There are many career options within the PM&R specialty. Students can work in the rehab setting to provide psychological support for patients recovering from head injuries and stroke. They may even pursue sports medicine.
The average minimum Step 1 score, according to the Program Directors Survey, by which interviews are typically not offered is 198. However, they also reported that students are, on average across programs, almost always offered an interview with a Step 1 score of 209. Those scores are very close, so those numbers are at first glance questionable. However, the average Step 1 score in the latest NRMP published report of 2009 was a 214 in PM&R and the average for unmatched applicants was 191 (for U.S. Seniors). This closely parallels the interview/non-interview range published in the Program Directors Survey indicating that the deciding Step 1 factors are very close in this specialty.
However, you are a U.S. Senior with good Step 2 scores, and good letters of recommendation, it is definitely worth the application. According to the NRMP Charting Outcomes in the Match, the mean Step 2 score was a 220 in 2009. The mean Step 2 score for an unmatched U.S. Senior was a 193. If your grades have been at the High Pass level, you may be considered despite a Step 1 score that falls more toward the passing cutoff. If your grades have been at least been consistently at the Pass range or above and you have not experienced any academic difficulties, you should go ahead and apply with a solid backup plan, such as a less competitive specialty (at other residency programs – not the same institutions at which you are applying for PM&R) in case this plan does not work out as expected.
Apply to as many programs as you can to increase your chances of matching. The average number of applications for PM&R across the nation is 20 programs, so you would want to at least double this. You would want to apply at programs that have not filled in past years, if there are any. Also apply to programs that are not hot spots geographically, as they may have fewer applications. Do some rotations in a rehab setting and/or electives in PM&R to network, learn about the specialty so you will be more knowledgeable on your interviews, and meet faculty that can write strong letters of recommendation on your behalf. If you can do a case study or short term research in the field, that may also help you stand out, but the best thing to do is earn a great Step 2 score.