Applying - The Boards

Updated September 2016

By the time you get to your EM rotations and into the application process you will have already taken step 1 of your USMLE or COMLEX.  What you need to figure out is:
  1. What impact do board scores have on my application?
  2. When should I take step 2?
The boards are one of the more important parts of your application.  Therefore they are worth putting the time in to study.  They are important because your scores are one of the few objective measures available to contrast you with your fellow applicants.  Everything else is subjective.  So even though most Program Directors feel that board scores do not predict how good a physician you will be, they are still a heavily weighted part of your application.  

Are my scores good enough?

That, fortunately, is a difficult question to answer because each program puts different weight on board scores. A result that would ruin your application at one program will be of no concern elsewhere. Thus there is no magic number that will guarantee interviews everywhere you apply.

That being said, some programs do set a cut-off where they filter out applications with scores below X.  Each program that sets a cut-off has their own X. More sought after programs may set X higher. In general, a score less than 200, or failing a step of the boards, will seriously hurt your application. The average USMLE step 1 score for successful applicants has recently been in the 230's.  Anything in this vicinity puts you solidly in the middle of the pack, which for most programs, is just fine.

Are step 2 scores important?

In EM your Step 2 scores are both more and less important than Step 1 scores.  Step 2 covers more clinically relevant material so a really good Step 2 score will make many Program Director forget about a mediocre Step 1 score. But you need the Step 1 score to get past any filters that may be in place.  All programs want to see your step 2, and some will not rank you, or even interview you, unless they have those scores.  The only reason not to take step 2 by September is if you are concerned that you cannot do as well as you did on step 1. You must take Step 2 by then end of December so that it is available for rank list decisions by the program.

The best thing you can do for your chances in EM is to get as many eyes on your application as possible.  Even if you are not happy with your scores you are better off having them available for the initial review of you application.   


  1. Very informative blog. Can you tell me how step 2CS is viewed by PDs? I'm a U.S-IMG and I ended up failing my first attempt, but passed my second one and submitted it on Oct 12th. Otherwise, I had a 244 and 247, 2 SLORs + 2LORs, all As in my 3rd year clerkships, and an A and B+ on EM clerkships. I wondering how badly the CS screw up would affect me. Thanks

  2. For the most part CS is not very important to your application. However, being in an applicant group, like US-IMG, where any "flaw" can weed your application out, I can see it being a bigger problem. There is not much you can do to mitigate this other than notify programs that you passed on your subsequent attempt.

  3. For someone like me with a step 1 of 208 and step 2 of 245, how would the filters work? Let say they put step 1 <210 and step 2 <220, would I still be excluded even though I qualify on the step 2 portion? Thanks again for the blog post.

    1. Filters are not commonly used for step 2 since many applicants don't have step 2 scores in mid-september, especially those who did well on step 1. Programs that use filters don't want to miss those students by screening them out for not having a step 2 score. A few programs will filter you out for a step 1 of 208. You can identify some of them using EMRA Match: and save your application money for another program.

      Once reviewed, most would put the weight on your step 2 score, sort of replacing your step 1, since step 2 is the more clinically relevant exam.

  4. What about if your step 2 is about the same as your step 1, (Step 1:221; Step 2 practices: 220) Is it worth putting off step 2 until later to obtain interviews? After all 221 is 9 points below the national average but 220 is 23 points below.

    1. In general it is better to have your step 2 in, even if it is below average. Showing the ability to consistently pass these standardized tests will be adequately reassuring to most programs. Average scores are not benchmarks that must be cleared to have a chance.