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[fleurdeneuro12]

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[Goro]

Very sorry to hear of this.

Why didn't you take a full leave of absence?

If you were one of my students, I'd be worried about what your school is worried about: that the pressure of studying for Boards will trigger yet another relapse.

It may be possible for you to finish your journey my taking a few years off to build coping skills and resilience, be successful in an SMP, and getting into the host medical school (and possible your current school).

 

[fleurdeneuro12]

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[Med Ed]

What does the student handbook say about all this?

 

[NotAProgDirector]

If I'm understanding the timeline correctly, you finished MS 2 early in 2025, so March perhaps. You then probably had 6 months to take Step 1, and did not. That would stretch into November. You then had an appeal process in November, and the likely gave you an extension of another 6 months, which would be April 2026.

Your life issues are truly unfortunate. However your school has given you lots of time to address your issues, and it's not at all clear that another 6 months will change anything. I don't think you'll be able to reverse their decision here.

As for what comes next, I think that's a real challenge. The first thing to do is to get your mental health issues as settled as possible. You could reapply to US medical schools but few will consider you just to let you take Step 1. You could try carib schools but they also are likely to be concerned about your ability to pass Step 1.

 

[DarkBluMage]

If I'm understanding the timeline correctly, you finished MS 2 early in 2025, so March perhaps. You then probably had 6 months to take Step 1, and did not. That would stretch into November. You then had an appeal process in November, and the likely gave you an extension of another 6 months, which would be April 2026.

Your life issues are truly unfortunate. However your school has given you lots of time to address your issues, and it's not at all clear that another 6 months will change anything. I don't think you'll be able to reverse their decision here.

As for what comes next, I think that's a real challenge. The first thing to do is to get your mental health issues as settled as possible. You could reapply to US medical schools but few will consider you just to let you take Step 1. You could try carib schools but they also are likely to be concerned about your ability to pass Step 1.

That’s honestly not a fair assertion. I had a mental health issue and received accommodations with a year to work through it to pass my step 1 exam and successfully did so without even being placed on a LOA. And yes it did take me the full year to do so. Kind of wild to see a physician say 6 months is sufficient to handle any mental health concern when severe ones can take much longer than that to get under control depending on medication regimens or the nature of the issue and surrounding factors. It sounds like during the first 6 months OP didn’t even recognize there was a mental health issue that really needed to be addressed so that can’t even be counted as a period of time where his mental heath issues were actively being addressed. His school would have been better off placing him on a LOA without holding him to the same testing timelines as his classmates because that could also have exacerbated his mental health issues. That honestly makes no sense to me. His school could have supported him better.

 

[DarkBluMage]

Hi all,

I was dismissed from my medical school yesterday after an appeal to the Dean, the "final appeal" available at my school.

In early 2025, as I was finishing my 2nd year, one of my siblings had 2 life-threatening hospitalizations, which required me to step in and help. This led to extreme burnout, as trying to finish exams while missing class to help was rough. I finished 2nd year successfully and was now getting ready to study for Step 1.

I realized I was heavily burnt out from so much on my plate in the last 2 months, and took a couple of weeks to destress, but that was not enough. I entered a cycle of trying to study for Step 1, being so burnt out, and also starting to experience brain fog as well throughout the year, but trying to push through, only to not consistently be able to study. I proceeded to have a cycle of many false starts, which led to missing the various school deadlines for taking Step 1.

In mid-Nov, a different sibling had a life-threatening emergency, and required multiple surgeries, sepsis etc which was a hit after being depressed all year long.

Eventually, I reached the final deadline in late November, which triggered dismissal. I appealed with a committee to not get dismissed, which I was granted, and they gave me until the end of the recent Spring. I felt optimistic on medication given for depression and I could finally concentrate again etc However, I now had to work on my endurance for a step 1 schedule. I also started having some depressive symptoms in late Feb/early March, and I was put on an additional med mid-march. I took a practice NBME 1 week out from the official test date and scored a 50%, with 33%chance passing within a week, so I could not risk taking the exam- because of this, I ended up having to appeal to the dean.

For context, prior to these circumstances, there was no record of me having mental health symptoms with admin/at the school. Sure, I saw a therapist for test anxiety, but that is not super uncommon. My depression started because of these medical events in my family.

Prior to these circumstances: I passed all preclinical courses( retook one final in one course and above passed the retake- WITHIN policy, a freebie they give once a year), was recognized for my research at my school, active on campus in leadership roles, active in my desired specialty, strong feedback from mentors in that specialty etc

During my dean meeting, the dean emphasized mental health, asking me about what my college experience was like, grad school experience (before med school), he subtly asked if my siblings hospitlizations was for mental health(which it was, but that's my sibling, not me), and brought up my lower-end undergrad GPA.-implying not typcial for most med students- which I worked hard to overcome with upward trend/grad research etc

I provided significant documentation, an outline of a strong plan, etc., and assured the dean I was feeling better after this medication change, as well as had more robust support than before etc but this was the outcome.

Looking for opinions, ideas, etc appreicate it

TLDR; dismissed for taking too long to take Step 1 after passing all courses, no other issues or misconduct, 1 final exam retake within normal policy (Allowed), but having a year of multiple family medical emergencies at both ends of the year.

You should be combing the schools student handbook and policies to see if you have any recourse besides the appeal and to see if they deviated at all from the proper process of dismissal. Either that or find students that were in a similar circumstance that they chose to grant more time to and speak to them on how things were handled. I will say that even though your school could have supported you better that you’re probably cooked. It doesn’t seem like you went through any ADA process, once you realized you had a serious issue, to request accommodations which left you up to the schools discretion of how much they would be willing to help you. 😕

 

[Med Ed]

I will say that even though your school could have supported you better that you’re probably cooked because it doesn’t seem like you went through any ADA process, once you realized you had a serious issue, to request accommodations which left you up to the schools discretion of how much they would be willing to help you. 😕

This isn’t an ADA issue.

 

[DarkBluMage]

This isn’t an ADA issue.

Untreated depression affecting USMLE readiness can be an ADA issue.

 

[Med Ed]

Untreated depression affecting USMLE readiness can be an ADA issue.

But this was treated. OP "felt optimistic on medication" and that they "could finally concentrate again." They still didn't take the exam by the new deadline.

These scenarios are always difficult to interpret because we get a partial one-sided story without much context.

 

[NotAProgDirector]

That’s honestly not a fair assertion. I had a mental health issue and received accommodations with a year to work through it to pass my step 1 exam and successfully did so without even being placed on a LOA. And yes it did take me the full year to do so. Kind of wild to see a physician say 6 months is sufficient to handle any mental health concern when severe ones can take much longer than that to get under control depending on medication regimens or the nature of the issue and surrounding factors. It sounds like during the first 6 months OP didn’t even recognize there was a mental health issue that really needed to be addressed so that can’t even be counted as a period of time where his mental heath issues were actively being addressed. His school would have been better off placing him on a LOA without holding him to the same testing timelines as his classmates because that could also have exacerbated his mental health issues. That honestly makes no sense to me. His school could have supported him better.

Thanks for the feedback.

I think I read their description of "burn out" and didn't equate that to a mental health issue.

I expect they were on some sort of LOA, since they were 12 months without any school activities or requirements other than taking Step 1.

An interesting question of how long they should give someone to try to get back on track.

 

[fleurdeneuro12]

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[karaya]

As I understand it, you had a whole year off to take Step. A LOA is a LOA; you weren't taking classes or (presumably) working. And those Step extended deadlines exist for a good reason: the farther away you get from preclinicals, the more you forget. Most students only need a 4-8 week dedicated. The extended deadlines are meant to cover all setbacks, including yours. There isn't a separate, more extensive LOA for mental health problems. Finally, most MD programs have a 6 year limit from entry to graduation, so any more time off and you'd be running up against the wall. It's likely your dean didn't see enough progress during your leave. It would've been a different story if you had multiple passing NBMEs by now.

All of this is water under the bridge since your appeals have been exhausted. There's nothing to do now but get your health back and maybe reapply down the road.

 

[Med Ed]

Feeling optimistic in late Dec does not equate to my mental health being back in tip-top shape. I could think clearly again, but my endurance for studying was still at an all-time low.

I did not mean to imply you were in "tip-top shape," just that your depression was recognized and treated.

@DarkBluMage hit the nail on the head: I was forced to stick to the normal step1 deadlines for any student despite mental health decline, which exacerbated mental health since I became locked in a cycle of trying to study and make it to the next deadline, when i didnt, starting over. What would have been helpful wouldve been time completely away without these ongoing deadlines I kept trying to meet throughout the year.

These situations are always terrible, and you will spend a lot of time ruminating on the chain of events. Most dismissed students could have changed their respective outcomes if they had done things differently. That said, here are your major options:

1. Comb through the student handbook, identify where the school deviated from published procedure (if applicable), and sue for reinstatement.
2. Find an attorney who is willing to sue the school on other grounds currently unspecified.
3. Get yourself sorted and reapply MD/DO in a few years.
4. Get yourself sorted and head to the Caribbean.
5. Find alternative career.

Even if you were to get back into school now, the underlying issues haven't vanished. You still have to pass Step 1, then survive clerkships, shelf exams, Step 2, etc, while dealing with knowledge decay and skill atrophy.

 

[NotAProgDirector]

To the OP, my apologies if my initial post came across as uncaring or harsh. Not my intention.

You do raise an interesting point regarding how your time was classified. If the 12 months of time you were given was classified as "Step 1 study time", then enforcing the timeline is completely appropriate. If the time was classified as an LOA, then they cannot require that you take the exam. Of course, when your LOA ends they then may, or may not, give you a big window to study. Asking for an LOA would have been your responsibility and then would show on your MSPE - so many try to avoid it.

Best of luck, whatever you decide to do.