To barely pass or to repeat the year?

What does your dean suggest?

 

Are you a gambler?

It just doesn't seem like you are on a lucky streak right now .... We all hit ice patches in life and it's how high you bounce that matters. Sometimes it is best to reboot and make a fresh start; show people what you are capable of by controlling the circumstances so that they are in your favor. I remember reading another thread where someone tried to push forward while going through a divorce and wound up failing out.

You have a great excuse for repeating the year. If it were me, I would interpret the dean's statement as a hint and retake the year, but I'm very conservative and will take the long slog if necessary. I don't get the impression that first year grades matter much, but perhaps failures do. I'm not sure. Your dean seems to suggest that it does matter if you fail two courses.

I have seen people take all kinds of risks and make it through. Do you feel lucky?

 

Oh the irony of having abdominal surgery forcing you to perhaps fail the GI block. I guess it depends on what you foresee as a career. If you were planning on making a living as in ophtho or ortho, perhaps repeating the year wouldn't be a bad idea. A medical LOA is justifiable to residency directors by the car crashes and the surgery. I have a hard time believing one failure would necessarily disqualify you from the most competitive fields or programs, but if it translates into a bottom quartile class rank, a lower Step score due to not learning the info, missing research opportunities over the summer while retaking the fundamentals class, etc. then your dean may be right. Then again if you're interested in pediatrics or family practice repeating the year would be a huge waste. Also check into the finances, you're only allotted so much post-grad Stafford money, and you have to be in-school so many months out of the year to receive any at all. I really have no idea what I would do in your situation, but good luck!

And take the bus from now on .

 

I dunno ...

 

Have you even started medical school yet? I'm not sure how you feel so confident giving advice about all things medical school related if you haven't gone through parts of it yet. It will invariably be different in some way from how you expect it to be.

Anyway, to the original poster, I personally think you should stick it out and haul ass to pass this exam. Spend every waking moment studying. Print out all relevant lecture materials, get organized, get your textbooks together, get some nutrition, turn off your computer, get to the library/wherever you study, and haul ass studying... there IS a question in the standard MSPE about "interruptions" in a student's medical education; failure per se doesn't count, but I believe making up a year or taking time off will be on there. If you do fine on the USMLE and on your core rotations, you should be ok. You'll be seeing all this material again in path anyway, to some extent. One more year is another year's of tuition in their pocket, and one fewer year of a doctor's salary. If you had a 4.0 at an Ivy undergrad, you should have no problems ramping up the learning and getting back on your feet. Good luck.

 

Barely missed the mark during my 2nd semester of first year. Was remediated to retake the entire year's curriculum without option of retaking the unpassed class again over the summer (tough love). Anyway, I'm not gonna lie, it stinks! It's frustrating, expensive and not a little embarassing (at least in my case because I had no excuse but my own unpreparedness). But, hindsight is 20/20 and in retrospect it was indeed a fortunate fall. Having been through the course work before there were no surprises. Repeating is an opportunity to sure-up the fundementals taught in the basic science courses. It has only helped with 2nd year material which build on the first year. Plus, repeating affords the opportunity to help classmates going through it for the first time--you get to meet a whole new group of people! And, from what I've heard grades and class rank vary from school to school and so are somewhat subjective and thus less reliable indicators of student performance. In the end it all comes down to Boards and 3rd/4th year rotations. So, the bottom line is learn the subject matter (just repeat it) and do your best to smoke Step 1. Just my opinion. Hope it helps.

 

I gave the OP my opinion based on what they said and my own life experiences. If you have a problem with my confidence, that's your problem, not mine. The OP didn't seem to have an issue with my comments, so I'm not sure who made you the hall monitor around here.

The OP's medical school dean warned the OP so I took that seriously. However, you seem to think you know what's better for a student than a dean, which doesn't come across very well to me. I would propose that the dean's advice should be given more weight than yours or mine for that matter.

It's my impression that the OP wanted to talk to others about the issue, so I think it's fair game for someone like me to comment. I didn't claim to be an expert nor already in medical school. Most of the information is there in the OP's message.

Getting more to your advice, I'm not sure how helpful your study advice is to someone who appears to be quite capable in that respect. In addition, you don't appear to have gone through abdominal surgery while in medical school, so you might change your mind if you were going through that surgery (or maybe you were in exactly the same situation and made it through?). I personally have no problem with you giving your opinion, but you seem to be set on the requirement of having been there before you are qualified to comment.

 

Hey, I immediately knew we go to the same school (I am a 2nd year) after you said you had no heat and electricity for a week...I suffered that fate during the Cardio module in October. I feel for ya, that was no fun. And multiple car accidents?? What a stressful time.

So, ok, moving on: you failed Fundamentals I but passed Fundamentals II and Anatomy. You can remediate Fundamentals over the summer. Failing Fundamentals sucks, but failing Anatomy is worse. Of the students in my class who failed Fundamentals, I'm pretty sure they're all still here...but 2 of my classmates who flunked Anatomy have left med school. So failing Fundamentals isn't the same "kiss of death" by any means.

Moving on to 2nd semester: I think you need to seriously consider the possibility that you are not going to be able to properly learn all of Metabolism while trying to keep up with the rest of GI. Metabolism is a killer course and I truly do not know if I would have been able to do it if I hadn't had the time to go to class and go through the notes and learn everything at a normal pace. Plus you have to pass the Metabolism exam, so it isn't even like you could squeek by by studying like crazy for the rest of the exams. I am perplexed as to why they have given you this as your only option, especially since you have a medical reason for missing the classes. Could you get extra time, maybe take the Metabolism portion later in the year or something?

Taking a leave of absence would not be in my mindset unless things were really, really bad. That being said, your situation is certainly hedging on being "really really bad." UB has a long history of letting people take leave of absences. I have a few friends who took time off and then came back, so it can be done, and they're all doing ok. Obviously, it's not ideal because you lose the year, but the people I know who did it seem to have really benefitted from it. GI is hard, but so is Renal and even Musculoskeletal isn't easy, so you're far from being done with the semester. If you think you can pass, then by all means do it, but failing 2 courses in first year is going to put you on an academic footing that you might not ever be able to recover from, so think hard about it and talk to the GI professors to see if they might be more reasonable. Good luck

 

Does an appendectomy count? That's abdominal surgery which I had in medical school. "I would be cautious and repeat the year" is misleading advice from someone who hasn't been through the rigors and hard work required to pass. It's not quite as simple as "repeat a year"... it is mentally taxing, and I don't feel you are capable of commenting on that if you have not been through it yourself.

 

Can you ask your Dean about delaying when you take the exam? AT my school, when stuff like that happens, many times students will take the exam later (sometimes even months later), during Christmas break, or cut down their course load and take a course during summer (OK, your summer is already full, but).

However, these arrangements can depend on who you talk to. Different deans are open to flexible arrangements, and ask your upperclassmen, or other students if there are certain people in the administration who would be your advocate to make things work out. I knew of cases where one academic progress advisor said to repeat the year, but other administrators tried to do partial remediation, cut down schedule, delay exams, etc. to make you not repeat.

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Anon-y-mouse: Can you be sure that your appendectomy was comparable to the "major abdominal surgery" that this person seems to be suggesting (perhaps something related to one of the car accidents)? It just doesn't seem like we have that information or can make a lot of judgments like that at this point. Did you experience this situation in the context of already having "fail[ed] the first intro/fundamentals class"? I seriously doubt your situation was practically a carbon copy of what this person is going through. You might even be going to a different school or into a different specialty as well. Based on what we know from the posts, it seems like there are many specifics that have not been provided.

Don't get me wrong, I'm not suggesting that I don't think you should post your comments (although I don't agree with the opinion/conclusion that you provided). As far as I'm concerned, I really could care less if you are in medical school or not or whether you had the same problems. I'm also not suggesting that I will not benefit immensely in my perspective on a situation like this from medical school.

Keep in mind that I'm almost certainly a lot older than you, have a Ph.D., am completing a post-doc, ran a company for 10 years (and worked in a variety of complex professional situations for several years prior to that), been married for 18 years, have children, so it's not like I just graduated from high school yesterday. I have some life perspective, and my assessment (incompetent as you claim it to be), is not at all inconsistent with at least one other post from someone who seems to know more about the specifics of the OP's program than you do (see previous messages).

Also, it seems very presumptuous to suggest that you, as an MSX, somehow have a monopoly on wisdom in sorting out a situation. In my life, some of the absolute best advice has often come from people outside of my specific situation. Sometimes people on the inside were locked into a particular mentality that was not at all helpful in sorting out the options. Over the years (decades, actually) great advice came not only from people who were beside me in my life but also those who gained wisdom in various ways that were not at all similar to my path ... something you appear to think is impossible. Also, as "bad" as medical school is, I can assure you there are other difficult situations out there that people can experience and can share the wisdom of.

Anyway, look up above at some of the other messages. You'll see that my advice is consistent with advice of other medical students. Just because I have not been in the specific situation does not mean that I can't give my opinion. I'm really unsure as to why you feel the need to get on my case.

 

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My school at least doesn't do things this way. They have a set # of incoming spots, and any failures are simply added on to that number, so somebody who repeats the year doesn't really take a spot away from somebody else. That said I've heard the cost of medical education is generally above and beyond the cost of tuition. Don't know if this is true or not, but whatever the case it doesn't make sense for schools to make decisions/offer advice in cases like this out of financial considerations of a few thousand dollars. Our ER for example is a total money pit, with millions going unpaid annually. And speaking of relative chump change, the lost year of future earnings is just that when comparing the difference between an FP's lifetime salary and that of a radiologist. Then again I compare the situation to those sadomasochists who take the MCAT over and over again to pull up a point or three. I would have a hard time putting myself through an extra year of Gross and biochem. Again I seem to be making arguments both for and against, but whatever.

 

That's all great, but you still don't really know what medical school is like, which is probably the key question - is slogging through another year of this crap worth reducing the risk.

In my opinion the answer is no. It's not even the tests, it's the other crap. Interviewing, PBLs, labs, intro courses, all that mandatory attendence stuff where you have to sit there and waste your life. You couldn't pay me enough to repeat MS1. Plus another year's tuition is brutal and you could max Staffords by the time you're done if you're not careful.

There are a lot of people who can't hack it and blame it on whatever circumstance X is giving them problems. If you've managed to get honors in some things (assuming that's top 20% or so), then you're not one of them and with proper commitment you should be able to pass, because just passing isn't that hard.

I'm not even convinced repeating MS1 and doing well looks all that much better than getting through with low passing grades. If you rock MS2 and Step 1 I don't think it will be a huge deal either way, but you're guaranteed to lose a year, tuition, and a whole hell of a lot of frustration by repeating.

 

Wow, touchy (but also really long! I guess it isn't just at my school where the PhD's feel the need to speak at length). At any rate, good for you, it sounds like you are quite accomplished and I'm sure you'll succeed given all that you have done so far. It isn't like this is the only thread on which you've given your sage advice, though. I'm still standing by my viewpoint of "you don't know what it's like until you've actually experienced it", although I'm sure the original poster does appreciate your advice. There are just some contexts which even the accomplished life-changers in my class were absolutely not prepared for.

Oh, and getting one's appendix removed isn't a walk in the park at all, at least not for me. Any sort of surgery is traumatic to the body. I had an allergy to the anesthesia, had some other complications; by and large I was out of commission for a good 10 days. Fortunately I worked at length with my dean and faculty and we came up with a schedule for me to catch up. In any case, repeating another year of medical school is hell.

 

No, I didn't mean to suggest that it was a no-brainer, and I can appreciate hell on earth and the idea of not repeating a year. I must have created the wrong impression.

Maybe in being much older now and a different sense of time duration I'm less worried about losing a year or suffering for another year of boredom or agony than messing up things in the long term. It isn't always an option, but doing something difficult over again to reach a long-term objective or just to create options is consistent with how I've done things throughout my life and has served me well. Losing a year or extending suffering when I was younger was a much bigger deal to me than it is now.

I was taking the angle of asking the OP about how they felt about taking risks with their career and I took the dean's opinion/hint rather seriously. I know people who somehow squeek through life and either don't care that bad things happen or just seem to be lucky at everything they do. I'm more a risk minimizer and when I do take risks, I weight the payoff. Ending suffering faster has never been a big plus for me. It seems to me there is an important risk element (unknowns) to the OP's question and the more conservative approach would be to 'reboot.'

 

True enough (if the LOA student takes up a spot in the incoming class, which isn't true at my school I believe), but by "the school gets another year of tuition" I actually meant "you're out another 20-40k"

 

While it would be hell, I would love to repeat anatomy again knowing what I do now, so I can appreciate the finer points and reinforce my learning. I did really well and didn't "squeak through" but if I failed or borderlined it, I would be doing everything I could to take any sort of make-up exam or anything else just to avoid that torture again. While, as you said, it is an "unknown" risk, I think the rewards are worth it given the proposition of repeating a whole year.

 

My guess is that when you have been out of school 20 years your perspective on medical school will change again. The physicians I spoke with all talked about it like it was no big deal at all ... a "gentle introduction to residency" is usually what they have called medical school.

The nice thing about offering my opinion is that when I do miss something or have a totally wrong-headed perspective, I learn something and I'm better prepared.

For example, I'm seriously considering doing a research year between MS2 and MS3 (Baylor offers that). I want to add publication related to oncology and possibly a LOR so if I aim for a Heme/Onc fellowship at a place like MD Anderson, I'll have a stronger CV coming out of my IM. One opthamologist (one of my Baylor alumn idols) said that was not a good idea ... better to wait until you are done with the MD to do things like research (when you can get paid more, etc.). Of course he also told me that he wanted to quit at several points in his medical education and, if he had to do it all over again, he would find something else without thinking twice (and this is a very wealthy, successful, down-to-earth guy). He did everything he could to try to discourage me from going to medical school because he things the medical education process as whole is too much torture. Also, I have seen complaints from students that say it makes MS3 hard when you have had a year to forget. Thus, this isn't just a point of idle interest. It's related to a concern that I have in my own planning.

 

MD/PhD students generally punctuate their education in a 2+3+2 format but I'm sure you knew that. One of my best friends, an MD/PhD senior medical student, said that she felt less prepared for the wards and initially faltered, but that by match time, she got the interviews at MGH/etc. mainly because of her PhD, and that many top residencies actually build in research rotations / research years to their residencies. Anyway, that was just a side note. The world needs more oncologists

 

Very cool. I did not know that some IM residencies had a research year. I thought it was just 3 years of non-stop work in the clinics. I'll certainly explore that as a possible alternative to delaying the MD by one year and risking making MS3 any harder than it already is (there goes my risk aversion again). Of course, being out of the research enviroment for 4 years is also a risk, but it doesn't seem as big a deal compared to foundering in the wards. Thank you for the information. .

 

Someone I know decided to take a leave of absence due to family issues. It really was the right thing for this person, from what I was told by this person, and it sounds like you would definitely benefit from a re-take. I voted to re-take, even though my initial impulse from seeing the thread title was to tough it out.

 

not so fast. my school has filled several spots in the M2 class b/c people have flaked out.

 

Yeah, I think filling spots with transfers is the exception rather than the rule. My class has lost a couple people, and nobody new has come along. I pretty sure transferring is uncommon in med skool

 

I voted "tough it out" before I read the original post. Now, I'm totally divided. I do think that the OP has a good reason to repeat the year, and I think it would be easier in their situation to explain on a residency application why they repeated the year than why they failed a course. That said, basic science year courses count for very little in the over-all scheme of residency applications, and with the kinds of hardships that the OP has incurred this year, no matter what happens with the grades it should be easy to explain later on.

Best of luck to you, no matter what you decide! Let us know what your decision is!

 

I think that in regards to the rest of your career, your first year studies will be little more than a minuscule blip in your proverbial radar. If you're going to retake an entire year, don't do it under the justification of better serving your patients. There are plenty of people that probably don't receive the educational experience you have (even with all your hardships) that still practice medicine. As far as the boards are concerned, they're mostly pathology, physiology, pharm, some biochem, and the rest (i.e. neuro, anat, histo) isn't quite as covered. I'd say press on if you believe you're capable. It's a year of your life...

 

Yes. I seriously doubt any of your patients will inquire as to your basic science grades, EVER. You can be an excellent doctor without being a biochemist, anatomist, or PhD pathologist.

 

currently an impossible task for me...

 

The amount of material on step 1 from 1st year is minimal. You can absolutely learn it on your own while studying for step 1, and besdies, it's not as if you haven't learned anything this year. Neither EM or Surgery is out for you just because of failing one and maybe even two courses in first year. Your third year grades and step 1 will be inifinitely more important. The biggest reason this will affect you IMHO is that it will drop your class rank. But if you do well after this year, even that will be minimal. You got a 4.0 from an ivy league in undergrad? You can do this! You just have to work very very very hard. It is not worth repeating the year.

I don't care what life experiences a person has had. It is not possible to understand how awful the first year of medical school is until you do it. I don't know anyone who has left medical school after the first year--if they don't make it, it's generally because they can't get through the crap of first year. (That said, most people do get through the crap of first year.) Perhaps the 3rd and 4th years are just a warm up compared to the rigors of residency, but the preclinical years are an entirely different experience altogether. It's like undergrad on speed.

 

The OP has the opportunity to make it through and should obviously try all the sensible options first; take makeup exams, get extra help postponements, etc. Obviously if OP can make it through, then s/he should do so. The dean even suggesting taking a look at the next exam and going from there. At this point the dean has simply warned that OP that a LOA is something that may make sense, although there are still opportunities to make it work out.

If, after failing the next exam (the one that is coming up), my dean sat me down and said, "you know this isn't working. You are setting up to fail two classes and possibly more and this is a problem; a leave of absence would look better on your record." I would respect my dean's opinion. I'm not suggesting that I would flippantly say, oh yeah, sure, just repeat the year. In my original reply, I had some trouble figuring out what the dean was suggesting, and the OP clarified the dean's comments to make it sound more like a warning in a later reply.

I would give my dean's opinion on how something would look on my record a lot more weight that what a classmate who is also an MS1 thinks or even what a poll on SDN says. If I had a question, I might go talk to a PD or two as well. Given that the OP has the talent and some rather difficult / unusual circumstances, a LOA would be totally justified if s/he runs out of options except for failing multiple classes.

The bottom line is that pain avoidance is not always the winning strategy. The easiest thing would be just to drop out of medical school and avoid this suffering altogether. If it was really that bad, this would be the best option and everyone's suggestion (unlike many other life situations that the OP could find him/herself in). I don't see anyone suggesting that. I also find it extremely humorous that some people think that med school is so bad that no one would want to repeat a year when very few people actually drop out and thousands of people want to get in.

If MS1 & MS2 was hell on earth >90% of the people would drop out every year at every school and medical schools would need to lower standards to a GED or below to get people to sign up (like recruiting bomb disposal crews for Iraq maybe). I've informally polled maybe 100 people (physicians, students, residents, etc.) about their experiences. The preclinical experience depends on many factors (like what school you go to, your study efficiency, whether you like PBL, etc.), and there are even people who enjoy it (treat it like a 9-5 job) and rock their STEP 1s. It's not like everyone finds MS1 & MS2 to be torture. I would dare say that about 80% of the people I spoke with said that MS1 & MS2 were a ton of studying and intense but not so bad that most people are looking to quit and leave at the first opportunity. I've never heard an MS1 or MS2 say, "Wow, that was rough; I bet MS3 and residency are going to be a cakewalk after this." Some people with 4.0's from top schools and high MCATs even said MS1 & 2 was 'easier than their UG' (engineers). Sure there are gunners who skip meals and forgo hygiene and agonize over the the fact that they must H's everything. There are people who are fighting tooth an nail just to pass. However, for most people it seems to be UG on speed as you say. Tough but doable.

If you want a famous reference, take a look at Panda's blog. Life as an MS1 & MS2 was good for him. He worked out and had time for life. He would probably trade the lifestyle of an MS1 for being an EM resident in a microsecond. He's not the only one who feels that way either. As far as other non-medical experiences, go, quit acting like med students are the only ones who work hard. There are engineers who work harder than med students and take all kinds of abuse but they plug away (and some of those jobs do have very high turnover). People take abuse in all kinds of jobs, whether it is patroling the streets of Bagdad, washing dishes in a steak house, working 120 hour weeks during a chemical plant turnaround, or just working for an abusive boss in a dead-end job because the economy is bad. If it came down to repeating MS1 or being stuck for the rest of my life in a medical specialty I didn't like I would repeat MS1. It's 1 year of pain versus 40 years of hell; sometimes it helps to think about the future as well.

 

I'd tough it out if you are on a traditional curriculum. I've had multiple classmates who failed one course or another in first year, remediated as necessary over the summer, and went on to do much better in second year with nice respectable scores on boards. A lot of it is about figuring out how to study; in your case of course, a lot is about handling big challenges in life outside school.

My advice might change if you are on a newer curriculum with all systems-based classes, where there is a lot less room for catching up on stuff in second year that you didn't really get in first year (since you only see stuff once).

We've had a few people repeat first year. Often you get no credit for tuition if you miss the last quarter; I agree that it would really suck to have to retake all the ethics etc. courses from scratch.

If you're worried about your future ability to serve patients, there are better ways to brush up on content knowledge than by retaking first year, since much of that material is esoteric or specific to particular fields, and not very useful for any kind of generalist.

 

Yeah, of course people take all kinds of abuse in all kinds of jobs. I've worked retail customer service full time and worked a second job simultaneously, and it sucked. But they were JOBS and I could have left them easily if I wanted to. In medical school, you PAY for the opportunity to be abused and it's not so easy just to leave when you're looking at the enormous financial investment many have made to be there.

No one here is saying there aren't harder life experiences than medical school. Of course there are. I just don't think anyone appreciates being told by someone who hasn't even started med school yet what they should be doing with their medical education. Congratulations for informally polling 100 physicians about their experiences and reading one guy's blog (which I have read myself). That does not put you in the position to act like medical school will be just like a 9-5 job and not so bad and that we're just all overeacting at how hard it is.

 

Let the OP tell me what s/he thinks. S/he seems perfectly capable of speaking on his/her own behalf.

 

Sure, let's talk offline. It just seems to me that we will treat patients with diseases that we have never had and hope never to experience. In current events, we don't need to personally go to Bagdad to provide valuable input on whether or not American troops should stay there or not. We should seriously consider the opinions of people who are in the situation, and that's exactly what I have done, and I have been given a variety of accounts. I'm convinced that we can provide input for situations based on reliable facts even if we ourselves have not personally experienced exactly the same thing.

 

don't 80-90% of Ivy leaguers graduate with honors?! so practically speaking, grades from ivy league are like grad school grades.

1st yr grades do matter as it is used for AOA determination, etc. But overall, like everyone else has said, do well from here on out and you don't have to worry too much. good luck!