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There is no simple “yes” or “no” answer to this question. Whether or not to bring up your poor USMLE test scores or bad grades in your application for medical school, a residency program, or a fellowship depends on 1) the strength of the rest of your application, and 2) the reasons behind those poor scores/grades.
You’ve probably heard the expression: “Excuses are like buttholes…most of them stink.” This sentiment applies to excuses for a poor academic performance. Think about it – what are the most common reasons people perform poorly on tests? 1) They didn’t study enough, 2) they’re notoriously poor test-takers, or 3) they’re just not that smart. Do you think that mentioning any of these excuses is going to win over the heart of a residency director? The first indicates that you’re lazy and can’t prioritize, the second means you freeze under pressure, and the third….well, that doesn’t need to be spelled out.
Here are some other poor excuses I’ve heard:
“I had a girlfriend during my first two years of medical school and my grades suffered because we spent too much time together.”
“I hated a lot of the subject matter during medical school, so I had a hard time motivating myself to study.”
“I drank too much the night before the USMLE.”
In these situations, honesty is NOT the best policy. You are better off leaving things unsaid until your interview, at which point you should skirt the topic as much as possible.
Now, there are some truly reasonable excuses for a less than stellar academic performance. If you have one of these, it is probably in your best interest to explain it – briefly and honestly. I highlight the word “honestly” because I am in no way advocating that you come up with a creative excuse to cover poor grades or test scores. However, if you had an uncharacteristically bad semester or bad test-taking experience, it is probably in your best interest to explain why. Otherwise, you run the risk that the person reading your application will jump to conclusions and think you just slacked off, while in reality you were taking care of your two-year-old nephew while your aunt received cancer treatments.
If you do decide to explain a poor performance, follow these two rules: 1) keep it brief, and 2) mention it toward the end of your statement. You want to have a chance to impress the person reading your statement before you point out any shortcomings.