Failed anatomy, residency options?

[Welsh Corgi]

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Hey all, so I failed anatomy in my first semester putting me in the bottom 5% of my class. I have to remediate in the summer and the failure will show up on my transcript. I feel like I've completely screwed myself over for any competitive residencies so early on in medical school and I'm having a hard time not giving up. I talked to my dean and she emphasized that while it isn't the end of the world it will be a big red flag on my residency application in the future. I had thought I wanted to go into radiology based on my shadowing and research experience but that's obviously not an option now. What fields would still be within my reach, with academic programs that might overlook my failure (assuming my grades and board scores are around average from now on)?

 

[general admission]

The most concerning thing is that you didn't learn the material well enough to help you with future tests, boards, material, clerkships and ultimately your patients. You've got to reevaluate your study strategies to make sure you're getting the most out of your classes and truly learning as much as you can. Anything less is doing yourself and future patients a disservice.

The grade itself won't mean **** honestly. I know a guy who failed two classes his first semester and is now a pgy 1 in a very, very competitive residency.


Sent from my iPhone using Tapatalk

 

[W19]

Hey all, so I failed anatomy in my first semester putting me in the bottom 5% of my class. I have to remediate in the summer and the failure will show up on my transcript. I feel like I've completely screwed myself over for any competitive residencies so early on in medical school and I'm having a hard time not giving up. I talked to my dean and she emphasized that while it isn't the end of the world it will be a big red flag on my residency application in the future. I had thought I wanted to go into radiology based on my shadowing and research experience but that's obviously not an option now. What fields would still be within my reach, with academic programs that might overlook my failure (assuming my grades and board scores are around average from now on)?

Radiology has 99% match rate for US seniors... Try not to fail other classes, then do well on the boards and you should be ok....

 

[atomi]

By the time you apply for residency, radiology could very well be in the "least competitive" group of residencies where psych, fm, and path are right now (i.e. where all the FMGs apply where their goal is to simply get a spot in the US, no matter what the field). I would advise against concrete thinking right now and focus on improving and doing well on step 1.

 

[DermViser]

Hey all, so I failed anatomy in my first semester putting me in the bottom 5% of my class. I have to remediate in the summer and the failure will show up on my transcript. I feel like I've completely screwed myself over for any competitive residencies so early on in medical school and I'm having a hard time not giving up. I talked to my dean and she emphasized that while it isn't the end of the world it will be a big red flag on my residency application in the future. I had thought I wanted to go into radiology based on my shadowing and research experience but that's obviously not an option now. What fields would still be within my reach, with academic programs that might overlook my failure (assuming my grades and board scores are around average from now on)?

According to SDN, Radiology is no longer competitive. I don't know if that is really the case or not.

 

[DermViser]

Radiology has 99% match rate for US seniors... Try not to fail other classes, then do well on the boards and you should be ok....

How do you know that isn't due to self-selection?

 

[operaman]

I feel a bit like a broken record on this, but it baffles me when people post some variation of:

"I failed X......can I still do Y residency/career/etc?"

What they SHOULD be posting is a variation of:

"I failed X...can you help me figure out why I failed at X so I don't make the same mistake again?"


OP, I know it sucks and you feel bad and I promise you I'm not trying to make you feel worse, but your first priority needs to be a complete re-evaluation of your study habits and time management going forward. M1 is one of the easiest parts of med school academically speaking and it will only get tougher going forward.

People who were qualified enough to be admitted to medical school only fail for a handful of really big reasons. Why else do you think it's such a red flag on an application even after you eventually pass? People will wonder: substance abuse? mental illness? burnout? immaturity? unhealthy relationships? illness? family instability? etc. Mostly, it's the first 2 of those that people are really wondering about, especially in someone who otherwise goes on to do very well. That may not be the case here and obviously those are very personal and very serious issues, but I would encourage you to seek help if there's even the slightest chance something like that could be going on.

You need to do some serious self-searching and have some private conversations with people you trust so you can fix whatever happened. There is also no guarantee you'll pass the remediation without changing your approach and then you'll be stuck repeating all of 1st year. Definitely take advantage of any and all tutoring or faculty-led reviews or whatever else is available going forward.

Long term, if this is an isolated thing and you address the underlying issues, you'll probably do just fine. You'll have no trouble matching radiology somewhere. I think the reason for the decline in stats has more to do with the proliferation of programs. You'll have to address the failure in your application and interviews, but if it ends up being isolated and your steps and clinicals are good, you'll probably do just fine in the match.

 

[W19]

How do you know that isn't due to self-selection?

5+ years ago it was very competitive, now when the market is in decline and rad is no longer competitive, it's self selection-- I'll believe that!

 

[Meh.meh]

5+ years ago it was very competitive, now when the market is in decline and rad is no longer competitive, it's self selection-- I'll believe that!

...mostly because it still has one of the higher board scores in matched applicants (241), and the people who were accepted averaged 5 abstracts/pubs/presentations. That's hardly any less than derm.

There were only 12 who didn't match, unlike derms 111, but derm has less than half as many spots. The point is, even with a very high % matching, those matching had great apps.

Given the very high match rate, we would expect lower scoring applicants to apply. A potential explanation
for the scores/match rate is some self-selection.

http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

 

[W19]

...mostly because it still has one of the higher board scores in matched applicants (241), and the people who were accepted averaged 5 abstracts/pubs/presentations. That's hardly any less than derm.

There were only 12 who didn't match, unlike derms 111, but derm has less than half as many spots. The point is, even with a very high % matching, those matching had great apps.

Given the very high match rate, we would expect lower scoring applicants to apply. A potential explanation
for the scores/match rate is some self-selection.

http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

At the end of the day if the number of spots equal or surpass the number of applicants it won't matter that much if someone has 10 publications as opposed to 2... People with low stats won't match at top programs, but they will match...

 

[DermViser]

5+ years ago it was very competitive, now when the market is in decline and rad is no longer competitive, it's self selection-- I'll believe that!

For a guy who thought if he's in 3rd or 4th quartile, that he would have no chance at residency, you seem to know quite a bit now.

 

[DermViser]

This, this, a million times this.

Every one of these threads is the same. Worrying about the implications for residency applications is putting the cart WAY before the horse.

I would say it even has the disastrous effect of getting things to snowball.

 

[Meh.meh]

At the end of the day if the number of spots equal or surpass the number of applicants it won't matter that much if someone has 10 publications as opposed to 2... People with low stats won't match at top programs, but they will match...

You're missing the point in a couple of ways, but I rarely seem to get through to you. I'm not sure if that's my writing or your reading.

A group of people who average a 241 would be competitive anywhere. The people who didnt match as amgs averaged scores higher than those who did match fp or pm and r. If that doesn't tell you anything, I really don't have anything more to say to you

 

[W19]

For a guy who thought if he's in 3rd or 4th quartile, that he would have no chance at residency, you seem to know quite a bit now.

Lol... I really wanted to do rad, that's probably why I know a little bit about it... I am watching the rad job market closely.

 

[DermViser]

Lol... I really wanted to do rad, that's probably why I know a little bit about it... I watching the rad job market closely.

And you can still do Rads. How do you know the job market for Rads? Are you reading the local classifieds?

 

[DermViser]

You're missing the point in a couple of ways, but I rarely seem to get through to you. I'm not sure if that's my writing or your reading.

A group of people who average a 241 would be competitive anywhere. The people who didnt match as amgs averaged scores higher than those who did match fp or pm and r. If that doesn't tell you anything, I really don't have anything more to say to you

It takes a while.

 

[W19]

You're missing the point in a couple of ways, but I rarely seem to get through to you. I'm not sure if that's my writing or your reading.

A group of people who average a 241 would be competitive anywhere. The people who didnt match as amgs averaged scores higher than those who did match fp or pm and r. If that doesn't tell you anything, I really don't have anything more to say to you

We are talking about US grad here! Step1 from 181-220 has a 92% match rate for rad... I would not call that competitive. Of course there might be some self-selection involved; however, it will be easier fro for someone with a 200 step1 to match in rad as opposed to gen surgery even if gen surg average step1 is lower..

I had 8 in VR, so that might explain my lack of comprehension of basic english.🙄

 

[W19]

And you can still do Rads. How do you know the job market for Rads? Are you reading the local classifieds?

I have visited the rad forum more than I should...

 

[DermViser]

We are talking about US grad here! Step1 from 181-220 has a 92% match rate for rad... I would not call that competitive.

I had 8 in VR, so that might explain my lack of comprehension of basic english.🙄

Those are likely at community programs not university programs as well.

 

[W19]

Those are likely at community programs not university programs as well.

I am not disputing that... I am talking about getting a spot overall... Don't you think it will be easier for someone with a 195 step1 score to match into rad as opposed to gen surgery even if gen surgery has a lower step1 average... I am not saying that there is absolutely ZERO self selection, but if the # of applicants is equal with the # of spots, PD will tend to be more lenient... This is not difficult to get IMO! Isn't the match is an algorithm?

 

[Meh.meh]

We are talking about US grad here! Step1 from 181-220 has a 92% match rate for rad... I would not call that competitive. Of course there might be some self-selection involved; however, it will be easier fro for someone with a 200 step1 to match in rad as opposed to gen surgery even if gen surg average step1 is lower..

I had 8 in VR, so that might explain my lack of comprehension of basic english.🙄

181-220 is a very large range, and this is one place where the statistics get funky. The sample size for those numbers is probably tiny, based on the avg. matching score (241). There is no way to tell if the people with the lower scores also had incredible CVs/other issues (family stuff) to explain the red flag. A person with 10 pubs and a 215 is not the equivalent of a person with 0 pubs and a 200.

We can't tell if that's what's going on or not. The point is, despite the lack of "competitiveness," rads seems to be pulling in a large number of high quality applications. So I wouldn't just roll up to application season with a 200 board score and all passes and expect to match rads (or any other specialty). The 92% number is probably deceiving.

Another potential explanation would be different "tiers" of programs, as dermviser seems to imply above. It might be that lower scoring applicants are only applying to lower level programs.

Anyways, I'm out

 

[DermViser]

I am not disputing that... I am talking about getting a spot overall... Don't you think it will be easier for someone with a 195 step1 score to match into rad as opposed to ten surgery even if gen surgery has a lower step1 average... I am not saying that there is absolutely ZERO self selection, but if the # of applicants is equal with the # of spots, PD will tend to be more lenient... This is not difficult to get IMO!

No.

 

[DermViser]

181-220 is a very large range, and this is one place where the statistics get funky. The sample size for those numbers is probably tiny, based on the avg. matching score (241). There is no way to tell if the people with the lower scores also had incredible CVs/other issues (family stuff) to explain the red flag. A person with 10 pubs and a 215 is not the equivalent of a person with 0 pubs and a 200.

We can't tell if that's what's going on or not. The point is, despite the lack of "competitiveness," rads seems to be pulling in a large number of high quality applications. So I wouldn't just roll up to application season with a 200 board score and all passes and expect to match rads (or any other specialty). The 92% number is probably deceiving.

Another potential explanation would be different "tiers" of programs, as dermviser seems to imply above. It might be that lower scoring applicants are only applying to lower level programs.

Anyways, I'm out

Not to mention practicing radiology these days requires completion of fellowship. I don't know anyone who just does Diagnostic Rads only and goes straight to a job. Might have to do w/timings of their certification though.

 

[Meh.meh]

I am not disputing that... I am talking about getting a spot overall... Don't you think it will be easier for someone with a 195 step1 score to match into rad as opposed to gen surgery even if gen surgery has a lower step1 average... I am not saying that there is absolutely ZERO self selection, but if the # of applicants is equal with the # of spots, PD will tend to be more lenient... This is not difficult to get IMO!

I lied. I'm back.

General surgery is a special situation: not every specialty gives an equal damn about board scores. I think GS might be an example of this. It's not that they don't care so much as they care about other stuff (like are you going to make it through residency).

Also, that's not the argument. You said Rads is non-compettive. The rest of us are saying that's not completely true.

 

[W19]

181-220 is a very large range, and this is one place where the statistics get funky. The sample size for those numbers is probably tiny, based on the avg. matching score (241). There is no way to tell if the people with the lower scores also had incredible CVs/other issues (family stuff) to explain the red flag. A person with 10 pubs and a 215 is not the equivalent of a person with 0 pubs and a 200.

We can't tell if that's what's going on or not. The point is, despite the lack of "competitiveness," rads seems to be pulling in a large number of high quality applications. So I wouldn't just roll up to application season with a 200 board score and all passes and expect to match rads (or any other specialty). The 92% number is probably deceiving.

Another potential explanation would be different "tiers" of programs, as dermviser seems to imply above. It might be that lower scoring applicants are only applying to lower level programs.

Anyways, I'm out

Now you are talking... Isn't the match a computer algorithm? This is common sense IMO...

 

[Meh.meh]

Now you are talking... Isn't the match a computer algorithm? This is common sense IMO...

I have no idea what this means. However, you seem to be implying that the match being a "computer algorithm" makes it purely number/chance based.

It is not.

The algorithm is based on the rankings of program directors, who choose based on a large number of factors. The computer is just the medium of expression

 

[DermViser]

Now you are talking... Isn't the match a computer algorithm? This is common sense IMO...

A computer algorithm for those who make it to the interview and are ranked. Not for applicant selection.

 

[Mad Jack]

How do you know that isn't due to self-selection?

Even those with below average Step scores matched into rads just fine last year. Just take a look at the match rates by Step score, they were ridiculously high across the board for US MDs. It's gotten far less competitive for sure.

 

[Meh.meh]

Even those with below average Step scores matched into rads just fine last year. Just take a look at the match rates by Step score, they were ridiculously high across the board for US MDs. It's gotten far less competitive for sure.

It probably is true that it's less competitive than it once was: the point is that it's hard to classify it as "non-competitive" because the applicants remain so strong overall. If there were droves of people applying/matching with 210s, it would make more sense to call it a less competitve specialty. It doesn't seem to fit that definition perfectly to me.

 

[DermViser]

Even those with below average Step scores matched into rads just fine last year. Just take a look at the match rates by Step score, they were ridiculously high across the board for US MDs. It's gotten far less competitive for sure.

Yes, but were those likely at low quality community programs?

 

[DermViser]

It probably is true that it's less competitive than it once was: the point is that it's hard to classify it as "non-competitive" because the applicants remain so strong overall. If there were droves of people applying/matching with 210s, it would make more sense to call it a less competitve specialty. It doesn't seem to fit that definition perfectly to me.

Exactly. The overall USMLE Step 1 average for Radiology is probably in the high 240s. Hardly "not competitive".

 

[Mad Jack]

Yes, but were those likely at low quality community programs?

Probably. But that's kind of irrelevant- op wants to know if his chances of matching radiology are shot, not whether his chances of matching a top-tier radiology program are shot.

 

[Meh.meh]

Probably. But that's kind of irrelevant- op wants to know if his chances of matching radiology are shot, not whether his chances of matching a top-tier radiology program are shot.

The OP? We moved on long ago.

Stop trying to be so relevant

But seriously, the OP is fine. You can probably still match plastics or derm with one failed pre-clinical course in the first semester.* Or at least that seems like the prevailing wisdom.

*As long as the rest of the application is flawless, and you have the crazy ass CV those people put together.

 

[W19]

Probably. But that's kind of irrelevant- op wants to know if his chances of matching radiology are shot, not whether his chances of matching a top-tier radiology program are shot.

That is what I have been trying to argue... No one said the top programs are not competitive...

 

[W19]

A computer algorithm for those who make it to the interview and are ranked. Not for applicant selection.

#applicants vs. #of spots.... If PD choose not to interview applicants for rad, they will not interview 12 applicants out 780... Lol...

 

[Mad Jack]

Exactly. The overall USMLE Step 1 average for Radiology is probably in the high 240s. Hardly "not competitive".

The top is 2014, bottom is 2011. In 2011 vs 2014 here were 8 more >260 apps, 3 more 251-260 apps, 42 more 241-250 apps, 67 more 231-240 apps, 29 more 221-230 apps, 17 more 211-220 apps, 5 more 201-210 app, 7 more 191-200 apps, 4 more 181-190 apps, and 3 more <180 apps (no longer an option). There are many fewer US MD applicants for rads positions, and many fewer high scoring applicants as well, despite an overall increase in USMLE scores over that time. only 12 applicants didn't match in 2014, versus 35 in 2011. Radiology may not be "not competitive" yet, but your chances are pretty solid with even an average Step 1 score nowadays.

 

[DermViser]

The OP? We moved on long ago.

Stop trying to be so relevant

But seriously, the OP is fine. You can probably still match plastics or derm with one failed pre-clinical course in the first semester.* Or at least that seems like the prevailing wisdom.

This is true.

 

[DermViser]

Probably. But that's kind of irrelevant- op wants to know if his chances of matching radiology are shot, not whether his chances of matching a top-tier radiology program are shot.

But what about mid-tier?

 

[Mad Jack]

But what about mid-tier?

Who cares. His question wasn't about tiers of residency, just the specialty at hand. I'd go to a rural community residency in Nebraska if I had to to get into my specialty of choice, because that residency tier is a whole lot less important than what you're going to have to do every day for the rest of your life.

 

[DermViser]

Who cares. His question wasn't about tiers of residency, just the specialty at hand. I'd go to a rural community residency in Nebraska if I had to to get into my specialty of choice, because that residency tier is a whole lot less important than what you're going to have to do every day for the rest of your life.

Except your prospects on getting an attending job and/or fellowship from a community Rads program is probably pretty ****ty.

 

[Mad Jack]

Except your prospects on getting an attending job and/or fellowship from a community Rads program is probably pretty ****ty.

Would you rather be a community rads guy or an attending FM physician at a big hospital?

Not everyone is looking for an educational attending appointment at a big hospital.

 

[DermViser]

Would you rather be a community rads guy or an attending FM physician at a big hospital?

Not everyone is looking for an educational attending appointment at a big hospital.

No one is talking about being a radiologist at an academic medical center. I'm talking about getting a rads job period.

 

[DermViser]

It's not a question of being a "community" rads vs an "academic" FM

It's a question of having ANY job. Period. As an attending radiologist.

The reason people are freaking out over rads, and the reason the application #s have dropped significantly, is that there is a huge paucity of jobs for new grads, even if they get subspecialty fellowship training. If you go to a low tier community rads program for residency, there is a very real threat that you will not be able to find employment after graduation.

^^This is what I was getting at.

Their system is real weird. They take their certifying exam 15 months AFTER residency completion. So while they're waiting they really have no choice but to do a fellowship while they wait, bc jobs aren't first going to go to those who are board eligible. Going into a community rads program makes it much more difficult to get those fellowships.

 

[Mad Jack]

No one is talking about being a radiologist at an academic medical center. I'm talking about getting a rads job period.

It's unknown what the radiology job market will look like in a few years. While it would be ideal to get an academic residency, if you had to choose in this sort of situation, would you go community and hope to eventually get a job or just not go into radiology altogether? Just curious. I mean, I know the ideal is getting a good spot, but beggars can't be choosers and all.

 

[DermViser]

It's unknown what the radiology job market will look like in a few years. While it would be ideal to get an academic residency, if you had to choose in this sort of situation, would you go community and hope to eventually get a job or just not go into radiology altogether? Just curious. I mean, I know the ideal is getting a good spot, but beggars can't be choosers and all.

Um, if the choice is a community program in Rads leading to a dead end and let's say another specialty to eventually get board certified and pay off loans - I would choose another specialty. A university program will always beat a community program.

 

[W19]

Classic @DermViser move... moving the gold post. The discussion was about rad not being competitive anymore, and now it is about getting a job after residency.

 

[DermViser]

Classic @DermViser move... moving the gold post. The discussion was about rad not being competitive anymore, and now it is about getting a job after residency.

Sigh. First of all, it's "goal post" not "gold post", which hasn't been done. #2 - Radiology not being competitive anymore depends on how you look at it. Unlike other specialties, getting to practice Radiology at all depends on the program. This isn't 1999.

 

[W19]

Sigh. First of all, it's "goal post" not "gold post", which hasn't been done. #2 - Radiology not being competitive anymore depends on how you look at it. Unlike other specialties, getting to practice Radiology at all depends on the program. This isn't 1999.

auto correct! I play soccer. I can at least spell that...

 

[Jabbed]

Out of curiosity, what happens if you fail a fluff class?

 

[operaman]

Out of curiosity, what happens if you fail a fluff class?

I think it would still be a red flag. I would wonder what else that student was going to blow off as "fluff" during residency. Is this going to be a resident who blows off didactics and required conferences? Will this person be productive during research time and elective time? I think any failure would require a good explanation.

Most fluff classes require only attendance and minimal work beyond that; failure there says a lot more about attitude than it does about academic ability.