by posting this, i am completely aware that i will get both good and bad responses. i will respond to all questions and inquiries in kind.
yes, my usmle failures are a red flag. i will explain further. take what you will from it, but they are not excuses. everything falls upon my shoulders, and if anyone is to blame, it is me. i was clearly not ready for step 1, and studied for it in the wrong way. after studying on my own, my score improved by 30 points, and i passed the examination successfully on my second attempt. on the eve before usmle step 2, i could not sleep. i was awake all night, and on the drive to the test center, called my dean, along with school educators, and asked for advice as to whether or not i should take the test or miss it and suffer the ramifications. i was told to do the best i could, and see what happens. after the first failure, i met with many specialists. not to determine if i had a test taking deficiency, but rather, to develop new test taking strategies and skills at the way i answered questions. i also enrolled in two supplemental enrichment programs. the second go around for step 2 was a failure. on the third attempt, i passed, with much help from the second educational program. i passed step 2 cs on my first attempt.
top gun - i graduated from an american medical school. thus, externships would not apply to me. as for family medicine, that career choice does not interest me. concerning test taking skills, that avenue has also been exhausted. after my step 1 failures, i began working with educational specialists at my school. i even met with a psychologist regularly to work on coping with stress, easing state of mind, relaxation exercises, etc. etc. in the end, all of the assistance i received did help in passing the tests.
buckley - i have spoken with my current pd many times. we have looked at all options, and both agreed my current plan (to seek out open pgy-2 positions and send my application materials) was the best. research? that is on the very backburner as something that i would be interested in. as i stated in the original post, i have come to grips with reality, and a subspecialty is not in my future, not right now, at least. concerning step 3, i am aware of all state rules concerning licensure. (
http://www.fsmb.org/usmle_eliinitial.html) if i am not able to secure a pgy-2 spot in the near future, i will be preparing for step 3, with hopes of obtaining state and national licenses (dea) to practice medicine. after all, i do have bills to pay back. as for open spots, i have subscribed to many resources, both free and paid.
darthneurology - i welcome your skepticism and incredulousness, yet, it is disheartening at the same time. yes, my pd and other attendings have hinted that i could stay at my current program. however, i am choosing a change of scenery for a variety of reasons. i am never one to burn bridges, and i may end up staying where i am currently at. this topic was initially a rant. i will not get into an argument concerning AMG vs IMG vs FMG, or MD vs DO for that matter. there are good and bad physicians in each of those categories, and it is what you learn, how motivated you are, how well you relate to patients that determines the type of person and physician you end up becoming. i cannot fault you for judging me based on my usmle step examinations. however, to judge me solely on that in comparison with other medical graduates around the world without other considerations, is, well, extremely short sighted and of narrow view. i hope the rest of your thought processes are not as limited. i doubt that, though, as you assume my credentials are poor based upon just my usmle test scores. i did well in my third and fourth year clerkships, with the majority of them being high satisfactory interspersed with a few superiors. and, i have received many excellent letters of recommendation, from my attendings during my school education to my attendings at my current program. the chairmen of the program, the program director, one cardiologist, and two prominent attendings have written letters on my behalf this year. in the end, i would hope you do not assume that all people with test failures and difficulties are deficient in other aspects of medicine.
rtrain - thank you for the words of encouragement. see above as needed, concerning your post.
darthneurology part 2 - yes, i am aware of "tough love". if i could not take the fire, i would not be in the kitchen. my complete application is strong, with the exception of usmle failures. again, take from that what you will. i understand the problem i will and have faced. i have started at the bottom of the hill, and have constantly been working my way back up. that was the point of my original post. as for subspecializing versus primary care, i do enjoy aspects of primary care. these last few months i have made it a point to remember the good patients and the good people that i have helped, and to dwell less on the rigors of internship. if medicine did not interest me ever slightly, i would not be trying to find a pgy-2 position. as for non-clinical positions, i have already looked into that. however, my first priority is to continue and finish residency. should that not work out is when i will exhaust other possibilities.
efex101- i have contacted many programs throughout the country. i have cast a net far and wide. i mainly focused on larger programs, or smaller programs with an academic affiliation, but have also contacted a few smaller community programs in desirable geographic locales. i have not contacted small programs in undesirable areas (to me, at least). as stated earlier, FM does not interest me. along with all the above thoughts, i am also considering other fields - neurology, pathology, and even possibly surgery. what do i want? i am not completely sure. hence, my dilemma(s).
drdre311 - strangely enough, the lyric below in relation to your handle is quite fitting. it seems you agree with rtrain in your assessment (or so i hope). if so, thanks.
"The last straw can land in your mix
Your best day could be apocalypse
Nobody paid attention to the first straw
It seems the last one is all we ever saw"
feel free to discuss among yourselves....
