hjdmx

5+ Year Member
Aug 9, 2013
39
2
Status
So in 3rd year of bed school went through Major depression and went through different doctors and meds and all that, so it caused me to fail step 2 ck 3 times and cs twice. I want to go to Family Med / applying to prelim internal med programs.

My stats:
US IMG
Graduated 2014.
MBA
MPH
Step 1 : 196/ 1 st attempt PASS
Step 2 ck: 214/ 4th attempt PASS
Step 2 cs: PASS 3rd attempt
Step 3: 192 PASS 1st attempt
Publication
Research experience
Working as Clinical Data Analyst & Clinical Educator - teaching 3rd and 4th year med students.

I know its bad, I told my adviser and he still wants me to try....even though I feel like giving up
 

SLC

A Punk rock Country doc
7+ Year Member
Mar 24, 2010
3,725
3,860
The Empire
Status
Attending Physician
So in 3rd year of bed school went through Major depression and went through different doctors and meds and all that, so it caused me to fail step 2 ck 3 times and cs twice. I want to go to Family Med / applying to prelim internal med programs.

My stats:
US IMG
Graduated 2014.
MBA
MPH
Step 1 : 196/ 1 st attempt PASS
Step 2 ck: 214/ 4th attempt PASS
Step 2 cs: PASS 3rd attempt
Step 3: 192 PASS 1st attempt
Publication
Research experience
Working as Clinical Data Analyst & Clinical Educator - teaching 3rd and 4th year med students.

I know its bad, I told my adviser and he still wants me to try....even though I feel like giving up
I think you'll have a steep uphill battle TBH, lots of folks out there have no failures.

But there may be a spot for you and I agree, you need to try.
 

JustPlainBill

Attending
10+ Year Member
Jan 5, 2007
2,568
2,933
Status
Attending Physician
So in 3rd year of bed school went through Major depression and went through different doctors and meds and all that, so it caused me to fail step 2 ck 3 times and cs twice. I want to go to Family Med / applying to prelim internal med programs.

My stats:
US IMG
Graduated 2014.
MBA
MPH
Step 1 : 196/ 1 st attempt PASS
Step 2 ck: 214/ 4th attempt PASS
Step 2 cs: PASS 3rd attempt
Step 3: 192 PASS 1st attempt
Publication
Research experience
Working as Clinical Data Analyst & Clinical Educator - teaching 3rd and 4th year med students.

I know its bad, I told my adviser and he still wants me to try....even though I feel like giving up
Ok -- you said to ---

I think you've got a reasonable explanation but I would expect to be where no one wants to be -- and then I would expect to be watched closely. But I view things differently -- I want to know what your character is like --- because to me, that's the best predictor of how you'll be in crisis -- ok, so you had a spell of major depression but you got it treated --- important thing to me is, you didn't quit and go suck your thumb and pout in the corner -- 4attempts to pass -- ok, you know the material and then on Step 3 you pass with 1 attempt -- to me, yeah, I'll keep an eye on you fo' sho' but it's not an automatic out -- hell, demonstrates character and persistence to me ---

I'd whole lot rather work with a Mark -1, Mod - 0 warthog grunt that just keeps working at it and improving than with some natural gazelle who's never faced adversity and is likely to give up when things get tough ---
 

AdmiralChz

ASA Member
10+ Year Member
Sep 8, 2008
3,300
2,727
Mid-Atlantic
Status
Attending Physician
Be prepared to explain the failures, the CS failure x2 is a gigantic red flag and often indicates to programs that you may have difficulty with English (not saying this is your case, but that's most often who fail to pass CS multiple times).

Then again you have a triumphant storyline which can play well at certain places. Lean on your advisors for help and advice.
 
OP
H

hjdmx

5+ Year Member
Aug 9, 2013
39
2
Status
fyi, many states cannot license you if you have more than 3 failures on board exams.
wow didn't know that I will look up the states that I am exuded from. Thank you for the info.
 

cabinbuilder

Urgent Care Physician
10+ Year Member
Nov 21, 2005
4,541
2,363
Texas
Status
Attending Physician
fyi, many states cannot license you if you have more than 3 failures on board exams.
Texas and Oregon for sure will not license.
 

hallowmann

Lifetime Donor
7+ Year Member
Mar 13, 2012
5,539
5,137
Status
Resident [Any Field]
wow didn't know that I will look up the states that I am exuded from. Thank you for the info.
The following states sound like they are out:

Alaska
Arkansas
Georgia
Idaho
Illinois
Indiana
Minnesota (but they might consider if you hold another state's license and are BC)
New Hampshire
North Carolina
North Dakota
Oklahoma
Rhode Island
South Dakota
Texas
Wisconsin

That still leave 35 more. Its worth trying. You can get more info here: https://www.fsmb.org/licensure/usmle-step-3/state_specific
 
OP
H

hjdmx

5+ Year Member
Aug 9, 2013
39
2
Status
The following states sound like they are out:

Alaska
Arkansas
Georgia
Idaho
Illinois
Indiana
Minnesota (but they might consider if you hold another state's license and are BC)
New Hampshire
North Carolina
North Dakota
Oklahoma
Rhode Island
South Dakota
Texas
Wisconsin

That still leave 35 more. Its worth trying. You can get more info here: https://www.fsmb.org/licensure/usmle-step-3/state_specific
The above list is incorrect b/c that's based on multiple attempts on Step 3 which I passed on the 1st attempt.

My Exclusion List is the following: Alaska, Idaho(ID), Indiana (IN), Maryland, Minnesota, Missouri, NH, North Dakota, Oklahoma, South Carolina, Rhode Island, Utah, West Virginia, Wisconsin, Texas

Source: https://www.healthcarelicensing.com/state-medical-license-requirements
 

cabinbuilder

Urgent Care Physician
10+ Year Member
Nov 21, 2005
4,541
2,363
Texas
Status
Attending Physician
Yes, but you have to look at step II as well. Texas will not even let you do a residency if you fail step II 3 times. I know this because we a guy in the residency program who took step II the third time while in residency and was told if he failed again would be dismissed from residency then and there.
 

hallowmann

Lifetime Donor
7+ Year Member
Mar 13, 2012
5,539
5,137
Status
Resident [Any Field]
The above list is incorrect b/c that's based on multiple attempts on Step 3 which I passed on the 1st attempt.

My Exclusion List is the following: Alaska, Idaho(ID), Indiana (IN), Maryland, Minnesota, Missouri, NH, North Dakota, Oklahoma, South Carolina, Rhode Island, Utah, West Virginia, Wisconsin, Texas

Source: https://www.healthcarelicensing.com/state-medical-license-requirements
That list was based on attempts on all steps, not just step 3, it just happened to be compiled under the Step 3 requirement on the FSMB website. That's the reason some of the requirements in that table only refer to Step 3, which makes it hard to know whether they would work for you.

I don't know much about the "Healthcare Licensing Services" that you linked to. It seems like a private consulting company. Regardless, you should spend a little time checking each state's requirements, and not rely solely on either of these websites to make major decisions.
 
  • Like
Reactions: hjdmx

NRAI2001

3K Member
15+ Year Member
Nov 5, 2001
4,638
49
Cali
Sure you have an explanation...

SO does everyone else... anyone who messed up at anything ever always had an excuse.

A real convincing Situation would have been failing your exam once and then learning your lesson and a) never failing again or ... even better b) rocked the rest of your exams and really used your first failure as a learning point..

Looks like you didnt do either.. multiple failures and the passes you actually had were just barely passing.
 
Last edited:
  • Like
Reactions: hjdmx

NRAI2001

3K Member
15+ Year Member
Nov 5, 2001
4,638
49
Cali
Next quesiton... how many years did it take you to graduate? I bet you its more than 6 or 7 years.

Being an IMG myself I know many people with similar stats like you.... they all also had "excuses" for why its not their faults. In the end they were all just idiots/immature/not realistic/partying/depression... call it what you like..

Some mistakes in life you just cant bounce back from... this maybe one of them.

Not getting a residency doesnt mean your life as a doctor is over... could do research, consulting, administration, education, pharmaceuticals, Mba, mph..etc ..Could go back to PA school if you re really set on clinical work, I ve know a few people in your situation who are applying for their 4 or 5 th year now and for the first time are applying to PA schools this year.

Just being honest.
 
Last edited:
  • Like
Reactions: hjdmx

DrMidlife

has an opinion
10+ Year Member
Oct 30, 2006
7,506
2,604
Status
Resident [Any Field]
I know its bad, I told my adviser and he still wants me to try....even though I feel like giving up
What adviser? At your med school? Can that adviser name at least one other former student with multiple, generally disqualifying, step failures who is now licensed and practicing? If not, what help is this adviser actually qualified to offer you? Where was this adviser when you needed him, ie after your first step failure when you should have been mobbed by helpfulness and kept from failing again?

Your med school kept taking your tuition money after you were effectively disqualified from licensure. That's gross negligence. You should probably also be looking for whether your med school is on state lists of approved foreign schools or not.

I agree with others who are telling you to consult official sources. Nothing that ends with .com. Start sending polite, concise emails.

Best of luck to you.
 
  • Like
Reactions: hjdmx

NRAI2001

3K Member
15+ Year Member
Nov 5, 2001
4,638
49
Cali
How many years have you applied already? If you ve never applied I would still apply bc you ll live the rest of your life with that nagging thought of never having applied before... If you ve applied before I would give it up... Unless if you got some really strong connection.. Even then it would be hard for them to justify taking you to their colleagues and admission committee..
 
  • Like
Reactions: hjdmx

NRAI2001

3K Member
15+ Year Member
Nov 5, 2001
4,638
49
Cali
Can you possibly explain this a bit?

Does a really strong connection mean that the applicant knows a program director? Or does it mean that an applicant knows a doctor really well who can advocate for him to a program director?
I would say just knowing some doc at a residency would not be enough... If your dad or uncle was the PD, they would still have trouble justifying to the rest of the committee why they should take you.

I see you already have an mba and an mph... You could probably find some sort of job were you could really utilize your MD/MBA/MPH... Maybe consulting or admin... That would actually be a pretty cool gig.
 

Natividad Resident

FM resident
2+ Year Member
Aug 13, 2016
50
89
Monterey County
Status
Resident [Any Field]
Residency admissions: led by the program director. Other faculty participate, usually some residents participate, sometimes staff participate. Lately a FM program of 10 residents can get 500-1000 apps, more than 50% IMGs, and will rank 100. There are 500+ FM residencies with 3000+ new positions in the match each year. 50% of IMGs do not match. (See nrmp.org.)

Licensing: starts before residency starts. The state medical licensing board has to grant permission before the intern is allowed to touch patients. For IMGs there may be a more extensive preliminary screen that takes longer. (See fsmb.org.)

Program directors and other residency app reviewers looking at a candidate with questionable license-ability: typically lack motivation to take a known risk given that there are hundreds more license-able candidates still in the pile. It makes no difference how well the candidate interviews if they can't be licensed.

IMHO unless/until the candidate brings legitimate evidence that he/she is license-able, as part of his/her residency app, this goes nowhere, regardless of how well the program knows the candidate.
 
  • Like
Reactions: hjdmx

NRAI2001

3K Member
15+ Year Member
Nov 5, 2001
4,638
49
Cali
My FM program has 8 positions every year.... We get about 1500-2000 applicants... Interview about 100 people and usually rank between 70-80 people.
 
Last edited:

NRAI2001

3K Member
15+ Year Member
Nov 5, 2001
4,638
49
Cali
Good link. Very detailed.

Only thing though this person with the seven fails:
1) matched at the program his wife was at (already a huge backdoor a lot people don't have), though with 7 fails even this would be very unlikely
2) I applaud him for making the smart move of taking a job at a hospital with a residency program and then becoming very involved with many projects at this program.
3) He was doing an MBA at the time as a back up plan
 

W19

Membership Revoked
Removed
Removed
Account on Hold
Gold Donor
2+ Year Member
Sep 24, 2014
6,096
4,210
Status
Resident [Any Field]
Your best hope IMO is to pray that these states (MO, VA) that are granting 'Assistant Physician' license to people who pass step 3 to start with these programs soon...
 
  • Like
Reactions: hjdmx

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,377
5,166
Status
Attending Physician
Your best hope IMO is to pray that these states (MO, VA) that are granting 'Assistant Physician' license to people who pass step 3 to start with these programs soon...
For the record, VA isn't granting "assistant physician" licenses. There's a bill going before the legislature this year, but it will likely be defeated.

As for MO, they've had their law on the books for over two years, but have yet to grant a single license.
http://www.columbiamissourian.com/news/state_news/zero-assistant-physician-licenses-issued-in-missouri-after-two-years/article_c28e905c-e3e2-11e5-8423-83a296fb0ae8.html

It's just a bad idea, IMO.
 

W19

Membership Revoked
Removed
Removed
Account on Hold
Gold Donor
2+ Year Member
Sep 24, 2014
6,096
4,210
Status
Resident [Any Field]
For the record, VA isn't granting "assistant physician" licenses. There's a bill going before the legislature this year, but it will likely be defeated.

As for MO, they've had their law on the books for over two years, but have yet to grant a single license.
http://www.columbiamissourian.com/news/state_news/zero-assistant-physician-licenses-issued-in-missouri-after-two-years/article_c28e905c-e3e2-11e5-8423-83a296fb0ae8.html

It's just a bad idea, IMO.
But why do you think it's a bad idea?

If the ANA is against it, I am for it!
 

W19

Membership Revoked
Removed
Removed
Account on Hold
Gold Donor
2+ Year Member
Sep 24, 2014
6,096
4,210
Status
Resident [Any Field]
I know the problem with implementation, but I thought you were saying the entire idea was bad... I think the best way to do it is to have one-year 'unpaid' internship for these people in some hospitals and make them sign a 2-year contract to work in 'area of critical need' i.e undesirable locations instead of having NP online schools jamming the system with people who have no desire to work in primary care and/or practice in undesirable locations...
 

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,377
5,166
Status
Attending Physician
I know the problem with implementation, but I thought you were saying the entire idea was bad... I think the best way to do it is to have one-year 'unpaid' internship for these people in some hospitals and make them sign a 2-year contract to work in 'area of critical need' i.e undesirable locations instead of having NP online schools jamming the system with people who have no desire to work in primary care and/or practice in undesirable locations...
The entire idea is bad. What you have suggested is completely unworkable. Whether you pay them or not, they would still require supervision, and would expose their supervisor(s) to liability. Who's going to do that for free? As for making them sign a contract, please refer to the 13th Amendment...

Our primary argument against midlevel equivalence is based on the superiority and standardization of the physician education and training program. The "assistant physician" idea throws that out the window, and risks devolving medical training back to the pre-Flexner era.
 
  • Like
Reactions: ThoracicGuy

W19

Membership Revoked
Removed
Removed
Account on Hold
Gold Donor
2+ Year Member
Sep 24, 2014
6,096
4,210
Status
Resident [Any Field]
The entire idea is bad. What you have suggested is completely unworkable. Whether you pay them or not, they would still require supervision, and would expose their supervisor(s) to liability. Who's going to do that for free? As for making them sign a contract, please refer to the 13th Amendment...

Our primary argument against midlevel equivalence is based on the superiority and standardization of the physician education and training program. The "assistant physician" idea throws that out the window, and risks devolving medical training back to the pre-Flexner era.
The Flener report is outdated IMO... We can educate competent physicians in less than 11 years... One should not need a BS/BA to degree to get into med school. I know some school do not require it, but it has become a de facto requirement... In addition, med school itself can be done in 3 years... Hence there are some 3-year program in the country now.. In fact, many foreign physicians that are doing residency in the US have gone thru a 6-year program. It does not have to be HS to med school for our system. It can be a 3-year prereq and 3-year med school...

I have a hard time believing that FM can't be done in 2 year when I saw 3rd year FM/IM resident was doing everything without supervision when I was working as a nurse. In fact, there are 2-year FM programs in Canada. Many of these stuff are just arbitrary IMO... We have 3 and 4-year EM programs... Are the people who do 3-year EM program incompetent when they are out practicing?
 

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,377
5,166
Status
Attending Physician
Raising the issue of residency length is irrelevant when you're talking about licensing physicians who haven't even completed a residency.

You're essentially advocating for an unregulated "homegrown" training track, which would be exactly what the Flexner report decried long ago.
 

W19

Membership Revoked
Removed
Removed
Account on Hold
Gold Donor
2+ Year Member
Sep 24, 2014
6,096
4,210
Status
Resident [Any Field]
Raising the issue of residency length is irrelevant when you're talking about licensing physicians who haven't even completed a residency.

You're essentially advocating for an unregulated "homegrown" training track, which would be exactly what the Flexner report decried long ago.
What do you mean licensing physicians who do not complete residency? That's why I am saying they should have a 1-year regulated internship. Whether it's GME or state funded or not, it's up to the states that want fill the void in 'area of critical need'. Do you know that all NP have to do is 500-700 clinical preceptorship to be INDEPENDENT practitioners in 20 states... These people will be "assistant physicians'--not physicians.

The only concern I have is that these AP might turn around and apply for resident after completing their internship, which might overwhelm the system.
 

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,377
5,166
Status
Attending Physician
You don't have to convince me that NP training is inferior. However, by advocating for an "assistant physician," you are eroding our argument.

Further, your argument that FM residency should be shorter flies in the face of the increasing complexity of modern medicine. There are lots of people who would disagree with you on that subject, myself included.

I have yet to meet a physician who wished they had less training.
 

W19

Membership Revoked
Removed
Removed
Account on Hold
Gold Donor
2+ Year Member
Sep 24, 2014
6,096
4,210
Status
Resident [Any Field]
If you have a better way to solve the physicians (or providers) maldistribution issue... Please share it!

NP organization have said they were the answer and most NP grads don't like to work in undesirable areas just like docs... In fact, some of them are working as floor RN in south FL because they can't find a job and they don't want to relocate.
 

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,377
5,166
Status
Attending Physician
This really isn't the appropriate thread for that. Feel free to start one if you'd like, or scan through the archives in this forum. It's come up plenty of times in the past.
 
  • Like
Reactions: W19

W19

Membership Revoked
Removed
Removed
Account on Hold
Gold Donor
2+ Year Member
Sep 24, 2014
6,096
4,210
Status
Resident [Any Field]
You don't have to convince me that NP training is inferior. However, by advocating for an "assistant physician," you are eroding our argument.

Further, your argument that FM residency should be shorter flies in the face of the increasing complexity of modern medicine. There are lots of people who would disagree with you on that subject, myself included.
Training in Canada which mirrors ours here has 2-year FM training and it works...
 

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,377
5,166
Status
Attending Physician
Last edited:

W19

Membership Revoked
Removed
Removed
Account on Hold
Gold Donor
2+ Year Member
Sep 24, 2014
6,096
4,210
Status
Resident [Any Field]
Personally, I'm not all that interested in seeing the United States emulate anything that Canada is doing. It's dollar driven, nothing more.
We are too good as Americans, so we should not copy from other countries that have done things that are proven to be effective. Is that what you are saying? Seriously!
 

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,377
5,166
Status
Attending Physician
We are too good as Americans, so we should not copy from other countries that have done things that are proven to be effective. Is that what you are saying? Seriously!
Read the articles I linked above before you start putting words in my mouth and throwing out straw men.
 
  • Like
Reactions: ThoracicGuy

witzelsucht

7+ Year Member
Jun 20, 2012
475
711
Status
Resident [Any Field]
Americans are much more obese and have more diabetes than canadians so family physicians need an extra year to manage all the fundus exams and statin myopathy.

And no one thinks it takes 4 years of residency to be a competent EM doc, the extra year is because 4 yr programs have more elective time and research. A lot of those guys do international stuff, research, and so forth with the extra months.
 

fatwalletuab

10+ Year Member
Jul 22, 2008
39
3
Status
Non-Student
those failures represent so flaws in both ck and cs. sorry man, but I'm happy you eventually pass, there's alway a chance, keep your hope up, because the chance might be very slim. I would say you might want to have plan B, because I knew people who have 2 failure on cs matched, but they have std +1 on Step 1 and ck. There is always hope, try every year but at the same time work too
 

Mad Jack

Critically Caring
5+ Year Member
Jul 27, 2013
35,552
65,176
4th Dimension
We are too good as Americans, so we should not copy from other countries that have done things that are proven to be effective. Is that what you are saying? Seriously!
Canada is the only industrialized nation in the world with a two year FM program, and they've been advocating to up it to three since literally its inception.
 

W19

Membership Revoked
Removed
Removed
Account on Hold
Gold Donor
2+ Year Member
Sep 24, 2014
6,096
4,210
Status
Resident [Any Field]
Canada is the only industrialized nation in the world with a two year FM program, and they've been advocating to up it to three since literally its inception.
A Canadian at my school matched this year in a one of the 2-year FM program and he told me that his program has good track record and has put out good FM docs... I don't see why they want to change something that is working
 

Ronaldo7

Dr Strange
Sep 6, 2016
3
0
Everywhere
Status
Medical Student
My stats:
Non-US IMG
Graduated 2014
step 1 : 228/1st attempt
step 2 CK:215/ 1st attempt
step 2 CS: Pass/ 2nd attempt
PUBMED Publications: 1 paeds RCT, 1 Pulmonology RCT, 1 Critical care RCT, one review article
10 non-PUBMED indexed research articles
Experience : working as a Primary care physician and ED physician plus doing some research

Want to go to Family Med. What are my chances ?
 

W19

Membership Revoked
Removed
Removed
Account on Hold
Gold Donor
2+ Year Member
Sep 24, 2014
6,096
4,210
Status
Resident [Any Field]
Yes, but you have to look at step II as well. Texas will not even let you do a residency if you fail step II 3 times. I know this because we a guy in the residency program who took step II the third time while in residency and was told if he failed again would be dismissed from residency then and there.
That was the golden age... Programs won't even rank you now if you don't have both CS/CK by January end or early February....
 

JonMonkey

7+ Year Member
Mar 10, 2011
96
55
Dallas, Tx
Status
Attending Physician
those failures represent so flaws in both ck and cs. sorry man, but I'm happy you eventually pass, there's alway a chance, keep your hope up, because the chance might be very slim. I would say you might want to have plan B, because I knew people who have 2 failure on cs matched, but they have std +1 on Step 1 and ck. There is always hope, try every year but at the same time work too