failed step twice, what are my chances? need advice

[wingandprayer]

So as the title says I failed step 1 twice, and even when I did pass it I didnt by much. Due to the fails I had to take time off of school. In my mind there is no excuse for not passing or even doing well on the boards but during my time off I was able to fix the personal issues that were plaguing me. Now I am a third year student and I have fallen in love with psych. Perhaps because I saw how psychiatrists helped me through my rough path or maybe because its the only rotation where I actually enjoy every moment I am there. Anyway I was wondering what chances you would give someone who is going to an american MD school, who has two fails on step 1. I am currently woking very hard on my rotations and depending on how a few grades come out I may even be in AOA (I really am not a bad student at all, I just had a very hard time in my personal life and it really affected me). I have been studying hard for step 2 and there WILL NOT be a repeat performance like last time. I also have a handful of poster presentations, abstracts and research papers at various conferences (none in psych) and I am working on a text book where I am second author. Any advice would be greatly appreciated as I want to do all I can to match into psych!!

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[BobA]

So as the title says I failed step 1 twice, and even when I did pass it I didnt by much. Due to the fails I had to take time off of school. In my mind there is no excuse for not passing or even doing well on the boards but during my time off I was able to fix the personal issues that were plaguing me. Now I am a third year student and I have fallen in love with psych. Perhaps because I saw how psychiatrists helped me through my rough path or maybe because its the only rotation where I actually enjoy every moment I am there. Anyway I was wondering what chances you would give someone who is going to an american MD school, who has two fails on step 1. I am currently woking very hard on my rotations and depending on how a few grades come out I may even be in AOA (I really am not a bad student at all, I just had a very hard time in my personal life and it really affected me). I have been studying hard for step 2 and there WILL NOT be a repeat performance like last time. I also have a handful of poster presentations, abstracts and research papers at various conferences (none in psych) and I am working on a text book where I am second author. Any advice would be greatly appreciated as I want to do all I can to match into psych!!

Just being a USMD it is likely that you will match. Just don't have too high expectations. Consider doing an away at a mid-tier or lower program.

 

[OldPsychDoc]

1) Pass Step 2.
2) Get at least 2 good psych LORs.
3) Pass Step 2.

 

[notdeadyet]

Apply broadly and apply early. You should find a match someplace. Keep an open mind.

 

[PistolPete]

You'll probably match somewhere, may be more difficult in California or New York.

Definitely do an away rotation somewhere where you want to be and is a realistic goal. Psych wants people that work well in a team, and if you shine, you can be placed ahead of the pack. Stats are considered, but not as important as in ortho/rads/plastics etc.

 

[vistaril]

So as the title says I failed step 1 twice, and even when I did pass it I didnt by much. Due to the fails I had to take time off of school. In my mind there is no excuse for not passing or even doing well on the boards but during my time off I was able to fix the personal issues that were plaguing me. Now I am a third year student and I have fallen in love with psych. Perhaps because I saw how psychiatrists helped me through my rough path or maybe because its the only rotation where I actually enjoy every moment I am there. Anyway I was wondering what chances you would give someone who is going to an american MD school, who has two fails on step 1. I am currently woking very hard on my rotations and depending on how a few grades come out I may even be in AOA (I really am not a bad student at all, I just had a very hard time in my personal life and it really affected me). I have been studying hard for step 2 and there WILL NOT be a repeat performance like last time. I also have a handful of poster presentations, abstracts and research papers at various conferences (none in psych) and I am working on a text book where I am second author. Any advice would be greatly appreciated as I want to do all I can to match into psych!!

if you're a US student(and dont have a horrid personality on interview day) you will match somewhere in psych. The most important thing is that you have a passing step2 score.

 

[psychattending]

If you have strong grades and the rest of your app is good, the best thing you can do would be to do extremely well on Step 2 as this would demonstrate that your Step 1 score is not a good indication of your ability. Even scoring high you still might struggle getting invitations to strong schools. Unless you have some plan to do research for your career writing stuff and doing posters will have minimal impact on your chances.

 

[Extralong]

If you have strong grades and the rest of your app is good, the best thing you can do would be to do extremely well on Step 2 as this would demonstrate that your Step 1 score is not a good indication of your ability. Even scoring high you still might struggle getting invitations to strong schools. Unless you have some plan to do research for your career writing stuff and doing posters will have minimal impact on your chances.

Agree with psych attending. Though some programs would not consider you because of step 1 issues, if you apply broadly, do well on step 2, I'm sure you will have a decent chance at getting an interview

 

[SpiritiualDuck]

Seriously, do very well on Step 2. If you don't, then the concern will be that you won't pass Step 3. That's a requirement for promotion in some programs. I can't imagine any program would graduate a resident without passing Step 3. The best predictor of Step 3 is Step 2 score.

Prove to them that you will do well on Step 3 by getting a killer score on your Step 2.

Also, do some audition months at a few programs that you'd want to go to for residency. Get to know them and that's going to help you.

Good luck.

 

[whopper]

Agree with all of the above. You can get in. Use a scattershot application approach. Err on the side of getting in and apply to as many programs as you can that are within reason. Just don't expect to get into a top program.

Word of advice, I've seen a lot of residents that were in your boat, and got in and they made great psychiatrists and were even very good in their knowledge of medicine The USMLE, unfortunately, is a test where one can know their stuff but due to the way that person processes data, just doesn't do well on multiple choice. I'm one of those types. On Step III, I barely passed the multiple choice section but scored within the top 1% on the computer simulation. I think it's because of the way I think and per the Meyers-Briggs test, I don't do well on multiple choice. I remember my buddies in medschool telling me they thought I knew more than they did on most things and I almost always got a mid-range B but they got As. One of my buddies never studied much and if he actually did study, he did worse on tests.

Getting to the point, people tend to be consistent on their scores between steps 1, 2 and 3. I was told by a resident that step 3 will be changed to be more science based, keeping in stuff from step 1 that was previously thrown out (any residents or medstudents know more about this or want to tell me I'm wrong please do so because I don't know much about this). If you're having problems with step 2, you likely will with step 3. Point is make sure you got some rock solid time studying for it and pick a residency that helps you to do this. Some of the lower tier programs kick the assess of residents unnecessarily.

My same buddy I mentioned above, told me that when he was a chief resident, he actually looked for applicants that didn't do well on USMLE tests but were good otherwise because, as he put it, "I knew the guy would feel like had had to prove he was good and would go the extra mile." He told me he was right in his recommendations, though when he left they apparently didn't keep using his philosophy and unfortunately I wouldn't expect most programs to use this one either.

 

[OldPsychDoc]

Seriously, do very well on Step 2. If you don't, then the concern will be that you won't pass Step 3. That's a requirement for promotion in some programs. I can't imagine any program would graduate a resident without passing Step 3. The best predictor of Step 3 is Step 2 score.

Prove to them that you will do well on Step 3 by getting a killer score on your Step 2.

Also, do some audition months at a few programs that you'd want to go to for residency. Get to know them and that's going to help you.

Good luck.

Our hospital (affecting all GME programs) will not issue a PGY3 contract for a resident who hasn't passed Step 3 by February of PGY2. Obviously, we're not looking to expend a position on someone who is a high risk for this.

 

[Slikateer]

Our hospital (affecting all GME programs) will not issue a PGY3 contract for a resident who hasn't passed Step 3 by February of PGY2. Obviously, we're not looking to expend a position on someone who is a high risk for this.

It appears more psychiatry programs are doing this, with my program being one of them. It's in the contract to pass Step 3 by October 31 of the PGY 2. If not, no PGY-3 contract, leaving you scrambling for a program that doesn't have this stipulation, which are few and far between.

Step 2 is vital to pass and to pass in one shot if you can, as it is testing your clinical decision making and management. I know some programs take into consideration about the number of times you took the exam as well. With Step 1 done and in the past, it's critical to pass the rest of the USMLE's on the first try.

It sure doesn't hurt to rotate in a psychiatry program for a few months to get your face recognized. Also, if you can pass USMLE 3 in one shot with fairly good scores while interviewing in the Match, that would be a HUGE boost, as it is similar to USMLE 2 CK and would give them more confidence that you will be able to handle the clinical responsibilities ahead. I did that, and the interviewers were noting this positively.

Good luck!

 

[notdeadyet]

Our hospital (affecting all GME programs) will not issue a PGY3 contract for a resident who hasn't passed Step 3 by February of PGY2. Obviously, we're not looking to expend a position on someone who is a high risk for this.

Ditto, except our program requires Step 3 exam scheduled by 12/31 of intern year. Our call requires a licensed doc by middle of PGY-2.

 

[wolfvgang22]

Our hospital (affecting all GME programs) will not issue a PGY3 contract for a resident who hasn't passed Step 3 by February of PGY2. Obviously, we're not looking to expend a position on someone who is a high risk for this.

It's that way everywhere I've seen.