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Importance of the USMLE

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

1. In 2018, the mean USMLE Step 1 score among U.S. seniors who matched to radiology was 240. Among unmatched U.S. seniors, the mean score was 223. 

2. In a survey of 43 radiology residency programs, 95% cited the USMLE Step 1 score 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.”

3. 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 Radiology examination. In one study, researchers evaluated the relationship between USMLE (Step 1 and 2 CK) and American Board of Radiology examination scores.  The authors concluded that “Success on the ABR examination can be predicted by medical school success in preclinical courses, some clinical courses, and USMLE examination scores."

4. Although 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. 67% of programs have established a target score while 30% look for evidence of a passing score. 

5. Applicants with low USMLE Step 1 scores may have difficulty matching with radiology residency programs. 32% of U.S. seniors with scores < 220 failed to match in 2018.

6. The USMLE Step 2 CK score is also a factor used by many radiology residency programs in deciding whom to invite for interviews. 61% of programs use the Step 2 CK score in their decision-making process.

7. Should you take the USMLE Step 2 CK exam before applying to radiology? Some programs want to see Step 2 scores when you apply. Applicants are urged to visit program websites as early as possible so that informed decisions can be made with respect to the timing of the USMLE Step 2 CK exam.  

8. Some programs want to see Step 2 scores before rank-order lists are due for submission in February. Review of program websites will allow for proper planning.

9. When radiology residency program directors were asked, “Would your program consider applicants who fail their [Step 1] exam on the 1st attempt,” 43% of programs indicated that they never do and 52% reported that they seldom do. 

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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