CONSIDERING LOA 1 yr- NEED ADVICE

[Shadow1996]

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Hi SDN,

I am currently finished with my M2 year at a low-mid tier US MD. I have passed all my semesters from M1 and M2. I am currently in my dedicated period with my exam USMLE STEP on July 15.

I found out my father is going through colorectal surgery for recurrent polyps and GI hemorrhage due from a longstanding history of chronic alcoholism. He is in Asia so I do not see him currently. He has struggled with his health significantly this year and I am preoccupied with worry which has affected my studying.

How badly does it look to take an LOA for family reasons to take care of a sick parent? (i would be in Asia for a few months) My studying during the dedicated period is heavily impacted, school CBSE 4/8 was a 194, NBME 24 5/7 192, NBME 26 5/23 201, UW first pass 54%.



I heard that LOA is looked down upon from residency directors and that I will have a red flag on my ERAS app unless I had a death in the immediate family or if a family member had cancer. I don't know what to do, right now I'm trying to power through for a July STEP but with scores this low (~200) I run the risk of failing. I don't know if I have the energy to continue... what should I do? Is my medical career doomed if I take an LOA?

I'm not going for competitive specialty, IM/FM, but I don't want to SOAP or match into rural preferrably.

tldr: dad sick, consider take LOA 1 yr to take care of him. worried about residencies discriminating me

 

[operaman]

Sorry to hear about your dad. You need to talk with your school stat.

Honestly the LOA is probably the safest bet at this point. If you’ve been studying for step 1 since 4/8 and you’ve only managed to pull your score from a 194 to a 201, id say the odds of you passing aren’t good. The issues are probably a combination of the family issues with an underlying foundational knowledge deficit. A step failure is definitely worse than an LOA so do whatever you can to prevent that.

 

[Banco]

Listen at some point you got to do what you got to do in life, residency application optics be damned. I think your situation is pretty easily justifiable. You will get the chance to explain on ERAS if you had an extension and why.

Life isn’t all about medical school and residency application. If you feel you will regret not being with your family during this challenging time, then you need to do what’s right for you.

 

[Redpancreas]

Hi SDN,

I am currently finished with my M2 year at a low-mid tier US MD. I have passed all my semesters from M1 and M2. I am currently in my dedicated period with my exam USMLE STEP on July 15.

I found out my father is going through colorectal surgery for recurrent polyps and GI hemorrhage due from a longstanding history of chronic alcoholism. He is in Asia so I do not see him currently. He has struggled with his health significantly this year and I am preoccupied with worry which has affected my studying.

How badly does it look to take an LOA for family reasons to take care of a sick parent? (i would be in Asia for a few months) My studying during the dedicated period is heavily impacted, school CBSE 4/8 was a 194, NBME 24 5/7 192, NBME 26 5/23 201, UW first pass 54%.



I heard that LOA is looked down upon from residency directors and that I will have a red flag on my ERAS app unless I had a death in the immediate family or if a family member had cancer. I don't know what to do, right now I'm trying to power through for a July STEP but with scores this low (~200) I run the risk of failing. I don't know if I have the energy to continue... what should I do? Is my medical career doomed if I take an LOA?

I'm not going for competitive specialty, IM/FM, but I don't want to SOAP or match into rural preferrably.

tldr: dad sick, consider take LOA 1 yr to take care of him. worried about residencies discriminating me

OP, you have one dad. Go take care of him.

The bolded is not true. I can see how some people may have said that, but honestly these things are reviewed on a case by case basis. On your ERAS there will be a section that says please describe explain any gaps in your medical education. You will matter of factly state the gap had to do with serious illness in your father abroad which you took time off for and this was at an inopportune time prior to Step 1.

Edit: Looked at the board scores. Agree completely. Board failure is worse than an LOA. If it needs to be a multifunctional LOA, let it be.

 

[ACSurgeon]

Hi SDN,

I am currently finished with my M2 year at a low-mid tier US MD. I have passed all my semesters from M1 and M2. I am currently in my dedicated period with my exam USMLE STEP on July 15.

I found out my father is going through colorectal surgery for recurrent polyps and GI hemorrhage due from a longstanding history of chronic alcoholism. He is in Asia so I do not see him currently. He has struggled with his health significantly this year and I am preoccupied with worry which has affected my studying.

How badly does it look to take an LOA for family reasons to take care of a sick parent? (i would be in Asia for a few months) My studying during the dedicated period is heavily impacted, school CBSE 4/8 was a 194, NBME 24 5/7 192, NBME 26 5/23 201, UW first pass 54%.



I heard that LOA is looked down upon from residency directors and that I will have a red flag on my ERAS app unless I had a death in the immediate family or if a family member had cancer. I don't know what to do, right now I'm trying to power through for a July STEP but with scores this low (~200) I run the risk of failing. I don't know if I have the energy to continue... what should I do? Is my medical career doomed if I take an LOA?

I'm not going for competitive specialty, IM/FM, but I don't want to SOAP or match into rural preferrably.

tldr: dad sick, consider take LOA 1 yr to take care of him. worried about residencies discriminating me

Just to play devils advocate: will one year be enough for your dad’s health problems to resolve? The problem with chronic problems that aren’t fatal is that they linger for years and years. A colon resection is usually not that serious and does not require “that much time” to recover. Taking a year off for this medical issue might be a problem for you if your dad or another family member develops a bigger problem that actually requires 3-6 months of family care and attention. If he still has significant alcohol related problems, much bigger problems are likely to develop before you finish training, and you can only take so many leaves of absence.

if your primary reason for the LOA is more step study time that’s a different discussion all together.

I don’t mean to sound callas, but I would be careful interrupting your training for family problems unless they are truly overwhelming your ability to move forward. And even then, some of us have families with too many problems and we have to decide if we can break away and become professionals or let our family drama hold us back. You can help your family overall much more as a well paid physician than you can as someone who lets family problems derail your career. Tread carefully.

 

[Redpancreas]

Just to play devils advocate: will one year be enough for your dad’s health problems to resolve? The problem with chronic problems that aren’t fatal is that they linger for years and years. A colon resection is usually not that serious and does not require “that much time” to recover. Taking a year off for this medical issue might be a problem for you if your dad or another family member develops a bigger problem that actually requires 3-6 months of family care and attention. If he still has significant alcohol related problems, much bigger problems are likely to develop before you finish training, and you can only take so many leaves of absence.

if your primary reason for the LOA is more step study time that’s a different discussion all together.

I don’t mean to sound callas, but I would be careful interrupting your training for family problems unless they are truly overwhelming your ability to move forward. And even then, some of us have families with too many problems and we have to decide if we can break away and become professionals or let our family drama hold us back. You can help your family overall much more as a well paid physician than you can as someone who lets family problems derail your career. Tread carefully.

I think these are excellent points. I figured at this point OP has first learnt what is going on with his dad. We spent so much time growing up we sometimes aren't aware of what our own parents maladies are but then suddenly we're halfway through medical school and family expects us to know what to do. I think OP should take some time to step aside from Step 1, assess the situation, and provide his family with the emotional support. If it doesn't work, I still think it matters that OP took the time to do it for his father.

From a medical standpoint, I can't tell if the recurrent polyps requiring resection is the major issue (more acute) or if this is cirrhosis leading to varices/PHGP/GAVE/etc. If it's the latter, you being there may be helpful to get your dad on the way to abstinence and potentially qualify for an OLT. I don;t know the situation though.

I think this is a tough call though and think @ACSurgeon may be onto something.

 

[ACSurgeon]

I think these are excellent points. I figured at this point OP has first learnt what is going on with his dad. We spent so much time growing up we sometimes aren't aware of what our own parents maladies are but then suddenly we're halfway through medical school and family expects us to know what to do. I think OP should take some time to step aside from Step 1, assess the situation, and provide his family with the emotional support. If it doesn't work, I still think it matters that OP took the time to do it for his father.

From a medical standpoint, I can't tell if the recurrent polyps requiring resection is the major issue (more acute) or if this is cirrhosis leading to varices/PHGP/GAVE/etc. If it's the latter, you being there may be helpful to get your dad on the way to abstinence and potentially qualify for an OLT. I don;t know the situation though.

I think this is a tough call though and think @ACSurgeon may be onto something.

Obviously I have minimal details regarding the OP’s family dynamics so trying to give generic advice that may or may not apply. We see the worst of the alcohol problems in the ICU and usually not a problem that is one and done for most patients.... it would be unfortunate to take a year off for a colon resection only for more serious problems to show up over the next 2-3 years that would have been more worthy for a full year off...

 

[NotAProgDirector]

I don't think an LOA for a family health emergency will be seen as a negative. Do the right thing for you and your family -- whether that's an LOA or staying in school.

 

[mrbreakfast]

I agree with the above posters in that this is something that needs a lot of thought. I'm not going to tell you what to do. But everything needs to be planned out clearly before you do - that is, you and your family need to know exactly what will happen at this time next year. Under what circumstances would you not go back to med school? Because if the answer to that is "if my father isn't doing better/is doing worse" there's a possibility your med school career is effectively over.

That may be fine. I honestly don't know what I'd do in your situation; I'd probably go too. But you have to plan ahead for what may happen if you're facing a similar situation next year.