ERAS USMLE attempt filter

[blue.jay]

Can programs screen out applicants with prior USMLE cs attempt? I am asking because I read it a website which said there isn't a direct filter to screen based on attempt history and PDs only know when they open the application. Is that true @NotAProgDirector?


Are candidates applying to cardiology, GI, HemOnc, pulmcrit with otherwise impressive CV and no connections getting screened out based on passed on first attempt filter?


Ref

The Truth About USMLE Exam Attempts | Match A Resident

Don’t Be Discouraged. Attempts Are Not the End of the World. The Attempt Myth A common belief among residency candidates is that having multiple attempts on your USMLE Transcript will end your US medical residency dreams, and make it impossible for you to get interviews from residency...

blog.matcharesident.com

Did you know?* Among the many filters ERAS provides residency programs when they receive applications, there is no direct filter for USMLE attempts. That means, programs cannot initially filter you out of their applicant pool. They will need to look at some of your application first before making a decision

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[Raryn]

I know that the program where I did residency - many years ago - stated they explicitly screened on USMLE failures. That is, they just set a screen that if you had ever failed a step, they wouldn't interview you.

Now, I would assume that the application review software let them automate it - but even if it didn't, it's easy enough to look at the USMLE transcript...

 

[GoSpursGo]

Agree with @Raryn , regardless of whether or not there's a direct filter the bottom line is that they can easily open the transcript and screen you out without looking at the rest. But if you are unsure, you can apply anyways and see what happens.

 

[NotAProgDirector]

Everything in this thread is true. Programs can only "filter" using software on your last USMLE score. So if you have failed CS and not passed it, we can filter on that. But if you failed and then passed, I cannot. But we can look to see the score, and then reject based on a fail if we want (of course).

 

[deleted979907]

Is there a chance for a candidate to reenter residency after multiple step attempts, passing them all in the long run, having many years of experience in the specialty including PGY1 of that specialty but due to personal/ health circumstances had to leave the program? Not finding PGY2 positions.

 

[gutonc]

Is there a chance for a candidate to reenter residency after multiple step attempts, passing them all in the long run, having many years of experience in the specialty including PGY1 of that specialty but due to personal/ health circumstances had to leave the program? Not finding PGY2 positions.

Yes...but....

Details or you're unlikely to get any useful information.

 

[deleted979907]

Long story short, not the best test taker and I let my nerves get the best of me so I had multiple attempts on my steps. I am from PR and was able to get into residency there which was pathology; was what I wanted all along since medical school. Was able to finish 1st year, but didn’t have step 3 for 2nd year. I was supposed to take it in a stipulated time and all of a sudden Hurricanes Irma and Maria hit the island. No light, no internet for months, lost my chosen date for the test, had to leave my house do to the aftermath of the destruction, etc. This affected my health and I had to leave the program.

 

[deleted979907]

I posted my CV in search of PGY2 position or I am willing to repeat PGY1 because I do have years of experience in Pathology and I love the field contrary to many.

 

[gutonc]

Then reapply and see what happens. PR is your best bet. And don't bother with PGY2. You're going to have to start over.

 

[deleted979907]

Thank you, but I can’t go back to PR, the program was placed on probation after I left. It also has a lot of deficiencies and the medical campus had mentioned closing it for good. I can’t take that risk. I am already in the US doing an Ophthalmic Pathology Fellowship and I have reapplied for residency.

 

[rokshana]

Hopefully you discussed your circumstances in your PS and programs will take that into account...do you have a letter of support from your previous PD...you will definitely need that.

 

[deleted979907]

Unfortunately I don’t, I didn’t think of that since I am not there anymore. I do have very strong LORs from my current attendings, including my current PD at Johns Hopkins.

 

[rokshana]

Unfortunately I don’t, I didn’t think of that since I am not there anymore. I do have very strong LORs from my current attendings, including my current PD at Johns Hopkins.

Any program is going to want to talk to your PD...will s/he support you if asked?

 

[deleted979907]

Any program is going to want to talk to your PD...will s/he support you if asked?

I am not sure, unfortunately she never showed real support to any of the residents in the program.

 

[Splenda88]

Thank you, but I can’t go back to PR, the program was placed on probation after I left. It also has a lot of deficiencies and the medical campus had mentioned closing it for good. I can’t take that risk. I am already in the US doing an Ophthalmic Pathology Fellowship and I have reapplied for residency.

Have you gotten any interview invites?

 

[deleted979907]

Have you gotten any interview invites?

Unfortunately no, I honestly don’t know what else to do. Don’t know how else I can prove myself to these programs if they are only going to look at test scores and not even bother to look at the rest of the application.

 

[j4pac]

Unfortunately no, I honestly don’t know what else to do. Don’t know how else I can prove myself to these programs if they are only going to look at test scores and not even bother to look at the rest of the application.

Just curious of the downside of going back to PR? I understand that they are on probation. You’re from PR right? At worst they shut down. Who knows, maybe you can get through.

You have two enormous red flags trying to get another program to take you on. It’s going to be tough.

 

[deleted979907]

Just curious of the downside of going back to PR? I understand that they are on probation. You’re from PR right? At worst they shut down. Who knows, maybe you can get through.

You have two enormous red flags trying to get another program to take you on. It’s going to be tough.

Which are the red flags? Why is it tough to get back in when I was already in a program before?

 

[deleted979907]

Which are the red flags? Why is it tough to get back in when I was already in a program before?

I also specified that the program has been put on probation due to resident abuse and I don’t mean just over working residents...

 

[Splenda88]

Unfortunately no, I honestly don’t know what else to do. Don’t know how else I can prove myself to these programs if they are only going to look at test scores and not even bother to look at the rest of the application.

If University of PR will give you credit for that one year, get a license in the 33-34 states that will license after 1-yr postgrad training. After that, you can do whatever you want with that license. Work urgent care, Indians health service, prisons etc... if you think you will be comfortable doing basics primary care.

Don't keep your life on hold because you think you have to be a pathologist. Be practical! Given your multiple board failures and year of graduation (I saw your CV in another thread), it will be quasi impossible to get residency spot in the mainland.

 

[Splenda88]

Which are the red flags? Why is it tough to get back in when I was already in a program before?

The truth is that programs want people who they think will past the board...

 

[deleted979907]

If University of PR will give you credit for that one year, get a license in the 33-34 states that will license after 1-yr postgrad training. After that, you can do whatever you want with that license. Work urgent care, Indians health service, prisons etc... if you think you will be comfortable doing basics primary care.

Don't keep your life on hold because you think you have to be a pathologist. Be practical! Given your multiple board failures and year of graduation (I saw your CV in another thread), it will be quasi impossible to get residency spot in the mainland.

I already received credit for that 1st year and I was able to get my license, that part is covered. So from the advice I am receiving here, because of the Steps, the rest of my CV becomes meaningless and I will never be able to finish what I started in pathology no matter how hard I try or work for it even though I passed all 3...wow I guess in the end we truly are just numbers in a system.

 

[deleted979907]

The truth is that programs want people who they think will past the board...

Having difficulty with the Steps doesn’t necessarily mean you will have it in your specialty board. Pathology is different from all other specialties, but I get it numbers is all that matters.

 

[deleted979907]

I thank everyone here for all the info I have received here; even if the system’s odds are against me I am not giving up.

 

[rokshana]

your biggest red flag simply put is that you don't have the support of your old PD, letter or verbal...without that, I doubt you will get very far...pathology has to be an even smaller specialty than IM and they all know each other...if the only issue you had the unfortunate timing of 2 massive hurricanes, the support from your previous program would be there.

If you are already in a ophthalmology pathology fellowship, can they not help with getting a spot at their pathology program?

Sorry, but there are things you are not telling us or yourself about your competitiveness for pathology...which isn't exactly the most competitive of specialties.

 

[deleted979907]

your biggest red flag simply put is that you don't have the support of your old PD, letter or verbal...without that, I doubt you will get very far...pathology has to be an even smaller specialty than IM and they all know each other...if the only issue you had the unfortunate timing of 2 massive hurricanes, the support from your previous program would be there.

If you are already in a ophthalmology pathology fellowship, can they not help with getting a spot at their pathology program?

Sorry, but there are things you are not telling us or yourself about your competitiveness for pathology...which isn't exactly the most competitive of

your biggest red flag simply put is that you don't have the support of your old PD, letter or verbal...without that, I doubt you will get very far...pathology has to be an even smaller specialty than IM and they all know each other...if the only issue you had the unfortunate timing of 2 massive hurricanes, the support from your previous program would be there.

If you are already in a ophthalmology pathology fellowship, can they not help with getting a spot at their pathology program?

Sorry, but there are things you are not telling us or yourself about your competitiveness for pathology...which isn't exactly the most competitive of specialties.

You are right, I have been afraid of saying what truly happened in the residency because of retribution against me. The hurricanes were just the tip of the iceberg hear and I was told to stay quiet or there would be consequences...

 

[deleted979907]

I saw things that were legally wrong, I was told to lie and stay quiet about the truth of the matter. When I didn’t comply to that, I was personally verbally attacked by the PD. I went for help to the dean of graduate medical study and they swept everything under the rug. I learned later that this was the norm in the program and a lot of residents would constantly leave. Weeks later the hurricanes hit the island and everything went haywire. I was notified that things were getting worse in the residency, it was placed on probation.

 

[Splenda88]

I already received credit for that 1st year and I was able to get my license, that part is covered. So from the advice I am receiving here, because of the Steps, the rest of my CV becomes meaningless and I will never be able to finish what I started in pathology no matter how hard I try or work for it even though I passed all 3...wow I guess in the end we truly are just numbers in a system.

Good to know... If plan A does not work, at least you can work. If you are ok taking care of minor medical issues, you can get a gig at Indian Health Service making ~200k/yr.

 

[deleted979907]

Good to know... If plan A does not work, at least you can work. If you are ok taking care of minor medical issues, you can get a gig at Indian Health Service making ~200k/yr.

That would mean I would have to stay in the mainland and could never go back to PR. That would be real hard for me. General physicians are extremely under paid. I have friends who are struggling right now to stay afloat as GPs there. The downfalls of being a colony.

 

[Splenda88]

That would mean I would have to stay in the mainland and could never go back to PR. That would be real hard for me. General physicians are extremely under paid. I have friends who are struggling right now to stay afloat as GPs there. The downfalls of being a colony.

I understand...

Based on what I was told, GP in PR can make 100k-130k... I see you graduated from San Juan Bautista in 2011. Tuition was not expensive at that time since they weren't even LCME accredited.

 

[deleted979907]

I understand...

Based on what I was told, GP in PR can make 100k-130k... I see you graduated from San Juan Bautista in 2011. Tuition was not expensive at that time since they weren't even LCME accredited.

I was from the class that was accredited and that income is false. The recent graduating GP are only earning $38.00 to $46.00 dollars an hour.

 

[deleted979907]

I was from the class that was accredited and that income is false. The recent graduating GP are only earning $38.00 to $46.00 dollars an hour.

Before this fellowship, my internship consisted in pathology work. I was given 25-30 cases per day with special stains and some IHCs to diagnose. My attendings there even gave me the job of revising the diagnosis of one of their pathologist that unfortunately wasn’t doing a good job. They said I just needed the license to make it official. That’s why I am fighting so much for this.

 

[NotAProgDirector]

I'm honestly a bit surprised that you're unable to find a spot. Path isn't all that competitive, and you now have some great experiences and mentors. You need to have your mentors advocate for you -- assuming they think you are doing good work. And you need to be less-than-picky about location.

 

[Splenda88]

I was from the class that was accredited and that income is false. The recent graduating GP are only earning $38.00 to $46.00 dollars an hour.

$42/hr is about 100k/yr if you work 45 hrs/wk which that # of hours most PCP work these days.


Hope you find a spot this cycle, but things do not look good since you have not had any invites yet...

 

[deleted979907]

I'm honestly a bit surprised that you're unable to find a spot. Path isn't all that competitive, and you now have some great experiences and mentors. You need to have your mentors advocate for you -- assuming they think you are doing good work. And you need to be less-than-picky about location.

I have strong LORs and I am not picky at all. I am willing to go anywhere I am called. I haven’t received any invites yet, although the replies have been that I am a strong candidate but they have limited interview spots. I think I may have applied too. I was waiting for my current PD’s LOR and I applied in November.

 

[j4pac]

Which are the red flags? Why is it tough to get back in when I was already in a program before?

Sorry...tough case. Tough to recommend going back to a program that abuses residents, but it unfortunately is easily your best chance of getting back in. Your scores, medical concerns, and absense from medicine are all red flags.

 

[j4pac]

I have strong LORs and I am not picky at all. I am willing to go anywhere I am called. I haven’t received any invites yet, although the replies have been that I am a strong candidate but they have limited interview spots. I think I may have applied too. I was waiting for my current PD’s LOR and I applied in November.

How many programs did you apply and when?

 

[deleted979907]

How many programs did you apply and when?

I applied to 50 programs on early November. I have received only 7 answers, so I am still waiting.

 

[deleted979907]

Sorry...tough case. Tough to recommend going back to a program that abuses residents, but it unfortunately is easily your best chance of getting back in. Your scores, medical concerns, and absense from medicine are all red flags.

I haven’t been absent from medicine. I have always been working in medicine in pathology and research. Also medical concerns shouldn’t be a problem if treated and clearance has been given. That would actually would be discriminatory if they are doing that.

 

[hallowmann]

I applied to 50 programs on early November. I have received only 7 answers, so I am still waiting.

I think the late application hurt you as well. Have you considered cytotech as an in to get close to and into a path program? I've known some IMGs that have done that when they struggled to get residency. Its obviously a step down, but might be worth it to get good connections at a path program if this cycle doesn't go well.

 

[deleted979907]

I think the late application hurt you as well. Have you considered cytotech as an in to get close to and into a path program? I've known some IMGs that have done that when they struggled to get residency. Its obviously a step down, but might be worth it to get good connections at a path program if this cycle doesn't go well.

I’ve actually been considering it to continue my pathology training because I hardly learned any of it in my PGY1. I received some training in the path internship and right now I am looking at ocular cyto specimens. I am basically specializing in Ophthalmic Pathology in every shape and form. All I need is an opportunity to finish a program and get my license to be able to sign out cases.

 

[j4pac]

I haven’t been absent from medicine. I have always been working in medicine in pathology and research. Also medical concerns shouldn’t be a problem if treated and clearance has been given. That would actually would be discriminatory if they are doing that.

I’m sorry...but a resident leaving their program brings up some concerns. Even if you had a legit reason, it will scare some programs away. That’s reality. Everything adds up to you being at higher risk applicant.

They are likely part of the reason why you are struggling to get an interview...along with a poor strategy.

You seem to be trying to stay within medicine...which is great. It may be too late this cycle...definitely stay connected and have a better strategy next round.

 

[j4pac]

I applied to 50 programs on early November. I have received only 7 answers, so I am still waiting.

That’s at least part of the problem. 50 applications is something I’m use to seeing in average to above average applicants...and they apply on opening day. You’re a higher risk applicant, applying to too few programs, too late.

 

[deleted979907]

That’s at least part of the problem. 50 applications is something I’m use to seeing in average to above average applicants...and they apply on opening day. You’re a higher risk applicant, applying to too few programs, too late.

Too few programs? That cost more than $1k. I don’t have the money to be applying to more programs. I already have my student loan debt. Also leaving an abusive program because of illegal issues inside the program shouldn’t make me a high risk candidate. Basically what you are telling me is I am getting punished for doing the right thing; if that is the case than I rather stay how I am right now. I am not compromising my integrity, I have no regrets of leaving that program.

 

[rokshana]

I applied to 50 programs on early November. I have received only 7 answers, so I am still waiting.

Why did you apply to so few...frankly you should have applied to practically all the path programs out there...next year apply on the first day eras opens and apply to at least 100-200 programs.

you application strategy was poorly done...you wasted a grand because now you will probably have to do it again next year...and why did you wait over a month to even apply?

and again, if the people at your current program are supportive of you, why are they not taking you at your current hospital/program?

if your old program would take you back, it’s probably your best bet...only you can decide if it’s worth it to you to deal with them to become a pathologist

 

[j4pac]

Too few programs? That cost more than $1k. I don’t have the money to be applying to more programs. I already have my student loan debt. Also leaving an abusive program because of illegal issues inside the program shouldn’t make me a high risk candidate. Basically what you are telling me is I am getting punished for doing the right thing; if that is the case than I rather stay how I am right now. I am not compromising my integrity, I have no regrets of leaving that program.

Regardless of the circumstances, until you come to the realization that you are of a high risk applicant, and adapt your strategy accordingly, you are going to struggle. Why did you apply in November, and not much sooner like all of your peers?

 

[GoSpursGo]

Too few programs? That cost more than $1k. I don’t have the money to be applying to more programs. I already have my student loan debt. Also leaving an abusive program because of illegal issues inside the program shouldn’t make me a high risk candidate. Basically what you are telling me is I am getting punished for doing the right thing; if that is the case than I rather stay how I am right now. I am not compromising my integrity, I have no regrets of leaving that program.

@j4pac isn't attacking you, he's just being honest. Your app is likely good enough to get a spot somewhere, but it's impossible to guess which SPECIFIC programs are going to be interested in you. None of us can speak to your finances, but 50 apps is objectively a low number for someone with some red flags--no matter how justified you leaving that program may have been, nobody can look at your application and know all of the circumstances that went into you leaving, so it is absolutely a red flag and NOT a positive. And applying after the application opened is an outright unforced error.

As you have said, you just need somewhere to complete your training so you can get licensed. Do whatever it takes to get to that point.