Shooting for the stars (PM&R match questions)

[AggieMed05]

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Hi everybody,

I'm sure you have better things to do than give free advice so I'll keep this as short and sweet as possible.

My background:

OMSIII

Pretty poor academic record (26 MCAT, bottom 15% of my class, remediated two courses, failed USMLE1, 446 COMLEX1), but strong work ethic and affable disposition. I'm the guy that, despite being clinically useless as a result of my poorly formed knowledge base, people enjoy working with because of my personality and attitude. I hope you don't interpret my saying that as me somehow trying to pretend this is a good thing. I would much rather have people like me because I am intelligent and competent than because I am "a nice person." But I digress…

To be honest, I've always been interested in PM&R. I was interested in rehab medicine long before I even realized there was an entire specialty devoted to it. Until recently, however, I felt that the only medical career I'd be able to pursue (given my track record) would be family practice. After much deliberation and discussion with family, friends, and colleagues, I've finally decided to follow my heart and chase my dreams; I want a PM&R residency!

So let's be real. ACGME programs are probably out of the question for me. Even if I were to retake the USMLE and pass, I still probably wouldn't do that well (we're being real, remember?). So that's out. Now we consider AOA programs, which I would actually prefer (I've got a soft spot for OMM/NMM). To my knowledge, there are four. If I got into one, great, my dreams come true and there's a happy ending with me riding off into a double rainbow sunset on the back of a unicorn. But let's say that doesn't happen. If I put all of my eggs into the AOA PM&R basket, I'm basically ranking four programs and that's it. Is that even a good idea? In the event that I were to rank only those four and didn't match into any, what would be my next best move? My understanding is that AOA PM&R programs require a traditional (rotating) AOA prelim year – could I scramble for (or include in my rank list) a traditional year program so that I could apply for PM&R during the next cycle and still be "on track"?

In summary (tl;dr) –

1) I failed USMLE1 – since full disclosure of all exam outcomes is mandatory now, am I out of the ACGME PM&R race?

2) Even if I am really serious about pursuing an AOA PM&R residency, is it a terrible idea to rank only that specialty since there are only four programs?

3) How does the AOA PM&R prelim year work? If I didn't match AOA PM&R, could I still do an AOA traditional year (to get it out of the way) and hope to match/start a PM&R residency during the next go-round?

Thank you, thank you, THANK YOU for reading. I would truly appreciate any and all advice/information.

 

[100YardDash]

hey whats up aggiemed. I think that if you go back and pass the step 1 with a decent score (doesn't have to be a 230, just try and improve and at least get over a 200), show a genuine interest in PM&R, do two months of PM&R electives during 4th year and get some strong LORs and you will have a pretty good shot at ACGME. You probably won't be competitive for the top programs but you will get in somewhere.

P.S. At least at my school, we didn't get any exposure to PM&R during our third year so it was like trying to read a foreign language during my first elective month. The attendings and residents know this and don't expect you to know everything. I think if you always show up on time (10 minutes before you need to be there), be respectful to patients and coworkers, have a good attitude, and read up on your patients, you'll do great and score some good LORs. Hope this helps and good luck

 

[Jitter Bug]

So you have diagnosed yourself as having the people skills and the work ethic to be a doctor, but not the knowledge base.

Bad news the knowledge base is not optional. First of all you need to determine if you are keeping up with that. You need to pass step 1, because step 2 and 3 only get harder. Maybe you need a tutor, or to seriously rethink how you study. If you are a hard worker, then you just need to learn to be an efficient learner. Fix this problem now before it gets worse. You will have to continue studying your whole career. I am 7 years out and I still pull out my textbooks and read articles to refresh and learn new things.

Don't pick PM&R because you have a small knowledge base. Fix your study habits, increase your knowledge base, and pick PM&R because it seems interesting to you and easier to get into with a checkered past than say Derm or ENT.

 

[kstarm]

I would consider a couple of things. Have you considered the possibility of a learning disability? I know that it seems a little far fetched but there are a number of people who get through medical school with one. A resident from my program a number of years back ended up having one, and once he had extra time for his tests he scored much higher. Just something to at least consider. Many medical schools have resources to help better figure this out.

I wouldn't rule out ACGME residencies. I agree that getting a top program may be difficult. However, if you do great on rotations, and have good LORs you may land yourself some interviews. PMR is a small world, and I know for our program if a candidate had a less than stellar academic record, but had a great LOR from someone our progarm knew and trusted we would want to interview that person. Also, showing some leadership (volunteering, running PMR interest group, etc.) can help bolster your application.

You need to decide about re-taking USMLE, and your future Comlex tests. Redemption is a nice story. Taking responsibility for the fact that you did poorly, and then making changes to pass/do well on your next exams shows maturity, and perserverance which are qualities most programs would like to have in their residents. By doing well on your next tests you get to turn this whole testing problem into a positive. "yeah I sucked, but I worked my butt off, and learned from my mistakes." Good Luck.

 

[GeneMD2B]

Hi AggieMed05,

First off, not all ACGME residency programs require the USMLE. I am told that many of osteopathic students applying to some of the top programs in PM&R don't take the USMLE.

Speaking with some of my friends and colleagues that are academic physiatrists and residency program directors, there seems to be a consensus that the least competitive ACGME programs are going to be easier for you to get into than the least competitive AOA program. So apply broadly.

Lots of good advice about how to improve your record, you should try to take it if you can.

I hope this helps.