Dismissed from Medical School at end of 3rd Year

[modisrules]

So I was dismissed from my school one rotation short of completing 3rd year. It's a super complicated situation, and let's just say that I had a lot of difficulty in medical school related to ADHD, which had gone undiagnosed my entire life until the summer between 1st and 2nd year. I did pass Step 1 on first try, but just barely. I had a bunch of conditional passes in my 3rd year clerkships and also received a couple professionalism evals related to tardiness and trouble handing in assignments, things related to my ADHD, as well as depression that was probably caused by one of the meds I took for ADHD.

At this time, I decided to take 8 months off to get over my depression and to really work my behaviors out. I had to sit before the academic standing committee for a dismissal hearing prior to starting up again, and they decided that I could stay but made me repeat almost the entire 3rd year. My repeat started out well in Family Med and ObGyn, but I had a setback during my Medicine rotation. There was a requirement that was not well described in the course literature, and the clerkship director gave me no leeway to fulfill this requirement (as others had been given, as it was an unclear requirement); I had also been late a few times, but my team never got on me about it (they mentioned that it was something I needed to work on, but that I communicated well and it never became a "problem" per se). The clerkship director gave me a conditional pass, and wrote a professionalism eval stating that I "could not be trusted to complete tasks, did not seek help appropriately, and was tardy despite frequent reminders." I realized I had to iron out these problems, so I got an apartment closer to the hospital and saw my psychiatrist, who thought I had developed a tolerance to the stimulant meds and adjusted them accordingly. This was exactly what I needed, and with my next clerkship (Surgery) I did fantastically. However, the previous grade and professionalism eval prompted another dismissal hearing.

At this hearing, I brought huge supporters, including the Surgery clerkship director who had written the first two professionalism evals, as she was so impressed with my improvements (on that recent Surgery rotation). I also had my Medicine attending write a letter (he couldnt be there), another Medicine attending who knew me well, and a Medicine resident who worked with me to comment on the severity of the issues raised. Unfortunately, the Medicine clerkship director is also the chairman of the Academic Standing Committee, and yes, he was there despite my concerns. After a closed deliberation, the ASC voted 11-2 in favor of dismissal simply on the technical grounds that I met to prompt the hearing - no further explanation was given.

I decided to appeal to the Dean, as this was the last step. I drafted a five page memo (while starting Pediatrics, and I continued to do really well). I had my supporters and my psychiatrist draft very strong letters, and I provided my Surgery grade and evals (which was now completed) and my preliminary Peds evals. The Dean and I had what I thought was a pretty good conversation, and he told me that given the info he needed to take some more time than usual to make a decision. Eleven days later, he called me to tell me that he agreed with the decision, with no further explanation, yet he had not asked me a single question for clarification or concern despite requests, nor had he contacted my psychiatrist or any of my supporters during that time.

So that's where I am now - dismissed from medical school, with a mountain of debt and nothing to show for it. The real tragedy is that I have all of this training, and I feel like I'm in a fantastic place as far as my behaviors - it took five years to undo much of the 23 prior to diagnosis, but I finally got there, and now they're letting me go. I feel like they should have worked with me just a little bit more, given all that I had done and how hard I had worked, how much the school and I had both invested, but they just kicked me to the curb. I feel like any US med school would be out of the question, and I'm not sure about off-shore med schools but am considering it (though there seem to be issues there too). Anyone been through this? Anyone have any advice for me?

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[Rollo]

Sorry to hear this happened to you.

First thing you need to figure out is do you really want to be a medical doctor or do you want to be just in medicine?

Your answer to the question above is very important because if you absolutely want to be a medical doctor, then I think you should re-apply to US medical schools. You seem to have figured out your problem (i.e. ADHD) and finally took care of it (albeit too late). Not to mention, you can have attendings and residents write you strong LORs. Also, it sounds like your dean and medical school can probably write a letter on your behalf should you re-apply.

Problem is the debt. You've already accumulated 3 years of medical school debt which can translate to anywhere from 120K - 180K before interest. If you re-apply, you have to understand that it will be absolutely critical that you succeed and get your license otherwise you'll be in unimaginable debt with no degree to show for it.

Now, if you want to be in medical field then there are several options out there (physician assistant, pharmacist, etc.) that pay well and schooling isn't too bad.

So the question to you is do you ABSOLUTELY want to be a medical doctor or do you just want to be in the medical profession?

 

[seelee]

Sorry to hear about your situation.

If you have explored every option to get reinstated, then I would first look and see what I could do to minimize my monthly payment, and then start looking for something else. Only because I can't see any medical school admitting someone who had been dismissed, no matter what the reason.

 

[Perrotfish]

Consult a lawyer and see if you have any leeway based on the Americans With Disabilities Act. If you're school was aware of your diagnosis you can argue that they failed to reasonably accomodate you. If the lawyer says you don't have a case then you don't, but it's worth the fee for a consultation.

 

[Gabby]

I just want to make sure I understand. You were nearly dismissed once, even after your ADHD was diagnosed and you were on medication. Your school agreed to give you another shot, under the condition that you repeat third year. You repeated third year and still got unprofessional evaluations and were dismissed for real this time?

I don't think you have much legal recourse if that's the case. ADHD can cause a multitude of problems, but how does it make you perpetually late for rotations? That seemed to be one of the biggest problems and I don't see the connection.

I'm really sorry for the predicament you're in. I wouldn't give up on U.S. schools though. I'd try some other MD schools and maybe some DO schools. Just make sure you can explain what happened and the ways in which you can correct it in the future, even if you develop a tolerance to your new dose of medication. If you don't get any bites stateside, consider the Caribbean. If you decide not to take that risk, maybe try PA school? I just wouldn't give up on US MD/DO yet.

 

[MegaProjectile]

"Could not be trusted to complete tasks, did not seek help appropriately, and was tardy despite frequent reminders."

Sorry for your situation. The quote above is quite damning and something that school admins cannot just overlook. It goes to the heart of your credibility and being entrusted with people's lives. Legally, I'm not sure if there's anything you can do although you can consult an attorney for a free consultation.

Even if you went to an offshore school(chance at US MD is slim to none), your Step 1 may be an issue since you're only allowed to take it once if you've passed (which you did) and it will be 4+ years old by the time you apply for residency. Not sure how programs will look that this.

My advice is look into PA programs. It's just 2 years and pays very well. You'll get to help people and use some of the skills and knowledge attained from med school.

 

[Bernoull]

OP my heart really goes out to you. I hope things work out for you and hopefully u get back in med school somewhere. It's definitely heart-wrenching to be that close to finishing and have everything come crashing down. I hope u're doing better with your ADHD and that it doesn't affect your future endeavors..

Keep ur chin up, don't give up, keep knocking on doors and most importantly don't get too down or depressed, if you do, get help right away!! This is definitely a personal tragedy but I hope you bounce back even stronger!!

 

[Stixman28]

"Could not be trusted to complete tasks, did not seek help appropriately, and was tardy despite frequent reminders."

I agree. this line is truly damaging. If i thought for a minute like the administrators might, I might definitely be concerned.

If they allowed you to graduate, and down the line, a mistake was made on your part leading to a patient being injured, or worse, perhaps it could come back to the school. They KNEW years earlier about problems regarding trusting your and your ability to act responsibly, and still allowed you to move forward. I do not know if they could be held legally responsible, but at least, their name will be attached to the situation, and most administrator actions are for the sole purpose of saving face.

Sorry though, that even though you have proven yourself to the precise individual who initially wrote this, they still will not let you go on.

Regarding adhd and perpetual lateness, I have known several students diagnosed with ADHD who are pathologically late. From talking with ppl ignorant of their diagnosis, I often hear complaints that these folks think that the rules do not apply to them. while this may be far from the actual reason that the person is chronically late, it may still seem this way to an outsider, and this is just another way that someone might have issues with handing over even larger levels of responsibility.

 

[MossPoh]

Regarding adhd and perpetual lateness, I have known several students diagnosed with ADHD who are pathologically late. From talking with ppl ignorant of their diagnosis, I often hear complaints that these folks think that the rules do not apply to them. while this may be far from the actual reason that the person is chronically late, it may still seem this way to an outsider, and this is just another way that someone might have issues with handing over even larger levels of responsibility.

Eh. I have ADHD and am late to things simply because I get distracted by other things. That being said, I've learned to adjust my life accordingly to compensate for this. If I'm told that something begins at 9 then I set my calendar for 8:45 and when my alarm goes off I drop whatever I'm doing and head over. I set my alarm earlier every morning because I am aware I will get sidetracked. Would I like to sleep more? Of course. Once one gets to this level you have to learn, on your own or through therapy, how to manage these kind of problems. People really don't care what your problem is if they are constantly waiting for you. We have reached the maturity level to learn how to manage these problems.

 

[Gabby]

Eh. I have ADHD and am late to things simply because I get distracted by other things. That being said, I've learned to adjust my life accordingly to compensate for this. If I'm told that something begins at 9 then I set my calendar for 8:45 and when my alarm goes off I drop whatever I'm doing and head over. I set my alarm earlier every morning because I am aware I will get sidetracked. Would I like to sleep more? Of course. Once one gets to this level you have to learn, on your own or through therapy, how to manage these kind of problems. People really don't care what your problem is if they are constantly waiting for you. We have reached the maturity level to learn how to manage these problems.

Regretfully, I have to agree. I don't want to pile on the OP, but the tardiness was an issue before and resulted in a near-dismissal. He was given a second chance. Instead of doing whatever in his power to not to blow (even if it meant sleeping at the hospital), he ended up having this problem again. It's an unfortunate situation and my heart goes out to you, but I don't know what you can do at this point.

 

[45408]

"Could not be trusted to complete tasks, did not seek help appropriately, and was tardy despite frequent reminders."

Sorry for your situation. The quote above is quite damning and something that school admins cannot just overlook. It goes to the heart of your credibility and being entrusted with people's lives. Legally, I'm not sure if there's anything you can do although you can consult an attorney for a free consultation.

Agreed. While this is a tough plight to be in, if the above quote is true, then it sounds like game over.

 

[modisrules]

Thanks to everyone for your advice. Regarding the "damning statement" that has been quoted and discussed above, I think that I failed to explain how these statements appeared in the evaluation. The idea of being unprofessional is not a self-defining entity, and therefore need to be defined or operationalized as certain behaviors. The form has a bunch of things listed that can be checked off and then explained by the faculty member filing the eval, and as a collection (there are about 10 possibilities) seem to generally refer to clinically active issues (things that may happen within your service team or with regard to patients). Those three statements were the ones chosen by this professor as he felt they described the situation, and then discussed each one as such. I actually think he tried to find as many things as he felt that he could check off, and some of it I think is pretty ridiculous.
1. "Could not be trusted to complete tasks"
He checked this off because I did not complete the one poorly-described clerkship requirement: my 8 H&P's, which I completed and were well-written, also had to cover these 14 diagnoses, something not written in the general clerkship guidelines or H&P guidelines, and no instructions were given on how to fill out the log form to this end. I had in fact covered these diagnoses with patient encounters and progress notes, as documented in my online case logs, but they were not fulfilled by the 8 H&P's I produced, which was a critical failure in the eyes of the clerkship director.
2. "Failed to seek help appropriately"
The clerkship director explained that his door was always open and that if I did not understand something in the requirements that I should have clarified it with him. Well, I understood the requirement to be that I had to see the 14 diagnoses within my patient encounters - as the online logs match up perfectly, and this is how every single other clerkship works. Also, all of the documents say "a total of 8 H&P's are required for a non-failing grade in this clerkship," but there's no mention of 14 diagnoses - seemed pretty clear to me. So I'm supposed to clarify what exactly? Other students understood it this way as well, and they were given leeway to complete the requirement with progress notes by their preceptors, but not mine. Never mind that the clerkship staff was continually aggressive and contrarian throughout (this is an opinion shared by just about everyone I have talked to about the clerkship); I generally look past this anyway, as dealing with difficult preceptors is par for the course in our field, but I think it's interesting given the described 'open-door policy.'
3. "Tardy despite frequent reminders"
I realize that this is a problem. I was commuting from an hour away, and I was under-medicated for my condition, both of which contributed. I was late a few times for pre-rounding in the morning, never more than 5-10 minutes, I always communicated with the team, and they were pretty understanding. Outside of these instances, I was never late to any other rounds, conferences, etc. Was it acceptable? No. But was it so bad that I should be kicked out of school? I don't think so. I saw it as a problem, sought my psychiatrist, found an apartment near the hospital, and the problem was fixed.

I need to reiterate that with regard to my clinical activities, I did not have any problems (except the morning tardiness). I completed various task independently: following up on lab results and consults, getting reports from outside hospitals, getting my own orthostatics and daily weights on a patient with volume losses when the nursing staff had not, even calling a patient's daughter on speakerphone every morning to translate her rare dialect for my prerounds, in addition to all the regular daily stuff that medical student do. As far as seeking help - I think I already discussed the psychiatrist and the moving, which I got on early enough to have in place right after the rotation ended.

Any other insights?

 

[Marcus Brody]

Dude, how can you be late? Seriously. It is the easiest thing. Set an alarm clock. Set 20 alarm clocks.

 

[Depakote]

Any other insights?

You're arguing the missing assignment... but you fail to recognize that this is the straw that broke the camel's back.

In your original post, you basically describe a constellation of issues which your school was concerned enough to consider dismissing you.

Then you're lucky enough to get a second chance... at which point, you should be doing absolutely anything and everything in your power to be an all star student.

Instead, you have issues with tardiness and fulfilling your professional obligations. Your peers are being held to these same standards, are they having similar difficulties?



My biggest concern is that you really don't take much responsibility for your actions. You blame the assignment for being vague, you say you live too far away to get in on time, you blame your ADHD for a lot... but you never take any responsibility for what occurred. I doubt you will have much success pleading your case to your schools administration as long as you continue to defer the blame.

 

[BigRedBeta]

And this thread shows, quite well I might add, that we physicians take ourselves very seriously. Whether that's right or wrong is irrelevant.

You stepped out of line, repeatedly. In perhaps any other profession the problems you've encountered may well have been overlooked (certainly would not have been an issue in law school). But we doctors and doctors-to-be got as far as we have by following the rules (most of the time) since we were 6 years old. We played the game about as well as it can be played and jumped through far more hoops as undergrads than pretty much any other group of students (and in a way, our desire to please and follow the rules results in us working 80 hours a week because they tell us to). Along the way, those people with the same aspirations who couldn't do what we've done, fell by the wayside. You, despite your issues, managed to make it this far. But now, surrounded by a group of people who are strikingly similar to each other in terms of academic demeanor stand out like a sore thumb. And then when given a chance to recover, to re-assume your place in the pack, you failed. Regardless of how insignificant or undermedicated you were or whatever it was may seem to you, you didn't manage to realign yourself with what everyone else was doing. You were the outlier, and an outlier in the worst possible manner. 90% of everything is literally just showing up on time, you have to know that by now. Even doing a piss-poor job on your tasks, so long as you had completed them all, probably would have saved you the first time. I'm willing to bet that very few medical students, residents or attendings who read this thread are surprised that you were not reinstated.

 

[Untraditional]

Professionalism. Other posters have hit on it but the chronic tardiness has got to be the biggest thing. You couldn't manage to show up for your rotations on time? That's really damning.

You might want to consider alternative careers. PA school could be a good fit for you with your training. Nursing gets you on the wards quickly and you could always go the NP route while making money to cover that debt. In 10 years the NPs might be doing more than us anyway...

 

[Hoju]

Sounds like you were given ample opportunity to turn yourself around, but didn't. There does not seem to be much owning up to that either. This situation is of your own making, and I can't say I disagree with the board decision based on your description. Sounds like some soul searching is in order. Unless you can improve your reliability, PA, nursing, or whatever may not be the best route. Even a fry cook should be on time regularly.

 

[Perrotfish]

Sounds like you were given ample opportunity to turn yourself around, but didn't. There does not seem to be much owning up to that either. This situation is of your own making, and I can't say I disagree with the board decision based on your description. Sounds like some soul searching is in order. Unless you can improve your reliability, PA, nursing, or whatever may not be the best route. Even a fry cook should be on time regularly.

1) Someone is late to prerounds a few times and you tell them they're not qualified to be a fry cook? For your own physicial safety I recommend you pursue a career in academic medicine, because nowhere else in the world will tolerate that kind of @sshole. Also medical students are occasionally late, especially to prerounds. They're before dawn, it happens.

2) Even if his problems did merit his dismissal (and I don't think they did, from his discription, I mean who gets kicked out over a CP?), you have to admit that the OP got a really raw deal in how the hearing was handled. The same guy who gave him the one poor grade that he recieved on probation was also the chair of the committee that reviewed him? How can you possibly appeal a decision if the person you're appealing to is the one who made the decision in the first place?

 

[Suenya]

1) Someone is late to prerounds a few times and you tell them they're not qualified to be a fry cook? For your own physicial safety I recommend you pursue a career in academic medicine, because nowhere else in the world will tolerate that kind of @sshole. Also medical students are occasionally late, especially to prerounds. They're before dawn, it happens.

2) Even if his problems did merit his dismissal (and I don't think they did, from his discription, I mean who gets kicked out over a CP?), you have to admit that the OP got a really raw deal in how the hearing was handled. The same guy who gave him the one poor grade that he recieved on probation was also the chair of the committee that reviewed him? How can you possibly appeal a decision if the person you're appealing to is the one who made the decision in the first place?

Seriously, this.

 

[naus]

You stepped out of line, repeatedly. In perhaps any other profession the problems you've encountered may well have been overlooked (certainly would not have been an issue in law school).

One would be fired in a New York minute if he constantly missed deadlines at a law firm. Maybe not dismissed from law school, but the end result is the same (loads of debt and no job).

Medicine actually has a lot less deadline pressure than many other professions (like law, consulting, journalism, etc), you just got to show up in medicine at your scheduled time.

OP, forget medical school. Get a 9-5 job, or maybe try PA school.

 

[naus]

I bet if you had a 250 Step 1, your fate would have been handled a little differently by the school.

All in all you were a pretty mediocre med student (actually bottom 5%), from the academics to the clinical/professionalism aspects.

 

[naus]

Eh. I have ADHD and am late to things simply because I get distracted by other things. That being said, I've learned to adjust my life accordingly to compensate for this. If I'm told that something begins at 9 then I set my calendar for 8:45 and when my alarm goes off I drop whatever I'm doing and head over. I set my alarm earlier every morning because I am aware I will get sidetracked. Would I like to sleep more? Of course. Once one gets to this level you have to learn, on your own or through therapy, how to manage these kind of problems. People really don't care what your problem is if they are constantly waiting for you. We have reached the maturity level to learn how to manage these problems.

How is this even ADHD? Everyone on the planet feels the same way about waking up in the morning. Especially if it's to get up for prerounds.

Who in their 20s doesn't want to roll over and sleep a little more?

 

[Perrotfish]

One would be fired in a New York minute if he constantly missed deadlines at a law firm. Maybe not dismissed from law school, but the end result is the same (loads of debt and no job). .

Missing deadlines yes, being 10 minutes late to the occasional early morning meeting no. Being late to the occasional pre-dawn preemeeting to discuss the early morning meeting (you notice how stupid that sounds when you put it in the context of another profession?) absolutely not.

 

[naus]

Missing deadlines yes, being 10 minutes late to the occasional early morning meeting no. Being late to the occasional pre-dawn preemeeting to discuss the early morning meeting (you notice how stupid that sounds when you put it in the context of another profession?) absolutely not.

Our OP skipped both.

It can sound as stupid as you want, but doesn't change the fact that rounding is the nature of the job and prerounding and writeups are the main tasks of a 3rd year medical student. It's part of professional training. No one wants to wait for the tardy anesthesiologist to show up for a scheduled operation. The attending might come in a little later than you, but when you're 35 with a baby crying all night long at home, even 7:00 seems really early.

The OP is free to do anything else where there are no deadlines or hard schedules (good luck). But don't sign up to be a train conductor and be habitually ten minutes late for the 6:00am train, and then whine about it when you get fired. It's obvious.

 

[modisrules]

Thanks to everyone for your honesty (even the brutal kind). I do realize that this is the straw that broke the camel's back, and despite how it might seem I do take a lot of responsibility for the things that have happened - I already felt like I'd been way too verbose in my posts, so I decided to cut out the "I realize that I screwed this up" and "I take full responsibility for that" from every-other sentence, so please understand that I do realize my role in this situation.

If you suggest that I get out of medicine because you somehow think that based on my story that I am unfit for the field, well, I appreciate your honesty but really this is not the type of advice for which I am looking. I'm mostly looking for advice on how to complete my education (e.g. in a Caribbean-based program with transfer credit), the problems associated with such avenues, or what legal rights I may have or may have been infringed upon by my former institution. I have been contemplating the idea of changing careers (though not too far away, like in public health, psychology or research), and I do think this may become relevant down the road, but at this point I am planning to continue along the physician's path somehow.

Also, for those that don't think the lateness thing has anything to do with ADHD, please read Hallowell and Ratey's Driven to Distraction. or even the WebMD blurb on ADHD, or just take it from an ADDer and (hopefully) future medical professional who knows a few things about the condition. I'm not saying it's acceptable or excusable, as it absolutely is NOT, but it is related to the condition - it was, in fact, the unacceptability of the behavior that led to my following-up with my psychiatrist and relocating, which were instrumental in eliminating this problem. The problem does not necessarily indicate a lack of effort on the part of the individual with ADHD; in fact, many have to try much harder and still end up being late. When it occurs, ADHD is often part of the explanation but NOT an excuse for the behavior, which can be improved both by medication and behavioral adjustments (removal of obstacles, establishing morning routines, setting multiple alarms, maintaining a calendar and figuring out other things that help - a PDA/smartphone device really helped me a lot).

 

[naus]

Honestly PA is the best way if you still want to pursue the field. Caribbean is high risk and has a much larger debt load (Stafford loans max out at 20k for Caribbean schools). Since you've already taken Step 1, I don't think you can retake it to improve your score (maybe I'm wrong, but you should certainly check) and your score will be at least 4 years old by the time you apply for residency.

PA is cheaper and faster (no residency either), and you might be better off in a less self-directed career path.

 

[Rollo]

What is the matter with some of the medical students and residents posting in this thread? Kick the guy while he is already down why don't you.

Anyway OP, needless to say you've learned from your mistakes. I'd say call the Caribbean schools and find out their policies on transferring and whether they will take you. And more importantly, if you would be allowed to start as a 3rd year.

You don't want to start from year 1 because that means more time + more money. And frankly it would be stupid for them to make you start over when you've already taken step 1 and completed what 2 years of clinical clerkships?

 

[rjmn]

Although I'm not expert here, my sense is that transferring with advanced standing to a different US allopathic institution is very unlikely, given how difficult it is even for top students to switch.

If you insisted on becoming a physician, would the military cover a retake of med school and absorb the existing debt?

What about working for government, where your pay scale is increased by the number of years of graduate education, whether or not it leads to a degree?

 

[silas2642]

Thanks to everyone for your honesty (even the brutal kind). I do realize that this is the straw that broke the camel's back, and despite how it might seem I do take a lot of responsibility for the things that have happened - I already felt like I'd been way too verbose in my posts, so I decided to cut out the "I realize that I screwed this up" and "I take full responsibility for that" from every-other sentence, so please understand that I do realize my role in this situation.

If you suggest that I get out of medicine because you somehow think that based on my story that I am unfit for the field, well, I appreciate your honesty but really this is not the type of advice for which I am looking. I'm mostly looking for advice on how to complete my education (e.g. in a Caribbean-based program with transfer credit), the problems associated with such avenues, or what legal rights I may have or may have been infringed upon by my former institution. I have been contemplating the idea of changing careers (though not too far away, like in public health, psychology or research), and I do think this may become relevant down the road, but at this point I am planning to continue along the physician's path somehow.

Also, for those that don't think the lateness thing has anything to do with ADHD, please read Hallowell and Ratey's Driven to Distraction. or even the WebMD blurb on ADHD, or just take it from an ADDer and (hopefully) future medical professional who knows a few things about the condition. I'm not saying it's acceptable or excusable, as it absolutely is NOT, but it is related to the condition - it was, in fact, the unacceptability of the behavior that led to my following-up with my psychiatrist and relocating, which were instrumental in eliminating this problem. The problem does not necessarily indicate a lack of effort on the part of the individual with ADHD; in fact, many have to try much harder and still end up being late. When it occurs, ADHD is often part of the explanation but NOT an excuse for the behavior, which can be improved both by medication and behavioral adjustments (removal of obstacles, establishing morning routines, setting multiple alarms, maintaining a calendar and figuring out other things that help - a PDA/smartphone device really helped me a lot).

As far as legal "rights" are concerned-- I'm not sure if you have too much to go on, but considering the financial investment you've already made, paying to consult a lawyer is not a crazy idea at all.

The thing that you really need to consider here is whether or not finishing your education is worth it at this point-- there is no way on earth another US allopathic school is going to consider you, much less with advanced standing. Reapplying to a US allopathic school is most likely out of the question as well, as you've been dismissed in unfavorable academic standing.

I suppose that you could reapply to DO schools and/or Caribbean schools. There is a DO student here who failed out of one med school and then reapplied to another school and was accepted (I believe to RVU), but you may have to start as an M1 again.

Again, the best case scenario at this point is that you reapply to osteopathic schools and/or Caribbean, are accepted and finish your medical education. However, your chances of being accepted to a residency program with this path seem really low at this point, and at this point you may just want to consider cutting your losses and finding another path.

 

[Rollo]

As far as legal "rights" are concerned-- I'm not sure if you have too much to go on, but considering the financial investment you've already made, paying to consult a lawyer is not a crazy idea at all.

The thing that you really need to consider here is whether or not finishing your education is worth it at this point-- there is no way on earth another US allopathic school is going to consider you, much less with advanced standing. Reapplying to a US allopathic school is most likely out of the question as well, as you've been dismissed in unfavorable academic standing.

I suppose that you could reapply to DO schools and/or Caribbean schools. There is a DO student here who failed out of one med school and then reapplied to another school and was accepted (I believe to RVU), but you may have to start as an M1 again.

Again, the best case scenario at this point is that you reapply to osteopathic schools and/or Caribbean, are accepted and finish your medical education. However, your chances of being accepted to a residency program with this path seem really low at this point, and at this point you may just want to consider cutting your losses and finding another path.

I'm pretty sure DO schools standards on admitting a previously dismissed medical student are the same as MD schools.

 

[christina30]

As far as legal "rights" are concerned-- I'm not sure if you have too much to go on, but considering the financial investment you've already made, paying to consult a lawyer is not a crazy idea at all.

The thing that you really need to consider here is whether or not finishing your education is worth it at this point-- there is no way on earth another US allopathic school is going to consider you, much less with advanced standing. Reapplying to a US allopathic school is most likely out of the question as well, as you've been dismissed in unfavorable academic standing.

I suppose that you could reapply to DO schools and/or Caribbean schools. There is a DO student here who failed out of one med school and then reapplied to another school and was accepted (I believe to RVU), but you may have to start as an M1 again.

Again, the best case scenario at this point is that you reapply to osteopathic schools and/or Caribbean, are accepted and finish your medical education. However, your chances of being accepted to a residency program with this path seem really low at this point, and at this point you may just want to consider cutting your losses and finding another path.

Not without having taken two years of OMM and passing COMLEX. So OP would practically have to start from the beginning as far as DO school is concerned.

 

[NontradICUdoc]

considering that the competition for seats at DO schools is already very competitive, in my opinion, I do not see the OP being accepted to any US medical school.

But that is my opinion.

If the OP would really like to pursue a career in medicine, I would suggest taking a break right now and getting your ADHD under control and your issues with tardiness in order before re-applying. Without showing that you have addressed the main issues that caused the dismissal, I do not know what school would sponsor a second look,

 

[Hoju]

Being late a couple times, OK. Being late more than a couple times after being told that your behavior is unacceptable would get you fired from nearly any job (even fry cook). Add that on to other forms of unreliability and termination should be expected, and I think warranted.

OP, sorry I don't have any advice on which professional route you should take. Work on being reliable or none of the suggestions in this thread will work.

1) Someone is late to prerounds a few times and you tell them they're not qualified to be a fry cook? For your own physicial safety I recommend you pursue a career in academic medicine, because nowhere else in the world will tolerate that kind of @sshole. Also medical students are occasionally late, especially to prerounds. They're before dawn, it happens.

2) Even if his problems did merit his dismissal (and I don't think they did, from his discription, I mean who gets kicked out over a CP?), you have to admit that the OP got a really raw deal in how the hearing was handled. The same guy who gave him the one poor grade that he recieved on probation was also the chair of the committee that reviewed him? How can you possibly appeal a decision if the person you're appealing to is the one who made the decision in the first place?

 

[coralfangs]

I am actually quite surprised that one can be dismissed over absence to certain meetings or even mild tardiness.

Personally, I believe that tardiness is not something one can control sometimes.
I have been late to didactics (5-10min late) because I would always finish my clinical works; I have been late to my afternoon outpatient duties because I got out from my morning inpatient duties later than expected and the drive is 1 hr away (+/- traffic and construction) (hell, I was 2 hrs late once because the whole Peds GI team had 2 ppl on service that day. Me and the attending); I have skipped conferences because they knew that I needed to study for my shelf exams and the time would be better spent on studying then to listen to someone proposing some new guidelines;

Hell, there are several attendings whom I work closely with on various projects and they are constantly late to many meetings. You know they are busy and they never give the students crap for being late once in a while (you know... **** happens).
My car's tire went flat one morning and I was 30min late for rounding. Who cares. We are just med students and they technically don't need us.


There must be something missing here that we are not aware of.
OP, have you offended your deans or any adminstrators in anyway before? Because if there is anyone who can vouch for you (ie. your surgery clerkship person), I fail to see why they need to dismiss you.
I almost got in trouble once because a bitchy OBGYN attending reported to my dean that I was unprofessional to the ethnic patients (she thinks I was being patronizing when I talked to them about soul food.... just because I am Asian). Little did she know that I work closely with a medical director on community-based projects on AA women's health. I know the city inside out and the patients love me. The director vouched for me and my case was dismissed.

 

[a winner is you]

Missing deadlines yes, being 10 minutes late to the occasional early morning meeting no. Being late to the occasional pre-dawn preemeeting to discuss the early morning meeting (you notice how stupid that sounds when you put it in the context of another profession?) absolutely not.

I don't buy the 10 minutes late to pre-rounds a few times thing. If it was just this and if his residents were as understanding as he makes us believe, then the clerkship director would never have even heard about it. It obviously was a problem with the residents or they would never have reported it.

 

[modisrules]

My residents mentioned that I needed to work on being on time in the formative comments section of their evaluations, but they generally graded me well in work habits. I think this issue was combined with the requirement issue in determining the grade and course of action of the clerkship director (one of my supporters, the Asst PD of the Medicine Residency, even thought he was making a mountain out of a molehill). That the clerkship director knew I had previously had problems, and that I had appeared before the committee previously (and that he was chairman of this committee and presided over the closed deliberation) did not help the situation.

I wish I better understood how the committee (and the Dean) felt they needed to dismiss me, as I believe there was much evidence that I had improved my behaviors significantly and should be allowed to continue. Also, there were people on the committee that felt I should stay, I had very strong support (even from the professor who previously cited me) and there were other complicating factors and doubts (including unsigned and contradicted resident evaluations) that I think should have obviated such harsh punishment. The only bases for dismissal given were that the entirety of the academic record was poor (essentially), which I understand, but it was not representative of my current performance and level of training and almost all of the negatives occurred prior to my leave of absence, when my conditions were not well-controlled. Also, these technical grounds for dismissal were present when they let me back in the first time. I think that if they were unwilling to work with me a little upon returning, then they should have just let me go initially and not have made me repeat (and pay for) 3rd year all over again. I guess they felt that they had given me a second chance and I blew it, but I personally think that's a myopic view of the situation and they should have considered the setback as part of the process of getting to where they wanted me to be.

Following my medical leave of absence I did quite well (save for the setback in Medicine), and following further adjustments I did really well - I think it's important to note that these adjustments (medication and relocation) were being worked on during Medicine (my psychiatrist had to try a few different things before finding one that worked, and it takes time to find a new apartment) in response to my own recognition of the problems. I think I've shown initiative and steady improvements along the way, and especially since that Medicine rotation (in Surgery and 3 weeks of Pediatrics). I realize they can't just keep giving me chances until I graduate, but I think it would have been reasonable to give me another chance at this point. However, I suppose all these points are now moot.

 

[naus]

What is the matter with some of the medical students and residents posting in this thread? Kick the guy while he is already down why don't you.

Anyway OP, needless to say you've learned from your mistakes. I'd say call the Caribbean schools and find out their policies on transferring and whether they will take you. And more importantly, if you would be allowed to start as a 3rd year.

You don't want to start from year 1 because that means more time + more money. And frankly it would be stupid for them to make you start over when you've already taken step 1 and completed what 2 years of clinical clerkships?

Better to kick while down than to be all rainbows and unicorns and convince the OP to take $300k of more debt for the Caribbean (he would probably need a cosigner for much of it, thereby putting his cosigner on the hook for non-dischargeable loans).

Why would for-profit Caribbean schools let you transfer into 3rd year? The most cost expensive part of off-shore medical schools is the clinical site contracts back in the States. The only Caribbean schools that would let him do that without remediating courses are probably ones that don't have greenbook rotations. This is insanely risky with the OP's barely passing Step 1 score.

The OP should smell the roses and think about pursuing a different career. Medicine is not the be all end all. Don't be Don Quixote. There are plenty of other lucrative careers that might work just as well for you, for less money and time sacrifice. Have you looked at being an actuary? Salaries are over 100k easily and the hours are very good. Hell, the FAA is hiring tens of thousands of air traffic controllers right now (though your ADHD might not be suited). They make $120k plus pension and retire at age 50.

Even if medicine is exactly what you want to do, PA is a perfectly reasonable option.

 

[majik1213]

1. "Could not be trusted to complete tasks"
He checked this off because I did not complete the one poorly-described clerkship requirement: my 8 H&P's, which I completed and were well-written, also had to cover these 14 diagnoses, something not written in the general clerkship guidelines or H&P guidelines, and no instructions were given on how to fill out the log form to this end. I had in fact covered these diagnoses with patient encounters and progress notes, as documented in my online case logs, but they were not fulfilled by the 8 H&P's I produced, which was a critical failure in the eyes of the clerkship director.
2. "Failed to seek help appropriately"
The clerkship director explained that his door was always open and that if I did not understand something in the requirements that I should have clarified it with him. Well, I understood the requirement to be that I had to see the 14 diagnoses within my patient encounters - as the online logs match up perfectly, and this is how every single other clerkship works. Also, all of the documents say "a total of 8 H&P's are required for a non-failing grade in this clerkship," but there's no mention of 14 diagnoses - seemed pretty clear to me. So I'm supposed to clarify what exactly? Other students understood it this way as well, and they were given leeway to complete the requirement with progress notes by their preceptors, but not mine. Never mind that the clerkship staff was continually aggressive and contrarian throughout (this is an opinion shared by just about everyone I have talked to about the clerkship); I generally look past this anyway, as dealing with difficult preceptors is par for the course in our field, but I think it's interesting given the described 'open-door policy.'
3. "Tardy despite frequent reminders"
I realize that this is a problem. I was commuting from an hour away, and I was under-medicated for my condition, both of which contributed. I was late a few times for pre-rounding in the morning, never more than 5-10 minutes, I always communicated with the team, and they were pretty understanding. Outside of these instances, I was never late to any other rounds, conferences, etc. Was it acceptable? No. But was it so bad that I should be kicked out of school? I don't think so. I saw it as a problem, sought my psychiatrist, found an apartment near the hospital, and the problem was fixed.

hey man. I have had ADHD all my life. Fortunately for myself, it was caught early (father = doctor; mother = nurse; diagnosed by age 7), and was started on pharmacotherapy for it. Now I'm a third year med student. In my first rotation, I felt that I should lower my dose to the maximum recommended (i'm above it) to see whether symptoms were gone. The result was a disaster. I was on pediatric rotation, and on the very first day the attending pulled me aside and asked whether there was any history of ADHD in my family. I ended up getting the dreaded "Pass" for that rotation - yuk - and got a beating on my evaluations - "student has strong points, but his drawbacks completely overshadow everything." Depressed, I even starting smoking marijuana daily to self-medicate (retrospect analysis, I wasn't like thinking: OK time to self medicate! when I did it ..)

I went back to my regular dose, and have honored/high pass ever since. as a convenient bonus, the amphetamine destroyed the psychologic craving for marijuana and replaced it with goal-directed thought processes that made the boring interesting again, and I once again appreciated all of the detail medicine has to offer. In addition, social interactions have improved tremendously, I was on time, my case presentations became infinitely sharper, differential diagnostic skills soared and, well, you get the idea.

why am I talking about myself? Well, it's because I think I know what is going on. ADHD, despite being an axis I disorder, obscures the afflicted individual's insight into his own condition. the person is rarely, if ever, aware of the extent of what they say or do. I will bet money that you did some things that seriously ticked off your attendings, none individually too serious, but when taken as a string of events they cumulated to get the kind of opinion they had of you. I, for example, was told, much to my surprise, by my attending how upset she was that everytime the group was working through a case, I was reading my review book for shelf exams. In all honesty, the setup for the rotation was that I did inpatient in morning, and then tagged along onto consult service in the afternoon. There were two medical students who were assigned to consult service all day. From my perspective, I was entering a consult case al media reis, with no clue who this patient was. Even if I knew the history, I made no difference whatsoever as all management affairs were to be worked out by the attending anad the student assigned to that case. So I was bored. From the attending's perspective, she saw a student who thought psych was a BS field and who instead preferred to read his book and not do interviews. Lucky for me, that attending then went on a prolonged vacation, and her replacement also has ADHD. We of course immediately clicked, and she loved the way I thought. Got high pass in the end, probably an average of a pass and honors. Now, rather than citing all of the little things you did, the attending performed a technical attack. What they have written is documented and provable. Other students might have missed the requirement if it weren't for the fact that, because they got along with the group so much more readily, residents and attendings went out of their way to inform them of their tasks to complete. Another explanation is that other individuals has less strained social relationships, and their friends may have informed them to do those requirements. A final explanation is that other students have missed the requirement as well, but have performed excellent H&P's. I know you said your H&P's were well-written, but in someone with ADHD who is under-medicated, it is impossible for them to create well-written histories, so quite frankly I don't believe that. No offense. I think your attending harbored an overall ill opinion of you, and emphasized technical drawbacks to convey his general impression without sounding subjective.

So now what? Well, you are at a therapeutic dose, so that's good. I agree to what an above-poster said: you need to decide whether medicine is right for you. I am sure you will agree that medicine is not conducive to ADHD because it requires an outstanding Wernicke's area for the most part for factual recall. ADHD patients classically have such poor Wernicke access (for which they make up for it via Broca's zone - hence mathematicians/physicists such as Albert Einstein, Isaac Newton, etc.) that unless they are at therapeutic dose, they will make for dangerous doctors. That being said, you probably have a lot of gifts to offer (humor, wit, looks, etc.) that students without this disorder lack (for example, they did not have to be so good looking to get this far; they were smart). Use these gifts, and now combine them with your restored cognitive and social functioning. you might have to start from scratch. Ask your school if they will help you get a fresh start elsewhere. Medical school hates having to dismiss students: they leave with so much debt and so little income. Be persistent and earnest, but not annoying, if you attempt to contact your Dean for guidance of where to go from here. Let your residents who supported you throughout know what has happened (without going too deeply into why it happened.) Above all else, stay as professional as possible whenever you are working with residents and attendings. The danger of this axis I disorder, again, is that you (and I) lack insight and therefore execute poor judgment quite often when it comes to self-censoring things we choose to say.

Hope that helps. I'm pretty sure some people will be scratching their heads, looking in their notes for the connection between ADHD and Wernicke's, to verify what I said.

If you want to do a bang up job, you can try to wait until your step 1 scores expire (work in lab), reapply to medical school, and study the way you should have during your first two years. Based on your story, we have few discrepancies, one of which is our step 1 scores: you barely passed, but I got a 259.

Good luck.

 

[SouthernSurgeon]

Missing deadlines yes, being 10 minutes late to the occasional early morning meeting no. Being late to the occasional pre-dawn preemeeting to discuss the early morning meeting (you notice how stupid that sounds when you put it in the context of another profession?) absolutely not.

Pre-rounding and rounding are, as you well know, the student's main opportunity to demonstrate their knowledge base and clinical reasoning abilities. The time of day is irrelevant.

 

[Jolie South]

Pre-rounding and rounding are, as you well know, the student's main opportunity to demonstrate their knowledge base and clinical reasoning abilities. The time of day is irrelevant.

I tend to agree.

Plus, I think being late to anything shows flagrant disrespect for others' time. When those people are your superiors who will be evaluating you, you're playing with fire. Plus, with all the stupid answers and wrong plans that we come up with on the wards, do you want to get "wrong" the one thing that's completely under your control?

 

[Bernardo_11]

hey man. I have had ADHD all my life. Fortunately for myself, it was caught early (father = doctor; mother = nurse; diagnosed by age 7), and was started on pharmacotherapy for it. Now I'm a third year med student. In my first rotation, I felt that I should lower my dose to the maximum recommended (i'm above it) to see whether symptoms were gone. The result was a disaster. I was on pediatric rotation, and on the very first day the attending pulled me aside and asked whether there was any history of ADHD in my family. I ended up getting the dreaded "Pass" for that rotation - yuk - and got a beating on my evaluations - "student has strong points, but his drawbacks completely overshadow everything." Depressed, I even starting smoking marijuana daily to self-medicate (retrospect analysis, I wasn't like thinking: OK time to self medicate! when I did it ..)

I went back to my regular dose, and have honored/high pass ever since. as a convenient bonus, the amphetamine destroyed the psychologic craving for marijuana and replaced it with goal-directed thought processes that made the boring interesting again, and I once again appreciated all of the detail medicine has to offer. In addition, social interactions have improved tremendously, I was on time, my case presentations became infinitely sharper, differential diagnostic skills soared and, well, you get the idea.

why am I talking about myself? Well, it's because I think I know what is going on. ADHD, despite being an axis I disorder, obscures the afflicted individual's insight into his own condition. the person is rarely, if ever, aware of the extent of what they say or do. I will bet money that you did some things that seriously ticked off your attendings, none individually too serious, but when taken as a string of events they cumulated to get the kind of opinion they had of you. I, for example, was told, much to my surprise, by my attending how upset she was that everytime the group was working through a case, I was reading my review book for shelf exams. In all honesty, the setup for the rotation was that I did inpatient in morning, and then tagged along onto consult service in the afternoon. There were two medical students who were assigned to consult service all day. From my perspective, I was entering a consult case al media reis, with no clue who this patient was. Even if I knew the history, I made no difference whatsoever as all management affairs were to be worked out by the attending anad the student assigned to that case. So I was bored. From the attending's perspective, she saw a student who thought psych was a BS field and who instead preferred to read his book and not do interviews. Lucky for me, that attending then went on a prolonged vacation, and her replacement also has ADHD. We of course immediately clicked, and she loved the way I thought. Got high pass in the end, probably an average of a pass and honors. Now, rather than citing all of the little things you did, the attending performed a technical attack. What they have written is documented and provable. Other students might have missed the requirement if it weren't for the fact that, because they got along with the group so much more readily, residents and attendings went out of their way to inform them of their tasks to complete. Another explanation is that other individuals has less strained social relationships, and their friends may have informed them to do those requirements. A final explanation is that other students have missed the requirement as well, but have performed excellent H&P's. I know you said your H&P's were well-written, but in someone with ADHD who is under-medicated, it is impossible for them to create well-written histories, so quite frankly I don't believe that. No offense. I think your attending harbored an overall ill opinion of you, and emphasized technical drawbacks to convey his general impression without sounding subjective.

So now what? Well, you are at a therapeutic dose, so that's good. I agree to what an above-poster said: you need to decide whether medicine is right for you. I am sure you will agree that medicine is not conducive to ADHD because it requires an outstanding Wernicke's area for the most part for factual recall. ADHD patients classically have such poor Wernicke access (for which they make up for it via Broca's zone - hence mathematicians/physicists such as Albert Einstein, Isaac Newton, etc.) that unless they are at therapeutic dose, they will make for dangerous doctors. That being said, you probably have a lot of gifts to offer (humor, wit, looks, etc.) that students without this disorder lack (for example, they did not have to be so good looking to get this far; they were smart). Use these gifts, and now combine them with your restored cognitive and social functioning. you might have to start from scratch. Ask your school if they will help you get a fresh start elsewhere. Medical school hates having to dismiss students: they leave with so much debt and so little income. Be persistent and earnest, but not annoying, if you attempt to contact your Dean for guidance of where to go from here. Let your residents who supported you throughout know what has happened (without going too deeply into why it happened.) Above all else, stay as professional as possible whenever you are working with residents and attendings. The danger of this axis I disorder, again, is that you (and I) lack insight and therefore execute poor judgment quite often when it comes to self-censoring things we choose to say.

Hope that helps. I'm pretty sure some people will be scratching their heads, looking in their notes for the connection between ADHD and Wernicke's, to verify what I said.

If you want to do a bang up job, you can try to wait until your step 1 scores expire (work in lab), reapply to medical school, and study the way you should have during your first two years. Based on your story, we have few discrepancies, one of which is our step 1 scores: you barely passed, but I got a 259.

Good luck.

This was well written and quite informative. You wouldn't happen to be going into Child Psych would you?

Nardo

 

[symphonica]

1) Someone is late to prerounds a few times and you tell them they're not qualified to be a fry cook? For your own physicial safety I recommend you pursue a career in academic medicine, because nowhere else in the world will tolerate that kind of @sshole. Also medical students are occasionally late, especially to prerounds. They're before dawn, it happens.

2) Even if his problems did merit his dismissal (and I don't think they did, from his discription, I mean who gets kicked out over a CP?), you have to admit that the OP got a really raw deal in how the hearing was handled. The same guy who gave him the one poor grade that he recieved on probation was also the chair of the committee that reviewed him? How can you possibly appeal a decision if the person you're appealing to is the one who made the decision in the first place?

I totally agree with this. That sounds less than fair to me, to say the least. The only thing I can think of is that legal advice might be helpful in this situation.

 

[Meerkatology]

continuing to be tardy after you've almost been dimissed the 1st time for it ... i don't know what to say. while ADHD may certainly contribute to the tardiness but when they gave you a 2nd chance, they expect you to have fixed it, REGARDLESS of what the reason was.

but having the only person who suggested you to be dismissed to be the chair of the appeal committee is pretty ridiculous =\


clinical grading is pretty subjective, most of the time when someone gets completely screwed, its a little bit of fault on both ends - the student did something wrong, and some ******* attending makes a disproportionally big deal from it. you really can't argue much here cuz you did do something wrong in the 1st place. just sucks that many other students may have been late just as many times but had attendings who didn't care at all.

regardless, unless you are able to retake and DESTROY step 1 + step 2, going to carrib or something is probably a bad idea, because even if you got in, the combination of IMG status, unfavorable history, and low step score would make it very difficult to get a residency

 

[Rollo]

I don't think he can take step 1 again since he has already passed it.

 

[majik1213]

I don't think he can take step 1 again since he has already passed it.

I agree that retaking Step 1 is difficult if you've already passed; however, according to this website, Step 1 and 2 Exam scores are valid for seven years for the purposes of US residency application.

Essentially, a retake would require a seven year commitment, five of which would be spent doing something before restarting medical school.

 

[tkim]

I agree that retaking Step 1 is difficult if you've already passed; however, according to this website, Step 1 and 2 Exam scores are valid for seven years for the purposes of US residency application.

Essentially, a retake would require a seven year commitment, five of which would be spent doing something before restarting medical school.

Uh, no.

 

[DrYoda]

Uh, no.

I thought so too, but it looks like it's generally true (state dependent).

If you pass a Step or Step Component, you are not allowed to retake it, except to comply with the time limit of a medical licensing authority for the completion of all Steps or a requirement imposed by another authority recognized by the USMLE program for this purpose. The medical licensing authority must provide information indicating that you are an applicant for licensure in that jurisdiction; have fulfilled all requirements for licensure in that jurisdiction; are eligible for licensure except for the out-of-date examination; and have completed the full USMLE sequence, including Step 3. Information regarding retakes allowed to comply with a requirement imposed by a recognized authority other than a medical licensing authority is provided at the time of exam application using ECFMG's Interactive Web Applications (IWA)....

...or purposes of medical licensure in the United States, any time limit to complete the USMLE is established by the state medical boards. Most, but not all, require completion of the full USMLE sequence within seven years from the date the first Step or Step Component is passed
http://www.usmle.org/General_Information/bulletin/2011/eligibility.html#timelimit

But regardless, 7 years just to retake step I? At that point it's time to move on and figure out something else to do with your life.

 

[Rollo]

I agree that retaking Step 1 is difficult if you've already passed; however, according to this website, Step 1 and 2 Exam scores are valid for seven years for the purposes of US residency application.

Essentially, a retake would require a seven year commitment, five of which would be spent doing something before restarting medical school.

That doesn't make sense. How can you retake Step 1 after 7 years (i.e. your old score expired) yet not be enrolled in medical school or have completed medical school?

I thought one of the requirements for taking Step 1 was you had to be currently enrolled in a medical school. IMGs are an exception obviously but that does not apply to OP's situation since he is not an IMG.

 

[majik1213]

That doesn't make sense. How can you retake Step 1 after 7 years (i.e. your old score expired) yet not be enrolled in medical school or have completed medical school?

I thought one of the requirements for taking Step 1 was you had to be currently enrolled in a medical school. IMGs are an exception obviously but that does not apply to OP's situation since he is not an IMG.

@Rollo: the OP was dismissed. S/he could technically re-matriculate at year 5 and retake step 1 at year 7 since initial pass.

@DrYoda: I agree that trying to retake step 1 would just be such a difficult task, even though it technically can be done. 7 years is an extreme amount of time - it's 7 years of lost earnings, 7 years of mounting debt, etc.

 

[modisrules]

I agree that retaking Step 1 is difficult if you've already passed; however, according to this website, Step 1 and 2 Exam scores are valid for seven years for the purposes of US residency application.

Essentially, a retake would require a seven year commitment, five of which would be spent doing something before restarting medical school.

So here's how I interpreted the USMLE rules: I have to take Steps 2 CK/CS and Step 3 within 7 years of passing Step 1. Otherwise, I need to retake Step 1, which I would be eligible for 7 years after first passing (June 2014) OR I can get an exemption and be allowed to retake earlier if my intended graduation date is more than 6 years after passing Step 1, and if that would be the case I could sit for Step 1 less than a year from now. I guess it depends how much credit I would receive from my future school.

And I am ready to crush Step 2, as well as Step 1 if need be (I didn't study particularly hard the first time).