Why it’s important to know IMG performance in Step 1
In 2018, only 9,000++ out of 25,000++ IMGs who passed Step 1 and applied for the match through NRMP was able to secure a residency position. About 18,000++ were able to get interviews, nevertheless only half of those number matched
Although other factors are also considered, the single biggest determinant for getting interviews and matching is scores. The higher your scores, the more interviews you get. And the more interviews you get, the bigger the chance you will match.
You need to remember that 25% of those who passed Step 1 will never get interviews. And one- half of those who gets interviewed do not get matched. You also need to know that about 30% of all IMGs who take Step 1 will fail it.
By extrapolating the figures of those who pass and those who got interviewed with the total number of IMGs who took the exam, you can see that half of all those who took the exam won’t get interviewed. 60% of them failed Step 1 and the other 40% got scores so low that programs won’t interview them even if they pass.
Only half of all total IMGs who took Step 1 will get interviews and only half of that will get matched. Therefore, in order to get interviews, your Step 1 scores need to be above the mean Step 1 scores for all IMGs. If you want to match, it needs to be at the top 25% of scores among all IMGs. There are exceptions of course, but planning your career based on being the exception is a big risk, and kind of stupid.
What is the passing rate for IMGs in Step 1?
Whereas it is relatively easy to get data on AMG performance on the the USMLE, (they actually publish them), it’s pretty hard to come by the actual performance scores for IMGs. The only way you can get any figures is to extrapolate from AMG results.
For example, the passing rate for all exam takers for Step 1 is about 80%. The passing rate for AMGs for Step 1 is ~96%. The passing rate for IMGs for Step 1 is NO information. So you need to derive the figure.
Approximately 19,000 ++ AMGs take the exam each year. About 25,000 ++ IMGs take the exam each year. So, around 44,000 people take Step 1 each year. At 80% passing rate about 35,000 people pass Step 1 each year. About 18,000 ++ of them are AMGs. So that leaves about 17,000 IMGs passing each year. 17,000 out of 25,000 is less than 70%. So the passing rate among IMGs is less than 70%.
You may be wondering why if only 17,000++ IMGs are passing each year, why 25,000 are applying each year? Well, most IMGs who don’t match on average apply for residency three more times before giving up. That was a decade ago, it might be less now. Anyway, if everyone who pass this year and failed to match applied again next year. Then total IMG applicant would total 25,000 the following year. (17,000 who passed this year and 8,000 whom failed to Match last year)
What is the Score Performance of AMGs on Step 1?
Finding out the relative score performance among AMGs is relatively easy. For 2016, the mean score for AMGs is 229 with a standard deviation of 11. In 2006, the mean score was 216 and the standard deviation was 24.
What this means is that whereas a decade before, half of all AMGs go scores above 216. Now about half of a AMGs get score above 229. The score 1 standard deviation of the mean represents the top 15 percent of high scorers. And that is 240. That is why 229 and up is considered a high score, while 240 and up is considered acing the exam..
What is the Score Performance of IMGs on Step 1?
Now extrapolating AMG performance to IMG performance using a bell curve and factoring a 30 percent failing rate. The mean score for IMGs will fall between 216 to 219. About 20% of IMGs will score above 229 and 5% will score above 240 or ace the exam.
So AMG performance overall is superior to IMG performance. While 15% of AMGs will ace this exam, only 5% of IMGs will. Half of AMGs will score above 229, while only less than 20% of IMGs will be above that score. Meanwhile, more than half of IMGs will get below 220, while only about 20% of AMGs will score below that.
What Score does and IMG need to get interviews and match?
It seems in order to get interviews, an IMG needs to score a 216 or even higher. Anything below that and statistically, your chance of getting interviewed is zero.
You need to be in the top 25% in terms of scores if you want to match, since almost 20% of IMGs score above 229, then the minimum score in order to have a good chance of matching is in the upper 220’s.
As I said, there are always exceptions. Just like in cases of terminal cancer. There may be survivors. But the bet is still that the statistics will prevail.
So I would say, to be sure. You need a 220 to have an almost sure chance of at least getting interviewed. You need a score at least 230, to have a very good chance of matching.
Therefore, if you really want to get interviews and actually match, you need to get high scores. Or better yet, you need to ace the exam. Remember, Just Passing, means Not Matching.