Failed Step 1- 4 times

[keyboardmouse]

Hello,

I needed some real advice from people who know a good deal about this. So I failed Step 1 4 times. The last 2 times were pretty close. This time I think I should be able to pass the exam iA. Im a US citizen, IMG.

So with that being said, say I do better and pass the step 1 this time, CK on my 1st attempt, CS 1st attempt and take the Step 3 and pass it before applying, would I still be a candidate for the IM residency? I will try to get all A's in my clinicals and get LORs. Try to do research and maybe get a publication out. I mean is there a chance for me at all?

thanks.

Sebas.

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[gutonc]

Hello,

I needed some real advice from people who know a good deal about this. So I failed Step 1 4 times. The last 2 times were pretty close. This time I think I should be able to pass the exam iA. Im a US citizen, IMG.

So with that being said, say I do better and pass the step 1 this time, CK on my 1st attempt, CS 1st attempt and take the Step 3 and pass it before applying, would I still be a candidate for the IM residency? I will try to get all A's in my clinicals and get LORs. Try to do research and maybe get a publication out. I mean is there a chance for me at all?

thanks.

Sebas.

Well, based on the information on this site, there are 24-25 states (let's just say half) that will not grant you a license based on your number of attempts on Step 1 and the likelihood of passing the remaining Steps in 1 shot (which is unlikely given that it will take you a minimum of 5 attempts to clear Step 1).

So long answer short, no, you're not really competitive for much of anything. Maybe FM, maybe IM at one of the out of match IMG mills in New York. Maybe. But it's going to be a massive uphill climb for you. Especially since I assume your graduation will be delayed by a couple of years because of all this. You're going to have a lot of explaining to do if and when the time comes to apply for residency. Good Luck.

 

[jerseytrash]

How in the living hell did you fail the step 1 FOUR times? I don't think I've ever seen that many failures at one go.

 

[IamnotFreud]

How in the living hell did you fail the step 1 FOUR times? I don't think I've ever seen that many failures at one go.

I don't think comments like these help. OP failed 4 times, those are the facts. It makes more sense to provide information like myself and gutonc have done and keep things factual than blame the OP or scold him/her as to how/why they failed 4 times.

 

[jdh71]

I don't think comments like these help. OP failed 4 times, those are the facts. It makes more sense to provide information like myself and gutonc have done and keep things factual than blame the OP or scold him/her as to how/why they failed 4 times.

I'm a jerk and even I agree about this

No need to kick a man when they are down, and OP is clearly down.

 

[Raryn]

Drop out before you accrue any more debt.

 

[keyboardmouse]

Well, based on the information on this site, there are 24-25 states (let's just say half) that will not grant you a license based on your number of attempts on Step 1 and the likelihood of passing the remaining Steps in 1 shot (which is unlikely given that it will take you a minimum of 5 attempts to clear Step 1).

So long answer short, no, you're not really competitive for much of anything. Maybe FM, maybe IM at one of the out of match IMG mills in New York. Maybe. But it's going to be a massive uphill climb for you. Especially since I assume your graduation will be delayed by a couple of years because of all this. You're going to have a lot of explaining to do if and when the time comes to apply for residency. Good Luck.

thanks.

How in the living hell did you fail the step 1 FOUR times? I don't think I've ever seen that many failures at one go.

everybody has times when they are trying to achieve something and it is delayed. Lets hope you dont get the same answer when youre in that position.

I don't think comments like these help. OP failed 4 times, those are the facts. It makes more sense to provide information like myself and gutonc have done and keep things factual than blame the OP or scold him/her as to how/why they failed 4 times.

thanks

I'm a jerk and even I agree about this

No need to kick a man when they are down, and OP is clearly down.

Not everybody thinks like you unfortunately.

 

[IamnotFreud]

thanks.


everybody has times when they are trying to achieve something and it is delayed. Lets hope you dont get the same answer when youre in that position.


thanks


Not everybody thinks like you unfortunately.

As I mentioned in my other post on the PMR forum, think carefully about this. Especially as an IMG, the path may be extremely difficult if not impossible for you (and trust me, I'm one of those people who believe *most* things are possible given time/dedication), but this seems like too great a barrier to get through. Have you considered other healthcare careers?

 

[Raryn]

Not everybody thinks like you unfortunately.

I was serious. IMGs chance of matching, even with a step 1 >250, never gets higher than 65-70%. Even assuming you go perfectly for the remainder of medical school and accumulate no more red flags, your chances will never be higher than 15-20%. Probably substantially lower, because you can't even apply to residency/licensure in a very large number of states.

Cut your losses now. You're only 2-3 years in debt, don't keep digging.

 

[gutonc]

How in the living hell did you fail the step 1 FOUR times? I don't think I've ever seen that many failures at one go.

This is a douchey, unhelpful way to ask it, but the question itself is actually germane to the situation.

Perhaps a better way would be to ask, "following each of your failures, what did you change in your approach to preparation in order to ensure that you would improve your score?"

If the answer is "I did UW a couple more times" then that's your problem right there, you need a new studying strategy. If, OTOH, the answer is "I took a different live course and new practice exams after each try" then it's a whole different (and frankly, much more problematic) kettle of fish.

 

[IamnotFreud]

This is a douchey, unhelpful way to ask it, but the question itself is actually germane to the situation.

Perhaps a better way would be to ask, "following each of your failures, what did you change in your approach to preparation in order to ensure that you would improve your score?"

If the answer is "I did UW a couple more times" then that's your problem right there, you need a new studying strategy. If, OTOH, the answer is "I took a different live course and new practice exams after each try" then it's a whole different (and frankly, much more problematic) kettle of fish.

It is true that there should have been an analysis of why this happened the first time around, at a 4th failed attempt, it does not really matter unfortunately how/why. It happened. Unless some serious serious serious connections are in place, it would be very difficult for OP to get a residency and as we know, it would be very difficult for them to get a license even with a completed 5th attempt on step 1. Also, let's bear in mind that while the other steps are easier than step 1, they are still difficult and it's possible that there would be additional failures there.

Best thing to do here is unfortunately move on.

 

[gutonc]

I was serious. IMGs chance of matching, even with a step 1 >250, never gets higher than 65-70%. Even assuming you go perfectly for the remainder of medical school and accumulate no more red flags, your chances will never be higher than 15-20%. Probably substantially lower, because you can't even apply to residency/licensure in a very large number of states.

Cut your losses now. You're only 2-3 years in debt, don't keep digging.

Assuming you're a Carib IMG, I have to agree with this advice. Assuming you rock 240+ from here on out (highly unlikely, but not impossible), you've got a <50% chance of matching in anything. If you're an IMG in another country (like where you have dual citizenship and can practice in the future if things don't work out) then maybe it's worth continuing.

But honestly, this comes up every now and again, people who are either unable to match or unable to complete a residency for one reason or another, asking why they can't practice as a PA or something. You still have that chance. If you leave med school now and enter PA school (it's a 2+ year program...26-28 mos IIRC) you'll finish at about the same time, won't have to do residency, and can make some decent money. If you manage to pass Step 1 and the rest of the steps and graduate, and can't get a residency, you will have a very hard time going to PA (or other professional) school and then you'll really be stuck.

 

[jerseytrash]

I don't think comments like these help. OP failed 4 times, those are the facts. It makes more sense to provide information like myself and gutonc have done and keep things factual than blame the OP or scold him/her as to how/why they failed 4 times.

Apologies for the tone - I was just genuinely surprised. It wasn't meant to be rude.

 

[jerseytrash]

thanks.


everybody has times when they are trying to achieve something and it is delayed. Lets hope you dont get the same answer when youre in that position.


thanks


Not everybody thinks like you unfortunately.

Like I said, it wasn't my intention to be a jerk and I really, truly apologize for that.

I do wonder though what exactly is causing that many failures. It's far beyond anything I've seen people report and it is certainly going to lock you out of being able to apply for a license or residency in many, many places and many specialties.

I just don't think it's realistic at this point, no matter how much you bust your behind trying to do well, to expect a fair chance in the match, which is becoming tougher and tougher every single year.

 

[IamnotFreud]

Assuming you're a Carib IMG, I have to agree with this advice. Assuming you rock 240+ from here on out (highly unlikely, but not impossible), you've got a <50% chance of matching in anything. If you're an IMG in another country (like where you have dual citizenship and can practice in the future if things don't work out) then maybe it's worth continuing.

But honestly, this comes up every now and again, people who are either unable to match or unable to complete a residency for one reason or another, asking why they can't practice as a PA or something. You still have that chance. If you leave med school now and enter PA school (it's a 2+ year program...26-28 mos IIRC) you'll finish at about the same time, won't have to do residency, and can make some decent money. If you manage to pass Step 1 and the rest of the steps and graduate, and can't get a residency, you will have a very hard time going to PA (or other professional) school and then you'll really be stuck.

I agree with gutonc here. I think cutting your losses now, and going the PA/NP/CRNA route may make the best sense. Unfortunately I dont think that it will be easy to match with 4 failures and it will limit your application greatly in terms of places you can apply to since many states may not license you, and even in those you *can* technically license you, they may give you a hard time. I think there is life after med school, and it may be a mixed blessing.

If I were in your situation, I would definitely go into allied healthcare. It may give you a heads up in terms of you competitiveness since you've been in med school, and you can still be in medicine and make good $$ while not spending years and very likely not being able to match.

Also, out of curiosity, have you had to ask the NBME for permission to take the USMLE? Bc I was under the impression that after 3 tries, you had to request permission.

 

[Raryn]

Also, out of curiosity, have you had to ask the NBME for permission to take the USMLE? Bc I was under the impression that after 3 tries, you had to request permission.

NBME doesn't care. They're happy to take your money.

You just have to ask your school's permission.

 

[IamnotFreud]

NBME doesn't care. They're happy to take your money.

You just have to ask your school's permission.

I don't think that's the case, I think after 3 tries you have to ask for permission and/or get some sort of letter, etc.

 

[gutonc]

I don't think that's the case, I think after 3 tries you have to ask for permission and/or get some sort of letter, etc.

Not sure that's the case based on this information. But you can't take it more than 3x in a year.

 

[umean2tellme]

I think it would be best to cut your losses and consider another career path. With 5 attempts to pass step 1 you will get screened out of most residencies during application season. And with your red flags you'd have to apply to hundreds of primary care/psych programs. Not to mention the 2 more years of med schools and applying for steps which you may need to retake as well if your usmle issues repeat themselves on ck and step 3. You're talking about some serious debt there. It's hard to hear, but it would be a very futile endeavor to keep going at this point, but that's just my opinion.

What has your medical school told you? What are their recommendations? Maybe someone there can give you some guidance as well.

 

[NotAProgDirector]

The OP has asked me to close this thread, which I will do. I agree with the advice on this thread. The OP is in a deep hole, and it's not clear he/she will be able to get out of it. Chances of success here are slim, Only the OP knows if it's "worth it". Financially, this is not a good bet. But these decisions are often based more upon emotions than logic.