Failed both the USMLE and COMLEX step 1 -> should I even try for Pediatrics

[The Masked Duck]

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I really hate asking this but I failed both the COMLEX Step 1 and USMLE Step 1 on my first attempt. For better or worse I retook both exams and managed to pass on the second attempt.

1st Attempt:
COMLEX Step 1 = 385/74
USMLE Step 2 = 181/71

2nd Attempt:
COMLEX Step 1 = 435/77
USMLE Step 2 = 194/79

At this time I have already had Pediatrics (of which I failed to honor, unfortunately) in the fall and the only remaining rotations I have left for third year are family and Internal medicine. I realize at this point that I face quite an uphill battle. Realistically I am pretty sure that ACGME residencies are out of the question for me and as such my best chance will be to apply to the 19 AOA pediatric programs, of which I few them I won’t have a chance at having been unable to pass the first time. At this point I would happy to get into any pediatrics program as I know I cannot afford to be picky.

I guess my plan is to do the best I can on COMLEX step 2 and apply to all 19 AOA peds programs and a ton of family medicine programs.

I guess my question is whether it is worth it for me to use the elective periods I have from September to January to do AOA Pediatric auditions rotations or would it be better to focus on Family Medicine rotations instead as there far more AOA family medicine residences then there are Pediatrics residences. In the end I am trying to figure how to make the most of 4th year.

If I am going to apply for pediatric audition rotations how do I go about figuring out which programs worth it for me to try and audition at.

I know I am asking a lot, so any help is greatly appreciated!

 

[BCLumas]

I really hate asking this but I failed both the COMLEX Step 1 and USMLE Step 1 on my first attempt. For better or worse I retook both exams and managed to pass on the second attempt.

1st Attempt:
COMLEX Step 1 = 385/74
USMLE Step 2 = 181/71

2nd Attempt:
COMLEX Step 1 = 435/77
USMLE Step 2 = 194/79

At this time I have already had Pediatrics (of which I failed to honor, unfortunately) in the fall and the only remaining rotations I have left for third year are family and Internal medicine. I realize at this point that I face quite an uphill battle. Realistically I am pretty sure that ACGME residencies are out of the question for me and as such my best chance will be to apply to the 19 AOA pediatric programs, of which I few them I won't have a chance at having been unable to pass the first time. At this point I would happy to get into any pediatrics program as I know I cannot afford to be picky.

I guess my plan is to do the best I can on COMLEX step 2 and apply to all 19 AOA peds programs and a ton of family medicine programs.

I guess my question is whether it is worth it for me to use the elective periods I have from September to January to do AOA Pediatric auditions rotations or would it be better to focus on Family Medicine rotations instead as there far more AOA family medicine residences then there are Pediatrics residences. In the end I am trying to figure how to make the most of 4th year.

If I am going to apply for pediatric audition rotations how do I go about figuring out which programs worth it for me to try and audition at.

I know I am asking a lot, so any help is greatly appreciated!

Good morning. Sorry to hear about your troubles up to this point. It looks like you still have options in front of you, so keep working hard!

What I have noticed is that the majority of osteopathic programs like to see progress and learning from Step 1 to Step 2. Your Step 1 passing score of a 435/77 is a good building block to grow on. My advice to you would be to study quite diligently for Step 2 and rock its boat out of the water (530/79, kind of score) compared to your first exam. This way schools will see that you have not only developed the technical skill of how to take exams, but that you have recognized your areas of weakness in your studies and have learned from these mistakes.

The next important step to take would be to research all of the programs. If you are applying to the osteopathic match, then you have very little room to be picky: there are only 19 programs available (as you've already stated). My advice here would be to make a list on your computer containing the following information for each program:

• Program name
• Program website
• Program contact information

After you have this list, contact each program coordinator directly asking them about minimum accepted COMLEX scores and maximum allowed attempts. I would not get into specifics right now as these people are quite busy getting ready for the D.O. Match day in a month. Afterwards, research the areas that these schools are in. Look at the sizes of each program. Check out the program benefits. Examine each aspect of the program and determine which ones you feel will best suit you and facilitate your learning. You still have time before you need to get into focus-mode for Step 2, so now would be a great time to work on this little project.


The final step (and your main question) is in regards to audition rotations. Realize first that the majority of people who match do not usually do so at places where they have auditioned. Yes, it helps tremendously, but what is equally as important is solid letters of recommendation. I cannot tell you personally how much my LoRs have helped me this application season. Therefore, my advice to you would be to examine your list and find which programs top that list. It makes sense to then audition at those rotations, putting your face and hard work in to show them what kind of resident you will be. Another option would be to do an audition at a program that you feel is a long shot given your sordid testing history (Doctor's Hospital might be one.. but I have no idea). Work harder than you ever have before and obtain a LoR from a high-ranking faculty member (or even the PD if you've worked with him/her) and use that letter to show how much you've matured as a student.


All hope is not lost for you, but now is the time to focus and be prepared. Use the end of your third year to prepare and work hard and you will have a nice, relaxing, lazy final semester ahead of you. Good luck!

EDIT: There is also the thought of doing a traditional rotating year to get yourself more exposure. Since I know little about this route I will not dwell on it, but never forget this path through medicine. Lastly, if you are thinking of doing Family Medicine instead of pediatrics, I would adjust my advice above for FM instead. Programs wish to see your LoR from faculty within their specialty more often than not.

 

[J-Rad]

Here is my inexpert opinion:
-study hard for COMLEX II and do well. I think you've already proven that taking USMLE unprepared can hurt you, esp. when you're looking at a non-competitive field in which many programs would accept COMLEX.

-Remember, all but two AOA peds programs are dually accredited, so, for the most part you have a high likelihood of training at a program that could get ACGME accreditation. That said, there are some malignant programs out there. Get as much word of mouth as you can about the programs.

-Unfortunately, the nature of most people's DO education is that they have no "home hospital", so I don't think you really have much of a choice other than to do an "audition rotation" somewhere. The other unfortunate thing is that, at a lot of DO schools, there is a high likelihood that most-to-all your peds experience was outpatient. This is an impediment-though not an insurmountable one-to shining on an inpatient peds sub-I which is what I would recommend (where I trained for residency I think the highest yield sub-Is for students was ward and NICU. YMMV). I would do one high yield peds subspecialty as well (obviously I'm partial to cardiology, but I think ID and endocrine are also useful. The question of what electives to take has been discussed elsewhere here). The good thing is that, even if you end up in FM, these will serve you well. I think there are a good few FM programs that lack a strong peds component, and having this experience in your education will do nothing but help you in the future-from an experiential standpoint. Spend other electives doing a variety of electives that can be helpful to primary care-radiology, sports med, etc.

-The obvious thing is that you need to figure out how to shine on your peds "auditions". Go back and talk to your preceptors about why you didn't honor your rotation and see what you can do better.

-My $0.02

 

[soko23]

I really hate asking this but I failed both the COMLEX Step 1 and USMLE Step 1 on my first attempt. For better or worse I retook both exams and managed to pass on the second attempt.

1st Attempt:
COMLEX Step 1 = 385/74
USMLE Step 2 = 181/71

2nd Attempt:
COMLEX Step 1 = 435/77
USMLE Step 2 = 194/79

At this time I have already had Pediatrics (of which I failed to honor, unfortunately) in the fall and the only remaining rotations I have left for third year are family and Internal medicine. I realize at this point that I face quite an uphill battle. Realistically I am pretty sure that ACGME residencies are out of the question for me and as such my best chance will be to apply to the 19 AOA pediatric programs, of which I few them I won't have a chance at having been unable to pass the first time. At this point I would happy to get into any pediatrics program as I know I cannot afford to be picky.

I guess my plan is to do the best I can on COMLEX step 2 and apply to all 19 AOA peds programs and a ton of family medicine programs.

I guess my question is whether it is worth it for me to use the elective periods I have from September to January to do AOA Pediatric auditions rotations or would it be better to focus on Family Medicine rotations instead as there far more AOA family medicine residences then there are Pediatrics residences. In the end I am trying to figure how to make the most of 4th year.

If I am going to apply for pediatric audition rotations how do I go about figuring out which programs worth it for me to try and audition at.

I know I am asking a lot, so any help is greatly appreciated!

keep your head up. i'm sure you'll be able to match into peds somewhere. and anyway, if worse comes to worse, you can always scramble into FP somewhere. for now, you should go for what you want to do for the rest of your life!
anyone know which are the competitive AOA peds programs and what kind of scores they'll be looking for?