Patchy record + failed step 2

[Grazia Lamberti]

Seeking some advice on behalf of a friend (really a friend, not me, I already matched, thankfully.) He's had a rough time in med school- "conditionally passed" a class first year, failed 1-2 classes 2nd year, passed step 1 by the skin of his teeth. Failed one shelf and successfully retook it, but has now failed step 2. He's interested in PM&R.

He's really shell shocked and unsure what to do right now, so I told him I'd do some digging. My idea was, maybe if he found a prelim, even a crappy one, he could at least slog through some kind of internship for the purpose of having a license. I don't know the details, but I understand that doing this gives people more options. The advising kind of sucks at my school, so I think he's unlikely to find adequate support there. With this kind of track record, would he stand a chance in a low tier FM or IM program? What about a surgery prelim (again, if only for the purpose of getting licensed?)


Sent from my iPhone using SDN mobile

---

Members don't see this ad.

 

[verdant]

Is he at a US school or is he an IMG?

 

[Grazia Lamberti]

US school, US-born


Sent from my iPhone using SDN mobile

 

[verdant]

I think he still has a decent shot at matching at a low tier community FM or IM program as a US MD. I went to the AAFP conference in 2015, and FM as a whole seems to really be trying to entice US MDs to apply. Has he taken CS yet? I noticed that a fair number of FM programs wanted a first-time pass on it specifically. He obviously needs to make sure that he passes CK this time around, of course. I'm a USIMG from a lower-tier Caribbean school that matched at a community IM program (has a mix of USMDs, DOs, and IMGs) with a miserably low Step 1 score, so I think he still has a good shot at IM or FM if he applies very broadly and has great LORs attesting to his work ethic and dedication.

Also, as a side note: when I went to the AAFP conference in 2015, representatives from Forrest General Hospital in Mississippi were there, but they said they were only able to accept applications from USMDs because of state rules or whatever. If you look at the 2016 NRMP Match Outcome, they only matched 1/6 spots, so tell him to look into their program when he's applying. Granted, Mississippi is not a place where a lot of people want to go to for three years, but if it's that or be unmatched, well, you do what you need to do.

 

[verdant]

Also, another thing that your friend may want to consider doing is to carefully read through the 2016 NRMP Match Outcome List and make a list of what programs didn't fill this year. The IM program at the Jamaica Med Center in NY only filled 7/22 spots, for example. The FM program at North Florida Regional Medical Center in Gainesville filled 2/8 spots. He can start constructing a potential list of programs he might be granted interviews at this way, and then he can choose to apply elsewhere too, of course. Granted, a lot of the programs that didn't fill may be malignant and/or full of scutwork, but the first step is to at least get interviews, then he can decide how and what he wants to rank from there.

 

[Lostin_space]

Seeking some advice on behalf of a friend (really a friend, not me, I already matched, thankfully.) He's had a rough time in med school- "conditionally passed" a class first year, failed 1-2 classes 2nd year, passed step 1 by the skin of his teeth. Failed one shelf and successfully retook it, but has now failed step 2. He's interested in PM&R.

He's really shell shocked and unsure what to do right now, so I told him I'd do some digging. My idea was, maybe if he found a prelim, even a crappy one, he could at least slog through some kind of internship for the purpose of having a license. I don't know the details, but I understand that doing this gives people more options. The advising kind of sucks at my school, so I think he's unlikely to find adequate support there. With this kind of track record, would he stand a chance in a low tier FM or IM program? What about a surgery prelim (again, if only for the purpose of getting licensed?)


Sent from my iPhone using SDN mobile

I think it may be difficult for your friend to match into PMR with repeated failures. PMR has become more competitive in recent years, with far more applicants than spots available. I think that while some people have issues with standarized testing and things like that, numerous repeated failures do present a concern. Why is your friend failing numerous times? Maybe something like FM may be a possibility due to the sheer number of spots available, but I think again it would be important to really do some soul searching here as to what's going on.

 

[Grazia Lamberti]

Thanks for the responses. I'm not sure of his thoughts on geography, but making a list of previously unfilled programs is probably a good idea. I'm sure he'll have no issue with CS- that's the sad part, he's a great guy that everyone likes, and does great clinically. The problem is getting to the end of the road. Having tried to help him study, I'd say his biggest issues are his approach to the material and his endurance. Most of us find ways to "make the material our own" in med school, like making charts, acronyms, etc., but this doesn't come naturally to everyone.


Sent from my iPhone using SDN mobile

 

[verdant]

It sounds like FM might be your friend's best bet at this point, given his failures + AMG status + strong positive personality. My FM interviews seemed to be really centered with how I'd fit in with the rest of the residents and faculty/staff, and not so much my academic performance. If he's really good with interpersonal interactions and can really shine on rotations and get glowing LORs and a fantastic MSPE that really emphasizes how great of a guy he is, even if he's academically had some trouble in the past, then I think he can still get a lot of FM interviews.

If your friend has the money to do so, I think he should also go to the AAFP conference in Kansas City this July to network. If he's a fun and memorable guy that can network well, it'll only help him come September. Of course, all of this is contingent on him figuring out how to pass CK this time around and not failing any more shelf exams. I really struggled with my endurance and approach with studying for Step 1, so I understand a bit of what he's going through. I wish him the best of luck.

 

[Sea_Bass]

.

 

[j4pac]

Have your friend PM me. I'm willing to help anyone passionate about the field.

 

[Law2Doc]

I don't think it's quite time to focus in on dead end surgical prelims just for a license just yet, but PM&R might be a long shot now. Applying to lots of FM and less desirable community IM programs might pan out. Concerns about geography and malignancy need to be irrelevant here-- he just has to suffer through 3 years and his career can be back on track. So yes, he might have to suffer through three awful malignant years in some armpit of the country, but if he can do that unscathed, job opportunities will be there, and frankly if he then wants to invest another three years he could probably have a shot at PM&R as his second residency, having proved himself an adequate resident (and still finish up training around the same time as some of his longer residency classmates.)

 

[dggopal]

I post to offer hope! I was where your friend was last year.... and the year before that!
I am a US citizen but I graduated from med school in India at the end of 2011. Passed step 1 with a 222, and CS on my first attempt and applied for the 2013 match and got 7 IM interview invites.... and then I failed step 2ck. I found out I failed CK in the middle of interviews in January. Ended up cancelling the rest of the interviews and wondering where and how to start over. Luckily I had a lot of support and I stayed the course. I remained clinical by finding clerkships and research where ever I could find it. Finally retook CK and got a 227 and again applied for the 2014 match. I managed to get 5 interviews for IM and 2 for FM. This is after applying to over 350 programs mostly IM, which is ideally what your friend will need to do. All the interviews went well with one program sending me love letters with vague promises of ranking me high. I failed to match again. Keep reading, I promise this story gets better! After the shock and shame melted away into the numbing realization that I dedicated my life to this endeavor and I was not going to let this be the end of me I finally started being proactive. I got back in the game and found a clerkship in Detroit that was with teaching faculty at a major teaching hospital in Detroit. To find out more about the clerkship, just google Heart & Vascular Institute, Detroit. It is 100% free. Rotating under these physicians and the level of freedom they afforded me to work up the patient and present my plan to the staff for patient care regenerated my confidence! Every interview I had gone on after failing to match the first time had interviewers who would tell me "you are a great candidate!" but not in a good way, but rather in a tone as if they were trying to convince me of this fact. I realize now that I probably conveyed my insecurity and lack of confidence to them non verbally! This rotation took care of that! In addition, these guys, by virtue of being teaching staff at local residency programs, are connected and can and will advocate for you! This is something foreign grads lack. No one knows your LOR writers and a private practice guy in the middle of the US who is not in touch with Academia is not going to be able to move a PD to give you a shot no matter what letter he writes you. You need to work with people that are in academics. Simultaneously I studied and took step 3. It is a beast of an exam, but preparing for it also boosted my confidence because it ensured that I knew my stuff! No worries about a pop quiz come interview day here! No one wants to match at places like that but matching there is better than not matching at all. Finally, after all this, I took a look at my personal statement and realized that I had written from the perspective of why I want an IM residency. I needed to write from the perspective of why a PD should consider me for an IM residency. Why will I not let him down? With a revamped PS and a transformed outlook on life I applied again to over 350 programs and finally... in the 2016 match, I matched into a Categorical IM residency!

Tell your friend, not to give up! It's not over until he says its over!

 

[dggopal]

also... I totally forgot to mention... I kept checking the ACGME website for newly accredited programs.... Most candidates hit send on their apps sept 15th and wait for interviews to roll in. Some programs that get accredited after this time are not on ERAS until later. I was able to apply to 5 more programs this way and got interviews from 4 out of those 5. That is pretty good stats in my opinion.

 

[zyxab]

I post to offer hope! I was where your friend was last year.... and the year before that!
I am a US citizen but I graduated from med school in India at the end of 2011. Passed step 1 with a 222, and CS on my first attempt and applied for the 2013 match and got 7 IM interview invites.... and then I failed step 2ck. I found out I failed CK in the middle of interviews in January. Ended up cancelling the rest of the interviews and wondering where and how to start over. Luckily I had a lot of support and I stayed the course. I remained clinical by finding clerkships and research where ever I could find it. Finally retook CK and got a 227 and again applied for the 2014 match. I managed to get 5 interviews for IM and 2 for FM. This is after applying to over 350 programs mostly IM, which is ideally what your friend will need to do. All the interviews went well with one program sending me love letters with vague promises of ranking me high. I failed to match again. Keep reading, I promise this story gets better! After the shock and shame melted away into the numbing realization that I dedicated my life to this endeavor and I was not going to let this be the end of me I finally started being proactive. I got back in the game and found a clerkship in Detroit that was with teaching faculty at a major teaching hospital in Detroit. To find out more about the clerkship, just google Heart & Vascular Institute, Detroit. It is 100% free. Rotating under these physicians and the level of freedom they afforded me to work up the patient and present my plan to the staff for patient care regenerated my confidence! Every interview I had gone on after failing to match the first time had interviewers who would tell me "you are a great candidate!" but not in a good way, but rather in a tone as if they were trying to convince me of this fact. I realize now that I probably conveyed my insecurity and lack of confidence to them non verbally! This rotation took care of that! In addition, these guys, by virtue of being teaching staff at local residency programs, are connected and can and will advocate for you! This is something foreign grads lack. No one knows your LOR writers and a private practice guy in the middle of the US who is not in touch with Academia is not going to be able to move a PD to give you a shot no matter what letter he writes you. You need to work with people that are in academics. Simultaneously I studied and took step 3. It is a beast of an exam, but preparing for it also boosted my confidence because it ensured that I knew my stuff! No worries about a pop quiz come interview day here! No one wants to match at places like that but matching there is better than not matching at all. Finally, after all this, I took a look at my personal statement and realized that I had written from the perspective of why I want an IM residency. I needed to write from the perspective of why a PD should consider me for an IM residency. Why will I not let him down? With a revamped PS and a transformed outlook on life I applied again to over 350 programs and finally... in the 2016 match, I matched into a Categorical IM residency!

Tell your friend, not to give up! It's not over until he says its over!

Such an inspiring story! Thank you for sharing!