May not graduate in time to start July 1. ****.

[Sally Struthers]

So, I found out that I failed a rotation and will need to make it up to graduate. I've already completed all of my interviews, certified a tentative rank list, daydreamed for hours about moving away, planned graduation festivities with my family, etc. Will I get kicked out of the match? If I match then am found to be unable to start on July 1 will I lose my spot? Will I need to reapply next year? HALP! I'm not sure when exactly I'll be officially graduating, but I'll post as soon as I know. Holy crap it would suck so bad to have gone through this process and then it all just go to **** and have to do it all again next year! That would look pretty bad, too, wouldn't it?

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[NotAProgDirector]

Just after rank lists are finalized and the deadline passes, your school will be queried to see if you will still be able to start on July 1. If not, your school will disqualify you from the match and you will be withdrawn from the match. Bad news.

If somehow your school "forgets" to withdraw you, you match, and then you can't start on time, your program could apply for a match waiver. They will get it -- if you can't start by July 1, they can waive your match. If you can start 1-2 weeks later they might decide to keep you, but it's completely their call -- and when they hear that the problem is that you failed a rotation, you can imagine that they will not be happy.

You need to sort this out ASAP. How in the world did you fail a 4th year rotation? That's a rhetorical question -- feel free to ignore it. The most common reason is missing too many days of the rotation for interviews -- many schools have a very small limit.

One other thing -- if you finish July 7th you might think "No big deal, it's just a week late". However, many schools only confer diplomas 2-3x per year. If you don't graduate in June, you might need to wait until October to actually graduate. Again, you should clarify this ASAP.

 

[FutureInternist]

How do you fail a rotation in your 4th year ???

 

[Sally Struthers]

Because I missed too many days...

 

[Sally Struthers]

What if I DID get withdrawn from the match?? Then what?? Apply the following year? Dig ditches in the meantime? This sucks.

 

[IM2GI]

Because I missed too many days...

Brutal, potentially career altering mistake. How many days did you miss, and how did you not know it? Any way to appeal and makeup the missed days? Seems crazy to ruin a kids career over missing a few days as a fourth year.

 

[Sally Struthers]

Brutal, potentially career altering mistake. How many days did you miss, and how did you not know it? Any way to appeal and makeup the missed days? Seems crazy to ruin a kids career over missing a few days as a fourth year.

I agree. (obviously ---> I'm the kid working on the career) I don't want to say too much, but yeah...horrible, horrible mistake. I'm working on appealing and asking if I can make up the missed, hell I'll work 12 hours a day up until the day I need to leave for [HOPEFULLY] my residency.

 

[Sally Struthers]

But anyway, if so....what happens????

 

[IM2GI]

I agree. (obviously ---> I'm the kid working on the career) I don't want to say too much, but yeah...horrible, horrible mistake. I'm working on appealing and asking if I can make up the missed, hell I'll work 12 hours a day up until the day I need to leave for [HOPEFULLY] my residency.

Do you have any well connected letter-writers or advisors? You need to appeal to someones sense of reason on this one.

 

[IM2GI]

But anyway, if so....what happens????

aPD knows better than I would, but I assume your application is voided and you have to re-apply next year. SOAP would not even be an option for you.

Suffice it to say, you do not want to let this happen to you.

Public or private school? US?

 

[rokshana]

Brutal, potentially career altering mistake. How many days did you miss, and how did you not know it? Any way to appeal and makeup the missed days? Seems crazy to ruin a kids career over missing a few days as a fourth year.

uh…crazy for said kid not to pay attention and not realize that s/he was missing too many days and screw up his or her career…the rules no doubt were in place…either you show up or talk to the preceptor before to make sure you can miss that many days or make up the time…

 

[SouthernSurgeon]

What if I DID get withdrawn from the match?? Then what?? Apply the following year? Dig ditches in the meantime? This sucks.

1) Apply the following year
2) Beg your school to let you defer graduation for a year
3) Get a research position in your field of choice
4) Hope this doesn't screw you the next time around

This is of course, assuming that you get withdrawn from the match, not that you actually match only to subsequently get labelled a match violator and are not allowed to participate the following year

Bottom line is you have approximately 3 weeks to figure out how to not get screwed by this. It's admirable that you're willing to work 12 hours per day - I'd suggest you strongly consider upping that number to 24. You have three weeks to salvage your match. Do everything you can in those three weeks. At the very least you need definitive answers from your school before the ROL deadline.

 

[IM2GI]

uh…crazy for said kid not to pay attention and not realize that s/he was missing too many days and screw up his or her career…the rules no doubt were in place…either you show up or talk to the preceptor before to make sure you can miss that many days or make up the time…

Clearly you have never made a mistake in your life. I mean he/shes is clearly in the wrong, but the punishment does not fit the crime.

 

[norwood]

I mean he/shes is clearly in the wrong, but the punishment does not fit the crime.

Well said, though IMHO I'm not sure what OP's options even were. I mean, if s/he was the kind of applicant who needed every possible interview, what else could s/he do?

Definitely +1 to the idea of finding someone who can overrule whoever's waving the rotation rulebook at you. Have you talked to the dean?

 

[Iamnotme]

uh…crazy for said kid not to pay attention and not realize that s/he was missing too many days and screw up his or her career…the rules no doubt were in place…either you show up or talk to the preceptor before to make sure you can miss that many days or make up the time…

I never understand how we can preach compassion, care, understanding, etc for patients, yet at the same time how people can think that we should treat our own with this level of harshness. Why do you feel the need to have such harshness with people? It's not so atrocious to miss days on a rotation, especially as a medical student. Blowing it out of proportion is the problem. What happened to compassion for us as students, physicians?

I never get this type of ideology...

 

[Iamnotme]

So, I found out that I failed a rotation and will need to make it up to graduate. I've already completed all of my interviews, certified a tentative rank list, daydreamed for hours about moving away, planned graduation festivities with my family, etc. Will I get kicked out of the match? If I match then am found to be unable to start on July 1 will I lose my spot? Will I need to reapply next year? HALP! I'm not sure when exactly I'll be officially graduating, but I'll post as soon as I know. Holy crap it would suck so bad to have gone through this process and then it all just go to **** and have to do it all again next year! That would look pretty bad, too, wouldn't it?

My thoughts: Why did you fail the rotation, and is it something that you can make up? by that I mean, did you fail an exam and need to re-do it, or was it the clinical part of the rotation that you failed?
-how far off from finishing your other rotations are you, and can you fit it in your schedule before graduation? Most med students graduate in may, but there is many times a summer time graduation that's offered. Are you able to do that?
-Can you do something else to make this rotation - project, etc? Have you already failed it or is it anticipatory ?
-It's not infrequent that people match and start late, so I don't think it's the end of the world in that regards.

 

[MerickManual]

As a fourth year, you are probably doing electives right now, right? Can't you cancel an elective and retake the failed elective again? For example I needed X weeks of medicine-based electives and Y amount of surgery electives, but I have completed the requisites and am just taking extra electives now that I would be able to cancel one and retake an elective before graduation. Is that possible for you?

 

[NotAProgDirector]

The usual story (I feel like this thread appears every year) is that a student has a rotation with a preceptor. They end up getting a bunch of interviews, and ask the preceptor if they can go to their interviews. "Sure!" they say, and off they go to their interviews. Then, the medical school admin finds out about it and fails the student if they fall below a minimum level of attendance. So you can see how a good student could get into trouble.

Schools do this to be fair about it. What happens if you and your buddy are both on two identical rotations with different preceptors. You both get inteviews and ask for days off. One preceptor says yes, the other says no. How is that fair? Plus, preceptors may actually be unhappy with students taking days off, but feel like they have to say "yes" to these requests. So the school sets a maximum to make the system fair. The problem is that there is a spectrum between what's "fair" and what's "right". Fair = rules based, everyone is treated the same, logical. Right = emotion based, individualized based upon circumstances.

Anyway, back to the OP's problem:

As stated above, your first plan is to FIX this. Do whatever it takes to fix it. Work weekends. Clean toilets. Whatever. Agreed that if your school has an ombudsperson, you should contact them ASAP. As mentioned above, maybe you can make it up and still finish on time.

Failing that, you need to clarify whether your school will be withdrawing you from the match. You need to verify when your graduation date will be. if they will not withdraw you from the match and you will simply graduate a bit late, then you need to contact all of your programs and tell them. Some might drop you -- that's life. Many might keep you in the match, and start you late. Theoretically your school should NOT do this, but who knows.

If your school will be withdrawing you from the match, then you are in big trouble. You will not qualify for the match or for SOAP. You can try to get a spot outside the match after all of that, but there will be little left. You could ask your home program to create a prelim position for you (if they are willing) and give it to you after the match. As mentioned above, you could delay graduation for a year (perhaps getting an MS or MPH -- sometimes there are awards to fund this). Or you can graduate, look for off cycle spots, plan to match next year, apply all over again, and try to get some sort of job in the meanwhile -- research most likely.

 

[IM2GI]

.

What obligations does a medical school have to its students that are paying tuition?

I feel like if the school is so unreasonable to ruin someones life for missing a few days of school, I would be calling a lawyer before going down like that.

 

[thefritz]

Because I missed too many days...

This is ludicrous. 4th year administrative issues are so stupid. Everybody knows that people do a 4 week radiology rotation and complete MAYBE 10 hours of actual work their entire four weeks. People do a 4 week research rotation and do basically nothing and get credit. Meanwhile this guy misses a few days for a legimate reason and now his career is screwed up. Absurd. How in the world did they find out about this? Did your attending actually have an issue with you not being there and report you to the admin?

 

[thefritz]

I never understand how we can preach compassion, care, understanding, etc for patients, yet at the same time how people can think that we should treat our own with this level of harshness. Why do you feel the need to have such harshness with people? It's not so atrocious to miss days on a rotation, especially as a medical student. Blowing it out of proportion is the problem. What happened to compassion for us as students, physicians?

I never get this type of ideology...

I have absolutely zero doubt that my program would do the exact same thing to one of its students. I have been shocked going through med school at what certain administrators are willing to do - throw a student's career under the bus for such a minor technicality. I am aware of many similar scenarios. Reason goes out the window - they are by the books and if if they find out you didn't cross a single t, you're screwed. It takes a special type of person to wield their administrative power like this. They must get some kind of kick out of it. Personally, I could never sleep at night if I did these things to someone. Yet, they are somehow totally justified in their heads for what they do.

 

[thefritz]

Dig ditches in the meantime? This sucks.

Pretty much. They don't care and won't lose a second of sleep over your condition.

 

[Top Gun]

uh…crazy for said kid not to pay attention and not realize that s/he was missing too many days and screw up his or her career…the rules no doubt were in place…either you show up or talk to the preceptor before to make sure you can miss that many days or make up the time…

No need for sanctimony. Most fourth-years have occasionally skipped during electives. I'm willing to bet you didn't have a perfect attendance record during fourth year either.

 

[Bacchus]

How many days did you miss over the course of the 4 weeks? We were "allowed" 4 days off while at PCOM. Obviously, the policy was zero days off, but there were 4 there just in case.

I know of a few students missing >6-7d and had to repeat a rotation.

 

[rokshana]

No need for sanctimony. Most fourth-years have occasionally skipped during electives. I'm willing to bet you didn't have a perfect attendance record during fourth year either.

no i didn't ..and of course i've made mistakes (most of undergrad for instance…but i accepted the consequences of my poor decisions) but I made a point of asking my preceptors on the rotations in which i had to take time off for interviews (and we don't know that is the reason the OP missed too many days, we are just assuming that since it is the season) or did rotations that were known for not caring about attendance(its not like 4th years don't know which rotation these are*cough* radiology*cough*)…and i've had med students on service that let me know that they are going to miss days (or worry about missing the days to the point they think about not accepting the interview) and i have no issue with that…i tell them their job as a 4th year is to get a job for next year. And even those that don't tell me…i'm not going to go an tell the clerkship dean that they missed too many days…OBviously someone was annoyed enough about it to the point that they DID say something...

 

[Doctor Bob]

I disagree with the "how can the school do this- it ruins this person's life" stance.

If you miss too many days of class during pre-school (if attendance is required) they can kick you out of school -> parents lose money
If you miss too many days of class during K-12, you can fail the class and have to repeat the class -> loss of summer/repeat a year
If you miss too many days of class during college (if attendance is required) you can fail the class -> loss of tuition, repeat the class
If you miss too many days of class during medschool you can fail the rotation -> have to repeat the rotation

There have been penalties all along the way. They just increase at each stage both in life-impact and financial impact.
And there are penalties at the next stage as well. There are always residents who skip out on light rotations during 3rd year to go on job interviews and they end up having to repeat rotations and graduate late (so then have to tell their prospective employers that they won't be able to start on time)
There are staff who take way too many days off so after a while we all get tired of covering for them and they get let go.
And on, and on, and on.

So in this instance, the OP was either unaware that missing too many days would cause them to fail the rotation (which is lack of understanding of the rules of engagement and lack of understanding of school policies); or they were unaware of the potential consequences of that failure (which is lack of foresight and lack of consideration of potential outcomes). Neither are excusable in an adult.

 

[shopsteward]

We don't know how many days this particular student missed , or why. But in general the match figures seem to show a growing trend of med students applying to greater numbers of residencies and increasing the number of interviews they go on. That suggests to me that the issue of time off for interviewing is going to become a bigger and bigger issue. It's quite probably something that med school admins, and the policies they work under, haven't caught up with yet.

Given the interest that med schools have in their students matching, and matching well, it seems likely that they should all to take a strategic look at how their fourth year programs work under these changing conditions, to maximise the learning opportunities for their students while providing the flexibility those students need to come through the match process with good outcomes.

 

[rokshana]

We don't know how many days this particular student missed , or why. But in general the match figures seem to show a growing trend of med students applying to greater numbers of residencies and increasing the number of interviews they go on. That suggests to me that the issue of time off for interviewing is going to become a bigger and bigger issue. It's quite probably something that med school admins, and the policies they work under, haven't caught up with yet.

Given the interest that med schools have in their students matching, and matching well, it seems likely that they should all to take a strategic look at how their fourth year programs work under these changing conditions, to maximise the learning opportunities for their students while providing the flexibility those students need to come through the match process with good outcomes.

which is why i think some schools are actually thinking about eliminating the 4th year completely and going back to the idea of a 3 year medical school…guess then you would be in some nether world… not a med student and not a resident…and apply to residency on your own time.

 

[killerleaf]

which is why i think some schools are actually thinking about eliminating the 4th year completely and going back to the idea of a 3 year medical school…guess then you would be in some nether world… not a med student and not a resident…and apply to residency on your own time.

I have heard this, but what would actually replace the 4th year would be a generalized intern year.

 

[scarletgirl777]

I disagree with the "how can the school do this- it ruins this person's life" stance.

If you miss too many days of class during pre-school (if attendance is required) they can kick you out of school -> parents lose money
If you miss too many days of class during K-12, you can fail the class and have to repeat the class -> loss of summer/repeat a year
If you miss too many days of class during college (if attendance is required) you can fail the class -> loss of tuition, repeat the class
If you miss too many days of class during medschool you can fail the rotation -> have to repeat the rotation

There have been penalties all along the way. They just increase at each stage both in life-impact and financial impact.
And there are penalties at the next stage as well. There are always residents who skip out on light rotations during 3rd year to go on job interviews and they end up having to repeat rotations and graduate late (so then have to tell their prospective employers that they won't be able to start on time)
There are staff who take way too many days off so after a while we all get tired of covering for them and they get let go.
And on, and on, and on.

So in this instance, the OP was either unaware that missing too many days would cause them to fail the rotation (which is lack of understanding of the rules of engagement and lack of understanding of school policies); or they were unaware of the potential consequences of that failure (which is lack of foresight and lack of consideration of potential outcomes). Neither are excusable in an adult.

Back in the day when people only went on 5 or 6 local interviews and had broad flexibility on which dates they could choose these policies made sense, but in some fields it's the norm to have to go on 20ish or so interviews all around the country with little to no notice and/or limited flexibility on dates. In addition, students from schools with weaker/nonexistent home programs in competitive specialties have to spend time doing aways which means less time to complete graduation requirements. Schools that reqire multiple subis and other rotations during 4th year with very restrictive attendance policies are not doing their students any favors--if you have students who aspire to aim high you should support them rather than make their lives difficult.

 

[2021Doctor]

Back in the day when people only went on 5 or 6 local interviews and had broad flexibility on which dates they could choose these policies made sense, but in some fields it's the norm to have to go on 20ish or so interviews all around the country with little to no notice and/or limited flexibility on dates. In addition, students from schools with weaker/nonexistent home programs in competitive specialties have to spend time doing aways which means less time to complete graduation requirements. Schools that reqire multiple subis and other rotations during 4th year with very restrictive attendance policies are not doing their students any favors--if you have students who aspire to aim high you should support them rather than make their lives difficult.

The above is an excellent reply.

First look at the facts:
1. The failure rate nationally on clinical clerkships is less than 1 percent ( reference: http://www.ncbi.nlm.nih.gov/pubmed/22722356 ). So passing clerkships is just about rubber stamping nationwide.
2. The match is getting more competitive every year.
3. The chances of matching correlate with the number of programs you interview and rank ( see Table 4 http://b83c73bcf0e7ca356c80-e8560f4...tent/uploads/2013/08/chartingoutcomes2011.pdf )

Therefore going on as many interviews as possible is a key step to ensuring you get a residency postion after medical school.
Medical schools need to allow flexibility to keep their grads from being unemployed and unmatched.