delay residency

[AsROMA]

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hi, just hoping to some insight. recently graduated us med student and decided to delay internship/residency due to family reasons. i am planning to apply in the upcoming application cycle, but not sure if it is alright to delay residency until next year. just to mention, did not participate in the last year's ERAS. would a pd looked upon this negatively despite family / personal reasons?

also planning to take step 3 this year as well. how much would a good step 3 score impact on a residency application? my step 1 and 2 passed first time, but quite low (ie 205 and 208). thinking about applying to good IM programs.
thanks

 

[silas2642]

hi, just hoping to some insight. recently graduated us med student and decided to delay internship/residency due to family reasons. i am planning to apply in the upcoming application cycle, but not sure if it is alright to delay residency until next year. just to mention, did not participate in the last year's ERAS. would a pd looked upon this negatively despite family / personal reasons?

also planning to take step 3 this year as well. how much would a good step 3 score impact on a residency application? my step 1 and 2 passed first time, but quite low (ie 205 and 208). thinking about applying to good IM programs.
thanks

Take this with an enormous grain of salt, but from browsing these forums, it seems like delaying residency two years post-grad is a really long time. Also, with your low step scores, are you sure that you can pass step III without having had the experience of internship? Failing step III seems like it could be very detrimental to your chances of matching well or even matching.

I don't really know what you mean about applying to "good IM" programs-- the average step score for IM is around the national average (I believe) according to the 2007 NRMP data (or whatever its called) so your board scores are below average. How were your third year grades?

I would think that when you enter the match, you would really want to make sure that you match. If I were you, I'd apply very broadly and very early, knowing that I was most likely a below average candidate. But again, I'm just the med student so take this advice with caution.

 

[AsROMA]

actually, delaying one year, not two.

 

[dragonfly99]

Don't take Step 3. It will be harder to do well without a year or two of residency experience,and I don't see that it would help your application much. Also, if you failed it could be very detrimental to you.

I don't think you'll be competitive for some IM programs with the low step score and having delayed residency, unless you have something big under the hood that we don't know about (i.e. PhD, multiple publications, etc.).
As a US grad you should definitely be able to get IM, though, and depending on your 3rd year and subI in medicine performance and your LOR's, you could still match at a pretty good university program if that is what you want. If planning hospitalist or primary care, and you want more family time, a cushy community program might be more advantageous.

 

[Winged Scapula]

DF is right.

Taking Step 3 now will not improve your application and because it is highly clinical, there is a chance you won't do well on it, which would make your chances even worse.

Its ok to take time off before starting residency but expect to get a lot of questions about it and what you were doing, and how you have kept up your medical knowledge. Maybe doing some things like getting ACLS certified or doing some research will also help, in a small way.

Who knows how PDs look at residency applications? It depends on the person and how "legit" they think your personal reasons are. Many would say its ok to take a year off if you have a parent with a terminal illness or are pregnant and having a baby, but would not give the same lee-way to someone who wanted to take a year off to travel or just hang around the house. Without knowing what your personal reasons are, where you're applying and the PDs at those programs, it would be hard to say if your application will be well received.

Unless you have some secret weapon you haven't identified for us, you are taking a big chance by taking some time off, given your application appears to be average to below average (given that we only know your scores). But what's done is done, so now you have to maximize your chances. A great score on Step 3 will not do it, so I wouldn't chance it. You need great LORs and probably some evidence, if possible, that you are still trying to retain your medical knowledge during the year off.

 

[futuredo32]

I didn't match, so ,my delayed residency is not by choice. I'm a DO and got advice from someone at my school that I should take Step 3 and I was planning to take it in August. I passed Step 1 and both Step 2 exams on the first attempt(not by much). Would the advice not to take Step 3 be different for a DO residency program or a dually accredited program instead of an allopathic program? I'm definitely not saying that WingedScapula or Dragonfly are incorrect, they give a lot of great advice (just gave me some very helpful advice today, as a matter of fact🙂 ). I'm just wondering if it's different for a DO than it is for an MD?

 

[Winged Scapula]

I didn't match, so ,my delayed residency is not by choice.

I'm sorry, I had forgotten that.

What are you doing differently to change your application from last year?

I'm a DO and got advice from someone at my school that I should take Step 3 and I was planning to take it in August. I passed Step 1 and both Step 2 exams on the first attempt(not by much). Would the advice not to take Step 3 be different for a DO residency program or a dually accredited program instead of an allopathic program? I'm definitely not saying that WingedScapula or Dragonfly are incorrect, they give a lot of great advice (just gave me some very helpful advice today, as a matter of fact🙂 ). I'm just wondering if it's different for a DO than it is for an MD?

IMHO it doesn't matter whether you are DO or MD.

Its a good idea to take USMLE Steps 1 and 2 as a DO applying to allopathic programs but I'm not sure Step 3 is helpful.

1) it has a very high pass rate (ie, its very easy) so if you don't pass it looks bad, very bad

2) there is a lot of clinical detail which internship can provide, improving your score/pass rate

3) they will be comparing your application against 4th year students who have not taken Step 3, so it becomes a moot point in terms of comparison

What was your faculty's reasoning for having you take Step 3? Most programs, AFAIK, aren't even going to be looking for it. Remember most programs that use filters do so for Step 1 and citizenship. I think if they even noticed you had taken Step 3, it would be as an afterthought.

 

[AsROMA]

thank you all for your kind input. well in regards to research, i have two co-authored papers with several abstracts. have nih experience. have acls certification. 3 good letters from IM attendings, but mostly pass and hp in my 3rd year clerkships. i am not looking into top IM progrms, but hoping to get trained at a good IM program with high fellowship placement. i know that my scores are not competitive for most top IM programs.
do i still have a chance? even with better step 3 score?

 

[futuredo32]

I'm sorry, I had forgotten that.

What are you doing differently to change your application from last year?



IMHO it doesn't matter whether you are DO or MD.

Its a good idea to take USMLE Steps 1 and 2 as a DO applying to allopathic programs but I'm not sure Step 3 is helpful.

1) it has a very high pass rate (ie, its very easy) so if you don't pass it looks bad, very bad

2) there is a lot of clinical detail which internship can provide, improving your score/pass rate

3) they will be comparing your application against 4th year students who have not taken Step 3, so it becomes a moot point in terms of comparison

What was your faculty's reasoning for having you take Step 3? Most programs, AFAIK, aren't even going to be looking for it. Remember most programs that use filters do so for Step 1 and citizenship. I think if they even noticed you had taken Step 3, it would be as an afterthought.

I think the OP is an MD, you didn't forget, I just jumped in🙂. (I didn't mean to steal the thread or anything, I was just surprised that the advice was to not take Step 3).
He didn't express a reason that he thought I should take it and he didn't know my step 1 or 2 scores. I was thinking that because I didn't have much wiggle room in Steps 1 and 2, that passing Step 3 would be one less thing for pds to worry about, ie- one of the programs I applied to this year, pulled their residents out of residency if they didn't pass Step 3 by something like Jan or Mar of their PGY-1(because it's psychiatry and they only have IM during the first 4 months of residency). I was just thinking that this would be one tiny thing that they wouldn't have to consider.
To the OP, sorry, I didn't mean to hijack your thread.

 

[Winged Scapula]

I think the OP is an MD, you didn't forget, I just jumped in🙂. (I didn't mean to steal the thread or anything, I was just surprised that the advice was to not take Step 3).

Well that explains things...I was about to write you and tell you that you can't have two accounts.

He didn't express a reason that he thought I should take it and he didn't know my step 1 or 2 scores. I was thinking that because I didn't have much wiggle room in Steps 1 and 2, that passing Step 3 would be one less thing for pds to worry about, ie- one of the programs I applied to this year, pulled their residents out of residency if they didn't pass Step 3 by something like Jan or Mar of their PGY-1(because it's psychiatry and they only have IM during the first 4 months of residency). I was just thinking that this would be one tiny thing that they wouldn't have to consider.
To the OP, sorry, I didn't mean to hijack your thread.

I see.

Well, I frankly don't think PDs worry much about people passing Step 3, since it has like a 97% pass rate. Its sort of unusual for programs I am familiar with to require you pass it half-way but hey, maybe its the norm for psych.