Need some good advice please.

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FirstMANdown

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Dear to whom it may concern,

What does one do who is a US medical grade in 2005" Had barley passing USMLE Step 1 and 2 scores after 2 attempts each, had 8 months of residency experience in family medicine which went bad but, want to continue with family medicine. I am currently studying to take and hopefully pass step 3 in March.

I have good clinical skill and great professionalism with patients and co-workers alike. I am a bi-racial African American and have not been getting any luck with ERAS 2008. I had 4 interviews total out of 78 total programs applied too. The interviews I had, letters state "you make a great resident", "I would be great to work with you", "we will give your application serious attention"...etc but when it came to 2nd look all but one suggested it would be a waste of my time(meaning, not going to be ranked).

I am 38 years of age, married with two wonderful daughters. It has taken me years to get to this point. Do I walk away from it all and start a new career or keep trying? I was considering about applying to a Canadian family residency program.

I love medicine, and it has always been a dream of mine to engage in patient care as a practicing physician. However, I am very disenchanted about the politics involved in medicine just to find a program that would have been relatively easy to get into 20 years ago. What the hell do I do?????:boom:
 
Dear to whom it may concern,

What does one do who is a US medical grade in 2005" Had barley passing USMLE Step 1 and 2 scores after 2 attempts each, had 8 months of residency experience in family medicine which went bad but, want to continue with family medicine. I am currently studying to take and hopefully pass step 3 in March.

I have good clinical skill and great professionalism with patients and co-workers alike. I am a bi-racial African American and have not been getting any luck with ERAS 2008. I had 4 interviews total out of 78 total programs applied too. The interviews I had, letters state "you make a great resident", "I would be great to work with you", "we will give your application serious attention"...etc but when it came to 2nd look all but one suggested it would be a waste of my time(meaning, not going to be ranked).

I am 38 years of age, married with two wonderful daughters. It has taken me years to get to this point. Do I walk away from it all and start a new career or keep trying? I was considering about applying to a Canadian family residency program.

I love medicine, and it has always been a dream of mine to engage in patient care as a practicing physician. However, I am very disenchanted about the politics involved in medicine just to find a program that would have been relatively easy to get into 20 years ago. What the hell do I do?????:boom:

You have some issues that need to be addressed separately and then put in context of what you need to do to get back into residency:

  • USMLE Step I & Step II
  • Leaving your former residency program
  • Everything else

USMLE Step I and Step II
Since you are interested in Family Medicine, most programs are happy that you have passing scores on these exams. The very competitive programs will be interested in more that just a pass but there are plenty of programs out there that will not fill and will be looking to pick up solid clinical performers who can get the job done.

Possible Scramble this year
Your biggest problem is that you may have to Scramble. If this turns out to be the case, you need to be sure that you understand all of the implications of this and get yourself back to your medical school (where you can be close to several fax machines and your Dean) where you can get someone to advocate for you (one of the faculty members assigned to the Scramble can do this). You don't want to do this from your home because you won't have the resources to get your material out to programs quickly.

Also keep in mind that many places will use ERAS for the Scramble so being in your Dean's office; near a computer with a fast connection will be a good option for you. Loads of time, programs that don't fill will call Deans' offices looking for candidates. A good friend of mine ended up in Internal Medicine at Tuft's because the Dean made a phone call for her. She did very well.

Leaving your previous program
I am certain that ERAS required you to list your former program director. If you left under less than amicable terms, then you need to find some way to make sure that this person isn't "black-balling" you. If programs who wanted to potentially interview, called your previous program, then your previous PD needs to not be giving you a bad recommendation. Make sure that this isn't the case. You may need to request a meeting and come to some amicable terms as sometimes residency programs and residents are just not a good fit. If this was the case, your PD needs to be in support of you moving on with your career and not keeping you out of medicine. Only you know why "things went badly" with your previous program. Get "things" resolved and move on.

Other things
Being biracial is a non-issue. Race isn't a factor one way or the other in terms of getting into a residency program. Program directors want solid candidates that can do a good job in training and get the job done in terms of performance in residency programs.

If you take Step III, you need to pass Step III on the first try. If you are not ready for this exam, put it off and don't take it. You can't afford not to pass so make sure that you are doing everything possible to pass.

You had four interviews so potentially, you could match at those four programs depending on how they rank you and how you rank them. Second-looks are not crucial to the match unless you need additional experience that you were not able to get on interview day. Most people match without a second-look.

Just by what you have said in terms of "politics", I think that your former program is killing you. You need to work things out with them or at least have an attending (preferably someone who is well-known in your field) be willing to call or e-mail the PDs of the places that you interviewed and explain the circumstances of your leaving your former program. In short, they need to be willing to do some "damage-control" for you. See if you can contact someone who is willing to do this for you.

Every residency faculty member or program director wants the best people who show evidence that they can get through the residency program and practice medicine with a high level of competency including passing specialty boards. You have your performance on the previous USMLE Steps that might cause a PD to be hesitant about hiring you and you have a previous residency program where you had a "bad" experience. If you look at things from their point of view, these things coupled together may indicate "bad risk" and that is why you are having difficulty.

As for attempting to go to Canada, I don't know anything about the Canadian system. Perhaps this is a viable route for you if you don't get back into a residency program. Other things might be health policy or getting your permanent license and working with a physician and doing an excellent job for a year. After that, this person may be able to vouch for you in terms of your clinical abilities and patient-care abilities. You don't want to take too long because many residency programs will not consider you once you have been out of medical school more than four years.

Good luck with your quest. You may also want to look into legal counsel in terms of making sure that your former program did not violate your rights in terms you leaving that program. Sometimes, if proper procedures were not followed, you may have grounds for monetary compensation which can be a positive for you in terms of proving that your previous program was wrong to let you go. I don't know the details of your previous employment (and a public message board is not the place to discuss them) but this may be an option that you want to explore.
 
Thanks NJBMD for the helpfull and detailed reply. It believe that this is very helpfull. Also I am happy to say that I will very likly match in a Prelim IM position. At least I have work for 12 months more and can put the past behind me.

👍
 
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