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Acceptance Factors for Matching into Internal Medicine Residency

13 min


An internal medicine resident and her patient.


What You Need to Match into an Internal Medicine Residency Program


Residency application season is coming! Today we’re looking at what you need to successfully match into an Internal Medicine Residency Program! What is a good Step 2 score for internal medicine? How many programs should you rank? Read on to find out everything you need to know about matching into an Internal Medicine residency in 2024!


The NRMP surveyed Program Directors to identify factors influencing candidate selection for residency interviews and rankings. The results were compiled into an interactive table tool. This is extremely helpful in gauging where your application packet stands compared to the applicant pool, and whether adding additional components, like another letter of recommendation (LOR) in the specialty, could give you a leg up as programs review your application.


The interactive table tool can be found here. We recommend taking a look at the specialty you’ll be applying to before submitting your ERAS packet. Given the recent changes in the 2024 residency application process, we have also included more recent data collected from the NRMP Main Match Results 2023. As well as the AAMC ERAS Statistics for 2022 and 2023.



Selection Criteria for an Internal Medicine Residency Interview


Selection Criteria for an Interview


For Internal Medicine, Step 2 is most important. In the 2020 NRMP director’s survey, Step 2 scores ranked as the top criterion for selecting interview candidates, even preceding the transition of Step 1 to a pass/fail format. Program directors want to see that you are able to keep up academically in a large field. Make sure to address failed exam attempts, as they can raise concerns about your application. The personal statement appears to be the least important factor in obtaining an interview for Internal Medicine. This isn’t to say that you shouldn’t spend time crafting a compelling personal statement. Given its lower impact, prioritizing Step 2 preparation is recommended over dedicating extensive time to the personal statement.


Top 10 factors program directors use in selecting applicants to interview and in ranking for internal medicine - 2020 NRMP director survey. Step 2 score is the top criterion for selecting applicants to interview for internal medicine.


Step 2 Scores According to 2022 NRMP Charting Results:


USMLE Step 2 CK scores of US MD seniors applying to internal medicine - matched and unmatched - according to 2022 charting NRMP results. What is a good Step 2 score for internal medicine?


What is a Good Step 2 Score for Internal Medicine Residency?


  • 221-230 seems to be the minimum threshold at which programs will grant interviews
  • Scores below 220 generally will place you in an unfavorable position to receive an interview 
  • 235+ is a good Step 2 score for internal medicine and will place you in a favorable position for an interview.



Step 2CK – Timing of Taking the Exam


Previously, having a strong Step 2 score for internal medicine upon application review was advantageous, though not obligatory. However, with the absence of Step 1 scores for program filtering, Step 2 scores are now prioritized. It’s crucial to schedule your Step 2 exam strategically to ensure your scores are available when programs begin reviewing applications. While it’s possible to add scores later, delaying may result in missing out on initial interview offers.


Step 1 Failure


Failing Step 1 is a BIG deal in ANY specialty, although Internal Medicine is more forgiving than many specialties. According to the 2020 directors’ survey, 18% of Internal Medicine programs will NOT consider you if you’ve failed Step 1 (compared to 28% in EM, 36% in Anesthesiology, and at the end of the spectrum of none in Family Med). Additionally, for Internal Medicine failing USMLE Step 2 will lose you an interview in around 20% 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).


Consideration of applicants who failed the exam on first attempt - Internal medicine - according to the 2020 NRMP Program directors' survey.



Types of Applicants Considered:


International Grads (U.S. and non-U.S.) have a good shot at matching into Internal Medicine:


According to the NRMP main 2023 match results data, during the 2023 match cycle, 41% of all Internal Medicine positions filled were by IMGs. Still, 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. Consider looking at Residency Explorer, or looking for the programs’ current residents on their website. If you see no, or few IMGs on their current roster, they may be less IMG friendly. Still, if a program is your top choice, it may still be a good idea to give it a try.


Osteopathic graduates are widely interviewed and ranked in Internal Medicine programs:


In the 2020 survey, 75% of programs regularly interview and rank DO applicants, a high proportion compared to other residencies. Only around 2% of programs will never interview or rank a DO applicant. Additionally, according to NRMP data, DO grads and seniors made up 19% of all Internal Medicine positions filled in the 2023 match cycle, and only 3.1% of DO seniors who listed Internal Medicine as their only choice went unmatched.



Internal Medicine Residency Interviews


Interview widely


If you get an interview invitation, you are fairly likely to end up on the rank list if you interview. We recommend ranking at least 12 programs, so once you receive 12 interview invitations, you can feel okay with starting to prioritize and cancel as more come in.


Number of contiguous ranks of US MD seniors in Internal Medicine - matched and unmatched - 2022 NRMP charting outcomes.


Expect to receive interview invitations in October and November


Internal Medicine is more front-loaded on interview invitations than some other programs. The vast majority of interview offers will be sent by early November. Following this, expect a gradual flow of interview invitations from cancellations, extending into January.  If you have not heard from a program you are very interested in by the second week of November, 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!)If you do not have at least 10 interviews at this point, we recommend sending out some letters of interest to up to 5 of your top programs.


Expect to interview Late-October to Late-December


Around two-thirds of all interviews are conducted in November and December, with some programs still interviewing even in January. For further discussion on how to prep for your interview, see our blog post on how to crush your residency interview, and our recorded session on virtual interviews.



What is Less Important for Internal Medicine When Compared to Other Specialties?


  • Personal statements aren’t as important in Internal Medicine as in other specialties. This isn’t to say that they aren’t important at all, just that your MSPE and Step 2 score will be the focus of most internal medicine programs. However, your personal statement should not have any red flags in it that would preclude you from an interview; reach out to us at EMP to ask any questions about this!
  • With the exception of your internal medicine clerkship grade, clerkship grades are also not as important for Internal Medicine residency. Many medical students are applying into Internal Medicine residency programs, and these PDs know that at some medical schools, there are a limited number of “honors” that clerkship directors can give out. That being said, PDs will want to see decent comments from all clerkships, and a good performance in your internal medicine clerkship.



Summary for Internal Medicine Applicants

  • You should aim for a Step 2 score of 235+ for Internal Medicine, with 230 being a minimum.
  • IMGs and DO candidates may have a better shot in Internal Medicine residency than many other programs.
  • Expect interview invites between October and early November. If you have not heard from a program you are very interested in by the second week of November, you should definitely reach out to the program to let them you how interested you are (and why!). 


Good Luck!


If you need further or specialized assistance understanding which residency specialties you are best suited to apply to, you can contact us or visit our residency advising page to learn more about how Elite Medical Prep residency advising services.

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