Impact of Step 1 fail with onset of epilepsy for residency (MD/PhD interested in CP)

[Peritus_Medicus]

Hello all - I am a current MD/PhD student in an MSTP (GS2 year, 4 out of 8 years overall). At the end of my preclinical phase, I experienced a number of neurological symptoms/cognitive difficulties during my dedicated period and failed my first attempt at Step 1 (despite high pre-testing). I pushed thru and passed on my 2nd attempt, but within a few weeks my neurological symptoms were diagnosed as epilepsy with grand mal seizures. I am grateful that I have a great Neuro team, and am currently stable on medical anti-convulsant management. During my 1st PhD year, I have produced 2 first-author papers (1 review, 1 short report) and hope to have at least 1 more first-author paper this academic year. Based on preclinical shadowing and content, I am strongly interested in pathology (particularly CP) and my early experiences in Path have been really fun (2 conferences including a 1st author blue ribbon presentation at ASCP24). I also had the chance to serve as a student member on a CAP committee.

With this in mind, my mentors have been unable to tell me what to expect during applications for Path residency. I would love to try to pursue AP/CP at a research-focused program, but have no idea how competitive I will be. I get that my Step 1 fail is 100% a red flag - I just don't know if programs will be willing to consider the context of epilepsy onset. Can I do anything to increase my competitiveness/chance of matching? Any advice/thoughts would be greatly appreciated.

Edit - this is an update to my post from last year, happy to share that I passed on the 2nd attempt 🙂

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[KeratinPearls]

Just be honest and straightfoward about your medical condition and try not to use it as an excuse. Just try to demonstrate that you have overcome obstacles. You are an MD PhD so you must have some smarts. You should be fine.

There are plenty of people who are far less qualifed academically than you and got in. Im not joking. One person on the reddit forum mentioned path is one of the top 4 least competitive residencies in medicine, which is unfortunate and sad for the field but it is what it is.

I see a bunch of these posts… “graduated 5-10 years ago, was a pediatric surgeon in my country, applied to internal medicine but didn’t match, am a medical assistant in a internal medicine private practice group, but I suddenly found my passion, Pathology. What are my chances?” LOL.