Career Options w/o Residency

[thrownawayx2]

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Hey guys, I'm looking for some long-term career ideas and desperate for any feedback.

HPI: 2015 Canadian Carib grad from SGU, applied twice already for the match (2015 & 2016), failed to match both times. First time around I did not get my CK re-score back till December, got one FM interview after my scores went and did not match. Needing a visa is a much bigger impediment than I ever could have realized.

My USMLE scores are: step 1 -- 212, step 2ck -- 244 (second attempt), step 2 cs passed, step 3 -- 203

After not matching, I enrolled in an MBA in Multi-Sector Health Management offered by SGU, and got my step 3 done. Decided to apply again for this year for the 2016 match. Interviewed at 5 FM programs, 1 IM, and 1 Psychiatry but once again failed to match. Had 7 ranked and at this point not sure if it's me or the match itself that's at fault.

I've been through this twice now. Got massive loans that need paying off and not sure I can afford to go throw it a third time. I'm looking for any feedback into whether I should give it another shot. I don't have any fresh clinical experience since graduating medical school, and all my LORs are from my clerkships in 2014-2015. There are third-party private companies that offer externships and observerships for $800-$1,000 USD PER WEEK. I'm not sure if I should even consider doing those for more experience and apply again a third time for FM/Psych/ IM.

Aside from the match, I was looking for any ideas as to what I can do with my MD/MBA degree going forward. I live in Canada but I'm assuming career options are pretty much similar to what one can do in the US. Just hoping someone can respond to this post or PM me for some advice, everything looks pretty bleak right now ....

 

[Law2Doc]

Hey guys, I'm looking for some long-term career ideas and desperate for any feedback.

HPI: 2015 Canadian Carib grad from SGU, applied twice already for the match (2015 & 2016), failed to match both times. First time around I did not get my CK re-score back till December, got one FM interview after my scores went and did not match. Needing a visa is a much bigger impediment than I ever could have realized.

My USMLE scores are: step 1 -- 212, step 2ck -- 244 (second attempt), step 2 cs passed, step 3 -- 203

After not matching, I enrolled in an MBA in Multi-Sector Health Management offered by SGU, and got my step 3 done. Decided to apply again for this year for the 2016 match. Interviewed at 5 FM programs, 1 IM, and 1 Psychiatry but once again failed to match. Had 7 ranked and at this point not sure if it's me or the match itself that's at fault.

I've been through this twice now. Got massive loans that need paying off and not sure I can afford to go throw it a third time. I'm looking for any feedback into whether I should give it another shot. I don't have any fresh clinical experience since graduating medical school, and all my LORs are from my clerkships in 2014-2015. There are third-party private companies that offer externships and observerships for $800-$1,000 USD PER WEEK. I'm not sure if I should even consider doing those for more experience and apply again a third time for FM/Psych/ IM.

Aside from the match, I was looking for any ideas as to what I can do with my MD/MBA degree going forward. I live in Canada but I'm assuming career options are pretty much similar to what one can do in the US. Just hoping someone can respond to this post or PM me for some advice, everything looks pretty bleak right now ....

Sounds like medicine is out. No idea what you can do with an offshore MBA in Canada, but that's probably your best bet. Something in pharmaceutical sales maybe?

 

[NotAProgDirector]

Several thoughts. First:

Had 7 ranked and at this point not sure if it's me or the match itself that's at fault.

It's not the match that's at fault. The match works just the way it is supposed to. Unfortunately there are more applicants than spots, so not all applicants will get a spot. Even without the match, your results might be the same. Not saying this to cause pain, but just to be realistic -- and also if you try to blame the match, programs will see that poorly.

Your options with an MD and no clinical training are not good. There are many threads about this, but the practical training you get in residency is critical. Some have argued that medical school should include a clinical year at the end that qualifies you to work in primary care, and residency would be for other fields -- whether that's a good or bad idea is debatable.

Your story is the unfortunate side of the Caribbean IMG story. There are many, many successful carib grads on this board, and several in my program. They can outperform my AMG's. But there are a good number of Carib IMG's that run into trouble, and hit a brick wall of being unable to get a residency spot. Failing the USMLE, a poor score on Step 3, and needing a visa are all working against you, as is the extended time now from your graduation. Unfortunately, an MBA is only as good as the school from which you get it, and no one is going to be impressed by SGU.

So, what to do? When you search threads like this, the ideas of "consulting" or "pharma" often come up, but I don't know how realistic either is with your background. More clinical exposure would be great, but I am equally leary of these companies that sell clinical exposure -- I expect most of them will pawn you off on a community based doc which won't really help your application.

I honestly wish I had more concrete advice for you. If there is a training program near where you live, see if you can volunteer and get some clinical exposure. If you know any local physicians, same plan. If anyone owes you favors, call them in. I assume you applied to a large number of programs -- if not, that's in your future. You might be able to get some sort of a clinical research position. You could try to get an admin position in a practice, but this won't help you get a residency. You're in a tough spot.

 

[thrownawayx2]

It's not the match that's at fault. The match works just the way it is supposed to. Unfortunately there are more applicants than spots, so not all applicants will get a spot. Even without the match, your results might be the same. Not saying this to cause pain, but just to be realistic -- and also if you try to blame the match, programs will see that poorly.

Your options with an MD and no clinical training are not good. There are many threads about this, but the practical training you get in residency is critical. Some have argued that medical school should include a clinical year at the end that qualifies you to work in primary care, and residency would be for other fields -- whether that's a good or bad idea is debatable.

No pain caused, and you're right. Did not mean to put blame on the matching algorithm or even the quantity/quality of fellow applicants. I took the Carib gamble and I think didn't make it through. Fully cognizant of the fact that simply applying again is not going to increase the odds or anything. Gets tougher and I'll be competing against all the IMG leftovers that didn't match this year along with fresh grads.

My dilemma now is yes the Carib gamble did not pay off. Odds are much worse now. I pretty much exhausted my personal network and contacts this time around, no idea how to even approach them again asking for more favors and explaining I'm facing the same scenario.

At the same time perhaps I'm at fault for not having a backup plan going into this. I can't imagine in anything like 'pharma' or 'consulting' . Feel those are just healthcare buzzwords lacking much of substance.

Is a Step 3 score of 203 a red flag in and of itself or is it at least a bonus having it passed? Yes visa does not help the situation, and fully aware it's compounded now by lengthy gap, and below-par USMLE performance.

Despite that, I feel there has to be some way to squirm and slide my way into a lower-tier program. I suppose now the decision to be made is whether I should abort before suffering further losses or keep chasing the dream.

Appreciate the response, and no need for concrete advice -- I'm just looking for some medium to express my thoughts and this is helping a bit I suppose.

 

[gutonc]

So...after being let down by your SGU degree once, you decided to double down (and, presumably drop another $50K) and get another degree...and are now unmatched x2.

You're in a tough spot, and I won't pretend to have a good answer for you.

At the very least you have insight into the fact that you're unlikely to score a "consulting" or "pharma" gig, regardless of whether or not you'd want one.

At this point, IMHO, your best bet is to go all in to the Match a 3rd time (really a 2nd time...and assuming you have no success in SOAP). You said you had 7 FM interviews...but didn't note the number of programs you applied to. If that number is any less than "all of them", you need to apply to "the rest of them" next year.

As to what to do with this year (if you don't succeed in SOAP), feel free to send me half of what you'd pay those "externship" companies and I promise to provide you with exactly the same benefit for your next application...and you won't even have to leave your living room.

 

[thrownawayx2]

So...after being let down by your SGU degree once, you decided to double down (and, presumably drop another $50K) and get another degree...and are now unmatched x2.

You're in a tough spot, and I won't pretend to have a good answer for you.

At the very least you have insight into the fact that you're unlikely to score a "consulting" or "pharma" gig, regardless of whether or not you'd want one.

At this point, IMHO, your best bet is to go all in to the Match a 3rd time (really a 2nd time...and assuming you have no success in SOAP). You said you had 7 FM interviews...but didn't note the number of programs you applied to. If that number is any less than "all of them", you need to apply to "the rest of them" next year.

As to what to do with this year (if you don't succeed in SOAP), feel free to send me half of what you'd pay those "externship" companies and I promise to provide you with exactly the same benefit for your next application...and you won't even have to leave your living room.

No, they offer 100% waived tuition for their MPH or MBA for graduates that fail to match in order to help keep them competitive and allow for diversified career options. MPH involves going back to the island for a year, MBA you can do from home.

Again, not looking for good answers that will boost my morale but more so for some sage advice from those more learned and experienced.

Wouldn't say I applied to all of them, but the vast majority of the one's that qualified for my narrowed criteria: accept visas, allow attempts, met my score cut-offs.

And no those third-party companies are a definite no-no. They're for people without any US clinical experience desperate for any LORs they can get their hands on. I'm better off just arrange clinical placements with folks I've rotated with over my two years of medical school.

I still feel I have a legitimate shot to squirm and slide my way into one of the lower-tier programs out there, and two years removed from graduation keeps me in the mix for most programs with regards to consideration criteria. But obviously that would count against me relative to fresher applicants.

 

[gutonc]

Your criteria for applications going forward should be "accepts applicants who are currently breathing, either on their own or with assisted ventilation".

 

[thrownawayx2]

Your criteria for applications going forward should be "accepts applicants who are currently breathing, either on their own or with assisted ventilation".

Trust me, I have no aspirations of matching into Man's Best Hospital.

 

[Gavanshir]

Try again. It is your best chance and all hope is not lost. Giving up on your SGU degree should not even be an option or consideration. Work on your PS and make as many connections as you can. You never know who can be helpful to you.

Also why arent you trying to SOAP this year?

Sent from my SAMSUNG-SM-N910A using SDN mobile

 

[NotAProgDirector]

At least the MBA didn't cost you anything. That's good.

I agree it's probably worth one more round of applications. In the meantime, you need some sort of income. ideally would be medical related. Maybe medical transcription? Or working in a hospital in some capacity? Or clinical research. You'll need to be creative.

The best thing would be exposure to a reasonable program -- reasonable as-in the type of program you could get into. Exposure at Man's Best Hospital isn't going to help much, unless you can get a killer LOR out of it. The best option is exposure at a smaller, community based program where you get to know the PD. Maybe ask if you can come to morning report / teaching conferences. Or see if there is any way you can do an observership. Etc. Unfortunately, none of this is likely to be paid -- so you'll need to do this on top of some other income creating job. Because you'll need another pile of cash to apply in ERAS again next year.

 

[Henle's Loop]

Several thoughts. First:

Thank you for the honest reply. I've always lurked on this site and never have actually posted, I have sent you a private message - I think it will be found on the inbox. If you had any suggestions, that would be really appreciated. Thank you again.


It's not the match that's at fault. The match works just the way it is supposed to. Unfortunately there are more applicants than spots, so not all applicants will get a spot. Even without the match, your results might be the same. Not saying this to cause pain, but just to be realistic -- and also if you try to blame the match, programs will see that poorly.

Your options with an MD and no clinical training are not good. There are many threads about this, but the practical training you get in residency is critical. Some have argued that medical school should include a clinical year at the end that qualifies you to work in primary care, and residency would be for other fields -- whether that's a good or bad idea is debatable.

Your story is the unfortunate side of the Caribbean IMG story. There are many, many successful carib grads on this board, and several in my program. They can outperform my AMG's. But there are a good number of Carib IMG's that run into trouble, and hit a brick wall of being unable to get a residency spot. Failing the USMLE, a poor score on Step 3, and needing a visa are all working against you, as is the extended time now from your graduation. Unfortunately, an MBA is only as good as the school from which you get it, and no one is going to be impressed by SGU.

So, what to do? When you search threads like this, the ideas of "consulting" or "pharma" often come up, but I don't know how realistic either is with your background. More clinical exposure would be great, but I am equally leary of these companies that sell clinical exposure -- I expect most of them will pawn you off on a community based doc which won't really help your application.

I honestly wish I had more concrete advice for you. If there is a training program near where you live, see if you can volunteer and get some clinical exposure. If you know any local physicians, same plan. If anyone owes you favors, call them in. I assume you applied to a large number of programs -- if not, that's in your future. You might be able to get some sort of a clinical research position. You could try to get an admin position in a practice, but this won't help you get a residency. You're in a tough spot.

 

[jonb12997]

Working for an insurance company doing billing/coding type stuff of some sort?


Sent from my iPad using SDN mobile

 

[rokshana]

So...after being let down by your SGU degree once, you decided to double down (and, presumably drop another $50K) and get another degree...and are now unmatched x2.

You're in a tough spot, and I won't pretend to have a good answer for you.

At the very least you have insight into the fact that you're unlikely to score a "consulting" or "pharma" gig, regardless of whether or not you'd want one.

At this point, IMHO, your best bet is to go all in to the Match a 3rd time (really a 2nd time...and assuming you have no success in SOAP). You said you had 7 FM interviews...but didn't note the number of programs you applied to. If that number is any less than "all of them", you need to apply to "the rest of them" next year.

As to what to do with this year (if you don't succeed in SOAP), feel free to send me half of what you'd pay those "externship" companies and I promise to provide you with exactly the same benefit for your next application...and you won't even have to leave your living room.

have to say something...his sgu degree is not what failed him...his red flags are the issue...low step 1 failed CK, and low step 3 and visa requiring...

but even then he had 7 interviews...meaning that there WERE programs that looked beyond those stats and extended an interview...but some how did not get ranked (or ranked high enough to match)...so OP you need to ask yourself what happened? and how are you going to fix it?

you need to try to talk to some of these places that interviewed you (after SOAP, PDs are busy right now) and find out if they will give you feedback...and then see what you need to do to polish your interview skills.

have you looked to see if there is ANYTHING in Canada? you can take the exams that Canada requires and see if you can get better scores...hopefully that would hold greater weight than the US exams...maybe do some research in Canada?

 

[waldenwoods]

The ED physicians at the hospital where I work have employees called "scribes" who document in the ED note template on the EMR while the ED physician interviews and examines a patient. The scribe is in the room with the ED physician and patient. It involves work, and a scribe's attention might be on documenting rather than observing the clinical interaction, but it is in some ways like shadowing. And it might lend itself to getting to know physicians and for physicians getting to know you, which may possibly create a good foundation for obtaining a recommendation later. I don't know what the minimum requirements for the job would be, but it might be worth considering.

 

[thrownawayx2]

Yeah a scribe job and even a health insurance gig are thoughts I've considered as sources of income. More I think about it and based on the feedback I've gotten here and from advisors it's a bit early to throw in the towel just yet. Being two years removed from graduation, while a definite cause for concern, still falls within most program's stated criteria (actually I would wager to say all of the ones I've ever come across). What's gonna matter at the end of the day is how I spend the next little while, and drowning away in self-pity is just gonna get in the way.

What is the general response PDs have from applicants they interviewed but did not rank highly when those candidates ask for feedback on their application and performance? I will for sure reach out and ask but not sure what exactly to expect as a response.

Another quick question. A couple of you had mentioned my step 3 result as a red flag, from what everyone else has told me its a bonus just to have it passed. Is it actually hurting my application in a way that I would have been better off never taking it in the first place? or is it more that it doesn't exactly inspire confidence given my step 1 score and ck attempt...

 

[tatsuchi]

Taking the Step 3 is a double edged sword, which all depends on the background you're coming from.

If you are a good applicant on paper who missed the Match because they may have made 1-2 minor stumbles along the way but decent scores, LORs, etc... passing the Step 3 is a sign to potential programs that "hey, I'm all set for residency, you don't have to worry about me failling Step 3 and potentially not being able to be licensed like the other interns, just pick me up and off we go!"

If you are less than favorable applicant (no mincing words, you fall into this group), the point of the Step 3 is to show you improved on your mistakes on the previous exams or other weaknesses in your applications. The idea is to score high enough to demonstrate competency and impress programs with your scores to hopefully lessen the blow of your poor failings on the previous two Steps.

 

[Law2Doc]

I actually don't think a passing score on Step 3 hurts the OP here. Not matching in a couple of cycles is the big hurdle because it makes future PDs concerned that even if they don't personally see what's so wrong with the OP, they know two other cycles (plus SOAPs) of PDs found something to keep him out.

It's really the "psychology of desirability" that's hurting the OP now. If others see value in something/someone, you'll want it/them more, and vice versa.

 

[azhrei]

You could attempt to transition into tech startups or companies needing an MD's clinical expertise. Learning to code might help as well, but that is another investment of $$$.

 

[caffeinemia]

Taking the Step 3 is a double edged sword, which all depends on the background you're coming from.

If you are a good applicant on paper who missed the Match because they may have made 1-2 minor stumbles along the way but decent scores, LORs, etc... passing the Step 3 is a sign to potential programs that "hey, I'm all set for residency, you don't have to worry about me failling Step 3 and potentially not being able to be licensed like the other interns, just pick me up and off we go!"

If you are less than favorable applicant (no mincing words, you fall into this group), the point of the Step 3 is to show you improved on your mistakes on the previous exams or other weaknesses in your applications. The idea is to score high enough to demonstrate competency and impress programs with your scores to hopefully lessen the blow of your poor failings on the previous two Steps.

Lesson for future applicants who stumble onto this -- step 3 is really a test about what you learned as an intern. It's showing that you can function at the most basic level in a clinical setting. Interesting choice to have taken it before residency...

 

[ThoracicGuy]

Hello everyone,

I am also in the similar spot as the OP. I'll be graduating this May, Carib US-IMG. My Step 1: 194 second attempt), Step 2: 216 (second attempt), but have excellent grades and LOR. Did not get a single interview and I am afraid that will be same story during SOAP. I believe I am a hard working student and not a slacker. My poor scores in USMLE exams are due to serious anxiety issues (I do feel impending doom prior and during exams). But I am not using that as an excuse and I take full responsibility for my poor scores. I know after one failure I should have found a way to do better and I am certain that I will. What are my options.

Like I mentioned I am an US citizen. I was considering taking Step 3 and hopefully doing very well and apply again next year. But what should I do in the mean time to increase my chances? I have a volunteer vascular surgery research assistant offer from a near by University program, but the problem is my $200k loan is about to start on repayment. So i need to find a way to get some income. Due to my poor scores I i'll be applying for IM and FM programs during next match. Will the vascular surgery publications help my case? What else should I do to improve my chances? Going to Gutemala and Haiti for medical trips help my case? I am extremely disappointed right now, but I am not ready to give up on my dream.

Medical trips overseas are unlikely to be of much benefit.

 

[randomcollusion]

I'm an unmatched x1 (looking like x2) AMG grad who made the genius decision of taking Step 3 after having scored pretty decently on Step 1 and Step 2 first try. It is very much an intern exam, and interns will say it's easy because internship makes it easy. They say to study for it for a few weeks and you'll do fine.

This is true for interns only. For people who have not had an internship, it is a real exam requiring real intensive study of real skills that medical students usually don't have a chance to develop to the level of interns. And it's not even a difficult exam; it's just a muscle memory test for interns that have seen the same thing over and over 50 times. But because I underestimated it, I probably failed it, and scuttled what was once a pretty good exam record and possibly my hopes of becoming a physician.

Don't do this to yourself. If you do step 3 prior to residency, study the heck out of it. Don't forget that the CCS cases, in addition to the simple knowledge tests, are a big part of it, and while they may not look challenging at first pass, remember that they are fill in the blank tests and not multiple choice tests. Strategies of sorta kinda knowing the answer and eliminating distractors do not work for this section. Repetition and moving the recall of basic tests from your brain to your fingers works for this section. Don't listen to any resident or intern who tells you this part is easy and it is just a "get it over with" test; this test is easy for people forced to do it hundreds of times and nobody else.

 

[Arcan57]

Yeah a scribe job and even a health insurance gig are thoughts I've considered as sources of income. More I think about it and based on the feedback I've gotten here and from advisors it's a bit early to throw in the towel just yet. Being two years removed from graduation, while a definite cause for concern, still falls within most program's stated criteria (actually I would wager to say all of the ones I've ever come across). What's gonna matter at the end of the day is how I spend the next little while, and drowning away in self-pity is just gonna get in the way.

What is the general response PDs have from applicants they interviewed but did not rank highly when those candidates ask for feedback on their application and performance? I will for sure reach out and ask but not sure what exactly to expect as a response.

Another quick question. A couple of you had mentioned my step 3 result as a red flag, from what everyone else has told me its a bonus just to have it passed. Is it actually hurting my application in a way that I would have been better off never taking it in the first place? or is it more that it doesn't exactly inspire confidence given my step 1 score and ck attempt...

Being a scribe is sort of an ok way to get some sort of clinical experience to get into med school. It pays an unlivable wage and isn't going to make PDs look more favorably on your application. Although there are more university programs that are using scribes, it's unlikely that the community pit doc you'll be working with at most scribe jobs is going to have any influence in terms of residency especially non-EM ones.

 

[Perrotfish]

Hey guys, I'm looking for some long-term career ideas and desperate for any feedback.

HPI: 2015 Canadian Carib grad from SGU, applied twice already for the match (2015 & 2016), failed to match both times. First time around I did not get my CK re-score back till December, got one FM interview after my scores went and did not match. Needing a visa is a much bigger impediment than I ever could have realized.

My USMLE scores are: step 1 -- 212, step 2ck -- 244 (second attempt), step 2 cs passed, step 3 -- 203

After not matching, I enrolled in an MBA in Multi-Sector Health Management offered by SGU, and got my step 3 done. Decided to apply again for this year for the 2016 match. Interviewed at 5 FM programs, 1 IM, and 1 Psychiatry but once again failed to match. Had 7 ranked and at this point not sure if it's me or the match itself that's at fault.

I've been through this twice now. Got massive loans that need paying off and not sure I can afford to go throw it a third time. I'm looking for any feedback into whether I should give it another shot. I don't have any fresh clinical experience since graduating medical school, and all my LORs are from my clerkships in 2014-2015. There are third-party private companies that offer externships and observerships for $800-$1,000 USD PER WEEK. I'm not sure if I should even consider doing those for more experience and apply again a third time for FM/Psych/ IM.

Aside from the match, I was looking for any ideas as to what I can do with my MD/MBA degree going forward. I live in Canada but I'm assuming career options are pretty much similar to what one can do in the US. Just hoping someone can respond to this post or PM me for some advice, everything looks pretty bleak right now ....

Just a thought, have you ever considered joining the military as a healthcare administrator? I think you MBA would qualify you for the medical service corps. Also the MD would certainly be an asset for an administrator, though you wouldn't be able to serve as a physician.. The requirements are listed in the link below, you can see if you meet the accredidation requirements.
https://www.navycs.com/officer/msc.html

 

[thxleave]

Interesting...

Was thinking career change too...

SGU
2016 US Citizen
Step 1 23x
Step 2CK 22x
Step 2CS 1st pass

Didn't match also this year in Psychiatry. Thanks!

 

[rokshana]

what is the point of the 23x? like it makes a difference if you post your actual score...

while that drop from step I can be a red flag, did you not apply very widely? Psych isn't crazy competitive...

 

[thxleave]

what is the point of the 23x? like it makes a difference if you post your actual score...

while that drop from step I can be a red flag, did you not apply very widely? Psych isn't crazy competitive...

Alright roksahna... details!

Step 1 235
Step 2 225

 

[thxleave]

I applied to all the Psych places that had a carib/FMG in their residency spots. 100 Psychiatry Places, and 10 FM places near home in November when I had 6 IV's in Psychiatry only.
*For Step 2CK drop... UWSA and NBME said I was going to get 240's-250's

Ended up with 10 Psych IV's and 2 FM

So far was able to ask all my 4th year attending to write me general specialty LORs since I think I will be applying to IM/FM......*Gotta get new LORs, since all of them says I want to do psychiatry
Not sure about Step 3... Already started studying, hear contrasting advice whether to take it or not.
Enrolling on an online MPH, since I did the interest calculations. It's cheaper to do online MPH with the student loan deferment.....
I have a case study ready to be done with one of my LOR writers.....

Feedbacks on IV was due to my heavy medicine electives they doubt my passion towards Psychiatry.... ICU, Pulm, Cardiology, GI, Endocrine.... I thought 4th year electives was to get exposure to fields. So I figure if my CV looks good for IM, might as well go for it. Since I did like my medicine electives.......

 

[blue0rchid]

i thought psych was pretty competitive this year. I have a friend, AMG, 11-12 interviews for psych and didn't match. :-(

OP, you will need your LOR tailored to psych. If you have heavy medicine electives, and no psych specific LOR, it seems like psych is an afterthought. MS4 is to get exposure to fields, but the beginning is to get letters in your specialty for residency. Even so, 10 psych interviews should be enough, unless you couldn't convince them during the interview that you're passionate about psych. Once they invite you for interview, they already overlook your LORs and electives. But you absolutely need to convince them that you chose psych as primary even though your application may not indicate that. You may need to work on interview skills, and get psych LOR.

 

[thxleave]

i thought psych was pretty competitive this year. I have a friend, AMG, 11-12 interviews for psych and didn't match. :-(

OP, you will need your LOR tailored to psych. If you have heavy medicine electives, and no psych specific LOR, it seems like psych is an afterthought. MS4 is to get exposure to fields, but the beginning is to get letters in your specialty for residency. Even so, 10 psych interviews should be enough, unless you couldn't convince them during the interview that you're passionate about psych. Once they invite you for interview, they already overlook your LORs and electives. But you absolutely need to convince them that you chose psych as primary even though your application may not indicate that. You may need to work on interview skills, and get psych LOR.

You are right though. At this point I am switching gears to FM and IM. Psych was originally primary goal, but with my heavy electives, and more case studies in medicine to write.... It seems like that's the direction I am at right now. Not upset, but man not matching Psych really hurts. Already have IVs for nonprofit jobs right now to clean PSLF. At this rate so upset about my loss, afraid if I apply FM/IM I still won't match. So if one of my IV gets me a job, I might stay out of fear to clean my loans with PSLF

 

[cookymonster]

It's crazy to me how much more competitive psych has gotten since I matched in 2010. I was very disappointed to get my 5th choice at the time, but this year, I do wonder if I would have matched at all.

Even if you switch gears and plan to match into IM/FM, I wouldn't give up completely. Your performance as a resident will supersede your Step scores and IMG status. If you can transfer into psych as a 2, you'll still finish in 4 years. Going to a residency with a big psych program makes sense, since they are more likely to have transfers. You might even be able to pull off a transfer into a combined program.

The question I can't answer is how risky it would be to go for a prelim spot if you couldn't match into psych afterward. I would think that a solid intern would at least find a PGY-2 IM spot somewhere, but I can't comment from any experience.

 

[thxleave]

It's crazy to me how much more competitive psych has gotten since I matched in 2010. I was very disappointed to get my 5th choice at the time, but this year, I do wonder if I would have matched at all.

Even if you switch gears and plan to match into IM/FM, I wouldn't give up completely. Your performance as a resident will supersede your Step scores and IMG status. If you can transfer into psych as a 2, you'll still finish in 4 years. Going to a residency with a big psych program makes sense, since they are more likely to have transfers. You might even be able to pull off a transfer into a combined program.

The question I can't answer is how risky it would be to go for a prelim spot if you couldn't match into psych afterward. I would think that a solid intern would at least find a PGY-2 IM spot somewhere, but I can't comment from any experience.

That's exactly the mentality I am trying to avoid, since maybe PD's got jedi mind reading. I like Psychiatry, but TBH as a carib person if I do reapply next year. Whatever specialty takes me, I like at this point. Be cold to abuse the opportunity a program will give me for being a re applicant that's a carib by jumping ships.

 

[cookymonster]

I promise you that any program that takes you isn't doing it to be charitable. They're doing it because you are the best applicant to fill a position for which they have a need. You're only obligated to do what the contract, which is renewed annually, states. If they think for any reason you are no longer providing sufficient value to renew the contract, or they are confident they can find a superior replacement, you shouldn't expect loyalty from them.

I don't recommend you blatantly lie in your interviews, but spin away and cherry pick among elements of the truth to sell yourself as a candidate. You may think it's slimy, but this is how millions of people find the best possible job they can every year.

 

[Doctor4Life1769]

I actually don't think a passing score on Step 3 hurts the OP here. Not matching in a couple of cycles is the big hurdle because it makes future PDs concerned that even if they don't personally see what's so wrong with the OP, they know two other cycles (plus SOAPs) of PDs found something to keep him out.

It's really the "psychology of desirability" that's hurting the OP now. If others see value in something/someone, you'll want it/them more, and vice versa.

That and the visa issue I think hurt him the most.

 

[avgn]

I, for one, am going to bookmark this thread to post when another Carib thread pops up in preallo

Godspeed people, may you become practicing physicians eventually...

 

[thxleave]

.................

 

[Phloston]

Hey guys, I'm looking for some long-term career ideas and desperate for any feedback.

HPI: 2015 Canadian Carib grad from SGU, applied twice already for the match (2015 & 2016), failed to match both times. First time around I did not get my CK re-score back till December, got one FM interview after my scores went and did not match. Needing a visa is a much bigger impediment than I ever could have realized.

My USMLE scores are: step 1 -- 212, step 2ck -- 244 (second attempt), step 2 cs passed, step 3 -- 203

After not matching, I enrolled in an MBA in Multi-Sector Health Management offered by SGU, and got my step 3 done. Decided to apply again for this year for the 2016 match. Interviewed at 5 FM programs, 1 IM, and 1 Psychiatry but once again failed to match. Had 7 ranked and at this point not sure if it's me or the match itself that's at fault.

I've been through this twice now. Got massive loans that need paying off and not sure I can afford to go throw it a third time. I'm looking for any feedback into whether I should give it another shot. I don't have any fresh clinical experience since graduating medical school, and all my LORs are from my clerkships in 2014-2015. There are third-party private companies that offer externships and observerships for $800-$1,000 USD PER WEEK. I'm not sure if I should even consider doing those for more experience and apply again a third time for FM/Psych/ IM.

Aside from the match, I was looking for any ideas as to what I can do with my MD/MBA degree going forward. I live in Canada but I'm assuming career options are pretty much similar to what one can do in the US. Just hoping someone can respond to this post or PM me for some advice, everything looks pretty bleak right now ....

I'd take it as a blessing in disguise. Why the adamance about being in the US? What are you so keen for - Trump, guns, John Boehner - do you even know why you want the US?

If you absolutely are insistent on practicing medicine, look into other countries too and see what their requirements are. Or you need to be more flexible with where you're applying to in the US - apply to 100 FM by all means.

Otherwise there are a billion things you can do with your life that would be equally if not more rewarding.

 

[Sea_Bass]

Thanks for the well wishes... I'll be honest it sounds worst then it really is. I have a supporting family, not rich, but emotionally supportive. A significant other that says she'll be my sugar momma until I figure what I want to do. Either go for PSLF or double down and reapply to aim to match next year.

These I didn't match posts I feel always end in melodramatic ways. Yeah I lost 4 years of my life, but hey... I was on a tropical paradise for 2 years... And I did some cool stuff for the past 2 years (bedside thoracotomies, chest compressions non-stop for a hour due to zealous surgeons, and massive transfusion protocols are always fun). Best of all, all my loans are federal. If I didn't go, and try to settle for a normal desk job... I know I'll be saying "man I could of been a doctor." Now if I get a desk job, I can say well... "Well at least I tried something in life.". I also took out all federal loans. So that helps.

Didn't read all the responses, but here's my advice for you. I'll be brief:

1. If you haven't graduated yet, delay graduation so future programs don't know it's your 2nd time in the match. Then take more electives at programs that you could match at.
2. If you have graduated, take step 3. People will tell you otherwise. Take it.
3. Make a list of all aspects of the application process: CV, interview, PS. Improve on all of them. Every single one. Make each aspect of your app better than before.
4. Apply to as many specialties as possible. Portray yourself as a legitimate candidate for all of them. It's up to you how to do that. I applied to 4 specialties last year: Psych, FM, IM, and Rads. Got IV's in all 4. None of them knew I applied to other fields.
5. Apply broadly (read: hundreds of programs), and don't be an idiot about where you apply. You should have an honest shot at every program. Don't apply to reach programs or programs you haven't researched. Every program you waste $26 on is $26 you could've spent applying to a program you have a shot at.
6. Do a little volunteer work.
7. for clinical experience, look on craigslist. Search "medical assistant" in your area and see what's available. It's tough to get psych experience since psych techs are mainly at hospitals and the hiring process and take many months, but other fields are wide open for you.

To the OP: I read you're Canadian. That definitely hurts you. I can't say anything different than what I did above, but you have a much higher hurdle to jump over.

 

[chocomorsel]

Thanks for the well wishes... I'll be honest it sounds worst then it really is. I have a supporting family, not rich, but emotionally supportive. A significant other that says she'll be my sugar momma until I figure what I want to do. Either go for PSLF or double down and reapply to aim to match next year.

These I didn't match posts I feel always end in melodramatic ways. Yeah I lost 4 years of my life, but hey... I was on a tropical paradise for 2 years... And I did some cool stuff for the past 2 years (bedside thoracotomies, chest compressions non-stop for a hour due to zealous surgeons, and massive transfusion protocols are always fun). Best of all, all my loans are federal. If I didn't go, and try to settle for a normal desk job... I know I'll be saying "man I could of been a doctor." Now if I get a desk job, I can say well... "Well at least I tried something in life.". I also took out all federal loans. So that helps.

I really hope you have others reading your personal statements and editing them. Your English is not what it should be.
Good luck.

 

[UBC2014]

Hey guys, I'm looking for some long-term career ideas and desperate for any feedback.

HPI: 2015 Canadian Carib grad from SGU, applied twice already for the match (2015 & 2016), failed to match both times. First time around I did not get my CK re-score back till December, got one FM interview after my scores went and did not match. Needing a visa is a much bigger impediment than I ever could have realized.

My USMLE scores are: step 1 -- 212, step 2ck -- 244 (second attempt), step 2 cs passed, step 3 -- 203

After not matching, I enrolled in an MBA in Multi-Sector Health Management offered by SGU, and got my step 3 done. Decided to apply again for this year for the 2016 match. Interviewed at 5 FM programs, 1 IM, and 1 Psychiatry but once again failed to match. Had 7 ranked and at this point not sure if it's me or the match itself that's at fault.

I've been through this twice now. Got massive loans that need paying off and not sure I can afford to go throw it a third time. I'm looking for any feedback into whether I should give it another shot. I don't have any fresh clinical experience since graduating medical school, and all my LORs are from my clerkships in 2014-2015. There are third-party private companies that offer externships and observerships for $800-$1,000 USD PER WEEK. I'm not sure if I should even consider doing those for more experience and apply again a third time for FM/Psych/ IM.

Aside from the match, I was looking for any ideas as to what I can do with my MD/MBA degree going forward. I live in Canada but I'm assuming career options are pretty much similar to what one can do in the US. Just hoping someone can respond to this post or PM me for some advice, everything looks pretty bleak right now ....

In the two years you have been out, have you not taken the MCCEE and NAC OSCE to apply to CaRMS? If so, have you applied to CaRMS... if not, why the hell not? With 2 failed cycles in the US, it isn't going to get easier...and your step 3 score makes things even worse.

I would strongly encourage you to look into the British Columbia IMG assessment program, and do so ASAP. LIKE RIGHT NOW. And get your Canadian exams so you can apply to CaRMS too. It won't be any easier than the US, but it opens up extra probability.

 

[Plasmatron88]

Didn't read all the responses, but here's my advice for you. I'll be brief:

1. If you haven't graduated yet, delay graduation so future programs don't know it's your 2nd time in the match. Then take more electives at programs that you could match at.
2. If you have graduated, take step 3. People will tell you otherwise. Take it.
3. Make a list of all aspects of the application process: CV, interview, PS. Improve on all of them. Every single one. Make each aspect of your app better than before.
4. Apply to as many specialties as possible. Portray yourself as a legitimate candidate for all of them. It's up to you how to do that. I applied to 4 specialties last year: Psych, FM, IM, and Rads. Got IV's in all 4. None of them knew I applied to other fields.
5. Apply broadly (read: hundreds of programs), and don't be an idiot about where you apply. You should have an honest shot at every program. Don't apply to reach programs or programs you haven't researched. Every program you waste $26 on is $26 you could've spent applying to a program you have a shot at.
6. Do a little volunteer work.
7. for clinical experience, look on craigslist. Search "medical assistant" in your area and see what's available. It's tough to get psych experience since psych techs are mainly at hospitals and the hiring process and take many months, but other fields are wide open for you.

To the OP: I read you're Canadian. That definitely hurts you. I can't say anything different than what I did above, but you have a much higher hurdle to jump over.

Hi, just read your post, so how many programs did you end up applying in total? And how many per specialty? And what did you end up matching in?
It would be helpful for me if share your stats. Thanks 🙂

 

[cerebral edema]

That's exactly the mentality I am trying to avoid, since maybe PD's got jedi mind reading. I like Psychiatry, but TBH as a carib person if I do reapply next year. Whatever specialty takes me, I like at this point. Be cold to abuse the opportunity a program will give me for being a re applicant that's a carib by jumping ships.

Why not apply to neurology?