Attempts and gaps

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I have been browsing the SDN forums for some time, mostly USMLE prep forums.

Here are my 4 questions, if you don't want to read the full details:
1. What speciality should one focus on, if there is a huge gap since graduation?
2. What speciality should one focus on, if there are USMLE attempts, with huge gap between attempts?
3. Is it important to mention attempts on CAF & CV? i.e., the attempts are there on transcript anyway, is it good idea to highlight them again in CAF & CV.
4. Is it important to explain attempts & gap in PS?

Now the details.:
Graduated from med-school in 1995, diploma in 1996. After final exam in 1995, a friend asked me to accompany her for USMLE Step2 exam. I had no plans to move to USA. She paid my fee and I tagged along. I didn't study & thought I knew it all. Ranked 4th in class final, but failed Step2. I didn't care much and went on to finish residency, 6 month in Medicine, 12 months in ObGyn. Started a private clinic. As luck would have it, I met my husband who worked in high-tech startup in USA. Got married, and moved to USA in 1998. He asked me to take USMLE. Being pregnant, I was not interested in taking exam, but took Step1 anyway after few weeks of half-hearted prep and failed. This was the end to my medical career.

9 years later...2007... 3 kids, US citizen, full-time soccer-mom, husband's dot-com bubble burst. When my youngest-one started KG, I decided to get back into medicine. Things had changed a lot. With Internet, forums, etc... I found a lot of information, and decided to take steps again. I knew it won't be easy with family life, plus I had to include text books like Guyton/Robbins/Harrison in my study plan. Still with full determination started my studies in Dec-2007.....Today...I am done with my Step1 240/99, Step2 258/99, CS, Step3 219/92. All within 11 months. This year I have also done 6+ months of externship in private clinics & hospital and have 4 US LORs. Now planning for 2010 Match. My dream is ObGyn but I am not sure how realistic is that. Sometimes I wonder if getting any residency is realistic, considering the fact that I will be 39 soon!


Your scores are great and with these scores your previous attempts will not be much issue as, you were not familiar with US exam system, 1995 was start of internet so you could not get advice with cyber people like this one, now you are here and you have passed them recently. There is latest NRMP report out there which mention all step scores for US seniors and FMG/IMGs who got into match. I think OBGYN is on the lower end. Only negative I think is your date of graduation and gaps in resume. This by the way is very big only.

I heard there are few family friendly programs in California which let you take a break from residency to raise family or produce family so you finish residency one year later. This by the way was IM program and hospital was in San Francisco area. So you may want to start reading all such program/hospitals which have family friendly residency program.
 
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I have been browsing the SDN forums for some time, mostly USMLE prep forums.

Here are my 4 questions, if you don't want to read the full details:
1. What speciality should one focus on, if there is a huge gap since graduation?
2. What speciality should one focus on, if there are USMLE attempts, with huge gap between attempts?
3. Is it important to mention attempts on CAF & CV? i.e., the attempts are there on transcript anyway, is it good idea to highlight them again in CAF & CV.
4. Is it important to explain attempts & gap in PS? QUOTE]

1. OBGYN, FM, peds, cand Psy are not very competitive, but with health care reform (if it get passed) you might have better days ahead. Actually FM program like people with OBGYN back ground or interest.

2. Same as one. Forget about failure it is done can't change. You have done it and done it very well. See some of the excuses which I have mentioned in my earlier post and don't mention any thing in your CV or personal statement. Only if asked in interview.

3. No need to mention it is already in transcript.

4. I would focus on gap in PS and find a damn good excuse.

Do you have only 1 failure attempt in each exam?
 
I honestly don't know how you will do.
I think that you can definitely get a job in health care...if the residency thing does not work out, you could go for PA school but that would take another 2-3 years.

I think that being out of school and practice for so long is a bigger deal than the failed steps, although the failed steps are also bad. The failed steps are probably less of a big deal because you now proved that you could pass all of them, and your scores on the I/II are also high.

I think the fact that you already did a residency in your country and have practiced for a little while is a plus. It's not like somebody who never did ANY internship or residency and now wants to get back into things. So that, along with the 6 months externships you have done, is what I would focus on in your personal statement if I were you. Also you need to discuss what you now plan to do with your career. It sounds like you have a lot of enthusiasm for ob/gyn so I think that you should just go for it...you probably should ask on the ob/gyn forum what your chances might be, though, and even seek advice from an ob/gyn program director or attending if you can find one in your area. You could consider cross-applying to both ob/gyn and family practice...like someone mentioned above, some fp programs love people with interest in OB and you have experience actually doing ob/gyn, it sounds like.

I just want to warn you, but you probably already know, that ob/gyn is kind of a rought lifestyle. I don't know that I'd want to do it with 3 kids, but that's just my personal opinion. I don't know that fp with OB would be much better, although at least the residency is easier and there is less need to do surgery with all the associated getting up and rounding super early in the a.m.
 
Please try to understand, gap is not bigger deal it is very big deal.

First PD has to get pass the situation, year of graduation which is 1995 and it will be 15 years since you graduated.

Other things I could be worry. Clearly you gave preference to your family (nothing wrong with that), if I am PD I would ask if a new situation arises sickness in family, hubby found a job else where, would you run away or say committed to your residency program. OBGYN is a long residency and more harder than FM.

Once you pass USMLE scores either with low grade or high grade, it is over and you can't change that so try to focus on other stuff which you can change. In your case you did very well on USMLE.

Game plan:

First try to make an appointment with PD in your area. Do it now and have a feel so you know where do you stand. Most people in USA don't pay much attention to your transcript from medical school unless it is full of red flags.

If you can't get into residency this year, consider doing MPH. Believe me that will change your fortune a lot. You can do MPH in one year and being a US citizen you will eligible for a grant which may cover full or half of your school fees. Remember grant is given for research project not to do MPH. So you can do MPH as a part of research project not to do MPH and conduct research associated with it. I hope you understand what I am trying to say.
 
My understanding is, OBGYN is not very competitive and most FMGs choose IM because they don't want to do OBGYN any way. I think OBGYN is as competitive as IM so you will be fine with OB and FM programs.

Q. Do you have any contacts, friends, former classmates in medical field who will be willing to make phone calls for you?

Probably you still don't understand. Because you are almost 15 years old graduate and have not practiced medicine or worked much in a health care field since graduation except 1.5 years of clinical work, you may not be eligible or may have difficultly getting a medical license in some states.

You have taken step 3 so I assume you are familiar with that website, go to state licensing chart and click one state after another, as it will take you to the state medical license website. Then either read that info carefully or print them out.

Q. Do you have geographic limitation? If yes then go to those states alone. So save some money by not sending your application in those states where you clearly or will have difficulty getting medical license. No program director will risk hiring you where you may have difficulty getting a license. I think you will have to climb a rock in order to get a medical license in the states such as IL. My information is not fresh. Many people start from present and go into future like take USMLE, apply for residency and medical license. Since you are a special case (sorry for the harsh words but it is reality) so start working from the future and go backwards.
 
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There are certain programs who don't seem to care about the gap as long as the scores are great. I know someone ( FMG ) who had a gap of 8-9 years who just got into an internal medicine residency.
 
I went through the list and after going through all of the states, including IL, I did not find a single reference to gap and it's relationship to getting/starting residency or license. Some states do ask to explain gap in medical education, i.e. if med-school is 4 years, and applicant has taken 6 to finish it. Most states do have requirements for all 3 USMLE Steps to be taken within 7-10 years to be eligible for license.

For someone like you, having taken all 3 steps within a short period of time, the issue with the gaps is not in licensure.

Many programs (not states) will specify that they do not accept applications from people X number of years after graduation. 5 is the most commonly bandied about number. For those who have been working in the medical field ((ie, an attending from another country, someone doing another residency), this requirement is usually lenient. However, for someone like you with essentially no clinical experience for 15 years, it will be much harder.

Your USMLE scores are impressive however and I hope someone gives you a chance. It may behoove you to check with programs to see if they do indeed have such a limit before applying.
 
I have a score of 209,226 passed cs in first attempt ad gap of 2 years.I want to do pathology.Currently doing observership. YOG is 2010.Two publications.how much does that hurt my chance?Thanks in advance.
 
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