effect of delaying one rotation

[sunset823]

---

Members don't see this ad.

for several reasons, my dedicated step 1 studying time has not been as dedicated as I would want it to be, and I am seriously considering delaying my step 1 for about 3 weeks and therefore delay my first rotation. I don't know much about this, and I'm not sure what impact that would have logistically and on residency apps. I'm considering anesthesia (which my school doesn't have a residency program in and only a 2 week rotation, so for which most people do at least one away), or IM. Plus, I only lose about four weeks of 3rd year, since I can fill the second half of the first block with a filler rotation that counts for 4th year requirements (like radiology or radonc, neither of which I have any interest in).

It just seems that this is much better than the alternative (doing poorly on step 1). Anybody been through this or have any thoughts?

Plus, I've heard starting with family medicine is a bad idea, cuz it's a hard shelf, but that's what would happen for me if I did do the delay, but I like the rest of my schedule. Anybody think this is third year grade suicide or manageable? An alternative schedule is available but that would mean doing surgery 4th year, which is a bad idea if I want to do anesthesia.

 

[WellWornLad]

I don't think it's a huge deal to delay rotations by one block. Residencies will have no idea, they don't get copies of your schedule. As for the FM shelf, I think it's blown out of proportion and your first shelf is going to suck no matter what subject it is (except maybe psych, that was one easy shelf).

I'd avoid delaying step 1 at all costs, however. If you truly haven't been studying it might be a good idea. If you've been studying on schedule and are just freaking out because you feel like you aren't ready, don't bother putting it off because that feeling never goes away. Adding 3 weeks to an intense study regimen is no light matter, and more does not always equal better. If you burn out 2 weeks before your exam, you're screwed.

 

[justdoit31]

Our school requires all breaks/delays- personal, academic, medical, etc. to be covered in the Dean's Letter so you might ask student services at your school if it would be mentioned and then evaluate if you can afford to have whatever reason you want to delay your step for broadcast to residencies.

Also, here if you delay a 3rd year clerkship you have to take it 1st in 4th year which is when most people do electives before applying for residency. So just another thing to consider. I want to do "audition" electives at a few programs that have a bigger children's hospital so it isn't important to me (the field I want to go into isn't even offered at my medical school because it is so specialized).

 

[xanthomondo]

Most people who I talked to that delayed taking step 1 regretted doing so. Of course, if you feel its the difference between just barely passing step 1 vs doing well I would do it.

It's definitely not the end of the world if you do need to defer your first block, though. One girl who I rotated with did it and ended up matching derm. n=1 there, but still.

 

[thepoopologist]

I'm thinking about it myself.

 

[b-real]

I agree that, generally speaking, it's a bad idea to delay Step 1. You'll never be confident that you preparing adequately, so it's best to set a date and stick to it. I'll echo the sentiments of a previous poster who said that people who do this end up regretting it. Remember that there will be a domino effect: delaying 3rd year will delay 4th year planning. Normally most people take time off to study for Step 2. You won't get this luxury, because you'll spend a lot of your "vacation" time on that missing block from 3rd year. You really won't get too much of a vacation at all. If that's not a concern to you, and you feel like an extra 3 weeks will really bump your score, then go for it.

 

[BTC]

Always a bad idea generally to delay step 1 and rotations, especially if your school has expanded enrollment recently. That roughly translates in to fewer rotation spots.

That said, its probably a worse idea to take the step 1 if you aren't ready. I cannot confirm this and I have no evidence to back this up but most medical schools will talk a big game about graduating on time, dean's letters, and promotion committees. But in the end, there is very little to back it up. They need you to succeed and you pay big money for these people to offer you the service of medical training.

You need to be clear in your motives and intent and provide frequent and productive communications with your medical school administration. Take their threats with a grain of salt - they're used to dealing with neurotic medical students and operate accordingly.

 

[sunset823]

Our school requires all breaks/delays- personal, academic, medical, etc. to be covered in the Dean's Letter so you might ask student services at your school if it would be mentioned and then evaluate if you can afford to have whatever reason you want to delay your step for broadcast to residencies.

Never thought about this, thanks for that point - will definitely ask if it shows up in the Dean's letter.

Most people who I talked to that delayed taking step 1 regretted doing so. Of course, if you feel its the difference between just barely passing step 1 vs doing well I would do it.

this is precisely the situation I feel I'm looking at right now, though I'll have to take an nbme to be sure. And I'm not interested in anything remotely as competitive as derm, so if they don't care much, that seems encouraging.

Always a bad idea generally to delay step 1 and rotations, especially if your school has expanded enrollment recently. That roughly translates in to fewer rotation spots.

my school is really small, so rotation spots are probably not an issue. And trust me, my school administration probably know me better than they would have wanted, so frequent contact with them is not a problem.

Thanks for the advice guys. Not sure what I'll do yet but having more info definitely helps a lot.

 

[Imagoober]

Hi Everyone,

I know this thread is a bit outdated, but I'm currently encountering the same situation of needing/wanting to delay Step 1. I took NBME 13 less than a week ago and received a 202 and NBME 11 two weeks ago with a 190. I still have 30% of UW to go and my cumulative is only 53% (mostly because I started off around mid-30's and have worked up to nearly 55%-65% for every block now timed and going by block). I'm scheduled to take the exam on July 3, but I'm not feeling confident at all. The study plan has been pathoma/FA before doing questions from UW and spending the time to go over correct answers and mistakes. I have until the end of July to take it without getting a new permit from NBME, but I might receive a W on my first rotation, which starts 7/6. Not sure if it will show up on the Dean's Letter, but will have to inquire about that as my testing date gets closer. Any advice would be appreciated especially from those who have been in my shoes. Oh, I'm interested in IM or PMR at this point and would prefer to be in a University-affliated hospital (in CA, IL, or MA), but I'm sure that'll change as my third year rolls along. CA because I'm from there and IL or MA because I've went to school in those two states. Thanks again!

 

[operaman]

Hi Everyone,

I know this thread is a bit outdated, but I'm currently encountering the same situation of needing/wanting to delay Step 1. I took NBME 13 less than a week ago and received a 202 and NBME 11 two weeks ago with a 190. I still have 30% of UW to go and my cumulative is only 53% (mostly because I started off around mid-30's and have worked up to nearly 55%-65% for every block now timed and going by block). I'm scheduled to take the exam on July 3, but I'm not feeling confident at all. The study plan has been pathoma/FA before doing questions from UW and spending the time to go over correct answers and mistakes. I have until the end of July to take it without getting a new permit from NBME, but I might receive a W on my first rotation, which starts 7/6. Not sure if it will show up on the Dean's Letter, but will have to inquire about that as my testing date gets closer. Any advice would be appreciated especially from those who have been in my shoes. Oh, I'm interested in IM or PMR at this point and would prefer to be in a University-affliated hospital (in CA, IL, or MA), but I'm sure that'll change as my third year rolls along. CA because I'm from there and IL or MA because I've went to school in those two states. Thanks again!

Can't remember if you're the same person I replied to a few days ago in another thread, but in case that was someone else:

If you get to within a week of test day and your NBME scores are still where they are now, you need to delay. Period.

Sub-200 scores put you in serious danger of failing. All of your logistical and residency locale and dean's letter concerns are meaningless when compared to a step 1 failure. Passing this exam needs to be your number one concern and it's with that concern that you should approach your administration as you craft a plan going forward. You still have 3 weeks until your test, but if things don't turn the corner soon, you need to start making arrangements for delaying your test day regardless of the cost.

Beyond delaying, you need to figure out a way to pass this thing. I'm not sure how long you've been studying, but if things don't change soon, you need to try something different. You are probably not the first person at your school to have this problem, so your admins may have some ideas about commercial prep courses you can take and other resources you can use to get those scores into a comfortably passing range.