Pre-clinical...res. advice/question...

[TJDoc7]

Hello,

Had a question, would appreciate help from anyone with background in residency match, or has solid foundation of knowledge on the subject.

I am currently a carrib. medical studnet, just finished third semester. To make a long story short, did "okay" first semester (c's and one b), second semester ran into problems on island with living situation (not like roomate b.s., crime, robberies, actual stuff), etc.., and failed 3/4 classes (should have simply withdrew for semester, tried to suck it up and pass, know it hurt me). Came back, swallowed by pride, retook all those classes and did well especially on shelf exams). This last semester (third), ended up doing very well (both classes and finals, all b's).

Now with that said, here is my question. I know that I have by no means "set myself up", but have I officially screwed myself? I know the importance of step 1 (as I know I need to nail it, as many do, and plan on doing so), but my real concern is preclinical grades, specifically that second semester. I really want to go into peds (not extremely competitive, but would still like a decent shot at a legit res), am I completely out? Will I even get an interview, chance to explain my transcript pending I do well on step 1?

I have heard mixed things (step 1 REALLY MATTERS, in addition to 3rd year grades, and pre-clinical is not THAT important...what about with failures, but steady progress afterwards, and good step one?). Any truth to that? By no means am I giving up, but would just like to be realistic here with my goals...ending up in family medicine, or is peds still realistic (even though it doesn't sound to be a lot higher in terms of competition)? Fellowship still possible or out of contention. Sorry for the sense of urgency in writing, someone (an *******, but still want to seek out advice), asked me "why I even bothered to stay", as I will never get a res. after passing step 1. Thanks for time and help.

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[TJDoc7]

anyone have any idea? advice would be much appreciated. Thanks.

 

[Brodiewankenobi]

not that I know anything on the subject, but as a carib student your pre-clinical years WILL most certainly matter to a prospective PD.

 

[TJDoc7]

right, no doubt they will be looked at/considered, but my question is how much importance is placed on them...would step 1 score carry a lot more weight, potentially pull it up?

 

[TJDoc7]

Not quitting type at all, but I don't want to put myself in even more debt if there is a dead end (pending I did well on both step I/II)...no matter what I do to pull myself up, will I STILL not be able to overcome that one semester?

 

[themudphud]

So I think the main point is that you haven't done yourself any favors but I wouldn't say that it's all over for you. You just need to be absolutely stellar on everything else, Step 1, the wards, research, etc. As a carrib. student, you will be facing an uphill battle to begin with. Make sure you do very well on Step 1 (I would say at least >240), score well on your clinical rotations and do away rotations at the best schools for whatever you want to go into. And, do some research.

Work really hard from here out.

 

[GZA]

If you can't match US, what shall you do instead?

 

[McGillGrad]

You are not in bad shape.

Considering that you are still in med school and you should be sitting for Step1/2 without any other mishaps, then you will certainly be in a good position to gain a residency spot...ALTHOUGH...it may not be what you want to do or where you want to be for 3 years.

It is true that PDs glance at basic science scores but considering the lack of consistency throughout the Caribbean, it is much much less important than your step 1 score.

I am no expert on this, but this is how I imagine it working out for you in the next 2 years.

#1) Successful completion of the rest of your basic science courses (P=MD)
#2) Scoring as highly as you can on the step (w/your goal of 220 or more)
#3) Pre-matching or matching into an IM/FM/Psych/Peds residency at an IMG friendly hospital, most likely community.
#4) Working as a hospitalist while exploring fellowship or job-offer opportunities

The main thing to remember is that as long as your scores are US-average or above and you are a US citizen, you have a distinct advantage over the majority of the non-US carib and true FMGs applying to the same hospital.

The basic science years are all leading up to step 1. If your step score is good, then your basic science years are a moot point, although you will need to explain it during interviews.

Your clinical marks, your LOR and your personality make up the majority of the non step component of your application.

 

[khadija]

this is an interesting topic. yes u've messed up on ur pre-clinical grades, but its not over until the fat lady sings. stop worrying/stressing over the past and focus on the future. use the fact that u had poor grades as an incentive to study harder and longer. knock-out ur step 1 and step 2. try to be one of the top students in ur 3rd and 4th year classes.

don't give up hope. it is possible to get into a decent residency, but not without hardwork and determination (sweat and blood will have to be shed). if ur not willing to do this then u may be better of giving up now.

 

[dragonfly99]

Nobody knows the future, so I disagree with whomever told you to bail out now. I actually don't think you are hosed, but you certainly have no margin for major errors now (like failing any USMLE test or getting a low score like below 200 or something). You also didn't tell where you are a student...if Ross or St George probably better chances than if you are at one of those random, very new Carib schools.

I think McGillgrad is on mark. I've never been a Carib grad, but I have worked with numerous medical students and residents. I think having a single black mark on the transcript like a bad semester would certainly not be the kiss of death if you were a US grad. As a Caribbean grad you're a bit backed into a corner. I don't think you can 100% count on peds, because there aren't nearly as many spots in that as IM or fp. Peds faculty also care more about standardized test scores than IM or fp ones, since reportedly the peds board certification exam is fairly hard and only maybe 80-85% pass on the 1st try...no program wants to take a resident who can't hack standardized tests b/c it could reflect bad on the program @the end of 3 years if he can't pass the board exam for his specialty. If all else fails you can do peds and then just focus more on peds and adolescent stuff...that would definitely be possible to do. The fp residency is potentially hard/tough because there is so much to know, but those guys get TONS of job offers, similar to IM docs like me (tons of places desperate for people to work outpatient, hospitalist, sometimes urgent care type gigs).

You mainly need to make sure you don't ever fail any class or rotation ever again, and try to do as well as you can on the USMLE step 1, 2 and 2 clinical exams. You don't have to get a 260...just try to get above the average if you can. You need to get honors on pediatrics and IM and fp (all of them if you can) during 3rd year.

I don't think you should bail at this point...you are already quite invested and I don't think your goose is completely cooked...you just don't have a margin for error and you seem to know that. Arise, go forth and conquer!

 

[lovelyaries]

Sorry to poster...I just saw the message. But I definitely think from what has already been said that you still have a fair chance. You might have to explain your situation, but I definitely think if you do well on the Steps that will pretty much negate preclinical grades and most programs look more at Steps and third and fourth year grades and letters of recommendations. Focus on doing well and peds is not super competitive and there are great programs out there. I think it is more important to find a place that you will fit in with the other residents cause they all follow the same requirements. Good luck with the rest of medical school!