Any chance? Lots of "what ifs"...

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Midnight_oil

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M3 from mid-tier US MD program. First two years went well, I was middle of the pack academically, nothing amazing. Got the wonderful news today that I failed USMLE 1. Not sure what happened, still processing it all, I need not list the range of emotions I've gone through in the last 24 hours. I knew I wouldn't blow it out of the water with serial 210s on practice tests, but thought it was perhaps good enough. Never saw myself as high-risk. No excuses, no one to blame but me. I just have to refocus and make it right. I understand that I won't be guaranteed anything, and that my road will be long and treacherous from here. The general wisdom is probably something along the lines of "hang in there, blow it out of the water on your second attempt, rock M3 year, rock USMLE 2 CK/CS, and get amazing LORs, etc". I am certainly appreciative of those sentiments.

My interest has always been in neurology. I've loved it shadowing inpatient and outpatient, done tons of research (with multiple pubs) and ECs in neuro, and loved it more than anything during pre-clinical by a large margin. I'm a newly-minted M3 who has yet to experience the entire world of medicine, and I certainly welcome the fact that another specialty can sweep me off my feet at any point, despite my previous inclinations. However, let's just say for argument's sake that A.) I retain my passion for neuro through M3, do well in the rotation, and no other specialty pulls me in, and B.) check off all the aforementioned boxes to polish my now-turd of an application. Would neuro be a realistic goal? I'd be willing to apply to every single program in the country (I believe there's 159 of them) just to get a shot. Any shot. And further, even IF I was to get in, is a USMLE failure an automatic no-go for future fellowship potential? (Not trying to look too far ahead, just wanna know what's potentially in store).

I know, there are many, many "what ifs" that are still not known. I've got a lot of work to do and feel like I let myself and everyone down, but there's no time to wallow in that. Am I still (at least partly) in control of my own destiny? Or is this going to be an IM/FM/Peds only scenario? If so, I'd like to know so I can start focusing my energy there. Throw the kitchen sink at me, I can do nothing more now than be humbled.

My many thanks
 
Neurology isn't really all that competitive, so I don't see why it wouldn't be realistic. Recover and apply smart. And as long as you have a decent personality, it shouldn't bar you from a fellowship either.
 
Does your home institution have a neuro program? If so, how competitive is it? If by the end of M3 year you check all the boxes and still want to pursue neurology, I'd maybe start there.
 
Neuro is still a realistic goal if you come back strong... Shoot for 220+ on your step1 retake and do well on your clerkships...


One of my classmates matched into a good university neuro program with not so great scores ~210/~220, though did not fail any steps.
 
Do you still have a shot at neurology? Sure. It won’t be at the UCSFs or MGHs, but if you are able to get decent scores from here on out, you should be able to match *somewhere* in neuro. From what I’ve heard from my school’s neuro faculty, neuro generally is more interested in finding applicants who are inquisitive and have the right mindset than those with the highest steps. So if you can get ~220s from now on, and have some neuro research to show your interest and analytical mind, it’s still a possibility.
 
Neuro is going to be fine. My program director at the school told us that frankly not a lot of us grads apply Neuro so they are happy to take anyone who does. Your focus should be to pass everything going forward and you should be able to match.

Who knows what fellowship will think, but I would not worry about it right now .
 
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Neuro is going to fine. My program director at the school told us that frankly not a lot of us grads apply Neuro so they are happy to take anyone who does. Your focus should be to pass everything going forward and you should be able to match.

Who knows what fellowship will think, but I would not worry about it right now .
Also as a whole neuro PDs seem to not care too much about step 1 versus ecs and demonstrated interest from my experience
 
Thanks for all the encouragement everyone, I know that I have to walk a tightrope for the next two years and I have absolutely no room for error. I am a bit comforted that my home institution has a fairly new (seemingly less competitive?) neuro program, I'm trying my best to show my face to them as much as possible.
 
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