Repeating first year as career changer

[deleted735882]

I am a first year at a DO school and due to being unprepared for how difficult medical school would be (and probably due to burn out from my prior career) I failed my first semester. I know I am capable of doing better but I had no background besides the minimum prereqs (non-science background), and the first semester was very basic sciences loaded. I had a 3.8+ science gpa and 32 mcat but chose a DO school over MD for location/family reasons. I was just emotionally overwhelmed being back in school all over again.

I took our school's mock board exam (required "final") and scored in the upper quartile of the class (good test taker). I am confident I can shape up over winter break, start honoring some courses once we hit systems.

I am wondering how residencies will view me repeating a year? I am interested in competitive specialties and discouraged the first semester closed off a lot of opportunities. Assuming I can achieve a Step 1 score above 250, upper quartile class rank (repeating erases your prior grades), and some honors in clinical rotations, am I still competitive?

I know a repeat looks bad but I am wondering if it will be alleviated by the fact I left my prior career and started medical school the same year. And all my fails were limited to the first semester.

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[Mad Jack]

You will be extremely limited in regard to competitive specialties, regardless of Step 1 score. You have two red flags for competitive specialties- you are a DO and you had to repeat a year. When they get hundreds to thousands of applicants, you will end up on the bottom of their interview list, if at all. I'm not trying to be harsh, but that's just reality. If you define "competitive," I could help you determine if you still stand a chance, as some fields are more forgiving than others. You can pretty much rule out anything surgical, but some other fields might give you a chance.

 

[deleted735882]

You will be extremely limited in regard to competitive specialties, regardless of Step 1 score. You have two red flags for competitive specialties- you are a DO and you had to repeat a year. When they get hundreds to thousands of applicants, you will end up on the bottom of their interview list, if at all. I'm not trying to be harsh, but that's just reality. If you define "competitive," I could help you determine if you still stand a chance, as some fields are more forgiving than others. You can pretty much rule out anything surgical, but some other fields might give you a chance.

It sounds harsh but I am looking for an honest answer so I appreciate the response. I really regret a lot of choices I made. I should have just went to the MD school and taken a leave of absence when I realized I was unprepared for school emotionally and psychologically. I am not interested in any surgical specialties but may be interested in EM, anesthesiology, or sub-specializing in IM (ie need to get into a good residency).

 

[Mad Jack]

It sounds harsh but I am looking for an honest answer so I appreciate the response. I really regret a lot of choices I made. I should have just went to the MD school and taken a leave of absence when I realized I was unprepared for school emotionally and psychologically. I am not interested in any surgical specialties but may be interested in EM, anesthesiology, or sub-specializing in IM (ie need to get into a good fellowship).

You can still do EM, anesthesiology, or IM. They are competitive, but not ultra-competitive. Your safest route would be IM>subspecialty. If you let me know what your interests are, I might be able to direct you further. EM is going to get a bit rougher after the merger, but tends to be a fairly holistic specialty. Anesthesia has had expanding positions and declining interest for years. You can definitely get into one of the three dude.

 

[deleted735882]

How about an IM residency at an academic center? That is at a non-community hospital. I am hoping to get into oncology or CC/PM (not GI or Cardio).

 

[AlteredScale]

How about an IM residency at an academic center? That is at a non-community hospital. I am hoping to get into oncology or CC/PM (not GI or Cardio).

Getting into academic IM residencies is much harder than a community. As madjack said, you have two dings on you. Do well on boards, honor your rotations, rotate at academic centers fourth year, get solid LORs from legitimate faculty, NOT unknown precpetors from a clinic. Those things will help but not clean your slate for failing out.

 

[deleted735882]

It is annoying because in retrospect a leave of absence would have been a much smarter move (or going MD). Medicine is pretty unforgiving...so much pressure from day one. I dont see how having a higher Step 1 score than other applicants won't be favorable especially since I switched from another career.

 

[Jinxapotato]

You can still do EM, anesthesiology, or IM. They are competitive, but not ultra-competitive. Your safest route would be IM>subspecialty. If you let me know what your interests are, I might be able to direct you further. EM is going to get a bit rougher after the merger, but tends to be a fairly holistic specialty. Anesthesia has had expanding positions and declining interest for years. You can definitely get into one of the three dude.

Sorry to ask a side question, but would you comment on how the subspecialties will view you after you complete your residency (let's say a solid ACGME IM program)? Would they still care about things like "DO, repeated a year in medical school"? Or will they simply consider the quality and performance of your residency? Also, what are the odds of a DO matching into a good academic IM program (I'm not talking about MGH level, but solid, mid tier ACGME residencies)? Thank you for your help!!

 

[Mad Jack]

Sorry to ask a side question, but would you comment on how the subspecialties will view you after you complete your residency (let's say a solid ACGME IM program)? Would they still care about things like "DO, repeated a year in medical school"? Or will they simply consider the quality and performance of your residency? Also, what are the odds of a DO matching into a good academic IM program (I'm not talking about MGH level, but solid, mid tier ACGME residencies)? Thank you for your help!!

Mid-tier is doable if you work hard. No one cares about where you went to medical school aside from a very small number of exceptions (MGH, etc)- there's probably only about 15-20 places in the country that will still hassle you at all based on where you went to medical school versus where you trained. That you repeated a year is completely irrelevant after residency- they just don't care to look back that far, that's like asking a medical student how well they did in high school when you're trying to sort out who to rank. Even if you can't match mid-tier, you should be able to match low-tier university, which is still better than a vast majority of community programs (and good enough to get into most fellowships if you do research and apply broad enough).

 

[Jinxapotato]

Mid-tier is doable if you work hard. No one cares about where you went to medical school aside from a very small number of exceptions (MGH, etc)- there's probably only about 15-20 places in the country that will still hassle you at all based on where you went to medical school versus where you trained. That you repeated a year is completely irrelevant after residency- they just don't care to look back that far, that's like asking a medical student how well they did in high school when you're trying to sort out who to rank. Even if you can't match mid-tier, you should be able to match low-tier university, which is still better than a vast majority of community programs (and good enough to get into most fellowships if you do research and apply broad enough).

Thank you for your response! In this case OP I think it would make most sense that you go for the IM->subspecialty route, work hard and land a good residency! GL!

 

[Mad Jack]

Thank you for your response! In this case OP I think it would make most sense that you go for the IM->subspecialty route, work hard and land a good residency! GL!

He could also go with the apply EM/Anesthesia with IM as a backup route- that's totally viable. Just make sure you've got the letters- you can really only make your app viable for a couple of specialties at a time unless you're really, really good.

 

[kenjixshadow]

You didn't tell us about your plan in the next half year. How about do some research and get publications? Publications will not forgo the failure, but it will make your application look great and that is assuming you are able to get over 250 on step 1 when you just failed first year. Moreover, ask your classmates for their notes and pre-study during the break you have. You want every exposure that you can get. When you start school again, make sure that you pass every class and get a tutor if you need to. Btw, I can tell you that EM is getting very competitive this year. Many applicants (MDs) with 230-240 on boards with no red flags + honors/HP SLOEs were not able to land double digits interviews whereas top applicants are going 12+ interviews to make sure that they will 100% match. Gas seems like the most favorable in your current situation. Anyway, GL. Keep me update.

 

[deleted735882]

I feel I failed first year because I didn't know a lot of minutia and was generally overwhelmed getting adjusted to medical school and being in school. I always favored critical thinking over rote memorization. I did well so far (MCAT/science gpa) because I could figure things out. Medical school is NOT about figuring things out. Hard work and brute memorization ftw.

 

[Mad Jack]

I feel I failed first year because I didn't know a lot of minutia and was generally overwhelmed getting adjusted to medical school and being in school. I always favored critical thinking over rote memorization. I did well so far (MCAT/science gpa) because I could figure things out. Medical school is NOT about figuring things out. Hard work and brute memorization ftw.

Yeah, pretty much. Medical school is a grind for the whole first two years. And the boards are this awful conglomeration of facts that you have to follow through insanely obscure paths to come to the right conclusion rather than critical thinking. Like, they'll tell you your patient has a specific type of appearance, then ask you what embryological layer the defective structure in their heart stemmed from. So you need to remember what appearance corresponds to the disease, what other components the syndrome has, and then remember the embryology behind those other components to successfully answer a question. There's like, three layers to everything on the USMLE like that. The COMLEX tends to be more two layer questions, but the USMLE is a ****ing onion of minutiae.

 

[235009]

OP, I appreciate that you are trying to be optimistic and make the best out of a bad situation. You need to have a more realistic outlook and be absolutely sure that you'd be ok with an outcome other than the ones you described. Failing a semester is a big deal and scoring 250 on step 1 is extremely hard as is honoring rotations. Again it's fine that you're optimistic but going from bottom 5% of your DO class to top ~15% of all step 1 test takers is far from likely.

The easiest route of the ones you described is anesthesia. The field's popularity is plummeting among US MDs which has opened it up to DOs and IMGs. You can end up at a solid program as a DO even with a red flag on your record. Realize though that the job market is pretty tight now with the encroachment of CRNAs and hospitals looking to cut costs.

EM and IM are both moderately competitive specialties that are getting more popular. I can't really comment about your chances in EM but the chance of ending up at an academic IM program after failing the first semester are very low. Only the cream of the crop DO IM applicants nationwide end up at the mid-tier academic programs that accept DOs. You're likely already out of the running for those spots. A handful more end up at low-tier programs, usually in less desirable locations. The vast majority end up at community programs. You can look up your school's match list or those of other DO schools to verify this and I'd be happy to help you interpret them if you want. I would guess that failing a semester will make it a very uphill battle with regards to getting into an academic IM program. This will be a big obstacle for matching heme/onc or pulm/CC, two of the top 4 subspecialties in terms of competition. This year only 4% of heme/onc and 8% of pulm/CC spots went to DOs. My point is that if you do end up applying IM you have to be at peace with being a hospitalist or PCP at the end of residency. You're still a long way off from making this decision though.

Good luck.

 

[Jinxapotato]

EM and IM are both moderately competitive specialties that are getting more popular. I can't really comment about your chances in EM but the chance of ending up at an academic IM program after failing the first semester are very low. Only the cream of the crop DO IM applicants nationwide end up at the mid-tier academic programs that accept DOs.

I have always been told that IM is a rather "non competitive" specialty 0.0 (and EM is described as the equivalent of fighter pilots in air force..)? Are you referring to the specialty as a whole (ie including all the community programs) or just the MD mid tier academic programs (which I too believe is quite competitive)?

 

[235009]

I have always been told that IM is a rather "non competitive" specialty 0.0 (and EM is described as the equivalent of fighter pilots in air force..)? Are you referring to the specialty as a whole (ie including all the community programs) or just the MD mid tier academic programs (which I too believe is quite competitive)?

if you look at charting outcomes you'll see that the average step 1 score for IM (including all those community programs) and EM are very similar (around 230). The top tier of IM is, I would say, as competitive as derm or other competitive subspecialties though they give some leeway to students from top tier US MD schools. The competition wanes from there and as a US MD you can land a spot at a mid-tier program with a very average or slightly above average app and if you aren't geographically restricted you can certainly end up in an academic program with a below average app. The bar is set much higher for DOs.

 

[deleted735882]

if you look at charting outcomes you'll see that the average step 1 score for IM (including all those community programs) and EM are very similar (around 230). The top tier of IM is, I would say, as competitive as derm or other competitive subspecialties though they give some leeway to students from top tier US MD schools. The competition wanes from there and as a US MD you can land a spot at a mid-tier program with a very average or slightly above average app and if you aren't geographically restricted you can certainly end up in an academic program with a below average app. The bar is set much higher for DOs.

This confims I should have went to a MD school. Ugh. Does it matter that much what residency you go to? I imagine there is a lot of self-selection with respect to fellowships. I didn't know the first few months of medical school would destroy my entire career. If I were to publish actively at a community hospital, get good LORs, with a high Step 1 score would PDs at fellowship shake their head at the fact I repeated the first semester (even as a career changer)?

In other words are you saying there is absolutely nothing I can do better relative to an MD applicant who didnt fail their first semester between now and the next 6 or 7 years of my medical education that will allow PDs to choose me?

 

[Mad Jack]

OP, I appreciate that you are trying to be optimistic and make the best out of a bad situation. You need to have a more realistic outlook and be absolutely sure that you'd be ok with an outcome other than the ones you described. Failing a semester is a big deal and scoring 250 on step 1 is extremely hard as is honoring rotations. Again it's fine that you're optimistic but going from bottom 5% of your DO class to top ~15% of all step 1 test takers is far from likely.

The easiest route of the ones you described is anesthesia. The field's popularity is plummeting among US MDs which has opened it up to DOs and IMGs. You can end up at a solid program as a DO even with a red flag on your record. Realize though that the job market is pretty tight now with the encroachment of CRNAs and hospitals looking to cut costs.

EM and IM are both moderately competitive specialties that are getting more popular. I can't really comment about your chances in EM but the chance of ending up at an academic IM program after failing the first semester are very low. Only the cream of the crop DO IM applicants nationwide end up at the mid-tier academic programs that accept DOs. You're likely already out of the running for those spots. A handful more end up at low-tier programs, usually in less desirable locations. The vast majority end up at community programs. You can look up your school's match list or those of other DO schools to verify this and I'd be happy to help you interpret them if you want. I would guess that failing a semester will make it a very uphill battle with regards to getting into an academic IM program. This will be a big obstacle for matching heme/onc or pulm/CC, two of the top 4 subspecialties in terms of competition. This year only 4% of heme/onc and 8% of pulm/CC spots went to DOs. My point is that if you do end up applying IM you have to be at peace with being a hospitalist or PCP at the end of residency. You're still a long way off from making this decision though.

Good luck.

9.8% of pulm/CC spots went to DOs, actually. DOs made up 8.7% of applicants overall, so that doesn't look so bad on the surface. Unfortunately, they only provide numbers for the number of applicants matched to a specialty, not those that applied (aside from on the allo side of things), so it is hard to say whether DOs underperformed or overperformed relative to their weight. To compare to the allo side of things, allo apps made up 54.2% of applications overall, 38.7% of pulmonary applications, and 50.3% of pulmonary/CC matriculants. I guess I'll just leave it at- things are going to get more competitive in the next few years, so, as MT said, don't go into IM unless you're comfortable doing primary care, doing a less competitive specialty, or being a hospitalist.

 

[Mad Jack]

This confims I should have went to a MD school. Ugh. Does it matter that much what residency you go to? I imagine there is a lot of self-selection with respect to fellowships. I didn't know the first few months of medical school would destroy my entire career. If I were to publish actively at a community hospital, get good LORs, with a high Step 1 score would PDs at fellowship shake their head at the fact I repeated the first semester (even as a career changer)?

In other words are you saying there is absolutely nothing I can do better relative to an MD applicant who didnt fail their first semester between now and the next 6 or 7 years of my medical education that will allow PDs to choose me?

Your best shot at getting into a fellowship is by getting into an academic program, though now you're likely going to be limited to low tier academic (or perhaps mid-tier if you're willing to go to some less than desirable areas, but even that would be an uphill fight) as your reasonable ceiling. That's going to be a long shot though. As to whether you should have gone MD- you still would have failed out that first year, and that still would have made you fairly damaged goods that would have a tough go at a mid tier or higher program. Fellowships don't care about what happened in medical school, but they do care about where you went to residency, and you need to go to the most academically inclined place you can get your foot into the door of if you want to make a decent fellowship happen.

Anesthesia though, still totally doable. EM is kind of a toss-up, as it gets more and more competitive each year and we're losing the protected AOA spots in the near future. I predict it'll be moderately competitive by the time you're matching- possible to get into, but have a backup.

 

[deleted735882]

It wont be easy but at least it wont be impossible. 🙂

 

[Mad Jack]

It wont be easy but at least it wont be impossible. 🙂

You really need to weigh the cost of failure of each career as well though- anesthesia and EM, you're where you need to be. End up failing the fellowship match in IM, and you're stuck writing discharge orders and wrangling social work until the day you die. If hospitalist medicine isn't your thing, and you're not down with primary care, that's a big risk to take, so choose wisely.

 

[cbrons]

How about an IM residency at an academic center? That is at a non-community hospital. I am hoping to get into oncology or CC/PM (not GI or Cardio).

Just worry for now about doing well. You are still only M1. Recognize that you cannot fail anything else from here on out and don't have red flags (grades, bad evals, "professionalism") from here on out.
And do not listen to many of your upper class DO classmates who say you don't have to take Step 1, because taking this test and doing very well on it will matter a lot for you. These are the things you should focus on. Don't even think about what type of residency you want to do until after you take Step I.
And ensure that you find ways of better controlling your stress that are efficacious long-term.

 

[235009]

This confims I should have went to a MD school. Ugh. Does it matter that much what residency you go to? I imagine there is a lot of self-selection with respect to fellowships. I didn't know the first few months of medical school would destroy my entire career. If I were to publish actively at a community hospital, get good LORs, with a high Step 1 score would PDs at fellowship shake their head at the fact I repeated the first semester (even as a career changer)?

In other words are you saying there is absolutely nothing I can do better relative to an MD applicant who didnt fail their first semester between now and the next 6 or 7 years of my medical education that will allow PDs to choose me?

It's unfortunate you were duped by the propaganda and DO cheerleaders on SDN. There is a very big advantage to going to an MD school.

From a 2007 article in Academic Internal Medicine, out of 18 criteria, fellowship PDs ranked "University-based residency" fourth behind your interview and LORs from known specialists and you PD. So yes it matters a whole lot which residency you go to. Interest in research was #5 and publications was #9. Fellowship applications also asked for the MSPE letter from med school which typically includes a summary of your first year grades and your class rank. If that indicates you failed our were a sub-par med student that might have an effect. One of my interviewers actually mentioned my MSPE so they certainly still look at it (to varying degrees probably) even for fellowship. The point though isn't that this one thing is going to specifically hold you back in 7 years... it's more of a snowball effect of potentially getting a step 1 score that's lower than you're hoping for, potentially struggling later on in med school, not going to a university program which will lead up to difficulty matching a subspecialty.

I would stop stressing out about this if I were you and come back in 2 years. Things will be clearer then. The only reason to have this discussion now is if you're considering dropping out and going back to your old career which it doesn't sound like you are.

9.8% of pulm/CC spots went to DOs, actually. DOs made up 8.7% of applicants overall, so that doesn't look so bad on the surface. Unfortunately, they only provide numbers for the number of applicants matched to a specialty, not those that applied (aside from on the allo side of things), so it is hard to say whether DOs underperformed or overperformed relative to their weight. To compare to the allo side of things, allo apps made up 54.2% of applications overall, 38.7% of pulmonary applications, and 50.3% of pulmonary/CC matriculants. I guess I'll just leave it at- things are going to get more competitive in the next few years, so, as MT said, don't go into IM unless you're comfortable doing primary care, doing a less competitive specialty, or being a hospitalist.

The 8% is coming from the match that happened two weeks ago. I don't think the data is available publicly yet but is available to those of us who took part in the match this year.

 

[Mad Jack]

There is an incredibly important lesson to be learned here, for anyone that might be considering this thread and is in the application process.

If you have even the slightest inkling that you want to choose even a moderately competitive specialty, if there's even a chance, ALWAYS go MD. App killers for DOs aren't as bad for MDs, you are more geographically flexible as an MD, research is easier to come by. Just, go MD if you can. Not because the schools are de facto better, but because they're higher up on the pecking order, and that matters.

Also you can avoid the annoyance of two sets of boards. And like a million other things.

 

[deleted735882]

Also if you are a career changer from an unrelated field ignore what people say about not doing anything before medical school. They are coming in with significantly more background knowledge that will make medical school easier. YOU should be doing some previewing. Nothing crazy but at least learn anatomy better or molecular biology.

 

[Jinxapotato]

I totally understand that if you had a MD and a DO acceptance in front of you, definitely go MD. However for most of us, it really wasn't a matter of choice. I had 2 MD waitlists that rejected me, and 1 DO acceptance. I mean I technically can wait a year and reapply, but who knows what's gonna happen? Might as well go for that DO and be a doc (although I was perfectly fine with not going derm/ophtho..)

 

[Jamie561]

It is annoying because in retrospect a leave of absence would have been a much smarter move (or going MD). Medicine is pretty unforgiving...so much pressure from day one. I dont see how having a higher Step 1 score than other applicants won't be favorable especially since I switched from another career.

sorry to be harsh, but getting a "250+" step 1 score like you hope for is not likely given that you repeated first year. the average step 1 is around 225 and though no data exist on this, I would guess that those who do above average are not those who repeated a year of medical school

 

[deleted735882]

sorry to be harsh, but getting a "250+" step 1 score like you hope for is not likely given that you repeated first year. the average step 1 is around 225 and though no data exist on this, I would guess that those who do above average are not those who repeated a year of medical school

I agree it is unlikely and totally depends on why I repeated. I would have to be a statistical aberration. Never contested this, but I view my failure as an aberration, not a foretold prediction of the future.

It really was a very difficult time for me emotionally and psychologically and these issues will be addressed.

 

[Drrrrrr. Celty]

OP, I appreciate that you are trying to be optimistic and make the best out of a bad situation. You need to have a more realistic outlook and be absolutely sure that you'd be ok with an outcome other than the ones you described. Failing a semester is a big deal and scoring 250 on step 1 is extremely hard as is honoring rotations. Again it's fine that you're optimistic but going from bottom 5% of your DO class to top ~15% of all step 1 test takers is far from likely.

The easiest route of the ones you described is anesthesia. The field's popularity is plummeting among US MDs which has opened it up to DOs and IMGs. You can end up at a solid program as a DO even with a red flag on your record. Realize though that the job market is pretty tight now with the encroachment of CRNAs and hospitals looking to cut costs.

EM and IM are both moderately competitive specialties that are getting more popular. I can't really comment about your chances in EM but the chance of ending up at an academic IM program after failing the first semester are very low. Only the cream of the crop DO IM applicants nationwide end up at the mid-tier academic programs that accept DOs. You're likely already out of the running for those spots. A handful more end up at low-tier programs, usually in less desirable locations. The vast majority end up at community programs. You can look up your school's match list or those of other DO schools to verify this and I'd be happy to help you interpret them if you want. I would guess that failing a semester will make it a very uphill battle with regards to getting into an academic IM program. This will be a big obstacle for matching heme/onc or pulm/CC, two of the top 4 subspecialties in terms of competition. This year only 4% of heme/onc and 8% of pulm/CC spots went to DOs. My point is that if you do end up applying IM you have to be at peace with being a hospitalist or PCP at the end of residency. You're still a long way off from making this decision though.

Good luck.

Idk about you needing to be cream of the crop to land mid tier IM as a DO. Maybe landing a high tier university program sure, but I'm sure that decent amount ( I'll say 30% of DO apps) DOs with a reasonable USMLE can land a mid tier IM program if at least in a less desired location.

 

[familyaerospace]

Well if it makes you feel any better, I am an MD student who had to take a LOA (I am also a career changer who came in with nothing) and is going to be repeating the year. You and I are going to be in it together so try to relax and we can do our best next year. 🙂

 

[FrkyBgStok]

Also if you are a career changer from an unrelated field ignore what people say about not doing anything before medical school. They are coming in with significantly more background knowledge that will make medical school easier. YOU should be doing some previewing. Nothing crazy but at least learn anatomy better or molecular biology.

i am sorry, but this is just false. i had nothing more than the prereqs, was a career changer in a completely unrelated field (truck driving can't be more unrelated) and did fine. There are plenty of people who were in the same boat as me that span from the top quartile to the bottom. i hate to burst your bubble, but you will be applying against other career changers that didn't fail any classes. you can blame your previous career, you can blame the fact that you went to a DO school, but none of that matters. You need to accept what is done, what your options are moving forward, and make the best of it.

 

[deleted735882]

i am sorry, but this is just false. i had nothing more than the prereqs, was a career changer in a completely unrelated field (truck driving can't be more unrelated) and did fine. There are plenty of people who were in the same boat as me that span from the top quartile to the bottom. i hate to burst your bubble, but you will be applying against other career changers that didn't fail any classes. you can blame your previous career, you can blame the fact that you went to a DO school, but none of that matters. You need to accept what is done, what your options are moving forward, and make the best
of it.

I respectfully disagree. There was also burnout involved for me and my prior career was very intellectually taxing but in a way that was very different from medicine. I think you came in with more of a blank slate while I had to re-wire the way my brain worked.

Having said that I definitely admire the fact you did well and I am sure you were ready in more ways than one to hit the ground running from day one. I was seriously burnt out / unprepared to think in a way which ran counter to years of prior training.

 

[FrkyBgStok]

i am not saying your career wasn't taxing or that the burnout wasn't warranted. i am just trying to paint a realistic picture for you. If I remember correctly, ERAS, the application you send to everyone when applying to residency asks if you have ever failed any classes or if your med school was extended in any way. I didn't have problems and interviewers see my application, and i still get asked in interviews if i had any struggles with classes in med school, if i failed any classes, or if my med school was extended in any way. I am not trying to discount what you did in, but I do think you need to look at the realistic side of things. There are residencies out there that won't give you the opportunity to explain yourself because there are plenty of people applying for the same spot that didn't have troubles.

And i agree with you. If you get a 250 on the USMLE but fail a class, you should still be looked at as knowing the material better than someone who got a 220 and didn't fail. But that isn't always how it is.

 

[235009]

Idk about you needing to be cream of the crop to land mid tier IM as a DO. Maybe landing a high tier university program sure, but I'm sure that decent amount ( I'll say 30% of DO apps) DOs with a reasonable USMLE can land a mid tier IM program if at least in a less desired location.

Just to be clear "high tier University program" is not attainable as a DO. Mid tier programs are the absolute ceiling and you do have to be the cream of the crop or have the right connections as a DO to get there.

 

[Drrrrrr. Celty]

Just to be clear "high tier University program" is not attainable as a DO. Mid tier programs are the absolute ceiling and you do have to be the cream of the crop or have the right connections as a DO to get there.

Just saying, but going off of just my school's list I counted about 20-30 IM matches at university programs and 1 or 2 at high tier places ( U Chicago Med Center). This not counting military matches.

idk, but when 60% of your class that applied for IM is going off to 'university' programs in that, it doesn't seem like you need to really be 'cream of the crop'.

 

[IslandStyle808]

Just to be clear "high tier University program" is not attainable as a DO. Mid tier programs are the absolute ceiling and you do have to be the cream of the crop or have the right connections as a DO to get there.

Wait if I recall correctly we had a thread about UW and internal medicine matching (a high tier program). There were two students one from RVU and one from DMU that match there. Wouldn't it be more correct to say you have to be cream of the crop to match at a high tier university program?

 

[Jinxapotato]

Wait if I recall correctly we had a thread about UW and internal medicine matching (a high tier program). There were two students one from RVU and one from DMU that match there. Wouldn't it be more correct to say you have to be cream of the crop to match at a high tier university program?

Apparently people from my school matched Yale, Mayo n U Wash, now I'm sure they are super stars and it is rare, but I think it does happen....Once in a while...

EDIT: we don't know if it is IM tho

 

[Drrrrrr. Celty]

Apparently people from my school matched Yale, Mayo n U Wash, now I'm sure they are super stars and it is rare, but I think it does happen....Once in a while...

EDIT: we don't know if it is IM tho

I think matching high tier IM is going to be difficult and will undoubtedly require you to be in the top 5% of your class. But mid tier IM? I imagine as long as you score average or higher on the USMLE you'll manage to get it.

 

[Jamie561]

I think the take home message for OP is to do as much research and step 1 prep as possible from here on out. target strong community programs and you should end up in a fellowship at least, even though it may not be a name brand one

 

[Jamie561]

Apparently people from my school matched Yale, Mayo n U Wash, now I'm sure they are super stars and it is rare, but I think it does happen....Once in a while...

EDIT: we don't know if it is IM tho

DO skools love spinning things. probably all noncompetitive specialties. just like when people brag about a UCSF match and people think it's IM but turns out it's UCSF Fresno family med

 

[235009]

Just saying, but going off of just my school's list I counted about 20-30 IM matches at university programs and 1 or 2 at high tier places ( U Chicago Med Center). This not counting military matches.

idk, but when 60% of your class that applied for IM is going off to 'university' programs in that, it doesn't seem like you need to really be 'cream of the crop'.

I suspect you may be confused by the names of programs where the affiliated community programs use the name of the University program or by community programs that just throw the word "University" in their name. A couple examples from my neck of the woods that I saw on the turo match list which I was looking at earlier in this thread are Staten island University Hospital and Nassau University Medical Center. Both are small community programs. If you link me to your schools match list I'd be happy to go through the IM portion with you or verify what you are suggesting.

I think matching high tier IM is going to be difficult and will undoubtedly require you to be in the top 5% of your class. But mid tier IM? I imagine as long as you score average or higher on the USMLE you'll manage to get it.

I think we have very different definitions of high tier. UW while certainly a solid University program does not come close to making the cut.

Also this is why a lot of people are shocked/disappointed when they apply for residency - they think IM is so easy to get into. As a US MD with a 250 in the top half of my class I didn't get a single top tier interview. Don't get me wrong I'm very happy with where I ended up and out got me to where I wanted but just pointing out that your notion that a DO can just waltz into a mid tier program with average stats is far from the truth.

 

[AlteredScale]

Apparently people from my school matched Yale, Mayo n U Wash, now I'm sure they are super stars and it is rare, but I think it does happen....Once in a while...

EDIT: we don't know if it is IM tho

I believe these matches did happen! but some detail:

Yale - if IM or surgery, probably not the main Yale university hospital. Yale has other university hospital affiliates. It's similar to ucla in that you have DOs matching to ucla harborview (smaller and filled with img's, not like Ronald Reagan which is their main university hospital). Possible chance of ten doing IM but a primary care track, not their categorical.

Mayo - If IM or surgery, probably the Arizona or Florida satellite. Mayo isn't considered a true university hospital like Stanford Med, NYP-Cornell/Columbia so in reality it's not a top tier university program per se. It's good don't get me wrong! But not the same as someone getting into IM at HUP (UPenn).

UWash - likely, but def not a surgical program or IM program. KCU pulls in a lot of of their grads to WashU through pathology and PM&R. Again not as competitive as IM or General surgery at WashU (which is Barnes Jewish hospital).

This is def not a rag on DO matches but better to put out the reality of it and get rid of the pipe dream that a ceiling is being broken right now. Our school decided to put "internal medicine - university of Chicago" when in reality it was NorthShore health system (communi-versity hospital) which is entirely different from a IM program at UChicafo.

 

[IslandStyle808]

I believe these matches did happen! but some detail:

Yale - if IM or surgery, probably not the main Yale university hospital. Yale has other university hospital affiliates. It's similar to ucla in that you have DOs matching to ucla harborview (smaller and filled with img's, not like Ronald Reagan which is their main university hospital). Possible chance of ten doing IM but a primary care track, not their categorical.

Mayo - If IM or surgery, probably the Arizona or Florida satellite. Mayo isn't considered a true university hospital like Stanford Med, NYP-Cornell/Columbia so in reality it's not a top tier university program per se. It's good don't get me wrong! But not the same as someone getting into IM at HUP (UPenn).

UWash - likely, but def not a surgical program or IM program. KCU pulls in a lot of of their grads to WashU through pathology and PM&R. Again not as competitive as IM or General surgery at WashU (which is Barnes Jewish hospital).

This is def not a rag on DO matches but better to put out the reality of it and get rid of the pipe dream that a ceiling is being broken right now. Our school decided to put "internal medicine - university of Chicago" when in reality it was NorthShore health system (communi-versity hospital) which is entirely different from a IM program at UChicafo.

I had a feel that that was what was going on.

 

[235009]

Wait if I recall correctly we had a thread about UW and internal medicine matching (a high tier program). There were two students one from RVU and one from DMU that match there. Wouldn't it be more correct to say you have to be cream of the crop to match at a high tier university program?

Just looked through the UW internal medicine roster which is publicly available online (https://depts.washington.edu/uwmedres/people/roster.htm). There are no CATEGORICAL DOs. There are two prelims: one from Touro and one from Rocky vista. Both are doing neuro at UW so THAT is their actual match not IM.
Don't believe everything you hear without looking into it yourself. People don't understand how to read a match list and the schools will try to exaggerate and obfuscate to try and make things sound better than they actually are.

 

[IslandStyle808]

Just looked through the UW internal medicine roster which is publicly available online (https://depts.washington.edu/uwmedres/people/roster.htm). There are no CATEGORICAL DOs. There are two prelims: one from Touro and one from Rocky vista. Both are doing neuro at UW so THAT is their actual match not IM.
Don't believe everything you hear without looking into it yourself. People don't understand how to read a match list and the schools will try to exaggerate and obfuscate to try and make things sound better than they actually are.

Not referring to those two.

There are two categorical DOs. An R3 from Des Moines University and an R2 from Rocky Vista University (in the internal medicine program). Since you have stated this is not considered top tier, then I believe what you are saying is true.

 

[Launcelot]

DO skools love spinning things. probably all noncompetitive specialties. just like when people brag about a UCSF match and people think it's IM but turns out it's UCSF Fresno family med

Hey! What's wrong with Fresno?! 😉

 

[AlbinoHawk DO]

OP, as a career changer that struggled a lot during first year, I can relate to your story. Unfortunately, excuses don't fly in the world of medicine. You just have to accept the reality of things to have happened. You also have to prepare yourself to the (realistic) possibility that 250 on your step will not happen. My suggestion to you is to stop taking advice from people in this forum as if it is gospel. Do your best from here on out and establish relationships with people that can help you. If you don't manage to match into an academic program, don't assume that you cannot do the fellowship you want. Will it be hard? Sure, but you need to speak to programs and advisors and do your best to get there. For now, take it one step at a time. There's no reason to set in stone your future.

 

[Jinxapotato]

I believe these matches did happen! but some detail:

Yale - if IM or surgery, probably not the main Yale university hospital. Yale has other university hospital affiliates. It's similar to ucla in that you have DOs matching to ucla harborview (smaller and filled with img's, not like Ronald Reagan which is their main university hospital). Possible chance of ten doing IM but a primary care track, not their categorical.

Mayo - If IM or surgery, probably the Arizona or Florida satellite. Mayo isn't considered a true university hospital like Stanford Med, NYP-Cornell/Columbia so in reality it's not a top tier university program per se. It's good don't get me wrong! But not the same as someone getting into IM at HUP (UPenn).

UWash - likely, but def not a surgical program or IM program. KCU pulls in a lot of of their grads to WashU through pathology and PM&R. Again not as competitive as IM or General surgery at WashU (which is Barnes Jewish hospital).

This is def not a rag on DO matches but better to put out the reality of it and get rid of the pipe dream that a ceiling is being broken right now. Our school decided to put "internal medicine - university of Chicago" when in reality it was NorthShore health system (communi-versity hospital) which is entirely different from a IM program at UChicafo.

I see, I was suspecting this as well. So according to you, what would be a more feasible, yet solid/strong ACGME IM program for the DO students? Assuming we do at least above average on the step1?

 

[AlteredScale]

I see, I was suspecting this as well. So according to you, what would be a more feasible, yet solid/strong ACGME IM program for the DO students? Assuming we do at least above average on the step1?

I'm not sure :/ above avg on steps really doesn't qualify you to enter any university IM program, there has to be something more than that. Speaking with a now heme/onc fellow at UW/Fred Hutchison Cancer Center who did a Physician Scientist ABIM track at UC San Diego, you have to show these PDs you know how to do science. Most DO schools just don't offer the resources to do the science. And no, a publication in JAOA or a poster presentation on a osteopathic case report at OMED isn't going to cut it. What will cut it is winning research awards such as this student who won a Sarnoff Research grant for a full year at UMich: https://www.kcumb.edu/about/news-events/news/?id=12884902181 EDIT (so people don't freak out): any research is obv good for your application. But seriously though, JAOA's impact factor in the scientific community has been ZERO (https://www.researchgate.net/journal/0098-6151_The_Journal_of_the_American_Osteopathic_Association). Im sure many would like highly upon an authorship in NEJM, JAMA vs one in JAOA.

A good amount of ACGME communiversity programs (community hospitas affiliated with a university health system) are open and welcoming to DO's. Like NorthShore. I know Loyola seems to take in a decent amount. A lot of the university programs in the mid west like north dakota, arkansas, etc etc have taken a lot of KCU grads but a lot of that probably has to do with living there prior to starting med school. Again, I'm not going to say "OH! One DO grad went to Jefferson University Hospitals for IM so you can get in there" because there are SOO many factors beyond what I am knowledgable on that I'd do many a disservice for saying you'll get in there too.

You could always look at different IM programs to see if they have current R's on their housestaff that are DO's (Categorical track, not primary care). You can also check their alumni link as well. If there's zero DO's in both you can probaby assume that it's unlikely you'll match there. Colorado University - Denver and Univ of Utah are very DO unfriendly when it comes to their IM program.