need to match, please help!

[img1993]

Hi everyone!, SUPER LONG POST AHEAD, SORRY!
I am an IMG(graduated in 2019), I am a US Permanent Resident with TWO FAILED attempts on Step 1, passed on my third attempt last year. I finished my OET too. I am currently preparing for Step 2, my recent NBME 9 was 231. I am planning on taking Step 2 end of next month hopefully bump my score a bit higher by then. I want to apply for Residency this year in September.
I have those two major red flags, I know its super hard to match but I am determined to at least try my best. The reason for my gap and failed attempts was basically I had to move back to India during COVID for family and had to stay back, I got married and then got pregnant. I took my exam 2 months Postpartum and it was chaotic. I was not at the right mental or physical state for it, I was pumping during break time since I was breast feeding my baby. I ended up taking it since my eligibility period was ending and I just wanted to get it done with.
I know I messed up, but now I want to try to see if I even have a chance. I previously did two rotations back when I was a student in 2018-2019, but I know they wont be valid now. I plan on doing 3 clinical rotations through a paid IMG rotations program, since its hard for IMG to get rotations directly.
I know Family Medicine or Internal is the best option to try. The question I have is, is it better to do all 3 rotations in Internal Medicine or Family Medicine? or Should I do 2 Internal Medicine and 1 in Family Medicine. The closest chance I have for matching would be in FM or IM. So please advice on which rotations are better in matching and how I can improve my chances in matching, literally any advice regarding this whole process is super helpful. I am also volunteering at few places like Hospice, other non profit organizations. I tried applying for research but didn’t go further with it since I have to move to another state for a year and I can’t do that with my baby who is 17 months now. I really am trying now to clean up my mess, please be kind and give any advice regarding my situation.

THANK YOU! I REALLY APPRECIATE YOU FOR TAKING TIME TO READ AND COMMENT!!

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[voxveritatisetlucis]

I’m sorry but a U.S. residency is likely out of the question at this point and putting more effort into it would be misguided as it could be used to pursue another career option

 

[theoceanman]

By failing Step 1 twice, then proceeding to have a potential Step 2 score that isn’t a “wow factor”, you’ll get screened out of most residency programs, including rural ones. Your best bet is to apply for a transitional year and potentially land an FM spot afterwards, but even then, I don’t think landing a US residency will be very likely nor in your favor. The odds are heavily stacked against you and you’re probably better off pursuing a residency program elsewhere that isn’t as competitive or looking into another career option with your MD.

Extra research and volunteering relatively only helps someone who is a US MD/DO graduate trying to match into a more competitive specialty, not typically someone that’s failed Step 1 twice. If you can’t move to another state to do research, what are the odds you can’t move to another state for residency? Overall, given the timeline of the time you graduated since medical school to now, which has been 4 years, along with the red flags and being an IMG, you probably won’t be able to match into any residency in the US. As stated earlier, I would say you should look into another career choice with your MD as you most likely won’t make it very far now.

 

[gyngyn]

Your best bet is to apply for a transitional year and potentially land an FM spot afterwards,

Transitional years can be quite competitive as all of the folks that need a first year (but don't want to do a surg pre-lim) scoop them up.

 

[gyngyn]

I am an IMG(graduated in 2019),

Year of Graduation (YOG) is a common filter for program directors.
The combination of IMG, YOG, and multiple Step failures is a powerful trifecta.
The companies that sell rotations to IMG's can be untruthful with regard to expected outcomes.

To your question, if you are to have any chance at all, you will need to find some form of legitimate US clinical experience, and then apply to every one of the absolute worst FM, IM and EM residencies. Sadly, as you have not begun USCE, your YOG will be delayed at least another year, making success even less likely.

 

[GoSpursGo]

I hate to be so negative, but I agree with above—between YOG, IMG and multiple step failures (plus the fact that you haven’t taken step 3 which many IMGs will take), you are very unlikely to match. You are simply going to get outcompeted by US grads and IMGs with fewer red flags.

The only possibility that I might entertain is leveraging your permanent resident status, get into some clinical research position associated with a med school, ingratiate yourself with the FM program and convince them to give you a chance. Otherwise, without connections I just don’t see how you would get selected from among random applicants through ERAS. And everyone is trying to make these kinds of connections, so there is no good advice for how to find such an opportunity other than being in the right place at the right time.

 

[LunaOri]

Getting a good research position for a year or two, plus excelling on Step 2, might get you a look at a low-tier pathology program. Not guaranteed, though.

 

[NotAProgDirector]

It's clear you are in a tough spot. You're at high risk of not getting a spot. But, at this point, it's probably worth moving ahead and trying for one cycle. You'll need to take S2 and see what your score is. If you can really get in the 230's, that's not amazing but is a solid score. Looks like step exams are $1000 for IMG's, even if you take it in the US. Then there's the cost of the rotations. Then there will be ERAS fees, which could easily be another $1000-2000.

Unclear whether the IMG rotations are worth it. They are often just in some private doc's office. If you have US experience from medical school, especially if it was at a place with residents, that's a positive. But more US experience can't hurt.

Only you can decide whether this is "worth it" or not. You'll need to apply to community programs in unpopular places. You'll need to be comfortable moving anywhere. If that's not acceptable, you might as well stop now.

Seems worth taking S2 for $1000 and seeing your score. Fail it, or get a just barely passing score, and you're likely at a dead end. Get a solid score, and there's some chance of success if you apply broadly. Good chance of getting nothing, so you'll need to weigh the cost in $$ and time.