Taking a year off between 3rd & 4th yr or after 4th year??

[nope80]

So is anyone taking a year off in between 3rd and 4th year or after 4th year? What prompted you to make the decision and how do you decide when the best time is? Is there any advantage to doing it between 3rd and 4th year as opposed to after 4th yr?

I'm wondering if this is a good idea since (a) I don't know exactly what specialty I want to do and we have to apply soon and I feel very pressured into making a decision quickly. (b) I don't have a very good step 1 score and one of the specialties I am considering is very competitive. I thought that maybe if I take a year I'd have time to figure out what I want to do, build my resume and make connections. I have a lot of research (publications) already but I have to somehow make up for such a crappy step 1 score. (c) I can take step 2 in august but then I only have september and october to do 4th year AIs and to get recommendations. This seems super rushed.

Basically I feel like this is all happening so quickly, that I don't have it together and that w my step 1 score I'm at a disadvantage to pursue what I want to do. Any ideas?

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[SeminoleFan3]

So is anyone taking a year off in between 3rd and 4th year or after 4th year? What prompted you to make the decision and how do you decide when the best time is? Is there any advantage to doing it between 3rd and 4th year as opposed to after 4th yr?

I'm wondering if this is a good idea since (a) I don't know exactly what specialty I want to do and we have to apply soon and I feel very pressured into making a decision quickly. (b) I don't have a very good step 1 score and one of the specialties I am considering is very competitive. I thought that maybe if I take a year I'd have time to figure out what I want to do, build my resume and make connections. I have a lot of research (publications) already but I have to somehow make up for such a crappy step 1 score. (c) I can take step 2 in august but then I only have september and october to do 4th year AIs and to get recommendations. This seems super rushed.

Basically I feel like this is all happening so quickly, that I don't have it together and that w my step 1 score I'm at a disadvantage to pursue what I want to do. Any ideas?

EVERYONE feels super rushed. Aside from maybe the low Step 1 score, most everybody is in your exact same position. Do you not think everyone needs to decide in the same time period? Everyone also needs the AIs and/or away rotations for letters and such. I honestly can't imagine taking a year off benefits you at all in this situation. Plus, it's hard for me to see a school allowing you a year off "to figure out what you want to do.". I've never heard of anyone doing this, although I welcome someone's opinion who has done it.
Good luck to you. Just realize that this situation isn't unique to you, as almost every third year student feels rushed to make a decision.

 

[nope80]

Well I feel like everyone I talk to knows exactly what they want to do in terms of specialties! Whereas I am debating between one competitive and one not so competitive. This makes doing aways hard since I don't know what to apply for. Also, I don't even think my schedule is such that I can do aways - up to what month in the year does it make sense to do away rotations?

 

[SeminoleFan3]

Well I feel like everyone I talk to knows exactly what they want to do in terms of specialties! Whereas I am debating between one competitive and one not so competitive. This makes doing aways hard since I don't know what to apply for. Also, I don't even think my schedule is such that I can do aways - up to what month in the year does it make sense to do away rotations?

I'd say November.

 

[RxnMan]

There's been a spate of this q lately.

Outside of a degree-granting (MS, PhD, etc.) or formalized research program (HHMI, CRTP, CDC, etc), it's not thought to be worth interrupting your studies. Delays are usually percieved by PD's as an attempt at remediation, and don't have the effect you're looking for. I think it would be better for you to work on getting a higher score on Step II CK and getting honors on your AIs. And I agree, its a short amount of time to make such a big decision.

For disclosure, I'm in a year out research program.

 

[PathMD2010]

I have heard of people taking a year off - but for medical reasons; not personal.

I don't think it would benefit you to do such; I think that you should be utilizing the time between now and the start of fourth year to figure out what you want to do. I was in a similar situation my 3rd year. To decide, I did a few things. First, I read the sections in Lange's "choosing your specialty" and even took their little personality test; both of the ones I was thinking about were in my list. I found it of little use except as a tool to further self examination.

What I found really helped was setting up time to talk to attendings/ residents in both fields and ask them what they liked/ disliked and how they chose. I even found one that had done both residencies! I found this to be pretty high yeild and highly recommend doing this. You can make an appt by email in most cases, and the meetings don't need to be more than a 15-30 mins and very high yeild

I had little exposure to path, which I ended up choosing. So I took part of my vaca (had April) to shadow the residents and see if it was something I was interested in.

After this, I wrote a pro con analysis for each field in as far as what day to day entailed (yes, I know I was working off of limited evidence but so is everyone else)

Then I made it a point to do my "subI" in path very early on in my fourth year. This way, if I found that I didn't like it, I would have time to do a SubI in the other field I was considering. It also let me get my LOR reqs in early.

You really don't have to make a firm decision... well until match day. If you end up still not being able to decide, you can always apply to two specialties and do two personal statements, ect. I would think this would be horribly stressful and expensive, but it has been done before.

Best of luck; hope this helps

 

[nope80]

well i was thinking of taking a year off to do more research and build connections for recommendations.

in terms of applying to two specialties, do you need different sets of recommendations? can you apply to two different programs at the same hospital?

 

[Law2Doc]

... Plus, it's hard for me to see a school allowing you a year off "to figure out what you want to do.". I've never heard of anyone doing this, although I welcome someone's opinion who has done it.
...

Happens all the time. Usually it's done by one or two folks each year that defer graduation and spend a year doing research to improve their competitiveness. Or by someone with a SO in the class behind who holds off the residency app a year to they can apply to match as a couple. But as an ulterior motive many really want more exposure to various fields via shadowing (during the year they are researching). The downside is you'd end up having to explain why you took an extra year at every residency interview you get, which may not be taken positively by every adcom. But as long as you have a plausible reason that doesn't make you sound wishy washy (ie you wanted to do more research to improve your credentials, or you were waiting for your SO to graduate, etc), youd probably be okay.

 

[SeminoleFan3]

Happens all the time. Usually it's done by one or two folks each year that defer graduation and spend a year doing research to improve their competitiveness. Or by someone with a SO in the class behind who holds off the residency app a year to they can apply to match as a couple. But as an ulterior motive many really want more exposure to various fields via shadowing (during the year they are researching). The downside is you'd end up having to explain why you took an extra year at every residency interview you get, which may not be taken positively by every adcom. But as long as you have a plausible reason that doesn't make you sound wishy washy (ie you wanted to do more research to improve your credentials, or you were waiting for your SO to graduate, etc), youd probably be okay.

But the OP's sole reason for taking the year off is basically to decide a field and get some connections. He doesn't need more research (as his original post said he had plenty); therefore, i think any attempt by the OP is explain it to residency programs as something other than it is would fail.

OP, why don't you do your AIs in those two things you might want to do in Sept/Oct, decide, and get your letters? Plus, could you not garner a letter or two from this year?

 

[xanerakoly]

I am in a very similar position, and I struggled with it for a very long time because I was unreasonably embarrassed about not matching/graduating with my class as well as concerned that it would effect my ability to compete for residency positions. Not to mention I found it difficult to get any decent advice about my options.
A little background: During my second year of med school, I had two operations on my back to repair a herniated disc during the winter, and then was hospitalized in the spring with viral meningoencephalitis. Needless to say, I missed a lot of school and had a long recovery that overlapped my Step 1 study time. However, upon receiving some terrible advice, I took Step 1 anyway and failed (178). I was devastated, but was allowed to continue my clinical rotations because of the circumstances. Unfortunately, my recovery took much longer expected, and I struggled through my rotations until the end of my 3rd year, when I finally went to the dean of the medicine school prepared to give up.
He recommended that I take a year off and complete an MPH program that our school offers. This would allow me to take break without just taking time off. He also noted that taking a year off to pursue something that will enhance your medical education (Masters Degree, Research, Medical Study Abroad) does not reflect negatively in your CV or in the Dean's Letter.
To directly address your concerns, as people have said, everyone feels rushed. Often the source of frustration is focusing on the few people you know who really have it together. In general, they are the exception. You have a low step 1 score, but you passed. You have research and publications which is an excellent start to making up for that score. Now you need to do well on Step 2ck, and you will be in much better shape than you think.
For letters of recommendation, my best advice is to speak to your attendings, the clerkship director, and the chair of the department you are interested. The worst that can happen is someone telling you that they deny your request. Faculty in medical education understand the process, and are unlikely to spend their time writing you a poor letter of recommendation. If you have elective time left, try one with few students and ample access to the attending so that he/she can evaluate your clinical skills and personality, and write something truly unique about you. Then there are always your PI/research advisors.
However, if you really dont know what you want to do, seriously consider a year off, or a transitional year. Sure, you can switch residencies, but it is a serious pain and does not reflect well if you want to later apply to competitive fellowships. If you have not yet found a specialty that you love, DO NOT SETTLE. This is your career, you didnt put in all this work to pull the trigger too soon and end up in a specialty you really dont like.

If you are still reading, I applaud because I know I am long-winded. However, I hope that at least some of this is helpful, and I wish you success in your endeavors.

 

[cchrrisstiinaaa]

If you decide to take a year off, ABSOLUTELY take time off b/t 3rd & 4th years. This is what I did. If you take time off AFTER you graduate, you are no longer considered a "US Senior" when you apply for residencies and you will be at a HUGE disadvantage regardless of your scores/grades/research/credentials/etc. Speak to your school's deans about this. They will say the same thing.

 

[etudiante04]

I agree with the above, especially if you are applying for something like surgery. You don't want to have a gap year after year 4 because it will show your lack of recent clinical experience.

 

[geekOCD]

Wow, I'm surprised by the responses I've read here. At my school it's pretty common for people to take a year off after 2nd or 3rd year to do research (some do a program like Cloisters/DD, etc. but many do not). Most are doing research to improve their app for a competitive specialty, which the OP states is a consideration. I'm going into a competitive specialty myself and almost everyone has research and many take a year off (and most are not doing programs). I think it's valid that everyone feels overwhelmed at this time and the OP should try his/her best to make a specialty decision...but if he/she really feels like the competitive specialty is a real option and/or really can't decide, I don't think there's any disadvantage at all to doing research for a year.