Failed my first class of M1 - can I kiss spinal surgery goodbye?

[throwawayNS]

Stating the question first, writing the post second: for a US MD student, does failing a course during M1 put him too far behind the eight ball to realistically match neurosurg or ortho (spinal surgery goal), and what should I focus on moving forward? Any advice and/or motivation would be greatly appreciated.

I am a US MD student, and I failed my first class of my first year of medical school (anatomy). I was 1/3 of the way into my second course when the grades were finalized, and they saw I had a 90% on my first biomedical sciences (second course) exam, so they let me stay in it. I received honors in it.

They said I did poorly enough in anatomy that I must repeat the year, so they are having me complete half the M1 courses this year and half of them next year with anatomy my second time.

I've gone to a bunch of interest group meetings recently, where program directors have rattled off their list of things they care about (1. STEP I, 2. 3rd year clinical grades, 3. AOA, 4. letters, 5. research)

But I never see pre-clinical grades. Yet, I have a red flag now.

Yeah, I know I should probably get a 240+ if I want ortho or neurosurg. But I want to know how self-selecting neursurg is, and whether I've done myself in already. I'd like a dose of realism and a direction to go in over the next four years. I'll have at least 4 pubs when it comes time for me to apply to residency (just to mention that minute positive), but i know that is so insignificant compared to the academic success that is necessary to get where i want to be.

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[Etorphine]

Stating the question first, writing the post second: for a US MD student, does failing a course during M1 put him too far behind the eight ball to realistically match neurosurg or ortho (spinal surgery goal), and what should I focus on moving forward? Any advice and/or motivation would be greatly appreciated.

I am a US MD student, and I failed my first class of my first year of medical school (anatomy). I was 1/3 of the way into my second course when the grades were finalized, and they saw I had a 90% on my first biomedical sciences (second course) exam, so they let me stay in it. I received honors in it.

They said I did poorly enough in anatomy that I must repeat the year, so they are having me complete half the M1 courses this year and half of them next year with anatomy my second time.

I've gone to a bunch of interest group meetings recently, where program directors have rattled off their list of things they care about (1. STEP I, 2. 3rd year clinical grades, 3. AOA, 4. letters, 5. research)

But I never see pre-clinical grades. Yet, I have a red flag now.

Yeah, I know I should probably get a 240+ if I want ortho or neurosurg. But I want to know how self-selecting neursurg is, and whether I've done myself in already. I'd like a dose of realism and a direction to go in over the next four years. I'll have at least 4 pubs when it comes time for me to apply to residency (just to mention that minute positive), but i know that is so insignificant compared to the academic success that is necessary to get where i want to be.

Residency directors will ask if you had to do remediation. Now the extent to which this will be a problem in uber-competitive specialties like spine remains a question.

 

[WaylonS]

You're not the first nor the last person to fail anatomy. Some students adjust to med school right off the bat, while others take a little bit longer.

Will this jeopardize your chances at NS or spine surgery? I am not going into either field, but chances are ortho will be off the table, NS, however, may still be possible. The reality is that NS has horrible hours, a horrible lifestyle, horrible surgeries, and horrible outcomes. Med students aren't stupid: the vast majority are aware that NS has argurably one of the worst if not the worst QOL out of any specialty. On the plus side, this means NS isn't as difficult to match as many pre-meds think. If you look at the 2011 charting outcomes in the match, 174 out of 202 us MD students matched, and the mean Step 1 of matched applicants was 239 vs 218 for unmatched applicants. However, you take a closer look at the data, there are nearly equal numbers of accepted applicants in the 221-230, 231-240, 241-250, and 251-260 cohorts.

Having to remediate first year will be a major red flag in your application, but if you excell in the rest of med school (like you did in biochem), network with your school's NS department (this is really, really important in your case because your best bet of matching will probably be at your home program), and get lots of research, it might be possible. Besides, for all you know, you may fall head-over-heels in love with OB/GYN in your third year

 

[survivordo]

I don't think it completely takes either off the table. If you succeed in the rest of your classes than it will be easier for PD's to see that this was a "fluke". Of course, this is assuming you ace the rest of your classes, dominate the USMLE, do stellar on your clinical rotations, and rock your interviews. Ortho is a long road! But if you really want it, I wouldn't let this hold you back from at least trying. However, you must be honest with yourself if you begin to continuously see yourself falling short of the requirements for ortho.

Survivor DO

 

[235009]

The reality is that NS has horrible hours, a horrible lifestyle, horrible surgeries, and horrible outcomes. Med students aren't stupid: the vast majority are aware that NS has argurably one of the worst if not the worst QOL out of any specialty. On the plus side, this means NS isn't as difficult to match as many pre-meds think. If you look at the 2011 charting outcomes in the match, 174 out of 202 us MD students matched, and the mean Step 1 of matched applicants was 239 vs 218 for unmatched applicants. However, you take a closer look at the data, there are nearly equal numbers of accepted applicants in the 221-230, 231-240, 241-250, and 251-260 cohorts.

now that's some serious real talk right there ....about time someone said this. it seems like in M1 like 20% of each US MD class wants to do neurosurgery and when it comes down to deciding it dwindles down to 1% because the rest realize that they'd rather actually live their life.

OP, worry about this during third year. concentrate on your schoolwork. if you are doing research that's getting in the way of passing your classes then stop it! odds are you'll change your mind about what you want to do but if you don't then you can deal with it and assess the situation when the time comes.

 

[Stellar Clouds]

You're not the first nor the last person to fail anatomy. Some students adjust to med school right off the bat, while others take a little bit longer.

Will this jeopardize your chances at NS or spine surgery? I am not going into either field, but chances are ortho will be off the table, NS, however, may still be possible. The reality is that NS has horrible hours, a horrible lifestyle, horrible surgeries, and horrible outcomes. Med students aren't stupid: the vast majority are aware that NS has argurably one of the worst if not the worst QOL out of any specialty. On the plus side, this means NS isn't as difficult to match as many pre-meds think. If you look at the 2011 charting outcomes in the match, 174 out of 202 us MD students matched, and the mean Step 1 of matched applicants was 239 vs 218 for unmatched applicants. However, you take a closer look at the data, there are nearly equal numbers of accepted applicants in the 221-230, 231-240, 241-250, and 251-260 cohorts.

Having to remediate first year will be a major red flag in your application, but if you excell in the rest of med school (like you did in biochem), network with your school's NS department (this is really, really important in your case because your best bet of matching will probably be at your home program), and get lots of research, it might be possible. Besides, for all you know, you may fall head-over-heels in love with OB/GYN in your third year

Maybe during residency, but PP spine guys have little call responsibilities and make serious bank.

OP--keep your head up, learn from your mistake, and bust your as* off for the rest of medical school.

 

[J ROD]

It will hurt..........how much....hard to say

 

[penguinism]

Your school doesn't offer any sort of summer remediation if you only fail one course?

That's rough...

 

[GadRads]

Your school doesn't offer any sort of summer remediation if you only fail one course?

That's rough...

This. That's a crap policy.

 

[mimelim]

Assuming that you have a competitive Step 1, solid clinical grades, research and LOR, it will not matter that you failed anatomy.

The more important question is, why did you fail anatomy and does that hinder you from having any of the above things?

 

[evilbooyaa]

Your school doesn't offer any sort of summer remediation if you only fail one course?

That's rough...

If it's a one time thing, then I agree with above.

One thing you have to ask yourself: Did you just screw up, or are you really bad at anatomy and unable to learn it? If you want to do spine or really any type of surgery, your anatomy has to be pretty on point.

 

[girlonfire]

Decelerating an entire year is pretty harsh. Can you appeal to retake the course over the summer break?

 

[music2doc]

Your school doesn't offer any sort of summer remediation if you only fail one course?

That's rough...

Agreed. That is rough. I know here, if you fail any 1 course, you can take a remediation final (passing said final = P on your transcript w/ a notation for having re-tested). If you fail the retest, THEN you do summer remediation but Anatomy and Physiology both require a full yr repeat due to the sizes of the courses (not feasible as summer courses). OP, that sucks. I'm sorry, man. Good luck!

 

[JGimpel]

If having spinal surgery is medically necessary, I assure you that you can get it.

If you'd like to perform them, you don't want to fail any more classes, can't repeat an entire year of school and must prove that you know human anatomy as well as that Gray guy by doing well in specialty clerkships that require it; lot's of surgery and PM&R ones to look at.

NS and Ortho guys fight over spine stuff all the time, and this is after almost 10 years of GME training each. There are a lot of factors, such as "mandatory" fellowships and research requirements that will push you further than the years FREIDA will show you. You could probably match Ortho somewhere; the sheer paucity of NS spots in comparison makes NS less likely. A specialty can be less desirable due to lifestyle but still be competitive for those with blinders on.

 

[CrimsonKing]

If you had said you had failed most courses, I would tell you that it would be extremely difficult, but you'd still have a shot at matching into Ortho or NS.

However, you failed ANATOMY. That should be a giant red flag to you that your interests and your aptitudes do not match up, and that is how surgical PD's will view it.

 

[tobi44]

If you had said you had failed most courses, I would tell you that it would be extremely difficult, but you'd still have a shot at matching into Ortho or NS.

However, you failed ANATOMY. That should be a giant red flag to you that your interests and your aptitudes do not match up, and that is how surgical PD's will view it.

Agree with the above post. Most students in my class who are interested in surgery usually overdo their anatomy studying to the detriment of their other classes, which is easy to do because anatomy is only like 10% of our grade in a given system. Do you mind if I ask what happened? How was it that you did so well in your other courses and missed the boat the course most related to your intended career? Are you sure you want to even do surgery?

 

[johnmendes]

Agree with the above post. Most students in my class who are interested in surgery usually overdo their anatomy studying to the detriment of their other classes, which is easy to do because anatomy is only like 10% of our grade in a given system. Do you mind if I ask what happened? How was it that you did so well in your other courses and missed the boat the course most related to your intended career? Are you sure you want to even do surgery?

He's only an M1... I honestly doubt he can be sure of anything regarding specialties (no offense...)

 

[Consigliere]

Family practice for you, kid.

 

[GoSpursGo]

If you look at the 2011 charting outcomes in the match, 174 out of 202 us MD students matched, and the mean Step 1 of matched applicants was 239 vs 218 for unmatched applicants. However, you take a closer look at the data, there are nearly equal numbers of accepted applicants in the 221-230, 231-240, 241-250, and 251-260 cohorts.

The problem with these stats is that it's my understanding that neurosurg is an extremely self-selecting specialty; the people applying with 221-230 would only apply if they had some idea from their mentors and home program director that the rest of their application put together still made them competitive. Furthermore, while no one ever lists preclinical grades in the things that PDs look for in applicants, another unspoken requirement is "no red flags;" in uber-competitive specialties where everyone has a high step score, AOA, honors in most clinical courses, multiple pubs, any glaring problem in your application will make it easy to dismiss you in favor of someone else with an otherwise equally good application without the red flag.

The unfortunate reality is that we're not talking about failing one class, which could probably be overlooked, we're talking about remediating the entire year (even if failing one class is what caused it). Taking an extra year to graduate, unless it's something formal and planned like a research year or getting an additional degree (ie MPH, MBA, etc), is going to be a major red flag; of the 174/202 who matched NS, I have to believe a vanishingly small number (if any) had to repeat a year.

Whether it's absolutely game over... honestly, I don't think any of us can tell you. I would reach out to some of those program directors who were at those interest group meetings and ask them whether they could see themselves seriously considering someone who had this major red flag and what it would take in the rest of the application to overcome it. I would not be surprised if someone could overcome this red flag with an uber-high step score, even more pubs than the standard NS applicant, and doing whatever it takes to make enough personal connections that you will have important people being willing to write you letters and make calls on your behalf... but that's a question better addressed to the actual PDs. Then you would have to decide for yourself whether you really want this SO BADLY that you're willing to do whatever it takes to make the rest of your app stand out that much.

 

[brownie]

What do you even know about spine surgery? Did you just look at the MGMA and choose the specialty with the highest pay?

 

[Planes2Doc]

If you had said you had failed most courses, I would tell you that it would be extremely difficult, but you'd still have a shot at matching into Ortho or NS.

However, you failed ANATOMY. That should be a giant red flag to you that your interests and your aptitudes do not match up, and that is how surgical PD's will view it.

I hear that the Anatomist Graduate Program... Err... I mean Gross Anatomy isn't reflective of things that come in the future. I mean c'mon, there's a difference between learning the relevant clinical aspects of human anatomy versus learning it from an anatomist perspective. I think I can honestly assume that no one in medical school has aspirations of becoming an anatomist. It seems like knowing every damn groove and hole in the body is a bit overkill. If someone wants to be a surgeon, does that mean they must know the name of fifteen different landmarks on the femur, especially if they will not ever operate in that area anyway?

Well, my point is that most of the anatomy courses in medical school are far beyond overkill.

 

[CrimsonKing]

I hear that the Anatomist Graduate Program... Err... I mean Gross Anatomy isn't reflective of things that come in the future. I mean c'mon, there's a difference between learning the relevant clinical aspects of human anatomy versus learning it from an anatomist perspective. I think I can honestly assume that no one in medical school has aspirations of becoming an anatomist. It seems like knowing every damn groove and hole in the body is a bit overkill. If someone wants to be a surgeon, does that mean they must know the name of fifteen different landmarks on the femur, especially if they will not ever operate in that area anyway?

Well, my point is that most of the anatomy courses in medical school are far beyond overkill.

1. This might be a valid reason to not score highly in med school anatomy, but it is absolutely no excuse to not PASS, considering that passing requires 70-80% knowledge depending on your institution.

2. He listed his interest as SPINE surgery, which is a subset off of Neuro and Ortho, both of which are the most anatomically intensive fields (with the exception perhaps of Radiology) in medicine. Knowing those landmarks can help a spinal surgeon determine which nerves and, therefore, which spinal level, is being injured in some way.