General Gap Year and Transfer as a USIMG

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TLDR - Took a year off during med school and considering transferring from one int'l med school to a Carib med school. What can I still do to ensure that I can match into a family med program?

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I'm an American who went to medical school abroad (not a Caribbean school). My grades during my first two years were middle of the pack - I'm probably ranked somewhere smack dab in the middle. My experience, however, was pretty miserable.

I discovered that the vast majority of my classmates were cheating. I'm not talking about memorizing old test banks, but straight up cheating. I reported this anonymously to the school administration as well as to the professors for each course in which I knew cheating was happening. I initially reported that cheating was occurring, but when I observed that no action was being taken, I began detailing the specifics of how the cheating was happening in subsequent emails.

I know some professors attempted to take action because there were revisions in our testing procedures for some classes. But I believe the administration dimed me out to my classmates by exposing my specific emails to several of my classmates. Though sent anonymously, my writing style and the peculiarity of the details probably allowed them (my classmates) to figure out that I was the sender.

Needless to say, I was shunned, and if not for a few students who kept me up to date on important events (like rescheduled exams, signups for events, etc.), I would likely have missed exams and critical events. The administration is very unhelpful - they've always been this way, but now that I have been marked as a troublemaker, my perception (though not necessarily reality) is that they're even more unhelpful.

After I completed my first 2 years, I took a gap year - primarily to separate myself from my classmates. I completed a good portion of a masters degree in that timeframe (I'll have the masters by the time I graduate medical school) and worked on my mental health - 1.5 years of being shunned by classmates is pretty brutal.

When I returned to med school, COVID was (is) in full-swing. Though I should have been placed with the M3's, the school placed me with the M2's, claiming that the school did not have the capacity to handle an additional person. This, despite the fact that I have completed all of my M1 and M2 requirements. I'm taking a bunch of elective coursework right now, but nothing involving hands-on clinical work.

So, I'm thinking of transferring to a Caribbean school, probably one of the "Big 4" to complete my clinical years rather than wait to see what my current school will do with me. US schools are clearly not an option to transfer into. My goal has always been to go into family medicine (it's true - I come from a small town and I want to return to my small town and take over after the current physician, a family med doctor, retires).

My question is this - with the obvious red flags of taking a year off during med school as well as a transfer from one international med school to another, plus the current year of largely useless coursework, how much will this hurt my chances of getting into a family medicine / general internal medicine residency?

There’s no way around if, you’re in a metric ton of trouble. It’s going to appear that not only did you take a gap year, but you also repeated MS2. Maybe that happened through no fault of your own, but that’s how it will appear. Transferring would be yet anotjer

Even if you could transfer to a big 4, don’t they require you to take Step 1 prior to starting clinical rotations? And to me, that is your last potential hope, to do well on step 1 and show you have what it takes. I am concerned that this will be difficult given that you’re now 1.5 years and counting removed from taking the material in your classes.

If transferring even is an option (which I’m not sure it is without step 1) and you feel like your current school is not setting you up to do well on step 1, then you could consider transferring. But IMO this is all window dressing surrounding the fact that you absolutely need to crush step 1, and somehow you need to focus on that rather than all the other drama surrounding your school situation.

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Wow, this is incredibly complex. Caribbean schools are degree-mills. If you have a shot at all of the switching, it would likely be a Caribbean school (although on SDN we really discourage people from attending Caribbean medical schools, your situation is different than most). It's weird to think that you want to transfer for the Caribbean clinicals, since they are basically non-existent and you have to set up your own.
 
Wow, this is incredibly complex. Caribbean schools are degree-mills. If you have a shot at all of the switching, it would likely be a Caribbean school (although on SDN we really discourage people from attending Caribbean medical schools, your situation is different than most). It's weird to think that you want to transfer for the Caribbean clinicals, since they are basically non-existent and you have to set up your own.
I would assume that his clinicals at his current international (non-carrib) school would be no better. With the exception of maybe one.
 
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My question is this - with the obvious red flags of taking a year off during med school as well as a transfer from one international med school to another, plus the current year of largely useless coursework, how much will this hurt my chances of getting into a family medicine / general internal medicine residency?

It's going to make your path very very difficult. When planning for applying for residency, you will need to make sure you very clearly articulate what happened and luckily, there is a section in the ERAS application to explain gaps in your education.
 
Also, one of you asked about taking Step 1. At the end of my (original) M2 year, we had to take the NBME General Sciences exam. We referred to it as a mini-Step 1. I don't remember what my two-digit score was, but I remember that the equivalent 3-digit score was a 210.

I don't know how it works for US med schools, but for my school, the school has to "authorize" students to take the Step exams. I think this happens because overseas schools need to maintain a certain pass rate in order to remain eligible for US federal student loans. They use the NBME General Sciences exam as a screening tool - you have to pass with a certain two-digit score and my score was well above that limit.

I'll have to retake the NBME General Sciences exam (my score from 2019 is considered too old by the school administration). I'm hoping to take it in April or May, pass with flying colors, then immediately take Step 1 in the summer.

Unless you think otherwise, my current thinking is that I should aim to take Step 1 while they still offer a 3-digit score, rather than the Pass/Fail version

At least one Caribbean schools you have to pass that exam as well before you take Step 1. You need to aim for a higher Step score if you’re gonna aim for a scored exam. 210 coming out of a Caribbean school is not going to serve you well when match time comes.
 
OP, I think that your best best at any sort of a medical career in the US is to dump your program and get into an SMP here that's hosted by a med school and has good linkage.

And in all truthfulness, you can blame the cheating scandal and the way the school treated you. You won't be a med school dropout, which is major red flag...you're more of a med school refugee.
 
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