Rectifying two failed attempts on step 3.

[step2now]

Hello my fellow NICU peeps,

As the title suggest, non-US IMG doing Peds residency in a small university program . Did not have any red flags on the CV up until the tragedy of step 3. Have 220 on step 1 and 215 on step 2- no attempts on any exam ever in my life before. Did research in med school, volunteer work, attended conferences etc to build up my cv and overall it looked well rounded . Given the evaluations of my residency, I would put myself in the average to above average resident in my program. I work hard and im not lazy(my PD agrees I’m one of the strongest hardworker).

I’m applying this year to nicu fellowship and started to work on personal statement. There have been conflicting advice given about mentioning step three failure versus talking about it only if asked during the interview. I personally feel like having two failed attempts on it warrants it to be addressed on the personal statement.

The problem with that examination was the technical aspect that comes with using the CCS case software that is not there in any previous USMLE exams. And I know it is the reason because until my third attempt I did not realize what wrong I was doing in terms of using the software and the steps to follow to treat a patient although I knew what the ultimate treatment was required. I did not change anything in the ways I was attempting multiple choice questions and my assessment practice scores were in 220s to 230s which made me believe that multiple choice questions for not the issue after I failed the second time but using the software for cccases was. I do understand that I should have looked into it the first time I failed but I did not and I don’t have any explanation for that. I assumed that it was a multiple-choice question that was bringing me down because I thought doing bad on CCS cases wouldn’t fail a person in the exam as the multiple choice questions consisted a larger portion.

Can anybody give some insights/ideas/advise regarding how I can put this in a succinct form on my personal statement. That would be of a great help for me.

Would appreciate any sort of advice/encouragement/motivation because I need it now more than ever.

Yours truly,
NICU applicant

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[GoSpursGo]

This is tough. Honestly, I think the only reason to bring up a negative is to highlight how you've learned and thus this "negative" won't be a problem in the future. In this case, you didn't learn from the failure until you failed twice... so right now I'd probably advocate for just being silent on this until it's brought up in an interview. When it is, be as honest and straightforward as you have been here.

 

[SurfingDoctor]

If you don’t address it in the personal statement, be prepared to answer a lot of interview questions about it realizing that people who you don’t interview with but are part of the rank list discussion 1) will not necessarily be able to see your application in full and 2) won’t hear the explanation with their own ears.

To be frank, a failed step 3 that happened twice is a red flag that may not be able to be overcome. Apply broadly and hope for the best but keep expectations low.

 

[oldbearprofessor]

This will be challenging as although neo doesn't really care about Step 3 except that you ultimately pass, the low Step 2 combined with this will have some folks concerned about your ability to pass neo boards. If you have good in-service scores that can be helpful although they're not supposed to be used in this way. I'd 1) make sure you have some research that will interest programs and 2) pay attention to smaller programs that may not always fully match (these exist) and 3) make sure you have strong LORs that speak to academic ability.

Yes, you do need to address this briefly in your PS.

 

[HemeOncHopeful19]

I'm assuming you have no in-house program that might could vouch for you or look past it because they know you. How have your annual in training exam scores been? If your ITE scores have been good (and by good I don't mean average) then you might ask your PD to mention that in THEIR letter for you.

 

[step2now]

This will be challenging as although neo doesn't really care about Step 3 except that you ultimately pass, the low Step 2 combined with this will have some folks concerned about your ability to pass neo boards. If you have good in-service scores that can be helpful although they're not supposed to be used in this way. I'd 1) make sure you have some research that will interest programs and 2) pay attention to smaller programs that may not always fully match (these exist) and 3) make sure you have strong LORs that speak to academic ability.

Yes, you do need to address this briefly in your PS.

Thank you for your reply.
I do not have great in service test scores to be honest because most of my time was spent preparing for step 3.
How does one find the programs that go unfilled? Is there any link for it?
I do plan on addressing this in my PS but just trying to figure out how much of words/lines/paragraphs should be given for this in my PS?

 

[step2now]

I'm assuming you have no in-house program that might could vouch for you or look past it because they know you. How have your annual in training exam scores been? If your ITE scores have been good (and by good I don't mean average) then you might ask your PD to mention that in THEIR letter for you.

We do have an in-house program but there are five people competing for the same spot and there is only one spot each year. My ITE scores Have not been great because most of my time was spent on preparing for step three

 

[step2now]

If you don’t address it in the personal statement, be prepared to answer a lot of interview questions about it realizing that people who you don’t interview with but are part of the rank list discussion 1) will not necessarily be able to see your application in full and 2) won’t hear the explanation with their own ears.

To be frank, a failed step 3 that happened twice is a red flag that may not be able to be overcome. Apply broadly and hope for the best but keep expectations low.

Ouch. It’s scary when you mentioned that I am in your be able to overcome this.
Yes I do plan to apply broadly. At this point I do not have any other option left mentally other than hoping for the best.

 

[step2now]

This is tough. Honestly, I think the only reason to bring up a negative is to highlight how you've learned and thus this "negative" won't be a problem in the future. In this case, you didn't learn from the failure until you failed twice... so right now I'd probably advocate for just being silent on this until it's brought up in an interview. When it is, be as honest and straightforward as you have been here.

Honestly, I did learn from my failure, its just that I got confused about what was causing the mistake. The first time I failed I thought it was the MCQs that was putting me down, only later to realise that it was not but it was a CCS software. I know this is something I can’t go back and change it, but this is honestly what happened with me

 

[GoSpursGo]

Honestly, I did learn from my failure, its just that I got confused about what was causing the mistake. The first time I failed I thought it was the MCQs that was putting me down, only later to realise that it was not but it was a CCS software. I know this is something I can’t go back and change it, but this is honestly what happened with me

This may be true. The problem is that when a program who doesn't know you sees your app they are not going to be able to know that, and trying to blame it on not understanding the interface/software isn't going to be well-received.

NICU is competitive relative to other peds specialties, as you are seeing within your own residency classmates. You have to convince the people reviewing your app that you will not just be a "good" neonatologist, but that in fact you'll be a BETTER one than the other applicants they don't rank to match. When you're coming in with some red flags on your ability to pass the neo boards, that's going to require that you shine on your research and other parts of your application that much more.

 

[step2now]

This may be true. The problem is that when a program who doesn't know you sees your app they are not going to be able to know that, and trying to blame it on not understanding the interface/software isn't going to be well-received.

NICU is competitive relative to other peds specialties, as you are seeing within your own residency classmates. You have to convince the people reviewing your app that you will not just be a "good" neonatologist, but that in fact you'll be a BETTER one than the other applicants they don't rank to match. When you're coming in with some red flags on your ability to pass the neo boards, that's going to require that you shine on your research and other parts of your application that much more.

Agreed. I am working on 1-2 case reports, QI projects . Did some research in med school as well.
Any suggestion on how to talk about this on the personal statement? I’m not a native English speaker, I did study English in my home country but I do not have enough fluency to form a really concise/succinct description of what transpired.
Have been trying to brainstorm about it since few months but I am not able to really come to a conclusion on it.
Truly sucks to have one red flag that will cost me everything in my CV when I have worked hard to come this far

 

[Step Up]

I think programs understand that overcoming adversity is a positive attribute.

Also, I think IF you have trouble matching into neonatology fellowship (hopefully not!), successfully passing pediatrics boards will demonstrate to programs that step 3 was a hiccup and that your chances of passing neonatology boards are good.