Failed Step 1 twice, advice needed ASAP!

[Slow N Steady]

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Hi there,
I'm a U.S medical student; I successfully completed my first 2 years of med school without failing any exam or repeating any course. I took Step 1 for the first time last summer (July 2009) and found out I failed (161) in August while on my first third year rotation Pediatrics. I fell into depression, but was allowed to continue on with Peds and the next rotation Surgery, both of which I also failed and have to retake 🙁.

The plan was for me to take time off earlier this spring semester between Jan-March 2010 (2 months) to study and retake the exam. But I was struggling with depression, anxiety and other personal issues (relationship, family) so I decided to take the entire spring semester off on a leave of absence to deal with my issues, study and retake the exam at a later time.

I started studying for the exam in the first week of March and retook it on June 11. Throughout the study period, I continued to struggle with depression, often had difficulty concentrating, felt demoralized, discouraged and defeated at times, constantly questioned my decision to keep trying/wondered whether it's worth continuing med school since my academic record is pretty much screwed by my Step 1 failure and residency options limited (even for primary care that I originally wanted to do).

I just checked my score today-- I failed again (173) 😳. Looking back, I can honestly say that on some days, my studying was not efficient and I didn't always stick to the plan. I mainly used FA, UWorld, BRS Phys & Path, HY Neuro (Goljan RR Path was too thick for me and I'm a slow reader). My schedule was:
8-9am Wake up, shower, eat breakfast
9-1pm Study
1-2pm Lunch
2-4pm UWorld 25-30 Qs focused, tutor mode
4-6pm Study
6-8/9pm Dinner, Relax, Exercise 3x a week
9-11pm UWorld 25-30 Qs random, tutor mode
12midnight Sleep!

I only got through 60% of UWorld Qbank, didn't finish reading Biochem, Anatomy and Neuro, skipped Embryo. Mostly focused on Phys, Path, Micro and Pharm. Towards the end of May, I started to burn out and didn't do a good thorough wrap-up review in the last week.

Brief background on me-- I'm not a good standardized test-taker, struggled with the MCAT, took it 4 times, highest score on last attempt was 25 😳.

My school's policy is that you must pass USMLE Step 1 in order to move on to 4th year. At this point, I'm not even sure I want to practice medicine anymore/do primary care-- my confidence has been shattered and my academic record is severely weakened by failing Step 1 twice, I don't know if any residency program will take me, even family med or psych. I just want to at least graduate with my M.D. degree because I'm in a lot of debt (out-of-state student $70k/year)-- As of right now, I'm $175,000 in debt from 2.5 yrs of med school. If I complete the remaining 2 years to graduate, I'll be at least $315,000 in debt... before interest!😱).

If I quit med school now, I won't earn enough with just a Masters degree to pay back my enormous debt. I have a strong interest in Public Health and am leaning towards potentially getting an MPH degree afterward to add to the M.D. degree if I can at least make it to graduation.

I wish my school would exempt me from having to pass USMLE Step 1 & 2 to graduate if I decide not to pursue residency or residency is not a viable option for me in light of my academic struggles. After all, why take a licensing exam if you no longer wish to be a licensed physician? I heard some med schools like UPenn allow this for students who change their minds about doing residency/practicing medicine, does anyone know or have experience with this?

I would like to attempt Step 1 one more time and continue on with my rotations but I also have doubts/fears. I guess my questions for you guys are:

1) Do you think it's worth it to continue med school? dig myself into more debt when there's a chance I may not practice clinical medicine?
2) What are my alternative career options if I decide to quit med school? I just have a Bachelors' in Biology
3) What would you do if you were in my shoes?

Also, any Step 1 study advice would be appreciated especially from those who've had similar struggles/had to retake the exam.

When I restart third year this fall 2010 semester, my schedule would be:
Internal Medicine - 3 months
Psych - 6 weeks
OB/GYN - 6 weeks (but split over winter/Christmas break: 2 weeks before break and remaining 4 weeks after). Our winter break is about 2 weeks.

I'm thinking of pushing OB/GYN to 4th year and studying to retake Step 1 for the third/last time during that 6 weeks block... it will suck having to study intensely over my winter break but I'm worried I'll be too burned out after Internal Medicine to study for Step 1 during the Psych block instead.

Sorry for the long post, I'm just trying to figure out what to do and unfortunately, I don't feel my school admin is sympathetic or helpful-- I think they've given up on me, and would probably be happy if I just quit med school already! I feel like such a loser and failure 🙁

Thanks for reading.

 

[Bernoull]

Hi there,
I'm a U.S medical student; I successfully completed my first 2 years of med school without failing any exam or repeating any course. I took Step 1 for the first time last summer (July 2009) and found out I failed (161) in August while on my first third year rotation Pediatrics. I fell into depression, but was allowed to continue on with Peds and the next rotation Surgery, both of which I also failed and have to retake 🙁.

The plan was for me to take time off earlier this spring semester between Jan-March 2010 (2 months) to study and retake the exam. But I was struggling with depression, anxiety and other personal issues (relationship, family) so I decided to take the entire spring semester off on a leave of absence to deal with my issues, study and retake the exam at a later time.

I started studying for the exam in the first week of March and retook it on June 11. Throughout the study period, I continued to struggle with depression, often had difficulty concentrating, felt demoralized, discouraged and defeated at times, constantly questioned my decision to keep trying/wondered whether it's worth continuing med school since my academic record is pretty much screwed by my Step 1 failure and residency options limited (even for primary care that I originally wanted to do).

I just checked my score today-- I failed again (173) 😳. Looking back, I can honestly say that on some days, my studying was not efficient and I didn't always stick to the plan. I mainly used FA, UWorld, BRS Phys & Path, HY Neuro (Goljan RR Path was too thick for me and I'm a slow reader). My schedule was:
8-9am Wake up, shower, eat breakfast
9-1pm Study
1-2pm Lunch
2-4pm UWorld 25-30 Qs focused, tutor mode
4-6pm Study
6-8/9pm Dinner, Relax, Exercise 3x a week
9-11pm UWorld 25-30 Qs random, tutor mode
12midnight Sleep!

I only got through 60% of UWorld Qbank, didn't finish reading Biochem, Anatomy and Neuro, skipped Embryo. Mostly focused on Phys, Path, Micro and Pharm. Towards the end of May, I started to burn out and didn't do a good thorough wrap-up review in the last week.

Brief background on me-- I'm not a good standardized test-taker, struggled with the MCAT, took it 4 times, highest score on last attempt was 25 😳.

My school's policy is that you must pass USMLE Step 1 in order to move on to 4th year. At this point, I'm not even sure I want to practice medicine anymore/do primary care-- my confidence has been shattered and my academic record is severely weakened by failing Step 1 twice, I don't know if any residency program will take me, even family med or psych. I just want to at least graduate with my M.D. degree because I'm in a lot of debt (out-of-state student $70k/year)-- As of right now, I'm $175,000 in debt from 2.5 yrs of med school. If I complete the remaining 2 years to graduate, I'll be at least $315,000 in debt... before interest!😱).

If I quit med school now, I won't earn enough with just a Masters degree to pay back my enormous debt. I have a strong interest in Public Health and am leaning towards potentially getting an MPH degree afterward to add to the M.D. degree if I can at least make it to graduation.

I wish my school would exempt me from having to pass USMLE Step 1 & 2 to graduate if I decide not to pursue residency or residency is not a viable option for me in light of my academic struggles. After all, why take a licensing exam if you no longer wish to be a licensed physician? I heard some med schools like UPenn allow this for students who change their minds about doing residency/practicing medicine, does anyone know or have experience with this?

I would like to attempt Step 1 one more time and continue on with my rotations but I also have doubts/fears. I guess my questions for you guys are:

1) Do you think it's worth it to continue med school? dig myself into more debt when there's a chance I may not practice clinical medicine?
2) What are my alternative career options if I decide to quit med school? I just have a Bachelors' in Biology
3) What would you do if you were in my shoes?

Also, any Step 1 study advice would be appreciated especially from those who've had similar struggles/had to retake the exam.

When I restart third year this fall 2010 semester, my schedule would be:
Internal Medicine - 3 months
Psych - 6 weeks
OB/GYN - 6 weeks (but split over winter/Christmas break: 2 weeks before break and remaining 4 weeks after). Our winter break is about 2 weeks.

I'm thinking of pushing OB/GYN to 4th year and studying to retake Step 1 for the third/last time during that 6 weeks block... it will suck having to study intensely over my winter break but I'm worried I'll be too burned out after Internal Medicine to study for Step 1 during the Psych block instead.

Sorry for the long post, I'm just trying to figure out what to do and unfortunately, I don't feel my school admin is sympathetic or helpful-- I think they've given up on me, and would probably be happy if I just quit med school already! I feel like such a loser and failure 🙁

Thanks for reading.

First off, I'm very sorry that u're experiencing such hardship. I'm not a med student yet (5 wks of freedom left..) so I don't have specific advice for USMLE. However, I'll strongly advice to get counseling/therapy/therapeutics whatever you need to address ur depression. This is a serious condition as you know and can impair ur performance on pretty much anything. Talk to family, friends about ur situation, talking/venting can be highly therapeutic. Try to do things u enjoy to lift ur spirits (sports, music, exercise whateva rocks ur boat). It's critical to take care of urself physically, nutritionally and psychologically so that u can get to ur peak performance. Also, seek academic support from ur school and other med students (don't be too proud or shy). U've already made it this far, so obviously u have what it takes I'll give the Step 1 another shot, assess where my prior preparations/weaknesses, improve them and retake. Keep ur head up and best of luck!!

 

[Taurus]

You have a serious problem and you need to take drastic measures. You're very, very close to getting kicked out of medical school. If you're a US MD student, you still will match decently in such fields as FM, IM, psych, neuro, etc. So hope is not all lost. What you do from here is critical.

1. Take another year off of medical school. Do "research". In reality, find a really easy lab that gives you a lot of free time. Don't do "Leave of abscence" because this raises red flags.
2. Get therapy and get started on anti-depressants.
3. Spend most of the year studying for Step 1 until your NBME practice tests indicate that you will pass.
4. Spend rest of year preparing for Step 2 CS and CK and the wards. There's no point in passing step 1 if you can't pass Step 2 and the wards. You don't have much time during 3rd year to study so efficiency is critical. If you failed step 1 x2, there's a good chance you'll fail step 2 unless you prepare for it in advance.

Doing this will at least allow you to graduate from medical school.

 

[Dr AHeart]

I am currently a 2nd year as well although in an international medical school.. I also just got my score and failed my second attempt.. My school doesn't permit rotations until my step 1 is passed... I haven't had any problems what so ever with my courses till this... What will anyone advice and also what are my chances of matching in pediatrics?

 

[malin]

Are you a US citizen at an international school, or an international medical graduate from a foreign country? If the former, then you need to take some time off: both to take a break so you don't burn out, as well as time to really study for the exam. You can start from scratch, or focus on your weakpoints. Read the 2015 scores thread for some useful pointers. it would also help to know what you did and didn't do when you were studying for both attempts before people give you advice.

If you're an IMG from a foreign country, then your chances are pretty bleak to be honest since you've failed twice.

I'll assume you're the former since you say your international med school won't let you go to rotations until you pass step 1. If you can get a good score on your 3rd retake, it'll definitely help. it'll undoubtely be a huge red flag, but it's not impossible. Just aim for as high of a score as possible, and take off as much time as you need to in order to get a good score (not to pass, but at least a 230, which is the average).

 

[worldbeater]

I only got through 60% of UWorld Qbank

This post is old, but I wanted to respond to this so other people in this situation can understand. I am not trying to put this guy down, but just want to share an opinion.

I don't care if you they gave you the answers for the exam, your still not going to do well, because this person has not developed the ability to APPLY the information to the questions. All the other prep in terms of reading is useless, unless you have developed that application ability.

How do you develop that ability? By doing UWorld questions and getting questions wrong, doing at least two full passes of the entire bank (timed, random), and getting an average of 75% or higher.

"But worldbeater, what if I am averaging like half of that, how the heck do you expect me to get to 75% in two passes"? Then do more rounds of UWorld until you get there, nobody is limiting your ability to do questions! It's just practice and moving upwards until you reach that target %.

I hope this person's scores do improve and he does better on his next attempt.