Out of practice D.O. seeking advice... please help.

[deleted542994]

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Hello everyone.

I am writing this post to receive help in regards to my current situation. I would really appreciate any sincere advice. Basically I am trying to explore the available possible options for me to get into a residency program.

A little background information about myself.

I graduated from a D.O. school in 2009 with a good standing. After that I applied for the 'Match' and could not get in and had to scramble for a Traditional Rotation Internship in an osteopathic medical program.

Unfortunately, due to personal circumstances I had performance issues during the residency training and signed a mutal release from the program.

After that as luck would have it, I got married and had a baby and again resumed residency training, thinking that I would be ready to face the challenge. This time it was an osteopathic internal medicine program. However, I was unable to get through the first year - due to performance issues caused by anxieties and stresses in my personal life.
Since that I have take a lot of time off and again tried for the third time to enter the match process for the year 2013. But however that was not at all successful as I received very few interviews (presumly owning to my 'undesirable' background).

But I am still determined to get into a training program as now I have a family to support and have the strong desire to meaningfully engage my life in patientcare and medical training.

I have passed both the USMLE Steps 1 & 2 and also COMLEX Levels 1 & 2CE/PE, addtionally I have an experience of about 15 months (albeit uncontiguously) from both the residencies.

USMLE Step 1 - 212/88 USMLE Step 2 - 182/78
COMLEX Level 1- 511/83 COMLEX Level 2 - 450/78

My aim to get into training again was to enroll myself into a MPH program where I could do some research activities - do some publications and also receive fresh references - on the basis of which I can make my resume stronger for re-application to the match.

My areas of interest are IM, FM, or PM&R.

I would really appreciate sincere, non-judgemental, and open advice as to how to proceed further. Your suggestions are welcome.

Thank you and God bless! 🙂

 

[BADMD]

I am going to be honest with you and I'm not going to tell you what you want to hear:

I don't think you will be able to secure a third residency position, no matter what you do.

Lets look at the situation: A DO candidate with a barely passing score on Step II and Comlex II (confirming each other), who graduated in 2009. In a 2014 match, that is basically 2 and 1/2 strikes. Now add that you have been unable to complete an intern year twice.

I'm sorry, but you are basically done. A program would have to be extremely desperate to fill in order to take a risk on you. You have twice been dropped for poor performance and your medical knowledge is increasingly out of date. I would strongly suggest you look for an alternate career path. I'm afraid you are going to spend several years and a significant amount of money and be in the same position.

If you are absolutely, positively 100% going to try this, the first thing you need is to take Step III and do extremely well. You need to show objective change. Of note, I'm assuming you took Step I/Comlex I in 2007, so you are approaching the soft 7 year limit that some states enforce.

You can try doing research, but it can't just be any research. You have to target who you are doing it with. You need to do it with someone who has influence in a residency program that is not too competitive and that you are willing to take. You basically need that person to swear to the residency director that you are much improved and aren't going to have academic and performance issue, like before.

I don't think an MPH is going to help you get into residency. I also don't think any non-clinical faculty references or letters of recommendation are going to get you into residency. You will need to present direct evidence that your past issues are truly past.

Again, I ultimately think you will not be successful in obtaining a new training program. You should still take Step III. You may want to get an MPH and consider that as a related field, but I don't think that degree will be a path to residency.

 

[survivordo]

As BadMD suggests this is going to be a tough (?impossible) road. It is not just that you dropped once, but TWICE is the killer. This shows repetition.

Your post screams of excuses. There are many people who experience severe personal issues during residency (divorce, death, sickness etc.), but most still make it. I really think it is time to own up that you just couldn't make it and put some of the onus on yourself. Once you stop blaming "external" circumstances I think you can begin to move on. Honestly, you should probably start looking into alternate ways to use your degree.

 

[vistaril]

Hello everyone.

I am writing this post to receive help in regards to my current situation. I would really appreciate any sincere advice. Basically I am trying to explore the available possible options for me to get into a residency program.

A little background information about myself.

I graduated from a D.O. school in 2009 with a good standing. After that I applied for the 'Match' and could not get in and had to scramble for a Traditional Rotation Internship in an osteopathic medical program.

Unfortunately, due to personal circumstances I had performance issues during the residency training and signed a mutal release from the program.

After that as luck would have it, I got married and had a baby and again resumed residency training, thinking that I would be ready to face the challenge. This time it was an osteopathic internal medicine program. However, I was unable to get through the first year - due to performance issues caused by anxieties and stresses in my personal life.
Since that I have take a lot of time off and again tried for the third time to enter the match process for the year 2013. But however that was not at all successful as I received very few interviews (presumly owning to my 'undesirable' background).

But I am still determined to get into a training program as now I have a family to support and have the strong desire to meaningfully engage my life in patientcare and medical training.

I have passed both the USMLE Steps 1 & 2 and also COMLEX Levels 1 & 2CE/PE, addtionally I have an experience of about 15 months (albeit uncontiguously) from both the residencies.

USMLE Step 1 - 212/88 USMLE Step 2 - 182/78
COMLEX Level 1- 511/83 COMLEX Level 2 - 450/78

My aim to get into training again was to enroll myself into a MPH program where I could do some research activities - do some publications and also receive fresh references - on the basis of which I can make my resume stronger for re-application to the match.

My areas of interest are IM, FM, or PM&R.

I would really appreciate sincere, non-judgemental, and open advice as to how to proceed further. Your suggestions are welcome.

Thank you and God bless! 🙂

barring some rasputin-like ability to get in with a pd or associate pd, I don't see any way you match.

One suggestion that may be helpful- it appears your previous clinical failures were in transitional year and IM. So I wouldn't reapply to family medicine(like a ty) or IM again. What is an fm/im pd supposed to think if he sees someone with two failures in the same field basically trying for a third time?

I still don't think you will match, but I would shoot for psychiatry. It's much less stressful/less acute than IM. And at least a psych pd would be able to say "yeah, he failed twice in im/fm but psych is different". It's also one of the most noncompetitive specialties.

If I were you I would try to line up observerships at a couple of very noncompetitive psych programs that has a hx of taking candidates with red flags, and then on those observerships just impress the hell out of key attendings.

 

[Gastrapathy]

Your best shot is back with one of the programs that took you before. Talk to the PD and explain what happened. See if he would let you do an observership or two to prove you can handle the load. Hard to see any other program taking the risk. Also, I think you should ask yourself whether you want to do this and are capable of doing it. You might consider applying to a medical informatics type company and working on EMR development or some other nonclinical job.

 

[umean2tellme]

How did you explain the circumstances that led to your previous intern year issues on your recent interviews? Any program that interviews you wouldn't want to hear some vague response to the question "Why did you have issues in your previous programs?" If you go into new interviews blaming everything but yourself then you'll never get another spot.

Another thing are your test scores. With a 212 Step 1 and a 182 Step 2 You aren't competitive at all for 99% of MD residencies. I believe the passing score for USMLE Step 2 now is 196, so although you may have had a minimum passing score when you took it when they see your score now you'll look that much worse. You should probably stop applying for the Match and focus on DO spots.

I agree with what everyone else said about taking Step 3 to show that you at least have the knowledge necessary to do well clinically. Get some observerships and target the programs that you do them at. Don't try to do an observership at a place that wouldn't offer you an interview. Try and find which programs didn't fill and apply to all of those. IF you want to do research target places you have a chance at and get in with the PD or someone important there that can vouch for you. Doing an MPH and getting a few random pubs won't be of much help.

At the end of the day, like someone else has said, you really need to make sure you want to continue down this path. It's already been expensive and will only be more expensive since you will have to apply to hundreds of programs in the next cycle. Plus you have already failed at intern year twice. What if another "situation" arises next year? Will you fail again? Have you dealt with the issues that have held you back in the past? Considering alternate careers may be an option that you should consider, preferably something that utilizes your degree. Good luck.

 

[vistaril]

How did you explain the circumstances that led to your previous intern year issues on your recent interviews? Any program that interviews you wouldn't want to hear some vague response to the question "Why did you have issues in your previous programs?" If you go into new interviews blaming everything but yourself then you'll never get another spot.

Another thing are your test scores. With a 212 Step 1 and a 182 Step 2 You aren't competitive at all for 99% of MD residencies.QUOTE]

well in the context of his application(already washed out of 2 programs), this is true. But in general a DO grad with a 212 step 1 and a barely passing step 2(if they were average in every other way) would most certainly be competitive for a good number of allo residencies in some fields. There are large numbers of family medicine, some smaller IM programs, psych, some neuro, and perhaps even some peds programs that would give an otherwise average DO person a look with those low scores.

Of course, as we know the OP is not an average DO candidate in ways other than his step scores though.....

 

[deleted542994]

Well thanks everyone for your replies..

I know it will be very hard for me to get into IM/FM residency again in my third attempt.. But at the same time I don't want to waste my Degree like this..

I suffered from depression, stress and anxiety issues in the past years due to some family circumstances and I was on Antidepressants during my training..that's why I couldn't perform well.

As for now I am not taking any medicines and my family conditions are way better than before...

No one gonna understand my situation coz of so many red flags.. That's why I posted over here to know what are my chances to get into Residency program again... If IM/FM are not for me then what other residencies/ fields I can go for..

Psych is good but again I don't want to deal with psych and depressed people all through my life.

What are the chances of Anatomy/ Pathology, Neurology and Preventative Medicine?

Please suggest..
Thanks..

 

[deleted542994]

Your best shot is back with one of the programs that took you before. Talk to the PD and explain what happened. See if he would let you do an observership or two to prove you can handle the load. Hard to see any other program taking the risk. Also, I think you should ask yourself whether you want to do this and are capable of doing it. You might consider applying to a medical informatics type company and working on EMR development or some other nonclinical job.

Thanks for your positive response.. I appreciate your reply..

 

[vistaril]

Well thanks everyone for your replies..

I know it will be very hard for me to get into IM/FM residency again in my third attempt.. But at the same time I don't want to waste my Degree like this..

I suffered from depression, stress and anxiety issues in the past years due to some family circumstances and I was on Antidepressants during my training..that's why I couldn't perform well.

As for now I am not taking any medicines and my family conditions are way better than before...

No one gonna understand my situation coz of so many red flags.. That's why I posted over here to know what are my chances to get into Residency program again... If IM/FM are not for me then what other residencies/ fields I can go for..

Psych is good but again I don't want to deal with psych and depressed people all through my life.

What are the chances of Anatomy/ Pathology, Neurology and Preventative Medicine?

Please suggest..
Thanks..

To answer your question- although path and neuro by some metrics are two of the least competitive specialties(especially path), I don't think they are great fits for your specific deficiencies. For one, path's average step scores are actually fairly decent(like 228 I think) and that is probably because in path 'book learnin' is valued by the programs more than in similarly noncompetitive fields. Neurology and path are also two of the most research heavy fields. My guess is a lot of very marginal candidates improve their applications through research in these fields. So I just don't think path in particular is a good fit for your weaknesses.

I can't answer your question on preventative medicine...I know nothing about it. I actually thought that would be like a 1 year fellowship rather than a residency.

Also, and you didn't ask for this bit of advice but Im going to throw it out there- you have to find a new 'excuse' for why you did not complete intern years on two separate occasions. Saying 'I had family issues' and 'I was on antidepressants(????)' is just not something that is going to really get it done there.

I really think psych is your best chance if you worked really hard to gain some experience through observerships there and stood out for a month as a cool guy to be around. I know it's not want you want to do, but if it came down to doing psych vs doing something completely outside of medicine(at least to the point of something requiring a DO/MD), which would be preferable....to do psych or do nothing? Lots of people don't get what they want....sometimes that is better than nothing though.

 

[vistaril]

Your best shot is back with one of the programs that took you before. Talk to the PD and explain what happened. .

the problem with this thoough is that it is a near certainty that he has already talked to the PD and there has already been a discussion about what happened.....If he got fired from these programs, it's not like the programs didn't have meetings and discussions with him about what was going on before telling him he was fired.

I really think the programs that took him before would be even less likely than other noncompetitive programs to take him.

 

[deleted480308]

Ditto to finding a new explanation. I'm a hiring manager and you can't come into my office and say, "I got fired in 6 months twice because of personal issues and a medical condition". Why would I sign up someone who couldn't cut it twice and then isn't even owning up their issues.

"Due to my own immaturity and inexperience at dealing with the pressures of adult life with a family, I allowed problems at home to interfere with my professional performance. I did not see it at the time but that was my fault and no one else's. Due to my personal failures I have been forced to reevaluate some things. I have learned more about my medical conditions and how treat them with the seriousness they deserve so that their effects do not creep into my professional life. I have also learned over the years how to separate the personal stresses at home and not bring them into my work in an unprofessional manner. I realize that I am responsible for my past, it is my hope to begin proving that I have the capacity to have a future in medicine and I would greatly appreciate an opportunity to do so here...."


Also, be prepared to answer exactly what got you fired. Were you stressed and getting rude with people? Did you come in late or "no show" or go argue on the phone with your spouse on shift? Did you just not know what diseases were what? "I was depressed" is not a reason you got fired, it's a personal excuse for you doing some things that got you fired. This self examination stinks but you need to do it. Also call your old PDs and mend any fences or bury any hatchets...ask them what you need to change about you. This might hurt a bit but you need them to say nice things when other programs call, even if the nicest thing they say is "he's not great but he's trying hard and is a nice guy". On a side note, you said you aren't on meds now. You don't need to respond to this on a forum but if you are off meds because a doctor said you don't need them, good. If you are off meds because you decided you can be off them.....go back to your doctor and do what they say. Don't be the person that keeps telling themself they are fine and selfmanaging off their meds.

 

[NotAProgDirector]

Several thoughts:

I agree that your chances are not good. You definitely need a plan B. But, your chances get worse the more time that passes, soif you're going to re-apply, the time to do it is now. An MPH or "research" is unlikely to help, since they don't clear address your prior problems.

As mentioned above, psych is a reasonable option. The skill set in psych is different than that in IM, so programs might be more willing to overlook prior problems. You might also get ~6 months of credit for your IM rotations already completed, so all you'd have is 6 months of PGY-1 psych to complete to finish your PGY-1 year. Whether or not to give you credit for your prior rotations would be up to your psych PD (and with unsatisfactory completion, that's questionable). But it would allow you to apply for off cycle positions.

PM&R is another option. Again, a different skill set than IM. PM&R requires 12 months of prelim IM first, and again ? if you'd be able to get credit for that with your 15 months of completed residency. Again, it appears that the PM&R PD must be willing to give you this credit and get approval from the ABPMR.

Neurology also requires a prelim year. They are much more strict about what can and can't be in the year.

So, bottom line, I think PM&R is probably your best choice. Looking for off cycle spots (i.e. positions for July 2014 which should have filled in the 2013 match) is a good idea. 2014 starts should also be in next year's match as "R" positions. The same plan for psych and neuro is reasonable.

As a US grad with >12 months of experience, you MIGHT be able to get a license. I could imagine that the board would see two unsuuccessful residencies totalling more than 12 months not equalling 12 months of clinical experience. Having a license would make getting clinical experience much easier, in fact you might be able to actually get a job. Certainly worth exploring.

 

[vistaril]

Several thoughts:

I agree that your chances are not good. You definitely need a plan B. But, your chances get worse the more time that passes, soif you're going to re-apply, the time to do it is now. An MPH or "research" is unlikely to help, since they don't clear address your prior problems.

As mentioned above, psych is a reasonable option. The skill set in psych is different than that in IM, so programs might be more willing to overlook prior problems. You might also get ~6 months of credit for your IM rotations already completed, so all you'd have is 6 months of PGY-1 psych to complete to finish your PGY-1 year. Whether or not to give you credit for your prior rotations would be up to your psych PD (and with unsatisfactory completion, that's questionable). But it would allow you to apply for off cycle positions.

PM&R is another option. Again, a different skill set than IM. PM&R requires 12 months of prelim IM first, and again ? if you'd be able to get credit for that with your 15 months of completed residency. Again, it appears that the PM&R PD must be willing to give you this credit and get approval from the ABPMR.

Neurology also requires a prelim year. They are much more strict about what can and can't be in the year.

So, bottom line, I think PM&R is probably your best choice. Looking for off cycle spots (i.e. positions for July 2014 which should have filled in the 2013 match) is a good idea. 2014 starts should also be in next year's match as "R" positions. The same plan for psych and neuro is reasonable.

As a US grad with >12 months of experience, you MIGHT be able to get a license. I could imagine that the board would see two unsuuccessful residencies totalling more than 12 months not equalling 12 months of clinical experience. Having a license would make getting clinical experience much easier, in fact you might be able to actually get a job. Certainly worth exploring.

I think the problem for pm&R in the OP's case is that he has pretty conclusively shown he is either not very good or completely incapable of performing the duties of an intern/resident. Is pm&r different than IM or a TY? Sure...but it's a heck of a lot more similar on a day to day basis than something like psych or path. Also, if you match into a pm&r or neuro residency, you've still got to do a year of IM or a transitional year, which has already been attempted twice. PDs from these specialties are going to rightfully question the OP's ability to even get into the pgy-2 year. And I think it is highly unlikely he would get credit for his intern year in either of these by combining partial years of two intern years he failed out of. In fact I would say there is zero chance of this.

In psych, you don't have a normal ty. You have 6 months off service, and programs can to a point get sort of creative(for example maybe a couple of those 6 months could be easy outpatient months with little responsibility). A psych intern year is much much different in reality than a true TY or a prelim medicine year. And of course there is no off service time in path, although for reasons noted earlier path probably isn't the best fit with the op's low step 2 scores.

Also, although the numbers don't tell the whole story(but part of it), I think neuro or pm&r is a more difficult match in general than psych. If you are talking about matching somewhere/anywhere(which is clearly the goal here). Simply because there are so many more psych spots than neuro or pm&r slots.

I really think the OP has a less than 15-20% shot of matching pm&R or neuro in the next cycle. I think if he got down to business now and played his cards right, he could have a 55-65% chance of matching psych somewhere.

 

[DubVille]

I think the problem for pm&R in the OP's case is that he has pretty conclusively shown he is either not very good or completely incapable of performing the duties of an intern/resident. Is pm&r different than IM or a TY? Sure...but it's a heck of a lot more similar on a day to day basis than something like psych or path. Also, if you match into a pm&r or neuro residency, you've still got to do a year of IM or a transitional year, which has already been attempted twice. PDs from these specialties are going to rightfully question the OP's ability to eveno the pgy-2 year. And I think it is highly unlikely he would get credit for his intern year in either of these by combining partial years of two intern years he failed out of. In fact I would say there is zero chance of this.

In psych, you don't have a normal ty. You have 6 months off service, and programs can to a point get sort of creative(for example maybe a couple of those 6 months could be easy outpatient months with little responsibility). A psych intern year is much much different in reality than a true TY or a prelim medicine year. And of course there is no off service time in path, although for reasons noted earlier path probably isn't the best fit with the op's low step 2 scores.

Also, although the numbers don't tell the whole story(but part of it), I think neuro or pm&r is a more difficult match in general than psych. If you are talking about matching somewhere/anywhere(which is clearly the goal here). Simply because there are so many more psych spots than neuro or pm&r slots.

I really think the OP has a less than 15-20% shot of matching pm&R or neuro in the next cycle. I think if he got down to business now and played his cards right, he could have a 55-65% chance of matching psych somewhere.

Also pm&r had 1 unmatched pre-soap spot this year and a tiny number last year (may have been 0 actually). It isn't competitive by board scores, but I got the sense its no longer the Ortho backup/"lazy" specialty. My interviewers all were by far most interested in: why I wanted PMR. They mostly asked about how many months I rotated in PMR, when I found out about the field, my mentors, most memorable rehab patients, etc. It may now be difficult to convince them. If the OP could show extreme interest in the field, perhaps someone would give them a shot? It seems clear that based on unfilled spots its not really an easy "fallback" anymore. Good luck OP! I do wish you the best!

 

[Arthroscope]

Forget anything allo and focus on DO residencies.

Don't give up, despite some naysaying here, I think you owe it to yourself to give residency one last shot.

You CAN match Osteopathic FM. There are so many slots that are still unfilled after the match and scramble. Do not hesitate however, apply early, be ready to explain everything, and you should be able to prove you don't suffer from any anxiety issues etc anymore.

It's pretty important to have some credit for an internship, barring not completing a full residency, you might be able to do an MPH, PhD MBA etc etc and move into non-clinical work, or perhaps do rural medicine or urgent care or something as a GP, they do still exist albeit in a minimum fashion. Also, if you have an intern year done you can also do OMM as an outpatient, or consider doing a fellowship in omm etc.

if you have the stones for it, consider military as a possibility for landing a residency also.

 

[deleted480308]

Just thinking outside the box here....you willing to go foreign?

 

[Doctor Bagel]

In psych, you don't have a normal ty. You have 6 months off service, and programs can to a point get sort of creative(for example maybe a couple of those 6 months could be easy outpatient months with little responsibility). A psych intern year is much much different in reality than a true TY or a prelim medicine year. And of course there is no off service time in path, although for reasons noted earlier path probably isn't the best fit with the op's low step 2 scores.

But even in a psych internship, you're expected to show up on time, take good care of your patients and get along with other people, which I'm guessing are the primary things that cause interns to struggle in any field. My psych residency would not look at the OP for good reason. Of course his dismissal of psych patients (when in fact he is one) isn't particularly reassuring.

 

[vistaril]

But even in a psych internship, you're expected to show up on time, take good care of your patients and get along with other people, which I'm guessing are the primary things that cause interns to struggle in any field. My psych residency would not look at the OP for good reason. Of course his dismissal of psych patients (when in fact he is one) isn't particularly reassuring.

well of course not....I'm not saying the OP is a good candidate for psych. I'm saying that in a VERY FLAWED applicant with some giant red flags, psych may give hima better shot than anything else to have a job next year.

I would give him the same advice in reverse if he had already washed out of two psych programs, for example, and would suggest he maybe try path or something(ie another noncompetitive field he hadn't already failed at)

The point is that if a big problem(and I suspect it is) with the OP is lack of general medical knowledge and how to apply that in common clinical scenarios, he's going to do better in a psych intern year than a medicine intern year. That's common sense. That doesn't mean he is going to do well(or even ok) in psych.

Think of it like this- if a person is being forced to jump off a building onto concrete below, much better to do so from a 15 foot height than a 25 foot height. that doesnt mean either is completely safe.

 

[Doctor Bagel]

well of course not....I'm not saying the OP is a good candidate for psych. I'm saying that in a VERY FLAWED applicant with some giant red flags, psych may give hima better shot than anything else to have a job next year.

I would give him the same advice in reverse if he had already washed out of two psych programs, for example, and would suggest he maybe try path or something(ie another noncompetitive field he hadn't already failed at)

The point is that if a big problem(and I suspect it is) with the OP is lack of general medical knowledge and how to apply that in common clinical scenarios, he's going to do better in a psych intern year than a medicine intern year. That's common sense. That doesn't mean he is going to do well(or even ok) in psych.

Think of it like this- if a person is being forced to jump off a building onto concrete below, much better to do so from a 15 foot height than a 25 foot height. that doesnt mean either is completely safe.

I guess my thought is the clinical knowledge is very rarely ever the true problem with interns and residents who struggle. Interns aren't expected to showing up knowing much of anything. It's attitude, ability to learn and professionalism that are the true factors in intern success.

 

[vistaril]

I guess my thought is the clinical knowledge is very rarely ever the true problem with interns and residents who struggle. Interns aren't expected to showing up knowing much of anything. It's attitude, ability to learn and professionalism that are the true factors in intern success.

but those things you mention exist along a spectrum.......someone who is significantly below average(but not the worst in the world) with respect to professionalism, getting along with others, figuring out how to fit in with a role on a team, etc is much more likely to make it through their first year of residency if they are average clinically than someone with these same deficits who is very poor clinically.

I don't have any data, but just from hearing and seeing occasional examples I would guess that most people who fail to complete residency have a combination of the things you mention and a very poor clinically. If one knows pretty much nothing and yet is great with people and can figure out how to get by on wards/rounds by various methods, they'll probably be ok. And likewise if one is not 'with it' when it comes to attitude, working with others on the team, and other such things but is very solid clinically they will usually get by as well(as long as their interpersonal deficits arent in the bottom 1% or whatever). But combine significantly below average basic clinical abilities with below average interpersonal skills and sense of how to fit in with a team, and that makes a recipe for failure.

 

[cjw0918]

OP, I don't think the practice of medicine is for you. Residency training is stressful no matter what field, and one must be very committed to make it through. Your previous two failures to me do not show your lack of ability as much as they show your lack of committment. Do you REALLY want to practice medicine or just say you do??

During residency I went through a divorce (PGY-1), moved half way across the country to a new residency program (PGY-3), and underwent 6 months of chemotherapy for lymphoma (PGY-4). I still finished on time. But only because I REALLY wanted to.

Find something non-clinical with low stress and a flexible schedule to use your degree. I think you wil be happier. Good luck.

 

[shopsteward]

Some of the replies to the OP assume they are male. Try reading the OP's message again with the assumption they are female. I read the possibility of a woman who was doing OK until she allowed herself to be distracted in her first internship year by a bad boyfriend who turned into a bad husband, compounded by pregnancy and a baby to bring up.

If that is the case, and the OP is now out of that relationship, things may not be as hopeless as they look. Provided the OP is prepared not to be choosy, they may get back on track in a medical career.

First, think about going to a careers adviser or similar. Tell them honestly what has happened to you at your previous programs, and get their professional advice on how best to present your previous experiences, both on a CV and in interviews. Create the best possible CV for yourself - it will be useful if a vacancy comes up unexpectedly, and having something to hand which shows your best face to the world will give you confidence.

Second, talk to people at the two programs already attended for advice and help. See whether they will give you any credit for the time you did, and what references you can get from them. If there are any positives (in-service exams passed, rotations with satisfactory assessments, etc.) point these out and ask for them to be noted in a factual reference. They might add up to be able to get some time credit towards your internship year. If you still have good relationships with any attendings at the programs, would they give you a personal reference to add to the official program reference?

Thirdly, look for the low-hanging fruit for next year - Osteopathic programs which in previous years have not filled, or have filled late. Be prepared to start with the less favoured locations, and less favoured end. Rural med is not desirable to most doctors, but for you it might give you a safe and cheap place in which to bring up your child. Also, keep an eye out for any opportunities coming up before next year's formal vacancies - an off-cycle spot for fewer than 12 months might be a way of giving yourself the start of a satisfactory track record.

Finally, while you are working on getting a residency, take some time to look around for alternative career routes for someone with a medical degree but no internship - there are some old threads on SDN about this.

 

[Doctor Bagel]

Some of the replies to the OP assume they are male. Try reading the OP's message again with the assumption they are female. I read the possibility of a woman who was doing OK until she allowed herself to be distracted in her first internship year by a bad boyfriend who turned into a bad husband, compounded by pregnancy and a baby to bring up.

I guess I'm not getting why this should make a difference. Male or female, we generally should be able to stick with our residencies even following "bad boyfriends" and babies and whatnot. BTW, I'm a female (and a feminist), so you can't accuse me of women hating or whatever.

 

[gutonc]

Some of the replies to the OP assume they are male. Try reading the OP's message again with the assumption they are female. I read the possibility of a woman who was doing OK until she allowed herself to be distracted in her first internship year by a bad boyfriend who turned into a bad husband, compounded by pregnancy and a baby to bring up.

If that is the case, and the OP is now out of that relationship, things may not be as hopeless as they look. Provided the OP is prepared not to be choosy, they may get back on track in a medical career.

I assumed the OP was a woman, and in this case, it's just not relevant. S/he was a borderline candidate at the outset who barely passed both USMLE and COMLEX (with nearly identical scores on 1 and 2 of each series, suggesting that it wasn't just a "bad test day"). Then s/he failed to match, scrambled into a TRI (perhaps the least competitive internship spot in the country and then failed out. This was followed by a 2nd failure the next year. Extenuating circumstances can't possibly make up for these issues.

I agree that one more shot (and only one) at getting a spot is warranted. I also agree that approaching the PD of the last IM program is a wise move (forget the TRI...nobody cares) as it's probably the best shot to get a 2nd chance (or at least a good LOR). But making this out to be an issue of sexism and discrimination is not only wrong, but also does the OP a disfavor by offering false hope.

 

[deleted525628]

OP, I don't think the practice of medicine is for you. Residency training is stressful no matter what field, and one must be very committed to make it through. Your previous two failures to me do not show your lack of ability as much as they show your lack of committment. Do you REALLY want to practice medicine or just say you do??

During residency I went through a divorce (PGY-1), moved half way across the country to a new residency program (PGY-3), and underwent 6 months of chemotherapy for lymphoma (PGY-4). I still finished on time. But only because I REALLY wanted to.

Find something non-clinical with low stress and a flexible schedule to use your degree. I think you wil be happier. Good luck.

I'm saving this for when I need it...

 

[shopsteward]

S/he was a borderline candidate at the outset who barely passed both USMLE and COMLEX (with nearly identical scores on 1 and 2 of each series, suggesting that it wasn't just a "bad test day"). Then s/he failed to match, scrambled into a TRI (perhaps the least competitive internship spot in the country

I agree with this, and if the OP originally went for the allopathic match over the DO match, it was a bad choice - although even in 08/09 it was less competitive than now.

But making this out to be an issue of sexism and discrimination is not only wrong, but also does the OP a disfavor by offering false hope.

There is no case to say that either program discriminated against the OP, and I didn't say so. Unfortunately in our culture women, even intelligent, educated women, are easily socialised into the whole marriage, babies, mommy-track career thing. Depend on the wrong man in that situation and things can suddenly end up in a relatively poor position very quickly. (And yes, I know this doesn't apply to all women, and that some men get badly done by too. But overall, the stats, and the social pressures behind them, don't lie.)

I don't want to offer the OP false hope (if s/he is still reading this thread), and as I suggested I do think the OP should look into alternative uses for a medical degree. On the other hand, I'm not yet convinced that the last word on this thread should be "the practice of medicine is not for you". I have seen people trying to cling on to a professional role for which they are technically qualified but which is just slightly above their natural abilities, and it is miserable for all concerned. They would be much better off fitting comfortably into a slightly lower level job if only status, and sometimes money, issues did not get in the way. But based on the OPs posts, I'm not yet convinced that given the basis of a stable family life, the OP is incapable of being decently competent and happy as a doctor. People, even people who are doctors, can move on from bad situations and get their lives back on track.

 

[deleted480308]

I guess I'm not getting why this should make a difference. Male or female, we generally should be able to stick with our residencies even following "bad boyfriends" and babies and whatnot. BTW, I'm a female (and a feminist), so you can't accuse me of women hating or whatever.

Yeah, gender is irrelevant here with exception of a pronoun now and then....you either pass or don't

 

[Top Gun]

I guess I'm not getting why this should make a difference. Male or female, we generally should be able to stick with our residencies even following "bad boyfriends" and babies and whatnot. BTW, I'm a female (and a feminist), so you can't accuse me of women hating or whatever.

Agree with this. You can't hold males to one standard and females to another.

 

[Sam212]

What I don't understand is that there are hundreds of DO FM spots open each year post match. So much so that they are literally begging people to sign up. Why could the OP not get one of those spots? They remain open with no residents, some of them are in remote locations such as Indian reservations. I am pretty sure if the OP tried contacting these programs, he/she will be able to get a spot. There just simply aren't enough DOs to fill those spots and a program, any program, somewhere may take a chance on the OP.

 

[Textbookversion]

What I don't understand is that there are hundreds of DO FM spots open each year post match. So much so that they are literally begging people to sign up. Why could the OP not get one of those spots? They remain open with no residents, some of them are in remote locations such as Indian reservations. I am pretty sure if the OP tried contacting these programs, he/she will be able to get a spot. There just simply aren't enough DOs to fill those spots and a program, any program, somewhere may take a chance on the OP.

Sooo this is a common misconception. They are open after the DO match, they are not open by July. Basically 600 or so people don't match via ACGME, then they fill those AOA spots left over.

All those spots fill. There are enough DO's to fill the AOA spots many times over. Those programs are not "begging" for residents.

 

[Sam212]

Sooo this is a common misconception. They are open after the DO match, they are not open by July. Basically 600 or so people don't match via ACGME, then they fill those AOA spots left over.

All those spots fill. There are enough DO's to fill the AOA spots many times over. Those programs are not "begging" for residents.

They are most certainly begging for residents post match. Many Many of those programs start cold calling the applicants and offering spots post match over the phone. I know this for a fact. In fact there were programs emailing everyone how they can't fill their spots and are increasing salaries to attract residents - still couldn't fill.

 

[Textbookversion]

They are most certainly begging for residents post match. Many Many of those programs start cold calling the applicants and offering spots post match over the phone. I know this for a fact. In fact there were programs emailing everyone how they can't fill their spots and are increasing salaries to attract residents - still couldn't fill.

Post AOA match. Not post ACGME match. There are large numbers of people that don't match ACGME and then are forced to go find AOA programs. And they almost all fill. Programs get panicky in between AOA and ACGME match but there are tons of DO students floating around after the ACGME match that need spots still.

 

[Crazy8s]

Just thinking outside the box here....you willing to go foreign?

I'm willing to go foreign...what do you suggest?

 

[thefritz]

Here's something I don't understand.

Everyone is basically telling this medical school grad that he/she is done in medicine (and does what now, work at wal-mart?). Ok. But...

Last years match filled only 450 of about 1300 surgery prelim spots with US applicants.

http://www.nrmp.org/data/resultsanddata2013.pdf

In the end over 400 spots went unfilled. Granted, surgery prelims are considered a road to nowhere and are the least competitive spots and in general the worst possible intern year imaginable. But, it will provide you the opportunity to get a license, which provides the opportunity to work in a limited capacity, and by completing such a program, would allow the possibility of applying for a FM categorical or even IM categorical spot.

If I were the OP, I would find some money and apply for a couple hundred of these programs, which should land at least some interviews at probably horrible programs. But the OP is desparate, and with so many unfilled spots, I have to believe he's land somewhere. Unless I'm missing something, I find it hard to believe the OP is "done."

 

[Crazy8s]

How can he get a license if he doesn't have the support of his residencies?

 

[deleted542994]

Well Isee so many responses since I left...

Let me make it clear..
I am a Male, not female..
And was struggling with some issues in the past which have been overcome now..

I will definitely give one more shot this year in psych positions and lets see what happens next..

thanks everybody for your replies..