Did I just completely screw the rest of my life?

[Screwed]

Got my Step 1 score yesterday and got a 79/193
Terrible score but even worse as an FMG
I just completely panicked during the test and could not concentrate or finish any block in time. My average on UW was in the 60's. NBMEs getting ~220 equivalence.

How screwed am I. Am I completely doomed to FM in the wilderness of Alaska?

My ultimate goals were EM or Univ. based IM for a Cards fellowship

---

Members don't see this ad.

 

[Screwed]

I feel soooo dumb, I'm soooo embarrassed, and angry at myself.
I put so much work into it, just to screw it up during the test
I wish I could take that F'ing test again.

I guess I better start studying for Step 2

P.S. Would RX be a good question bank to have year round? I want to save UW to when I get closer and I'm assuming Q-bank will be insanely expensive?

Thanks

 

[g6pddfishnc]

.

 

[g6pddfishnc]

.

 

[lord_jeebus]

Sorry about the disappointing score.

As for questions for Step II, don't forget about Kaplan QBook, which is conveniently organized by subject. Step II is very much like the shelf exams, so just study very hard for those and the rest will fall into place.

 

[lankysudanese]

Am I completely doomed to FM in the wilderness of Alaska?

as an FMG with a 193, a more appropriate phrase is "will i be fortunate enough to get FM in the wilderness of Alaska". I know several FMGs with 99's who did not match into ANYTHING (including FM). I dont want to sound like a prick (and you might very well end up doing well in the match) but I just wanted to correction any misconceptions that any FMG who barely passed Step 1 can match (even at that seriously noncompetitive FM spot in Alaska).

work hard for step 2, get an MPH or do some serious research in the meantime, and work on some stellar letters of recommendation.

Good Luck

 

[Pinkertinkle]

Looks like you'll have to take what you can get.

 

[sparkygalore]

One of my mentors is a fantastic urologist who bombed both Step 1 and Step 2 the first time around, as well as failing Biochem. I know, it was back in the day and she ended up in urology by transferring into a spot after leaving a general surgery program, but hey! Now she's a hot shot with conferences, research and position she loves. Everyone's path is different, and if you set your eyes on the prize (and kick *** at whatever you're good at) you can get yourself where you want to be.

 

[Labslave]

One of my mentors is a fantastic urologist who bombed both Step 1 and Step 2 the first time around, as well as failing Biochem. I know, it was back in the day and she ended up in urology by transferring into a spot after leaving a general surgery program, but hey! Now she's a hot shot with conferences, research and position she loves. Everyone's path is different, and if you set your eyes on the prize (and kick *** at whatever you're good at) you can get yourself where you want to be.

Hate to burst your bubble, but your mentor's path to success is the exception, not the rule. It's nice that you're so idealistic, but you're wrong. Not everyone can end up a hot shot at HSS just because they want to.

 

[It'sElectric]

Hate to burst your bubble, but your mentor's path to success is the exception, not the rule. It's nice that you're so idealistic, but you're wrong. Not everyone can end up a hot shot at HSS just because they want to.

You're completely right about that person's anecdote being the exception and certainly NOT the rule, but let's be fair here. I took their comment to mean something entirely different - Basically, what's done is done, so focus on what you can do from this point forward to achieve the dreams you still hold dear.

Certainly nothing will come to you simply because it happened to others, but maybe if you work your *** off and get a little lucky along the way, you can achieve great things, despite the odds against you.

Yes, that's a bunch of tree-hugging hippie crap (which I'm not), but there is at least a little truth to it.

 

[Labslave]

You're completely right about that person's anecdote being the exception and certainly NOT the rule, but let's be fair here. I took their comment to mean something entirely different - Basically, what's done is done, so focus on what you can do from this point forward to achieve the dreams you still hold dear.

Certainly nothing will come to you simply because it happened to others, but maybe if you work your *** off and get a little lucky along the way, you can achieve great things, despite the odds against you.

Yes, that's a bunch of tree-hugging hippie crap (which I'm not), but there is at least a little truth to it.

And my point is that the OP has to be realistic about his (or her) chances and not take such stories to mean that he can still get a competitive residency here in the States without a significant amount of luck. Odds are he'll be lucky to get a residency of any kind in the US, and he deserves to hear that instead of hearing long shot success stories.

 

[AK_MD2BE]

What's wrong with Alaska? It is the most beautiful state in the country.

 

[docmd2010]

take hope. although it is good to be realistic of your goals, it certainly isn't unrealistic for you to work extremely hard in rotations. be the first one there and the last one to leave. if u want IM, you can get it. work your *** in your internal medicine rotation-that'll really be the key to whether you match or not.

an uphill battle indeed-but not 90 degrees.

 

[polyposis]

Well, there's nothing wrong with comforting an obviously sad person Now isn't really the time to be a downer...

Anyways, don't let your score define you. No one can predict what will happen in the future.

 

[mercaptovizadeh]

Maybe others would know better about this, but I think that this could be partially compensated by superb basic science research (first author articles in high-powered journals, this may require several years of research in a very productive lab) or some sort of amazing leadership initiative (FOUNDED a clinic in a third-world country), and a great Step 2 score is an absolute must. I don't think it's "over" by any means, although given the current state of affairs a cards fellowship may be well off the table.

The alternative is waiting out seven years until the Step 1 score expires. At this stage that's probably a ridiculous proposition, but if the OP is on the young side and has other interests that he/she could put the time into, then this might not be entirely out of the question.

The final alternative is trying to match into a less competitive specialty, such as pediatrics or family medicine.

It's a real shame that the USMLE can't be retaken if passed.

 

[Mr. Freeze]

What's wrong with Alaska? It is the most beautiful state in the country.

Dammit! Beat me to it...

Well, I for one think it takes some sack to get on SDN and post a sub-average score, since no one ever seems to do that here. 'Spek.

More importantly, what would you do differently or where do you think you went wrong? I don't know a great deal about predictors, but it seems like with what you say you were averaging, depending on which NBME's those were, that you would've been in a better spot. Closer to what you were prolly expecting anyhow.

 

[snips44]

I know several FMGs with 99's who did not match into ANYTHING (including FM).

What a bunch of bulllllllllllllllllllllllllllll****.

 

[SoCuteMD]

as an FMG with a 193, a more appropriate phrase is "will i be fortunate enough to get FM in the wilderness of Alaska". I know several FMGs with 99's who did not match into ANYTHING (including FM). I dont want to sound like a prick (and you might very well end up doing well in the match) but I just wanted to correction any misconceptions that any FMG who barely passed Step 1 can match (even at that seriously noncompetitive FM spot in Alaska).

work hard for step 2, get an MPH or do some serious research in the meantime, and work on some stellar letters of recommendation.

Good Luck

For what it's worth, a friend of mine failed Step 1 the first time, passed the 2nd time and will begin her IM residency at a University-based program in July. There's no need to completely destroy someone's hopes.

ETA: According to the program director at my home IM program (which has a TON of FMGs) the biggest barrier for FMGs matching into our IM program is spoken English. Even though some people do well on the TOEFL their spoken English is very hard to understand. Those whose English is easily understood on interview day are much more likely to be ranked.

 

[lankysudanese]

For what it's worth, a friend of mine failed Step 1 the first time, passed the 2nd time and will begin her IM residency at a University-based program in July. There's no need to completely destroy someone's hopes.

ETA: According to the program director at my home IM program (which has a TON of FMGs) the biggest barrier for FMGs matching into our IM program is spoken English. Even though some people do well on the TOEFL their spoken English is very hard to understand. Those whose English is easily understood on interview day are much more likely to be ranked.

great. let me know the name of ur home IM program and I will send them your way. Their spoken English is good and they are great applicants (like I said, 2-digit scores of 99). they applied to surgery and didn't match. then applied to internal medicine and didn't match. then applied to FM and didnt match.

tough times, it seems

 

[SoCuteMD]

great. let me know the name of ur home IM program and I will send them your way. Their spoken English is good and they are great applicants (like I said, 2-digit scores of 99). they applied to surgery and didn't match. then applied to internal medicine and didn't match. then applied to FM and didnt match.

tough times, it seems

I feel certain that if they have 2-digit 99 scores AND good spoken English AND failed to match in surgery, IM, and FM then they likely suffer from one of a few conditions:
1) Acute personality deficiency
2) Acute "I'm better than all of y'all" syndrome

In addition, is it possible that 3 attempts to match in 3 different specialties made their applications (especially to IM and FM) less desirable and made them seem less sincere? I would think it would be hard for someone with their heart set on surgery to seem sincere in an IM or FM interview.

It has been my observation that once someone has passing test scores and is invited for an interview at a program, scores matter far less than personality (and, in the case of IMGs, spoken English). That was the discussion I heard during match season at my home program. The 99s won't do them much good if they can't carry a conversation.

Please note that I did not say "My program takes everybody and anybody with good spoken English and passing USMLE scores." It is an excellent University-based program with a wide variety of patients and pathology AND strong fellowship placements as well as extremely bright residents. Just because they take a significant number of IMGs does not necessarily mean that they are "desperate" for warm bodies to fill residency spots. All of the IM residents I worked with were bright, hard-working, personable, and humble (far more so than most of the medical students at my school).

 

[lankysudanese]

I feel certain that if they have 2-digit 99 scores AND good spoken English AND failed to match in surgery, IM, and FM then they likely suffer from one of a few conditions:
1) Acute personality deficiency
2) Acute "I'm better than all of y'all" syndrome

In addition, is it possible that 3 attempts to match in 3 different specialties made their applications (especially to IM and FM) less desirable and made them seem less sincere? I would think it would be hard for someone with their heart set on surgery to seem sincere in an IM or FM interview.

It has been my observation that once someone has passing test scores and is invited for an interview at a program, scores matter far less than personality (and, in the case of IMGs, spoken English). That was the discussion I heard during match season at my home program. The 99s won't do them much good if they can't carry a conversation.

Please note that I did not say "My program takes everybody and anybody with good spoken English and passing USMLE scores." It is an excellent University-based program with a wide variety of patients and pathology AND strong fellowship placements as well as extremely bright residents. Just because they take a significant number of IMGs does not necessarily mean that they are "desperate" for warm bodies to fill residency spots. All of the IM residents I worked with were bright, hard-working, personable, and humble (far more so than most of the medical students at my school).

first of all, i don't even know what ur last paragraph was pertaining to. I didn't inquire about the quality of your program, and never questioned it. secondly, have you already gone through the match process? b/c you certainly speak with the tone of a program director (let alone someone who has already matched). if not then maybe u should put urself in the shoes of some of the IMGs and what they have to go through. I have no idea what "acute personality deficiency" is, and I know that half of the intern class in surgery & medicine (at my school) has the "I'm better than all of y'all" syndrome. regarding the reason why they applied to 3 different specialities: i think it makes perfect sense for someone who is 2-3yrs out from medical school to try and at least get into some residency so that they get closer to becoming financially independent and put some food on the table. some of them have families and aren't at liberty to chase that dream gen surg spot forever.
but i do agree with you that the 99's do nothing more than guarantee you the interview, and that after that stage it is all about personality and how well you sell yourself. but without a great step 1 score, getting the interview is the first huge obstacle for IMGs.

 

[SoCuteMD]

first of all, i don't even know what ur last paragraph was pertaining to. I didn't inquire about the quality of your program, and never questioned it. secondly, have you already gone through the match process? b/c you certainly speak with the tone of a program director (let alone someone who has already matched). if not then maybe u should put urself in the shoes of some of the IMGs and what they have to go through. I have no idea what "acute personality deficiency" is, and I know that half of the intern class in surgery & medicine (at my school) has the "I'm better than all of y'all" syndrome. regarding the reason why they applied to 3 different specialities: i think it makes perfect sense for someone who is 2-3yrs out from medical school to try and at least get into some residency so that they get closer to becoming financially independent and put some food on the table. some of them have families and aren't at liberty to chase that dream gen surg spot forever.
but i do agree with you that the 99's do nothing more than guarantee you the interview, and that after that stage it is all about personality and how well you sell yourself. but without a great step 1 score, getting the interview is the first huge obstacle for IMGs.

I'm an MS3 who has been lucky enough to receive significant insight into the match from a variety of program directors, faculty, residents, and applicants. I happened to be working with the program director at our IM program leading up to and right after match day, and had the opportunity to pick his brain regarding how he ranks candidates. I certainly do not pretend to be a program director or to know exactly how they make their decisions (if only I did, I'd feel much better about next year!).

I have to say that ALL of my residents have been very humble (with the exception of some of the surgery residents) with great personalities. If you can't recognize "acute personality deficiency" then I don't know what to tell you!!

While I agree that the time comes that everyone has to buckle down and stop chasing rainbows, to jump from one specialty to another and then to a third seems a bit...flighty regardless of the circumstances. I didn't say it was wrong, but simply mentioned how it might be perceived by program directors (as not a true commitment to the field). Not having a true commitment to the field is a turnoff in any professional job application, but I suspect that it is even more of one in medicine. Especially when the program director has another IMG with similar or slightly weaker scores who really wants to be in that field and in that program.

Anyways, back on track!

To the OP: you most certainly do face an uphill battle in the match. You are going to have to study your butt off for step 2 and find a way to avoid panicking on test day. Find and apply to a TON of IMG-friendly programs. A friend of mine who successfully matched after a failure and then a mediocre performance on Step 1 did so by 1) interviewing well and 2) making it known to her first choice that they were her first choice and she would GLADLY accept a pre-match from them if offered. They prematched her. She also did a (paid) research externship in her field in the US. Lots of

 

[Pinkertinkle]

One of my mentors is a fantastic urologist who bombed both Step 1 and Step 2 the first time around, as well as failing Biochem. I know, it was back in the day and she ended up in urology by transferring into a spot after leaving a general surgery program, but hey! Now she's a hot shot with conferences, research and position she loves. Everyone's path is different, and if you set your eyes on the prize (and kick *** at whatever you're good at) you can get yourself where you want to be.

Wow impressive, was your mentor an FMG?

 

[lilzelda2]

Sorry to the OP but anything is possible and you still have 3rd yr and Step. I know someone who failed COMLEX the first time and then matched in to a Ortho Program, its a different situation but anything is possible.

Some of you should spend less time studying and more time working on your people skills. Empathy goes a long way.

 

[hj0517]

I have to unequivocally agree with the post above. I have also been trying to work out "worst case scenarios" (not taken step 1 yet). The only thing I can say is that people write about friends who didn't match OR heard of a person who didn't match with a 99 OR conversely have heard of success stories.

I think it is important for you to acknowledge that none of these people are you and everything is still in YOUR hands in terms of gaining a place in whichever field you wish to enter.

I'm not going to say that you've lost all hope of gaining residency nor am I saying that you're going to find it a walk in the park when it comes to filling out applications. All I can say is hard luck with the score mate, but if you want something bad enough there are ways and means with which to reach your goal. Don't dwell on your result, look forward and also learn from your experience taking step 1

 

[Terpskins99]

Got my Step 1 score yesterday and got a 79/193
Terrible score but even worse as an FMG
I just completely panicked during the test and could not concentrate or finish any block in time. My average on UW was in the 60's. NBMEs getting ~220 equivalence.

How screwed am I. Am I completely doomed to FM in the wilderness of Alaska?

My ultimate goals were EM or Univ. based IM for a Cards fellowship

Sorry to hear about this. Unfortunately, this sort of thing happens every year. For every person that pulls a 250 after averaging 220's on their NBME's, it only makes sense that there are just as many that draw a 190 at the opposite end. We just don't hear from most of them because they don't post.

One of my friends went to a Virgin Islands medical school barely passed Step 1 and 2 and didn't match. He did eventually scramble into a family medicine slot (I remember helping him fax his CV to 50 hospitals that day). Its not all doom and gloom, but the cards are stacked against you now and you need to plan accordingly or you too won't match anywhere.

First, you need to focus on absolutely annihilating Step 2. Figure out what went wrong this time around, and make whatever adjustment you have to in order to make sure it doesn't happen again.

Second, you should re-evaluate your plans towards acquiring residency/fellowship. A university IM slot is likely out of reach (though who knows, if are still able to do an elective rotation/sub-I at a couple places that have a history of taking FMG's from your medical school... you still have an opportunity to dazzle them into making an exception for you), you should still be able to potentially land a community hospital IM slot. I'm pretty sure a couple people from community programs land cardiology every year (though it is a HUGE uphill battle for them to do so). It means you have to spend EVERY opportunity you can to pursue independent research (e.g. clinical trials/studies run by a nearby cardiologist) to get your name published as well as performing like a superstar intern/resident.

 

[Screwed]

Thank you for all the replies.
I've come to terms that I completely F'd up, but there is nothing I can do about that test. I can however do something about Step 2 and clinicals.

I'm definitely not afraid of hard work and will act accordingly.
I do have a very steep uphill battle - but as they say - The fruits of hard work are much sweeter. I guess, I'll have to go with that where ever it takes me.

I guess the most important thing for me is to actually figure out what happened during that test. I am normally, very calm and very focused during stressful situations. I just really don't know why I freak out.

I've been pretty depressed for the past few weeks, but I've realized that the score is just a score and as someone said, it is not what I am, it's not even representative of what I can do. I will use this pathetic score as a driving force.

As for the unmatched 99's - I'm not concerned - I will match and will succeed, at worse, my plans may change.

Thank you all for your thoughts

 

[It'sElectric]

The very best of luck to you!