Dermatology Practice Board Scoring: How does 70% Percent Correct Convert into the Lowest Quartile Nationally?

It all starts by matching with some of the most qualified and high achieving medical students that apply for  dermatology residency programs. Most of these students have been top students throughout high school, college, and medical school. They typically have extremely high Step 1 scores compared to their medical school classmates, and half have been elected to their chapter of AOA. Then give them all an annual test where their scores are only separated by a few correct answers because they have all been preparing for the test so diligently. Then rank their percentile correct score against all of the other test takers in their PGY year of residency. That is how to convert a reasonable (and to most observers a satisfactory passing score) into one that will alarm many PGY3 and PGY4 residents and their program director. They know that the looming certification examination will typically fail approximately 10% of examinees. It is a new inverse reality for professionals who were usually on the other side of the curve during previous academic testing.