Time off before residency to Travel

[kc09]

Hey all! I'm thinking about taking time off before residency to do an around-the-world trip for one year. I definetly plan on doing some medical work here and there(africa, nicaragua..places I have hook ups) but that would not be the main focus of my trip.
I'm wondering if anybody has done this before and if it will look bad when I get back and apply for residency programs?? My other question is if you can match and defer for a year? That's probably a long shot but who knows! Any info or knowledge on the subject would be greatly appreciated!

kc

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[maxnm]

A number of people in my class wanted to do something similar to that, but they found out that you can not take time off after you graduate. You can fit in some medical stuff in there and I think that it will look good on your application. Instead what a few of them did was take a year off betweek MS 3 and MS 4 and then will go through the match and graduate this year. Another student frontloaded all of his 4th year rotations and then was able to have the whole spring off to travel around the world.

 

[green plastic]

A number of people in my class wanted to do something similar to that, but they found out that you can not take time off after you graduate. You can fit in some medical stuff in there and I think that it will look good on your application. Instead what a few of them did was take a year off betweek MS 3 and MS 4 and then will go through the match and graduate this year. Another student frontloaded all of his 4th year rotations and then was able to have the whole spring off to travel around the world.

Why can we not take time off after 4th year, before residency? I was thinking about taking a year off to possibly have a baby. Will this look bad when applying for residencies?

 

[Winged Scapula]

You CAN take time off between 4th year and residency; there is no limit to the amount of time you can take off. It has been done time and time again, for many reasons. Most PDs and faculty recognize that this might be the last time in your life you have this freedom to do whatever you want. If you're doing some medical relief work while you're off, all the better; PDs like to see that you're keeping a "finger in the pie".

The match statistics for those not applying as MS4s are rather disappointing, but these also include people who have been out of medical school and medical practice for years...thus, you cannot compare yourself to them. However, you should bear in mind that there may be some slight bias against those who are 1 year out from working in a hospital, studying etc. You might be a little rusty - but IMHO, the learning curve for internship is so steep that everyone is at a loss when they start. You just might have to work a little harder when you come back.

What you probably CANNOT do, is match into a PGY1 position, then tell the program that you want to take a year off and won't be starting for another year. Most places would frown upon that. Perhaps this is what the second poster in alluding to. If you are planning on taking a year off, make sure that you have all you ducks in a row before you leave. This means...

1) you will have to have computer access while away; most programs send interview invites via email these days
2) all your letters must be written beforehand and ready to go (including dean's letter)
3) you must have access to US funds to pay for the match
4) must be have information from NRMP about how the Independent Candidate match works (which you will be)
5) must have a good US address with reliable people on the other end; God forbid you have my parents who would let weeks go by before opening your mail, only to send it to you with a little sticky attached, and you find out Harvard or some other wonderful place invited you for an interview, but now its too late. The US address must have people who will regularly open your mail for you and contact you ASAP if there is an interview invite, missing material for an application which needs to be provided, etc.
6) you must have access to a phone in case you need to call programs
7) you must be able to return to the US at short notice for interviews. This is where most people find a sticking point. If you are half-way around the world in Namibia taking care of Brad and Jennifer's next adoptee, are you going to be able to get on a plane, without the benefit of Super Saver fares, and come back to the US for residency interviews? If you can be in the US from October through January, this would alieviate some of those problems.

In rereading the OP, it sounds as if you are planning on being away for a year, then coming back and applying, so you would be TWO years out from medical school. Same things still apply, just wanted to make sure I had the time-line right.

 

[secretwave101]

These "will XX look bad" questions kinda bug me (not meaning to flame you, just saying this theme comes up frequently). What's wrong with being who you are, and then standing up for yourself when asked about it? It isn't against ANY rules to take time off before residency. CONSTANT training for a career for years on end should probably be regarded as a little unbalanced anyway.

I think that if you're the type of person who wants to travel and see the world - you'll probably be happiest in a program that has people who share similar ambitions and will thus respect what you did.

My advice: Quit looking at yourself through the lens of someone else's theoretical value system and be unique (again, not trying to be harsh...this was advice I finally gave myself after 10 obsessive years of app-fret).

Oh, if you're going for neurosurgery or optho or something...then forget what I just said

 

[georgia_md]

Hey all! I'm thinking about taking time off before residency to do an around-the-world trip for one year. I definetly plan on doing some medical work here and there(africa, nicaragua..places I have hook ups) but that would not be the main focus of my trip.
I'm wondering if anybody has done this before and if it will look bad when I get back and apply for residency programs?? My other question is if you can match and defer for a year? That's probably a long shot but who knows! Any info or knowledge on the subject would be greatly appreciated!

kc

If you haven't yet, probably it's best to take step 3 before you go on your trip

 

[Winged Scapula]

If you haven't yet, probably it's best to take step 3 before you go on your trip

He isn't eligible until he's completed at least 1 year of post-graduate residency training (depending on the state; some may require more). From the USMLE web site...

" The USMLE program recommends that for Step 3 eligibility, licensing authorities require the completion, or near completion, of at least one postgraduate training year in a program of graduate medical education accredited by the Accreditation Council for Graduate Medical Education (ACGME) or the AOA. You should contact the FSMB or the individual licensing authority for complete information on Step 3 eligibility requirements in the state where you plan to seek licensure. "

While the USMLE program only recommends that licensing authorities require the completion of at least 1 year post-grad training, the states are the final word. The Federation of State Medical Boards lists all the state boards and their requirements for a medical license; none of the require less than 1 year GME and passing Step 3. http://www.fsmb.org/usmle_eliinitial.html

In addition, when registering for Step 3, he must list the state board under which he is applying. Unless the OP already has, or will have a residency position, at the time of applying, he is not eligible. Thus, most people are in a US residency program when they take Step 3.

Besides, I'm not sure, even if the OP was eligible, why taking Step 3 before his trip would be advisable. A good base of clinical knowledge under your belt is helpful for this exam, IMHO, something he's more likely to get in residency.

 

[dockdock]

These "will XX look bad" questions kinda bug me (not meaning to flame you, just saying this theme comes up frequently). What's wrong with being who you are, and then standing up for yourself when asked about it? It isn't against ANY rules to take time off before residency. CONSTANT training for a career for years on end should probably be regarded as a little unbalanced anyway.

I think that if you're the type of person who wants to travel and see the world - you'll probably be happiest in a program that has people who share similar ambitions and will thus respect what you did.

My advice: Quit looking at yourself through the lens of someone else's theoretical value system and be unique (again, not trying to be harsh...this was advice I finally gave myself after 10 obsessive years of app-fret).

Oh, if you're going for neurosurgery or optho or something...then forget what I just said

Oh God thank you for saying this.

You're ALLOWED to do whatever the hell you want, and I recommend you do so. Personally, I struggled so much with this question of "Can I leave medicine? Can I go explore other interests?" All that worrying was for nothing--after graduation, I just flat-out walked away from medicine. I worked, I traveled the world, I was a bartender in London, I slept in the mountains of Andorra...you're ALLOWED to do whatever the hell you want.

Got it? Now re-read the first line of the above paragraph.

 

[vashka]

So is it impossible to travel during residency. I checked Freida and most residencies have about 3wks of vacation time. Or is this BS and we will really never catch a break during residency?

 

[secretwave101]

So is it impossible to travel during residency. I checked Freida and most residencies have about 3wks of vacation time. Or is this BS and we will really never catch a break during residency?

DURING residency is totally different than between residency and medical school. Yeah, there's a lot of ownership on your time when you're IN residency. Prior to that point, however, people fret and bite their nails wondering how their application to residency will be regarded if they take time off. It's the worrying and machinating about this time - when your life really is your own - that I think is silly.

 

[Winged Scapula]

So is it impossible to travel during residency. I checked Freida and most residencies have about 3wks of vacation time. Or is this BS and we will really never catch a break during residency?

Of course you are given time off during residency - some may require you to take it all in a single block, some may require 2 week blocks at a time, and others define "weeks" as the workweek, ie, 5 days (not 7).

 

[dockdock]

DURING residency is totally different than between residency and medical school. Yeah, there's a lot of ownership on your time when you're IN residency. Prior to that point, however, people fret and bite their nails wondering how their application to residency will be regarded if they take time off. It's the worrying and machinating about this time - when your life really is your own - that I think is silly.

Secretwave, where were you when I was fretting and biting my nails during 4th year of med school?

Seriously though, you're dead-on in your statements. I'm 25, and only during 4th year of med school did I realize that my life really IS my own.

To the OP:

Sure, if you take time off before residency, you'll probably not get into radiology at Hopkins or derm at UCLA. If your primary goal in life is to get into a super-specific speciality of medicine, then don't take the time off. However, you're completely within your rights as a human being to take time off. Take YEARS off. Do whatever the hell you want!

It is truly your own time, and it is truly your own life. You want to travel? Screw the medicine aspect (since that doesn't seem your goal). Do what I did: work here in the states for a while, save money, and hit the road.

It's so simple, yet it takes such a long time for many people (including me) to learn: yes, you CAN walk away, and yes, you CAN do what you want.

 

[trotter]

dockdock,

Do you intend to apply for residency or come back to medicine in the future?

I think that many people have considered leaving medicine, exploring other interests, taking time off for travel, etc. However, a deterring factor is that most of us tend to be 175k+ in debt by the time we start getting a realistic feel for what a life of pursuing medicine entails.

There aren't many alternative careers/activities that will allow you to overcome that kind of debt in less than 40 years. Not to mention that the fed gov will demand that you start paying it off 6 months out of school.

So do you have a plan as to what you will be doing instead of medicine (once you're done travelling)? Assuming you have debt...

 

[dockdock]

I used debt as an excuse throughout 4th year--"If I don't go into residency, I'll go to jail, because I won't be able to pay my debt."

Wrong. That's just more rationalization.

I graduated from a great US med school, and my debt is above the national average for med school grads.

My loans are all federal loans, which are the world's most forgiving, gentle loans. Residency or not, I'm in 3 years of hardship deferral, where the government is paying my interest. My rate is locked in at 3.3%--which is only slightly higher than inflation.

Tell me, is there any other loan like this? Try buying a new car with a loan at 3.3% with lots of deferral potential.

Anyway, I'm young, unmarried, and my only financial responsibility is to myself. I have very meager tastes--fancy cars, boats, clothes, and sushi mean nothing to me. So I'm lucky.

The debt is a very poor excuse to cheat yourself out of the life you want. This isn't the freakin' mob to whom you owe money.

I'm going to school part-time now, working full-time as a lab scientist, with the goal of entering the field of physics. I'm also playing in a rock band. I looked in the mirror today and realized I haven't been this happy since I entered the world of medicine.

And, my M.D. will never expire. Despite the naysaying, I don't think a single person here has taken years and years away from medicine and then started residency. By the end of this year, I'll have passed all 3 steps of the USMLE, my scores are high, I'm a nice guy, and I'm sure I can get into IM or FP residency down the line, if I feel like it.

 

[dockdock]

And concerning Step 3:

Once and for all, YES, you can take Step 3 without doing a single day of residency. I called up the committee myself, and here's what you do:

Regardless of which state you're in, get an application and list that you're applying for a license in California (even though you're not). Then take Step 3 wherever the hell you want--it doesn't have to be in Cali.

Presto! Step 3 finished, and the whole damn USMLE circuit is complete. Forever. And ever. Go open a bar in Rome for 30 years and live a life that your med school friends could only dream of, then decide to do residency back in the USA--your USMLE scores are good for life.

I dare you to tell me it's impossible.

 

[Winged Scapula]

And concerning Step 3:

Once and for all, YES, you can take Step 3 without doing a single day of residency. I called up the committee myself, and here's what you do:

Regardless of which state you're in, get an application and list that you're applying for a license in California (even though you're not). Then take Step 3 wherever the hell you want--it doesn't have to be in Cali.

Presto! Step 3 finished, and the whole damn USMLE circuit is complete. Forever. And ever. Go open a bar in Rome for 30 years and live a life that your med school friends could only dream of, then decide to do residency back in the USA--your USMLE scores are good for life.

I dare you to tell me it's impossible.

Interesting...so they said you didn't have to have any post-grad training to take the exam (despite what the website says)?

 

[rirriri]

i spent time playing in a rock and roll band after school......it was DAMN worth it.....now i started my residency.

do what you want...make sure you grow as a person and realise all you wanna do. you're only young once. screw the timelines, rules, blah blah blah...you'll find a good spot later, after your head is happy.

cheers

 

[dockdock]

About Step 3: absolutely, you can take it without a day of residency.

The website is kind of misleading--it states that you need to meet the specific requirements of the state in which you're registering for the exam. For example, my home state will not let me register for the exam, but many other states WILL allow me to register, even if I don't live there.

I think it's a good policy--I mean, if they're going to impose a time limit on completing the entire circuit (7 years, e.g.), then they should make provisions for people who aren't going to be in residency.

After all, if you've made it through med school and have passed all previous steps, I see no reason why a person wouldn't be able to pass step 3 without any residency training.

 

[dockdock]

i spent time playing in a rock and roll band after school......it was DAMN worth it.....now i started my residency.

do what you want...make sure you grow as a person and realise all you wanna do. you're only young once. screw the timelines, rules, blah blah blah...you'll find a good spot later, after your head is happy.

cheers

 

[georgia_md]

i spent time playing in a rock and roll band after school......it was DAMN worth it.....now i started my residency.

do what you want...make sure you grow as a person and realise all you wanna do. you're only young once. screw the timelines, rules, blah blah blah...you'll find a good spot later, after your head is happy.

cheers

Kudos!

 

[zambo]

Be aware that extended time off during med school or delay in starting residency will need to be explained to the state medical board when you apply for a license. Things like taking time off to do research, pregnancy, or for health reasons are self-explanatory. But other reasons for gaps in your education once you start med school will need to be explained. One person I know was called in for an interview in front of the medical board to explain just this sort of thing. Apparently taking time off raises "red flags" of sorts.

 

[dockdock]

You're right--taking time off WILL be questioned by the state medical licensing board if you ever want to go back into residency. That's a far cry, however, from being completely denied a license.

My best friend took a year off from med school after 2nd year; after getting into residency, he had to apply for a license in his state, and there was a delay in getting approval. But did he get it? Of course.

Leaving medicine for 10 years before starting residency? I don't know of anyone who has done such a thing, and I daresay none of us know anyone like that...so, it's impossible to say either way.

But back to the issue at hand: you're free to dictate your own path in life.

 

[trotter]

It's interesting to hear from folks that have taken a different path in medicine and their lives.

Dockdock, you seem a bit defensive about your stance. I suppose that's reasonable, as I'm sure you have had to explain and defend yourself to many many people. I give you props for ultimately having the courage to do what you wanted to do with your life. I'm certainly not trying to pose "excuses" for any individual deciding to go into residency when that's truly not what they want to pursue.

When fourth year was getting underway, I was unsure of which career to choose. I thought EM was the gig for me until I did a rotation and found out otherwise. Ultimately I decided to extend my fourth year curriculum over two years so that I could decide what I wanted to go into and so that I could have some personal/travel time. I ended up going to Africa all of last spring, spending about 6 weeks working at a hospital in Malawi and about 10 weeks travelling. It was fantastic. I climbed Kilimanjaro, went whitewater rafting on the Nile, saw mountain gorillas in the jungles of Uganda and had a number of other fantastic life experiences. Of course, the medical portion of this trip was equally unique and worthwhile. I have no doubt that doing this made me a better and happier person and that I will never regret it. Now I am doing a few rotations to finish up school and preparing to apply for residency. And I'll still have 4-5 months after interviews to do with what I please.

From time to time, I still have the desire to put things off even further in order get out and have more adventures. But I know that I am lucky enough to have done many things that most people never do (I also deferred my admission to med school to live in Australia for a while) and I also can't really see myself pursuing careers other than medicine in the long run. And, I have a fantastic girlfriend who probably wouldn't stick around for another year if I took off.

As far as loans go, it's true that if you have federal loans and you consolidated them with a good rate that you won't be in complete and immediate financial ruin by not continuing medical training. However, you will need to pay them off eventually (assuming you don't want to declare bankruptcy and/or completely ruin your credit). Given that, it's probably a good idea to have some sort of plan as to what type of work/career will make it feasible to live resonably and erase your debt. Also, many people have private non-federal loans they have to consider. These definitely don't have the attractive interest rate and forgiving repayment options that subsidized federal loans tend to have.

Step 3 can definitely be taken without ANY post-graduate training. I have looked into this and intend to study for it during my interview months and take it shortly after I graduate in December. There are some very informative threads about how to do this in the step2/step3 forum.

All in all, I would encourage anyone who feels the need to take a year or more of time to travel, think, be with family or pursue another interest to DO IT. If it's really a decision that you're struggling with, it's probably more likely that you'll regret not doing it than vice versa. It's easy to get caught up in the medical culture and tunnel vision, and being that entrenched in something is often not healthy.

Rirriri, what was your experience like in getting back into residency after taking time to play music?

 

[dockdock]

All in all, I would encourage anyone who feels the need to take a year or more of time to travel, think, be with family or pursue another interest to DO IT. If it's really a decision that you're struggling with, it's probably more likely that you'll regret not doing it than vice versa. It's easy to get caught up in the medical culture and tunnel vision, and being that entrenched in something is often not healthy.

+1,000,000

 

[georgia_md]

He isn't eligible until he's completed at least 1 year of post-graduate residency training (depending on the state; some may require more). From the USMLE web site...

" The USMLE program recommends that for Step 3 eligibility, licensing authorities require the completion, or near completion, of at least one postgraduate training year in a program of graduate medical education accredited by the Accreditation Council for Graduate Medical Education (ACGME) or the AOA. You should contact the FSMB or the individual licensing authority for complete information on Step 3 eligibility requirements in the state where you plan to seek licensure. "

While the USMLE program only recommends that licensing authorities require the completion of at least 1 year post-grad training, the states are the final word. The Federation of State Medical Boards lists all the state boards and their requirements for a medical license; none of the require less than 1 year GME and passing Step 3. http://www.fsmb.org/usmle_eliinitial.html

In addition, when registering for Step 3, he must list the state board under which he is applying. Unless the OP already has, or will have a residency position, at the time of applying, he is not eligible. Thus, most people are in a US residency program when they take Step 3.

Besides, I'm not sure, even if the OP was eligible, why taking Step 3 before his trip would be advisable. A good base of clinical knowledge under your belt is helpful for this exam, IMHO, something he's more likely to get in residency.

thorough answer

 

[georgia_md]

Interesting...so they said you didn't have to have any post-grad training to take the exam (despite what the website says)?

interesting

 

[secretwave101]

The SIII exam can be taken, and passed, any time. But, all 50 state licensing boards require at least a year of PGY training. As K. Cox said, some states require more than a year.

So, you can easily get into a situation where you've passed all 3 MLE's but are not eligible for licensure. No big deal...it's just that MLE passage does not = licensure, and some further hoop-jumping may need to happen.

A note: There's no reason to claim that Dr. Cox has no idea what she's talking about. This is basically never true and is a rude assertion anyway.

 

[Winged Scapula]

obviously, you have no clue what you're talking about

Since I copied my post from the USMLE web site verbatim, I suggest you take up your complaint with them rather than me. It is clear from other posts in this thread that the USMLE web information is not clear and that you may register in other states without having completed at least 1 year of GME.

I am willing to admit that I'm wrong, and have been on several occasions. But since this information is from USMLE, not me, your comment was unwarranted. In addition, since you list yourself as "Pre-Med" one might assume that I, a BE surgeon, might have a smidge more knowledge about the licensing process than you. But I wouldn't be rude enough to point that out to you, now would I?

 

[georgia_md]

Since I copied my post from the USMLE web site verbatim, I suggest you take up your complaint with them rather than me. It is clear from other posts in this thread that the USMLE web information is not clear and that you may register in other states without having completed at least 1 year of GME.

I am willing to admit that I'm wrong, and have been on several occasions. But since this information is from USMLE, not me, your comment was unwarranted. In addition, since you list yourself as "Pre-Med" one might assume that I, a BE surgeon, might have a smidge more knowledge about the licensing process than you. But I wouldn't be rude enough to point that out to you, now would I?

Thank you. I apologize for the unneccessary comment. I didn't know you were a real doctor.

 

[Winged Scapula]

Thank you. I apologize for the unneccessary comment. I didn't know you were a real doctor.

Thank you; your apology is accepted. You can always check on a user's status (if they provide it - which I do) by looking at their profile.

But again, thank you for your information regarding taking Step 3 without being in a residency program. It appears that the USMLE site is not clear on this issue (nor was I - having never heard of anyone doing it without being in residency).

 

[secretwave101]

having never heard of anyone doing it without being in residency).

Is common with FMG's who are licensed in other countries but need to do a residency here.

I know of one who took S1 and S2 in the same week. Then did S3 the following week - THEN came to the states and worked for 6 months prior to applying for residency. Incidentally, he passed all 3 and matched to something intense like optho.

 

[foodcoma]

thorough answer

you DEF don't need to start a residency to take step 3. Look at all these FMGs that come into this country, take 2 years to study for step 1, 2, and 3..take it all back to back and THEN apply. Most FMGs have all 3 steps done without a day of residency.

 

[Winged Scapula]

Is common with FMG's who are licensed in other countries but need to do a residency here.

I know of one who took S1 and S2 in the same week. Then did S3 the following week - THEN came to the states and worked for 6 months prior to applying for residency. Incidentally, he passed all 3 and matched to something intense like optho.

That is true...since the OP is here in the US, I hadn't thought about FMGs. I was a bit blinded and obviously not up to date on this topic. Thanks to you and others for clarifying it for me (and the OP).

 

[ramonaquimby]

And, my M.D. will never expire. Despite the naysaying, I don't think a single person here has taken years and years away from medicine and then started residency

frantically raising hand i did! i did!
i took years "off" between med school and residency and was still competitive in the fields i was interested in (IM, FP)...as previously stated, i wasn't into optho or derm or ortho, so that's why it all worked out (i guess), but i say DO IT! sinc ei didn't 'waste' my time during those years, i was NEVER (not ONCE!) frowned upon...it was always interpreted as the road less traveled...[sigh]...

i miss it [=a real life] already!!! lol!

 

[trotter]

Ramonaquimby,

What did you do during the interim time between school/residency?
Why did you decide to come back to medicine?

Just curious, it's really interesting to hear about people's alternative paths...

 

[dockdock]

Hooray for freedom to choose!

(Ummmm, sorry, that could be interpreted as a political statement!)

Seriously though, pretty much anything is possible in this here great country. Don't let things like debt and other people's values get in your way (unless, like I said before, your debt is to the mafia!).