Residency contract non-renewal. How should I move forward?

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Originally Posted by sella turcica

Any thoughts on Step 3? I can't find any specific dates (such as the MCAT back in my day, which was given 2x per year) so I'm guessing that you can sign up for Step 3 at any time? Also, if you had tons of free time, how much would you spend studying for Step 3? I spent 4-5 weeks on step 1 and 2, made >220 on both.

Step 3 has specific dates, but there are a lot of them and they are spread throughout the year so you can pretty much take it whenever.

If I had tons of free time I would spend about 6 ounces of it studying for Step 3 and the rest doing something to improve my CV...or pay the rent. Step 3 won't really do much to improve (or worsen) your application at this point. And frankly, it's the easiest of the steps by far. I probably spent a total of 25 hours over the course of a month studying for it, usually an hour or two at a time, and scored 15 points higher than my Step 2 (which was about 15 points higher than my Step 1...which I studied an insane amount for).

Originally Posted by gutonc

Step 3 has specific dates, but there are a lot of them and they are spread throughout the year so you can pretty much take it whenever.

If I had tons of free time I would spend about 6 ounces of it studying for Step 3 and the rest doing something to improve my CV...or pay the rent. Step 3 won't really do much to improve (or worsen) your application at this point. And frankly, it's the easiest of the steps by far. I probably spent a total of 25 hours over the course of a month studying for it, usually an hour or two at a time, and scored 15 points higher than my Step 2 (which was about 15 points higher than my Step 1...which I studied an insane amount for).

Let me clarify what I was thinking - if I take Step 3 and pass with a decent score, I assumed that this would help convince a place (even somewhat) that I'm not a complete crap resident. It surprises me to hear that this wouldn't matter, but perhaps that is true.

As for beefing up the cv, I'm not sure how to realistically do that in the interim. Jobs are hard to come by and I might end up doing some kind of random crap-job in the time being. It would be nice to do something in clinical research/etc but obtaining something related will be sheer luck. People see MD on a cv and probably assume that I won't walk in the door for <75k.

Originally Posted by sella turcica

Let me clarify what I was thinking - if I take Step 3 and pass with a decent score, I assumed that this would help convince a place (even somewhat) that I'm not a complete crap resident. It surprises me to hear that this wouldn't matter, but perhaps that is true.

If you had gotten 185 on Step 1 and 2 and then rocked a 260 on Step 3, then yes, it would probably help you out a little bit. But you did fine (not stellar, but just fine) on Step 1 and 2. Nobody is going to take an extra look at your app because you bump another 20 or 30 points on Step 3 simply because that's not really a useful comparator since very few other applicants have taken it. A good score on Step 3 is roughly equivalent to being involved in your med school's IM interest group. Potentially something to talk about during an interview but not particularly important.

As for beefing up the cv, I'm not sure how to realistically do that in the interim. Jobs are hard to come by and I might end up doing some kind of random crap-job in the time being. It would be nice to do something in clinical research/etc but obtaining something related will be sheer luck. People see MD on a cv and probably assume that I won't walk in the door for <75k.

I understand this and it definitely makes life difficult for you. I guess what I don't understand is what you've done with your med school to help you out in this situation. You've stated previously that your dean was aware of your situation and helping you out. That's honestly your best chance at this point. Put your tail between your legs and go hobbling back home. Sucks, but that's the reality at this point.

Step 3 is offered on a rolling basis, so once you register for it you get a "window" of 2-3 months to take it. You can simply sign up any day in your window and take it (although don't forget it's two days long).

You should be certain that there is no more than 7 years between whenever you passed your first step exam, and step 3. Anything longer than that can cause licensing problems in the future. Assuming you are on a "normal" timeline, this shouldn't be a problem (you likely took Step 1 about 3-4 years prior, so you have plenty of time).

What to do about getting your career back on track depends heavily on what you want to do. You absolutely should apply / participate in next year's match. However, you might be able to finagle an off cycle opening -- if I have someone drop out of my program, I'll look at my applications from prior grads, and try to get someone to start early.

Very sorry to hear your about situation, Sella Turcica. Keep your chin up, and only look forward. Do not give up on residency. Medicine is not the same, and every field is different. You must apply again in the next match season this September. Try to apply to a different specialty from the one you were in.

I had a medical school friend who also had his contract non-renewed when he was an intern (that was about 6 years ago). He was an IMG. What he did was, he took Step 3 and did well on it. He also started working as a "medical floor secretary" at a hospital. He then applied to programs in a different specialty in the Match. His new specialty was acctually more competetive than his old one. He got a pre-match very early on in the application season! He then went to complete his new specialty with no problems.

So there is definately hope. If an IMG did it, you as an AMG can definately do it. So take Step 3 and find a job (any medically related job), and apply in the Match in September. Keep your chin up, and move forword to your goal.

Best of Luck.

Step 3 can be an important factor IF the rest of your application is strong. One thing it does is that it is one less thing for a PD to worry about and it shows you can prepare and pass a board exam. I know most people on here claim step 3 is the easiest but trust me, you do not want to fail and have to retake it as an off cycle resident. I didn't match into rad onc and all I had left was step 3... So make it count!

As the above post stated, anything is possible and it's up to you to make it happen. You just need to keep trying and an opportunity will reveal itself.


Good luck!

Originally Posted by sella turcica

Let me clarify what I was thinking - if I take Step 3 and pass with a decent score, I assumed that this would help convince a place (even somewhat) that I'm not a complete crap resident. It surprises me to hear that this wouldn't matter, but perhaps that is true....

the problem is you'd be doing comparably well on a test that nobody else is putting much time or effort in on. If you studied really hard, you "should" do better than the majority who are just doing enough world problems to pass. so whether places put any stock in an above passing score is questionable. Passing tells them you will actually be able to get licensed, which s important.

But doing well above passing is kind of the equivalent of hitting an inside the park home run against a team that's not even playing anyone in the outfield. Some people might appreciate your swing and your hustle, but most will say that against that kind of lazy competition, it's hard to give you kudos.

Just my two cents.

Originally Posted by Law2Doc

the problem is you'd be doing comparably well on a test that nobody else is putting much time or effort in on. If you studied really hard, you "should" do better than the majority who are just doing enough world problems to pass. so whether places put any stock in an above passing score is questionable. Passing tells them you will actually be able to get licensed, which s important.

But doing well above passing is kind of the equivalent of hitting an inside the park home run against a team that's not even playing anyone in the outfield. Some people might appreciate your swing and your hustle, but most will say that against that kind of lazy competition, it's hard to give you kudos.

Just my two cents.

I do agree with you that it probably won't make me stand out in a crowd - after all, there are also MS4's applying for residency who have not been non-renewed and they will also look better than me because of that. Same with residents switching specialties with intern year already completed. I don't kid myself that Step 3 will suddenly make me look as good as those guys. However, I am trying to make myself look as good as I can in the interim, since this is a narrow window for me. I imagine that once I get 2-3 years out from now, it will be a lot harder to get back in than it is right now. I have some connections in the clinical trials field (and I currently live in an area overflowing with that stuff) so I'll probably swing into that for now. Anybody else have suggestions on what to do, in the interim?

What sort of work are you doing in the meantime?

Did you find a clinical or non-clinical job?

Originally Posted by SnowyRox

What sort of work are you doing in the meantime?

Did you find a clinical or non-clinical job?

Trying not to divulge too much information right now, but I'd like something in the EHR or clinical research realm. They would fit me well. I signed up for Step 3, it can't hurt to get that thing out of the way.

I would spend several hours/day for a few weeks studying for the Step 3. Maybe even a month or two.
I agree that you should try to get a medically-related job.
I would then after a few months look for an off-cycle stop, while at the same time reapplying to the Match. You need to decide which specialty though (your same old one or a new one).

Now that I am preparing to enter the residency application cycle again, I was wondering what I ought to do about my personal statement. Clearly the situation will come up during interviews but should I talk about this in a personal statement now? Of course with all the "I learned xyz from this and blah blah". Good idea or not?

My personal n=1 opinion is to address it head on in ome facet of your application. Otherwise, it seems you're "hiding" something, and I'm unlikely to explore your application further for fear of what I would find (and hence wasting my time). If you are submitting an LOR from the PD of your prior program, it might all be discussed there and then addressing it in your PS is less critical. You could also address it in the "reason you left" box when you enter it as prior training -- but I don't know how much room they give you there, and whether you can adequately address it there.