1 month Leave of absence for Step 1

[Lazlow]

Hello everyone,

First, I realize that threads have been posted with regards to LoA's for Step 1 studying before, but I would appreciate your input regarding this somewhat atypical situation:

I recently got back from a national meeting where I gave an oral presentation, for which I spent an extensive amount of time preparing, during which time I was not really able spend time studying Step 1. Now that I am back at school, I find that my Step 1 exam is just over 3 weeks away, and my first practice test score is a 200. My goal is to score a ~235-240, given my career goals.

I don't feel as if I will be able to adequately prepare in the time remaining, and so I asked my school's administration if a 1 month extension may be granted, which was allowed, given that my research commitments have interfered with my study time. The catch is the 1 month extension can only be granted as a 1 month "leave of absence for academic remediation", though I was told that it could be explained in the Dean's letter that this extension was given due to research commitments conflicting with study time, rather than any academic shortcoming of my own.

I feel as if I am in a catch 22 situation - I think that my score is far from plateauing, and I could definitely take advantage of the extra month, at the same time, I wonder if the LoA in question is enough of a red flag to make me rethink this extension, or if I should take the time to reach my goal, and study thoroughly rather than a somewhat rushed review.

I'd appreciate your input - thank you for taking the time to consider this.

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[ScarletRMD]

I'm actually in a similar situation. I had a medical issue that required extensive PT during my study period. It was actually ulnar neuropathy. My left forearm and ulnar portion of my hand went numb and I lost strength in the pinky and ring finger. Dr said its probably from resting my left elbow/forarm hyper-flexed on my desk while highlighting/annotating FA with my right hand (Don't do this!!!). EMG and nerve conduction studies showed signal slowing in my right ulnar also, so I am probably also predisposed.

In any case, our assistant dean offered me independent study while pushing my 1st rotation into the beginning of fourth year. I was scoring in the 220s, but I wouldn't come even close to executing my study plan and only finish 60-70% UWorld by the test, so I took him up on the offer.

While independent study will be mentioned on the MSPE, he said its largely been a nonissue. According to our assistant dean previous students at my school doing this for step 1 haven't had this brought up during residency interviews and one such student even matched ENT this past year.

Major downside, however, is scheduling during 4th year. There will be less free weeks, so either interview time, Step 2 study time, away rotation time, or free time will suffer. It will be the latter two in my case as I need to make it up next summer. Losing an away rotation or 2 can be a big deal depending on what which specialty you choose.

 

[Lazlow]

Thanks for your reply --- In my case, I am most interested in going into Medicine, albeit I would like to train at an institution with a strong academic reputation, so programs are still rather competitive. My primary concern here is that I would have to take an official leave of absence for the month, which may qualify as a "gap" in my medical school education, furthermore, the flag of this leave being for "academic remediation" is a serious concern, even given the fact that elsewhere in the Dean's letter, this will be explained as a the result of a research commitment conflicting with study time rather than remediation due to academic difficulties. I worry that in the capricious world of residency applications, this may constitute a red flag regardless of its reasons - though I am not sure, and thus am seeking advice.

 

[ScarletRMD]

I guess it depends on the wording in your Dean's letter. As I said our dean said its been a non-issue in the past. The official wording in the letter would be "Independent Study" for step 1 due to health reasons.

I guess "Leave of Absence" and "Academic Remediation" sound more a little more harsh and may suggest a gap in education. Maybe you could ask your letter writer to word it so it seems as benign and in your favor as possible?

I think most residencies know that students get a "gap" b/w 2nd and 3rd for step 1. Given that this gap ranges anywhere from 3 weeks to 8 weeks depending on school, I really don't think taking a 4 week leave to study for step 1 for a school approved reason will be a big deal for anyone who actually understands the situation.

 

[Lazlow]

The written part of the Dean's letter will most likely word the leave in a benign manner, however, the automatically generated part of the Dean's letter will simply have a line with something to the effect of "Leave of Absence - Academic remediation - Date X, Date Y". Furthermore, I imagine I will have to mention the leave on ERAS in some way where it asks about gaps in the educational process.

I think a reasonable PD would not look upon such an extension unfavorably, despite the harsh wording in the title of the leave itself. That said, I am concerned that residency application is a capricious process, and a PD that takes only a cursory look at my records will consider the leave a red flag.

 

[235009]

Your step 1 score is going to be pretty crucial. If you get a sub-220 score you're really going to have a huge uphill battle to secure a strong academic IM spot. I think you should take the extra month and make sure you fully explain it whenever necessary. Also read the MSPE closely when it is released to you and push your deans office to make it sound as benign as possible. strong academic IM programs are extremely competitive so you really need to maximize your stats (step 1, step 2 CK, class rank) to get your foot in the door.

 

[Law2Doc]

Your step 1 score is going to be pretty crucial. If you get a sub-220 score you're really going to have a huge uphill battle to secure a strong academic IM spot. I think you should take the extra month and make sure you fully explain it whenever necessary. Also read the MSPE closely when it is released to you and push your deans office to make it sound as benign as possible. strong academic IM programs are extremely competitive so you really need to maximize your stats (step 1, step 2 CK, class rank) to get your foot in the door.

A leave of absence that is explainable and a high step score is probably something that won't haunt you. Most places will give you an opportunity to explain things like this if your numbers are good. A leave of absence followed by a low step score may look like two strikes. You may not get the same opportunity to explain things away.

 

[survivordo]

I think it is worth your time to do whatever you can to make sure you get the Step 1 score you desire. It is not like the MCAT where you can just take it again... This might be one instance where you may actually want to READ your Dean's letter and make sure the school has explained it adequately. Either way, it doesn't look GREAT some people may say that you should have been able to juggle both... but again getting a great Step 1 score is by far the most important part.

Survivor DO

 

[xrevision]

How strong of an academic program were you shooting for? UCSF, MGH, Hopkins, etc will all say you should have been able to juggle both at the same time, because they expect their residents to be able to juggle research and patient care at the same time. With that being said, once you get below this tier the best thing you can do is score very well on Step 1. This will get you past the automatic filters. Some other prestigious medicine programs will also filter you out if you do not honor medicine.

This can also backfire if you end up scoring low on step 1 after taking a leave of absence just to study.

 

[imer]

Hello everyone,

First, I realize that threads have been posted with regards to LoA's for Step 1 studying before, but I would appreciate your input regarding this somewhat atypical situation:

I recently got back from a national meeting where I gave an oral presentation, for which I spent an extensive amount of time preparing, during which time I was not really able spend time studying Step 1. Now that I am back at school, I find that my Step 1 exam is just over 3 weeks away, and my first practice test score is a 200. My goal is to score a ~235-240, given my career goals.

I don't feel as if I will be able to adequately prepare in the time remaining, and so I asked my school's administration if a 1 month extension may be granted, which was allowed, given that my research commitments have interfered with my study time. The catch is the 1 month extension can only be granted as a 1 month "leave of absence for academic remediation", though I was told that it could be explained in the Dean's letter that this extension was given due to research commitments conflicting with study time, rather than any academic shortcoming of my own.

I feel as if I am in a catch 22 situation - I think that my score is far from plateauing, and I could definitely take advantage of the extra month, at the same time, I wonder if the LoA in question is enough of a red flag to make me rethink this extension, or if I should take the time to reach my goal, and study thoroughly rather than a somewhat rushed review.

I'd appreciate your input - thank you for taking the time to consider this.

I probably would just put my head down and study for the three weeks - without distraction (like posting here). Having this Dean's letter wildcard rattling around in the back of my head for the next year + would haunt me. It doesn't get easier - fwiw I understand UCSF medicine only interviewed AOA this year. Good Luck. .

 

[COXblocker]

Haha, I knew there would be a thread on this topic. I tore a disc in my back and had to have surgery. Basically delayed my dedicated time 2 weeks. I also had to wait a week to do my makeup exams. I had a vacation planned that I will still take, then start studying for Step 1. I still get the 4 weeks I wanted...but after about a 4 week delay.

Luckily I have a year long masters program this delay eats into. Plus my dean thought it would be better that I wasn't on wards post spinal surgery. I don't think any of this will reflect poorly on applications, but I do think your Step 1 score will be judged more harshly. I don't think it's very fair since I spent 2 weeks drugged out of my mind more worried about morphine induced constipation poops than all my missed exams and rescheduling step 1. I also think there is an ideal window after MS2, like the final sprint, where you should peak, that I am missing.

1. Make a realistic plan
2. Don't burn out
3. Rock boards
4. Explain the LOA and show you took advantage of it
5. ???
6. Profit

 

[disorder]

I probably would just put my head down and study for the three weeks - without distraction (like posting here). Having this Dean's letter wildcard rattling around in the back of my head for the next year + would haunt me. It doesn't get easier - fwiw I understand UCSF medicine only interviewed AOA this year. Good Luck. .

Seems like it was this way for many "top tier" programs.