Poor Step I USMLE Scores- What Do I Do?
Hello Dr. Barry Julius,
Question About Step I USMLE Scores And Application:
I am a foreign medical graduate that finished Med School in 2016. During this 2 years I’ve been studying and taking the USMLE steps, I took my step I USMLE and got an unsatisfactory score of 209 for multiple reasons. Then, I took my step II CS, passed the first attempt, and received a step II CK score of 250. I have an upcoming paid rotation (very hard to find in radiology) in a large city for 3 months starting in February 2019. Unfortunately, I don’t see myself doing anything else than radiology. Since I grew up with it and came from a family full of radiologists back home, this is what I see myself doing and breathing.
Am I dreaming about getting into a radiology residency? Or, is it possible and should I keep on pursuing it? I have all the upcoming months to make my application stronger and more appealing to apply in 2019. I am thinking about taking the step 3 USMLE if that would help my application. However, I have heard mixed opinions about completing it before applying. Also, I don’t have any research. Moreover, I have also found conflicting information on the importance of research for radiology applications.
I would really love to enter a radiology residency but I want to keep it real. Can I have your professional opinion on whether it will be
Thank you very much for your response,
Honestly, since you are a foreign grad, a score of 209 on Step I USMLE may limit your ability to obtain interviews. However, some programs may still give you one because you did so well on the step II exam. I think it is worthwhile to attempt the application process. You never know. But, I agree that it may be very challenging for you this year. You should temper your expectations for getting into a radiology residency.
In terms of the USMLE series, in your case, I would probably consider taking the USMLE Step III and try to ace the examination. A good score would confirm that the initial Step I exam results were a fluke. But, be careful. If you perform poorly on it, you can ruin your application. So, you need to study hard! (Not that I expect that you wouldn’t do so)
Also, it is often just as competitive to get into a prelim year prior to starting radiology residency. All foreign grads need a clinical year in an ACMGE certified program in the United States. So, make sure that you also apply for this as well. Foreign clinical programs are not a substitute.
Finally, as I’ve told some other foreign grads before, you need to make sure that you get to know the program director at the site of your paid rotation, This will help you get your foot in the door for an interview at least at that site. Also, this person can be a great resource to find a way to get involved in radiology research that can also bolster your application. Potentially, this person can also give you a good recommendation. That would help as well.
Let me know if you have any other questions,
Thank you very much for your answer. I have to apply to both programs at the same time, meaning the first categorical year and radiology at the same time. Is that correct? Is there a possibility to start a separate IM program and then transfer after the first year to radiology?
I think it’s a little bit easier to get into internal medicine residency for the IMG. And, some programs require a lower Step 1 grade. As per your advice, I will definitely take the step III before applying and try to complete some research. It is hard to find, but hopefully, during my upcoming rotation, I can get my hands on something.
Finally, I forgot to mention that I have a U.S. residency. So, I think that would improve my chances a little bit since I have seen lots of programs not interested in sponsoring VISAS, is this correct? I just want to make my case as strong as possible when applying to improve my chances, but I’m also considering internal medicine residency as another possibility because of my bad STEP 1 grade.
Thanks again for your reply,
Follow Up Answer:
It is possible to start a separate internal medicine program and then transfer over to radiology. However, I would recommend applying to both a preliminary clinical year and the categorical program as well as the three-year IM program. But, I would make sure to rank the categorical radiology and prelim clinical year programs first. You should be able to use the IM three year program as a backup if all else fails.
And, I agree. U.S. residency will help you a bit to secure a residency slot. It’s one less
Barry Julius, MD