Taking a gap year between medical school and residency - bad idea?

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Phloston

Phloston

Osaka, Japan
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I have not committed to this yet. It's still just an idea. And I'm aware of the potential negative implications, such as programs being concerned about loss of clinical skill, etc. There is a report floating around somewhere showing that the more time one takes after med school, the lesser his or her chances are of matching. But yet again, these situations are complex.

I would not be using the year to climb volcanoes or scuba dive.

I also would not be using it to do research or work in a medical setting (as those are potential reasonable explanations).

I'd use it to work >12 hrs per day writing and publishing miscellaneous works (yeah, I know that's vague).

I'm an Australian IMG (doesn't help my situation), with a Step 1 of 262 (hoping this could justify my gap year if I combine it with a strong 2CK?).

I think some people would think it's idiotic/crazy to take a gap year, but I have goals I don't want to protract any longer.

I'll probably look to apply transitional/prelim/IM (i.e., no, not anything like derm, rads, surg, etc.) after the gap year.

Any thoughts?

Thank you again,

Phloston
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Yes, it's a bad idea, as you already know, and for exactly the reasons you specified. And it's an especially bad idea since you're an IMG, which is already one major strike against you. Apply for the match on schedule. You can write and publish your miscellaneous works after you get through with residency.
 
@Phloston, What do you mean by "writing and publishing miscellaneous works"? Are you talking about writing and publishing in your specialty of interest or your personal memoirs? It makes a big difference.

Most people in the United States who decide to take a year off to do research, do it in their specialty they'll be shooting for in the match - either informally on their own or thru a official program - HHMI, Doris Duke, etc. They usually do it after the 3rd year of medical school when everything that contributes to your class rank on your MSPE (Dean's letter) is done, although there are some who do it after their 2nd year. Regardless, they do it BEFORE they graduate from medical school, not after. Hence why you're getting the resounding, unanimous answer of "No".

I don't know why you genuinely think a Step 1 score of 262 is not a strong score and why that score justifies a gap year.
 
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No for all the reasons people have posted above.

You may as well try for the match in whatever field you are planning on writing publications in. If you match, cool. If you don't, you have a year to write publications. Seems silly to resign yourself to the fate of not matching at this point.

Now if you were going to do this during your medical school, then sure, a number of people applying to competitive specialties do this. However, PDs won't know the difference between someone who took a gap year for publications willingly and someone who did manuscripts and the like because they didn't match. Regardless of the reason, it will be a negative mark on your application that you're not applying to start residency immediately after finishing medical school.
 
Well, having a year gap is not exactly a scarlet red flag for an IMG. Most (nearly all non-US citizens) have time between their med school graduations and matching in the US, and it's not assumed that they failed the first go-around.

It sounds like you're trying to do something like write a novel? I think it's great and you certainly won't have time to write in residency or even as a junior attending. My advice would be to go for it if you're really passionate about it, but try to keep yourself clinically active too-- can you work one day a week in a clinic, for example? You need to take the remainder of the USMLE steps, etc. A year is certainly not a deal-breaker.

Your excellent step 1 score will help, as will the fact that you're coming from another "first world" country. Especially if you're interested in a less competitive specialty, I think you'll be fine. Hell, I personally would much rather chat with an applicant who spent a year writing a novel than one who dithered around in a lab and got a single fourth-author publication out of it, or was a senior med student with a very conventional story.
 
As an Australian grad, you typically complete your medical studies during the Northern winter: November, December.

As an IMG, you'll find many programs want to see not just that you have completed all the requirements toward the ECFMG certificate but the actual certificate in hand to interview.

Therefore, you may have a built in gap year anyway: graduate in December, obtain ECFMG certificate a few weeks/months later usually after ROL is due.

Of course its possible to apply and match without the ECFMG certificate; however, you may find more success with it and the benefit outweighs the risk of taking the year off IMHO.

I don't think its the big disaster others have painted. Yes, some may feel that the reason for the gap year is because you failed to match and there is the concern about being farther out from graduation but given the increasing requirement of programs to have the certificate, the different academic year in the Southern Hemisphere, your excellent Step 1 score, the fact that you're applying for IM, and the reason for the break, I'm not convinced its a career killer.

FYI: you've mentioned applying for Transitional Years - those are amongst the most competitive programs; they are not on competitive par with Prelim IM or Categorical IM.
 
Phloston said:
Why? @AStark @DermViser @ThoracicGuy @thehundredthone @Kaputt

I tagged you guys here but you don't have to respond if you don't want to. Would be curious to hear your thoughts though apart from just "No."
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The tag didn't give me any sort of notification at all. Different things in play here, Phloston. Most of it already covered well by everyone else.

Like @Winged Scapula said, your graduation year might build a gap year in anyway. It definitely does for me, I graduated this March, so I will be a year plus out by the time I start because of the way this works with the ECFMG requirement. Sure, you could apply in September before you graduate but if you do really graduate in November/February (is it 4 years, starting in February?), you won't have much time to interview (and you'll get fewer interviews, not being certified at the time of application). Which means that if you're applying the next September anyway, you have your gap year (and a half) already.

Your Step 1 score is above the curve, regardless of what you and I think about it. As an American citizen from an Australian school, you may actually be in slightly better standing than a Caribbean graduate. Kill Step 2 with a similar score and you're good to go for a lot of academic programs given the rest of your application profile. The one concern might be the field you're applying to. TY and non IM prelim programs are very difficult to get into, because you're competing against the derm/rads/surgery etc. people. If you're applying to IM, the question is whether you really want to do IM, because I didn't think that was the case.

All in all, you may not need a special gap year, and applying any later after graduation will definitely affect (though no one can say how much or how little) your chances at matching. If you were planning to apply before you graduate, then plan to apply after instead, then you'll have time before applications open to get this other work done. The fruits of your labour will make for good CV material and talking points at interviews. Don't take an extra year outside of this time after graduating, dynamics can change from year to year for IMGs and may go against you.
 
thehundredthone said:
The tag didn't give me any sort of notification at all.
Click to expand...

This is a point of confusion for many: when tagging someone, a pop up menu will provide user names which match, you need to click on that (rather than typing the whole name with @) so that your taggee actually gets a notification.
 
Hey phloston I thought you were set on surgey/plastic surgery?
Change of heart?
 
The vagueness of what you're working on makes it hard to give decent advice. Can you be more specific to what you are writing? Is it a book, screen play etc? I will go slightly against what others have stated and say taking a gap year may or may not be a good idea if you are using it to pursue research (I do understand that you said you weren't pursuing this), but is it even remotely medical?

I know of people (moreso IMGs but some AMGs) who took 1-2 years to get involved in a lab or with a PI and co author a lot of published research. More difficult with basic sciences but very doable with clinical work (chart reviews, database studies etc) and ended up with several publications and lots of connections and they ultimately matched at very competitive programs. They also had the prerequisite strong Step1/2 scores. Of course if you take this route you have to be cognizant that some places have strict guidelines about how far out of medical school you can be when applying. If it's just a year, should be no problem but if it's more than that, keep that in mind.

Also, with this gap year, if you don't have anything tangible to show for it, it's probably going to hurt you in the eyes of PDs. And I'd probably say that if it was significantly non medical, lets say you sold a novel etc, it probably wouldn't be that much of a positive (PDs want worker bees with no other options, in general who will focus on residency).

Your step 1 score is great. Being an IMG is a negative as usual but it is not insurmountable.

One word of advice that applies to IMG and AMG is your value as a prospective resident applicant declines the further out you are from medical school regardless of your accomplishments.
 
Do you want to be a physician or a PhD? If I was a program director I would seriously question your dedication to clinical medicine and you wouldn't get an invite from me regardless of your USMLE score. PDs want worker bees.

You have the rest of your life to publish papers. Get into residency.
 
I'm going to take one or more years working as a writer before remotely considering residency, as I see it getting in the way of my goals.

And I'd rather drop dead than go into surgery or research. I recently converted my PhD candidature into a completed Masters (I loathed the lab and was becoming dumber by the day, and was disgusted by how plaintive and trapped everyone seemed to feel; I also saw it as a waste of time), and I hated my surgery rotation (and the personalities) and the idea of that lifestyle.

I'll sit the Step 3 to complete the series / learn for myself, but I'll likely not even apply to the States (will likely live in Australia or Israel; the latter accepts the USMLE).

My thoughts have changed as far as wanting to pursue an ideal residency/impress PDs and would rather focus all of my energies on my writing, even though I know that's considered mad by 99% of people (including my family, who is strongly opposed to the idea).

That being said, I am very passionate about medicine. It's just the sequence/timeline isn't ideal for me. And if that means I screw myself over in the future in terms of trying to land a job, then I take responsibility for that, but I'll know I didn't shortchange what's important to me.

I'm appreciative of the advice everyone on this thread has given.
 
I know a lot of people who have completed their intern year and got licensed before taking time off. I think that would be a smart idea because then you could moonlight as a doctor and make good money, which is very unlikely with a writing career.
 
cartoondoc said:
I know a lot of people who have completed their intern year and got licensed before taking time off. I think that would be a smart idea because then you could moonlight as a doctor and make good money, which is very unlikely with a writing career.
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He's a foreign grad. There are only (IIRC) 2 states where it's possible for IMGs to get a license with just an intern year.
 
gutonc said:
He's a foreign grad. There are only (IIRC) 2 states where it's possible for IMGs to get a license with just an intern year.
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Wisconsin (which was in the process of changing the requirement but is still at 1 year for the time being) and Georgia (which has a limited list of foreign schools whose graduate it will allow to get a license after 1 year)
 
Phloston said:
I'll sit the Step 3 to complete the series / learn for myself, but I'll likely not even apply to the States (will likely live in Australia or Israel; the latter accepts the USMLE).

My thoughts have changed as far as wanting to pursue an ideal residency/impress PDs and would rather focus all of my energies on my writing, even though I know that's considered mad by 99% of people (including my family, who is strongly opposed to the idea).

That being said, I am very passionate about medicine. It's just the sequence/timeline isn't ideal for me. And if that means I screw myself over in the future in terms of trying to land a job, then I take responsibility for that, but I'll know I didn't shortchange what's important to me.

I'm appreciative of the advice everyone on this thread has given.
Click to expand...

If you don't care about doing residency in the US, then sure, go for whatever craziness you're thinking.
 
evilbooyaa said:
If you don't care about doing residency in the US, then sure, go for whatever craziness you're thinking.
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This.

OP, I think most of us assumed you were looking to practice in the US when we gave you advice earlier. If you're not, heck, who cares whether taking a year off will hurt you with US programs? You don't really need/want to get into a US program anyway. So in that case, sure, go work on your manuscripts, and best of luck with your writing career.
 
Phloston said:
I'm going to take one or more years working as a writer before remotely considering residency, as I see it getting in the way of my goals.

And I'd rather drop dead than go into surgery or research. I recently converted my PhD candidature into a completed Masters (I loathed the lab and was becoming dumber by the day, and was disgusted by how plaintive and trapped everyone seemed to feel; I also saw it as a waste of time), and I hated my surgery rotation (and the personalities) and the idea of that lifestyle.

I'll sit the Step 3 to complete the series / learn for myself, but I'll likely not even apply to the States (will likely live in Australia or Israel; the latter accepts the USMLE).

My thoughts have changed as far as wanting to pursue an ideal residency/impress PDs and would rather focus all of my energies on my writing, even though I know that's considered mad by 99% of people (including my family, who is strongly opposed to the idea).

That being said, I am very passionate about medicine. It's just the sequence/timeline isn't ideal for me. And if that means I screw myself over in the future in terms of trying to land a job, then I take responsibility for that, but I'll know I didn't shortchange what's important to me.

I'm appreciative of the advice everyone on this thread has given.
Click to expand...
I don't think your mad (crazy). I'm just not understanding how this writing stint fits into the overall picture of things. Ok, so you found out that you hate the surgery lifestyle - fine. There are many other specialties that are available that have great lifestyles - certain subspecialties of IM, PM&R, Rads, etc. Do you just not want to pursue residency (GME) in the United States? If so, then nothing we say applies as we don't know what the residency process is in other countries. Honestly, you sound like the guy with a mid-life crisis who goes out and buys a motorcycle, not to mention this all just reeks of impulsivity.
 
Phloston said:
I have not committed to this yet. It's still just an idea. And I'm aware of the potential negative implications, such as programs being concerned about loss of clinical skill, etc. There is a report floating around somewhere showing that the more time one takes after med school, the lesser his or her chances are of matching. But yet again, these situations are complex.

I would not be using the year to climb volcanoes or scuba dive.

I also would not be using it to do research or work in a medical setting (as those are potential reasonable explanations).

I'd use it to work >12 hrs per day writing and publishing miscellaneous works (yeah, I know that's vague).

I'm an Australian IMG (doesn't help my situation), with a Step 1 of 262 (hoping this could justify my gap year if I combine it with a strong 2CK?).

I think some people would think it's idiotic/crazy to take a gap year, but I have goals I don't want to protract any longer.

I'll probably look to apply transitional/prelim/IM (i.e., no, not anything like derm, rads, surg, etc.) after the gap year.

Any thoughts?

Thank you again,

Phloston
Click to expand...

The next Michael Crichton?

Of course, most everyone will think you're mad but if your finances are in order (e.g. US Fed loans, etc) then have at it. With your USMLE performance and additional graduate degree I don't believe matching the following year, esp. in IM/FM/Psych/etc., would be unfeasible to accomplish despite completing medicine abroad.

I'm surprised that you didn't enjoy your surgery rotation since I recall you were interested in craniofacial plastics.

Go for it, @Phloston!
 
OutRun said:
The next Michael Crichton?

Of course, most everyone will think you're mad but if your finances are in order (e.g. US Fed loans, etc) then have at it. With your USMLE performance and additional graduate degree I don't believe matching the following year, esp. in IM/FM/Psych/etc., would be unfeasible to accomplish despite completing medicine abroad.

I'm surprised that you didn't enjoy your surgery rotation since I recall you were interested in craniofacial plastics.

Go for it, @Phloston!
Click to expand...
Michael Crichton probably not a good example, considering the news he has made for himself recently.
 
Phloston said:
That being said, I am very passionate about medicine. It's just the sequence/timeline isn't ideal for me. And if that means I screw myself over in the future in terms of trying to land a job, then I take responsibility for that, but I'll know I didn't shortchange what's important to me.
Click to expand...

I really don't see how finishing residency before you devote yourself to writing full time short changes your writing career. It just delays it, and not by a lot. On the other hand everyone you know can see how delaying residency could seriously impact your medical career.
 
Have had more time to reflect (only came back to this thread bc of a notification of a liked post). Am three weeks from end of med school now and will 100% be taking time away. Six months to two years minimum, and probably about 50% sure I'll even return to medicine, but I'll hold off on the fruitful speculation for now.
 
Phloston said:
Have had more time to reflect (only came back to this thread bc of a notification of a liked post). Am three weeks from end of med school now and will 100% be taking time away. Six months to two years minimum, and probably about 50% sure I'll even return to medicine, but I'll hold off on the fruitful speculation for now.
Click to expand...

Wishing you the best, Phloston, in the direction that you're choosing.


Sent from my iPhone using SDN mobile
 
Phloston said:
Have had more time to reflect (only came back to this thread bc of a notification of a liked post). Am three weeks from end of med school now and will 100% be taking time away. Six months to two years minimum, and probably about 50% sure I'll even return to medicine, but I'll hold off on the fruitful speculation for now.
Click to expand...

TombstoneBye.gif
 
Funny considering all the time this guy spent studying minutiae for step 1 and 2. I remember looking at the step 1 threads and half the posts were from Pholston. Time well spent. Although I do remember the dude wanted to do plastics in the US or something else nearly impossible for IMGs to get into.
 
Seems bizarre, in fairness though Phloston has done so much for the community on this forum. If he doesn't go into residency he can always make an absolute fortune just tutoring people for step 1 and 2, in fact he could probably write some sort of book like first aid/pathoma or make an online video series. I read recently he was writing questions for USMLE Rx.
 
Phloston mentioned in a different SDN thread he's heading off to Japan to teach English, learn Japanese, etc. I believe he's also most interested in FM if he does decide to return to medicine. But I agree he's done so much for the SDN community here (e.g., Step 1, Step 2, US-IMGs in Australia and in general, etc.). I hope him all the best success wherever he ends up.
 
Phloston said:
Have had more time to reflect (only came back to this thread bc of a notification of a liked post). Am three weeks from end of med school now and will 100% be taking time away. Six months to two years minimum, and probably about 50% sure I'll even return to medicine, but I'll hold off on the fruitful speculation for now.
Click to expand...

Wishing you all the best. I wish I was bold enough to do something like this. 🙂
 
bashwell said:
Phloston mentioned in a different SDN thread he's heading off to Japan to teach English, learn Japanese, etc. I believe he's also most interested in FM if he does decide to return to medicine. But I agree he's done so much for the SDN community here (e.g., Step 1, Step 2, US-IMGs in Australia and in general, etc.). I hope him all the best success wherever he ends up.
Click to expand...

Solid use of a medical degree
 
Pollux said:
Wishing you all the best. I wish I was bold enough to do something like this. 🙂
Click to expand...

Will continue to keep an eye out for 'Pollux Path' series. We should liaison in a few years' time. I know you must be accomplishing a lot, intrinsic and extrinsic, wherever you are. Thanks for your inspiration.
 
bashwell said:
Phloston mentioned in a different SDN thread he's heading off to Japan to teach English, learn Japanese, etc. I believe he's also most interested in FM if he does decide to return to medicine. But I agree he's done so much for the SDN community here (e.g., Step 1, Step 2, US-IMGs in Australia and in general, etc.). I hope him all the best success wherever he ends up.
Click to expand...
coreytayloris said:
Seems bizarre, in fairness though Phloston has done so much for the community on this forum. If he doesn't go into residency he can always make an absolute fortune just tutoring people for step 1 and 2, in fact he could probably write some sort of book like first aid/pathoma or make an online video series. I read recently he was writing questions for USMLE Rx.
Click to expand...
calvnandhobbs68 said:
Funny considering all the time this guy spent studying minutiae for step 1 and 2. I remember looking at the step 1 threads and half the posts were from Pholston. Time well spent. Although I do remember the dude wanted to do plastics in the US or something else nearly impossible for IMGs to get into.
Click to expand...

Posting my plans below not because I think or expect that anyone cares. I don't think anyone cares. I'm posting this for those who inevitably Google/research this 'time off from med' prospect in the future and who want a sense of one person's (i.e., n=1) trajectory.

Moving to Osaka in June (holding non-refundable ticket). Accepted into a Japanese language school for a period of two years (and have already paid; had considered Israel for greater spiritual fulfillment but might go there later in life instead). Am not abandoning medicine. Will support myself on ~10 hrs/wk of ongoing Skype USMLE coaching + activities (which Gd bless have been lucrative). Am an avid poet and am developing anthologies.

50% chance of returning to practice med, but pretty much only have an interest in the textual/academic side of things. Have pathway into textbook writing and am gestating that direction. See myself as too akathisic to make it through residency/training programs (maybe I need iron studies or a dopamine agonist). Am aware of risks and am cognizant of the three-year cap for applying into an intern year in Australia before one's priority # drops. Rather than entertain a hypothetical, will continually assess over the next couple of years short-, moderate- and long-term goals.

Have confided in those my senior who are supportive of my path / non-linearity. My sentiment is these types of life choices can initially be viewed objectively, and precipitately, as high-risk or impetuous. Although one should bear in mind people's perceptions of risk differ and are manifold, as are perceptions of assets. The same way a piece of art at an auction is only worth as much as one is willing to pay for it, the amount of risk associated with any given scenario is only as great as one perceives it to be. This is why I don't meet opposition to, or repugnance of, my plans with hostility, and acknowledge individuals want different things out of life.
 
Sounds pretty awesome. I'm getting ready to quit my job and apply for fellowship in the next year, and I'll be taking a two month detour to live on a kibbutz and learn Hebrew in between. First trip to Israel for me too, and I am hoping to get to know some family I found out about recently while I'm there. 👍

As I said above, if you don't care about practicing medicine in the US, and you have a way to support yourself, then the usual straight-arrow training pathway advice doesn't apply to you. Japan would be a really neat place to go live for a while. Hope you come back to post every once in a while about your experiences there.
 
Phloston said:
Posting my plans below not because I think or expect that anyone cares. I don't think anyone cares. I'm posting this for those who inevitably Google/research this 'time off from med' prospect in the future and who want a sense of one person's (i.e., n=1) trajectory.

Moving to Osaka in June (holding non-refundable ticket). Accepted into a Japanese language school for a period of two years (and have already paid; had considered Israel for greater spiritual fulfillment but might go there later in life instead). Am not abandoning medicine. Will support myself on ~10 hrs/wk of ongoing Skype USMLE coaching + activities (which Gd bless have been lucrative). Am an avid poet and am developing anthologies.

50% chance of returning to practice med, but pretty much only have an interest in the textual/academic side of things. Have pathway into textbook writing and am gestating that direction. See myself as too akathisic to make it through residency/training programs (maybe I need iron studies or a dopamine agonist). Am aware of risks and am cognizant of the three-year cap for applying into an intern year in Australia before one's priority # drops. Rather than entertain a hypothetical, will continually assess over the next couple of years short-, moderate- and long-term goals.

Have confided in those my senior who are supportive of my path / non-linearity. My sentiment is these types of life choices can initially be viewed objectively, and precipitately, as high-risk or impetuous. Although one should bear in mind people's perceptions of risk differ and are manifold, as are perceptions of assets. The same way a piece of art at an auction is only worth as much as one is willing to pay for it, the amount of risk associated with any given scenario is only as great as one perceives it to be. This is why I don't meet opposition to, or repugnance of, my plans with hostility, and acknowledge individuals want different things out of life.
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Awesome, all the best to you, Phloston!

I've been to Israel once, will go again hopefully soon.

לְשָׁנָה הַבָאָה בִּירוּשָלַיִם הַבְּנוּיָה
 
@Phloston Your contributions to the forums about step exams were a major source of advice/inspiration for me. Best of luck in whatever you choose to pursue.
 
If you would like to do this and come to America, let me save you a few thousand dollars.

Take your application.

Burn it.

Place application remains in toilet.

Watch application remains be flushed in a clockwise direction, and get used to that direction, because you'll likely never come back to America.
 
He doesn't want to practice here. He's from Australia, and it sounds like he doesn't really even want to practice there. He's also found another way to support himself, and he probably has little to no school debt. So there goes every good reason for doing a residency. As I said, the usual forum advice doesn't apply to this guy.
 
QofQuimica said:
He doesn't want to practice here. He's from Australia, and it sounds like he doesn't really even want to practice there. He's also found another way to support himself, and he probably has little to no school debt. So there goes every good reason for doing a residency. As I said, the usual forum advice doesn't apply to this guy.
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From what I had seen, he is a US citizen and went to Australia.
 
ThoracicGuy said:
From what I had seen, he is a US citizen and went to Australia.
Click to expand...
Even so, if he doesn't want to come back here to practice, who cares if he is "ruining his chances" to ever practice here? Dude doesn't want to practice medicine; he wants to be a writer and tutor on the side to support himself. Logistically, it seems like a feasible plan. And doing a residency just because that's what most people do after med school would take a lot of time and energy away from what he wants to actually be doing.
 
I took a gap year, though am an AMG, and decided to get that ol' MPH. Worth it? Yep. Matched into 1st choice IM program in major metropolitan area.
 
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