Rush or Delay?

[Mike97]

Looking for some advice here. Short story... I'm halfway through M3 year due to delaying step 1 and I have 2 options in terms of graduation.

1) Cram, submit a late residency application, and graduate on time
2) Delay a year and be able to submit an application on time

For context, I'm interested in EM or IM fellowship. Discussing with advisors it seems like if I decide to go EM, the best option may be to cram and hope the application is good enough. However if I was thinking IM fellowship it may be better to slow down and have an overall better application. Another thing I'm trying to keep in mind is how much of a red flag graduating a year late will be vs an on time application. Appreciate any thoughts. Thank you!!

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[Dr. Robb Bassett]

Hey Mike—really appreciate you sharing where you're at. This is one of those moments that feels heavy because both paths come with trade-offs, and the decision you're making isn’t just about timing—it’s about identity, stamina, and long-game strategy.

You're not alone in facing this kind of fork in the road. Plenty of strong physicians-to-be have had to recalibrate timelines for Step 1, and it doesn’t make you any less capable—it often means you're being thoughtful and prioritizing long-term success over the “on paper” timeline.

That said, your two options have very different emotional and logistical weight.

If you cram and graduate on time, what does that version of you look like? How are you showing up for rotations, for interviews, for yourself? Are you able to feel proud of the app you're submitting, or just relieved that it’s in? Sometimes we tell ourselves we can push through, but is that sustainable, or will you be burning emotional capital you’ll need later during intern year?

On the flip side, taking the extra year might allow you to be more intentional—with Step 2, with getting strong LORs, maybe even with some research or leadership work—especially if you're leaning toward IM and a fellowship track. Would that extra time give you the space to build a version of your application that feels more “you”?

As for the red flag concern—there’s a difference between a delay with purpose and one that’s unexplained or surrounded by doubt. Many program directors care more about why you made a decision than that you made it. If you take the extra year and can clearly articulate how it allowed you to show up more fully, grow, and put your best foot forward, that’s not a red flag—it’s maturity.

So maybe the coaching question is: What version of this story would you be most proud to tell during interviews?

Whatever you choose, it sounds like you're already doing the deep thinking that sets good clinicians apart. Wishing you clarity as you decide—happy to keep the conversation going in the thread if it helps you process further.

 

[Goro]

Looking for some advice here. Short story... I'm halfway through M3 year due to delaying step 1 and I have 2 options in terms of graduation.

1) Cram, submit a late residency application, and graduate on time
2) Delay a year and be able to submit an application on time

For context, I'm interested in EM or IM fellowship. Discussing with advisors it seems like if I decide to go EM, the best option may be to cram and hope the application is good enough. However if I was thinking IM fellowship it may be better to slow down and have an overall better application. Another thing I'm trying to keep in mind is how much of a red flag graduating a year late will be vs an on time application. Appreciate any thoughts. Thank you!!

Can you enlighten us as to why you haven't taken Step 1 yet?

 

[Splenda88]

Looking for some advice here. Short story... I'm halfway through M3 year due to delaying step 1 and I have 2 options in terms of graduation.

1) Cram, submit a late residency application, and graduate on time
2) Delay a year and be able to submit an application on time

For context, I'm interested in EM or IM fellowship. Discussing with advisors it seems like if I decide to go EM, the best option may be to cram and hope the application is good enough. However if I was thinking IM fellowship it may be better to slow down and have an overall better application. Another thing I'm trying to keep in mind is how much of a red flag graduating a year late will be vs an on time application. Appreciate any thoughts. Thank you!!

FWIW, I submitted at the end of November of 2017, got a lot invites and ultimately matched at my #2 (low tier university IM). Step1 was ~220 and step2 ~230. US MD with no failures.