how to address failing step 2 during interview

[dlm13cwru]

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I just found out that I failed step 2 and am retaking it in Nov. I have already recieved interviews from some of the psychiatry residencies I applied to. I didn't score very high on step 1 also. I have never done well on standarized exams since I have trouble with recall. My neurologist told me this is due to my Temporal Lobe Epilepsy. I had no problem doing well on my exams during first and second year since they consist of less matieral that can be reviewed the night before and this shows with my class rank. I studied about 4 months for step 2 (completing USMLEworld, reading over first aid many times as well as Secrets and boards and wards).Should I discuss this problem I have when asked or does it just sound like an excuse for not studying hard enough. Right now I just want to pass step 2.

 

[NotAProgDirector]

I just found out that I failed step 2 and am retaking it in Nov. I have already recieved interviews from some of the psychiatry residencies I applied to. I didn't score very high on step 1 also. I have never done well on standarized exams since I have trouble with recall. My neurologist told me this is due to my Temporal Lobe Epilepsy. I had no problem doing well on my exams during first and second year since they consist of less matieral that can be reviewed the night before and this shows with my class rank. I studied about 4 months for step 2 (completing USMLEworld, reading over first aid many times as well as Secrets and boards and wards).Should I discuss this problem I have when asked or does it just sound like an excuse for not studying hard enough. Right now I just want to pass step 2.

You've done the most important thing already, which is to re-register for Step 2. Taking it in November and getting a passing score will be the best way to address this. Of course, try to make sure that between now and Nov you do as much as you can to improve your score.

As far as what to tell programs, that's tough. The argument that your TLE (presumably treated) --> long term memory recall problems (explaining your good performance in class and poor step scores) could be seen as a big negative -- I certainly don't want a resident in my program that can't remember things in the long term.

In addition, you'll have to determine whether or not you have any disabilities that will need to be accomodated due to your TLE. Although I am not a lawyer, my basic understanding of the ADA is:

1. If you tell programs that you have TLE, and they match you, then they must make "reasonable accomodations" for your problem.
2. If you tell programs you have TLE or they ask you if you will need any special accomodations during the interview process, and you say no, you cannot later claim that you now need accomodations (unless the underlying problem becomes worse or changes).
3. If you don't tell them and they don't ask and then you request accomodations, it can work out both ways (but is often ugly)

 

[Samoa]

You aren't required by law to inform anyone, until and unless you need accommodations.

Whether that's the right course of action probably depends on a number of factors, but the law doesn't require you to disclose prior to hiring.

 

[NotAProgDirector]

I stand corrected.

A great summary of the ADA is here.

Most of the confusion / conflict is around "reasonable accomodation". If you match to a program, require some accomodation, and that program decides it's not able to do so, you are stuck with no program or a lawsuit, neither of which is much fun.