Options for students with multiple failures

[VerbaLatina]

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What are the options for US MD grads with multiple failures (failed step 1 twice, or had to repeat a year and failed step 1 once, or failed multiple clerkships, etc) who don't match? In other words, what can you do with an MD without a residency, or what alternative paths are there to practicing clinical medicine for a student with a poor academic record? I've done a thorough search on this but most of what I found is either very old (before the increasing shortage of residency spots) or for people who had decent grades but just didn't want to practice medicine.

Some options that come to mind if the student is set on a clinical career:
-pursuing a foreign residency with the intention of remaining in that country permanently
-transitional year followed by preventive medicine residency (how does this work exactly, and how competitive is it?)

If the student is ok with not doing anything clinical (does the MD help at all or is the student better off cutting their losses and withdrawing after failing a couple things because they would be just as capable of getting these jobs without the MD?):
-something in the pharmaceutical industry
-something in the law field
-getting an MBA or MPH to increase job prospects

 

[evilbooyaa]

Even with multiple failures, you should be able to get into a malignant FM program.

 

[VerbaLatina]

Even with multiple failures, you should be able to get into a malignant FM program.

Maybe. Right or wrong, the school wants to dismiss these students because they are under the impression that the students have 0% chance of getting any residency, even the least competitive ones. Being able to say there are other options for people with MD degrees and it's only fair to pass a student if they successfully remediate everything in a reasonable amount of time might be the only argument one could make.

 

[Wordead]

Maybe. Right or wrong, the school wants to dismiss these students because they are under the impression that the students have 0% chance of getting any residency, even the least competitive ones. Being able to say there are other options for people with MD degrees and it's only fair to pass a student if they successfully remediate everything in a reasonable amount of time might be the only argument one could make.

Edit: never mind

 

[SouthernSurgeon]

Maybe. Right or wrong, the school wants to dismiss these students because they are under the impression that the students have 0% chance of getting any residency, even the least competitive ones. Being able to say there are other options for people with MD degrees and it's only fair to pass a student if they successfully remediate everything in a reasonable amount of time might be the only argument one could make.

I don't really agree with any of this.

Schools shouldn't be, and at least from my experience, aren't in the business of prognosticating about a student's residency chances as a metric to graduate them or not. Well maybe the caribbean schools, but that's an entirely different can of worms.

Schools should be graduating students that they believe have met the standards and competencies required of a physician. Future career paths should not be a part of the conversation.

 

[thefritz]

I don't really agree with any of this.

Schools shouldn't be, and at least from my experience, aren't in the business of prognosticating about a student's residency chances as a metric to graduate them or not. Well maybe the caribbean schools, but that's an entirely different can of worms.

Schools should be graduating students that they believe have met the standards and competencies required of a physician. Future career paths should not be a part of the conversation.

I agree with this 100%. If you have a 190 step 1 and want to apply for derm, your dean isn't going to stop you. Med students seem to always think the school has their back. The reality is the school is a robot that will advance or fail you based on strict compliance with their policies. People get kicked out of school for technicalities and students are allowed to apply for residencies they have very little chance of matching to. The school is a machine. It does not want anything besides maintaining accreditation and every decision and policy is centered around its ability to maintain accreditation.

So what do you do with an MD and no residency? Whatever you want. This is America. To make a good living, you need a skill that is of value to someone. To use medical skills requires state license. You can no longer do this, but there are myriad other skills you can obtain that are not as regulated, if at all. Until you obtain a skill of value, you are stuck with low paying jobs for unskilled labor. You may be able to slide into an entry level office job using your college degree, but you would have to spin your time at med school so you don't come off as a failure. Entry level jobs are just one way to obtain valuable skills. You can also obtain valuable skills through the military. Or through apprenticeships. Or through trade/vocational school. Or through professional school if you really are a glutton for punishment and debt. I'm sure dental, law, pharm, business, PT, whatever school would take an MD.

 

[swamprat]

I agree with this 100%. If you have a 190 step 1 and want to apply for derm, your dean isn't going to stop you. Med students seem to always think the school has their back. The reality is the school is a robot that will advance or fail you based on strict compliance with their policies. People get kicked out of school for technicalities and students are allowed to apply for residencies they have very little chance of matching to. The school is a machine. It does not want anything besides maintaining accreditation and every decision and policy is centered around its ability to maintain accreditation.
.

At my school they actually ask and have you fill out forms at different times stating what you are going into and how many interviews you have etc. I hear that if your number is low they will contact you to discuss back up options. So yeah they won't stop you from applying but they do want people to match and have a job. I think it probably looks poorly on the school to have a high no match rate.

 

[SouthernSurgeon]

At my school they actually ask and have you fill out forms at different times stating what you are going into and how many interviews you have etc. I hear that if your number is low they will contact you to discuss back up options. So yeah they won't stop you from applying but they do want people to match and have a job. I think it probably looks poorly on the school to have a high no match rate.

98% of the time or so, a school's interest and the students' interests align. Giving sound career advice and keeping tabs on how your application process is going helps you match and helps the school look better.

 

[VerbaLatina]

98% of the time or so, a school's interest and the students' interests align. Giving sound career advice and keeping tabs on how your application process is going helps you match and helps the school look better.

Most of the time, yes. But they're not miracle workers. Some students really do have almost no chance of matching. From what I've seen, students will always go for it as long as they are given the option, even though they are taking a huge financial risk. I can't blame them; if they always wanted to be a doctor and they worked so hard to get as far as they had, they aren't going to give up easily. This is one situation when the "follow your dreams, you never know until you try" might not be the best advice for everyone. It's in the school's best interest to dismiss students with poor records because the school wants to have a high match rate, and they can justify it by saying that it would be a disservice to allow a student to waste their money on a degree that won't benefit them in any way. On the other hand, I get the argument that students should be able to make the choice about whether they want to take the risk.

I think, anyway. I haven't actually seen any hard evidence on the match rate for people with multiple failures, so maybe the situation isn't as bad as it seems. All I can go off of is the knowledge that a growing number of students are not matching and program directors who say, "I would never interview someone with these stats."

 

[evilbooyaa]

Most of the time, yes. But they're not miracle workers. Some students really do have almost no chance of matching. From what I've seen, students will always go for it as long as they are given the option, even though they are taking a huge financial risk. I can't blame them; if they always wanted to be a doctor and they worked so hard to get as far as they had, they aren't going to give up easily. This is one situation when the "follow your dreams, you never know until you try" might not be the best advice for everyone. It's in the school's best interest to dismiss students with poor records because the school wants to have a high match rate, and they can justify it by saying that it would be a disservice to allow a student to waste their money on a degree that won't benefit them in any way. On the other hand, I get the argument that students should be able to make the choice about whether they want to take the risk.

I think, anyway. I haven't actually seen any hard evidence on the match rate for people with multiple failures, so maybe the situation isn't as bad as it seems. All I can go off of is the knowledge that a growing number of students are not matching and program directors who say, "I would never interview someone with these stats."

You and fritz have a similarly pessimistic view of the situation.

Med Schools monitor your specialty choice (and how it corresponds with your stats) like doxycycline said. They won't stop the 190 Step 1 person from applying to Derm, but they will heavily recommend that the student have some back-up options. It's not the school's fault if the student is stubborn and isn't willing to listen.

It is NOT within "the school's best interest to dismiss students with poor records" because you can easily look up the attrition rate of any medical school. If a US MD school has an attrition rate of > 10-15% I'd run away in terror. I believe most US MD schools have a graduation rate of 95%+

What you're saying about a school kicking out students to have a high match rate applies to the Carribbean, where students are either kicked out (or prevented from applying to ERAS) so the school can boast a certain match percentage. That doesn't happen, per my knowledge, in US schools.

Anyway, we're getting off-topic. To answer your OP:

Some options that come to mind if the student is set on a clinical career:
1)pursuing a foreign residency with the intention of remaining in that country permanently
2)transitional year followed by preventive medicine residency (how does this work exactly, and how competitive is it?)

If the student is ok with not doing anything clinical (does the MD help at all or is the student better off cutting their losses and withdrawing after failing a couple things because they would be just as capable of getting these jobs without the MD?):
3)something in the pharmaceutical industry
4)something in the law field
5)getting an MBA or MPH to increase job prospects

1) No.
2) Probably not a TY (as those are pretty competitive) but rather a pre-lim year in IM or Surg. If you manage to get that, you can practice at an urgent care in certain states (1 year of education + Step 3 is enough to get you licensed in some areas without being board eligible). I don't have info about the preventative medicine residency.
3) Possibly. Not sure if it's required to be residency trained. I've heard these spots are relatively competitive.
4) Possibly as a consultant. Some people are MD/JDs and are likely malpractice lawyers.
5) Won't really help get you a residency. A MBA might get you consulting for a business, but again, these spots are competitive.

 

[dsm5md]

"During his clinical rotations at the Boston City Hospital, Crichton grew disenchanted with the culture there, which appeared to emphasize the interests and reputations of doctors over the interests of patients.[12] Crichton graduated from Harvard, obtaining anM.D. in 1969,[17] and undertook a post-doctoral fellowship study at the Salk Institute for Biological Studies in La Jolla, California, from 1969 to 1970.[citation needed] He never obtained a license to practice medicine, devoting himself to his writing career instead."

http://en.wikipedia.org/wiki/Michael_Crichton