DUI before medical school. Really interested in Ortho or CTS. Would really appreciate any advice...

[LapMyChole]

Hello Everyone,

So i'll cut to the chase. I'm a current MS3 at a mid-tier state MD school. 1 year before before medical school, I made the absolutely absurd and irresponsible decision to drive after a few drinks, and i got nailed for it. Ended up getting a DUI (a misdemeanor in my state). I've since had it set aside on my record (although i've been advised to still disclose it on ERAS, which I will definitely do).

Well it turns out i'm really interested in some of the more competitive surgery specialties, Ortho and cardiothoracic specifically. Besides this glaring red flag, i'd like to think i'm a decent applicant - mid 240's step 1, MS degree before medical school, a decent amount of research, solid extracurriculars during school.

Does anyone have experience applying with a DUI to a competitive specialty ?
Should a forgo the competitive specialties and settle for something else?
Do you think it will outright prevent me from matching?
Is there anything I can do to ease the burden of this on my ERAS app?
Any thoughts are much appreciated. Thank you all so much.

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[Emmet2301]

I swear this question is asked every year.

 

[deleted393595]

Hello Everyone,

So i'll cut to the chase. I'm a current MS3 at a mid-tier state MD school. 1 year before before medical school, I made the absolutely absurd and irresponsible decision to drive after a few drinks, and i got nailed for it. Ended up getting a DUI (a misdemeanor in my state). I've since had it set aside on my record (although i've been advised to still disclose it on ERAS, which I will definitely do).

Well it turns out i'm really interested in some of the more competitive surgery specialties, Ortho and cardiothoracic specifically. Besides this glaring red flag, i'd like to think i'm a decent applicant - mid 240's step 1, MS degree before medical school, a decent amount of research, solid extracurriculars during school.

Does anyone have experience applying with a DUI to a competitive specialty ?
Should a forgo the competitive specialties and settle for something else?
Do you think it will outright prevent me from matching?
Is there anything I can do to ease the burden of this on my ERAS app?
Any thoughts are much appreciated. Thank you all so much.

Applying for the combined CT programs without significant research AND a CT mentor with whom you have a strong longitudinal relationship over many years is an extremely uphill battle. Especially when you imply that you've done ortho research that is going to scare combined CT programs away. Do you mean that you want to apply GS and then do CT?

 

[LapMyChole]

Applying for the combined CT programs without significant research AND a CT mentor with whom you have a strong longitudinal relationship over many years is an extremely uphill battle. Especially when you imply that you've done ortho research that is going to scare combined CT programs away. Do you mean that you want to apply GS and then do CT?

I apologize, I should have been more specific. I have narrowed my interests down to CT and Ortho. My research is in cardiology, ortho, and general surgery. I have not decided which specialty I will apply to yet - I am a new 3rd year (just took STEP 1 in January, since my school is on a 17th month didactic curriculum). I was supposed to start clerkships in march but they were delayed due to the situation with COVID. I was planning to make a firm decision in the next 2 months regarding if I will apply to Ortho or combined CT. Hopefully that makes sense.

 

[LapMyChole]

I swear this question is asked every year.

I looked pretty deep and found some posts about students with DUIs applying to Anesthesia and general surgery. But was unable to find anything regarding the two specialties I mentioned above. Do you think the answer to my question is the same regardless of the specialty I apply to?

 

[deleted393595]

I apologize, I should have been more specific. I have narrowed my interests down to CT and Ortho. My research is in cardiology, ortho, and general surgery. I have not decided which specialty I will apply to yet - I am a new 3rd year (just took STEP 1 in January, since my school is on a 17th month didactic curriculum). I was supposed to start clerkships in march but they were delayed due to the situation with COVID. I was planning to make a firm decision in the next 2 months regarding if I will apply to Ortho or combined CT. Hopefully that makes sense.

If you want to do combined CT, get talking with a CT mentor immediately. Have a friend going through the same process who now is going through the regular GS match since they didn't build CT relationships early enough

 

[LapMyChole]

If you want to do combined CT, get talking with a CT mentor immediately. Have a friend going through the same process who now is going through the regular GS match since they didn't build CT relationships early enough

Understood, i'll start the process immediately. thanks so much for your insight! do you think I should tell the folks I speak to now about my red flag?

 

[deleted393595]

Understood, i'll start the process immediately. thanks so much for your insight! do you think I should tell the folks I speak to now about my red flag?

I'd say yes, but I'm also not the most socially astute

 

[V5RED]

Have you done anything to show you have changed/fixed whatever led you to commit a DUI? Not much time has passed since the DUI, but obviously your school thought it would not keep you from matching into at least some specialties or else they would not have admitted you. Have you talked to advisors in this department? Do you still drink/get drunk?

Idk about advertising it to everyone you work with, but your advisors definitely need to know, and probably any mentor so you know whether or not you are wasting your time on this specialty.

 

[LapMyChole]

Have you done anything to show you have changed/fixed whatever led you to commit a DUI? Not much time has passed since the DUI, but obviously your school thought it would not keep you from matching into at least some specialties or else they would not have admitted you. Have you talked to advisors in this department? Do you still drink/get drunk?

Idk about advertising it to everyone you work with, but your advisors definitely need to know, and probably any mentor so you know whether or not you are wasting your time on this specialty.

Thanks for the advice. I really believe I've done the necessary personal development work to fix what led to the DUI. I occasionally have a drink, I do not get drunk. I told a few members whom i trust in my school administration about it, but none in the departments of the specialties im interested in.

 

[LapMyChole]

Even though you had it set aside, you should still answer in the affirmative on your ERAS application to the question asking if you have something on your record that could limit licensing (the misdemeanor or felony question only nets so many red flags. The licensing question pretty much nets all/the rest). If you don't disclose it and it somehow surfaces later, whether through discovery or your own confession, your program could potentially dismiss you if they so choose.

Oh absolutely. 100% im disclosing it, im not hiding a single thing about it. and if it prevents me from matching one of the surgery specialties im interested in so be it, ill own it

If this were me, I would shoot for the stars and still go for my specialty of choice because the situation is out of my hands (there's nothing you can do about it but move forward), but definitely have a back up to apply to.

Yep thats the plan as of now. I don't apply to ERAS until 2021 (graduation date is 2022) so ill be trying to make myself as competitive of an applicant as i can in the mean time. While it would haunt me if i couldn't be a surgeon because of this, i'll have a backup in play and make the best of it. Thanks for sharing your perspective.

 

[deleted480308]

Thanks for the advice. I really believe I've done the necessary personal development work to fix what led to the DUI. I occasionally have a drink, I do not get drunk. I told a few members whom i trust in my school administration about it, but none in the departments of the specialties im interested in.

If I heard you still drank after a DUI, I would immediately push hard for a “do not rank” in a resident meeting

 

[longhaul3]

If I heard you still drank after a DUI, I would immediately push hard for a “do not rank” in a resident meeting

Why—because you think he shouldn't be drinking or he shouldn't have brought it up?

I don't think it matters that OP still drinks, but I agree that he/she should try to avoid talking about it. Appearances matter and it strikes me as borderline taboo to say in a formal, public setting that you still drink. Whatever specialty you go into, you should not drink at the interview dinners.

 

[deleted480308]

Why—because you think he shouldn't be drinking or he shouldn't have brought it up?

I don't think it matters that OP still drinks, but I agree that he/she should try to avoid talking about it. Appearances matter and it strikes me as borderline taboo to say in a formal, public setting that you still drink. Whatever specialty you go into, you should not drink at the interview dinners.

Either. Once you have a DUI you shouldn’t be drinking

If someone doesn’t have an established history of risking other lives with alcohol and the residents at the interview are drinking it is ok for an applicant to do so if they stay VERY under their tipsy limit. You are still responsible for your words/actions and people with a lot of alcohol can ruin that job interview

 

[sovereign0]

In my completely honest opinion, you would have a hard time matching any surgical sub-specialty with an average Step 1 and a red flag like this without any significant redeeming factors. Both CT6 and Ortho have more applicants who are equally if not more qualified than you than they have spots, and with the DUI being disclosed on ERAS it's unlikely enough programs would be willing to take a chance in offering you an interview. Even once interviewed, what reason would a program have for ranking you higher than a completely identical applicant without a DUI on record? Programs are very risk-averse, especially smaller specialties like CT6.

I don't mean to discourage you from applying, but the safe option here is to dual-apply Ortho or CT6 as well as general surgery and then potentially a cardiothoracic fellowship.

 

[deleted393595]

If someone doesn’t have an established history of risking other lives with alcohol and the residents at the interview are drinking it is ok for an applicant to do so if they stay VERY under their tipsy limit. You are still responsible for your words/actions and people with a lot of alcohol can ruin that job interview

On the flip side, what if you don't drink (and don't have any pmh of EtOH problems)? Would you not partaking with the other residents be seen as a negative?

 

[deleted947265]

On the flip side, what if you don't drink (and don't have any pmh of EtOH problems)? Would you not partaking with the other residents be seen as a negative?

Anyone that would hold it against you for not drinking or try to pressure you into drinking is an ass you don't want to work with them.

 

[deleted393595]

Anyone that would hold it against you for not drinking or try to pressure you into drinking is an ass you don't want to work with them.

In a professional setting I worked in before med school, being a non-drinker was considered abnormal. If you were, you were encouraged to have a cup on you and pretend to drink from it. Not sure if the same expectations hold at the residency level

 

[deleted480308]

On the flip side, what if you don't drink (and don't have any pmh of EtOH problems)? Would you not partaking with the other residents be seen as a negative?

In a professional setting I worked in before med school, being a non-drinker was considered abnormal. If you were, you were encouraged to have a cup on you and pretend to drink from it. Not sure if the same expectations hold at the residency level

At interview dinners I will generally say, "the program won't buy them for you but you are welcome to have a drink with your meal here. We don't consider a plus or minus either way, we have a number of residents who don't drink for whatever reason. I'm gonna buy one for myself, you do what makes you happy."

 

[deleted393595]

At interview dinners I will generally say, "the program won't buy them for you but you are welcome to have a drink with your meal here. We don't consider a plus or minus either way, we have a number of residents who don't drink for whatever reason. I'm gonna buy one for myself, you do what makes you happy."

Thanks! Appreciate the inside perspective on this

 

[deleted480308]

Thanks! Appreciate the inside perspective on this

I'm a huge hardass for interview behavior. You hit on a resident? DNR. You drop racial jokes? DNR. You show up late for something without communicating (like you can't just walk downstairs from your hotel room on time?)? I'm annoyed with you. On your phone the whole time? annoyed. Can't hold your liqour and get sloppy at dinner because you won't stop at 1? annoyed. I figure if you can't be easy to work with for a few hours when you are trying to impress your way into the program, you will be a trainwreck once you think you are secure here and you are tired a few months in.

I have never held the decision to have a drink or not against someone (who doesn't have a DUI). Nor have I ever seen a resident bring it up in our rank meetings

 

[deleted393595]

You show up late for something without communicating (like you can't just walk downstairs from your hotel room on time?)?

Just practicing future attending behavior

 

[longhaul3]

On the flip side, what if you don't drink (and don't have any pmh of EtOH problems)? Would you not partaking with the other residents be seen as a negative?

Different programs and specialties have different cultures. There are a few places where people would judge you negatively for not drinking, but at the vast majority, there's no judgment either way unless you have too much. Drinking at dinners and going out with residents afterwards is the norm in my specialty. Lots of interview dinners end up with people pretty hammered at a bar at 3am with interview day starting at 7am.

Many programs also have a happy hour with attendings hosted by the department before the pre-interview dinner or after the interviews. Best to limit it to one drink at these or just graze on the finger food. I was always self-conscious holding a beer making small talk with the chairman, but it's okay if you want to.

At interview dinners I will generally say, "the program won't buy them for you but you are welcome to have a drink with your meal here. We don't consider a plus or minus either way, we have a number of residents who don't drink for whatever reason. I'm gonna buy one for myself, you do what makes you happy."

For the poster who asked, this varies by specialty—dinners are pretty extravagant in mine and drinks are always paid for. If we go out to the bar afterwards, the residents pick up the tab.

I'm a huge hardass for interview behavior. You hit on a resident? DNR. You drop racial jokes? DNR. You show up late for something without communicating (like you can't just walk downstairs from your hotel room on time?)? I'm annoyed with you. On your phone the whole time? annoyed. Can't hold your liqour and get sloppy at dinner because you won't stop at 1? annoyed. I figure if you can't be easy to work with for a few hours when you are trying to impress your way into the program, you will be a trainwreck once you think you are secure here and you are tired a few months in.

I have never held the decision to have a drink or not against someone (who doesn't have a DUI). Nor have I ever seen a resident bring it up in our rank meetings

I totally agree with this idea. We are happy to host you and honestly enjoy meeting most applicants, but you are not part of it until you're part of it. It really bothers me when applicants aren't on their best behavior. On the other hand, this is one of the best parts about matching—you're finally part of the club and you can stop walking the tightrope you've been on since the beginning of your clerkship year.

 

[LapMyChole]

I'm a huge hardass for interview behavior. You hit on a resident? DNR. You drop racial jokes? DNR. You show up late for something without communicating (like you can't just walk downstairs from your hotel room on time?)? I'm annoyed with you. On your phone the whole time? annoyed. Can't hold your liqour and get sloppy at dinner because you won't stop at 1? annoyed. I figure if you can't be easy to work with for a few hours when you are trying to impress your way into the program, you will be a trainwreck once you think you are secure here and you are tired a few months in.

I have never held the decision to have a drink or not against someone (who doesn't have a DUI). Nor have I ever seen a resident bring it up in our rank meetings

Thanks for your perspective, this is all great for me to know. In your opinion, would you advise me to not even apply for a surgical sub-specialty, since there are clearly applicants that are more equally and more competitive than I am without DUIs?

 

[deleted480308]

Thanks for your perspective, this is all great for me to know. In your opinion, would you advise me to not even apply for a surgical sub-specialty, since there are clearly applicants that are more equally and more competitive than I am without DUIs?

I generally advise a backup specialty (apply to two things)for those who are aiming above their paygrade and still want to go for it

my biggest advise to you is more about life, don’t drink anymore. the risk outweighs the reward

 

[wxman]

Just practicing future attending behavior

Being late or distracted (e.g., texting or on social media non-stop) is noticed during residency dinners and interviews. It is a hot topic for discussion during our rank meetings as we don’t want to work with someone that portrays themselves as lazy, unprofessional, and/or non-caring when they should be showing us why they want to come to our program. In addition, I personally don’t want to pick up their slack when they are late for rounds or they fail to finish their notes on time.

We had a resident fired from our program because they were constantly late. There is an ACGME metric for professionalism, and it is built into our residency contracts. This resident had stellar USMLE scores too......

@sb247 is absolutely right. Residency programs have tons of applicants that do not have red flags on their records like a DUI, misdemeanor or not.

At the end of the day, a PD might not want a resident in his or her program that still drinks after getting a DUI.


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[LapMyChole]

@sb247 is absolutely right. Residency programs have tons of applicants that do not have red flags on their records like a DUI, misdemeanor or not.

At the end of the day, a PD might not want a resident in his or her program that still drinks after getting a DUI.

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Thanks for the comment. Do you think i should drop my dream of being a surgeon and consider less-competitive specialties? or apply broadly to my programs of interest and hope for the best?

 

[wxman]

Thanks for the comment. Do you think i should drop my dream of being a surgeon and consider less-competitive specialties? or apply broadly to my programs of interest and hope for the best?

I wouldn’t say drop your dream by any means. Always have a contingency. Many people think that all of residency is about getting super high Step/Level scores. At least at my program, you better have a personality and a work ethic to go along with those scores.


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[deleted393595]

At least at my program, you better have a personality and a work ethic to go along with those scores.

Are you in a mil program by any chance?

 

[wxman]

Are you in a mil program by any chance?

Nope. Civilian program that prioritizes work ethic, timeliness, and professionalism over scores on a multiple choice examination. Our first-time pass rates (Step/Level 3, board certification) are 100% if that means anything.

 

[FindersFee5]

Thanks for the comment. Do you think i should drop my dream of being a surgeon and consider less-competitive specialties? or apply broadly to my programs of interest and hope for the best?

I think you'll still be competitive for general surgery, and you can do a number of different fellowships from there.

 

[LapMyChole]

I think you'll still be competitive for general surgery, and you can do a number of different fellowships from there.

Thank you! i'll definitely consider that. are you speaking from experience related to my situation?

 

[FindersFee5]

Thank you! i'll definitely consider that. are you speaking from experience related to my situation?

No. But in gen surg you'd probably be closer to an above average applicant than in the surgical subs. So programs would have more reason to look past it. You can also do a gen surg -> CT pathway.

 

[Detailsmatter]

just an MS1 here so take everything with a grain of salt. you f*cked up with the DUI, owned it, and showed a solid med school that you were worth being accepted. med schools are super risk averse and they still accepted you. Ppl like to say "oh show what youve done that youre different" but if it was a mistake and poor judgement theres not much you can do. You've done well in med school and if the stress of med school didnt cause you to drink and drive again then im not sure what else would show youve learned and moved on from this situation. I think you need to form close relationships with a mentor in the fields youre interested in and when you feel its appropriate bring up the DUI. Those are the only ppl who will really know if it will matter or not. I would focus on getting the best application as possible. make sure you kill step 2 and depending on conversations with the mentors you find, take a research year. I personally dont see why they would hold the DUI against you if you have a great application. just my 2 cents

 

[radsisrad]

Thanks for the advice. I really believe I've done the necessary personal development work to fix what led to the DUI. I occasionally have a drink, I do not get drunk. I told a few members whom i trust in my school administration about it, but none in the departments of the specialties im interested in.

You should get in the habit of never letting anyone see you having so much as a sip of wine. Ideally, if someone who might have an impact on your career were to ask an acquaintance of yours about this, that acquaintance would say, "Come to think of it, I never have seen him drink any alcohol."

Everyone has made mistakes, and there is nobody who has not accidentally endangered themselves and/or others at some point or another. You just happened to get caught doing something pretty bad. You have the burden of proving (whether actively or passively) that you've taken strong steps to never do something as dumb as that again. If you go through med school without incident, mature PDs/faculty will give you a chance.

 

[LapMyChole]

You should get in the habit of never letting anyone see you having so much as a sip of wine. Ideally, if someone who might have an impact on your career were to ask an acquaintance of yours about this, that acquaintance would say, "Come to think of it, I never have seen him drink any alcohol."

Everyone has made mistakes, and there is nobody who has not accidentally endangered themselves and/or others at some point or another. You just happened to get caught doing something pretty bad. You have the burden of proving (whether actively or passively) that you've taken strong steps to never do something as dumb as that again. If you go through med school without incident, mature PDs/faculty will give you a chance.

Thanks for that, and thats great advice. even in competitive specialties like the ones I listed, you think most mature PDs will give me a chance?

 

[radsisrad]

Thanks for that, and thats great advice. even in competitive specialties like the ones I listed, you think most mature PDs will give me a chance?

I can't tell you one way or another. All you can do is... well, whatever you can do. The rest is fate.

Speaking for myself, I would not want to read a whole discourse in your PS about this incident. Unless you killed someone with your DUI (and it doesn't seem like you did), I'd just want to see someone who matured quickly from the experience and is now a normal member of society. With kick-@ss LORs and grades, of course!

 

[augeremt]

Thanks for that, and thats great advice. even in competitive specialties like the ones I listed, you think most mature PDs will give me a chance?

Depends on the program. At one ortho program, they didn't rank anyone with a criminal conviction (why they even invited them for an interview is another story...).

A friend with a DUI applying to IM (completely different ball game, I know) didn't even mention it in their personal statement, partly because it was >10 years ago and expunged at that point. It did show up on ERAS, as required, but didn't seem to affect their chances of matching at a competitive program.

If you're planning on applying to your home program, they'll know about your DUI anyway once they receive your application, so might as well meet with the PD now and ask them these questions. They'll have better insight about your chances there and at other programs. You can also ask them if you should mention it in your PS or leave it out.

Good luck!

 

[GoSpursGo]

I generally advise a backup specialty (apply to two things)for those who are aiming above their paygrade and still want to go for it

FWIW, I actually disagree with this. You need to decide what you want to do, and put your all into it, because if you do a half-assed job of applying to two different specialties I think you're hurting your chances for getting into the one you actually want and/or match at a worse program for the specialty that you are competitive for in the first place.

I think before deciding whether or not to apply for a competitive specialty, you need to: 1) be brutally honest with yourself and maybe ask some mentors in that field to be honest with you about whether you stand a shot; and 2) decide if you really would be significantly happier in that more competitive field than anything else. If the answer to both questions is yes but you know you're reaching by applying for the more competitive specialty, then I advocate for giving your all to applying to that specialty--you're already fighting an uphill battle as it is, and the hours that you spend putting together a backup application are hours that you could be spending maximizing your primary application. Accept that if you don't match you may need to extend graduation by a year and reapply to a less competitive specialty--at least then you'll know that you gave your dream every possible chance to succeed, and 20 years down the road the fact that you reapplied once will be no big deal. If the answer to either question is no, then I think you need to give strong consideration to applying to a less competitive specialty and doing your best to ensure that you match in something that will make you happy even if in your dream scenario you would've done something different.

It's hard for me to tell exactly where you fit in here. You say you have "a decent amount of research," but both of those fields require a high number of publications and it's not clear if your research has led to those. Given that you don't seem to have an identified mentor in either of these fields, it seems like you have a long road ahead of you to rack up the kinds of presentations and publications that would make you competitive in the next 18 months. Furthermore, you seem pretty quick to seem OK with the idea of applying to less competitive specialties.

It isn't clear to me that you could be competitive by September 2021 for one of those specialties just on the merits of your application--once you add the DUI, it gets really dicey. And from reading your posts here, it's not clear that you are the kind of person who would "only be happy in ortho/CTS/etc." If you could be happy in gen surg and then pursuing a fellowship, I would strongly advise going that route.