Failed Step 1, achieved average score on retake - Need advice

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DAN325

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Hello, I am a US medical student and I went through so many major challenges in my life which have now lead me to this point. I am a bit confused about what possiblities are left for me. I will appreciate any advice.

I had many challenges in my life during my first 2 years of med school which greatly affected my grades and my step 1 score. I failed step 1 with a score of 175. It was quite devastating, but I regrouped 2 months later and pass with a score >230. I pass my step 2 with a score >230. My other credentials are high pass in all clerkship except remediation of family medicine, and I am bottom half of my class.

I am interested in anesthesiology, internal medicine, general surgery, and radiology. I don't really know where I stand. Should I just not even consider general surgery and radiology? Do I still have a reasonable chance at anesthesiology? Thanks for reading.
 
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I don;t think it matters. You have good scores above 200 on both steps, you are a citizen, have USCE. Not a problem. Just be able to explain the failure, what you learned and move on. I was an IMG and failed step 1, and 2 once and passed 77 and 87 and got 1 interview in path and prematched on 1 interview.

YOu have a lot on your side compared to most so why doubt yourself, go ahead and apply.
 
What year are you applying? I'm assuming next year since you've taken step 2, but it also appears you are MD/PhD (right?) so I'm not sure where you're at in your schooling. I would advise you to figure out which one of these fields you are most interested in via electives, so that you can really focus on making yourself the best pathology candidate or gen surg candidate, etc, etc. Doing research in the field even if it's just a case report and performing well on sub-i's in the field (and getting good LOR's from these rotations) can boost your chances of landing a residency spot. Talk with a mentor about how you can boost your application and make it as competitive as possible. Another very important tip is to apply early and broadly. Have your application in the first week of September if possible even if you're still waiting on a couple of LORs to increase your chances of gaining interviews. I am certainly not an expert on all of the fields you are looking into (I'm doing peds). I would think you would have a chance of gaining a good residency spot provided LORs, clinical grades, and sub-i's are all good. You may get filtered out by some programs b/c you didn't pass Step 1 on the first try, but I think there will be several programs willing to look past that considering your high step 2 score. The only fields you may have considerable difficulty attaining interviews would be radiology and possibly anesthesia. Disclaimer: I am currently applying, but have pretty much finished my interview season so I've been through the application process. Good luck!
 
No I am just a medical student, not a MD/Phd. That was just an error. I will be applying this fall 2010. I agree that I need to pick a specialty and do the best I can to boost my application in that area. The first thing I wanted to do since I have such a wide field of interest and of course now an asterisk mark by my application is to eliminate all the choices that I have absolute no chance at. I think after doing some more shadowing and early electives, I will have a better idea of what I feel will be the best fit. I greatly appreciate the advice and support so far. Thanks.
 
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DAN325 said:
I had many challenges in my life during my first 2 years of med school which greatly affected my grades and my step 1 score. I failed step 1 with a score of 175. It was quite devastating, but I regrouped 2 months later and pass with a score of 230. I pass my step 2 with a score of 245. My other credentials are high pass in all clerkship except remediation of family medicine, and I am bottom half of my class.

I am interested in pathology, anesthesiology, internal medicine, general surgery, and radiology. I don't really know where I stand. Should I just not even consider general surgery and radiology? Do I still have a reasonable chance at anesthesiology and pathology? Thanks for reading.
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There are, from what I see, four strikes against you:

- The Step 1 failure
- The need to remediate a (fairly basic) clinical clerkship. Why did you have to remediate family med? 😕
- All HPs, and no honors, in your clinical clerkships
- The fact that you're interested in five somewhat distinct specialties. It makes it seem like you're not interested in any of them.

Radiology and anesthesia will be difficult (if not impossible) with that background. Depending on why you had to remediate family med, IM and general surgery may also be very difficult - although there are always programs that are just looking for a warm body.

Your best bet may be to do a lot of away rotations and develop connections, but first you will have to sit down and figure out what your clinical weaknesses are. A program will already see you as a risk from an academic standpoint; you will have to figure out why you're clinically weak and how to improve that before you can go about doing away rotations.
 
I think it would be quite hard to get into radiology having failed Step 1 and one of your clerkships..they have too many applicants who are perfect on paper. It is kind of a curveball that you did so much better on the Step 2 and the Step 1 retake, though.

General surgery and anesthesiology are also kind of competitive. Surgeons tend to be unforgiving so I think it will be hard for you to get interviews in general surgery, unless you have LOR's from powerful people. You could likely find a prelim surgery program that would take you, but that can be a dead end.

pathology and IM are not competitive, but getting into a higher tier university IM program may be tough with the red flags on your application. An away rotation might help if you do well. I agree w/above that you need to figure out what are your clinical weaknesses before you do your subI and any 4th year away rotations.

By the way, I don't think fm is necessarily an easy rotation...it probably depends a lot on your med school and who the attending is. Any rotation can be a killer if the person evaluating the student is harsh, and/or the work is brutal.
 
dragonfly99 said:
By the way, I don't think fm is necessarily an easy rotation...it probably depends a lot on your med school and who the attending is. Any rotation can be a killer if the person evaluating the student is harsh, and/or the work is brutal.
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That was poor wording on my part.

By "basic," I meant "core." I feel like FM represents a lot of general knowledge and patient interaction that most people learn during the first two years of med school....not doing well in such a fundamental rotation (as opposed to something very specialized like CT surgery or some obscure ortho rotation) is a red flag, I think.
 
dragonfly99 said:
I think it would be quite hard to get into radiology having failed Step 1 and one of your clerkships..they have too many applicants who are perfect on paper. It is kind of a curveball that you did so much better on the Step 2 and the Step 1 retake, though.

General surgery and anesthesiology are also kind of competitive. Surgeons tend to be unforgiving so I think it will be hard for you to get interviews in general surgery, unless you have LOR's from powerful people. You could likely find a prelim surgery program that would take you, but that can be a dead end.

pathology and IM are not competitive, but getting into a higher tier university IM program may be tough with the red flags on your application. An away rotation might help if you do well. I agree w/above that you need to figure out what are your clinical weaknesses before you do your subI and any 4th year away rotations.

By the way, I don't think fm is necessarily an easy rotation...it probably depends a lot on your med school and who the attending is. Any rotation can be a killer if the person evaluating the student is harsh, and/or the work is brutal.
Click to expand...

Family medicine is obviously an easy rotation, although there is a ton of busywork and showing you know something about applying evidence level criteria and other things like that, that can make it challenging from an 'amount of work' standpoint.

I disagree with smq that not knowing what you want to do is a red flag. So many medical students don't know what they want to do and might be happy in many fields.

Obviously, radiology is out for you. Try again after completing an internal medicine residency if you really want to be a radiologist. Don't go for a prelim surgery position because the chances of you getting that categorical spot are very low.

Anesthesia will be fine if you are willing to go to somewhere undesirable or somewhere in the south.

I think I would recommend internal medicine as your best bet to salvage your medical school performance. You will be competitive at programs which IMG's consider high-tier -- which isn't bad.

I'm not sure how many path spots there are in the nation, but I think this could be doable too.

You need to do a lot of research. Grab a notebook and go on FREIDA state by state, then find the websites associated with the residency programs. Look for resident listings, and find out where people went to medical school. Your best bet will be to find residency programs with lots of IMG's, Caribbean and/or people from ultra-low tier medical schools.

Do NOT fixate on your challenges. Simply move on from them. I wouldn't even mention them in your personal statement. It'll come up during your interview but you can have a canned story and show how you've moved on. Do some aways. Find some doctor to write you a 90 day script for Prozac with lots of refills.

While all these negative people have focused on your red flags, I think your status as an American graduate is worth quite a lot, a lot more than you think.

In 5 years you will be looking back on this moment and laugh.
 
DAN325 said:
Hello, I am a US medical student and I went through so many major challenges in my life which have now lead me to this point. I am a bit confused about what possiblities are left for me. I will appreciate any advice.

I had many challenges in my life during my first 2 years of med school which greatly affected my grades and my step 1 score. I failed step 1 with a score of 175. It was quite devastating, but I regrouped 2 months later and pass with a score of 230. I pass my step 2 with a score of 245. My other credentials are high pass in all clerkship except remediation of family medicine, and I am bottom half of my class.

I am interested in pathology, anesthesiology, internal medicine, general surgery, and radiology. I don't really know where I stand. Should I just not even consider general surgery and radiology? Do I still have a reasonable chance at anesthesiology and pathology? Thanks for reading.
Click to expand...

Believe me, you'll be fine in all the specialties you mentioned. Only radiology may give you some trouble.

But believe it. YOU WILL DO FINE in the match.

It is human nature for students to expect the worst. So they often take the easy way out and apply safe. I can't fault students who do this, but in my experience, you will actually do well in the match.
 
Speculatrix said:
Family medicine is obviously an easy rotation.
Click to expand...
Whoa now. I think it was easily one of my hardest, much worse than IM or surgery. This is obviously highly variable from school to school. I have a ton of respect for those going into FM.
 
You are still in 3rd year and you already took step 2? That is a bit odd, unless you are currently a 4th year and will be graduating this year and then entering the match, in which case you severely hinder your prospects (US Non-senior does not equal US Senior). Or you could be in a weird schedule where you still will be graduating 2011 but have already finished your clinical rotations...

I think what some people aren't asking though, is what are you end all career goals? It does require you to have a specialty in mind, but do you want to be in private practice in the community? Want to be an academic? What about fellowship?

Radiology will definately be your hardest shot, but if that is what you really want, I would recommend getting very friendly with your home program or doing an away somewhere you would really want to go to get a repore and familiarity with them, get some good letters, apply broadly, and hope for the best. Is your home program very strong or weak? Strong would probably give you better letters (if you work good) but would make it harder for you to stay... weak would make your letters not worth as much, but give you a better chance of matching at home.

Beyond that, I don't know how a failed score will be viewed. Community programs will definately be much easier (they are regardless) to get into, even in Gen Surgery, Anesthesia, IM... but with community places it makes fellowship all that much harder (but not impossible) to get into

As for FM vs other clerkships, it was one of the easier as far as the clinical responsibilities (nice hours, no call, all outpatient) but I did better on almost all my other rotations grade wise because so much weight was on just 2 things (55% on only 1 clinical eval and 40% is test... you get a less than perfect eval and you are forced to ace the test to honor)... Medicine was more painful clinically (q4 call, 7am-5pm every day, heavy inpatient duties and load) but grading was more kind due to having evals from 6 people (so 1 less than perfect one could be balanced out), an OSCE, H&P writeups, the Shelf... so even though I got a 74 on my OSCE, still honored because high shelf, eval and H&P scores)... and most my courses, regardless of final grades, if you fail the shelf you fail the course until you remediate it, which could very well have happened here (but is a bad sign because it would show the failing step 1 was not just a fluke but maybe a pattern...)
 
hello - you sound exactly like me...I too have had a bumpy road - personal health problems, family tragedies, etc. and I am preparing to retake Step 1. I really would love to score 230+...Would be great for my career and help to recover from the so many kicks in the psyche I've had to endure over the past couple of years. Could you PLEASE tell me what you did the second time around when you were preparing to retake step 1? A private message is ok if you prefer. Many, many thanks.
 
This thread was bumped from almost two years ago, and it doesn't look like the OP has been active since shortly after the 2010 Match.

TexasPhysician said:
Radiology, anesthesia, and gen surg would all be a tough sell. Maybe possible, but difficult.
Click to expand...

Judging from his posts (this one in particular), he matched at his top choice in anesthesia.
 
K31 said:
This thread was bumped from almost two years ago, and it doesn't look like the OP has been active since shortly after the 2010 Match.



Judging from his posts (this one in particular), he matched at his top choice in anesthesia.
Click to expand...

Yeah, don't believe the hype, anesthesia is not THAT hard to get into, if geography is not an issue.
 
From everything that you described, I'd say you can get surgery, IM, gas but not radiology. Apply widely to low and medium tier programs. As others have said, have very good explanations for your failure, however having a failing score and then 230+ on the next re-take with a reasonable "real-life" distraction would be perfectly believable considering that's a pretty drastic improvement, so it's not an issue of aptitude. Just be prepared for the tough questions but I'd say 3 of those 4 are not without reach. I just don't think you'd get a radiology spot personally and if you hedged all your bets on that field with no backup, you'd be taking a big risk.

I think what's more important right now is to figure out what field you WANT to do. You listed some pretty drastically differing fields in just about every respect. It sounds like you have no idea what you want to do. I can't imagine someone that is happy in IM, being happy in surgery or anesthesia, etc.. Completely different specialties in just about every way.

Good luck.
 
Dan325 - I too have had challenges throughout med school - health issues, family crises, etc... I failed step 1 twice and would love to get your advice on how you approached step 1 retake and achieved a great score
 
Law2Doc said:
We still don't know that there weren't other bumps in the road for this guy there's still step 3, inservice exams, the boards...
Click to expand...

Wow. This reminds me of a guy my dad told me about who he used to work with (let's call him Bob).

My dad: "Bob, it's Friday, isn't that great?"

Bob: "Yeah, only three more days to Monday. 🙁 "
 
Law2Doc said:
We still don't know that there weren't other bumps in the road for this guy there's still step 3, inservice exams, the boards...
Click to expand...
Don't forget that he has to drive to work every day, too. What if he can't find a parking spot? That is a pretty daunting task on many hospital campuses!
 
Q - I'm such a lurker these days, but your posts make me smile. You rock. 🙂 Love your response! Hope you are surviving intern year well.
 
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