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Importance of the USMLE

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Your USMLE Step 1 exam score is a major factor used by dermatology residency programs in the selection process. In 2018, the mean USMLE Step 1 score among matched U.S. seniors was 249.


Among unmatched U.S. seniors, the mean score was 241.


33% of U.S. seniors with Step 1 scores less than 230 failed to match.

USMLE Step 1 and 2 CK:  9 Important Points for the Dermatology Residency Applicant

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.

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.

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.

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.”

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.

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.

Some applicants are concerned about their chances of matching in the specialty or securing a position in highly competitive residency programs.


If you have such concerns, consider our Strategy for Success Session with Dr. Samir Desai.


Dr. Desai will perform a comprehensive review of your credentials, assess your strengths and weaknesses, and provide you with a specific plan to implement tailored to your unique situation and school.


This plan will significantly improve your chances of a successful outcome.

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