Questions from a very uncompetitive applicant to IM

[devildoc2]

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OK so I failed the 2nd year of med school, and now retaking it. I am passing everything now. I hope to get a 215 on Step I, just average.

I go to a top 5 med school, I have a couple of good letters of rec (1 from a pulmonologist) but none of those letters are from clinical rotations, and 2 years of research experience with 1 first author publication and 1 third author pub.

I want to just get into a barebones, worst of the worst IM program. I dont care where it is, as long as I can get in.

Questions:

1) Since I failed the 2nd year, can I still get into one of the 3rd tier IM program?

2) Do I need to apply to like every IM program in the United States? I have no problem applying to only 3rd tier IM programs. How many of them do I need to apply to?

3) Since I am a noncompetitive applicant, is it a must to do an away rotation in IM at some of these places? Or is it just a waste of my time?

4) On my IM rotations here at my med school, do I have to get honors in the rotation or just pass? If I just pass the rotation without getting honors, will my attendings in IM refuse to write me a letter? Or as long as I did good and they know I'm only trying to get into a 3rd tier program they would still write the letter for me?

 

[Fermi]

Hold on there. The situation is not as dire as you think. You are not necessarily an "uncompetitive applicant" for IM or any other specialty. Take inventory of what you have: a "top 5" school, published research, a chance to do well on Step 1, and then a clean slate for 3rd year, which is about as important as all other years put together. I had a friend who had to take a year off for academic dishonesty(!), but then rocked Step 1 and 3rd year and matched into a good surgery program.

My advice--talk to your adviser. You should get the straight truth from that. Probably wouldn't hurt to meet with the dean who'll be writing your MSPE so they have a good picture of how hard you're working to recover, and willl thus write a strong dean's letter. Lastly, stop any extra commitments at this point like your reseach and extracurriculars. You've already demonstrated the research skills so consider that "category"of your application complete and concentrate on the clinical, which is most important. A good performace from here on out will probably put you in position to apply just about anywhere.

 

[JetsPickVYoung]

As someone who is going through the Match process, here's my 2 cents:

1. Don't just aim for average on the boards -- a great Step 1 score can help erase some of the painful memories of the past. Take more time to prepare than your classmates and DO LOTS OF PRACTICE QUESTIONS!!! Kaplan Q-bank, usmleworld.com are examples. The same applies for Step 2....

2. Work hard on your rotations. Residency programs are looking for CLINICIANS not basic scientists. Sure it helps to know the steps in the urea cycle when being pimped by a nephrology fellow, but honoring your rotations through hard work and preparation will impress program directors much, much more.....

3. DO do away rotations at places you are interested in. Give the PDs of those programs something more than a med school transcript to evaluate you with....

4. Apply wherever you damn well please. The worst they can do is reject you, right? Don't limit yourself based on a bad year's work. You still have two years and two board exams to show you're not a quitter.

Above all, have faith in yourself and keep your chin up!

 

[devildoc2]

thanks for the replies... the reason for my failing 2nd year is due to severe personal problems at home... my dean of student affairs knows me very well and I think he will write a good dean's letter for me. However, at the same time he will be forced to put in that letter that I failed 2nd year, and it will be on my transcript. The reason I'm skeptical is because I didnt just fail one class, I failed the whole year. As I said, I am retaking now and almost done and I am solidly passing all the courses. But I feel the damage has already been done.

My anxiety has increaesd lately because now some people are saying to me that IMG programs actually will prefer IMGs over lower tier US med students! This is very bad, and now I'm worried.

I will study very hard for Step I. Maybe I can get above average, but I seriously doubt that I'm going to get a super score of like 240 or something like that. Probably 220 might be a good estimate of my abilities.

The one thing that I do have working in my favor is good letters of recommendation. I have worked on research and gotten good letters of rec from a pulmonologist and as I stated, my deans letter should be good overall because he knows me very well and I did well in one of his courses. Since I go to a top 5 med school, I'm hoping that my dean's influence will push me over the edge. If I have to scramble somewhere, perhaps a phone call from him would be enough to get me in SOMEWHERE.

 

[BigBadBix]

I just want to echo what others have said here. Board scores and clinical clerkship grades, along with AOA, are much more important to IM programs than the preclinical years. Sure, you won't have a "perfect" application, but this isn't derm or plastics.

If your true goal is to go to the "worst of the worst" IM program, then by all means, relax, pass your boards, pass your clerkships, and you will be fine. On the other hand, if you originally had loftier goals and are adjusting them b/c you failed 2nd year, don't sell yourself short just yet. If you excel from here on out, I'd guess you would have a decent shot at a number of University IM programs.

Regarding your question #4, no matter what your goals, you should certainly try to do well in your IM clerkship by working hard and showing enthusiasm. Your clinical performance is what will shape the impression your attendings have of you (and whether they are willing to write you a letter), not your grade. Most of your letter-writers won't even know your grades; they will write letters based solely on their interactions with you.

Best of luck!

-BBB

 

[u_r_my_serenity]

The bottom line:

1. There is a shortage of doctors in the United States and many IM programs are forced to accept IMGs to fill.

2. Contrary to what you've heard, US programs in general favor US grads over IMGs (just as any country should).

100% of the students in my school (top 50 school) had a job at the end of fourth year last year. This included some students who failed the step I on the first attempt, some who failed various rotations, some who had to repeat an entire year, and a handful who had to scramble.

You will get in. (But try to improve your application as much as you can in the meantime to increase the chance that you will get a program you desire, not merely settle for)

 

[inositide]

I agree with the replies above that the situation is not nearly as dire as the original thread author might think.


Just try to do as well as possible in the remaining part of med school. 3rd year is as much about being energetic and active as it is about knowing your stuff. Do well in 3rd year and worry about letters of rec at the end of third year.

You will certainly be able to match into an IM residency program. In fact, it is extremely likely that you would still be able to match into a university IM program. It may not be Mass. General or UCSF or Duke or Hopkins, but you should still be able to match into a pretty good IM program.

Don't set your goals so low. Relax, work hard, a good IM residency is still very possible.

 

[Hiram Coggin]

Good lord, I did a prelim year of medicine at a decent community med program affiliated with a major academis medical center. Some of the categoricals were so weak that they had to do up to 6 months of extra training just to finish their intern year. One guy was so dumb he couldn't figure out how to use the paging system or find the call room, AFTER 6 MONTHS. If you aren't an ax murderer programs such as this would grab a top 5 grad in a heartbeat. Don't sell yourself short.

 

[Ice-1]

Some of the categoricals were so weak that they had to do up to 6 months of extra training just to finish their intern year. /QUOTE]

How is it possible to do 6 extra months of training in one year (I'm assuming that these people did have to do all of the first year rotations)?

 

[Hiram Coggin]

Some of the categoricals were so weak that they had to do up to 6 months of extra training just to finish their intern year. /QUOTE]

How is it possible to do 6 extra months of training in one year (I'm assuming that these people did have to do all of the first year rotations)?

It means that an extra six months of training was tacked onto the intern year, before you are promoted to PGY-2. Of course this means extending entire residency training by 6 months as well.

 

[Ice-1]

It means that an extra six months of training was tacked onto the intern year, before you are promoted to PGY-2. Of course this means extending entire residency training by 6 months as well.

Yikes! What a deal for those people! Hopefully the decision to do that to them wasn't based on some subjective opinions but on a measurable or objective basis.