med school LOA and residency match

[subalpinesun]

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Guys; I could use some feedback. I completed all of my 3rd year of med school, but I stopped before my last rotation (surgery) and took 2 vacation months that are built into our curriculum. I'm scheduled to start back again tomorrow (!!!), but I have the option of taking a 1 year LOA. I'm tempted to do this so I can recenter, refocus, and become clear on what I want from medicine and life in general. My plan would be to take classes (likely in psych) and take Step 2 during my year off.

I got a 235 on Step 1, and have pretty much all honors from my first 2 years and all high pass from my 3rd year. I want to know how much effect a LOA would have on my ability to match into psych. If I knew it wouldn't be a problem at all I'd probably take it. Any thoughts you guys have would be really appreciated.

 

[peppy]

How do you plan to explain the absence to programs? I think that the reason for it is a huge factor in how it will be taken by residency programs.
Do you have a plan for something you can do during the time off to add to your application? I

Because it is very common for people with mental health issues to be attracted to working in mental health, I think there is a good chance that some programs will assume that your leave was due to battling some mental health issue unless you have a very plausible alternate explanation for it. That kind of admission will unfortunately be held against you at some programs (though some might be sympathetic, others will be very gun shy about taking in a resident who may have to take another leave of absence during residency).
However, with a good Step 1 and good academic record I think you would be able to find a spot somewhere - just not necessarily at your first choice.

 

[notdeadyet]

Great advice here, Peppy....

 

[subalpinesun]

Thanks for the feedback.

Not 100% sure what I would do with my time, but most likely I would take Step 2 and some classes/work/research.

Well I suppose it would technically be considered a "mental health" issue in that there are a lot of things I like about medicine and a lot of things I don't, and I feel like I need to be really sure (and I'm not) that med/psych is what I want to do with my life (instead of biology, or psych PhD for example) before I commit myself to a residency.

Also, interesting point you bring up about ppl with mental health issues wanting to work in psych. I wonder if you don't think this could be an advantage in some respects? For example, someone who is obese would make a pretty ****ty fitness/nutrition instructor.. But, someone who was obese and became healthy would IMO be a superior fitness/nutrition instructor than someone who was never obese. Just a thought..

 

[TexasPhysician]

I agree that it would be a red flag.

Why not use your good scores to get into a lifestyle friendly minimal call program?

Just a thought.

 

[subalpinesun]

Thanks man, you make a good point there.

 

[digitlnoize]

Guys; I could use some feedback. I completed all of my 3rd year of med school, but I stopped before my last rotation (surgery) and took 2 vacation months that are built into our curriculum. I'm scheduled to start back again tomorrow (!!!), but I have the option of taking a 1 year LOA. I'm tempted to do this so I can recenter, refocus, and become clear on what I want from medicine and life in general. My plan would be to take classes (likely in psych) and take Step 2 during my year off.

I got a 235 on Step 1, and have pretty much all honors from my first 2 years and all high pass from my 3rd year. I want to know how much effect a LOA would have on my ability to match into psych. If I knew it wouldn't be a problem at all I'd probably take it. Any thoughts you guys have would be really appreciated.

It sucks, but taking a break is looked at unfavorably by residency program directors.

Take a look at this Program Directors' Survey from the NRMP: http://www.nrmp.org/data/programresultsbyspecialty2010v3.pdf

They tend to rate "no gaps in medical education" as pretty important. See Page 139. 72% of PD's cite "Gaps in Med. ed." as an important factor in determining whether to interview a candidate.

That's more important than: Clerkship grades, Dean's Letter, Class Rank, Honors, AOA, and being an MD. It's EQUAL in importance to Step 2.

In fact, the only things MORE important than not having gaps is your Step 1 score and Psych LOR's.

We won't go into my thoughts on the problems with medical education, but this one ranks up there, and I wish it didn't have to be this way, but I would suck it up, get going, and match and graduate on time.

 

[splik]

Let's be clear on this: unexplained gaps in your medical education are a red flag. If you do something productive in that time and sell it, actually it enhances your application. One Psych PD told me he filters apps by answering yes to the "has your medical education been interrupted...", not to cut out those who answer yes, but because the applicants he wants answer yes - i.e. MD/PhD students, those doing research etc. Note that people gunning for derm, plastics, neurosurgery etc typically take a year or two out of med school to beef their app with research fellowships, MPHs, MBAs etc, so it is not a red flag to have gaps in medical education.

I did take a year out of medschool because I was disillusioned etc - but during that year I did a lot teaching, research, published papers, won awards etc. If I hadn't of taken that year out, I would likely not have been as successful in the match. Now I can't be sure, but I don't believe it hurt my app having 2 interruptions in medical training, I interviewed as a foreigner at many of the top 10-20 programs (bar MGH etc).

Now taking a year off 'to do step 2' is not a reason, no one will believe that, it takes a day not a year. You need to do something like a research fellowship (not a bit of research) or a Masters (not take a few classes), or something exciting like working internationally doing research with MSF or program planning, or spend a year in the jungle working in a small hospital.

No clearly defined plan, it will look like you don't know what you want to do with your life (which is fine, but not accepted by the powers that be). Worse still, it will look like you had a breakdown or some mental illness which will make people concerned you will not be able to cope with residency.

 

[subalpinesun]

Thanks so much guys, hugely helpful. My plan is to start back on surgery tomorrow AM.

 

[Doctor Bagel]

My program had a policy last year of not interviewing people with gaps in training, so as others have said, it could hurt you. It sounds like you'll probably still be OK assuming the rest of your application remains solid, but there are programs who might hold it against you.

 

[peppy]

Also, interesting point you bring up about ppl with mental health issues wanting to work in psych. I wonder if you don't think this could be an advantage in some respects? For example, someone who is obese would make a pretty ****ty fitness/nutrition instructor.. But, someone who was obese and became healthy would IMO be a superior fitness/nutrition instructor than someone who was never obese. Just a thought..

I think your point is valid. The thing to keep in mind is this: It is a huge pain in the butt for the residency admin and other residents in the program when a resident is absent for a prolonged time. Someone has to cover whatever work that resident was going to do. That can cause all kinds of scheduling problems, not to mention the resentment that some of the other residents may feel for having to take on extra work. For that reason, many residencies will try their best to screen out people who might be at risk of taking future absences.
I do feel that isn't always fair to people who may have recovered from a problem like an episode of depression, but residency programs are trying to make decisions based on limited info.

Good luck to you in finishing things and figuring out what direction you want to go in. 🙂

 

[vistaril]

Guys; I could use some feedback. I completed all of my 3rd year of med school, but I stopped before my last rotation (surgery) and took 2 vacation months that are built into our curriculum. I'm scheduled to start back again tomorrow (!!!), but I have the option of taking a 1 year LOA. I'm tempted to do this so I can recenter, refocus, and become clear on what I want from medicine and life in general. My plan would be to take classes (likely in psych) and take Step 2 during my year off.

I got a 235 on Step 1, and have pretty much all honors from my first 2 years and all high pass from my 3rd year. I want to know how much effect a LOA would have on my ability to match into psych. If I knew it wouldn't be a problem at all I'd probably take it. Any thoughts you guys have would be really appreciated.

look, you'll be fine in the long run either way. A 1 yr unexplained break in med education(youd have to make something up I guess) would not look good, but with decent scores and no other red flags from an american med school you'd be a shoe in to match at a decent to good psych program.

That said, why would you want to delay this? Just start back, fight through a crappy surgery rotation, and match in psych on schedule........

I dont think it will make a huge difference in your app either way because it's psych and with a 235 from an american med school one red flag wont kill you, but why lose a year???? that would just suck for no reason....

 

[2000 Man]

My program had a policy last year of not interviewing people with gaps in training, so as others have said, it could hurt you. It sounds like you'll probably still be OK assuming the rest of your application remains solid, but there are programs who might hold it against you.

I posted about my situation previously (wanted to get some new insight on my situation).

I was dismissed after failing 3 classes in 2nd year. I managed to address the issue that led to the failures (an alcohol problem) and was allowed to return by the school that dismissed me. I have since done well in school. I have great clincal evals and outstanding LORs and have been sober for >5 years.

Are PDs going to take one look and toss my application into the trash? Am I finished before I even start the process?

 

[splik]

did you start again from scratch or rejoin 2nd year? is there any reason why you need to mention the dismissal? will your medical school mention it on your MSPE? things to think about...

 

[2000 Man]

I redid 1st and 2nd year. Everything was reset; class rank and GPA. But the dismissal shows up in my transcript and will be mentioned in the MSPE.

 

[Doctor Bagel]

I posted about my situation previously (wanted to get some new insight on my situation).

I was dismissed after failing 3 classes in 2nd year. I managed to address the issue that led to the failures (an alcohol problem) and was allowed to return by the school that dismissed me. I have since done well in school. I have great clincal evals and outstanding LORs and have been sober for >5 years.

Are PDs going to take one look and toss my application into the trash? Am I finished before I even start the process?

Somewhere in between the two -- some programs aren't going to look at you because of this, but others will. Apply broadly and perfect everything else that you can in your application. Also, get in good with the people at your home program. Congratulations on your recovery!

 

[IAmAUser]

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[OldPsychDoc]

Make sure you read this article before you contemplate a research route... 🙁

 

[subalpinesun]

not to be a downer, but do you really have that choice now with 3 years of med school loans (+undergrad?) under your belt? maybe you are lucky and don't have to worry about that

I have absolutely zero debt. That's pretty much the reason I'm even considering this.

 

[subalpinesun]

Make sure you read this article before you contemplate a research route... 🙁

Thanks man, I appreciate that. I could be interested in a research degree in psych but likely not a research career primarily. I'd want to do clinical work.