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Importance of the USMLE

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USMLE Step 1 and 2 CK:  12 Important Points for the Ob/Gyn Residency Applicant

1. In 2018, the mean USMLE Step 1 score among U.S. seniors who matched to Ob/Gyn was 230. Among unmatched U.S. seniors, the mean score was 218. 



2. In 2018, 32% of U.S. seniors with a USMLE Step 1 score of less than 210 failed to match into Ob/Gyn. If your Step 1 score will be of concern to programs, then a well-thought-out strategy for match success will be important. Of chief importance is the assistance of a mentor or advisor to help you overcome the challenges of a low Step 1 score.



3. In a survey of 79 Ob/Gyn residency programs, 94% cited the USMLE as a factor in selecting applicants to interview. “As some residency programs are becoming more competitive because of either the reduction in the number of positions or the increase in the number of applicants, the USMLE scores are being used in various ways in making decisions on whom to select for interviews,” writes the University of Washington School of Medicine. “The following programs consistently use the scores in the screening process: Anesthesiology, Emergency Medicine, Neurosurgery, Obstetrics & Gynecology, Ophthalmology, Orthopaedic Surgery, Otolaryngology, Radiology, Surgery, and Urology.”

4. Why are scores so important to obstetrics and gynecology residency programs? Among the reasons for the importance of the USMLE in the selection process is the desire to select residents who will pass the American Board of Obstetrics & Gynecology (ABOG) written examination. In one study, researchers evaluated the relationship between USMLE Step 1 scores and Council on Resident Education in Obstetrics and Gynecology (CREOG) in-training examination scores in eight residency programs.  The authors found that “USMLE step 1 scores were significantly correlated with CREOG in-training examination scores. None of the residents who scored >200 on USMLE step 1 and a mean of >200 on the CREOG in-training examinations failed the ABOG written examination.”

5. Although Ob/Gyn programs differ in how USMLE Step 1 scores are used in the residency selection process, the score is an important factor used to make interview decisions. 73% of programs have established a target score while 23% look for evidence of a passing score. “Admission to the Obstetrics and Gynecology Residency Program at Saint Joseph Hospital is highly competitive,” writes the Saint Joseph Hospital Department of Obstetrics and Gynecology. “Applicants can be expected to have a first time USMLE Step 1 score of 210 or higher.”


6. The USMLE Step 2 CK score is also a factor used by many Ob/Gyn residency programs in deciding whom to invite for interviews. 78% of programs use the Step 2 CK score in their decision-making process.



7. Should you take the USMLE Step 2 CK and CS exams before applying to obstetrics and gynecology? In advice given to students interested in pursuing the specialty as a career, the Department of Obstetrics and Gynecology at Wayne State University recommends “taking Step II CK by September and Step II CS by October (want to post passing scores by January so programs know you have passed).” Research programs of interest well in advance so you can make informed decisions regarding the timing of your Step 2 CK and CS exams.



8. Note that some programs will not place interviewed applicants on their rank-order list unless CK and CS scores have been received. “The program ‘prefers’ that both CK and CS scores are submitted before you are offered an interview but they are ‘required’ before submission of our rank order list to NRMP,” writes the Department of Obstetrics and Gynecology at the University of Pittsburgh. 

9. Although most programs will use the Step 2 CK score in their decision-making process, some programs may not require the score for consideration of your application. “The USMLE Step 2 scores are not required at the time of the application process, however, must be submitted once you are selected into the program,” writes the Department of Obstetrics and Gynecology at NYU.

10. In deciding when to take the Step 2 CK exam, applicants should also consider their Step 1 score. Dr. Carol Major is the Program Director of the Obstetrics and Gynecology Residency Program at the University of California Irvine. She feels that Step 2 scores should be available for review “if the Step 1 scores are low. Students who have Step 1 scores that are low (< 200), should plan to take Step 2 early and have the scores available, especially if they show an improvement from Step 1.

11. “Step I scores of 200 or higher generally get interviews before other candidates,” writes Dr. Clara Paik, Program Director of the Obstetrics and Gynecology Residency Program at the University of California Davis. “However, all things are considered, including Dean’s letter, personal statement, etc. A low USMLE score does not preclude someone from going into OB-GYN.”

12. When obstetrics and gynecology residency program directors were asked, “Would your program consider applicants who fail their [Step 1] exam on the 1st attempt,” 34% of programs indicated that they never do and 65% reported that they seldom do. Only 1% of programs often consider applicants who have failed. Failing the Step 2 CK exam is considered even more of a red flag with 51% of programs reporting that they never consider such applicants. 49% indicated that they seldom consider applicants who fail the Step 2 CK exam on their first attempt. “All exams must be passed on the first attempt,” writes the Department of Obstetrics and Gynecology at the University of California San Diego. “Applications received from applicants who have not passed their USMLE on the first attempt will not be considered.”  As you can see, the road to match success is difficult for those who have failed either exam. At MD2B and The Successful Match, we have helped applicants overcome such obstacles, and you are welcome to contact us for more information.

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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