AMG w/ NO Anesthesia IVs....Please Help.

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VersedGuy82

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I am an AMG who did the unthinkable. I failed Step 1 on the first attempt. I then passed with only a 75 on the second attempt. After this I made a 78 on Step 2 on the 1st attempt. I am now completing my intern year in a prelim general surgery program. I applied to 80 anesthesia programs this year and received ZERO interview invites. I am taking Step 3 the 1st week in February and am beginning to think that no matter what I do; I may never get a chance at becoming an anesthesiologist. I am just wondering if there is anything anyone could suggest for me to do in order to gain access to a residency in anesthesia. I have a 3.0 avg from med school and excellent LORs/Dean's Letter/Program Director Letter, but my application is most likely being screened out do to the failure/low board scores. I am willing to go anywhere and even re-do my intern year, but I can't seem to find any program that will even look at me. Any serious suggestions would greatly be appreciated.
 
Is there a Anesthesia residency at your current program?
 
not easy man..

but as Frank implied, try to get one of your surgery attendings or the surgery chair to vouch for you at your place or a place around you. Sometimes hving these surgeons vouch for you can help.
 
My program does have an anesthesia program; however, it can only accept 3 residents and the chair/program director says he is looking for people with scores on steps 1 and 2 >230 b/c this is the greatest predictor that people will pass the anesthesia boards on the 1st attempt. He said everyone he selects this year must pass the anesthesia boards on the 1st attempt since continued accreditation of a program requrires >90% of residents to pass the anesthesia boards on the 1st attempt. So if even 1 resident fails, then that would equal 66% first time pass rate and the accreditation would be lost.
 
Unfortunately, I think you are out of luck.

Sorry to be so harsh but reality is harsh. I'm not saying you need to quit trying but your chances are very very slim. I think you know this.
 
The only other option would be to complete another residency and then apply for Anesthesia, with board certification in another specialty maybe the USMLE scores won't be a big issue. Keep in mind though that with this approach some other issues will come up, one being a funding issue since you'd be doing a 2nd residency. Also I have no idea about the weight of step 3 in this whole process, maybe others can shed some light on this issue.
 
the thing here is that all these exams require 1 skill - looking over a body of knowledge and then applying it on an exam. whether or not this skill correlates with clinical acumen is a different discussion.

as a program director, which i am not, i would really have a difficult time taking you into my program as an almost guaranteed board failure statistic.

you may have some sort of learning disability (how did you get into med school?) which may need to be addressed with a professional.

if you Destroy step 3 - someone may give you a chance. otherwise, i agree with previous posters, do another residency, pass their boards and apply to anes.
 
Jeff05 said:
the thing here is that all these exams require 1 skill - looking over a body of knowledge and then applying it on an exam. whether or not this skill correlates with clinical acumen is a different discussion.

as a program director, which i am not, i would really have a difficult time taking you into my program as an almost guaranteed board failure statistic.

you may have some sort of learning disability (how did you get into med school?) which may need to be addressed with a professional. if you Destroy step 3 - someone may give you a chance. otherwise, i agree with previous posters, do another residency, pass their boards and apply to anes.
Click to expand...


Are you serious? Residency programs do not have much to evaluate applicants with so they place what I think is an over emphasis on the steps.
The fact that someone had difficulty with the step exams does not mean that they should be on the short bus. I am sure that most of you guys performed better than I did on the steps but I can tell you that wasn't the case with the ABA exam. Letters become very important the further that you are in your training. You need very strong letters.

How have you performed in your internship?

I applied to an anesthesia program after I practiced family medicine for four years. I hope that you don't have to complete another residency before you find an anesthesia program.

I discovered anesthesia later in life.

If you do not find a gas program go for your second choice. Work had and secure excellent letters.

It is funny how time changes things . When I was in med school anyone could find a position in anesthesia. Now programs can set usmle cut-offs @ 230.
Does anyone out there really believe that someone with a 250 will be a better physician than another individual with a 205.

Good luck,

Cambie
 
The race is not to the swift, nor the battle to the strong... but it's always best to bet that way.

Gotta agree with Noy on this one. Not everyone gets to live the dream.

-copro
 
CambieMD said:
Does anyone out there really believe that someone with a 250 will be a better physician than another individual with a 205.
Click to expand...

The issue isn't whether he will be an amazing clinician but rather that his low step 1 with repeat and step 2 scores bordering failure make programs apprehensive. I know that while applying, if a program said that 1 in 3 of their residents the year prior failed, i would wonder why that happened. Often times, its not the programs fault but programs like to brag at times about their >90 or 100% board pass rates and want to take applicants who won't have trouble.

You could always go through the scramble and find a program willing to take you if you don't mind the location. It's not the best of scenarios but it could save you another year and/or another residency to go through that route.
 
Well I do appreciate the insight from you guys. I was uncertain whether or not I should do a year of research in anesthesia (even though I have research and an abstract presented at the annual meeting for Regional Anesthesia.) It appears that my only option may be to apply or scramble for a medicine spot somewhere and complete that residency program. I guess I just really needed to discuss this because I am rather disappointed that program directors don't/can't look any deeper than a USMLE score to decide who is the best fit for their program. However, this is not always the case as I have a good friend who failed both step 1 and 2 twice and then did not even graduate on time from medical school and still received a spot at a reputable Northeast program due to his brother having graduated from the same program in anesthesia. Nonetheless, I cannot worry about such matters that are out of my control.

As far as my internship, I have excellent evals but there is no one for me to ask my chair to even call since I have interviewed no where. No one even gets to read the letters of recommendation or anything else in my 30+ page application once their computer system deletes all applicants with USMLE scores below whatever arbitrary number they have set.
 
Take this with a grain of salt, because I'm only an MSIV and haven't gone through the match yet...

but maybe the scramble is a decent chance (or the *most decent* given the situation)? If you apply through ERAS and NRMP, even without interviews, you could still conceivably scramble into a program if you (a) have good support from your current program and (b) can move locations.

Probably doesn't hurt to try?
 
Your chair (or dean, or mentor, or whomever,) can call programs that *haven't* offered you an interview and ask that they reconsider.

A phone call from one PD to another can go a long way to getting them to look past the numbers.

I have a friend applying in surg who scored in the 190s on Step 1... so interviews became very reliant on good relationships with deans and PDs willing to advocate. Ended up with a number of interviews at very solid programs.
 
Im on the interview trail again homey. Watching family guy in the holiday inn is very humbling. At least the pillows are soft. Which is good because ill probably be biting one tomorrow. Hex jet ill be in new orleans and baton rouge next week.
 
VentdependenT said:
Im on the interview trail again homey. Watching family guy in the holiday inn is very humbling. At least the pillows are soft. Which is good because ill probably be biting one tomorrow. Hex jet ill be in new orleans and baton rouge next week.
Click to expand...

You're gonna be the only applicant that can intubate a gravid fire ant.
 
error404 said:
Take this with a grain of salt, because I'm only an MSIV and haven't gone through the match yet...

but maybe the scramble is a decent chance (or the *most decent* given the situation)? If you apply through ERAS and NRMP, even without interviews, you could still conceivably scramble into a program if you (a) have good support from your current program and (b) can move locations.

Probably doesn't hurt to try?
Click to expand...

I agree that the OP should try the match, but I would not hold out much hope for it. As I have stated before, the scramble may list 50 spots available, but the real actual number is much much less and those are frequently gone through back room deals before the scramble even opens. The reputable programs that show up with open spots will frequently not go through the scramble to fill their spots. Since anesthesiology is matching for spots to start after an intern year, these programs could either scramble to find a candidate who didn't match (and probably has some academic issue for why that is the case) or they could sit on that spot and fill it with someone who comes along over the next year who they plenty of time to interview and evaluate thoroughly. There is, simply put, no rush to fill that spot. Surgery residents come along all the time that would love to take that spot.
So, basically, why scramble to fill a spot with a subpar candidate you can't even interview face to face when you can fill it later with a candidate of your choice?
I suspect the most likely way he can get it done is to finish another residency as stated previously. Board certification in another specialty will give some credibility that is not there currently. Plus, who knows what the competitiveness of our field will be even 3 or 4 years from now? It is cyclical. It was not very long ago that a pulse and the ability to speak English got you a guaranteed spot of your choice.
 
VersedGuy82 said:
My program does have an anesthesia program; however, it can only accept 3 residents and the chair/program director says he is looking for people with scores on steps 1 and 2 >230 b/c this is the greatest predictor that people will pass the anesthesia boards on the 1st attempt. He said everyone he selects this year must pass the anesthesia boards on the 1st attempt since continued accreditation of a program requrires >90% of residents to pass the anesthesia boards on the 1st attempt. So if even 1 resident fails, then that would equal 66% first time pass rate and the accreditation would be lost.
Click to expand...


I'm finding it hard to believe there is a program out there so small it only takes three, but with a USMLE cutoff of 230. Furthermore, if this is really the difficult problem the PD suggests, it would be shared with any program that takes <10. There are a number of these programs out there, and I promise they don't all have 100% pass rates.

I hear what you're saying, Versed, but this dude's blowing smoke.
 
VentdependenT said:
Im on the interview trail again homey. Watching family guy in the holiday inn is very humbling. At least the pillows are soft. Which is good because ill probably be biting one tomorrow. Hex jet ill be in new orleans and baton rouge next week.
Click to expand...

nothing like a GOOOOOD animated tv series to pass the time!

d712
 
Last edited:
Sure, I think if you want to try again you should. Re-apply, inquire about positions outside the match, see if you get any interviews, and if you don't get a position that way, try the scramble and see what happens.

But I think you need to be realistic and move on. Don't waste any more time. While you do all of that, cast your nets for a second choice specialty. That way if you don't get an anesthesia residency this year, you will still end up with a job.

Don't delude yourself into believing that it's all about the "dream job." If dreams came true, they wouldn't have to pay us money to make us go to work. Anesthesiology is still a job, as is any other specialty where you might be able to get a residency position. Put the notion of "dream job" behind you and make it your goal to find a real job. Good luck to you.
 
Bertelman said:
I'm finding it hard to believe there is a program out there so small it only takes three, but with a USMLE cutoff of 230. Furthermore, if this is really the difficult problem the PD suggests, it would be shared with any program that takes <10. There are a number of these programs out there, and I promise they don't all have 100% pass rates.

I hear what you're saying, Versed, but this dude's blowing smoke.
Click to expand...

Is it true that if a program has less than 90% pass rate in any given year they lose they accreditation or are put on probation? Isn't the national pass rate in the mid 80s?
 
frank51 said:
Is it true that if a program has less than 90% pass rate in any given year they lose they accreditation or are put on probation?
Click to expand...

No. That's crazy talk.

frank51 said:
Isn't the national pass rate in the mid 80s?
Click to expand...

At most. Some years, it's substantially less than that.
 
i thought i remembered seeing the average usmle score of those accepted in anesthesia last year to be around 218 or 222 or something like that. how many programs really follow a strict 230 cutoff or is this just wishful thinking of program directors? i understand mayo or other prestigous programs having higher scoring applicants but there also must be less difficult residency programs to get into with lower than the national average acceptance scores.
 
I still say that the guy should try. I thought that my chances of getting into a gas residency program were slim.I found a program and the rest is history. I remember a guy who looked me in the eye and said that he did not think that I had a chance of making it. The op should keep trying but make alternate plans as well.

Cambie
 
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