Please help! CRITICAL decision. Not sure what to do.

[davezhan]

My last 3 NBME/UWSAs taken in the past 2 weeks have been 190 flat. I have 1.5 weeks left to study. If I delay, I have to skip my first clerkship which will be scheduled in 4th year and possibly prevent me from graduating on time.

Should I gut it out and hope for a 5 or 10 point improvement and take my exam in 1.5 weeks or should I delay?

At this point, I just want to pass. Would I be at high risk for failing if I take the exam without delay?

PLEASE HELP!

---

Members don't see this ad.

 

[NEEDTOPASS123]

Tough situation, but if it was me, I'd think of it this way:
You can take the exam and accept you might pass and if you do, it could be close to the NBME scores.
Or if you delay it a few months, you'll pass and have a chance of breaking a 220.
It's your pick. Are you trying to just pass or get a high number on the Step 1 for a competitive residency.
Best of luck

 

[davezhan]

I think like any other student, I would like to get as high of a score as possible, but administration is pressuring me to take it on time by listing the consequences of delaying. I want to match into internal medicine, so I know I don't need a super high score, but I would like to match somewhere. I don't know if barely passing (<200) on the real exam would even give me a shot or not. Administration says there are always spots open but I'm a bit doubtful with IM step 1 averages being around 230.

 

[davezhan]

Tough situation, but if it was me, I'd think of it this way:
You can take the exam and accept you might pass and if you do, it could be close to the NBME scores.
Or if you delay it a few months, you'll pass and have a chance of breaking a 220.
It's your pick. Are you trying to just pass or get a high number on the Step 1 for a competitive residency.
Best of luck

Thanks for the response by the way!

 

[NEEDTOPASS123]

Even though competitive IM residencies need a 230 and above, you also have noncompetitive areas like SD/KS or what not who need physicians.

 

[davezhan]

Even though competitive IM residencies need a 230 and above, you also have noncompetitive areas like SD/KS or what not who need physicians.

Yeah you're right. What I mentioned is thinking too far ahead. Back to the situation at hand, I am fine with just passing but I would like to pass >200. If I study hard, I think I have a fair shot at it. At the same time, my foundation is shaky. I had trouble getting through the first 2 years, so the exam can also backfire on me and I might fail it if it just happens to test my weaknesses.

After telling this all to administration, it sounds like they still want me to take it on time regardless unless my next NBME is still around 190. It sounds like they really dislike having students take extra time unless there is no chance of passing. Should I give into their pressure or should I demand extra time regardless of them discouraging me from taking extra time?

 

[NEEDTOPASS123]

If you're ok with getting scores around your NBME, go for it.
NBME was 190, you're more likely to pass it.
Just read and understand FA as much as possible.

 

[davezhan]

Well maybe I should rephrase - I'm NOT OK with a 190ish but given the circumstances with the administrators pushing me to start on time and my lack of confidence in getting to my goal score even if given another month, I feel incredibly discouraged and hopeless. In a sense, I feel as if I've given up inside already, which is a shame because I had such high hopes for a better score. =(

 

[sloop]

It's definitely your decision but 190 is sketchy territory. It's possible (maybe even just more than 50% probable) that you would dodge a bullet and pass the exam. On the other hand, there is also a considerable chance you might fail. This might not break you in IM like it might in other specialties, but it is not a good situation in any specialty and could be severely limiting.

It's a hard decision and I can't be sure exactly what I would do but I don't think I would risk failing that exam.

 

[davezhan]

It's definitely your decision but 190 is sketchy territory. It's possible (maybe even just more than 50% probable) that you would dodge a bullet and pass the exam. On the other hand, there is also a considerable chance you might fail. This might not break you in IM like it might in other specialties, but it is not a good situation in any specialty and could be severely limiting.

It's a hard decision and I can't be sure exactly what I would do but I don't think I would risk failing that exam.

Thanks for the response. I'm going to go for a delay then and hope that administration can schedule me in for a rotation sometime shortly after third year. No doubt will this constitute as an administrative LOA but I think you're right, this exam is not worth failing even if it sets back my match by a year in the worst case scenario and shows up on my dean's letter?

 

[sloop]

Thanks for the response. I'm going to go for a delay then and hope that administration can schedule me in for a rotation sometime shortly after third year. No doubt will this constitute as an administrative LOA but I think you're right, this exam is not worth failing even if it sets back my match by a year in the worst case scenario and shows up on my dean's letter?

Obviously I'm not a residency director so I can't tell you for sure. That said, if I was I would certainly prefer someone who recognized they were in trouble and then did what they had to in order to fix it over someone who sat the exam unprepared, failed, and then had to take it again and deal with all the issues that come along with that. Residencies want people they are not worried will fail step 3. Failing step 1 is a good way to tell residencies that you might fail step 3.

 

[nds86]

Thanks for the response. I'm going to go for a delay then and hope that administration can schedule me in for a rotation sometime shortly after third year. No doubt will this constitute as an administrative LOA but I think you're right, this exam is not worth failing even if it sets back my match by a year in the worst case scenario and shows up on my dean's letter?

Agreed. Also, even though you just want to pass and passing is a 192, I wouldn't take it unless I'm above 10-15+ 192 on the NBMEs. All the best!

 

[Ceusina]

Are you at a US allopathic medical school? If so, your clinical schedules 3rd and 4th year will likely allow you to make up the leave of absence, without delaying graduation (most schools build in some vacation time during 3rd/4th year... you can usually make up a missed rotation during that time period). I don't know how it works at international schools. I'm guessing you're not an osteopathic student, since your school is making you take the USMLE.

Either way, do NOT take it if your next NBME isn't 205+ (maybe even 210+). The consequences of failing are much worse than taking a (brief) leave of absence. Obviously your goal is still to graduate on time, but I think even if your graduation is delayed by a year, having a passing USMLE on the first try is the better way to go.

People take leaves of absence all the time, for various reasons.

Not taking a leave of absence, and failing the USMLE shows poor judgement, which (in my opinion) would not be so well received by program directors. Taking a leave of absence to ensure that you pass the USMLE (again, in my opinion) shows better judgement. And then your application won't be "tainted" by a USMLE failure.

Good luck!

 

[davezhan]

Are you at a US allopathic medical school? If so, your clinical schedules 3rd and 4th year will likely allow you to make up the leave of absence, without delaying graduation (most schools build in some vacation time during 3rd/4th year... you can usually make up a missed rotation during that time period). I don't know how it works at international schools. I'm guessing you're not an osteopathic student, since your school is making you take the USMLE.

Either way, do NOT take it if your next NBME isn't 205+ (maybe even 210+). The consequences of failing are much worse than taking a (brief) leave of absence. Obviously your goal is still to graduate on time, but I think even if your graduation is delayed by a year, having a passing USMLE on the first try is the better way to go.

People take leaves of absence all the time, for various reasons.

Not taking a leave of absence, and failing the USMLE shows poor judgement, which (in my opinion) would not be so well received by program directors. Taking a leave of absence to ensure that you pass the USMLE (again, in my opinion) shows better judgement. And then your application won't be "tainted" by a USMLE failure.

Good luck!

Thanks for the help so far guys. This is exactly what I needed to hear. I'm glad others think the same. It is confirmation that what I'm doing is not so reckless as administration is making me think.

In response to Ceusina, I am at a US allopathic school that is actually in the top quartile of all medical schools, so it actually is a bit shameful for me to perform at this level when our class step averages have been exceeding 230 for past few years. The first 2 years for me were an academic struggle for several reasons which I will not discuss here.

This is totally unrelated, but do you guys know why admins strongly encourage students to take the exam, even for borderline students like me? I mean, I understand for a student who only wants to increase his score from 230 to 250, it may not be as justifiable to grant them extra time, but for someone who's truly struggling like me, why would they still encourage me to take the exam? Is it because they think I'll goof off when given extra time and end up failing anyway or that I have some ulterior motives which frankly I think is ridiculous or maybe there are too many people like me asking and they just can't offer everyone more time? I'm just really confused about this. Maybe they are saying this to force me to study hard this week, which I am already (save the few times I check the forum to take a break from Pathoma).

 

[tahtnot]

Thanks for the help so far guys. This is exactly what I needed to hear. I'm glad others think the same. It is confirmation that what I'm doing is not so reckless as administration is making me think.

In response to Ceusina, I am at a US allopathic school that is actually in the top quartile of all medical schools, so it actually is a bit shameful for me to perform at this level when our class step averages have been exceeding 230 for past few years. The first 2 years for me were an academic struggle for several reasons which I will not discuss here.

This is totally unrelated, but do you guys know why admins strongly encourage students to take the exam, even for borderline students like me? I mean, I understand for a student who only wants to increase his score from 230 to 250, it may not be as justifiable to grant them extra time, but for someone who's truly struggling like me, why would they still encourage me to take the exam? Is it because they think I'll goof off when given extra time and end up failing anyway or that I have some ulterior motives which frankly I think is ridiculous or maybe there are too many people like me asking and they just can't offer everyone more time? I'm just really confused about this. Maybe they are saying this to force me to study hard this week, which I am already (save the few times I check the forum to take a break from Pathoma).

You're not alone. I too am a student who barely passed preclinical years, and with 1 week left of dedicated scored a 211 on nbme 17 (target is > 240).

When I inquired about pushing back (we were never told about this option, unless we failed the school-administered nbme), I was immediately told that it was NOT an option unless I had failed the school's nbme (I got a 205).

I had to find documentation that a delay can be requested in the student handbook and cite that in order to have a chance to request a delay in front of some committee.

So either:
A. the administration knows something about the bad consequences of delaying that we don't, and are trying to help

Or

B. They could care less about our target score, unless we fail, and just want to keep us moving along.

 

[davezhan]

You're not alone. I too am a student who barely passed preclinical years, and with 1 week left of dedicated scored a 211 on nbme 17 (target is > 240).

When I inquired about pushing back (we were never told about this option, unless we failed the school-administered nbme), I was immediately told that it was NOT an option unless I had failed the school's nbme (I got a 205).

I had to find documentation that a delay can be requested in the student handbook and cite that in order to have a chance to request a delay in front of some committee.

So either:
A. the administration knows something about the bad consequences of delaying that we don't, and are trying to help

Or

B. They could care less about our target score, unless we fail, and just want to keep us moving along.

Did you get the delay? I still haven't yet even though I'm requesting for it. Apparently, administration wants me to take another NBME next week to see where I'm at. I have the feeling that they're trying to force me to take the exam unless I'm still failing so B sounds more likely to me than A.

 

[tahtnot]

Did you get the delay? I still haven't yet even though I'm requesting for it. Apparently, administration wants me to take another NBME next week to see where I'm at. I have the feeling that they're trying to force me to take the exam unless I'm still failing so B sounds more likely to me than A.

Yeah for some reason it seems like unless there is a big chance of failing, they do not want us to postpone Step 1.

I am supposed to present my case to a committee of ~10 faculty members tomorrow. I don't see why this should be such a difficult process. This is only the most important exam of my life. I've spoke with upperclassmen, friends from other schools, and reasoned through it all in my mind tens of times only to come to the same conclusion every time: for me, the suckiness of receiving a 210-215 Step 1 score far outweighs any suckiness from being behind a clerkship.

I am strongly leaning towards a more competitive specialty. Although there is no guarantee that I will improve my Step 1 score, I believe I can and I have to try.

You could intentionally bomb the nbme, giving them no choice. This is all silly.

 

[davezhan]

Yeah for some reason it seems like unless there is a big chance of failing, they do not want us to postpone Step 1.

I am supposed to present my case to a committee of ~10 faculty members tomorrow. I don't see why this should be such a difficult process. This is only the most important exam of my life. I've spoke with upperclassmen, friends from other schools, and reasoned through it all in my mind tens of times only to come to the same conclusion every time: for me, the suckiness of receiving a 210-215 Step 1 score far outweighs any suckiness from being behind a clerkship.

I am strongly leaning towards a more competitive specialty. Although there is no guarantee that I will improve my Step 1 score, I believe I can and I have to try.

You could intentionally bomb the nbme, giving them no choice. This is all silly.

Good luck, man! I hope you make it. Did you intentionally bomb an NBME?

My intention was to take an NBME to gauge where I'm actually at next week because the problem may actually be my inefficient studying, and if I'm at a higher range, then that would be great but if I'm not then they can't deny me. If my NBME were outside the danger zone and I got denied, my intention was to request a LOA even if they deny me to stress that I actually need the extra time and I'm unwilling to back off, but I honestly don't know if that is the best way to do things (can they deny a LOA request?). I know that I would have to meet with a bunch of people as well to get approved. It was hinted at in the email they sent me. Can you keep me updated on how things go? It is very likely I'll have to go through the exact same thing. Thanks.

 

[tahtnot]

Good luck, man! I hope you make it. Did you intentionally bomb an NBME?

My intention was to take an NBME to gauge where I'm actually at next week because the problem may actually be my inefficient studying, and if I'm at a higher range, then that would be great but if I'm not then they can't deny me. If my NBME were outside the danger zone and I got denied, my intention was to request a LOA even if they deny me to stress that I actually need the extra time and I'm unwilling to back off, but I honestly don't know if that is the best way to do things (can they deny a LOA request?). I know that I would have to meet with a bunch of people as well to get approved. It was hinted at in the email they sent me. Can you keep me updated on how things go? It is very likely I'll have to go through the exact same thing. Thanks.

Fasho dave I'll let you know how it goes.

I didn't intentionally bomb mine. If I did, I wouldn't be in this position. People in our class who bomb the school-administered NBME "have" to (get to?) delay their exam. That's what makes it so silly, because if I had known that only those who fail the NBME will be allowed to delay their exams, I would have intentionally failed mine for the chance that I would have to delay.

I'm not sure how I would handle a denial---whether I would just take Step 1 or find a way to force a delay (like you, request a LOA?). If I took Step 1 I could get in the 230s range, but that's if I am clutch on exam day, and it's still below my target score.

 

[Ceusina]

Just an FYI, if you take a leave of absence, your financial aid may be affected, although just temporarily. While you're on your leave, you typically don't qualify for aid/loans. So, if your next loan disbursement was scheduled for the very near future, it might be delayed until you're "reinstated" and no longer on leave. I wonder if the financial aid aspect is one of the reasons why schools don't like to grant a leave of absence... just a thought...

 

[Pisiform]

exactly in the same position as you except I am in osteopathic school. Admin is telling me take the exam but I don't feel safe at all. If I pass its gonna be a crap shoot dodging the bullet. I would rather delay a month and then take it where I know I won't be on the russian roulette

 

[davezhan]

exactly in the same position as you except I am in osteopathic school. Admin is telling me take the exam but I don't feel safe at all. If I pass its gonna be a crap shoot dodging the bullet. I would rather delay a month and then take it where I know I won't be on the russian roulette

I think a valid concern which my admins pointed out is that they don't know how much if any that I will improve given extra time. It's one thing to give extra time to someone who hasn't peaked but for students who have plateaued then it becomes more dangerous, but of course, it is unlikely to plateau at passing if you've passed the first two years - even if barely. Someone correct me if I'm wrong.

 

[Pisiform]

I think a valid concern which my admins pointed out is that they don't know how much if any that I will improve given extra time. It's one thing to give extra time to someone who hasn't peaked but for students who have plateaued then it becomes more dangerous, but of course, it is unlikely to plateau at passing if you've passed the first two years - even if barely. Someone correct me if I'm wrong.

Well, if you have already prepared and did what you are supposed to do and still not improving in scores - that's a plateau but at that point you should already be passing.
For me, there are some chunks in First Aid that I haven't even reviewed in a long time or topics that I know I am poor in like behavioral etc. Another run through FA and by doing more questions I can improve my score. It can't be worse than what I already have which is barely passing.
I don't know man. This entire thing sucks ballz. I was much happier as a cashier

 

[davezhan]

Well, if you have already prepared and did what you are supposed to do and still not improving in scores - that's a plateau but at that point you should already be passing.
For me, there are some chunks in First Aid that I haven't even reviewed in a long time or topics that I know I am poor in like behavioral etc. Another run through FA and by doing more questions I can improve my score. It can't be worse than what I already have which is barely passing.
I don't know man. This entire thing sucks ballz. I was much happier as a cashier

Me too except flipping burgers at Wendy's for the summer wasn't that fun for me. I do have some weak sections that I need work on - mainly pathology and sections that require memorization such as micro, biochem and pharm. I just can't for the life of me memorize stuff.

 

[catzzz88]

Hey guys, sorry to revive an old thread--just wondering how things turned out for you guys?

 

[Pisiform]

Hey guys, sorry to revive an old thread--just wondering how things turned out for you guys?

Same Sshiit new year #3rdyearproblems


Sent from my iPhone using SDN mobile

 

[davezhan]

Hey guys, sorry to revive an old thread--just wondering how things turned out for you guys?

Just so you're on board, both tahtnot and I passed quite above expectations actually. There should be posts somewhere on the forum if you want to know about my experience. Good luck.

 

[Pushtothestars]

Just so you're on board, both tahtnot and I passed quite above expectations actually. There should be posts somewhere on the forum if you want to know about my experience. Good luck.

I would like to know can't find it though

 

[FistLength]

I would like to know can't find it though

I think it was towards the end of the 2015 thread, he scored 240 if I am not mistaken (great job!)

http://forums.studentdoctor.net/thr...experiences-and-scores-thread.1104788/page-71