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Low Step 1 score vs LOA?

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Domerr

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For anyone that had to take a Leave of Absence during medical school, how badly did the LOA affect your residency application?

I am contemplating delaying entry into third year to give myself more time to study for Step 1 (the delay will be 2 month). However, I'm afraid that the LOA status will ruin my chances at any competitive programs.

My last NBME (taken 2 days ago) was a 219, and the real thing is less than a week away. I messed up my study schedule and didn't even finish my first pass of FA. So what would you guys recommend, stick with the low Step 1 score or take the LOA?
 

Seijitsu

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For anyone that had to take a Leave of Absence during medical school, how badly did the LOA affect your residency application?

I am contemplating delaying entry into third year to give myself more time to study for Step 1 (the delay will be 2 month). However, I'm afraid that the LOA status will ruin my chances at any competitive programs.

My last NBME (taken 2 days ago) was a 219, and the real thing is less than a week away. I messed up my study schedule and didn't even finish my first pass of FA. So what would you guys recommend, stick with the low Step 1 score or take the LOA?


How long are you planning to delay entry into third year?
 

Domerr

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Two month, so I'll still be graduating with the rest of my class. My main problem is having "Administrative LOA" written on my transcript.

My goal is anesthesiology or EM at a higher ranked program.
 

Seijitsu

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Two month, so I'll still be graduating with the rest of my class. My main problem is having "Administrative LOA" written on my transcript.

My goal is anesthesiology or EM at a higher ranked program.


Administrative LOA aside. If you are not ready to take step 1, then do not take it. What is the point of taking a test that you know that you are not prepared for; you are just setting yourself up for possible failure. Students taking additional time into third year is not uncommon. Put yourself in two different situations: 1) No LOA and unfortunately you don't do as well as you want on step 1; 2) Taking a LOA and getting a good/great score. Which one would you like to explain more? Of course you can also do exceptional well on step 2 if you have a low score.

I am not sure how your school works, but please correct me if I am wrong. I assume that the rotations you missed in third year you must make up at the beginning of 4th year. Meaning that if you take two months off, you will be two months into 4th year till you can start doing audition rotations. Therefore, is two months really necessary? What is your studying schedule?
 
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Domerr

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My first rotation will be pushed back to the end of third year. So I get 2 less month of vacation. The biggest down side is that taking Step 2 early becomes impossible.

I'm confident that I can pass Step 1 without taking the LOA, but my score will be on the low side (210-220 range).
 

Law2Doc

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For anyone that had to take a Leave of Absence during medical school, how badly did the LOA affect your residency application?

I am contemplating delaying entry into third year to give myself more time to study for Step 1 (the delay will be 2 month). However, I'm afraid that the LOA status will ruin my chances at any competitive programs.

My last NBME (taken 2 days ago) was a 219, and the real thing is less than a week away. I messed up my study schedule and didn't even finish my first pass of FA. So what would you guys recommend, stick with the low Step 1 score or take the LOA?

A smarter move would be to take a whole year off to do research. Take step 1 at some point during this research year. And do som EM/Anesthesia related study during that year as well. That way you don't have the blemish of two months off that you have to explain. Instead you have actually improved your CV, and won't get any flack about that.
 

Domerr

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A smarter move would be to take a whole year off to do research. Take step 1 at some point during this research year. And do som EM/Anesthesia related study during that year as well. That way you don't have the blemish of two months off that you have to explain. Instead you have actually improved your CV, and won't get any flack about that.

That wont work at my school. Even if a student wants to take time off for research, he/she still has to take Step 1 with the rest of the students. Extension of Step 1 date automatically = administrative LOA at my school unless the student has medical excuse or death in family...

Speaking of research, I do plan to do some research during the 2 months off. My plan to is take Step 1 after the first month, and using the second month to finish an ongoing research project (and hopefully get a publication out).

My main concern is mid-higher tier programs not even giving me a chance due to the administrative LOA. I have heard that anesthesiology is getting more competitive every year and any aberration can kill my chances at the higher ranked programs... Obviously, a low Step 1 is also an automatic rejection for many programs, but I don't know which one's worse; step 1 of 210-220 or 220+ with ALOA.
 
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Law2Doc

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...but I don't know which one's worse; step 1 of 210-220 or 220+ with ALOA.

it would be hard for most of us to answer this. The programs in these fields could be more or less competitive in a couple of years, and only the PDs in these fields really know how they weigh LOAs. But bear in mind that it's entirely conceivable that you could take the two months off and still score 210 -- it happens.
 

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My score went up 30 POINTS between my last practice test and my real Step 1 score, and my practice test was a mere 6 DAYS before I took Step 1. I wasn't able to postpone Step 1, so I took it on my original date despite my low practice score. How did I do it? I studied 16 hours every day and was more focused that I've ever been before. You can do it! I wouldn't recommend postponing by 2 months. You'll get so tired of studying and then your score will start going down. Have confidence in yourself and focus like you've never focused before. I found that the last week of studying really tied things together for me. I hope the same happens for you. Good luck!
 

sunset823

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Hey,
I'm going through a very similar situation. Two things are different: 1) I already have 'blemishes' on my record because I had to retake more than one M2 exam (which I passed with flying colors, but it's still on the transcript) and 2) We do not have anything calling a delay an 'administrative LOA', so technically if we play our cards right the programs don't have to find out about the delay. (and I'm also interested in anesthesia at academic programs, I have tons of research)

I decided to delay, because I needed more time after having to worry about my class subjects for a while, but I've been able to fill in 6 of the 8 weeks I'm missing (for my first core) with 4th year electives. Do you have this option? That way, you only lose 2-4 weeks, though you still have to push off step 2 and any elective rotations in your specialty till later.

Hope that helps!
 

Domerr

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My score went up 30 POINTS between my last practice test and my real Step 1 score, and my practice test was a mere 6 DAYS before I took Step 1. I wasn't able to postpone Step 1, so I took it on my original date despite my low practice score. How did I do it? I studied 16 hours every day and was more focused that I've ever been before. You can do it! I wouldn't recommend postponing by 2 months. You'll get so tired of studying and then your score will start going down. Have confidence in yourself and focus like you've never focused before. I found that the last week of studying really tied things together for me. I hope the same happens for you. Good luck!

+30 points? You are my hero....no, really... Did you go through FA during the last week? Or was it more practice questions?
 

Domerr

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Hey,
I'm going through a very similar situation. Two things are different: 1) I already have 'blemishes' on my record because I had to retake more than one M2 exam (which I passed with flying colors, but it's still on the transcript) and 2) We do not have anything calling a delay an 'administrative LOA', so technically if we play our cards right the programs don't have to find out about the delay. (and I'm also interested in anesthesia at academic programs, I have tons of research)

I decided to delay, because I needed more time after having to worry about my class subjects for a while, but I've been able to fill in 6 of the 8 weeks I'm missing (for my first core) with 4th year electives. Do you have this option? That way, you only lose 2-4 weeks, though you still have to push off step 2 and any elective rotations in your specialty till later.

Hope that helps!

No, I don't have that option... I guess my school is not as flexible as your's...

But at your school, you guys can just delay step 1 without having to get an LOA? That sounds too good to be true...
 

turkeyjerky

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No, I don't have that option... I guess my school is not as flexible as your's...

But at your school, you guys can just delay step 1 without having to get an LOA? That sounds too good to be true...
I'd have to say that's the standard policy at most schools. Sorry dude, you're getting hosed.

I've heard that having a 'gap' in your CV is something you want to avoid, but your situation is different from the standard "voluntary" year away from med school. Seems like yours would be easily explainable ("I needed to delay step 1 for a few weeks b/c a family emergency messed up my study schedule--this had absolutely no effect on my education and didn't delay my graduation one minute"), but I have no idea how PDs would react.
 

Domerr

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I'd have to say that's the standard policy at most schools. Sorry dude, you're getting hosed.

I've heard that having a 'gap' in your CV is something you want to avoid, but your situation is different from the standard "voluntary" year away from med school. Seems like yours would be easily explainable ("I needed to delay step 1 for a few weeks b/c a family emergency messed up my study schedule--this had absolutely no effect on my education and didn't delay my graduation one minute"), but I have no idea how PDs would react.

According to my adviser, the only thing that will be put on my transcript is "Administrative LOA" and the dates I took off. Same for the Dean's letter; it wont even mention the fact that I delayed my Step 1. So technically, I can embellish my "excuse" as much as I want. But a LOA is still a LOA, and to make things worse, it's an "Administrative" LOA.
 

turkeyjerky

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According to my adviser, the only thing that will be put on my transcript is "Administrative LOA" and the dates I took off. Same for the Dean's letter; it wont even mention the fact that I delayed my Step 1. So technically, I can embellish my "excuse" as much as I want. But a LOA is still a LOA, and to make things worse, it's an "Administrative" LOA.
That's exactly the problem--if you could just take the time off, there'd be no problemo (because, keep in mind, this situation happens to a ton of people every year and nobody finds out). But, it'll say LOA, and you'll need to explain it.

I don't know if a PD will think this is significant enough to put you down a few spots on the rank list--I'd say, as a rational person, that it really shouldn't. But people in these positions are, quite frankly, notorious for their irrationality. An "administrative leave of absence" could be be deadly.

You need advice from somebody in the know--try your dean of student affairs, or student wellness or whatever they call it at your school. And do it quick cause the clock is ticking.
 

Domerr

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That's exactly the problem--if you could just take the time off, there'd be no problemo (because, keep in mind, this situation happens to a ton of people every year and nobody finds out). But, it'll say LOA, and you'll need to explain it.

I don't know if a PD will think this is significant enough to put you down a few spots on the rank list--I'd say, as a rational person, that it really shouldn't. But people in these positions are, quite frankly, notorious for their irrationality. An "administrative leave of absence" could be be deadly.

You need advice from somebody in the know--try your dean of student affairs, or student wellness or whatever they call it at your school. And do it quick cause the clock is ticking.

I already talked to my adviser, but I didn't get anything useful from him. Pretty much what he told me was, 1) a LOA will not prevent me from getting residency, 2) competitive residencies can be very picky about LOA.
:sleep:
 

dynx

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I already talked to my adviser, but I didn't get anything useful from him. Pretty much what he told me was, 1) a LOA will not prevent me from getting residency, 2) competitive residencies can be very picky about LOA.
:sleep:

My thoughts:
1. I know programs, mine included, run a filter that eliminates people with low step 1 scores from consideration. Meaning if you get less than 220 on step 1 or so they wont ever even see your application. I've never heard of the same thing happening for a LOA. So at least for my program...you'll never even get to explain your low step 1 score but you might get to explain your LOA.
2. There is no good excuse for a low step 1 score but you can come up with whatever BS story you can put together over the next 2 years for your LOA.
 
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Depakote

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I don't know that it's the best idea.

A number of people in my class delayed Step 1 to study longer because they weren't satisfied with the scores they were getting and their actual results were not significantly better with the extra time. At a point, you hit diminishing returns. Personally, if I was scoring just around 220 (not a low score, dude)... I'd take the test now and get on with 3rd year.
 

Domerr

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I don't know that it's the best idea.

A number of people in my class delayed Step 1 to study longer because they weren't satisfied with the scores they were getting and their actual results were not significantly better with the extra time. At a point, you hit diminishing returns. Personally, if I was scoring just around 220 (not a low score, dude)... I'd take the test now and get on with 3rd year.

The problem in my case is that I don't think I've hit my plateau yet. I have gone through all of UWorld, but I'm still going through FA for the first time. I have not touched any other Qbank or books.
But I don't know...maybe I already hit my plateau, and it's just my ego refusing to believe that... I'm so lost...
 

kaioukenx

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I would have to agree with diminishing returns. You've already gone through UW, which is IMO the lion's share of the studying. I have no idea what you'll do for two extra months. You still have a week to get through FA a couple times (should be pretty fast since you've already done UW) and go through some of your missed questions. You should also have an idea what your weaknesses are from UW, and you can target your studying that way. Doing another Qbank is overkill.
 

Domerr

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A bit of an update. I emailed several anesthesiology Program Directors about my situation, and none of them seemed to care about my leave being "administrative" as long as I had a good explanation for the LOA.

So I guess the main question now is whether taking 2 month off is worth the minimal increase in score. Pushing back my schedule will make it impossible for me to take Step 2 early. Also, scheduling interviews will be a pain. And a LOA is still a LOA...the stigma is still there.

My Step 1 is 4 days away...
 

Seijitsu

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A bit of an update. I emailed several anesthesiology Program Directors about my situation, and none of them seemed to care about my leave being "administrative" as long as I had a good explanation for the LOA.

So I guess the main question now is whether taking 2 month off is worth the minimal increase in score. Pushing back my schedule will make it impossible for me to take Step 2 early. Also, scheduling interviews will be a pain. And a LOA is still a LOA...the stigma is still there.

My Step 1 is 4 days away...


How long have you been studying so far? I feel that one should have ample amount of study time in 4-6 weeks. Taking an additional 2-4 weeks is not as bad as 2 months. Two months is easily 2 sub-Is. For competitive fields that is critical.
 

Domerr

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How long have you been studying so far? I feel that one should have ample amount of study tie in 4-6 weeks. Taking an additional 2-4 weeks is not as bad as 2 months. Two months is easily 2 sub-Is. For competitive fields that is critical.

At my school, there are only three entry points into 3rd year. Aside from the original entry date, the next closest one is September (2 month from now). So I don't get to choose the amount of time I want off.
I don't think I will be using the whole 2 month to study for Step 1 though. I'll probably use the second month to finish an ongoing research project and hopefully get a publication out.
 

Seijitsu

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At my school, there are only three entry points into 3rd year. Aside from the original entry date, the next closest one is September (2 month from now). So I don't get to choose the amount of time I want off.
I don't think I will be using the whole 2 month to study for Step 1 though. I'll probably use the second month to finish an ongoing research project and hopefully get a publication out.

That is most unfortunate. If you think you can really improve your score, then take the LOA hit. I agree with dynx. Very hard to argue a low step 1 score. Some programs will not look past it. In addition to program that have the cut offs. However, if you have plateau then two months is just over kill as mentioned by a previous post.
 
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