1. In 2018, the mean USMLE Step 1 score among U.S. seniors who matched to dermatology was 249. Among unmatched U.S. seniors, the mean score was 241. 

 

 

2. Although a higher Step 1 score significantly improves the chances of a successful outcome, it offers no guarantees. In 2018, 41 applicants with a score > 240 failed to match.

 

 

3. A low Step 1 score is a major obstacle to match success in dermatology. In 2018, only 7/14 applicants with scores < 220 matched.

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4. Many dermatology residency programs have threshold or cut-off scores. Applicants below the threshold score may not receive any further consideration. At Columbia University, “applicants must score a minimum of 200 on their USMLE Step 1 in order for their application to be reviewed by the Resident Selection Committee.” The filter is set higher at many programs. “Applicants who received at least a 220 on their USMLE Step 1 will be reviewed by the Faculty,” writes the Department of Dermatology at the Texas A & M Health Science Center. “Based on past years, candidates with USMLE Step 1 board scores below 220 are unlikely to receive an interview,” writes the University of Michigan Department of Dermatology.

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5. A moderate correlation has been found between the Step 1 score and the dermatology in-training examination. Program directors have concerns that low-scoring applicants might not pass the dermatology board exam. “From listening to program directors and chairs at our annual Professors of dermatology meeting, I think the consensus opinion was < 220 higher risk of board failure,” writes Dr. Cloyce Stetson, Chairman of the Department of Dermatology at Texas Tech University.

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6. Most dermatology residency programs do not require Step 2 CK scores to grant interviews. Whether to take the Step 2 CK exam early is often based on the Step 1 score achieved. “If you have done well enough on your Step 1 examination, there is probably no benefit in taking Step 2 Clinical Knowledge early; defer this to the latter half of the fourth year,” writes Dr. Ali Alikhan, a faculty member at the University of California Davis. “If, however, your Step 1 examination score is ‘low’ by dermatology standards, the Step 2 CK examination may give you a chance to effectively demonstrate your knowledge base and critical thinking skills.”

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7. Strong clerkship grades can help overcome a low USMLE Step 1 score. “We do not have a minimum cutoff for USMLE Step I exam scores, and give somewhat limited weight to these scores, though applicants with Step I scores below 220 need to show evidence of stellar clinical performance on difficult clinical rotations to be competitive,” writes the Department of Dermatology at the University of California San Francisco.

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8. Applicants who have failed the USMLE Step 1 exam are highly unlikely to match. “If you failed Step 1 or Step 2, your application will not be considered,” writes the Marshfield Clinic Department of Dermatology. In the 2018 NRMP Program Director Survey, 100% of program directors indicated that they seldom or never consider applicants who failed the USMLE Step 1 exam on the first attempt.