From the Viewpoint of a Program Director: What You Need to Match into Internal Medicine
The NRMP conducted a survey to determine what factors Program Directors consider when deciding which candidates to interview and rank for their residency program. The results were compiled into a “at a glance” tool, which is extremely helpful in gauging where your application packet stands compared to the applicant pool, and whether adding additional components, like a letter of recommendation (LOR) in the specialty, could give you a leg up as programs review your application.
The interactive tableau tool can be found here, and we recommend taking a look at the specialty you’ll be applying to before submitting your ERAS packet: https://public.tableau.com/profile/national.resident.matching.program#!/vizhome/PDSurvey_0/Desktoptablet
For IM specifically, major components of the survey you should pay attention to include: (from top to bottom of the page):
- Selection Criteria for an Interview – For IM, step 1 and Step 2 are most important. Program directors want to see that you are able to keep up academically in a large field. Many do not want to see that you have failed exam attempts, but this is only around 80% of programs. The personal statement appears to be the least important factor in obtaining an interview for IM, so if you are having to choose between spending 20 hours writing your personal statement vs. 20 hours studying for step 2, you are probably better off crushing step 2.
- Step 1 and Step 2 Scores:
- Step 1 – Score
- 225+ is a good score to expect an interview in IM, with the median being 230 for those who are almost always offered interviews.
- Programs do NOT typically offer interviews in the 200-205 range. You may need to contact programs individually if you are in or below this range, to ask them to take a special look at your application. Make sure you have some other stand-out parts of your application to make up for this!
- Programs do typically offer interviews: 230+ seems to be the range at which you can feel comfortable in being offered interviews by a decent number of programs. If you’re in the 240+ range, you can likely be selective about where you apply.
- Step 2CK – Score
- 210 seems to be the minimum threshold at which programs will grant interviews
- Scores below 210-215 generally will place you in a unfavorable position to receive an interview
- Scores of 235+ place you in a favorable position for an interview.
- Step 2CK – Timing of Taking the Exam
- 68% of programs required at least passing CK, with only 32% having it not required for interview and ranking. The issue is that with this survey we cannot be sure which step in the process CK is important for – obtaining that first interview, or landing yourself on the rank list. Therefore, for IM we think it is important to take step 2 early enough for your scores to be available before September 15.
- There is some forgiveness for failing Step 1:
- Failing Step 1 is a BIG deal in ANY specialty, although IM is more forgiving than many specialties. 23% of IM programs will NOT consider you if you’ve failed Step 1 (compared to 37% in EM, 35% in Med/Peds, and at the end of the spectrum of 3% in Family Med), and for IM failing step 2 will lose you an interview in around 33% of programs. So, if you’ve failed an exam, you are not automatically excluded from interviews, but you should try to ascertain which programs prioritize non-failure of exams (which you can sometimes find on their websites); or, you can email the program coordinators to ask before ERAS is due (to save you some serious application fees!).
- Types of Applicants Considered:
- International Grads (U.S. and non-U.S.) have a good shot matching into IM:
- Over 50% of programs report they often interview and rank US IMG students and about 40% report they often interview and rank non-US IMGs. Around 10% of programs will not consider US IMGs, and 20% will not consider Non-US IMGs. We recommend doing your homework to determine which programs may be more likely to consider IMGs, and preferentially contact and rank these programs. And, as above, save yourself some serious application fees by taking these programs off of your lists in advance of Sept 15.
- Osteopathic graduates are widely interviewed and ranked in IM programs:
- Around 70% of programs will routinely interview and rank DO applicants, which is on the higher end of the spectrum for residency programs. Only around 10% of programs will never interview or rank a DO applicant. With the remaining 20 % that seldom consider DO applicants, it is very important to do your research to identify these programs so that you can best increase your chances of matching.
- Interview widely: If you get an interview invitation, you are fairly likely to end up on the rank list if you interview (on average, programs ranked 149 / 177 applicants interviewed, around 84%). This is lower than many other residency specialties, because IM is widely applied to and they can easily accommodate many large interview days. We recommend ranking at least 14 programs, so once you receive 17 interview invitations, you can feel okay with starting to prioritize and cancel as more come in.
- Expect to receive interview invitations in September and October (and a few in November): IM is more front-loaded on interview invitations than some other programs. 20% will be sent in the last two weeks of September, and 51% of interview invitations will be sent out during October. 17% are sent in November, and almost none in December or January. If you have not heard from a program you are very interested in by the end of October, we recommend reaching out to their program coordinator and director telling them how interested you are in their program, and why (be as specific as you can!).
- Expect to interview November – January Only 14% of interviews will occur before November, which gives you ample time to prepare. Around two thirds of all interviews are conducted in November and December, and a significant 21% of programs are still interviewing in January. For further discussion on how to prep for your interview, see our blog post on how to crush your residency interview: https://elitemedicalprep.com/preparing-for-your-residency-interview/
After you’ve browsed your specialty, take a look at a few other specialties and note what’s NOT important for IM:
- Personal statements aren’t particularly important in IM (however, your personal statement should not have any red flags in it that would preclude you from an interview; reach out to use at EMP to ask any questions about this!).
- Clerkship grades are also not as important for IM. Many medical students are applying into IM programs, and these PDs know that at some med schools there are a limited number of “honors” that clerkship directors can give out. That being said, having the equivalent of a “pass” instead of a “high pass” can stand out in a negative light, and you will likely need to perform very well on at least one sub-I to make up for this.
Summary for IM Applicants
- Goal Step 1 scores are above 230. Step 2 scores are a little less important, and you should aim to get above a 220.
- IMGs and DO candidates may have a better shot in IM than many other programs (aside from maybe Family Medicine).
- Expect interview invites on the earlier side in September and October. If you have not heard from a program you are very interested in by the end of October, you should definitely reach out to the program to let them you how interested you are (and why!).