Internal Medicine Residency Match: Beat more than 10,000 Applications (2021-2022)

Based on the 2018 Program Director’s Survey published by the NRMP, there are many factors that are important in deciding whom to invite for an internal medicine residency interview. What is most interesting about internal medicine is that standardized test scores and the MSPE are considered the most important factors with regards to who receives an interview invitation. Below are the factors considered most important in selecting applicants to interview:

1. Any failed attempt in USMLE/COMLEX

There is no question that a USMLE/COMLEX failure is a deal breaker for many programs. However, in our experience, this is “easier” to overcome if you are a US allopathic student. The 2018 Program Director’s Survey indicated that 66% of programs rarely consider an applicant with a Step 1 failure and 23% never consider an applicant with a Step 1 failure.

2) USMLE Step 1/COMLEX Level 1 score and Step 2 CK/COMLEX Level 2 CE Score

It is a fact of life that your performance on Step 1 or COMLEX 1 will impact the likelihood that your application is “screened in” and that you will be invited for an interview. Many programs automatically screen out applications if the Step/COMLEX 1 score falls below a certain threshold. The 2018 Program Director’s Survey indicated that 70% of internal medicine programs have a “target score” they like to see applicants earn on Step 1. The average number for that cutoff is 215. By the same token, some programs automatically grant interviews for students with scores above a certain threshold. That threshold varies but is typically 235 or higher for Step 1. Keep in mind that not all programs offer automatic interviews. If you don’t do as well on Step 1 as you would have liked, take Step 2 CK early in the fourth year and do as well as you can!

Your score on Step 2 CK/COMLEX Level 2 CE Score is also very important in internal medicine for program directors when deciding whom to interview. Therefore we suggest that most applicants take this exam early in the fourth year. 51% of programs indicate they use a target Step 2 CK score and for programs that like to see target scores, that number is 215 (on average). Similarly, Step 2 CK scores above 235 will earn automatic interviews at some programs.

Your score on Step 3 (if you have already graduated from medical school) really doesn’t influence much as 96% of programs don’t use this score.

3) Medical Student Performance Evaluation (MSPE/Dean’s Letter)

The specialty of internal medicine pays close attention to your MSPE. This means your “class rank/quartile” is important as are the narrative evaluations listed in your MSPE.

4) Evidence of Professionalism and Ethics

You might ask how your professionalism and ethics might be assessed based on your written application. Program directors glean information about your personal characteristics and traits from your internal medicine personal statement, ERAS written application, and letters of reference. This is why it is important to compose your personal statement and ERAS work, research, and volunteer experience entries thoughtfully. It is empowering to know that the outcome of your application season is, in part, within your control at this stage of the process.

5) Grades in clerkship in internal medicine rotations, personal statement, class ranking and quartile, internal medicine letters of recommendation.

Letters of recommendation from academic internal medicine physicians who know you well are of the utmost importance and was considered one of the most important factors in deciding whom to interview. By the same token, grades in internal medicine rotations and required clerkships will influence your chances of gettin an interview. The personal statement is also valuable to those program directors surveyed.