2+ Years Post Medical School

[flga]

To make a long story short, I did crappy in Medical School but made it through in 7 years (Caribbean). I finally passed Step 1 on the 8th try, but still need to pass Step 2. I am approaching my 7 year limit as far as my USMLEs and need to make a decision as to whether I will attempt to get into a residency or just forget it altogether.

I finished medical school in June 2007 and have been a Physician Recruiter since then till now. The job is going ok. It gets boring and monotonous at times, but has a regular, predictable schedule in which I get to spend a lot of time with my family. Money is not bad either, but as with almost all industries these days (except being a practicing healthcare practitioner), there is always a chance of being laid off.

I am at the point (I guess because of the 7 year deadline to finish the USMLEs), where I don't want to have any regrets with regards to Medical School and my attempt to becoming a physician. I have plenty of regret with regards to my education and such, but I feel like I can make amends for it for by somehow finishing what I started. I am sure I will have to go through hell and back in order to get into a residency, but wanted to hear feedback from someone who possibly went through the same thing or something similar (I know my case is rather extreme). Hell, there may not even be any success stories with similar backgrounds to mine at all, in which case I am probably screwed.

Obviously I have to pass Step 2 (and maybe even Step 3) before I begin a residency. Assuming I pass at least Step 2 (even this is not even a guarantee), what steps should I take in order to get myself "back in the game?" Or should I not even bother? With my dismal academic record, will any program even consider a candidate like myself?

I was thinking I would need to do some Observeships in order to prove my clinical competence, my desire to return and my ability to kiss as much ass as possible. Would this even be enough? How many Observeships is this going to take or at what length of time will a program be like, "Ok, this is adequate?" Are there any programs in the US that will even consider a candidate like myself assuming I am at least ECFMG certified?

Thanks in advance for the commentary (even the "you are such an idiot ones"). Even if it doesn't work out for me, I have kind of prepared myself for life outside of medicine. Take care.

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[maceo]

To make a long story short, I did crappy in Medical School but made it through in 7 years (Caribbean). I finally passed Step 1 on the 8th try, but still need to pass Step 2. I am approaching my 7 year limit as far as my USMLEs and need to make a decision as to whether I will attempt to get into a residency or just forget it altogether.

I finished medical school in June 2007 and have been a Physician Recruiter since then till now. The job is going ok. It gets boring and monotonous at times, but has a regular, predictable schedule in which I get to spend a lot of time with my family. Money is not bad either, but as with almost all industries these days (except being a practicing healthcare practitioner), there is always a chance of being laid off.

I am at the point (I guess because of the 7 year deadline to finish the USMLEs), where I don't want to have any regrets with regards to Medical School and my attempt to becoming a physician. I have plenty of regret with regards to my education and such, but I feel like I can make amends for it for by somehow finishing what I started. I am sure I will have to go through hell and back in order to get into a residency, but wanted to hear feedback from someone who possibly went through the same thing or something similar (I know my case is rather extreme). Hell, there may not even be any success stories with similar backgrounds to mine at all, in which case I am probably screwed.

Obviously I have to pass Step 2 (and maybe even Step 3) before I begin a residency. Assuming I pass at least Step 2 (even this is not even a guarantee), what steps should I take in order to get myself "back in the game?" Or should I not even bother? With my dismal academic record, will any program even consider a candidate like myself?

I was thinking I would need to do some Observeships in order to prove my clinical competence, my desire to return and my ability to kiss as much ass as possible. Would this even be enough? How many Observeships is this going to take or at what length of time will a program be like, "Ok, this is adequate?" Are there any programs in the US that will even consider a candidate like myself assuming I am at least ECFMG certified?

Thanks in advance for the commentary (even the "you are such an idiot ones"). Even if it doesn't work out for me, I have kind of prepared myself for life outside of medicine. Take care.

physician recruiter huh? SOunds good. i was thinking about dabbling in that on the side. 25k per placemetn.. All i have to place is 4 in ayear to make 6 figs cant be that hard.

anyway, Ill be honest with you and keep in mind I totally root for the underdog. Here is the deal.

Most states before you get a license ask if you took usmle step 1, 2 and 3. and they ask you if you passed those steps. Thats not enough for them. They want you to pass them within 7 years. Not all states have that requirement. Most do however. I think there are like 15 states that do not. The states that do not i think ask you how many times you took any of the steps. and if its more than 4 you are out of the running. So right there, you are out of like most of the states. SO they make it difficult for you to find a state to practice. the laws suck i know.. I say go for it. but look to practice in states that are ok with you situation.

How much do you make recruiting if you dont mind me asking?

 

[dragonfly99]

Need to check with the medical boards in several states where you'd consider practicing, to make sure they will allow you to do so with the 7 attempts at Step 1, and as you said need to check the limit on how long they allow for passing all the steps. If you're going to miss the time window, not even worth it to attempt Steps 2 and 3.

 

[Ludicolo]

There are legends/rumors of physicians with multiple (most I’ve heard is 12) board attempts who have gone on to successful practice. But it is exceedingly rare. Never heard about 8 attempts just for step I though.

I see that your location is NY. I’m pretty sure that NY doesn’t have a time limit requirement nor a finite number of USMLE attempts to get licensed. Check to make certain. And there are certainly bottom-of-the-barrel, malignant residency programs in NY that will take any warm body and scut them out to no end. You will have a miserable time at these places.

You gotta be honest with yourself – is this truly what you want, and what are you willing to go through in order to get it? Are the additional years of residency worth it to you AND your family? Quite frankly, are you cut out to be a good physician? Not everyone is – no shame in that. Personally, your track record on the USMLE and the 7 year tenure in a Caribbean med school suggests to me that you don’t really have the chops to make it. But I’m just one anonymous opinion out there – salt to taste. I do commend you for your perseverance though.

You must analyze why you have done so poorly so many times on step I, and how will you be able to overcome those obstacles to eventually pass the remainder of the steps. Not to mention future inservice exams and specialty boards. If you proceed and pass the remainder of the steps, you are right in that you will likely require some more recent clinical experience. Observerships/shadowing don’t really count but it will be better than nothing. And for these bottom-tier residency programs – shadowing experience may be sufficient, I have no idea. We know your scores suck. We know that your med school transcript sucks. Don’t know what kind of LORs you have. They will have to be very good and address any clinical performance issues you may have. Your personal statement will have to address your poor performance on the steps and in med school and reasonably answer why anyone would want to take a chance on you.

If you decide to pursue this, you will have a very steep uphill climb ahead of you. We’re talking sheer verticality. But I wish you luck whichever way you decide to go.

 

[analgold09]

Another option would be to obtain a prelim medicine or surgery spot, as these might be easier to obtain (especially the latter), then look for a state that will license you after one year of residency. This, of course, would be contingent on that same state allowing multiple attempts at the step exams.

You might then be qualified to work at a doc-in-the-box type operation or urgent care clinic.

 

[LadyGrey]

The "license after 1 year" thing has been discussed in the past, with consensus being that it doesn't happen. But I have no independent knowledge of this beyond the collective wisdom of SDN, so obviously check it out yourself.

 

[dragonfly99]

You usually need 2 years of GME to get a full medical license, though there may be a state or two that will allow you to be licensed after one. The OP can check the state medical licensing boards to find out.

I share the concerns of the attending above r.e. the OP potentially ending up in a malignant program if he can even find a spot...and that might be worse than no residency. On the positive side, the OP is presumably a US citizen, so there are no visa issues to be dealt with, which makes the OP more attractive to programs. The 7 years in med school as well as the problems on the step exams would have to be addressed, though.

I don't know...it sounds like the OP has an OK job, and might do better for himself just staying in business or some sort of health care administration. I honestly think it would be much better than being in some lousy residency program...

 

[Doowai]

You usually need 2 years of GME to get a full medical license, though there may be a state or two that will allow you to be licensed after one. .

I think it is Wisconsin that allows FMG's to be licensed after one year - but I am sure you have to appear in front of the board and probably have to have a PD support. I would imagine a board would not consider if for one year of surgery, but perhaps after one year of primary care. A number of states license FMG's after 2.

 

[silas2642]

To make a long story short, I did crappy in Medical School but made it through in 7 years (Caribbean). I finally passed Step 1 on the 8th try, but still need to pass Step 2. I am approaching my 7 year limit as far as my USMLEs and need to make a decision as to whether I will attempt to get into a residency or just forget it altogether.

I finished medical school in June 2007 and have been a Physician Recruiter since then till now. The job is going ok. It gets boring and monotonous at times, but has a regular, predictable schedule in which I get to spend a lot of time with my family. Money is not bad either, but as with almost all industries these days (except being a practicing healthcare practitioner), there is always a chance of being laid off.

I am at the point (I guess because of the 7 year deadline to finish the USMLEs), where I don't want to have any regrets with regards to Medical School and my attempt to becoming a physician. I have plenty of regret with regards to my education and such, but I feel like I can make amends for it for by somehow finishing what I started. I am sure I will have to go through hell and back in order to get into a residency, but wanted to hear feedback from someone who possibly went through the same thing or something similar (I know my case is rather extreme). Hell, there may not even be any success stories with similar backgrounds to mine at all, in which case I am probably screwed.

Obviously I have to pass Step 2 (and maybe even Step 3) before I begin a residency. Assuming I pass at least Step 2 (even this is not even a guarantee), what steps should I take in order to get myself "back in the game?" Or should I not even bother? With my dismal academic record, will any program even consider a candidate like myself?

I was thinking I would need to do some Observeships in order to prove my clinical competence, my desire to return and my ability to kiss as much ass as possible. Would this even be enough? How many Observeships is this going to take or at what length of time will a program be like, "Ok, this is adequate?" Are there any programs in the US that will even consider a candidate like myself assuming I am at least ECFMG certified?

Thanks in advance for the commentary (even the "you are such an idiot ones"). Even if it doesn't work out for me, I have kind of prepared myself for life outside of medicine. Take care.

I have no real good opinion to offer, but right now I'm just starting to study for step I and just want to say I cannot believe that you had the guts to take that thing 8 times without quitting. That is truly perseverance.

 

[flga]

maceo

it would be great if i had my own business doing physician recruiting and could make 25K per permanent placement-six figures would be easy that way. i am employed by a company that does both permanent and locum tenens placement and you get a percentage for each placement you do. it ranges from 15% to 40% based on each $100,000 going from $0-$400,000. my first year I made $70K and should make around $100k this year.

 

[flga]

I actually live in Florida now, not NY. Unfortunately, for IMGs, they require 3 years of post graduate training in order to obtain a FL license. To my knowledge, there is no time limit or number of attempts for USMLEs in FL. If I were to apply for residency, the problem is I would have to leave FL to do it somewhere else-bottom rung program.

 

[gutonc]

To the OP:
AS most people here, I have no good advice to give you re: your chances of a residency. You're right though, it's going to be an uphill battle but, if you feel like you have to have one last go at it, you do have options.

First of all, for all intents and purposes, you need Step 1 and Step 2 (CK+CS) in order to get into a residency (and ECFMG certification which shouldn't be a problem assuming you can pass Step 2). You do not need to be eligible for a permanent/unlimited license in a particular state in order to get a residency spot in that state.

As far as which states you have the option of being licensed in, check out this page: http://www.fsmb.org/usmle_eliinitial.html if you haven't already. A quick glance shows that you would retain eligibility for licensure in a number of states including, as you point out, FL (which has no limits on # of attempts or time to complete the Steps).

If you want to have a go at this, get cracking on studying for Step 2 and take it ASAFP. Do NOT blow off CS. IMGs tend to fail it at a rather alarming rate (AMGs fail it suprisingly often too). Once you've got those under your belt, you've got nothing to lose (aside from, you know, money and potentially self esteem) by applying for residencies.

Good luck to you.

 

[mjl1717]

The "license after 1 year" thing has been discussed in the past, with consensus being that it doesn't happen. But I have no independent knowledge of this beyond the collective wisdom of SDN, so obviously check it out yourself.

Yes, thats what I heard!!!!

Also flga: I really commend you for being a "good fighter" with relentless perserverance and NEVER going down for the count....

You realize it is extrememly hard to work and study at the same time.. If anything work less then 20 hours/week or not at all..

 

[flga]

Thanks for all of the comments-very helpful.

 

[maceo]

maceo

it would be great if i had my own business doing physician recruiting and could make 25K per permanent placement-six figures would be easy that way. i am employed by a company that does both permanent and locum tenens placement and you get a percentage for each placement you do. it ranges from 15% to 40% based on each $100,000 going from $0-$400,000. my first year I made $70K and should make around $100k this year.

nice income. I say branch on your own.. work less make more..

you dont even have to have an office.. all internet.. buying physician lists... **** you can be on the beach constantly.. NICE NICE NICE NICE.

If you still wanna practice medicine. go for it. NOTHING is stopping you. you may be limited in the states you practice unless you want to retake step 1 and take step2 and 3 right away. BUt its a bitch as you know. its like that song TI made. Whatever you like.

 

[LadyGrey]

If you still wanna practice medicine. go for it. NOTHING is stopping you. you may be limited in the states you practice unless you want to retake step 1 and take step2 and 3 right away. BUt its a bitch as you know. its like that song TI made. Whatever you like.

FYI, I'm pretty sure retaking Step 1 isn't allowed. (Thank God! I'm imagining how much pressure there would be to retake it if your score wasn't exactly what you wanted, and how many anguished SDN threads there would be on "should I retake it or not, pls help!")

flga, I can't imagine the pain of taking Step 1 eight times! I retook the MCAT, I had to apply to med school twice, and thought that was enough suffering -- but that's a piece of cake compared to your perseverance. I hope it gets you somewhere that makes you happy!

 

[Nick Name]

-- but that's a piece of cake compared to your perseverance. I hope it gets you somewhere that makes you happy!

Seriously, all other things aside - your spirit of stick-to-it-iveness is impressive. If I was an employer one thing that would impress me about hiring you is that you certainly are determined to finish things you start. Kudos for crossing the finish line

 

[bullpup777]

I think he means he would have to retake step one if he gets out past the seven year limit. Then you have to retake it.

 

[maceo]

FYI, I'm pretty sure retaking Step 1 isn't allowed. (Thank God! I'm imagining how much pressure there would be to retake it if your score wasn't exactly what you wanted, and how many anguished SDN threads there would be on "should I retake it or not, pls help!")

flga, I can't imagine the pain of taking Step 1 eight times! I retook the MCAT, I had to apply to med school twice, and thought that was enough suffering -- but that's a piece of cake compared to your perseverance. I hope it gets you somewhere that makes you happy!

hey lady

I too took the mcat twice and applied to med school twice. My year was viciously competitive.. 47k applicants.

At any rate, I think you can take step 1 again. Plenty of people doing it. those people who want to practice in a state and missed the 7 year cut off between step 1 and step3 will retake all three steps. not pretty I agree,
anyway congrats on achieving what you wanted. Determination is everything. You can achieve anything you set your mind to achieving.

 

[Winged Scapula]

At any rate, I think you can take step 1 again. Plenty of people doing it. those people who want to practice in a state and missed the 7 year cut off between step 1 and step3 will retake all three steps. not pretty I agree,
any

From the 2009 USMLE Bulletin:

Can I retake a Step that I passed to raise my score?

If you pass a Step, 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. See USMLE Bulletin: Time Limit and Number of Attempts Allowed to Complete All Steps.

Obviously, if you fail (ie, score below the minimum passing) you can retake it.

 

[mjl1717]

flga

To get back in the game Id say pass step2 and step 3 as fast as you can.. (I know its easy for me to say)...Since PD will easily say you will not have time to study for step 3 during residency!..
I notice some who pass all 3 steps do observerships or extra rotations thru a group called America-clerkship, for $$.

After getting over these hurdles I think you will have to do 'the best Sherlock Holmes search" ever for a PGY 1 slot...
Good luck!

 

[PublicEnemy]

just for clarification there are many states that have a 10 year window for completing all the steps though most are 7. also many states grant licensure after 1 year of postgraduate training. each state has its own requirements:

http://www.fsmb.org/usmle_eliinitial.html

 

[PublicEnemy]

perusing the list of requirements, Pennsylvania, Louisiana, and Wyoming are great possibilities. they pose no limit on the number of attempts nor is there a time limit. Virginia has no limit on the number of USMLE attempts and has 10 year window.

http://www.fsmb.org/usmle_eliinitial.html

 

[maceo]

perusing the list of requirements, Pennsylvania, Louisiana, and Wyoming are great possibilities. they pose no limit on the number of attempts nor is there a time limit. Virginia has no limit on the number of USMLE attempts and has 10 year window.

http://www.fsmb.org/usmle_eliinitial.html

new york as well no limit on usmle or number of attempts

it seems like the states that limit the number of attempts are discouraging stick-to-itiveness