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Medstudent15_

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I had personal family issues going no.

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I was in the process of completing my first year of masters program that is linked to a medical school when I ended up failing a course. This resulted in me getting dismissed from the program even though all my other grades were well. I also interviewed for the medical school and am on the top tier of the waiting list. I felt like I was very close to being accepted had it not been for failing that one course (you needed a 70 to pass, I got a 67.5). Can anyone offer advice on what my next steps should be? I feel like this is a very unique situation and I'm not sure how to handle it.

I don't feel this is that unique. I've heard of my own school doing this often. Unfortunately, failing these types of Masters programs and being dismissed is a pretty significant red flag and I can't imagine a medical school would take that chance as they're usually easier than medical school courses.
 
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Did the interview and being waitlisted happen before you got dismissed? Because it makes a huge difference. If you got dismissed after your interview then your chances are slim, especially if it's a school that has a large waitlist group.
 
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Was it an smp? One modeled after a med curriculum? Or did it have nothing to do with the sciences? Your biggest hurdle after this will be convincing med schools you can handle the workload. Some masters programs are as tough or close to as difficult as the first year of med school. But then some others are easier than undergrad. You might need to think about if you can handle a med school workload. Bc honestly in most programs anything below an 80 is failing... All that being said, really try to analyze why you failed and try to express that too them (were there extenuating circumstances? lacked maturity?) They will have to know and/or will find out. Showing maturity and what you learned from it may be your best bet now

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Real talk:

There is roughly 0% chance of being accepted as a medical student at a school where you were recently dismissed from the master’s program.

They didn’t admit you the first time, so you had to do a master’s program. Then you failed the master’s.

I’m sorry this happened to you, and I don’t say this to be harsh, but you need to be realistic moving forward. I wouldn’t be surprised if your only shot was a different master’s, as much as that would suck.
 
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I know of one person who was in an SMP linked with a DO school, failed a class, got booted out, did anouther SMP linkage, made the grade (had to retake the MCAT) and got accepted. It does happen, but you got to be realistic with yourself.
 
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I was in the process of completing my first year of masters program that is linked to a medical school when I ended up failing a course. This resulted in me getting dismissed from the program even though all my other grades were well. I also interviewed for the medical school and am on the top tier of the waiting list. I felt like I was very close to being accepted had it not been for failing that one course (you needed a 70 to pass, I got a 67.5). Can anyone offer advice on what my next steps should be? I feel like this is a very unique situation and I'm not sure how to handle it.
I can't sugar coat this. Find a different career.

In these types of programs, you have to ace everything. My own program has found, the hard way, that students who do suboptimally in the SMP do poorly in med school, and often take LOA and/or fail COMLEX. Hence, we have a strict red GPA line for whom we interview for the COM. A failing course would be an auto-reject even somehow with an interview.

Whether you failed by 2.5 points or 25 is irrelevant. You failed to achieve minimum competency, much less display any mastery of the material.

Suppose that you were accepted to the med school. It's going to be 2-5x harder! Would you magically pass the course you failed in the MS program? I'm not sanguine, about that. Then you have a failing grade on your transcript. Imagine how that will look to PDs, especially in a time where we may have a residency crunch.

Your school did you a great disservice by interviewing you without having your full transcripts available.
 
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Even if you are accepted, your life would be hell. You would have to work 2x, 3x, 4x the amount of effort that your classmates have to work, and from personal experience, it absolutely sucks. Everyone (>95%) works hard in medical school, so imagine spending 15+ hours every! single! day! seven! day! per! week! just to pass your classes. Could you personally do it? Maybe, but your physical and mental health would be in a very bad place. If you're dead set on a career in the healthcare field, there's plenty of other great options.
 
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This is an example of why Masters/SMPs are a make or break option. You have to go all in. One cannot just get by, otherwise it leads to situations like this. I'm sorry OP, but the chances are slim and I'm not sure its mentally wise to hang on to hope for the interview. They probably waitlisted you to see how you do in the program. After the failure, they have no reason to keep you.
 
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On the note of SMPs how much does a good performance in one negate an underwhelming uGPA?
 
On the note of SMPs how much does a good performance in one negate an underwhelming uGPA?

Very much, if not all of it.

Tulane ACLP, will be attending Tulane SOM in the Fall. this time last year i had a 3.06 sGPA lol
 
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Very much, if not all of it.

Tulane ACLP, will be attending Tulane SOM in the Fall. this time last year i had a 3.06 sGPA lol

Tip my hat to you good sir; mind asking mcat score; also how hard was the smp relative to what you thought prior to going in (going from 3.06 sgpa to what I assume 3.5+ takes a lot of self awareness)
 
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Tip my hat to you good sir; mind asking mcat score; also how hard was the smp relative to what you thought prior to going in (going from 3.06 sgpa to what I assume 3.5+ takes a lot of self awareness)

510, pretty even distribution. knew exactly what I signed up for, studied like my life depended on it (you know, which it kind of did zzzzz)
 
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It’s called high risk high reward for a reason. Many people on the forums share their reward experience, not a lot of people like to share the fail part.
 
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I know of one person who was in an SMP linked with a DO school, failed a class, got booted out, did anouther SMP linkage, made the grade (had to retake the MCAT) and got accepted. It does happen, but you got to be realistic with yourself.
Do you know what they had to do to be allowed the chance to do another SMP?
 
Even if you are accepted, your life would be hell. You would have to work 2x, 3x, 4x the amount of effort that your classmates have to work, and from personal experience, it absolutely sucks. Everyone (>95%) works hard in medical school, so imagine spending 15+ hours every! single! day! seven! day! per! week! just to pass your classes. Could you personally do it? Maybe, but your physical and mental health would be in a very bad place. If you're dead set on a career in the healthcare field, there's plenty of other great options.
My concern is that this dismissal is going to ruin my chances of getting accepted into any other program
 
I had a medical reason that led me to do poorly in this class and by the time I figured out what was going on, it was too late for this one specific course because there weren't enough points left in the semester to salvage the class. I was however able to improve my grade in other classes because there was still points available
How were your other grades? How many As vs Bs vs Cs? In Fall and Spring semester?
 
And notice from the history he also had very strong MCAT scores.

OP, barring federal offenses and criminal incarcerations, I don’t think someone’s chances for medical school in the United States are ever officially 0%. There are a lot of backdoors into DO school that are cropping up. LECOM, VCOM, and other programs offer a guarantee if you meet the GPA and MCAT thresholds. The issue is if you can realistically do the work. You were in an SMP. You have heard from people that it’s about 2-3X harder than that. Now yes, many DO schools won’t kick you out for failing a class, but even if you fail, you have to remember all that info for STEP.

What happens if you cobble together 2 years of medical school barley passing with a 2.0 and then fail the STEP three times and are dismissed? What happens if you barley pass anything and graduate bottom of your class and no Family Med program will take you? The amount of students in medical schools are expanding, and as others have said, it’s not gonna be the top performers hurting for spots.

As others have suggested, it might be time for plan B. If you still wanna be a doctor but can’t handle the coursework, look into optometry or dentistry, as their cirriculium is different and easier than medical school. I can’t recommend DPM because it’s just as hard as Medical school (with the exception of boards, they are easier and shorter).

Pharmacy might also be an option, but they have some saturation problems they complain about.

In a bind. Need advice.

Here is a link about a person who was in a similar situation. Read the entire thread.
 
I would talk to admissions, see if you can retake the class and re-apply. This happened to someone at my DO school and they were competent and matched well.
 
I was in the process of completing my first year of masters program that is linked to a medical school when I ended up failing a course. This resulted in me getting dismissed from the program even though all my other grades were well. I also interviewed for the medical school and am on the top tier of the waiting list. I felt like I was very close to being accepted had it not been for failing that one course (you needed a 70 to pass, I got a 67.5). Can anyone offer advice on what my next steps should be? I feel like this is a very unique situation and I'm not sure how to handle it.
See if you can re-mediate the grade over the summer and if it could replace your failing grade. If you have money, you can look into similar SMPs and re-take one somewhere else but you cannot mess it up. I believe several osteopathic schools have an SMP program but without linkage.
 
I would talk to admissions, see if you can retake the class and re-apply. This happened to someone at my DO school and they were competent and matched well.
They gave me a week to retake the entire semester's worth of the class but I was still dealing with the same problems that led to me originally failing so when i retook my test i ended up missing two more questions than allowed.
 
See if you can re-mediate the grade over the summer and if it could replace your failing grade. If you have money, you can look into similar SMPs and re-take one somewhere else but you cannot mess it up. I believe several osteopathic schools have an SMP program but without linkage.
Is it normal for a school to give you essentially 1 week to remediate a whole semester's worth of a class? Also my concern is that other SMP's will not consider me due to the dismissal on my transcript. It feels like the end for me.
 
I would talk to admissions, see if you can retake the class and re-apply. This happened to someone at my DO school and they were competent and matched well.
Unfortunately this school does not allow that to happen very easily. I could easily repeat the course next year and I am also okay with repeating the entire first year but I had to write an appeals letter to the Dean and have yet heard back. From what I gathered from my school advisor, once you're dismissed, you're done.
 
They gave me a week to retake the entire semester's worth of the class but I was still dealing with the same problems that led to me originally failing so when i retook my test i ended up missing two more questions than allowed.
What is plan B?
 
How were your other grades? How many As vs Bs vs Cs? In Fall and Spring semester?
First semester was 3 B's and a C. My second semester was an A, a B, a C and than the failing class (D)
 
First semester was 3 B's and a C. My second semester was an A, a B, a C and than the failing class (D)
Why were you getting C's and then a D? What was the medical issue?

Click and read the link in post# 21.
 
Why were you getting C's and then a D? What was the medical issue?

Click and read the link in post# 21.
I was having a respiratory problem for the past 6 months that is finally being looked at now after having gone to a specialist (my PCP was trying to label it as allergies when it was so much more, there were days I couldn't function because I was having so much trouble breathing) on top of being treated for anxiety with medication that was giving me a lot of negative side effects on top

Also these classes were essentially the same classes that the first year medical students take. I think if it weren't for everything going on in my personal life I could have done much better. I was on the waiting list for the medical school with my first semester grades so the school did not have a problem with my C's

( edited this so that people would focus less on the anxiety and more of the actual physical condition in which I know have a diagnosis of as of last week)
 
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Click and read the whole thing so you can figure out your next steps.
I actually just went and read all this. The only problem with me is that my school chose to dismiss me rather than me leaving on my own and withdrawing. That being on my transcript makes it really difficult to even be considered by other schools/post bac's
 
I actually just went and read all this. The only problem with me is that my school chose to dismiss me rather than me leaving on my own and withdrawing. That being on my transcript makes it really difficult to even be considered by other schools/post bac's

The OP of that thread did not withdraw from the program (you must have missed that). The OP was dismissed because the OP didn't meet the 3.0 mark due to failing a course. All together the OP of that thread did three masters programs. The OP got accepted to the school where they did their third masters program (that takes tenacity and grit).

Your situation is not unique. Move forward and figure out your next steps.
 
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First semester was 3 B's and a C. My second semester was an A, a B, a C and than the failing class (D)
I can't sugar coat this: Your medical career is over. You had your best chance at an audition for med school, and it's simply not enough, health issues or not.

Your Fall semester alone is a sign that you'd have poor luck with med schools. One is supposed to be aceing things, not getting Bs.
 
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This is not the end of the world and I know its very easy to say but please fix your issue what you have and may be take some time off from school or a gap year then go back to do SMP at another school. I'm sure you will rise. Just get the advice from here and do the best what you feel like it. People will give you their opinion but at the end of the day you need to decide what is best for you.

All the best!!!
 
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Is it normal for a school to give you essentially 1 week to remediate a whole semester's worth of a class? Also my concern is that other SMP's will not consider me due to the dismissal on my transcript. It feels like the end for me.

Having a week to remediate a failed class is not atypical, it is pretty common at many medical schools (fail a class, have a week to study for an exam and then take a single exam to pass). Given your medical issues why did you not seek a medical LOA? I know this is besides the point now, but if your SMP isn't malignant they should have recognized this and allowed you to repeat when you were in better health. If you chose not to then it is a sign of poor decision making. That combined with your mediocre master's transcript (as previously stated, you should be getting mostly A's) is pretty much going to kill any chances you've got in the next year or two.

You've got 3 realistic options (assuming you can't appeal this decision, which it sounds like you can't):

1. Apply to other SMPs with linkages and explain what happened. In this case you'll have to hope they give you a lot of leeway and are willing to take that risk. If you don't perform there, frankly you're screwed. If you fail or under-perform it will have just been more wasted time and money. It may be that even if you are successful in the program, but you'd be able to say you tried.

2. Take a couple of years, work (preferably at a medically related job), and reapply to an SMP in 3-5 years as a "fresh" applicant. This will give you time to sort out your medical issues, get some real world experience, do some volunteering/get involved in the medical world, and save up some money. Imo this is the most realistic option if you're dead set on becoming a physician. Not everyone gets to take a direct route (I certainly didn't), but if you really want it then you'll put in the work to prove you deserve it.

3. Move on and find another career. There's nothing wrong with taking another path and there are plenty of other careers that are just as fulfilling and rewarding as being a physician. Additionally, at some point it become a better option to cut your losses and move on. Only you can decide if you're at that point in your life or if you should keep pushing, but staying realistic is also important.

Only you can really decide what to do and what your next steps are going to be. You should be realistic with yourself about what your weaknesses and capabilities are though and not just make decisions based on what you want. Best of luck with whatever choice you make, because it's not any easy one.
 
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Having a week to remediate a failed class is not atypical, it is pretty common at many medical schools (fail a class, have a week to study for an exam and then take a single exam to pass). Given your medical issues why did you not seek a medical LOA? I know this is besides the point now, but if your SMP isn't malignant they should have recognized this and allowed you to repeat when you were in better health. If you chose not to then it is a sign of poor decision making. That combined with your mediocre master's transcript (as previously stated, you should be getting mostly A's) is pretty much going to kill any chances you've got in the next year or two.

You've got 3 realistic options (assuming you can't appeal this decision, which it sounds like you can't):

1. Apply to other SMPs with linkages and explain what happened. In this case you'll have to hope they give you a lot of leeway and are willing to take that risk. If you don't perform there, frankly you're screwed. If you fail or under-perform it will have just been more wasted time and money. It may be that even if you are successful in the program, but you'd be able to say you tried.

2. Take a couple of years, work (preferably at a medically related job), and reapply to an SMP in 3-5 years as a "fresh" applicant. This will give you time to sort out your medical issues, get some real world experience, do some volunteering/get involved in the medical world, and save up some money. Imo this is the most realistic option if you're dead set on becoming a physician. Not everyone gets to take a direct route (I certainly didn't), but if you really want it then you'll put in the work to prove you deserve it.

3. Move on and find another career. There's nothing wrong with taking another path and there are plenty of other careers that are just as fulfilling and rewarding as being a physician. Additionally, at some point it become a better option to cut your losses and move on. Only you can decide if you're at that point in your life or if you should keep pushing, but staying realistic is also important.

Only you can really decide what to do and what your next steps are going to be. You should be realistic with yourself about what your weaknesses and capabilities are though and not just make decisions based on what you want. Best of luck with whatever choice you make, because it's not any easy one.

Thanks for taking the time to write all this. I have been working at this for so years and have invested a lot of time. It's almost like I'm mourning the loss of something so I think if my school doesn't allow me to repeat, I will just find a job and take time before reapplying to anything (that is if i even want to at that point)
 
This is not the end of the world and I know its very easy to say but please fix your issue what you have and may be take some time off from school or a gap year then go back to do SMP at another school. I'm sure you will rise. Just get the advice from here and do the best what you feel like it. People will give you their opinion but at the end of the day you need to decide what is best for you.

All the best!!!
Thanks! I have already started looking for jobs.
 
Having a week to remediate a failed class is not atypical, it is pretty common at many medical schools (fail a class, have a week to study for an exam and then take a single exam to pass). Given your medical issues why did you not seek a medical LOA? I know this is besides the point now, but if your SMP isn't malignant they should have recognized this and allowed you to repeat when you were in better health. If you chose not to then it is a sign of poor decision making. That combined with your mediocre master's transcript (as previously stated, you should be getting mostly A's) is pretty much going to kill any chances you've got in the next year or two.

You've got 3 realistic options (assuming you can't appeal this decision, which it sounds like you can't):

1. Apply to other SMPs with linkages and explain what happened. In this case you'll have to hope they give you a lot of leeway and are willing to take that risk. If you don't perform there, frankly you're screwed. If you fail or under-perform it will have just been more wasted time and money. It may be that even if you are successful in the program, but you'd be able to say you tried.

2. Take a couple of years, work (preferably at a medically related job), and reapply to an SMP in 3-5 years as a "fresh" applicant. This will give you time to sort out your medical issues, get some real world experience, do some volunteering/get involved in the medical world, and save up some money. Imo this is the most realistic option if you're dead set on becoming a physician. Not everyone gets to take a direct route (I certainly didn't), but if you really want it then you'll put in the work to prove you deserve it.

3. Move on and find another career. There's nothing wrong with taking another path and there are plenty of other careers that are just as fulfilling and rewarding as being a physician. Additionally, at some point it become a better option to cut your losses and move on. Only you can decide if you're at that point in your life or if you should keep pushing, but staying realistic is also important.

Only you can really decide what to do and what your next steps are going to be. You should be realistic with yourself about what your weaknesses and capabilities are though and not just make decisions based on what you want. Best of luck with whatever choice you make, because it's not any easy one.

Also I did not take a medical leave of absence because my primary care kept on assuring me it was just allergies and that seems like not something people take medical LOA for. It wasn't until after the semester ended and I saw specialist and got x-rays done where I found out it wasn't just allergies. Im still seeing my specialist to figure out what is exactly going on causing my symptoms. A similar thing happened with a girl in our class earlier in the year. She having symptoms that the school clinic diagnosed as depression/anxiety so they just kept pushing pills on her. She eventually withdrew really early on because her grades were bad and a month later she was diagnosed with something serious and had to get surgery. Almost a year later, she is still recovering. When she informed the school of this, they did not respond to her emails and she has yet to hear back from them so it seems like the school is not very sympathetic.

I used to sit in class and meetings with my advisors with constant drainage for the entire second semester and would often have to leave class to use my inhaler because I wasn't able to breathe. Even my classmates noticed this. I explained this to my advisor in the beginning of the semester and told her about it but she also seemed to just relate it to allergies so she didn't really pay any mind to it. Imagine sitting in class every single day and having to focus when you can't breathe. No one was taking me seriously so I just chose to live it. I was convinced it was allergies and would just go away, I did not think it would be something I would still be dealing with.
 
Also I did not take a medical leave of absence because my primary care kept on assuring me it was just allergies and that seems like not something people take medical LOA for. It wasn't until after the semester ended and I saw specialist and got x-rays done where I found out it wasn't just allergies. Im still seeing my specialist to figure out what is exactly going on causing my symptoms. A similar thing happened with a girl in our class earlier in the year. She having symptoms that the school clinic diagnosed as depression/anxiety so they just kept pushing pills on her. She eventually withdrew really early on because her grades were bad and a month later she was diagnosed with something serious and had to get surgery. Almost a year later, she is still recovering. When she informed the school of this, they did not respond to her emails and she has yet to hear back from them so it seems like the school is not very sympathetic.

I used to sit in class and meetings with my advisors with constant drainage for the entire second semester and would often have to leave class to use my inhaler because I wasn't able to breathe. Even my classmates noticed this. I explained this to my advisor in the beginning of the semester and told her about it but she also seemed to just relate it to allergies so she didn't really pay any mind to it. Imagine sitting in class every single day and having to focus when you can't breathe. No one was taking me seriously so I just chose to live it. I was convinced it was allergies and would just go away, I did not think it would be something I would still be dealing with.

I'm sorry to hear about all of this. It sounds a bit like your program isn't very forgiving of it's students and that they have a certain set of priorities. Idk if I'd necessarily call it malignant, but they certainly don't sound like they're doing their students any favors.

This actually illustrates a point that I think gets skimmed over a lot when people are choosing schools to attend or programs to enter, and that is how do they treat their students during times of stress. Most medical schools will do whatever they can to ensure their students don't fail out, the same can't be said for UG or master's programs. For others out there looking into master's or SMP programs, try and talk to people in the program or alumni to find out what resources are available to students and what happens when students have personal issues come up. It can be difficult to find out, but if you can it can make a huge difference if an actual emergency or stressful situation comes up.
 
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To be fair, this was an SMP. These programs are last ditch efforts to get into a Med school stateside. I would argue part of that test is to see how the applicant handles pressure. OP failed. As ADCOM have stated on the thread, applicants have to really stick the landing with these programs (3.7 for MD, 3.5 for DO) which is hard to do taking medical school level equivalent classes. Why would an SMP care to cater to a failing student when they have ten more lined up waiting to take a med school spot and who dont need to be hand holded and who got the scores needed?

OP, did you know the risks going in? Did you know this was your "last chance"? Did you look at alternatives, like retaking the MCAT?

Also, you said you have been at this for a while. How long will you attempt to try and chase this dream of medical school. Till you are 30? 40? Are you willing to put your life on hold for that long? Why would a medical school pick you over someone who hasnt failed out of an SMP? This isnt to be mean, or to kick you while youre down, but if you are going to try again, you need to ask yourself why you failed. You didnt just not make the GPA cuttoff, you FAILED. Is your brain built to memorize huge quantities of information in a short amount of time, or is your brain built differently? Some people have much more spatial reasoning while others are better at reading comprehension and retention. Medical school rewards reading comprehension and recollection. It doesnt matter if you have the nicest bedside manner in the world, or if you would make an excellent doctor and all the patients love you, you have to achieve minimum competency to practice medicine as a MD/DO.

Now, the good news is you can still be a "doctor". That is why if this were me, I would look into something like Optometry or Dentistry, as the material is much more strait forward and not as difficult. Compare OD curriculums to DO. I also think OD and PharmD schools still do grade replacement, which if you were to retake that F, you could turn it into an A (double check).

I'm sorry to hear about all of this. It sounds a bit like your program isn't very forgiving of it's students and that they have a certain set of priorities. Idk if I'd necessarily call it malignant, but they certainly don't sound like they're doing their students any favors.

This actually illustrates a point that I think gets skimmed over a lot when people are choosing schools to attend or programs to enter, and that is how do they treat their students during times of stress. Most medical schools will do whatever they can to ensure their students don't fail out, the same can't be said for UG or master's programs. For others out there looking into master's or SMP programs, try and talk to people in the program or alumni to find out what resources are available to students and what happens when students have personal issues come up. It can be difficult to find out, but if you can it can make a huge difference if an actual emergency or stressful situation comes up.
 
Why would an SMP care to cater to a failing student when they have ten more lined up waiting to take a med school spot and who dont need to be hand holded and who got the scores needed?

Because when students start an SMP and don't get into med school or some other grad school (dental, vet, etc) it reflects poorly on the program. Even a small number of people not making it can look really bad unless the program is large (if 4 out of 100 don't make it it's not an issue, if 4 out of 30 don't make it that's actually not the best sign). If the students straight up can't cut it, that's one thing. If students have a medical issue and the school isn't supportive, that's a red flag imo. I say that as someone who just finished medical school and matched into a solid program after taking a medical LOA during grad school.
 
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Because when students start an SMP and don't get into med school or some other grad school (dental, vet, etc) it reflects poorly on the program. Even a small number of people not making it can look really bad unless the program is large (if 4 out of 100 don't make it it's not an issue, if 4 out of 30 don't make it that's actually not the best sign). If the students straight up can't cut it, that's one thing. If students have a medical issue and the school isn't supportive, that's a red flag imo. I say that as someone who just finished medical school and matched into a solid program after taking a medical LOA during grad school.
My class had about 50 people starting out. 42 after the first semester. After the second semester only 5 people got into the medical school
 
My class had about 50 people starting out. 42 after the first semester. After the second semester only 5 people got into the medical school

I amend what I said, that's a straight up malignant program and I'm sorry to say it sounds like you were almost doomed from the start there. Were you aware of those stats when starting? Because in all honesty this if this were a med school this would make the Caribbean schools look like the Ivy league. Sorry if that's harsh, I hope things work out one way or the other though.
 
I amend what I said, that's a straight up malignant program and I'm sorry to say it sounds like you were almost doomed from the start there. Were you aware of those stats when starting? Because in all honesty this if this were a med school this would make the Caribbean schools look like the Ivy league. Sorry if that's harsh, I hope things work out one way or the other though.
When I applied, their class size was only 20 and people were matriculating into the medical school succesfully . The first class size was about 10 and about 8 students got in but they have been increasing the class size every year so I was assuming I was going into a program with about 20 students not 50.
 
Very much, if not all of it.

Tulane ACLP, will be attending Tulane SOM in the Fall. this time last year i had a 3.06 sGPA lol
If you don't mind me asking, how were you able to afford the tuition since it doesn't qualify for federal aid. Sorry if this is too person. We have a certification program near me but I cannot afford to pay 10000 out of pocket plus other living expenses.
 
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