DO student, Failed step 1,Hoped for ob, need advice

[ohnoeshelp]

---

Members don't see this ad.

So today has been the worst day I can remember. I'm a 3rd year DO student who has done WELL so far but I got my Step 1 results back today. 192 (after consecutive UWSAs in the 220s) . I'm heartbroken. My COMLEX 1 is 425 and the same thing happened last year (550s on practice COMSAEs) which is the main reason I postponed Step. I thought I was going to be able to at least get in the low 200s but I guess my practice scores cannot be trusted :-(. I love Ob, and I've got several OB rotations set up for next year (including at a few reach programs) and want to know what you think I can/should do. Other than that, my application is fine. I did well in 1st- 3rd year, never failed a shelf, great feedback and recommendation letters, and I've got a good mix of extracurriculars. and I think my enthusiasm make me a strong applicant. I also have an interesting personal story as a first generation immigrant, first in family to go to college. My only drawback is my test scores.

I am well aware of the detrimental nature of my situation and I have reached to my school advisors who have given me conflicting information. - MD advisor said , Take step 2 -->crush it, see if you can retake step 1 with a MUCH better score and only then retake it (recommended not signing up for the test again unless I am way passed 240s in NBMEs). Broaden your horizons, look into FM, IM, Peds, Psych. - DO advisor said DO NOT TAKE step 2, only study for Level 2 and show improvement. Apply only AOA and look into mostly FM programs. Write an Essay in preparation to soap.

I need your help here with either personal, or anecdotal evidence of people you know who have recently made it through this situation. At this point I honestly just want to match anything.

Should I retake step 1? Should I just skip it and take step 2? should I just skip both and take comlex level 2. Are there any other less competitive specialties willing to take someone with a history of Fail. Thank you all and may you never ever have to be in this situation.

 

[Dr.Jekyll75]

tough situation... I mean personally in your predicament id focus on maxing out my Comlex and not bother with step, apply solely AOA or to former AOAs that are acgme

 

[Spectreman]

Anecdotal, but I met a gal a few weeks ago who had a similar situation, but turned it around with COMLEX 2 (450ish 1, 700+ 2) and matched. You really got to wreck that thing though. Best of luck.

 

[Drrrrrr. Celty]

Personally in your position I would focus on COMLEX 2. Likewise I would figure out why you're choking on the real thing.

 

[Postictal Raiden]

Don't report your USMLE score. Destroy COMLEX. Audition like your life depends on it.

 

[BorntobeDO?]

Ah man that sucks. I think you have to not assign the USMLE and apply AOA/former AOA heavily to have a shot. I would focus on COMLEX level 2. I wouldn't want a failing Step anywhere near my app.

 

[ohnoeshelp]

Anecdotal, but I met a gal a few weeks ago who had a similar situation, but turned it around with COMLEX 2 (450ish 1, 700+ 2) and matched. You really got to wreck that thing though. Best of luck.

Thank you! Matched FM?

 

[Moose A Moose]

Your MD advisor is giving you MD advice. You’re a DO. You need to push your Step 1 score aside and forget about Step 2. All of your focus needs to be on Level 2. Good luck.

 

[deleted480308]

Walk away from usmle, that’s over now

 

[jrlob91]

Rough. A lot of the prior AOA ob residencies have jumped or will be jumping to the ACGME match next year. Look into residencies with osteopathic recognition, they will be more likely to give you a chance with a much improved comlex. Also, look into unopposed FM programs that will get you certified in c sections as an FM doc. There are some out there.

 

[AMEHigh]

I would focus on the comlex.

I failed comlex step 1 and applied OB. (I didn't take the usmle, this was several years ago). I did get about 8 acgme interviews, but ultimately didn't match.

I'm family medicine and am very, very happy. I never had much interest in ob, but more on gyn and family planning and that's exactly what I'm doing for my career through family medicine. There are a bunch of family med trained doctors that do a lot of OB and/or gyn (some do that only exclusively and don't practice general family med anymore).

I think you should still have your sights set on trying to match obgyn if that's what you really want, but family med is a great alternative that you should consider. I know the devastating feeling, but I promise it's not the end of the world.

 

[JamesPotterMS-3]

see if you can retake step 1 with a MUCH better score and only then retake it (recommended not signing up for the test again unless I am way passed 240s in NBMEs)

This would take a month or more of full-time work. You don't have the time for that. Focus on Level 2. Look into OB heavy FM programs and new OB programs

 

[Dr.Jekyll75]

I think this is the first time in SDN ive seen multiple people say the same thing in a row

 

[ohnoeshelp]

Walk away from usmle, that’s over now

I am starting to see that this is the consensus here. My fear is that as of now, I have to report the USMLE if the program is AOA/ACGME accredited and that this will automatically cause my application to be blacklisted everywhere. My other concern is that if I don't report it and it comes up, I will have my credibility questioned and this will be regarded as a violation of ethics and trust. I want to try to match my application seen in the best light possible given the awful circumstances. Do you have any thoughts on how and how soon I have to report the fail to the AOA programs? Thank you.

 

[ohnoeshelp]

I think this is the first time in SDN ive seen multiple people say the same thing in a row

Thank you. It is also a small comfort to see that the consensus not to leave medicine and that all is lost. I am trying my hardest to move on and I am just trying to see what is the best way of doing approaching this in such awful circumstances. Thank you for your input.

 

[ohnoeshelp]

This would take a month or more of full-time work. You don't have the time for that. Focus on Level 2. Look into OB heavy FM programs and new OB programs

Thank you.Are you suggesting programs for AOA or ACGME match?

 

[UTsksk]

FM -> OB fellowship or just go to an unopposed FM program like someone else said

 

[ohnoeshelp]

Rough. A lot of the prior AOA ob residencies have jumped or will be jumping to the ACGME match next year. Look into residencies with osteopathic recognition, they will be more likely to give you a chance with a much improved comlex. Also, look into unopposed FM programs that will get you certified in c sections as an FM doc. There are some out there.

Thank you. Do you recommend I only look at the active AOA programs (both OB and FM) and do not apply for the ones that are dual AOA/ACGME?

 

[ohnoeshelp]

Your MD advisor is giving you MD advice. You’re a DO. You need to push your Step 1 score aside and forget about Step 2. All of your focus needs to be on Level 2. Good luck.

Thank you. That will be my focus now.

 

[ohnoeshelp]

Rough. A lot of the prior AOA ob residencies have jumped or will be jumping to the ACGME match next year. Look into residencies with osteopathic recognition, they will be more likely to give you a chance with a much improved comlex. Also, look into unopposed FM programs that will get you certified in c sections as an FM doc. There are some out there.

Thank you, will spend much of this time doing research about where to go. Thanks

 

[trs88]

No you don't.

And how will it come up? Unless you volunteer that info it's as if it never happened.

They could be asked directly "Have you ever taken usmle step 1?" during an interview and at that point. OP is in a hard spot between lying and saying "No" and saying "I did but did not include the score in my application".

 

[Spectreman]

Thank you! Matched FM?

Matched OBGYN

 

[ohnoeshelp]

Don't report your USMLE score. Destroy COMLEX. Audition like your life depends on it.

Thank you for your reply. Do you know if this is possible? If you do, is there a place I can find the info so that I can bring this in when I meet with my advisors next? I would love to not have to report this

 

[ohnoeshelp]

Matched OBGYN

That's awesome and really encouraging. I hope that I can manage some sort of similar miracle. Do you know if she did a Sub I in the place where she matched?

 

[Postictal Raiden]

Thank you for your reply. Do you know if this is possible? If you do, is there a place I can find the info so that I can bring this in when I meet with my advisors next? I would love to not have to report this

Sorry. I’d defer to someone else. I don’t have sufficient information about the field to confidently answer your qs.

 

[ohnoeshelp]

No you don't.

And how will it come up? Unless you volunteer that info it's as if it never happened.

Thank you for this. I am looking into this right now. Do you have any good source where it says that it is possible not to submit my USMLE transcripts if I am a DO applying through ERAS. I would love to bring up any sources when I meet with my advisor next week.

 

[W19]

You are not going to match ACGME Obgyn. Period. Who knows how many Obgyn programs will be in the AOA match next cycle.

 

[Laito]

Will class of 2020 have an option not to report USMLE if one fails?

 

[DocWinter]

I matched ACGME OB with only COMLEX (not great level 1, very good level 2) and no USMLE. It was a struggle to get ACGME interviews and the majority of them came from former AOA programs. For you with a 425 level 1 you will really have a hard time getting interviews without auditions, and many places require a 450 or a 500 level 1.

Your ONLY real hope of becoming an OB is very small, and would entail that you apply for auditions at several AOA or former AOA programs who will accept your low COMLEX. You need to ASK the program coordinators if they have COMLEX cutoffs to interview, otherwise you could possibly audition at a place and be screened out from interviewing there, which is a total waste of your time and $$. You have little to no chance of enough interviews at to match at (original) ACGME programs with a COMLEX below 450.

Don't retake step 1, don't take step 2, just focus on level 2. Make FM or an alternative your plan B and go in expecting plan B. If I were you I would start looking at FM as a reality to get comfortable with and move in that direction, but understand if you're the type to exhaust all options first.

Also, it's somewhat of a myth that now that the merger is pretty much occurred that you NEED USMLE. Those AOA programs that were roped into going ACGME are still pretty much the same and can now take MDs but as far as most PDs are concerned it's business as usual as far as having their COMLEX criteria and a good personality.

 

[ohnoeshelp]

Ah man that sucks. I think you have to not assign the USMLE and apply AOA/former AOA heavily to have a shot. I would focus on COMLEX level 2. I wouldn't want a failing Step anywhere near my app.

Thank you!I I will focus on comlex and look into the rules of USMLE reporting for DO's for this upcoming cycle.

 

[AlbinoHawk DO]

Step is over. I would do AOA exclusively except maybe ACGME FM. I don't think you will need to SOAP if you have FM backup.

 

[ThreeCheers]

Not gonna lie, matching OB with those stats will be difficult even if there are a good amount of programs in the AOA match for this upcoming cycle.

What is it that you like about OB/GYN? If you don’t care abut GYN surgeries, and you don’t care about living in NYC/LA/Boston/Chicago, then unopposed FM —> women’s health/OB fellowship is a great tract. Many people go that route either as a backup or because they don’t want to take on a surgical residency.

You have nothing to lose by auditioning your heart out at the programs that accepted you for a rotation, but definitely be prepared for a plan B. I hope it works out for you with OB, but it’s not the end of the world if it doesn’t. Best of luck!

 

[Lexdiamondz]

They could also be asked if they snort cocaine off hookers.

Point is no one is gonna ask that. And no one is gonna ask, "have you ever taken step 1."

I'm willing to bet that the number of PDs who ask DO students, without a reported step score, if they took step and subsequently didn't report it, closely approaches 0.

But you have absolutely no basis for that opinion. We have no idea what PDs ask and even less of an idea of what they will require after the merger.

 

[Leggomyeggo128]

But you have absolutely no basis for that opinion. We have no idea what PDs ask and even less of an idea of what they will require after the merger.

Maybe you are right, but all these threads about DO students failing usmle and trying to hide it looks so bad for us. The USMLE is a minimal competency exam for US MD students. DOs have every right to not take it, but if they choose to take it and they fail it....they have essentially demonstrated that they have not met minimal competency standards expected of a third year medical student at the start of their clinical education.

ERAS is very clear. If you have taken USMLE you must report it. Sure there is zero accountability for this written policy, but as it is becoming the norm for an increasing minority of DO students this will undoubtedly become a factor in how ACGME program directors view all DO students. Questions of ‘what is this student hiding?’ will become the norm. USMLE step 1 is predictive of national liscensing board pass rate (https://www.google.com/amp/s/www.re...redictor_of_Success_in_Surgical_Residency/amp) and by lying about it you are selling false goods to a residency program. As these students flame out of residency this will sour program director opinions on DO candidates (as they look bad if there residents can’t hack it) and less and less will be interviewed and accepted into these positions.

The free lunch for DOs is ending. The residency merger was a huge step in establishing parity between MD and DO candidates. If we want to continue on this path to parity (in the eyes of PDs), we should be held to the same standards as MDs. And for me, that means if you decide to take the USMLE you should do the honest (and contractually obligated but not enforced) thing and report it. Anything less is a step back for us DOs.

 

[ThreeCheers]

Granted I am no expert because I didn’t even do the ACGME match, but my understanding is that “reporting” your score (per ERAS rules) simply means entering your USMLE ID number. It does not necessarily mean you have to authorize those scores for release to each program.

This was a surprisingly common issue, at least for my class, because most people do better on the COMLEX than on the USMLE. The general consensus seemed to be that it is a (perhaps ethically questionable) loophole to withhold scores from release, but it is not an outright contractual violation. Again I am only going by hearsay so feel free to correct me if I’m wrong or if the rules have changed.

Hopefully one day the two exams will be merged somehow to eliminate this issue altogether.

 

[Leggomyeggo128]

Granted I am no expert because I didn’t even do the ACGME match, but my understanding is that “reporting” your score (per ERAS rules) simply means entering your USMLE ID number. It does not necessarily mean you have to authorize those scores for release to each program.

This was a surprisingly common issue, at least for my class, because most people do better on the COMLEX than on the USMLE. The general consensus seemed to be that it is a (perhaps ethically questionable) loophole to withhold scores from release, but it is not an outright contractual violation. Again I am only going by hearsay so feel free to correct me if I’m wrong or if the rules have changed.

Hopefully one day the two exams will be merged somehow to eliminate this issue altogether.

You are right. You don’t have to release your scores, but you do “have to” report you took the exam by punching in your usmle id. Failure to do so is a match violation if ever found out.

However, people who fail choose to risk this because A) as of now there is no real way to enforce this and B) Program directors probably won’t ask about the usmle if not prompted by your USMLE ID and no score. An easy way to fix this would to have standardized test scores (or maybe just percentiles) listed on the mspe.

Personally, I don’t think it’s fair for someone lying about their application by failing to report an exam score to take an interview spot from someone who had an honest application

 

[Dr.Jekyll75]

You are right. You don’t have to release your scores, but you do “have to” report you took the exam by punching in your usmle id. Failure to do so is a match violation if ever found out.

However, people who fail choose to risk this because A) as of now there is no real way to enforce this and B) Program directors probably won’t ask about the usmle if not prompted by your USMLE ID and no score. An easy way to fix this would to have standardized test scores (or maybe just percentiles) listed on the mspe.

Personally, I don’t think it’s fair for someone lying about their application by failing to report an exam score to take an interview spot from someone who had an honest application

I don’t think we’ll see a unified exam for a long time if ever. It’s too much of a money grab. Secondly say the program director does go and look up the percentile the students scored in, they might not even offered an interview. OPs Best bet is to stick to former AOA’s and audition like his life depends on it. At the end of the day, if they program director has the slightest doubt that you will pass your specialty boards they won’t match you. That is why op needs to crush Level 2.


Sent from my iPhone using SDN mobile

 

[ohnoeshelp]

Maybe you are right, but all these threads about DO students failing usmle and trying to hide it looks so bad for us. The USMLE is a minimal competency exam for US MD students. DOs have every right to not take it, but if they choose to take it and they fail it....they have essentially demonstrated that they have not met minimal competency standards expected of a third year medical student at the start of their clinical education.

ERAS is very clear. If you have taken USMLE you must report it. Sure there is zero accountability for this written policy, but as it is becoming the norm for an increasing minority of DO students this will undoubtedly become a factor in how ACGME program directors view all DO students. Questions of ‘what is this student hiding?’ will become the norm.

The free lunch for DOs is ending. The residency merger was a huge step in establishing parity between MD and DO candidates. If we want to continue on this path to parity (in the eyes of PDs), we should be held to the same standards as MDs. And for me, that means if you decide to take the USMLE you should do the honest (and contractually obligated but not enforced) thing and report it. Anything less is a step back for us DOs.

I appreciate your point of view and rest assured that I am not trying to hide my score or any other part of my application. My issue is that the way the a FAIL is used now, to filter out an application entirely from residency consideration. In my case is a reductionist view of my ability to do well in residency given the rest of my application and grades in medschool.

Additionally, it is well documented that using STEP 1 scores as the single selecting factor for a resident is not an accurate way to predict resident performance: americanjournalofsurgery : S0002-9610(14)00453-X and annemergmed article: S0196-0644(00)01583-3 to list a few examples.
The demographic characteristic data of students who fail vs. those who do well is also well documented and it seems to demonstrate that students who are likely to fail the exam falling into specific socioeconomic and demographic groups and students with higher scores consistently meeting certain racial and socioeconomic characteristics see here: Academic and professional career outcomes of medical school graduates who failed USMLE Step 1 on the first attempt Leon McDougle (2013).
I happen to meet most of the criteria for predictive failure but I have never let my background determine my future. Only I can do that through the hard work and dedication that has gotten me here so far.
I am not trying to justify by any means my performance in the exam with these facts, all I am trying to show you is that one score on a test does not tell the whole story of an applicant and their ability to do well in residency and beyond.

Since I have done very well on my shelfs and other exams in medschool and even practice exams for Step (high 220s on the last 2 practice tests) , my issue seems to be related to the actual test day and not a lack of knowledge or failing to meet I am certain that I do not fall in the "failing to meet minimal competency standards of a third year medical student you mentioned". I am gathering information form multiple reliable sources including current PDs as to when it is the best time to disclose this information in a way that is honest and transparent but also does not get me automatically black listed from getting an interview by my own merit. No attempt to get a "free lunch for Dos" here, just a fair review of my qualifications and my potential. To the point "As these students flame out of residency this will sour program director opinions on DO candidates (as they look bad if there residents can’t hack it) and less and less will be interviewed and accepted into these positions" There is absolutely zero chance that this will be my case based not only on my 3rd year grades, recommendation letters, and faculty feedback; but on the fact that regardless of whether I match, or SOAP into OB, IM or rural FM, I decided a long time ago that I will be an excellent physician for my patients, I have worked harder than anyone I know, and will continue to do so and not let one test define me. As my man Brady said before the 2016 super bowl "I did not come this far, to only come this far".

See you at the end zone, Leggomyeggo128

 

[Leggomyeggo128]

I appreciate your point of view and rest assured that I am not trying to hide my score or any other part of my application. My issue is that the way the a FAIL is used now, to filter out an application entirely from residency consideration. In my case is a reductionist view of my ability to do well in residency given the rest of my application and grades in medschool.

Additionally, it is well documented that using STEP 1 scores as the single selecting factor for a resident is not an accurate way to predict resident performance: americanjournalofsurgery : S0002-9610(14)00453-X and annemergmed article: S0196-0644(00)01583-3 to list a few examples.
The demographic characteristic data of students who fail vs. those who do well is also well documented and it seems to demonstrate that students who are likely to fail the exam falling into specific socioeconomic and demographic groups and students with higher scores consistently meeting certain racial and socioeconomic characteristics see here: Academic and professional career outcomes of medical school graduates who failed USMLE Step 1 on the first attempt Leon McDougle (2013).
I happen to meet most of the criteria for predictive failure but I have never let my background determine my future. Only I can do that through the hard work and dedication that has gotten me here so far.
I am not trying to justify by any means my performance in the exam with these facts, all I am trying to show you is that one score on a test does not tell the whole story of an applicant and their ability to do well in residency and beyond.

Since I have done very well on my shelfs and other exams in medschool and even practice exams for Step (high 220s on the last 2 practice tests) , my issue seems to be related to the actual test day and not a lack of knowledge or failing to meet I am certain that I do not fall in the "failing to meet minimal competency standards of a third year medical student you mentioned". I am gathering information form multiple reliable sources including current PDs as to when it is the best time to disclose this information in a way that is honest and transparent but also does not get me automatically black listed from getting an interview by my own merit. No attempt to get a "free lunch for Dos" here, just a fair review of my qualifications and my potential. To the point "As these students flame out of residency this will sour program director opinions on DO candidates (as they look bad if there residents can’t hack it) and less and less will be interviewed and accepted into these positions" There is absolutely zero chance that this will be my case based not only on my 3rd year grades, recommendation letters, and faculty feedback; but on the fact that regardless of whether I match, or SOAP into OB, IM or rural FM, I decided a long time ago that I will be an excellent physician for my patients, I have worked harder than anyone I know, and will continue to do so and not let one test define me. As my man Brady said before the 2016 super bowl "I did not come this far, to only come this far".

See you at the end zone, Leggomyeggo128

I’ll be waiting for you!

Leggomyeggo128, MS4 for another week.

 

[SLC]

It might just be where I work, but OB seems miserable. Maybe be glad your options are limited? Happy, congenial obstetricians are an endangered species around here.

Go FM, find an OB heavy program, and learn the joys of taking care of Mom and baby together!

 

[mediseen712]

Hi! I am in the same boat right now and was wondering if you had any success matching into OB/GYN?

 

[NotAProgDirector]

The OP hasn't logged in since 2019, so you're not going to get much of an answer, I expect.

 

[GoSpursGo]

The OP hasn't logged in since 2019, so you're not going to get much of an answer, I expect.

Agree.

Locked