Help: Haven't submitted ERAS, did not pass Step 2

[sunk]

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So, I really screwed up. I'm a D.O student, planned on applying to only Allo Psych programs due to the relative dearth of Osteopathic programs. I haven't submitted ERAS yet as I've been waiting on a particular LOR and thought it would be best to include my Step 2 scores which I hoped would show an improvement from Step 1 (took both USMLE and COMLEX step 1, passed both on 1st attempt). In the past 2 days I received the news that didn't pass either COMLEX or USMLE step 2. I feel absolutely devastated. The worst of it is, since I never saw this coming, I selected automatic release of scores on my ERAS profile.

I've already rescheduled COMLEX step 2 as my school requires it to graduate, and since I only missed passing by 3 points thought it was due to my relative ineptitude for OMM and 'healthcare delivery/medical jurisprudence' which I had hoped to rectify within a few weeks with COMQUEST. Unfortunately my performance on the USMLE demonstrates that I was simply not prepared at all for either of these exams. Should I even bother with the USMLE again? Do I even bother submitting ERAS?

I've contacted my school, but other than that I just don't know what to do. I now know that I should have applied before ever getting these scores, and would have if I had all my LORs. Before anyone suggests it, I have absolutely no desire to do FP (no offense to anyone that does). I'm already preparing for the fact that I may be relegated to an independent internship before seeking out a PGY-2 position, assuming I eventually pass.

 

[Johnny321]

hey man,
sometimes these things happen to the best of us. i think your best bet is to apply to some osteopathic programs. or do some audition rotations so the programs know you outside of what they see on paper. also, you should email your top 5 programs to let them know you are very interested in them. don't give up! good luck on your step 2!

 

[sunk]

I appreciate the pep talk, but I guess I'm looking for more practical advice. Again, I've rescheduled the COMLEX for about 4 weeks frow now, which means I would get my scores back before some app. deadlines, but not all. I'm guessing I should just go ahead and apply, at least to the places whose deadlines will be up before I receive a new score, but what about the rest? I know interview slots run out before the deadlines arrive.

The problem with osteopathic programs is just that aren't many in Psych. 1 in the state where I live, and 1 more in another state I might move to. I realize beggars can't be choosers, but I'd sooner do an internship than live somewhere I'd be completely unhappy.

More than anything, I'm thoroughly despondent right now that I screwed up my entire application by clicking 'automatically update' for my board scores even though I didn't submit ERAS yet, when I might have had a few interviews by now where I could at least get my foot in the door. I didn't understand the potential reprecussions at the time and thought nothing was final until I submitted ERAS. Poor reading skills, I suppose. 🙁

 

[NotAProgDirector]

I don't know if this will make you feel any better, but you didn't "screw up" by choosing the "automatically release" option. Per your description, you have not applied to any programs yet. When (If) you apply to programs, your most updated USMLE transcript will be sent -- NOT the one that was present when you signed your ERAS app, but whatever scores are available on the day you apply. The auto release option simply re-releases your USMLE scores if new ones come in AFTER you apply. So, even if you had chosen manual release, you'd be in exactly the same situation that you are now, no worse.

If you had chosen "Manual release" AND had already applied to programs, then you might be in a better situation. If those programs interview applicants with only step 1. And, if they don't demand Step 2 prior to ranking -- because if they do, you might simply spend lots of cash interviewing places and simply not get ranked.

So, practically, what can you do?

1. Forget USMLE 2CK for now. There is no way to take it, pass with a good score, and apply for allopathic programs in this year's match. Focus on COMLEX II. You need to pass it to graduate, and it needs to be your priority.

2. There is little point to applying to ACGME programs with two failed Step 2's. You're very likely to get minimal interview offers. Once you're rejected, the chances of PD's looking at your app again are minimal. I get 1000's of apps -- once rejected, I hardly ever go backwards.

3. Osteo programs may have earlier deadlines. The match is earlier, so I assume everything is moved up. You may need to apply to osteo programs now. Luckily, you don't have to share your USMLE scores with them, so all they see is a single failure. You'll need to review their application timeline with your dean or advisor, to figure out what makes the best sense.

4. You need a plan B. Consider applying to TRI's. Do you really want to find one in the scramble? Or, plan on a research year.

5. Focus for the next 4 weeks on the COMLEX. You do not want to "pass". You want to do well -- as well as you can. You'll have a much better argument if you pass it by a wide margin than if you pass it by a few points. Failing it a second time would be horrible.

6. If you get your scores back before deadlines expire, then you apply to ACGME programs. Even if you do apply ontime, you may find that your multiple board failures will not be overlooked. You may need to broaden your applications.

7. If you don't get many ACGME interviews, then you'll want to consider ranking TRI's in the osteo match. If you get a few ACGME interviews, you'll have a really tough choice -- try to match a TRI or hope for an ACGME match and if not, find a TRI in the post NRMP TRI scramble. If your home program has a TRI and openings, that might be a less stressful option. If you decide to do research with your off year, these decisions are much easier -- you simply go for the match, and if you fail to match you do research.

8. If you don't match in psych, then you take USMLE Step 2 in May or June. You study like crazy. You get as good a score as possible. You are then in the best position to apply for ACGME psych positions in the next match. Do not try to take Step 2CK while in an internship.

Good luck with all of this.

 

[sunk]

My sincerest thanks for your reply.

I don't know if this will make you feel any better, but you didn't "screw up" by choosing the "automatically release" option. Per your description, you have not applied to any programs yet. When (If) you apply to programs, your most updated USMLE transcript will be sent -- NOT the one that was present when you signed your ERAS app, but whatever scores are available on the day you apply. The auto release option simply re-releases your USMLE scores if new ones come in AFTER you apply. So, even if you had chosen manual release, you'd be in exactly the same situation that you are now, no worse.

If you had chosen "Manual release" AND had already applied to programs, then you might be in a better situation. If those programs interview applicants with only step 1. And, if they don't demand Step 2 prior to ranking -- because if they do, you might simply spend lots of cash interviewing places and simply not get ranked.

So, practically, what can you do?

1. Forget USMLE 2CK for now. There is no way to take it, pass with a good score, and apply for allopathic programs in this year's match. Focus on COMLEX II. You need to pass it to graduate, and it needs to be your priority.

2. There is little point to applying to ACGME programs with two failed Step 2's. You're very likely to get minimal interview offers. Once you're rejected, the chances of PD's looking at your app again are minimal. I get 1000's of apps -- once rejected, I hardly ever go backwards.

3. Osteo programs may have earlier deadlines. The match is earlier, so I assume everything is moved up. You may need to apply to osteo programs now. Luckily, you don't have to share your USMLE scores with them, so all they see is a single failure. You'll need to review their application timeline with your dean or advisor, to figure out what makes the best sense.

4. You need a plan B. Consider applying to TRI's. Do you really want to find one in the scramble? Or, plan on a research year.

5. Focus for the next 4 weeks on the COMLEX. You do not want to "pass". You want to do well -- as well as you can. You'll have a much better argument if you pass it by a wide margin than if you pass it by a few points. Failing it a second time would be horrible.

6. If you get your scores back before deadlines expire, then you apply to ACGME programs. Even if you do apply ontime, you may find that your multiple board failures will not be overlooked. You may need to broaden your applications.

7. If you don't get many ACGME interviews, then you'll want to consider ranking TRI's in the osteo match. If you get a few ACGME interviews, you'll have a really tough choice -- try to match a TRI or hope for an ACGME match and if not, find a TRI in the post NRMP TRI scramble. If your home program has a TRI and openings, that might be a less stressful option. If you decide to do research with your off year, these decisions are much easier -- you simply go for the match, and if you fail to match you do research.

8. If you don't match in psych, then you take USMLE Step 2 in May or June. You study like crazy. You get as good a score as possible. You are then in the best position to apply for ACGME psych positions in the next match. Do not try to take Step 2CK while in an internship.

Good luck with all of this.

 

[Superstarz34]

Do programs have a file for applicants they have already rejected if they are reapplying the following year?

 

[NotAProgDirector]

Do programs have a file for applicants they have already rejected if they are reapplying the following year?

Not exactly. There is a whole new version of ERAS every year, so all applications are fresh. However, most of us keep our old versions of ERAS handy. If a name looks familiar, it's a quick search to find the app from last year. But I'd have to do that for each person who applies individually, so it only happens if someone has a very memorable application.

 

[Superstarz34]

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[rgerwin]

Do NOT retake USMLE. I'm not sure, and I apologize if I missed this in your previous posts, who said you needed USMLE step 2 anyway, but you don't. Definitely do comquest-twice if possible. I definitely said if I hadn't studied OMM i would have failed, b/c I got hammered with it. It will be ok, but you will probably need to be as flexible as possible regarding location.

 

[sunk]

I appreciate the input. I signed up for Comquest the other day and have done a little over 300 Qs so far and aim to go through it at least once more before the exam. I foolishly neglected OMM, and like you got hammered with it, only I obviously paid for it. I couldn't believe how much medicolegal stuff I got too, which was far more difficult than anything UWorld had. Considering I got a 73 and 75 is passing, I think I should be ok, though my goal now is to do far better than simply passing.

Honestly, I was far more shocked and dismayed about the USMLE, considering I passed Step 1 comfortably and actually did better on that than Comlex step 1. This was why I took both for Step 2, thinking it would help my application. Instead I've now handicapped myself. C'est la vie. At the suggestion of my dean, I also just applied to several Osteopathic programs, 4 total, but will probably wait on allopathic programs until I (hopefully) pass and get my results.