Looking for advice - Crossroads after medical school dismissal

Jun 22, 2013
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Hello my fellow SDNers!

This is probably one of the most challenging things I have ever had to write, but here it goes....

Summary: I entered a U.S. medical school years ago only to be academically dismissed in my 4th year. I admit that I was not the strongest med student, but the main issue centered around some shelf examinations during my 3rd year. I was always able to clear these specific exams when I was allowed to take them again. I even passed Step 1 on the 1st attempt. I tried everything I could to get help while pressing forward, but I did not realize a LOA might have been the best move until too late and more damage was done to my grades. I was denied an appeal to my dismissal and am now at a crossroads with regards to where I go next.

My conflict: I have worked so hard for this and still feel drawn to medicine despite this experience. Although I have had academic difficulty, my clinical feedback was always positive and highlighted my professionalism. Therefore, I feel it would be a waste for me not to pursue a career in medicine (my interest was always in primary care). However, I am realistic and recognize this situation has made things complicated. I am between going into another part of healthcare as a mid-level provider or chasing after my degree at a Caribbean medical school. I am concerned about not being able to procure a residency position (assuming I get in and am successful in the Caribbean) given my story, especially considering the shortage of U.S. residency positions predicted in the years to come. Of course, I have a significant loan burden from all of this and must be careful about my next moves as I also am a non-traditional student who has yet to make certain life decisions (ie having a family, buying a home, etc).

I would love to hear from people who either have gone through this personally or know someone who has to find out how they handled their situation - either via PM or a reply to this post. For anyone who can not relate to my story, I would greatly appreciate your discretion regarding your feedback as anything other than constructive criticism is not only hurtful but also unhelpful. Thanks!
 

Chir0nex

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I'm so sorry for situation, I can't imagine how difficult it must be to deal with all of this. While I don't have a similar story to share, there are a couple things that came to mind.
First of all, are you sure your dismissal was handled properly? It seems weird that you would be allowed to retake the shelf exams, and be allowed to continue into 4th year before being dismissed, or that there was no way for you to repeat third year. If you haven't already, it may be worth meeting with a lawyer to review the school policies and be sure that there was not something missing there that could allow you to return and finish.
Secondly, I feel that carribean school is simply not a realistic option. You would be entering with a history that would complicate an already difficult application process for residency, and, as you have said, you are not the most competitive student as is which lowers your chances even more. If you are serious about completing your degree, then I would consult with your old UG premed advisor and see if there are any lower-tier DO or MD programs that may be interested in taking you in.
In the end though, if you cannot reverse the dismissal I would lean towards shifting into a PA or NP program. The debt load from starting med school all over again, with your old loans accruing interest would likely be enormous, not to mention, that it will mean another 4 years of missed attending salary.
 
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ruralsurg4now

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My conflict: I have worked so hard for this and still feel drawn to medicine despite this experience. Although I have had academic difficulty, my clinical feedback was always positive and highlighted my professionalism. Therefore, I feel it would be a waste for me not to pursue a career in medicine (my interest was always in primary care).
The thing is, when you say your clinical feedback was positive, that really means that you interacted well with patients, right? Because I think the issue -- and I'm not trying to be mean here, but it's tough to say this any other way -- is that you really have what sounds like a low "fund of knowledge" (based on your poor testing). And while you may enjoy interacting with patients, the reality is that it's different doing it as a medical student, where you really have no responsibility to them, versus a resident or an attending. You know, I knew students who really got to know their one patient and they had long conversations with them about their personal lives and stuff, but that's not how things are in the medical field, honestly, unless you're maybe in some town of fifty people like Mayberry.

My point is that it may not be your "destiny," so to speak, to be a physician or even a PA or NP. You know, being a physician extender does mean less responsibility and less call for knowledge, but do you see yourself basically being a life-long intern or "gofer"? I don't know the answer to that and I'd never tell someone to give up on their dream of medicine if that's what they really wanted, but you really should give it some thought.
 

Anastomoses

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Isn't this a repeat of another thread from a year ago?
 

ruralsurg4now

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Isn't this a repeat of another thread from a year ago?
If it is, then this guy is a sh*thead. Why do people feel the need to play games like that?
 
OP
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Jun 22, 2013
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Isn't this a repeat of another thread from a year ago?
No, this is not a repeat posting and happened less than a year ago.

I know there are other people who posted their stories before that are similar to mine, but I wanted to start my own thread to make sure that I was able to accurately explain my situation and be 100% real. In my experience, there are many people who either leave out vital details or blatantly lie when asking for advice which makes no sense to me.
 
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OP
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The thing is, when you say your clinical feedback was positive, that really means that you interacted well with patients, right? Because I think the issue -- and I'm not trying to be mean here, but it's tough to say this any other way -- is that you really have what sounds like a low "fund of knowledge" (based on your poor testing).
Ruralsurg4now, I definitely understand your point as I have heard this idea come up before from admins and will take this into consideration along with the other pieces of feedback that have been offered thus far. I know that I am a "work in progress", but I also believe there were other factors that were contributing to my poor performance that would not be an issue moving forward. By the way, I forgot to mention that I am also considering using a BSN as a stepping stone into something like informatics or administration since I'm not sure I can see myself being a "life long intern" as you stated.
 

ruralsurg4now

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Ruralsurg4now, I definitely understand your point as I have heard this idea come up before from admins and will take this into consideration along with the other pieces of feedback that have been offered thus far. I know that I am a "work in progress", but I also believe there were other factors that were contributing to my poor performance that would not be an issue moving forward. By the way, I forgot to mention that I am also considering using a BSN as a stepping stone into something like informatics or administration since I'm not sure I can see myself being a "life long intern" as you stated.
Yeah, but now you're talking about a goal that has nothing to do with patient interaction. You really sound, again, no offense, all over the place. Honestly, it seems like you just want to stay in the medical field to be in the medical field (i.e., to be able to say that you deal with medicine). The reason I say that is because you initially justified continuing a pursuit of medicine by saying that you got good clinical feedback. But then you say that your ultimate aim is to go into administration. See how that has nothing to do with one another? You really need to be honest about your motivation and goals. And, look, if you're just wanting to go into medical administration for the money, no harm in that because that's probably what most of the administrators are in it for. But you do need to be honest with yourself about it.
 
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I see how my last statement about the BSN as a stepping stone seems opposed to what I initially stated, but that was simply me "thinking out loud". My ultimate goal at this point is to put myself in a place where I can balance being content in my career while being able to pay my bills. On one hand, I naturally want to finish what I started or find another way to work directly with patients, but there are lingering questions: Will I be able to get into residency if I take the leap to attend a Caribbean school? Will I ever feel fulfilled as a mid-level provider given my past? On the other hand, perhaps there is something else that combines what I have learned as a medical student with my strengths and other interests allowing me to achieve the balance I desire even though it might require sacrificing direct patient care. This is why I brought up other things like informatics or administration. Regardless of which direction I go, I know I have to accept that this is not what I had planned, but it could turn out to be even better if I open myself up to all my options to remain in healthcare.
 

ruralsurg4now

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I see how my last statement about the BSN as a stepping stone seems opposed to what I initially stated, but that was simply me "thinking out loud". My ultimate goal at this point is to put myself in a place where I can balance being content in my career while being able to pay my bills. On one hand, I naturally want to finish what I started or find another way to work directly with patients, but there are lingering questions: Will I be able to get into residency if I take the leap to attend a Caribbean school? Will I ever feel fulfilled as a mid-level provider given my past? On the other hand, perhaps there is something else that combines what I have learned as a medical student with my strengths and other interests allowing me to achieve the balance I desire even though it might require sacrificing direct patient care. This is why I brought up other things like informatics or administration. Regardless of which direction I go, I know I have to accept that this is not what I had planned, but it could turn out to be even better if I open myself up to all my options to remain in healthcare.
The reality is that, in general (there are always exceptions), with you being a non-traditional person who tests poorly and has already been dismissed very late in school (which is a red flag because, frankly, I think most places would try hard to get you graduated if you were a month away versus if you were a first year), you'd have a very difficult time getting a residency spot for anything. It's not to discourage you from trying, since the only way you're guaranteed to fail is if you don't even try, as they say. But it is just presenting you with a realistic picture of what lies ahead. In general, people who have done medical school are pretty averse to "going down" and being nurses or PAs, both because those are honestly just labor positions with relatively little thinking involved and because the prestige level is markedly lower. People love to introduce "my son, the doctor," but they're very lukewarm about introducing "my son, the nurse," even if people dislike that. I personally would find that intolerable and, frankly, I'd just get a job completely out of the medical field rather than try to stay in it and be a nurse, if that was my options. But that's just me. One of the issues is you're older, so it's not like you have the luxury to sit around collecting diplomas. Perhaps something like being a vet or dentist might suit you? Although I don't know how difficult it is to get into those fields with your background, I know that de novo it's easier than getting into med school.
 

michaelrack

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Perhaps something like being a vet or dentist might suit you? Although I don't know how difficult it is to get into those fields with your background, I know that de novo it's easier than getting into med school.
:corny:Waits for the dentists and vets to jump into this thread and state how difficult their fields are.
 

ruralsurg4now

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:corny:Waits for the dentists and vets to jump into this thread and state how difficult their fields are.
You should re-read what I wrote. Remember, reading is fundamental!
 

michaelrack

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You should re-read what I wrote. Remember, reading is fundamental!
I'm just joking around, I know how much you love the generic google images I post:).

You did hedge some about not knowing how difficult it would be to get into these professional schools. I think what will really get the vets and dentists upset is the idea that their field is a suitable option for someone who couldn't academically handle allopathic medicine.
 

ruralsurg4now

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I'm just joking around, I know how much you love the generic google images I post:).

You did hedge some about not knowing how difficult it would be to get into these professional schools. I think what will really get the vets and dentists upset is the idea that their field is a suitable option for someone who couldn't academically handle allopathic medicine.
You still didn't read what I wrote. Try again.
 

michaelrack

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You still didn't read what I wrote. Try again.
I think I get what you are saying- something like don't go down in status/prestige/professional autonomy by becoming a nurse or PA, instead shoot for a field equivalent to being a physician such as vet or dentist (though that may be difficult with your background).

Please correct me if I am misunderstanding you. And if I were a vet or dentist, I would still find the above offensive (the idea that my field would be suitable for someone who flunked out of medical school). Of course, I am not a vet or dentist so maybe I am wrong.


Regarding your statement "I know that de novo it's easier than getting into med school," I don't think that is true for vet school.
 

sidefx

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The reality is that, in general (there are always exceptions), with you being a non-traditional person who tests poorly and has already been dismissed very late in school (which is a red flag because, frankly, I think most places would try hard to get you graduated if you were a month away versus if you were a first year), you'd have a very difficult time getting a residency spot for anything. It's not to discourage you from trying, since the only way you're guaranteed to fail is if you don't even try, as they say. But it is just presenting you with a realistic picture of what lies ahead. In general, people who have done medical school are pretty averse to "going down" and being nurses or PAs, both because those are honestly just labor positions with relatively little thinking involved and because the prestige level is markedly lower. People love to introduce "my son, the doctor," but they're very lukewarm about introducing "my son, the nurse," even if people dislike that. I personally would find that intolerable and, frankly, I'd just get a job completely out of the medical field rather than try to stay in it and be a nurse, if that was my options. But that's just me. One of the issues is you're older, so it's not like you have the luxury to sit around collecting diplomas. Perhaps something like being a vet or dentist might suit you? Although I don't know how difficult it is to get into those fields with your background, I know that de novo it's easier than getting into med school.
Sorry, but I whole-heartedly disagree that nursing is "just a labor position with relatively little thinking". You honestly make it sound like being an RN might as well be equivalent to scrubbing the toilets at the hospital. Quality nurses have pretty solid knowledge bases about a wide range of medical things and in many practice settings have a lot of responsibility in clinical decision making and patient care. I don't know why you and so many other physicians seem to find it necessary to mock and belittle other medical professionals as being inferior. Get over yourself.
 
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ruralsurg4now

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I think I get what you are saying- something like don't go down in status/prestige/professional autonomy by becoming a nurse or PA, instead shoot for a field equivalent to being a physician such as vet or dentist (though that may be difficult with your background).

Please correct me if I am misunderstanding you. And if I were a vet or dentist, I would still find the above offensive (the idea that my field would be suitable for someone who flunked out of medical school). Of course, I am not a vet or dentist so maybe I am wrong.


Regarding your statement "I know that de novo it's easier than getting into med school," I don't think that is true for vet school.
I made a very simple statement. Without his current baggage -- which I listed -- as a "fresh" student, I believe that it is more difficult to get into medical school than vet or dental school. With his problems, I have no idea how possible getting into those schools, either, would be.
 

ruralsurg4now

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Sorry, but I whole-heartedly disagree that nursing is "just a labor position with relatively little thinking". You honestly make it sound like being an RN might as well be equivalent to scrubbing the toilets at the hospital. Quality nurses have pretty solid knowledge bases about a wide range of medical things and in many practice settings have a lot of responsibility in clinical decision making and patient care. I don't know why you and so many other physicians seem to find it necessary to mock and belittle other medical professionals as being inferior. Get over yourself.
I'm not mocking anyone. I'm merely stating what is. The only person who said that being a nurse is like scrubbing toilets was you. I'm not interested in getting into a "doctors versus nurse" debate, since it doesn't have anything to do with his question or problem. If he disagrees with me and feels that he would want to pursue nursing, why would I care? He can be a nurse if he wants and it wouldn't affect me in the least. I only told him my position.
 

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If you don't mind moving to Madison, WI you could apply to work at Epic, I'm sure your med school experience would be very valuable there. It's a pretty sweet gig, the pay is nice, plus you would work with healthcare people all the time. Even if you're not sure you want to make it your career, you could work there for a while to pay off loans and save some $$$ while you reassess.
 
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Suomi

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Okay, I'll bite and jump in here. Chances to get into vet school, after getting that far through med school and being dismissed, are slim to none. Vet school curriculum is just as rigorous as med school curriculum and the admission panel would see that as a huge red flag and likely not even grant an interview. I don't know about dentistry, but I would assume the same would apply there as well. Vet schools also place a huge emphasis on why you're choosing vet school. After initially choosing med school, I think they would view this just as a fall back option, but not a true passion, which comes across negatively. And, to be honest, vet salaries absolutely suck and he would seriously struggle paying off vet school and med school loans on a vet salary.
 

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Vet salaries suck? Then why does anyone become a vet?
 

Brain Bucket

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Vet school curriculum is just as rigorous as med school curriculum
no.

and the admission panel would see that as a huge red flag
yes.

and likely not even grant an interview.
no.

I don't know about dentistry, but I would assume the same would apply there as well.
see above

Vet schools also place a huge emphasis on why you're choosing vet school.
everybody wants to feel special.

After initially choosing med school, I think they would view this just as a fall back option, but not a true passion, which comes across negatively.
yes, but, see above.

And, to be honest, vet salaries absolutely suck and he would seriously struggle paying off vet school and med school loans on a vet salary.
yes.
 

Law2Doc

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OP, the short answer is that going to Caribbean at this juncture will not be fruitful. Offshore grads are already disadvantaged in the residency match/soap process, and that's grads who haven't already been kicked out of a US med school. So that's a nonstarter. If you want to be a doctor, your only realistic path is to beg your way back into the school that dismissed you.
 

Anastomoses

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I'm going to venture into stating a novel idea....because they might actually like it? I hope there are many doctors that go into medicine for reasons other than$
That's right. I like medicine so much that the pay would have to drop significantly for me to even consider something else. I guess I just can't imagine being paid enough to be a vet - let alone being paid badly to be one. I rarely want to see children patients, let alone animal ones.
 

ruralsurg4now

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That's right. I like medicine so much that the pay would have to drop significantly for me to even consider something else. I guess I just can't imagine being paid enough to be a vet - let alone being paid badly to be one. I rarely want to see children patients, let alone animal ones.
No way, animals seem like they'd be awesome. If you've ever seen "Animal Cops" on Animal Planet, it's hilarious (not the animal mistreatment, lol). Once in a while they'll find some puppies and have to vaccinate them and the puppy will just be sitting on the table with his mouth open and looking around. Then they'll just give him the shot and he just keeps sitting around with his mouth open without a care in the world. It's hysterical. The only problem is I'd never get any work done, I'd just be playing with the kittens for several hours.
 

punkedoutriffs

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That's right. I like medicine so much that the pay would have to drop significantly for me to even consider something else. I guess I just can't imagine being paid enough to be a vet - let alone being paid badly to be one. I rarely want to see children patients, let alone animal ones.
Have you never had a dog? They are the greatest things in the world.
 

ruralsurg4now

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Have you never had a dog? They are the greatest things in the world.
Boobs >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> dogs.
 

sobored

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That's right. I like medicine so much that the pay would have to drop significantly for me to even consider something else. I guess I just can't imagine being paid enough to be a vet - let alone being paid badly to be one. I rarely want to see children patients, let alone animal ones.
Children patients are so sweet and innocent. It's their parents that hellish to deal with.
 

ruralsurg4now

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ruralsurg4now

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Unconditional love is worth a little diarrhea. Also, aren't you a general surgeon? Shouldn't you be used to poop by now? :naughty:
I like my poop in my hands, not on my floor.
 

ruralsurg4now

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Lol, just pick up the poop from the floor then. Done. Easy.
The floor is still dirty then. I hate cleaning floors. Also, you can't pick up diarrhea. I've tried.
 

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My my, I wasn't expecting this thread to give so much.

Children patients are so sweet and innocent. It's their parents that hellish to deal with.
Children are the devil - many do awful things; and even when they aren't, they're just relatively dumb. I have difficulty talking down to anyone, let alone pretend cutesy faces to go with.
 

ruralsurg4now

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Children are the devil - many do awful things; and even when they aren't, they're just relatively dumb. I have difficulty talking down to anyone, let alone pretend cutesy faces to go with.
I was going to replace "children" with "women," but I figured that wouldn't sit well with you, huh? :)
 

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I was going to replace "children" with "women," but I figured that wouldn't sit well with you, huh? :)
Now I see why the ladies are flocking to you.
 

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Meh, debatable. Boobs don't love you back, at least not unconditionally.
As for you...I remember your issues. You're just upset that boobs out of your league don't love you back. Next.
 

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punkedoutriffs

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As for you...you're just upset that boobs out of your league don't love you back. Next.
*Sigh. Same 'ol Anastomoses. Will you ever deign to come down from your majestic, alabaster throne to tread amongst our humble and contemptible hovels?
 

ruralsurg4now

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*Sigh. Same 'ol Anastomoses. Will you ever deign to come down from your majestic, alabaster throne to tread amongst our humble and contemptible hovels?
...with your lice? :D
 
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*Sigh. Same 'ol Anastomoses. Will you ever deign to come down from your majestic, alabaster throne to tread amongst our humble and contemptible hovels?
you can eat cake. hmpf