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Discussion in 'General Residency Issues' started by drydenian, Aug 9, 2015.
I think that having a passing step 3 score would greatly improve your chances of matching again since 3 fails on step 2 is a big red flag. If that means sticking it out with Path for a year then I think that's what you'd have to do.
Also important is to change up your attitude about all this. It's simply not relevant to bring up someone else's match violation or all the reasons that other people caused you to fail step 2 three times (not only does it not matter to your question here, but no program you apply to wants to hear that). You need to accept responsibility for your situation, and not just faking it on an application essay but really believing it.
Tough position. I don't think failing Step 2 CS 3 times is something that most programs will overlook. With that, you went from a clean app to one with red flags. It's great that you scrambled into a position you don't hate but it's not a patient-care specialty and doing spectacularly in a pathology residency has almost no correlation to the skill set required to succeed in EM. Don't expect passing Step 3 or being successful in your current residency to significantly remove the red flag of failing a test designed to assess ability to interact with patients. Completing your current residency then reapplying at least shows your desire for EM but by then the salad days of bouncing back from night shifts will be long gone. You attribute your 3rd failure to inability to cope with stress, which is also a red flag. If stress causes your performance to fail catastrophically, EM may not be the ideal mate that you've pictured.
Barring some ace in the hole that wasn't mentioned in your email (1st degree relative with an EM PD, extraordinarily tight relationship with EM at current program, able to guilt your previous EM program into guaranteeing matching you for the upcoming year in writing) I think EM is unlikely enough to happen for you that jeopardizing your current spot is foolish.
What year of residency are you in?
I think you'd be gambling with your life if you quit this current residency program to try for another one. But, I'm a very conservative sort of guy when it comes to life decisions.
If you lose the current residency position, you may be considered toxic and never get into another residency program again.
I have always been told this:
Take the bird in hand. If this means pathology, then run with it.
I just don't think you are going to be able to overcome the red flags on your application. Regardless of your reasons, you failed an exam 3 times which >90% of graduating allopathic seniors pass on the first attempt. With EM becoming increasingly competitive, I don't see a way that you convince a PD that you're worth the risk over all of the other applicants who don't have that red flag, as you saw by your inability to get any interview invitations when you tried to reapply last year.
The only glimmers of hope I could imagine would be if the EM PD who previously accepted you would be willing to consider your application again, or if there was some way to make a connection with the EM at the institution you're currently working at. Those are both incredible longshots at this point, but I think your only hope is to use connections you've already made to convince someone that you're worth the risk, since the reapplicant x2 and CS fail x3 will likely screen you out at any other programs.
Ah, I always mix up CS and CK. I think failing CK several times but then passing step 3 would be much better than failing CS.
I'd like to add that I think you should be grateful that you are in a residency program at all. Do you know how many thousands of FMGs would kill for your position?
Do the path residency and find a fellowship that you could live with. I don't know much about path but I'm sure there are some fellowships that could be interesting.
I'm an ER doc by the way. Trust me, ER has its perks but it also has a lot of cons too.
He may want to look into forensics.
One option is complete your path residency, and then (in your last year) do some clinical electives in the ED and then apply for an ED residency. This is a longer, but much safer plan. If you get an ED spot, you'll take another 3 years but end up with your "dream" field. If not, you still have a path career to fall back upon. This assumes that you don't need to do a fellowship in path -- if so, then more difficult (but still possible).
Get your step 3 in order and apply for EM through ERAS. Make friends with the EM guys at your institution and try to work out some way that you'd have an edge in the next match. All the while continue with your pathology residency and keep your EM goals quiet.
If you match, run with it. If you don't, you at least have pathology under your belt and can concentrate all of your efforts on trying to get back into EM (which you will likely be doing since the job market in pathology is not great).
Trouble deciding? Become an emergency pathologist.
Failing a test that 95% of people pass not just once, but three times? That's not a red flag, that's a red banner. A red blimp. Take what you have and be thankful. I thought there were even states where you couldn't get licensed if you fail a step more than twice.