Asked to Voluntarily Withdraw and Looking for Advice for Next Steps

[GoSpursGo]

Hypothetically speaking, is there anything I need to be careful about when asking for mercy, or just lettting the dean know I got a passing score and requesting for a Zoom appointment to discuss the matter of reconsideration? Should I say anything special when asking about a letter? What about addressing the reason of transfer in transfer and residency applications (i.e. if I should be 100% transparent about all red flags including but not limited to failed L2, not passing a rotation, and MOU execution)?

As always, thanks very much for your advice and willingness to follow through.

Have you in fact already gotten a passing L2 score, or are you still awaiting the results?

Rather than asking for specific content in a letter I would ask the dean what he would plan to say.

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[YJ2022]

Have you in fact already gotten a passing L2 score, or are you still awaiting the results?

Rather than asking for specific content in a letter I would ask the dean what he would plan to say.

Score not available until August. Still waiting.

I see. Will do and see what she would say in the hypothetical scenario that I passed L2.

 

[ortnakas]

I feel like OP’s situation has been addressed very adequtely, but for readers in the future: if you find yourself in the situation where you’re on probation or otherwise on the verge of being expelled/held back/asked to resign:
You are not the one with the bargaining power. You can’t negotiate, you aren’t in a position of power. If there is a health issue, be it physical if mental, make sure it’s being addressed and eliminate that confounder. And if you’re given hoops to jump through, however arbitrary, just jump through them. OP has a whole array of issues they’re up against which I’m not getting into, but failing to do a biweekly email was an unfortunate and unnecessary nail in the coffin.

 

[Nevergiveupok]

Hello there. It seems that I cannot start a private conversation with you now but thanks very much for your willingness to connect and sincerely hope that things have already worked out perfect for you.

Messaged you.

 

[YJ2022]

Always remember that there are two sides for every story.

And if you stick around here long enough, when you you look at the "help! I've been dismissed from med school/residency!" posts, you find that the OPs are all lacking in info, making it seem like they're the victims. BUT, when you go through the thread, then it gets revealed that the OPs all omit important info.

No one person can ruin a medical student's life except the medical student, as we see here.

If the entirety of the corresponding preceptor's evaluation is not sufficient for the other side, please let me know what else helps if you do not mind.

Some additional contexts for that unprofessional incident in case I omit anything important. There was >1 hour commute between the rotation location and my residence. Because the housing around the hospital was much more pricier, I ask for the preceptor's opinion. He said it sounds challenging but if it does not affect my performance much then go ahead and commute. He also recommended some podcasts for me to listen to on my way, which I did. In a hindsight I should have moved just next to the hospital for that 4 weeks, though I did not expect to fail an outpatient elective after passing all previous inpatient and outpatient rotations and electives with some honor nomination while sparing time for Step 1 and Level 2.

Then that incident happened pretty much as what the evaluation described. Initially the two physicians threw some jokes and asked about if I was OK. After the encounter the preceptor seriously but kindly explained that the behavior is unprofessional, which I totally agreed and promised that it would not happen again. The preceptor then proceeded to ask if I have any sleep problem. I responded by saying since high school it has been difficult for me stay totally awake for any talk longer than 45 minutes, and I sometimes was woken up by my own snoring. However, we both agreed I was unlikely to have OSA considering that I was thin with SBP around 100 and no severe ENT history (I now decided to do a polysomnography to confirm, which is recommended by current psychiatrist. The appointment to obtain referral for a sleep study would not take place until Sept., however.) He concluded the discussion by asking me to leave early for the day and see if I could manage to stay awake in the future. Fortunately I did not fall asleep any more during patient encounters through going to bed as early as possible and drinking a lot of coffee. The preceptor never mentioned the issue throughout the rotation until his last weekly feedback session, where he praised on my effort to avoid falling asleep.

Again it may sound like I am portraying myself as a victim of some sort. If anybody believes so please feel free to do so. I post the more detailed story here just to see what more I could learn and hopefully others could get something from my experience.

 

[Osteosaur]

I respect your judgment if you believe I am sugar coating. I unpack the scores just in case anybody needs more information, otherwise I probably would not disclose the other 370. In a hindsight, I think scoring much lower than the first attempt after months of board study could support their decision to have me withdraw.

At the bottom of this message I present the corresponding preceptor's evaluation and my original appeal about the failed elective.

The MOU required me to contact a specific faculty member every two weeks. I forgot that stipulation and did not email her that often.

Probably I somehow miscommunicated again and I apolgize for that. I was trying to say between signning the MOU and receiving the decision I the SPC met me several times via Zoom and there is no mention of the "every two weeks" stipulation during any of the meetings, for which I never forget and were always punctual.

I am not sure how to categorize the master program, as my reply to NotAProgDirector says, the program is like a post-baccalaureate plus around 200 hours of research, for which students do need to do a paper and presentation. I am interested in the degree because if I end up returning to China and choose to continue my medical career there, a medicine-related master degree is definitely much better than a B.S. bioglogy one.

According to the SPC member I met if I did not do the paper in a month or two the school would automatically label me as "voluntarily withdrawn." I was delaying the withdrawal paperwork because enrolled students seem to have higher chance of transferring. If there is indeed zero likelihood of begging for mercy with a passing score or transfer, then it would not hurt too much to acknowledge that status.

As for carib schools, I am curious about how they would kick me out, by intentionally making me fail a rotation or something else?

To my perception the mental and family problems already exist before signing the MOU but significantly worsened afterwards. It could also at least partially be a mental thing why I forgot the "2 weeks" stipulation. Every time I read the MOU I feel ashamed and stigmatized. So later I chose to put it aside, thinking that as long as I end up passing level 2 things will get back on track. The false assumption was strengthened as SPC never contacted me for anything other than COMLEX, and one SPC member once said "If SPC do not reach you, you are doing fine. SPC only meet students when they did something wrong." Again I am not using those as excuses, but to reflect on how come I did not remember to do something that would has a decisive impact on my DO career. I did not do LOA because the MOU already placed me on probation, and according to a faculty member I cannot schedule any standardized test while on LOA. Plus the probation was like a LOA because I arranged my own schedule, as long as I do not spend more than 6 years in total as an enrolled student.


Copy of the evaluation of the preceptor who failed me.

I have precepted numerous trainees in various stages of their education. I am clinical faculty to physician assistants during their clinical years, precept medical students, residents at (program name) program as well as program name's HIV fellowship. (My name) did have some improvement during our month together, though I do have concerns he is below the level of what I would expect from a clinical 4th year medical student. I base this also on his fund of knowledge in comparison to the 2nd year PA students I precept and encourage (My name) to read more. I shared resources with him including MKSAP, UptoDate, USPSTF guidelines, American Thoracic Society handouts to support him and his learning. It is unfortunate he could not differentiate or recall H1 vs H2 blockers, and suggested cetirizine as a treatment for dyspepsia. I would also expect a fourth year medical student to have more of a plan for a routine check up beyond blood work. He was unable to articulate vaccines or age appropriate cancer screening such as cervical cancer screen etc which should been learned in your 3rd year. His presentation needs to be more succinct, and he needs to evolve from being a data gatherer to formulate a differential diagnosis and formulate an assessment and plan if he is to be a rising 4th year and soon to be intern.

Early in the rotation it was apparent that (My name) was fatigued or disengaged as it could be seen by his shifting about during the patient encounter. Additionally he fell asleep during one encounter where the patient was in fact a physician himself and we both stopped talking to stare at (My name) as he had his eyes closed with head propped on his hand leaning against the exam room sink. It was not only uncomfortable for (My name), but myself as well as he represents my alma mater. (My name) presented disheveled and sloppy to the rotation, with his white coat being several sizes too large and his hair consistently disheveled. I do give him praise as he shared he had lost 30 pounds which is not an easy feat, and credit for spending the weekend finding a white coat that fit him. He also did cut his hair during the rotation. I shared the importance to present professionally, not only for the fact that patients entrust their care to us, but also as you are under the scrutiny of attendings and future colleagues. I did allow him to optionally come to clinic in scrubs, or preferably alternating outfits--I do know finances can be difficult as a student. Unfortunately (My name) wore the same outfit of blue/white striped tie, pinstriped button up shirt and black pants during the entire 1 month rotation. Although patients would not know this to be the same outfit, it would certainly be noticed by residents and attendings on an audition rotation and would present poorly. (My name) also has the habit of cracking his knuckles very frequently against his own hands or on his face, even during patient encounters which is off putting. I commented upon this and he is actively trying to limit this distracting behavior.

In general, (My name)'s documentation is adequate and he did make improvements. Early in the rotation we had a patient with prior medical history of hypertension, hyperlipidemia, whose chief complaint was carpal tunnel. This was the predominant focus of our visit, though in review of (My name)'s documentation he only documented hypertension and hyperlipidemia as topics addressed. This was because I had dragged over these two diagnoses on our EMR but had yet to code for carpal tunnel. Although I had not yet had time to complete charting and code all diagnoses, I would expect an MS4 to be able to address in their note all topics discussed in the patient encounter--especially if carpal tunnel was the main crux of the visit. The situation where I do not have time to code all diagnoses in the EMR until the end of the day is common and other students have not omitted diagnoses in their note. I did bring this to (My name)'s attention and he did make improvements as accurate documentation in the clinical note is important not only for continued patient care but in the interest of the medical center for billing as well.

I do want (My name) to succeed. It is incredibly brave to see immigrants embarking to a foreign country where English is a second language. It is a story of my parents as well, and I want to see him do well. I hope these comments are not seen as overly harsh, but solely for the purpose of providing clear areas of improvement so that we may have more bilingual and culturally competent clinicians in our community.

Copy of my original email appealing the rotation failure.

I recently noted that Dr. L failed the internal medicine elective I did with him. Strongly disagreeing with the failing decision for reasons below, I have talked to Miss D during the virtual CED office hours this Tuesday regarding the matter (by the way, the Zoom links for office hours did not work for me yesterday and today). According to Miss D, a report would be submitted to the Dean and updates regarding the investigation would be available Wednesday. Yet I have not received any related emails. Thus, I am wondering if any CED faculty could please let me know whether any progress regarding the issue has been achieved at this point. Thanks very much and wish the CED team wonderful holidays. As a side note, I have not contacted Dr. L since noticing the failure and according to SPC I should not "chase after preceptors" negative comments on CPE. However, if by any chance Dr. L is willing to interact with me again to discuss his evaluations, I am more than happy to in any means he prefers, with or without the involvement of any (school name) faculty. Please also feel free to let Dr. L view whatever I put down here if he is interested.

Reasons why I think I should not have failed the elective:
1. Though Dr. L frequently shared with me his opinions about my performance regularly, he did not start working the CPE by the end of the last day of my elective with him. However, in the evaluation, he selected "Yes" for the question asking if he has reviewed the evaluation with me. Considering that Dr. L seemed very busy with both work and family during that last week. I am afraid that he might not have the energy to accurately, objectively, and comprehensively recall my strengths and weaknesses when deciding to fail me.

Also, I could clearly recollect that the cetirizine Dr. L referred to was not about dyspepsia but GERD. We were going over antihistamines for reflux management and then naming first vs second generation antihistamines. I could hear or remember it wrong but Dr. L might have said that cetirizine belongs to the first generation.

As for the age appropriate vaccine and screening, the context is that we were discussing the management plan for a middle-aged female presenting for an annual physical exam. I was saying “what about basic labs like CBC?” Dr. L then took over the conversation, listing the vaccines and screening exams in his mind. Had I been given more time to fully elaborate my thoughts or been asked more specific pertinent questions, I would have provided a more satisfying answer.

2. For more than one time Dr. L had asked me to self-evaluate, agreeing with me and reassuring me that I did fine overall when I made statements like "at least I think I have not failed this rotation."

3. Despite my relative weakness in medical knowledge, I still managed to pass all previous rotations, USMLE Step 1, COMLEX Level 1, and all COMATs. Even Dr. L himself mentioned he was impressed by my understanding of SSRIs, skin and eye pathologies, and HIV medical management. Another physician that Dr. L recommended me seeing on my last day of the elective verbally praised my recollection of the vaccine schedules for AIDs patients as well.

4. Throughout the 4 weeks Dr. L's feedback was more positive versus negative to my perception and never did he raise the forewarning that I should fail the elective for not perfectly satisfying his expectations.

5. I have made my best attempts to address the problems Dr. L pointed out in CPE, including but not limited to purchasing multiple white coats, cutting hair super short, and refraining from nodding my head and touching knuckles, which Dr. L himself appreciated verbally and literally in his evaluation.

6. Dr. L expressed in CPE and verbally that he wanted me to succeed and positively represents (school name) alumni and Asian immigrants. I truly value his comments but I am afraid that his determination to fail me may impact me more seriously than he might have anticipated. SPC has already reached out to me about dismissal after recognizing the failure and changed my rotation schedule. I am confronting the risk of not being able to graduate and moving forward to residency in time, and failing an elective of the specialty I am applying to could be a red flag for program directors. Additionally, I cannot help but spare time from preparing for board exams to work on this matter given concerns about its effects. Personally speaking, I think this failure has harmed me much more than it could benefit me in any ways I can imagine, and honestly now I feel the need to think carefully before choosing to do work with a (school name) alumni preceptor, worrying that I might end up unexpectedly failing the corresponding rotation.

First, I'd like to thank you for being as open and honest with us as you can be. I'm sure it's difficult to share these details with a bunch of internet strangers.

I'm going to assume you want our honest, unvarnished thoughts and opinions. It would be easy to tell you that "I'm sure this will all work out". The truth is going to be much more complicated than that.

Starting with the MOU contract -- it's very interesting. In many ways it's "horribly brilliant" much like the oft discussed abortion law in Texas. Because they state in the MOU that any failure triggers a "voluntary withdrawal", you lose all options to appeal the decision. The school leaves you with what is essentially a Hobson's choice -- you can either sign the MOU to continue in school but forfeit all appeals, or you can appeal immediately but then perhaps end up just getting kicked out for refusing the MOU. It's also similar to contracts where you agree in advance to settle differences with an arbitrator, only to discover that the arbitrator is paid by the other party and hence has a built in interest in keeping them happy. It's probably legal and binding, yet unfair and exploitative of them to force it upon you. I agree with you that it's arbitrary - yet you signed the contract and so it's binding on you. In any case, trying to fight this in court is a losing battle for you -- both in time and money.

If the MS is free, then it may be worth pursuing. You mention that it might be helpful in China -- and if that's the case then it may be worth the time investment. I was worried that the reason you were considering it was that it would make you more competitive for a new MD/DO spot -- which it will not.

Which brings us to the failed rotation evaluation. It's an incredibly detailed, helpful evaluation of your performance and the issues involved. I am so used to reading DO MSPE's that have "Good job!!!!!" as the only comment for an 8 week rotation. The evaluator really seems to care about you and about your success.

Summarizing the evaluation, there are two main themes:

Medical knowledge. Your exam scores were low, suggesting poorer levels of knowledge. Sometimes students do poorly on exams, but actuaclly have a good knowledge base. In this case, they clearly delineate multiple deficiencies. Perhaps you have good knowledge in some areas, but your overall knowledge was felt to be lacking. In your appeal letter (which I will get to later) you mention an example where they didn't give you enough time to answer fully -- but that's part of having good medical knowledge, to answer the exact question asked and not diddle daddle around with random factoids. And there were documentation issues.

Professionalism / communication skills -- honestly, this is probably the bigger issue. Documented is a mix of problems from being disheveled, poor habits (cracking knuckles), and falling asleep in an exam room. I have no idea what personal or health issues you were facing, but if they impact your clinical performance like this then your only choice is to take an LOA to address them.

As to your appeal, I hate to tell you this but it was exactly the wrong way to appeal something like this, and almost certainly made your situation worse. You blamed your preceptor for most of the problems, rather than accepting any responsibility. you use the fact that you passed exams (albeit by a few points, and still having failed L2 several times) as proof that there is no problem. You state that you said "at least I'm not failing this rotation" and that no one disagreed with that as proof you should have passed -- I do agree with you here that it's unfortunate, one of the most meaningful experiences I have had as an educator was once telling a medical student after 2 days (of a 7 day week together) that if their performance continued at the same level that I would assign them a failing grade. Up until that time I had tried to be "nice" and give them constructive feedback. I thought it was done in such a way that anyone could see that their performance was a huge problem. But they missed all those subtle signs, and it took being 100% honest to help get them on track. They didn't fail.

But then, there's #6 in your appeal. I want you to take a good, close look at that. You basically say that your preceptor has it out for you (which he/she doesn't given the content of their eval), that failing isn't going to "help" you, and that you have more important things to do like study for L2. You then declare that you will no longer work with alums from the school. I cannot begin to tell you how damaging this all is. It makes you sound incredibly entitled, without humility, and lack introspection.

So, next steps:

This is the end of the road at this school. You could choose to not voluntarily resign -- sounds like they have paperwork they want you to sign to do so, and you could refuse. That would then leave them to expel you instead, and then you might be able to appeal or sue in court. But all this is a horrible idea, you will lose, just that evaluation alone will be catastrophic (along with your appeal). And then you lose any chance at an MS or any clean break from your school. So you really have no choice.

A low tier Carib school is a terrible option. You can look on the Carib section of SDN, there's a recent thread about one of them where less than 10-20% of student who started actually ended up graduating. Given the issues in the eval above, I worry that your issues are much more than just passing tests. And even if you did OK in a carib school, trying to match from a low tier carib school after "resigning" (which everyone will know you were actually terminated, as who would resign voluntarily in their 4th year?), your chances of getting a residency spot will not be good.

You're talking about moving to China, and my guess is part of that decision is to elope from your educational debts. It's a reasonable plan, assuming you'd actually be happy in China forever. if so, one could argue that going to a Carib school doesn't actually make anything any worse -- if it doesn't work out (you fail out, or you don't get a residency spot) then you go to China and it doesn't matter how much debt you have. This assumes all the debt is in your name -- if you have cosigners they will be on the hook for everything. This plan may limit your ability to visit or ever come back to the US.

Even if you're in lots of debt, repayment plans will limit how much you'll have to pay and ultimately it will all get discharged. But you can't discharge it in bankruptcy (usually) and it will stay with you for decades at least.

Personally, I think the best plan is to move on from DO or MD school. Take your talents and find something else to focus on -- whether that's research, being involved with managing clinical trials, or something health care adjacent (like tech/EMR, insurance, etc). Pursuing this further is only likely to yield more heartache. I can;t speak to moving to China -- I'm sure that has lots of challenges also.

Best of luck

I am sorry this is happening and its so devastating. If you were not so far along I'd suggest cutting your losses but its just one more year. If you can convince your school to let you stay all you need to do is apply for residency. If you can get through residency is another matter. Think hard about that. There is a good chance of going unmatched as is.

1) The stupidest thing you could do is re-enroll elsewhere. You'd be sinking even more time in with a bunch of red-flags you can never, ever, get rid of. If you can't convince them to give you a shot at applying for residency get out and do something else. You will rack up half a million dollars in debt you will never ever pay off.

2) Are you sure the preceptor... meant to fail you? It seems like they was invested in you. If he is an experienced preceptor surely they understood the grading system; but is it possible this is one of those "I did not know developing meant failure and not developing" situations? It just seems odd he would provide hopeful feedback and then fail you unless it was read by someone else and turned into a fail. Did you see the actual grades?

3) All you can do is beg for mercy. You signed an agreement. Your only hope is to convince them to just let you apply for residency if you pass level 2, and hope to god you match. Maybe a passing level 2 or some evidence of improvement on rotations would help? I do think its a bit unusual no one noticed you were not checking in until 6 months later. You should have been paying attention but you should also be on their radar. Being adversarial or quibbling won't help.

So far as the evaluation went is that an MSPE comment or not? I agree that its valuable feedback. A preceptor willing to take a struggling student aside and bluntly tell them what not to do, and offer real constructive feedback to correct it, is gold. I do question whether its right to have that stuff as an MSPE comment. Plenty of students might be off-putting and respond well to correction.

But I simply can't buy that a "Student was a responsible and a pleasure to work with, but should read more." evaluation would be received worse than "student needed a haircut and fell asleep and had all these ****ty encounters" with no evidence of how they improved. I would imagine the former might just be indicative of "would make a decent resident" versus problems with general professionalism like falling asleep or appearing disheveled.

P.S. I believe you may be getting a bit confused. It was not first versus second generation antihistamines he was asking. Cetirizine is a second generation meaning its non-sedating. Cetirizine would be inappropriate for GERD as you want to use an H2 blocker, like famotidine, which will stop acid release. Cetirizine targets H1. I only say this as, if you are ever addressing this comment, please make sure you're correct in your understanding of antihistamines.

 

[Goro]

If the entirety of the corresponding preceptor's evaluation is not sufficient for the other side, please let me know what else helps if you do not mind.

Some additional contexts for that unprofessional incident in case I omit anything important. There was >1 hour commute between the rotation location and my residence. Because the housing around the hospital was much more pricier, I ask for the preceptor's opinion. He said it sounds challenging but if it does not affect my performance much then go ahead and commute. He also recommended some podcasts for me to listen to on my way, which I did. In a hindsight I should have moved just next to the hospital for that 4 weeks, though I did not expect to fail an outpatient elective after passing all previous inpatient and outpatient rotations and electives with some honor nomination while sparing time for Step 1 and Level 2.

Then that incident happened pretty much as what the evaluation described. Initially the two physicians threw some jokes and asked about if I was OK. After the encounter the preceptor seriously but kindly explained that the behavior is unprofessional, which I totally agreed and promised that it would not happen again. The preceptor then proceeded to ask if I have any sleep problem. I responded by saying since high school it has been difficult for me stay totally awake for any talk longer than 45 minutes, and I sometimes was woken up by my own snoring. However, we both agreed I was unlikely to have OSA considering that I was thin with SBP around 100 and no severe ENT history (I now decided to do a polysomnography to confirm, which is recommended by current psychiatrist. The appointment to obtain referral for a sleep study would not take place until Sept., however.) He concluded the discussion by asking me to leave early for the day and see if I could manage to stay awake in the future. Fortunately I did not fall asleep any more during patient encounters through going to bed as early as possible and drinking a lot of coffee. The preceptor never mentioned the issue throughout the rotation until his last weekly feedback session, where he praised on my effort to avoid falling asleep.

Again it may sound like I am portraying myself as a victim of some sort. If anybody believes so please feel free to do so. I post the more detailed story here just to see what more I could learn and hopefully others could get something from my experience.

Moot, as you will be withdrawing.

Falling asleep during a patient encounter would have you fail a rotation at my school, and others.

Time to move on.

 

[Goro]

3) All you can do is beg for mercy. You signed an agreement. Your only hope is to convince them to just let you apply for residency if you pass level 2, and hope to god you match.

One of the things not being discussed is why should the school let the OP graduate when they are at high risk for poisoning the well for their school at that residency site?

 

[DrStephenStrange]

Moot, as you will be withdrawing.

Falling asleep during a patient encounter would have you fail a rotation at my school, and others.

Time to move on.

What if OP ends up having an undiagnosed central sleep apnea or narcolepsy? Would that change anything? Sounds like OP also needs some counseling or mental health consult from reading that preceptor evaluation.

 

[ortnakas]

What if OP end up having an undiagnosed central sleep apnea or narcolepsy? Would that change anything? Sounds like OP also needs some counseling or mental health consult from reading that preceptor evaluation.

That might buy some lenience for that particular incident. But then again, OP mentioned they’ve always struggled staying awake for 45 minutes which makes one wonder why it took until now to look into it. And, unfortunately, even ignoring that episode, OP still has enough strikes to be out.

 

[YJ2022]

I am sorry this is happening and its so devastating. If you were not so far along I'd suggest cutting your losses but its just one more year. If you can convince your school to let you stay all you need to do is apply for residency. If you can get through residency is another matter. Think hard about that. There is a good chance of going unmatched as is.

1) The stupidest thing you could do is re-enroll elsewhere. You'd be sinking even more time in with a bunch of red-flags you can never, ever, get rid of. If you can't convince them to give you a shot at applying for residency get out and do something else. You will rack up half a million dollars in debt you will never ever pay off.

2) Are you sure the preceptor... meant to fail you? It seems like they was invested in you. If he is an experienced preceptor surely they understood the grading system; but is it possible this is one of those "I did not know developing meant failure and not developing" situations? It just seems odd he would provide hopeful feedback and then fail you unless it was read by someone else and turned into a fail. Did you see the actual grades?

3) All you can do is beg for mercy. You signed an agreement. Your only hope is to convince them to just let you apply for residency if you pass level 2, and hope to god you match. Maybe a passing level 2 or some evidence of improvement on rotations would help? I do think its a bit unusual no one noticed you were not checking in until 6 months later. You should have been paying attention but you should also be on their radar. Being adversarial or quibbling won't help.

So far as the evaluation went is that an MSPE comment or not? I agree that its valuable feedback. A preceptor willing to take a struggling student aside and bluntly tell them what not to do, and offer real constructive feedback to correct it, is gold. I do question whether its right to have that stuff as an MSPE comment. Plenty of students might be off-putting and respond well to correction.

But I simply can't buy that a "Student was a responsible and a pleasure to work with, but should read more." evaluation would be received worse than "student needed a haircut and fell asleep and had all these ****ty encounters" with no evidence of how they improved. I would imagine the former might just be indicative of "would make a decent resident" versus problems with general professionalism like falling asleep or appearing disheveled.

P.S. I believe you may be getting a bit confused. It was not first versus second generation antihistamines he was asking. Cetirizine is a second generation meaning its non-sedating. Cetirizine would be inappropriate for GERD as you want to use an H2 blocker, like famotidine, which will stop acid release. Cetirizine targets H1. I only say this as, if you are ever addressing this comment, please make sure you're correct in your understanding of antihistamines.

Thanks very much for the feedback

1) Totally agree. If transferring to any form of medical school does not work I cannot see me re-enrolling to any medical or related schools (e.g. the pharmacy school the dean offers). Also, as I mentioned somewhere in my long series of threads, I do not have any debt currently and can afford another couple of years of medical school without worrying about loans. Meanwhile, I do hope to get some medical degree to possibly practice medicine somewhere else if that is impossible in States. So I totally heard voices discouraging me to do so but I still give transfer a try if convincing the dean is not successful.

2) The preceptor meant to fail me though like I mentioned earlier he felt strong anguish about doing so according to the school. And as he mentioned in his evaluation he seems to be quite experienced in precepting, though I do not know how he would react once knowing what happened after that rotation failure.

3) Just to clarify per MOU I cannot do any rotation before passing L2. Also agree that begging for mercy is the most feasible and effective path if there is a passing score.

None of the posted preceptor evaluation is included in the MSPE, and the preceptor literally chose to put nothing on the comment that would be in MSPE. I rechecked my unofficial transcript the failing grade including that rotation did not even show up. More weird is that the rotations I originally scheduled after the failed elective but later cancelled due to MOU were on the transcript as "courses in progress."

Responding to P.S.: Thanks for the reminder. I was trying to say the preceptor made those some false statements about the purpose and generation of cetirizine. It could be that I heard what he said wrong and I admitted it would be a poor strategy to mention those in my appeal.

 

[Goro]

What if OP ends up having an undiagnosed central sleep apnea or narcolepsy? Would that change anything? Sounds like OP also needs some counseling or mental health consult from reading that preceptor evaluation.

After four years, OP has had his/her chance.

Y'all keep focusing on one thing. But it's NOT one thing...it's the collection of red flags.

OP signed an MOU; OP failed to live up to their end of the agreement.

 

[Nevergiveupok]

After four years, OP has had his/her chance.

Y'all keep focusing on one thing. But it's NOT one thing...it's the collection of red flags.

OP signed an MOU; OP failed to live up to their end of the agreement.

Also most schools have a limited time frame where you must finish the program (my school was 6 yrs, regardless of academic standings - if you're not done by then, you're kicked out but my school would likely give the student the chance to withdraw first).

 

[joey jake]

Does OP have connections in residency programs? That might change things with regards to the Carribean. Also, if OP is close friends with classmates, they might be willing to help him as residents often have a say in who gets matched.

 

[YJ2022]

What if OP ends up having an undiagnosed central sleep apnea or narcolepsy? Would that change anything? Sounds like OP also needs some counseling or mental health consult from reading that preceptor evaluation.

That might buy some lenience for that particular incident. But then again, OP mentioned they’ve always struggled staying awake for 45 minutes which makes one wonder why it took until now to look into it. And, unfortunately, even ignoring that episode, OP still has enough strikes to be out.

In the last SPC meeting I did mention that I am regularly seeing a psychiatrist and therapist, having tried maximum dose of bupropion with no visible benefits. SPC's response is like "you were never in a jail or asylum where you cannot access internet, then you should still had been able to send emails." I have seen two psychiatrists so far, one first recommended half max dose of bupropion for a month and then max for another. Then he said he did not think I have typical depression or ADHD and suggested tapering off in a week and then complete off the medication. The psychiatrist left the group afterwards and the new one think I should do a genetic test to see which drug better works for me, in addition to the polysomnography. I have requested my mental health records, which is still on its way.

My academics was seldom problematic like I am now, and even when there was (e.g. failing some organic chemistry tests in college and not doing well initially in anatomy) I managed to improve through modifying study strategies. I mentioned the sleep problem in probably half of my physical exam appointments, and none of the physicians seriously thought it is OSA, with responses like "you would likely get over it as you age" "anyone could fall asleep when listening to something long and boring" "no worries as your life and study are not really affected." Also, the more coffee I had, the less I snooze. For example, if I only drink water in a two-hour average lecture, I would be sleepy for 5-10 minutes. If I drink a trenta Starbucks cold brew with as many shots as they can add whenever tired, then 0-5 minutes. On the Sleep Cycle app, my sleep quality varies between 60s% to 90s%. Scarcely had difficulty falling and even less frequently for staying asleep.

Some other physical problems that I did not even bother mention in the SPC meeting but could remotely be related to OSA just in case anyone is medically curious. Since I remember things I have balance and coordination problems and is never able to ride a bicycle or jump rope. I have latent TB with normal CXR, though I can never blow a balloon and per PFT I have COPD. On the other hand, I have no significant documented PMH and had only been to hospitals for my physicals and rotations. Regardless, I would not really know unless the PCP I will see in Sept. referrs me for sleep study.

 

[RNthenDoc]

The dean offers to have me admitted to the school's pharmacy program, though I have to start all over.

WHAT

>_>

 

[cabinbuilder]

Was required to sign a "Memorandum of Understanding (MOU)" and put on probation after retaking several COMATs, failing COMLEX Level 2, and not passing an elective rotation. While about to attempt Level 2 for the third time (previous scores 395 and 370) recently, my school's Student Promotion Committee (SPC) met me as I unfortunately did not email a specific faculty member every 2 weeks, which is required by the MOU. As the document mentions that students failing to satisfy any of its stipulations is subject to voluntary withdrawal with no right to appeal, the SPC and Dean both agree that I should quit the DO program immediately.

Later I had appointments with some SPC members and the Dean individually to provide further explanations (e.g. that I remain regular communications with other faculty members, whom the person I should email recommended me to contact; that I was busy attending an in-person board prep program; mental problems, family issues, etc.), yet their decision remains unchanged.

The school offers a Master of Science in Medical Health Sciences program that starts in September and takes around 200 hours. Currently I am planning to secure a master degree first, and then hopefully transfer to another medical school. Any advice (e.g. schools where I could have some hope) would be sincerely appreciated.

Some sidenotes: 1. Per that MOU I should have already violated the stipulation about emailing in early January, though it seems that both SPC and Dean had neglected it until this month, despite having had several Zoom meetings with me in between.
2. I fortunately did not fail any pre-clinical course with a GPA around 3.6 and obtained passing scores for Step 1 and 2 first time. The school still allowed me to take Level 2 and the score will be available in two weeks.
3. So far I have not signed the withdrawal paperwork and I wonder if remaining my enrollment status as long as possible would be beneficial for transfer, though I have to do so in around a month according the SPC member I met.
4. That SPC member also clarified the anything related to the MOU would not show up on my transcript, whose unofficial version for some reason did not reveal that I failed rotation and was on probation. However, I am uncertain if the Dean would do a letter of good academic standing or mention anything related to probation or MOU incompliance in her writing.
5. I am in my last year of the program and have about 8 months' rotations to finish when receiving the school's decision.

it says that you failed step II twice but then down the paragraph says you passes step I and step II the first time. Plus why all the grief over an elective rotation? People fail classes all the time, I'm not getting why they are trying to force you out. what am I missing?

 

[Goro]

WHAT

>_>

It appears that the OP rewrote or deleted that sentence, and the wording is oddly familiar with a post made by someone who is failing out of an MD school.

I'm beginning to think we're being trolled. If so, 10/10.

 

[Goro]

it says that you failed step II twice but then down the paragraph says you passes step I and step II the first time. Plus why all the grief over an elective rotation? People fail classes all the time, I'm not getting why they are trying to force you out. what am I missing?

OP failed Level II; passed Steps.

 

[GoSpursGo]

It appears that the OP rewrote or deleted that sentence, and the wording is oddly familiar with a post made by someone who is failing out of an MD school.

I'm beginning to think we're being trolled. If so, 10/10.

Buried at the bottom of a very long post which I honestly skimmed over. Kind of neither here nor there as far as I'm concerned unless the OP wants to be a pharmacist.

 

[cabinbuilder]

OP failed Level II; passed Steps.

I guess I have been out of school too long. What are Steps???

 

[YJ2022]

it says that you failed step II twice but then down the paragraph says you passes step I and step II the first time. Plus why all the grief over an elective rotation? People fail classes all the time, I'm not getting why they are trying to force you out. what am I missing?

As Goro clarifies, I passed USMLE Step 1, Step 2, and COMLEX Level 1 first time but have failed L2 twice. The grief is because 1) some people seem to be interested in the full story why I failed that elective; 2) if by any chance my school allows be to continue, then all I need before graduation is about 8 months' rotations. So I tried to thoroughly reflect on that experience to assure I would not repeat any mistakes; 3) I got plenty of time to kill.

 

[YJ2022]

Buried at the bottom of a very long post which I honestly skimmed over. Kind of neither here nor there as far as I'm concerned unless the OP wants to be a pharmacist.

I am not interested in starting over for the pharmacist training. It is dean who mentioned in her email that she can help enroll me in the pharmacy school after my begging for mercy appointment with her.

 

[Goro]

I am not interested in starting over for the pharmacist training. It is dean who mentioned in her email that she can help enroll me in the pharmacy school after my begging for mercy appointment with her.

Can't see a Pharm school touching a med school dropout, even with the sorry state of Pharm. But we digress.

 

[YJ2022]

It appears that the OP rewrote or deleted that sentence, and the wording is oddly familiar with a post made by someone who is failing out of an MD school.

I'm beginning to think we're being trolled. If so, 10/10.

How I wish I am just making all these things up but unfortunately they all hurt as undeniable truths. Agree if the post is really by a troll the person must be excellent at role-playing and willing to spend a whole lot of time. Pretty much all what I am doing before any update appears is just checking my thread, reading SDN posts by people who are in similar situations, browsing pages of schools and lawyers, studying some Step 3-related materials, doing my best to maintain physical and mental well-being, and getting some income through part-time jobs. Feels like most of what I am doing could end up being pointless in the long run. Sometimes time goes by super slow to me but then I suddenly realizes the day already turns dark. My apologies for the digression and irrelevant catharsis.

 

[TruthInMedEd]

Also most schools have a limited time frame where you must finish the program (my school was 6 yrs, regardless of academic standings - if you're not done by then, you're kicked out but my school would likely give the student the chance to withdraw first).

General information that pertains to the OP, but also good to know in general in regards to potential transfers:

There is a COCA requirement Standard 6, Element 6.3: Maximum Length of Completion that states a COM must ensure that each student completes the DO degree within 150% of the standard time to achieve the degree. However, there is the ability to submit information as part of evidentiary submissions within 6.3 which states: "Provide a list identifying any single-degree DO student(s) who graduated beyond 150% of the standard time and provide a detailed explanation as to the reason for allowing the student(s) to graduate past the 150% of the standard time. This is a loophole so this could be used by any school depending upon the situation. Schools often use this requirement as justification to limit a poorly performing student from racking up additional debt trying to get through failed board exams or other issues. However, schools are able to submit students who exceed 150% of the standard enrollment time for consideration and this is often done with a student who lost time for legitimate reasons such as an injury or illness, etc. It is hard to get longer extensions when that time was due to failures, professionalism issues, etc.

There is also Standard 9, Element 9.3: Transfer Policies that set standards for transfer. Something very important to keep in mind with this element is that there is a requirement that students must complete the last 2 years of curriculum at the school from which they graduate and grants their DO degree. Most schools have policies that state a student must be in good standing upon transfer, but can vary on what they view as good standing. Some state that a student must be eligible for continued enrollment at their current school (which would negate transfer in the above case), but other simply say good standing, which could be used by the current Dean to explain the situation and provide support some form of support. Transfers are tough, but not unheard of. Most come between OMS2 and OMS3 years because that is the easiest point to allow them. It allows for staying in compliance with Element 9.3 and also avoids the risk of differences in curriculum timing between two schools. IE: one school teaches respiratory in OMS2 year, then a student transfers to a school that teaches it in OMS1. That student would miss that component of education. That is the top reason transfer requests during OMS1 or early OMS2 are denied.

 

[YJ2022]

General information that pertains to the OP, but also good to know in general in regards to potential transfers:

There is a COCA requirement Standard 6, Element 6.3: Maximum Length of Completion that states a COM must ensure that each student completes the DO degree within 150% of the standard time to achieve the degree. However, there is the ability to submit information as part of evidentiary submissions within 6.3 which states: "Provide a list identifying any single-degree DO student(s) who graduated beyond 150% of the standard time and provide a detailed explanation as to the reason for allowing the student(s) to graduate past the 150% of the standard time. This is a loophole so this could be used by any school depending upon the situation. Schools often use this requirement as justification to limit a poorly performing student from racking up additional debt trying to get through failed board exams or other issues. However, schools are able to submit students who exceed 150% of the standard enrollment time for consideration and this is often done with a student who lost time for legitimate reasons such as an injury or illness, etc. It is hard to get longer extensions when that time was due to failures, professionalism issues, etc.

There is also Standard 9, Element 9.3: Transfer Policies that set standards for transfer. Something very important to keep in mind with this element is that there is a requirement that students must complete the last 2 years of curriculum at the school from which they graduate and grants their DO degree. Most schools have policies that state a student must be in good standing upon transfer, but can vary on what they view as good standing. Some state that a student must be eligible for continued enrollment at their current school (which would negate transfer in the above case), but other simply say good standing, which could be used by the current Dean to explain the situation and provide support some form of support. Transfers are tough, but not unheard of. Most come between OMS2 and OMS3 years because that is the easiest point to allow them. It allows for staying in compliance with Element 9.3 and also avoids the risk of differences in curriculum timing between two schools. IE: one school teaches respiratory in OMS2 year, then a student transfers to a school that teaches it in OMS1. That student would miss that component of education. That is the top reason transfer requests during OMS1 or early OMS2 are denied.

Thanks very much for the reference. I should have graduated this year if the MOU-related events did not happen, and I am currently in a borderline withdrawal/dismissal status. Say in the hypothetical scenario that I transferred to another DO school and do another two years there, would that count as beyond 150% in total? Should my around eight months' probation be included in the time spent?

 

[GoSpursGo]

Thanks very much for the reference. I should have graduated this year if the MOU-related events did not happen, and I am currently in a borderline withdrawal/dismissal status. Say in the hypothetical scenario that I transferred to another DO school and do another two years there, would that count as beyond 150% in total? Should my around eight months' probation be included in the time spent?

All time, from matriculation to graduation, would be included.

 

[Suzukaze]

OP - I am just another medical student, so I can't comment on your transfer plans. Other people are much more experienced in this than me.

However, I noticed that you mentioned moving to China - especially "returning". In this case, I highly DON'T recommend considering anything related to Carib. I am also planning on working there after graduation as well (I have the citizenship and residency for my desired specialty is in general easier to get in there), and I can't imagine what the PDs' thoughts would be when they look at your resume that carries a random Carib country's name. I hate to say it this way but the prestige isn't really on your side if you actually transfer to a Carib school.

 

[Browns99]

Where's this thread going, the OP failed to meet the standards set by the school, all of which he/she agreed to. It's not easy becoming a physician and it shouldn't be. Medical schools are not and should not be in the business of handing out diplomas to students who have shown an inability to meet the educational requirements to become a doctor.....Time to move on.

 

[joey jake]

Can't see a Pharm school touching a med school dropout, even with the sorry state of Pharm. But we digress.

I know several people who were dismissed from prior programs who are in med school.

 

[YJ2022]

All time, from matriculation to graduation, would be included.

Is there any similar requirement for MD schools?

 

[YJ2022]

OP - I am just another medical student, so I can't comment on your transfer plans. Other people are much more experienced in this than me.

However, I noticed that you mentioned moving to China - especially "returning". In this case, I highly DON'T recommend considering anything related to Carib. I am also planning on working there after graduation as well (I have the citizenship and residency for my desired specialty is in general easier to get in there), and I can't imagine what the PDs' thoughts would be when they look at your resume that carries a random Carib country's name. I hate to say it this way but the prestige isn't really on your side if you actually transfer to a Carib school.

Thanks very much for the advice. Do you mind me asking if you have lived in China for long or have connections in the medical field there? Personally I do not recommend practicing medicine in China if you can do so in States or any other developed country. In public Chinese hospitals and clinics, which outnumber private ones, average wages for physicians could be 1/20 of with those of the same specialties in U.S. if you consider currency ratio. Housing is extremely unaffordable and majority of people are on life-long loans in major cities. Outpatient doctors rarely spend >5 minutes for one patient given the population. Schedules are much busier and one could scarcely expect a 9-5 day. I saw tons of Chinese physicians trying to move to America but zero case the other way. I am thinking about returning to China only because according to the feedback here it is very unlikely for me to be a physician in U.S. and I do have some connections and my entire family in China.

As for the Carib schools, so far what I heard from my connections is that Chinese medical institutions accept whatever US ones accept. So Carib MDs are technically acceptable though they are indeed at a disadvantage in comparison to American ones.

 

[TruthInMedEd]

Is there any similar requirement for MD schools?

I am not aware of any, but will defer to colleagues at LCME accredited schools.

 

[JStarMD]

I’m just going to tag @Goro @operaman @GoSpursGo (and everyone else) here. Maybe I’m getting a little jaded after seeing a lot of these dismissal threads lately, but I don’t think transferring is a viable option.

I’m just going to tag @Goro @operaman @GoSpursGo (and everyone else) here. Maybe I’m getting a little jaded after seeing a lot of these dismissal threads lately, but I don’t think transferring is a viable option.

Agree (and quite politely stated). Deans don't want to issue MOUs. Perfection and a major turnaround was due upon its issuance....and did not materialize. Your school's "had it".

 

[GoSpursGo]

Is there any similar requirement for MD schools?

I am not sure, but to put this as politely as possible there is no chance that you will manage to transfer to an MD school. I would put all of your eggs in the basket of hoping your current school lets you stay, even though that is ALSO a long shot at this point.

 

[YJ2022]

I am not sure, but to put this as politely as possible there is no chance that you will manage to transfer to an MD school. I would put all of your eggs in the basket of hoping your current school lets you stay, even though that is ALSO a long shot at this point.

By MD I include Carib schools, which technically also give MD degrees, my apologies for the confusion as always thanks for the information.

 

[Goro]

I know several people who were dismissed from prior programs who are in med school.

I can't argue with outliers.

 

[ortnakas]

Transfers are very rare, even among students with the most excellent of credentials. I wouldn’t put all your eggs in that basket.

 

[gyngyn]

Is there any similar requirement for MD schools?

Yes. Any school with a lick of sense has a 6 year limit with exceptions for MD/PhD.

 

[Gastrapathy]

that’s quite a thread. OP, your only shot is getting your school to let you stay. I can’t see how they will given that they seem to have constructed this whole “MOU” process to make it so they can claim you’ve resigned.

I guess I’d recommend sending the Dean a very short email “Dear Dr Dean, I understand my performance has been marginal. I have retaken level 2 and am awaiting the results. I would like to delay my voluntary resignation until the results are available in August. In the event that I pass the exam, could we meet to discuss if there is any way forward for me to complete my degree?
With Respect,
You

If they will meet with you, then you have some serious work to do to prepare for that meeting. Really convincing this one person is your only hope.

Finally, do you want to do this for a living? You might be happier if you moved on.

 

[YJ2022]

that’s quite a thread. OP, your only shot is getting your school to let you stay. I can’t see how they will given that they seem to have constructed this whole “MOU” process to make it so they can claim you’ve resigned.

I guess I’d recommend sending the Dean a very short email “Dear Dr Dean, I understand my performance has been marginal. I have retaken level 2 and am awaiting the results. I would like to delay my voluntary resignation until the results are available in August. In the event that I pass the exam, could we meet to discuss if there is any way forward for me to complete my degree?
With Respect,
You

If they will meet with you, then you have some serious work to do to prepare for that meeting. Really convincing this one person is your only hope.

Finally, do you want to do this for a living? You might be happier if you moved on.

Thanks very much for providing the template. After receiving the school's decision meeting I have had a meeting with the Dean where I said something very similar, which unfortunately did not make a difference. The template could still be helpful, however, if I am fortunate enough to achieve a passing score for the Level 2 I took earlier and decide to email the Dean one more time.

If "do this for a living" means trying to convince the Dean so that I can continue the path of medicine, I am more than happy to. Initially transferring from a Chinese college where I was learning Russian language, I had one additional transfer between U.S. colleges (not for reasons like what this post is about) before applying twice for medical school. Having stayed in a foreign country mostly by myself for over a decade solely for the goal of becoming a physician certified by the highest standard, I personally do not find exhausting all available options in the next year or two too unaffordable or unreasonable. On the other hand, ending the path at this moment would be the most unexpected and ironic matter to me.

 

[Goro]

Thanks very much for providing the template. After receiving the school's decision meeting I have had a meeting with the Dean where I said something very similar, which unfortunately did not make a difference. The template could still be helpful, however, if I am fortunate enough to achieve a passing score for the Level 2 I took earlier and decide to email the Dean one more time.

If "do this for a living" means trying to convince the Dean so that I can continue the path of medicine, I am more than happy to. Initially transferring from a Chinese college where I was learning Russian language, I had one additional transfer between U.S. colleges (not for reasons like what this post is about) before applying twice for medical school. Having stayed in a foreign country mostly by myself for over a decade solely for the goal of becoming a physician certified by the highest standard, I personally do not find exhausting all available options in the next year or two too unaffordable or unreasonable. On the other hand, ending the path at this moment would be the most unexpected and ironic matter to me.

*sigh* He meant "do Medicine for a living."

 

[YJ2022]

*sigh* He meant "do Medicine for a living."

Of course I would enjoy doing Medicine for a living if possible, like many people who visit SDN do. Otherwise I do not get why someone other than a troll would publicize his or her unprofessional mistakes in thousands of words for advice and sighs.

 

[epple]

No one's asked OP the Real Questions... Are you mentally stable enough to continue in medicine? Who are you doing this for? Why are you so defensive about your shortcomings? Why are you holding on so tightly to this plan? What is actually bringing you joy?

I feel emotionally drained and physically exhausted just reading this thread. I can only imagine how OP feels living all of this. This is a sunk cost predicament-- you feel like you've invested the time, energy, and resources, so you're forcing yourself to stick to some arbitrary plan. But with all this pressure mounting, your decision-making isn't at its clearest right now.

It might be a good time for some real introspection. Step away from SDN and all the forums. Reflect and reassess. If you continue in medicine, the stakes are only going to get higher.

 

[Suzukaze]

Thanks very much for the advice. Do you mind me asking if you have lived in China for long or have connections in the medical field there? Personally I do not recommend practicing medicine in China if you can do so in States or any other developed country. In public Chinese hospitals and clinics, which outnumber private ones, average wages for physicians could be 1/20 of with those of the same specialties in U.S. if you consider currency ratio. Housing is extremely unaffordable and majority of people are on life-long loans in major cities. Outpatient doctors rarely spend >5 minutes for one patient given the population. Schedules are much busier and one could scarcely expect a 9-5 day. I saw tons of Chinese physicians trying to move to America but zero case the other way. I am thinking about returning to China only because according to the feedback here it is very unlikely for me to be a physician in U.S. and I do have some connections and my entire family in China.

As for the Carib schools, so far what I heard from my connections is that Chinese medical institutions accept whatever US ones accept. So Carib MDs are technically acceptable though they are indeed at a disadvantage in comparison to American ones.

I have lived there up to the point where college started, and I do have multiple family members in the medical field, plus I don't really have an intention to remain in the US indefinitely since the beginning. Maybe residency but definitely not for life, and for my speciality in mind it's much harder to do residency stateside (still have to pump out research tho). Since I know I'll be happier back there it's not really a tough decision for me.

Anyways - it's off topic for this thread so feel free to PM me if you would like to, and good luck on your journey. I know it's a hard time for you and please take care of yourself. Best of wishes.

 

[Epicenter]

This is probably an unhelpful aside but why did OP wear the exact same tie, shirt, and pants every single day for over a month? The Dr. was reasonable in allowing/suggesting OP to wear scrubs because financial trouble is real. Even the most ill-fitting scrubs can be purchased from a thrift store for $10-20 and OP could have at least alternated those 2 outfits back and forth. I was sympathetic until OP stated they have ZERO debt and money isn't an issue...... WHAT?! Why then?? Even with the 30 pound weight loss OP could have purchased a single pair of Walmart brand scrubs. Some of the other things can be written off as medical issues/circumstance, but if you have money and choose to wear the same outfit everyday (very much hoping it was washed) it just seems like you could care less.

In the words of RuPaul's Drag Race's Bianca Del Rio, "what do you do successfully?" Not medical knowledge, not Step scores, not patient interactions, not clinical rotations, not looking professional. I think the school/Dean/Dr want to help OP succeed but give them something to make them want to fight for you.

 

[doctadank]

This thread just makes me wonder, can really anyone do medicine? OP I know you've worked hard to get to med school but it doesn't seem like you kept working hard once you got there. Are you absolutely sure you have to do this? I think you decided you wanted to do this and never considered alternatives.

If you're absolutely convinced this is the path for you, best of luck OP but it just feels like your character isn't suited well for medicine. Inability to stay awake for long periods of time, lack of emotional control, poor personal skills, and a strong self serving bias in retrospection. I will say that you don't seem like someone who gives up easily but at the same time neither do you come off as someone who is willing to put in the work needed to get where they want to be. I think you need to seriously look at yourself and ask, "would I want to be a patient of a doctor with my educational profile and history?" Like this isn't even an issue of feasibility at this point but maybe even ethics which I think might be why your preceptor refused to revise his eval.

I'm premed personally so take this with a grain of salt but your story has been a huge wake-up call for me that working hard won't stop for me the moment I get into med school.
Reading this thread gives me the impression that you care more about the status of medicine than treating patients but again that might just be me and I'm not even officially in the field of medicine.

 

[YJ2022]

No one's asked OP the Real Questions... Are you mentally stable enough to continue in medicine? Who are you doing this for? Why are you so defensive about your shortcomings? Why are you holding on so tightly to this plan? What is actually bringing you joy?

I feel emotionally drained and physically exhausted just reading this thread. I can only imagine how OP feels living all of this. This is a sunk cost predicament-- you feel like you've invested the time, energy, and resources, so you're forcing yourself to stick to some arbitrary plan. But with all this pressure mounting, your decision-making isn't at its clearest right now.

It might be a good time for some real introspection. Step away from SDN and all the forums. Reflect and reassess. If you continue in medicine, the stakes are only going to get higher.

Answers to the Real Questions are: The two psychiatrists and one therapist I have seen since March never discouraged me from continuing in medicine. If by "this" you mean "continue in medicine," then I am doing it for for patients, as most docotors are, for my family and friends who support my dream of becoming a physician, and for myself with that aspiration. I have been trying to be as objective as possible by, for example, posting the entirety of that preceptor's evaluation. Otherwise, being defensive makes some sense to me as I cannot stop but try to finding something to beg for mercy. If there are less defensive way to present my case, I am more than happy to learn about it. Could be seriously helpful for "why transfer." As you mentioned in your second paragraph, a lot has been invested for so long to this plan of becoming a doctor. Plus it does bring me joy to address patient's concerns, heal their pain, and achieve self-realization through patients' positive feedback.

Trying to do some real introspection is part of why I posted here and continue to respond to all responses that do not seem to help me defend at all to me. You are right and from now on I would refrain from putting down responses unless I feel the necessity to address a specific question or I have any major update for the case.

 

[YJ2022]

This is probably an unhelpful aside but why did OP wear the exact same tie, shirt, and pants every single day for over a month? The Dr. was reasonable in allowing/suggesting OP to wear scrubs because financial trouble is real. Even the most ill-fitting scrubs can be purchased from a thrift store for $10-20 and OP could have at least alternated those 2 outfits back and forth. I was sympathetic until OP stated they have ZERO debt and money isn't an issue...... WHAT?! Why then?? Even with the 30 pound weight loss OP could have purchased a single pair of Walmart brand scrubs. Some of the other things can be written off as medical issues/circumstance, but if you have money and choose to wear the same outfit everyday (very much hoping it was washed) it just seems like you could care less.

In the words of RuPaul's Drag Race's Bianca Del Rio, "what do you do successfully?" Not medical knowledge, not Step scores, not patient interactions, not clinical rotations, not looking professional. I think the school/Dean/Dr want to help OP succeed but give them something to make them want to fight for you.

My side of the story (admit that I could recall things wrong or even subconsciously omit something unfavorable to me for a rotation that happened last year): On day 1 my plan is to pick one each from my two ties, two shirts, two coats, and two pair of pants. Wash them the same day after returning home. Afterwards wear the others and again wash them same day. Then switch back to my intitial pick on day three. The two ties have the same color of blue. One shirt is white the other light blue. Two coats have exactly the same design as I ordered both from school. Both pairs of pants black. The preceptor soon realized the pattern early in the frist week and then recommended the follows: five coats/scrubs. No verbal comments about shirt, tie or pants to the best of my memory. Personally I prefer coats, as the hospital building was cold and I find it more convenient to use the multiple larger pocket of a coat to carry the handbooks, a notepad, and multiple pens, which the preceptor recommended me to bring in addition to my phone (in case I did not miss interview invitation emails) wherever I go. The preceptor voiced understanding of my preference and is fine with my continuing the alernation of outfits until new coats I ordered online arrive in the second half of the rotation. Later he praised on the new coats, and the attire matter was never mentioned until the last self-assessment session by the end rotation, where he recognized the change but add something like "you should have a different coat on every single day of same week to begin with, and keep on improving your ironing skills."

By the way, I am not that rich or spoiled to not worry about money at all. I prioritize on having no debt (which turned out to be something very beneficial for the current situation), at the cost of an average monthly expenditure of no more than $1000 for everything including housing, despite living within an hour from a metropolis.