and if my chances are significantly diminished now, it's something I want to take into account in order to re-evaluate whether or not I still want to go through with school.
Your chances of matching into EM are significantly diminished. Is it impossible? Of course not. That said, the major concern I have from this post and your other posts on this board is not whether you can do this, but whether or not you even want to try. Much of what you've written elsewhere seems to indicate that you want to be an ED attending, but that you are unwilling/extremely reluctant to do the work necessary to get there.
So let's say I do pull through with the work. Are my chances still significantly diminished? What is the main reason for this? Because I'm a DO, or because I failed one year, or both?
While the general rule is that no one gives a crap about your second year grades, FAILING them is entirely different. You need to explain what happened in your personal statement and why it won't be an issue going forward, then prove it with excellent 2nd and 3rd year grades and Step I/II scores.
Personally, if I were a PD, I'd be very hesitant to take someone who had failed a year of school. I've been to medical school. I know what you have to do to fail a year and it's not pretty. I wouldn't want any of the people I knew who failed a year working on my family members. Blunt but true.
I don't think the bizarre schedule and stressful shift work of EM is a very good idea for someone who suffers with anxiety/depression by the way. Make sure you do enough rotations in EM that you really know what you're getting into. It wouldn't be surprising to me to see you pick a different specialty because you want to do a different specialty, and not because you can't get into EM.
Thanks for your response.
Are first and second year grades a useful predictor of clinical grades? I'm not as good with the books as I am with people interaction, and so even though I struggled first 2 years, do I still have a good chance of acing clinical grades?
The only thing that performance in years 1+2 and years 3+4 have in common is that if you have the work ethic required to get good grades, it will typically translate well to your clinical years. That said, your clinical years are completely different. You still have shelf exams, and generally are disqualified from Honors / High Pass if you don't meet a certain threshold on those exams. Beyond that, the rest of your grade is almost entirely based on reviews from your attendings and residents. So to answer the question of "do I have a good chance of acing clinical grades?" the answer is: maybe. If your personal skills are as good as you say, that will help. On the other hand, your grades to date don't seem to indicate that you would do well on the shelf exams.
I also want to echo what white coat investor said about the lability of EM schedules. It is only a "lifestyle" specialty to people who haven't worked in it. Switching from days to nights then having a "day off" where you are basically just resetting your internal clock before you switch back to days isn't really a "lifestyle" specialty. Plus you have to take into account the fact that many of your days off will be on days when everyone else that you want to hang out with will be working. And then when the weekend rolls around and they're free, you will be back at work.
Long story short: don't do EM because it's a "lifestyle specialty." Do EM because you like EM. If you want lifestyle, go for radiology or outpatient IM/Peds.
Of course the hours are wacky in EM, but I like that for some reason rather than a typical 9-5, at least for now. Of course when I get a family, it might be harder. But the good thing about EM is that I can at least control the # of shifts I do. So if it gets too bad, I'd reduce that.
Radiology kind of interests me too, but that would be even tougher than EM. I like Anesthesiology as well.
The reason I am very focused on these specialties is because I also have another non-medical opportunity for work (I'm a non-trad). So I don't necessarily have to return to school. If I knew that I could only do Family or Internal, then I probably wouldn't go back. Hence I really want to get a feel of what my chances would be.
You can't control the number of shifts during residency.
To be perfectly honest, I think your chances are less that 1% given grades and other factors. You can't really just expect to rock step 1 after failing so many pre-clinical courses.
As a former chief (which mainly involved doing resident schedules), I wouldn't endorse an applicant who could be such a liability and potential burden on the rest of the residency and the department.
I'm listening to you and my opinion is that you're not a good candidate for EM. I'd recommend looking for a traditional lifestyle specialty or a part time career in medicine. You sound like you have a lot of personal issues and are not 100% sold on the specialty. If I were a PD, I probably would not strongly consider you unless your board scores were very good along with your clinical grades + outstanding SLORs showing a very clear turnaround with consistency. No PD or fellow class mate wants
You came in here asking for the opinions of the people on this board. They have more experience than either you or I. They are not stating these things to be hurtful, they are honestly answering the question you asked.
What makes you think I have "a lot" of personal issues? Yes, I failed one year due to some personal issues, but that was temporary and it got resolved. And I stated that I need a social life and can't work constantly, otherwise I get depressed, but I think that is fairly common. It's no secret that Medical Students and Residents have higher rates of depression, probably for that reason.
As far as being sold on EM. I don't think I can be more clear from my posts that I am really drawn to it, and I have been ever since I was a pre-med. I've shadowed in the ER, I've researched the typical work/procedures, the lifestyle, the misconceptions, the burnout factor, and all in all I remain very drawn to it. Who knows, I may change my mind during rotations, but you can say that about any student. As of now though, I remain 100% sold on EM.
When you say my board scores need to be very good - how good do you mean, compared to the typical EM resident?
Board score-wise, it's going to be somewhat of a catch-22, especially given the increased competitiveness of the field:
If you get less than 230-240, you won't be considered
If you get higher than 250-260, then people are going to wonder whether you were lazy during pre-clinical years and didn't apply yourself, which you can't do in EM, where you have to be on top of it all the time (one of the reason we work so few shifts is because you have to be on point for 8-12 hours making rapid decisions)
Not to pile on but this post magnifies why EM probably won't be a good choice for you. You say- I can't work constantly or I get depressed and I need a social life.....residency will cut into those areas of life drastically.
From what I have heard residents at my program and others say is that off service months are rough-icu you will be working long hours, trauma surgery long hours, etc... so your social time will drop significantly.
Also your med school clinical years might be rough for you as well. I can tell you during gen surgery it was up at the crack of dawn and got home 8/9pm. If there were any emergency cases you could kiss sleep goodbye.
Furthermore, from my previous career I can tell you that although everyone loves EM due to shift work it's stressful. You will wonder if you made the right call to discharge patient x or maybe you should have done a further workup for patient y. So please think about these things with your history of depression.
EDIT- I reviewed your old post and you were dismissed from your school? Did you transfer to another school or were you reinstated back into your old one? If you transferred to a new school I think your situation will be even bleaker.
This is my thought as well. You state that you have other non-medical employment/income opportunities so you're not reliant on future income as a physician to live your life.Honestly, aside from Emergency Medicine, I would do some deep soul searching and see if medicine is what you want to do period - regardless of the specialty.
Thanks for the reply.
I know I can't control shifts in residency, but I meant as an attending.
As far as my Step 1. Historically I've done well on standardized tests, if that counts for anything; I got above 30 on my MCAT. Not to mention, screwing up the way I did really will give me an extra boost since I really want to redeem myself.
And yes, if I get below average (for EM) scores, then I know my chances are almost nil. But what I really want to figure out is how much better in terms of Step 1, Step 2, grades, clinicals, LOR, research, will I have to do than the average person who gets accepted into an EM program, in order to compensate for my failed year. If I was asking this question in Dermatology, I know the answer would be "infinitely better". So am just trying to get a gauge for EM.
Ah, so school finally started and on my first round of exams I got B's. Now that I'm in the trenches, I am not so confident anymore I can get amazing grades, in school or on the boards. I think I can do well, but idk. I want EM and I am simply not into FM/IM/Peds. Given that I have another career opportunity and the uncertainty about me getting EM, I am really tempted to just pull the plug.
I'm sure most of you will say that I should go ahead and leave since most are already saying how slim my chances are in EM.
I agree with all posters here that you have a rough road ahead if you can only be happy if you match into EM, but you may be able to find a way in via an EM fellowship after an FM residency if you're willing to practice in more underserved areas.
I think you misunderstood. He's not talking about a combined EM/FM residency (in which case, your statements are correct), rather doing FM then an unaccredited 1y "EM Fellowship" (in which case I'm not so sure about your statements).No, not regarded lower. No change in chance of getting a job, no change in pay.
The combined family medicine/emergency medicine residency is incredibly competitive and fills every year with applicants who are devoted to eventually practicing in underserved areas. Given that you have failed your second year of medical school, you will not be interviewed for any of these positions. As far as the family medicine residency followed by an unaccredited emergency medicine fellowship, there may still be hope for you. If you are willing to take a rural job that no one else wants then maybe you can still practice some emergency medicine – although it will likely be a walk-in clinic at this point. I will echo what multiple other posters have said on this board: failing a year of medical school is going to kill your chances at most programs. My alma mater would not interview you. Most places are not going to interview you. Reading over the rest of your post I think that you have a large disconnect with what's going to happen in the future. Your best preparation for Step I is the first two years of medical school. If you don't do well during these two years I doubt that you are going to ace Step I as you claim. And although clinical grades do depend quite a bit on subjective factor such as evaluations from attendings and senior residents, you still need to impress them with the knowledge of disease processes that comes from hours of reading independently. I'm not sure about the competitiveness of community DO programs, but the ship has sailed on going the ACGME route. I also read your post where you mentioned that emergency medicine is a lifestyle specialty and that you think you'll be happy in it because you can simply cut down the number of shifts worked as an attending. This won't happen. EM is hard on families given that you have to work so many nights and weekends. Your spouse and kids don't care that you are available on a Tuesday morning to spend time with them. And given that many first time jobs right out of residency are going to expect you to work full time, simply stating that you're going to work fewer shifts may land you in the unemployment line. The few people who I know who can turn emergency medicine into a lifestyle specialty are department chairmen who get the pick of shifts and generally work occasional weekday day shifts and nocturnalists who have set schedules such as working every Sunday, Monday, and Tuesday night. Other than stating that you want a lifestyle specialty, you haven't really mentioned why you are so interested in emergency medicine. Is it the procedures? Lots of specialties have procedures and for some, such as breast surgery, the hours aren't that bad.
Can't hurt. Especially with AOA programs, the best way to match is to do a sub-I and convince them that you are so awesome they could barely function without you.Would it help me if I reach out to several PD's and Residency Programs in my area, particularly those rotation sites affiliated with my school? I am thinking about doing this and asking to meet with PD's to show interest, ask them how I can increase my chances, ask for research opportunities if they have. I'm hoping this will help them to get to know me, and show my passion. I would of course disclose that I am repeating a year.
I've never heard of students doing this, so I don't know if it is good or bad. Any opinions?
Would it help me if I reach out to several PD's and Residency Programs in my area, particularly those rotation sites affiliated with my school? I am thinking about doing this and asking to meet with PD's to show interest, ask them how I can increase my chances, ask for research opportunities if they have. I'm hoping this will help them to get to know me, and show my passion. I would of course disclose that I am repeating a year.
I've never heard of students doing this, so I don't know if it is good or bad. Any opinions?