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Failed CK 1 week before match. Lung cancer and USMLE
- Thread starter Final Fantasy
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For once, I have no advice. I know it is going to be hard to get something this cycle without a passed CK at this point.
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I cannot imagine what you must be going through. You have dealt with a lot, but I am sure your mother would never in her wildest dreams think that you let her down.
I do not know if I have good advice, but at this point, I would consider to take a step back and reassess. I am certain you could use an extra year to your advantage. Take the time you need to ace Step 2, it will become clear that Step 1 is not reflective of your knowledge level, but understandable given your familial situation. Find other ways to build your CV if your situation allows it, e.g. research in your field of interest. It may be better to address all these issue in your personal statement and apply broadly with the next cycle (but only to specialties that you like). I am sure your school would help as much as they can. Again, only you will know what is best for you, but it seems to me that taking some time to regroup may be a better option than throwing yourself into any internship right now. I wish you all the best.
I do not know if I have good advice, but at this point, I would consider to take a step back and reassess. I am certain you could use an extra year to your advantage. Take the time you need to ace Step 2, it will become clear that Step 1 is not reflective of your knowledge level, but understandable given your familial situation. Find other ways to build your CV if your situation allows it, e.g. research in your field of interest. It may be better to address all these issue in your personal statement and apply broadly with the next cycle (but only to specialties that you like). I am sure your school would help as much as they can. Again, only you will know what is best for you, but it seems to me that taking some time to regroup may be a better option than throwing yourself into any internship right now. I wish you all the best.
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I think you need to go talk to your Dean...tomorrow.
you might be better off asking to stay another year and apply to the match next year...if you match prelim, well then you can take CK between now and the start of intern year.
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First of all, you're not a loser. And you haven't let anyone down.
But you need to focus on yourself. I know that's hard with all that's going on, but if you don't take care of yourself you can't help anyone else.
Your story is somewhat incomplete in the details. If I understand correctly, you're in the match presumably for EM. But (I'm guessing) you didn't get any EM interviews, or perhaps you decided to only focus on a PGY-1 year to maintain more flexibility given your personal issues. More details (if you're willing) would help us advise you.
In any case, if you submitted a match list for PGY-1 surgery positions, the die is cast. Either you'll match to Prelim GS on Monday, or not. If you match, that's binding on the program -- they can't let you go because you failed the Step. They can let you go if you don't pass the step, if it's needed for a training license or for credentialing. So, you'll need to come up with a plan/timeline to pass the step shortly so that you can get licensed/credentialed (assuming that it is needed, something that you can ask your new program once you know where it is). If you match somewhere you can't just back out -- the match is binding on both parties.
Again, assuming you match, the next question is what you want to do for your PGY-2. You can participate in SOAP, looking for open PGY-2 positions (Rads, Anesthesia, etc). Unfortunately, when you apply to these programs they will see your updated USMLE scores, so they will see the fail. You may not get much love in SOAP. But you should develop a plan, it costs nothing to submit your 30 applications.
if you don't match to a PGY-1, then you have different options. First, you can participate in SOAP, this time for categorical positions. You only get 30 applications, so you would need to decide what fields/programs to apply to, and be smart about it. If you don't get a spot in SOAP, then the options of a gap year of some sort, or extending your medical school training (perhaps with an LOA to save tuition). In this case, you'd want to delay taking Step 2 until you're pretty certain you'll get the score you want.
In all cases, you need to address your issues. You can't have this distracting you while you're an intern. Get help.
But you need to focus on yourself. I know that's hard with all that's going on, but if you don't take care of yourself you can't help anyone else.
Your story is somewhat incomplete in the details. If I understand correctly, you're in the match presumably for EM. But (I'm guessing) you didn't get any EM interviews, or perhaps you decided to only focus on a PGY-1 year to maintain more flexibility given your personal issues. More details (if you're willing) would help us advise you.
In any case, if you submitted a match list for PGY-1 surgery positions, the die is cast. Either you'll match to Prelim GS on Monday, or not. If you match, that's binding on the program -- they can't let you go because you failed the Step. They can let you go if you don't pass the step, if it's needed for a training license or for credentialing. So, you'll need to come up with a plan/timeline to pass the step shortly so that you can get licensed/credentialed (assuming that it is needed, something that you can ask your new program once you know where it is). If you match somewhere you can't just back out -- the match is binding on both parties.
Again, assuming you match, the next question is what you want to do for your PGY-2. You can participate in SOAP, looking for open PGY-2 positions (Rads, Anesthesia, etc). Unfortunately, when you apply to these programs they will see your updated USMLE scores, so they will see the fail. You may not get much love in SOAP. But you should develop a plan, it costs nothing to submit your 30 applications.
if you don't match to a PGY-1, then you have different options. First, you can participate in SOAP, this time for categorical positions. You only get 30 applications, so you would need to decide what fields/programs to apply to, and be smart about it. If you don't get a spot in SOAP, then the options of a gap year of some sort, or extending your medical school training (perhaps with an LOA to save tuition). In this case, you'd want to delay taking Step 2 until you're pretty certain you'll get the score you want.
In all cases, you need to address your issues. You can't have this distracting you while you're an intern. Get help.
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,.l
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I'm still confused. You had 0 interviews for anything? Including prelim surg?
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he did only have a 199 on step I...even as an AMG thats gonna be rough for cat GS...
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The additional details are helpful. Your story is still somewhat convoluted, but here's how it looks: You applied to Gen Surgery with EM as a backup. Sounds like you got zero interviews for either. Your first post mentioned that you "applied for preliminary surgery only", hence our confusion. From your last post, I'll assume you had truly zero interviews.
In that case, you will (of course) not match on Monday. But you're wide open for SOAP, and you need to make some strategic decisions tomorrow about how to proceed. You have several options:
1. You could apply for prelim surgery. If there is an open categorical surgery spot you could certainly apply for it, but honestly with your USMLE scores and the new fail, your chances are basically zero for cat surgery. But you might get a prelim GS spot. Then, you would need to pass Step 2, and then start studying like crazy for the ABSITE. As a prelim GS intern, your only chance of getting a categorical GS spot is to do really well on the ABSITE, and prove that the USMLE exams were both not representative of your skills. To be fair, even if your UWorld was 22x for Step 2, that's not a great score (the current average is 238), so I worry that even if you put your full energy into doing well on the ABSITE, it might still be a very difficult test for you. Without a dramatic improvement on Step 2 or a great ABSITE score, your chances of getting a categorical surgery spot are very poor.
2. You could apply for something else. With your poor scores, you're options will be the less competitive fields: FM, Psych, Path, and Neuro. PM&R is a possibility also but that requires both a prelim and advanced match, so less than ideal. Realize that if you match into one of these fields, your chances in GS are zero -- but you;ll have a defined career moving forward.
3. You decide not to match at all, or you try to SOAP and are unsuccessful. This gives you an entire year to rehab your application. You deal with your family health issues. You take the time it takes to do well on Step 2. You do several surgical Sub-I's and get more letters (or decide to target EM instead). Or you take the year to explore other options (Neuro/FM/Psych/Path/PM&R) because honestly your chances in GS are not good, even with a year off. It really depends upon whether you want to fight an uphill battle for several years, or choose an easier path that lets you focus on moving forward. But I totally understand that you may have a love for surgery and be willing to try to fight for it -- as long as you understand that it might be very painful (for you) and ultimately unsuccessful.
Next steps:
1. You need to go talk to your advising Dean tomorrow AM, 8AM sharp. No excuses. Doesn't matter if you don't have an appointment, show up and tell them it's an emergency and you'll wait all day if needed. Because it is. You need a plan. You don't want this eating at you all weekend any more than necessary. If I was meeting with you, we'd discuss the three options above. We'd review the SOAP list from last year, to get some sense of what might be available. You'd leave with a plan.
2. Personally, I think you need to seriously consider not matching and planning to attack this next year. Are you really going to be ready to start residency in July? Or are your mother's health issues still going to be unstable/ongoing? Are you really ready for the rigors of residency, especially a prelim GS spot if that's what you try for? These are very important questions to review with your Dean.
In that case, you will (of course) not match on Monday. But you're wide open for SOAP, and you need to make some strategic decisions tomorrow about how to proceed. You have several options:
1. You could apply for prelim surgery. If there is an open categorical surgery spot you could certainly apply for it, but honestly with your USMLE scores and the new fail, your chances are basically zero for cat surgery. But you might get a prelim GS spot. Then, you would need to pass Step 2, and then start studying like crazy for the ABSITE. As a prelim GS intern, your only chance of getting a categorical GS spot is to do really well on the ABSITE, and prove that the USMLE exams were both not representative of your skills. To be fair, even if your UWorld was 22x for Step 2, that's not a great score (the current average is 238), so I worry that even if you put your full energy into doing well on the ABSITE, it might still be a very difficult test for you. Without a dramatic improvement on Step 2 or a great ABSITE score, your chances of getting a categorical surgery spot are very poor.
2. You could apply for something else. With your poor scores, you're options will be the less competitive fields: FM, Psych, Path, and Neuro. PM&R is a possibility also but that requires both a prelim and advanced match, so less than ideal. Realize that if you match into one of these fields, your chances in GS are zero -- but you;ll have a defined career moving forward.
3. You decide not to match at all, or you try to SOAP and are unsuccessful. This gives you an entire year to rehab your application. You deal with your family health issues. You take the time it takes to do well on Step 2. You do several surgical Sub-I's and get more letters (or decide to target EM instead). Or you take the year to explore other options (Neuro/FM/Psych/Path/PM&R) because honestly your chances in GS are not good, even with a year off. It really depends upon whether you want to fight an uphill battle for several years, or choose an easier path that lets you focus on moving forward. But I totally understand that you may have a love for surgery and be willing to try to fight for it -- as long as you understand that it might be very painful (for you) and ultimately unsuccessful.
Next steps:
1. You need to go talk to your advising Dean tomorrow AM, 8AM sharp. No excuses. Doesn't matter if you don't have an appointment, show up and tell them it's an emergency and you'll wait all day if needed. Because it is. You need a plan. You don't want this eating at you all weekend any more than necessary. If I was meeting with you, we'd discuss the three options above. We'd review the SOAP list from last year, to get some sense of what might be available. You'd leave with a plan.
2. Personally, I think you need to seriously consider not matching and planning to attack this next year. Are you really going to be ready to start residency in July? Or are your mother's health issues still going to be unstable/ongoing? Are you really ready for the rigors of residency, especially a prelim GS spot if that's what you try for? These are very important questions to review with your Dean.
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I can't say enough how much I agree with aPD above
DO NOT start an intern year if you really are not ready in July
and I know, the pressure is enormous, the list of reasons why you "have" to is enormous
don't let your school talk you into it
don't let a program talk you into just showing up and trying it out if you're not sure you're ready to start
some programs want a hot body to show up and sign notes so badly they will give you enough rope to hang yourself with, they will work you to an early grave or at least to some sort of collapse that once they become convinced you're not of any immediate future use to them they will just cut you loose then and then you'll be worse off than if you follow the advice above on how to fill your time
residency deferred is better than a residency attemped and failed IMHO
DO NOT start an intern year if you really are not ready in July
and I know, the pressure is enormous, the list of reasons why you "have" to is enormous
don't let your school talk you into it
don't let a program talk you into just showing up and trying it out if you're not sure you're ready to start
some programs want a hot body to show up and sign notes so badly they will give you enough rope to hang yourself with, they will work you to an early grave or at least to some sort of collapse that once they become convinced you're not of any immediate future use to them they will just cut you loose then and then you'll be worse off than if you follow the advice above on how to fill your time
residency deferred is better than a residency attemped and failed IMHO
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I don't mean to add to your stresses with doom and gloom talk
I have seen firsthand people with similar circumstances to yours 4th year navigate, and regrouping is not only possible, I think it's better than just trying to push through to a residency if you're not quite ready to succeed intern year
doing your best with the cards LIFE dealt YOU is never failure even when the result looks nothing like your expectations
don't compare yourself to anyone else in medicine, the seemingly perfect colleague sitting next to you could very well be slitting their wrists in secret at home and are just a few weekend booze binges away from losing it all, if there's one thing a medical education will teach you it's how to hide your pain and put on a good face (sounds like you've been doing that this year!)
if you've got some self destructive behaviors going on right now, PLEASE seek help
I truly wish you the best
PM me with anything
no judgement here
last thing, is do you have someone you can talk to if things seem beyond hopeless?
I would encourage you, if you have presence of mind to consider the people who love you
I would tell you, if you are thinking of self harm, that to your loved ones the idea of losing you over what is ultimately from their point of view a *job* would be.....unfathomable
I'm sure that even if very "successful" there are quite a few of them if not most that are NOT Dr. So and So
remember they loved you before you ever went to medical school
in medical training it's easy to get tunnel vision and the standards of what makes someone a success in life becomes drastically skewed in relation to the other 99% of the rest of society
as a medical school graduate you will never seem like a loser to anyone but your own harsh inner critic or maybe some select perfectionistic dingus doctor/career types whose opinions shouldn't count
your MD is not your whole identity, not by a longshot
remember what makes you you and a worthwhile human that has nothing to do with career choice
remember the talented child of your mother's that you were first in life!
hopefully, if you reflect on all this, you can see no matter what happens with your career you are doing your best, you are not a loser, you are not letting your family down, every day you put another foot in front of the other you are honoring them (might not feel like it, but yeah) and that is always what they would wish for you to keep doing
I have seen firsthand people with similar circumstances to yours 4th year navigate, and regrouping is not only possible, I think it's better than just trying to push through to a residency if you're not quite ready to succeed intern year
doing your best with the cards LIFE dealt YOU is never failure even when the result looks nothing like your expectations
don't compare yourself to anyone else in medicine, the seemingly perfect colleague sitting next to you could very well be slitting their wrists in secret at home and are just a few weekend booze binges away from losing it all, if there's one thing a medical education will teach you it's how to hide your pain and put on a good face (sounds like you've been doing that this year!)
if you've got some self destructive behaviors going on right now, PLEASE seek help
I truly wish you the best
PM me with anything
no judgement here
last thing, is do you have someone you can talk to if things seem beyond hopeless?
I would encourage you, if you have presence of mind to consider the people who love you
I would tell you, if you are thinking of self harm, that to your loved ones the idea of losing you over what is ultimately from their point of view a *job* would be.....unfathomable
I'm sure that even if very "successful" there are quite a few of them if not most that are NOT Dr. So and So
remember they loved you before you ever went to medical school
in medical training it's easy to get tunnel vision and the standards of what makes someone a success in life becomes drastically skewed in relation to the other 99% of the rest of society
as a medical school graduate you will never seem like a loser to anyone but your own harsh inner critic or maybe some select perfectionistic dingus doctor/career types whose opinions shouldn't count
your MD is not your whole identity, not by a longshot
remember what makes you you and a worthwhile human that has nothing to do with career choice
remember the talented child of your mother's that you were first in life!
hopefully, if you reflect on all this, you can see no matter what happens with your career you are doing your best, you are not a loser, you are not letting your family down, every day you put another foot in front of the other you are honoring them (might not feel like it, but yeah) and that is always what they would wish for you to keep doing
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