Consequences of pre-clinical class failure on match

[TragicalDrFaust]

I failed and remediated neuro 1 around this time last year during OMS-1. Got an A in neuro 2. Expecting a 30th percentile score on boards based on practice materials and my class rank (Step and Level 1 will be P/F for me though). I'm interested in psych but open to anything, depending on which rotations I enjoy the most. I'm passionate about public health so also see myself doing FM or IM in an underserved region, rural or urban. I spent about a decade working before I got to medical school and want to open my own practice or have part ownership in a larger practice, if that's still profitable and enjoyable down the line.

As a hypothetical question, how bad are two pre-clinical failures? I just took finals and may have bombed an OSCE - I took it when I felt "tired" but was actually pretty sick and ended up getting the rest of the week off.

Edit: I did not fail the OSCE so one failure total.

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[Angus Avagadro]

2 failures? 30% tile boards? I'd say a university program is probably out of reach. Some community programs are quite good. Once you have decided on a specialty, I would target those for auditions your 4 th yr. Crushing an audition can cover up more than a few warts. My 2 cents. Good luck and best wishes!.

 

[AlbinoHawk DO]

It's really bad to where you closed multiple doors. I would recommend applying to community programs only with a backup specialty. FM would be the easiest backup

 

[hallowmann]

Apply broadly psych, especially community programs in the midwest. Would also recommend backup FM broadly too. You won't go unmatched, but might have a tougher time doing psych.

 

[chilly_md]

Thread moved to appropriate forum.

 

[GoSpursGo]

Psych will be an uphill battle, though not impossible if you have a home program and/or do well on Level 2. IM and FM certainly in play.

 

[deleted1100659]

I failed and remediated neuro 1 around this time last year during OMS-1. Got an A in neuro 2. Expecting a 30th percentile score on boards based on practice materials and my class rank (Step and Level 1 will be P/F for me though). I'm interested in psych but open to anything, depending on which rotations I enjoy the most. I'm passionate about public health so also see myself doing FM or IM in an underserved region, rural or urban. I spent about a decade working before I got to medical school and want to open my own practice or have part ownership in a larger practice, if that's still profitable and enjoyable down the line.

As a hypothetical question, how bad are two pre-clinical failures? I just took finals and may have bombed an OSCE - I took it when I felt "tired" but was actually pretty sick and ended up getting the rest of the week off.

Edit: I did not fail the OSCE so one failure total.

I graduated from a fairly solid psych residency that was a university program, and I was on the selection committee one year for applicants. Ranking itself has a multitude of factors, but experiences and personality can overcome certain deficits like an isolated failure.

I never took OSCEs serious and I turned out well.

You are someone who may benefit from audition rotations. Crushing an audition rotation at my program would definitely open some doors. Auditions aren't about being the smartest; its about having the best personality, and the hardest working. Staying late, arriving early. People liking you. The right people like you, that will go a long way.

You are not out of the running for psych but you need to be real with yourself. Meaning "Hey I have a few deficits. What are my strengths, and how do I utilize them?"

 

[TragicalDrFaust]

I graduated from a fairly solid psych residency that was a university program, and I was on the selection committee one year for applicants. Ranking itself has a multitude of factors, but experiences and personality can overcome certain deficits like an isolated failure.

I never took OSCEs serious and I turned out well.

You are someone who may benefit from audition rotations. Crushing an audition rotation at my program would definitely open some doors. Auditions aren't about being the smartest; its about having the best personality, and the hardest working. Staying late, arriving early. People liking you. The right people like you, that will go a long way.

You are not out of the running for psych but you need to be real with yourself. Meaning "Hey I have a few deficits. What are my strengths, and how do I utilize them?"

Thanks for your response, I understand matching psych won’t be a cake walk having failed a class but want to do everything I can to try to make it happen.

I’m hoping my personality and personal factors might be helpful. I’m openly gay and have extensive experience in upscale customer service roles. I know how to be accommodating and gracious but also know what it’s like to be food insecure and live paycheck to paycheck. Currently volunteer for the Trevor project which has honed my abilities to listen to, reflect and empathize with folks in crisis plus learn how to reduce harm and set goals without telling people what to do. So I do believe my people skills are a strength although admit that plenty of people have pretty poor insight into their social skills. Also hoping being lgbtq will be a plus at some places, since we’re over represented in the patient population. Do you know if that’s the case anywhere?

How does one determine reasonable places to set up audition rotations? Apologies for my ignorance - I’ve tried checking with faculty at my school but since I’m finishing up OMS-2 and haven’t done core rotations, they said it was too soon to start thinking about that.

 

[deleted1100659]

Thanks for your response, I understand matching psych won’t be a cake walk having failed a class but want to do everything I can to try to make it happen.

I’m hoping my personality and personal factors might be helpful. I’m openly gay and have extensive experience in upscale customer service roles. I know how to be accommodating and gracious but also know what it’s like to be food insecure and live paycheck to paycheck. Currently volunteer for the Trevor project which has honed my abilities to listen to, reflect and empathize with folks in crisis plus learn how to reduce harm and set goals without telling people what to do. So I do believe my people skills are a strength although admit that plenty of people have pretty poor insight into their social skills. Also hoping being lgbtq will be a plus at some places, since we’re over represented in the patient population. Do you know if that’s the case anywhere?

How does one determine reasonable places to set up audition rotations? Apologies for my ignorance - I’ve tried checking with faculty at my school but since I’m finishing up OMS-2 and haven’t done core rotations, they said it was too soon to start thinking about that.

1. Interestingly enough, in the 5 years ive been a psychiatrist (counting residency) I havent had many trans patients. Very rare. I think a lot of transgender patients don't seek help due to fear of stigma and being treated differently. Even others from that population, I don't see too often. My program was a southeastern program, and you being in the lgbtq would have earned you some points believe it or not. The year I was recruiting, there was a woman who was married to another woman, had a great personality, everyone thought she was super easy to talk to. Lower end stats though. She still got ranked high. Diverse experiences+highly personable=someone people often want to work with. My program was very welcoming of people of different backgrounds. During my year, I was the only white guy.

2. Having ties to a location helps some, it gives them reason to believe you want to move there. They want someone who wont hate where they live and drag everyone else down with a negative attitude about it. Be realistic, dont sub i at top programs, go for those mid tier programs you have a shot at. In your case, I would say do as many as possible. Look at the websites, see who is matching there. See if they're DO friendly going off that. Look at the diff kinds of people matching there. See how you can relate to something unique about their program. My program for example, had an attending who was considered one of the best neurostim providers in the region.

3. Build confidence without arrogance. Thats a delicate balance to learn that all residents/med students need to learn. Even if you have no idea what you're doing, patients don't want to see a provider who looks terrified. Patients are often terrified. You have to reassure them. Attendings want someone who takes control of a situation, or jumps in (without being obnoxious about it) because that shows they can adapt/learn/function indepdently when the time comes. When I was a intern, I would run an entire unit myself and do floor consults. Though things are more cush these days, lol.

4. Target regions that you're most likely to get into. It helps you have a reason to want to go to. Obv dont apply for top california programs or new york. Midwest programs or SE may be your best bet. Historically, midwest has massive psychiatry shortages. Technically everywhere does, but those states are often paying insane money just to get providers.

 

[TragicalDrFaust]

1. Interestingly enough, in the 5 years ive been a psychiatrist (counting residency) I havent had many trans patients. Very rare. I think a lot of transgender patients don't seek help due to fear of stigma and being treated differently. Even others from that population, I don't see too often. My program was a southeastern program, and you being in the lgbtq would have earned you some points believe it or not. The year I was recruiting, there was a woman who was married to another woman, had a great personality, everyone thought she was super easy to talk to. Lower end stats though. She still got ranked high. Diverse experiences+highly personable=someone people often want to work with. My program was very welcoming of people of different backgrounds. During my year, I was the only white guy.

2. Having ties to a location helps some, it gives them reason to believe you want to move there. They want someone who wont hate where they live and drag everyone else down with a negative attitude about it. Be realistic, dont sub i at top programs, go for those mid tier programs you have a shot at. In your case, I would say do as many as possible. Look at the websites, see who is matching there. See if they're DO friendly going off that. Look at the diff kinds of people matching there. See how you can relate to something unique about their program. My program for example, had an attending who was considered one of the best neurostim providers in the region.

3. Build confidence without arrogance. Thats a delicate balance to learn that all residents/med students need to learn. Even if you have no idea what you're doing, patients don't want to see a provider who looks terrified. Patients are often terrified. You have to reassure them. Attendings want someone who takes control of a situation, or jumps in (without being obnoxious about it) because that shows they can adapt/learn/function indepdently when the time comes. When I was a intern, I would run an entire unit myself and do floor consults. Though things are more cush these days, lol.

4. Target regions that you're most likely to get into. It helps you have a reason to want to go to. Obv dont apply for top california programs or new york. Midwest programs or SE may be your best bet. Historically, midwest has massive psychiatry shortages. Technically everywhere does, but those states are often paying insane money just to get providers.

Really appreciate the insight. Thank you so much!

 

[hallowmann]

Really appreciate the insight. Thank you so much!

LGBTQ+ patient population is very regionally dependent, typically a result of how welcoming the medical community in the region is. I have treated numerous trans patients throughout my training in multiple different settings. I am in the midwest, but we have a very strong LGBTQ clinic and community locally, and this drives a lot of patients to the psychiatry practice, in fact for a solid 6 mos it seemed like 30-50% of my intakes were referred from the LGBTQ clinic. This seems similar to experiences of others whom I've talked with at different institutions in the midwest and west coast.

I would look towards programs that have LGBTQ clinics and have psychiatry residents with a shared interest if that's the patient population you are hoping to work with. Strongly recommend applying throughout the midwest at university settings, as your likelihood of success there will be greater.