Is it hard to match into FM anywhere if I fail Step 1?

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grindtime1

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Long story short, I went into med school for no real reason other than to make a living basically. Never really liked it or cared about helping anyone and I honestly don't really care about anything I'm learning. During anatomy lab I would skip half the labs and make my classmates do most of the dissecting since it was simply a waste of time and all of the learning (vasculature, muscles, etc) came outside of lab time at my own home watching Acland's vids or using Netter's atlas, etc.

I also study for classes so I don't fail my exams but not b/c I care about the stuff I'm learning or am trying to get a high Step 1 score cus i honestly don't give a sh** about any of that. I'm just looking forward to getting out of here ASAP b/c I don't really like it.

I also know there's no way in hell I'm doing a rigorous, demanding specialty like IM, Anesthesiology, Surgery, OB/Gyn etc with crazy work hours and being on call all the time, getting up at 3 am, etc and all that. Specialties like Derm, Plastic, Ortho etc have easy hours and are not that demanding at all but I don't care for them really.

So basically all of that is to say, if I just half-ass Step 1 and get like a 195 or even fail it the first time and get a 195-200 the second time around and my ONLY goal is to land a residency even if I don't care how undesirable/uncompetitive it is..... will i have trouble finding an FM spot? Basically just looking to land a job, don't care if i make like 140K/year or whatever.

appreciate the advice
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grindtime1 said:
Long story short, I went into med school for no real reason other than to make a living basically. Never really liked it or cared about helping anyone and I honestly don't really care about anything I'm learning. During anatomy lab I would skip half the labs and make my classmates do most of the dissecting since it was simply a waste of time and all of the learning (vasculature, muscles, etc) came outside of lab time at my own home watching Acland's vids or using Netter's atlas, etc.

I also study for classes so I don't fail my exams but not b/c I care about the stuff I'm learning or am trying to get a high Step 1 score cus i honestly don't give a sh** about any of that. I'm just looking forward to getting out of here ASAP b/c I don't really like it.

I also know there's no way in hell I'm doing a rigorous, demanding specialty like IM, Anesthesiology, Surgery, OB/Gyn etc with crazy work hours and being on call all the time, getting up at 3 am, etc and all that. Specialties like Derm, Plastic, Ortho etc have easy hours and are not that demanding at all but I don't care for them really.

So basically all of that is to say, if I just half-ass Step 1 and get like a 195 or even fail it the first time and get a 195-200 the second time around and my ONLY goal is to land a residency even if I don't care how undesirable/uncompetitive it is..... will i have trouble finding an FM spot? Basically just looking to land a job, don't care if i make like 140K/year or whatever.

appreciate the advice
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Not going to gross ain't a sign of being a sh*tty medical student.Perhaps you're a bad labmate but that is not the point.

No, anything in primary has a big demand, because Uncle Sam and the higher echelon folks really want people to be in primary care, which includes FM. Your chances of going to a top notch residency are indeed shot though... assuming that your step scores are in the low 200s to high 190s, I would place your most likely prospect at a residency in either the inner cities (ST. Louis/Baltimore/Birmingham/Buffalo/Newark), with luck, a mid-sized city in the Rust Belt (Cheyenne, Des Moine, Lincoln, Augusta); or the middle of Nowhere (essentially redneck county, NorCal - excluding SF; and Upstate NY, and the small towns of the rust belt) . I can guarantee that there is little hope for you to match in LA, NYC, Miami, Chicago, Houston, or any big-name metropolis.

At this point, just ace third year in order to open new doors/cover losses.

TL;DR: You'll be fine, but your career may be confined to a location where you may deem undesirable... worst case scenario, you'll end up in redneck country or "da hoodz" given that you can come to terms with that.
 
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I would think the month worth of effort to make a 220 or something would be worth it just so you decide what location to do residency in. If you half ass it then you'll likely be stuck in some crappy area for 4 years
 
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sliceofbread136 said:
I would think the month worth of effort to make a 220 or something would be worth it just so you decide what location to do residency in. If you half ass it then you'll likely be stuck in some crappy area for 4 years
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I would argue he may be stuck there for a career. From where I am, most physicians tend to stay local in respect to their where they did residency.
 
elgauchotejano said:
I would argue he may be stuck there for a career. From where I am, most physicians tend to stay local in respect to their where they did residency.
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Yes but I am going to just go ahead and guess that the chances of that are much lower if you do a terrible fm residency in some terrible location
 
elgauchotejano said:
He does have a point for Derm though....
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That's why I removed it from the quote. In terms of hours at least. All of the dermatologists I know are CRAZY smart. Listening to their conferences/case presentations is like listening to a different language with all the terminology they have.
 
Why don't you just use your degree to get a job in business or consulting? You will not have to suffer through residency, and you patients won't have to suffer your indifference. Honestly, there are no easy residencies, and you shouldn't pursue medicine if you don't care about your patients. That being said, you might enjoy clinical years more than the pre-clinical years.
 
Family medicine often has a different dynamic from other specialties. Many people going into family often want to go to unopposed programs that are in smaller areas. Some programs you would think are completely worthless might actually have some screening tools, especially because many of them get 2000+ applications since they get the flood of people either IMG or who have some severely negative aspects of their application (such as step failures) that make many of those applicants apply to hundreds of programs.

With that being said: you should really try and pass step the first time. If you can pass step first time and are a USMD and can avoid crapping your pants during your interview (or ranting about how much you hate being a doctor...) you will be highly desired at 85% of FM programs. Don't let SDN step score averages fool you. Here, most people start their dedicated making a 230 and eventually make a 270. The reality is most students wouldn't pass step without any dedicated studying. So, do yourself a favor, don't shoot for a 195, shoot for a 220 to ensure you pass. That way, you don't have to go through all this stuff where you have to talk to your administrators about why you failed step, delay third year (and ultimately cut into your vacation months for 4th year), and you can apply to much fewer programs when fourth year comes, and have less worry about where you end up.

I'm not telling you not to slack off, but if you take a practice test and make a 195, you are in too high a risk of failing step 1, and that failure isn't just "oh go retake it." That failure will cause you so much more work, money, and time than is worth it.
 
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grindtime1 said:
Long story short, I went into med school for no real reason other than to make a living basically. Never really liked it or cared about helping anyone and I honestly don't really care about anything I'm learning. During anatomy lab I would skip half the labs and make my classmates do most of the dissecting since it was simply a waste of time and all of the learning (vasculature, muscles, etc) came outside of lab time at my own home watching Acland's vids or using Netter's atlas, etc.

I also study for classes so I don't fail my exams but not b/c I care about the stuff I'm learning or am trying to get a high Step 1 score cus i honestly don't give a sh** about any of that. I'm just looking forward to getting out of here ASAP b/c I don't really like it.

I also know there's no way in hell I'm doing a rigorous, demanding specialty like IM, Anesthesiology, Surgery, OB/Gyn etc with crazy work hours and being on call all the time, getting up at 3 am, etc and all that. Specialties like Derm, Plastic, Ortho etc have easy hours and are not that demanding at all but I don't care for them really.

So basically all of that is to say, if I just half-ass Step 1 and get like a 195 or even fail it the first time and get a 195-200 the second time around and my ONLY goal is to land a residency even if I don't care how undesirable/uncompetitive it is..... will i have trouble finding an FM spot? Basically just looking to land a job, don't care if i make like 140K/year or whatever.

appreciate the advice
Click to expand...

Why would you plan on failing step 1 the first time? You do realize that it's not the only board exam you will be taking in your future, just the first of many? Apply the same motivation you have for classes to Step 1. You don't want to fail. It's a pain in the @ss as described above and it's going to probably cause you to have to do more work in the future to apply to more programs and do more interviews because you have to cast a wider net. Plus you have no leeway for other standardized exams you have in medical school (step 2 ck and cs).

You think any of us really love the Step 1 material? We don't. It's the most esoteric, boring crap in medicine that has little actual clinical relevance, but we learn it because it's part of having a career in medicine and meeting the requirements of a program if you actually want to do that. It's part of being an adult. Doing sh1t you don't want to do. Either study or really decide if you actually want to do medicine. This is the stuff you have to go through to get that paycheck and even at the end of it, if you don't enjoy it, then all the money in the world is worth jacksh1t.
 
elgauchotejano said:
Not going to gross ain't a sign of being a sh*tty medical student.Perhaps you're a bad labmate but that is not the point.

No, anything in primary has a big demand, because Uncle Sam and the higher echelon folks really want people to be in primary care, which includes FM. Your chances of going to a top notch residency are indeed shot though... assuming that your step scores are in the low 200s to high 190s, I would place your most likely prospect at a residency in either the inner cities (ST. Louis/Baltimore/Birmingham/Buffalo/Newark), with luck, a mid-sized city in the Rust Belt (Cheyenne, Des Moine, Lincoln, Augusta); or the middle of Nowhere (essentially redneck county, NorCal - excluding SF; and Upstate NY, and the small towns of the rust belt) . I can guarantee that there is little hope for you to match in LA, NYC, Miami, Chicago, Houston, or any big-name metropolis.

At this point, just ace third year in order to open new doors/cover losses.

TL;DR: You'll be fine, but your career may be confined to a location where you may deem undesirable... worst case scenario, you'll end up in redneck country or "da hoodz" given that you can come to terms with that.
Click to expand...
Looked it up and doesn't seem accurate at all. Just found many of the smaller, not competitive "community" type places whose requirements are 198-205 on the second try (not even on first attempt) in all of the cities you just mentioned.

Or did you mean chances of landing a spot at a major academic center at one of these big cities? Because then of course I'd agree, but I never cared about that to begin with.
 
StupidRoo said:
Why don't you just use your degree to get a job in business or consulting? You will not have to suffer through residency, and you patients won't have to suffer your indifference. Honestly, there are no easy residencies, and you shouldn't pursue medicine if you don't care about your patients. That being said, you might enjoy clinical years more than the pre-clinical years.
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Cus I'm already paying 250K for it. 😉

Too late to back out now.
 
Do your best to pass step 1 on first attempt; the match is getting scarier by the year even for the less(er) competitive specialties... You should aim for 210+, and anything lower than that might put you in a difficult spot where you might need to apply to 100+ FM programs in order to land a spot somewhere... GL!
 
grindtime1 said:
Long story short, I went into med school for no real reason other than to make a living basically. Never really liked it or cared about helping anyone and I honestly don't really care about anything I'm learning. During anatomy lab I would skip half the labs and make my classmates do most of the dissecting since it was simply a waste of time and all of the learning (vasculature, muscles, etc) came outside of lab time at my own home watching Acland's vids or using Netter's atlas, etc.

I also study for classes so I don't fail my exams but not b/c I care about the stuff I'm learning or am trying to get a high Step 1 score cus i honestly don't give a sh** about any of that. I'm just looking forward to getting out of here ASAP b/c I don't really like it.

I also know there's no way in hell I'm doing a rigorous, demanding specialty like IM, Anesthesiology, Surgery, OB/Gyn etc with crazy work hours and being on call all the time, getting up at 3 am, etc and all that. Specialties like Derm, Plastic, Ortho etc have easy hours and are not that demanding at all but I don't care for them really.

So basically all of that is to say, if I just half-ass Step 1 and get like a 195 or even fail it the first time and get a 195-200 the second time around and my ONLY goal is to land a residency even if I don't care how undesirable/uncompetitive it is..... will i have trouble finding an FM spot? Basically just looking to land a job, don't care if i make like 140K/year or whatever.

appreciate the advice
Click to expand...

This has got to be the funniest post I have ever seen on SDN. It's also quite sad. I can't imagine how the OP ever got into medical school. The BS must have really been flying at his interviews. I wonder how many clinics he promised to open in Appalachia.

grindtime1, I bet you get about a 215 on Step 1 because you won't be under the same pressure that most people are. Furthermore you must be a bright guy because pre-med must have come easy to you. On the other hand you really need to think about your life choices. If you're hell bent on practicing medicine to pay off your loans, at least avoid taking care of children. Furthermore, don't go to a Family Medicine program that is heavy on obstetrics. I couldn't bear the guilt of hurting a child. Even if your interviews were utterly fraudulent, you must have some kind of conscience.

You might think about Physical Medicine as a specialty. It's not that competitive. Once you get past the internship I should think you wouldn't kill anyone and the hours are fairly humane. Who knows? You might even like it. God help us and you.
 
68PGunner said:
lol at all the people here taking this dude seriously.
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If you look at grindtime1's prior posts, you will see that he is a complete slacker. He repeatedly asked how little he could do and still get into medical school. He's not trolling. I can imagine Owen Wilson, as a younger man, acting out this dude's life in a movie.
 
grindtime1 said:
Looked it up and doesn't seem accurate at all. Just found many of the smaller, not competitive "community" type places whose requirements are 198-205 on the second try (not even on first attempt) in all of the cities you just mentioned.

Or did you mean chances of landing a spot at a major academic center at one of these big cities? Because then of course I'd agree, but I never cared about that to begin with.
Click to expand...
The latter
 
I've had students who fail COMLEX I, then retook and passed it, and who did NOT take USMLE I, and were still able get into ACGME FM programs (and a few others, like Psych, IM, or EM....yes, EM). So, failing Step I is not the end of your medical career.

But on the whole, I'm getting a strong whiff of one of these:

18485898.jpg




grindtime1 said:
Long story short, I went into med school for no real reason other than to make a living basically. Never really liked it or cared about helping anyone and I honestly don't really care about anything I'm learning. During anatomy lab I would skip half the labs and make my classmates do most of the dissecting since it was simply a waste of time and all of the learning (vasculature, muscles, etc) came outside of lab time at my own home watching Acland's vids or using Netter's atlas, etc.

I also study for classes so I don't fail my exams but not b/c I care about the stuff I'm learning or am trying to get a high Step 1 score cus i honestly don't give a sh** about any of that. I'm just looking forward to getting out of here ASAP b/c I don't really like it.

I also know there's no way in hell I'm doing a rigorous, demanding specialty like IM, Anesthesiology, Surgery, OB/Gyn etc with crazy work hours and being on call all the time, getting up at 3 am, etc and all that. Specialties like Derm, Plastic, Ortho etc have easy hours and are not that demanding at all but I don't care for them really.

So basically all of that is to say, if I just half-ass Step 1 and get like a 195 or even fail it the first time and get a 195-200 the second time around and my ONLY goal is to land a residency even if I don't care how undesirable/uncompetitive it is..... will i have trouble finding an FM spot? Basically just looking to land a job, don't care if i make like 140K/year or whatever.

appreciate the advice
Click to expand...
 
grindtime1 said:
Cus I'm already paying 250K for it. 😉

Too late to back out now.
Click to expand...
Yeah, but the degree is more versatile than people make it out to be. Companies look for individuals with medical credentials to act as consultants. You will make more than a resident. You may eventually reach a somewhat similar pay grade as a practicing physician. Honestly, you probably have a higher pay potential on the business side of medicine, and you would be far less stressed. It would be worth at least completing an intern year and getting a license, but it would be silly to go into a challenging, stressful field like family medicine if you don't enjoy it....I second the PMR statement. It's an awesome field and a well hidden gem: decent pay, great hours, and low stress.
 
grindtime1 said:
Long story short, I went into med school for no real reason other than to make a living basically. Never really liked it or cared about helping anyone and I honestly don't really care about anything I'm learning. During anatomy lab I would skip half the labs and make my classmates do most of the dissecting since it was simply a waste of time and all of the learning (vasculature, muscles, etc) came outside of lab time at my own home watching Acland's vids or using Netter's atlas, etc.

I also study for classes so I don't fail my exams but not b/c I care about the stuff I'm learning or am trying to get a high Step 1 score cus i honestly don't give a sh** about any of that. I'm just looking forward to getting out of here ASAP b/c I don't really like it.

I also know there's no way in hell I'm doing a rigorous, demanding specialty like IM, Anesthesiology, Surgery, OB/Gyn etc with crazy work hours and being on call all the time, getting up at 3 am, etc and all that. Specialties like Derm, Plastic, Ortho etc have easy hours and are not that demanding at all but I don't care for them really.

So basically all of that is to say, if I just half-ass Step 1 and get like a 195 or even fail it the first time and get a 195-200 the second time around and my ONLY goal is to land a residency even if I don't care how undesirable/uncompetitive it is..... will i have trouble finding an FM spot? Basically just looking to land a job, don't care if i make like 140K/year or whatever.

appreciate the advice
Click to expand...

There are some really bad residencies out there from what I've seen. Having a minimum score to do a specialty will cause some problems even if you match. Just try and do well. It will make 3 years of your life much better do you aren't in a sweatshop residency and can learn and come out as a good doctor.
 
MrChance2 said:
There are some really bad residencies out there from what I've seen. Having a minimum score to do a specialty will cause some problems even if you match. Just try and do well. It will make 3 years of your life much better do you aren't in a sweatshop residency and can learn and come out as a good doctor.
Click to expand...
It's better to match into a bad program than not matching at all....
 
MrChance2 said:
There are some really bad residencies out there from what I've seen. Having a minimum score to do a specialty will cause some problems even if you match. Just try and do well. It will make 3 years of your life much better do you aren't in a sweatshop residency and can learn and come out as a good doctor.
Click to expand...
Honestly though I don't really care about becoming a good doctor or anything like that. I pretty much just made up some BS in my personal statement and lied about caring about helping people and stuff during my interviews so I could get into medical school but the reality is I'm basically just here for a good salary and recession-proof job.

So from that standpoint I was thinking it wouldn't be so bad if I flunked Step 1 or even got a sh*tty score as long as it gets me somewhere, cus I can at least make 150-180K/year doing FM which is way, way better than what most people could dream of. And from what that Goro guy said and from my own research, there are definitely a lot of places (although admittedly likely at undesirable locations) that accept ppl after a flunked Step 1 as long as they pass on the 2nd or 3rd try.

Also from my understanding the places that accept the higher Step 1 scores at like large academic hospitals etc have super rigorous and demanding work hours for rotations and residency, whereas the bad places might have easier laid back hours even if you don't learn anything as a 3rd year and have limited patient experience.

I'm currently an M2 btw gearing up for the USMLE Steps.
 
grindtime1 said:
Honestly though I don't really care about becoming a good doctor or anything like that. I pretty much just made up some BS in my personal statement and lied about caring about helping people and stuff during my interviews so I could get into medical school but the reality is I'm basically just here for a good salary and recession-proof job.

So from that standpoint I was thinking it wouldn't be so bad if I flunked Step 1 or even got a sh*tty score as long as it gets me somewhere, cus I can at least make 150-180K/year doing FM which is way, way better than what most people could dream of. And from what that Goro guy said and from my own research, there are definitely a lot of places (although admittedly likely at undesirable locations) that accept ppl after a flunked Step 1 as long as they pass on the 2nd or 3rd try.

Also from my understanding the places that accept the higher Step 1 scores at like large academic hospitals etc have super rigorous and demanding work hours for rotations and residency, whereas the bad places might have easier laid back hours even if you don't learn anything as a 3rd year and have limited patient experience.

I'm currently an M2 btw gearing up for the USMLE Steps.
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Try to be less apathetic and do well on step. It's good advice. 100% guaranteed. If you end up doing poorly your world isint over but change your mindset, you will regret it if you don't.
 
I would not go into family with that attitude, the breadth of knowledge required is huge and to be a good doctor you have to put forth more than the minimum. Family does everything, internal medicine is the adult side of things and plenty of people do general primary care from the internal medicine route. For family you have to do peds, obgyn, and adult medicine during residency both inpatient and outpatient, it's different than what most people think. However, if you are this apathetic now, studying for exams will often bring that out even more. Depends on the location you would want for residency but I would say failing without a reason other than I didn't care very much would make it very difficult to match.
 
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