are not competitive based on their academic performance." Instead, students should see what program directors are looking for in the residencies that they plan to apply for.

"Students should review NRMP publications such as the Program Director Survey, which describes the characteristics by specialty that are important to program directors, and Charting Outcomes in the Match, which describes the characteristics of applicants who matched to their preferred specialty."

Desai is an employee of Osmosis—a Web- and mobile-based learning platform to help medical students pass USMLE Step 1—which has a partnership with Medscape. He is a consultant and shareholder of Knowledge Diffusion and has received research grants from the Robert Wood Johnson Foundation.


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