US med school grad unemployed after PGY-1

[VersedGuy82]

I'm a US medical school graduate that always wanted to be an anesthesiologist. However, I failed my step 1 and then passed with a 75 on my 2nd attempt. After this I went on to take step 2ck and pass on 1st attempt with a 78. Then on step 2cs, I failed the 1st attempt and passed on the 2nd attempt. I just finished a PGY-1 preliminary surgery internship. However, I am currently unemployed and have had no luck at obtaining an anesthesiology spot. I applied to every anesthesia program in the country last year and received rejections from all the ones I heard back from. I then applied to a few pgy2 spots in pmr and radiation oncology and got 3 interviews, but they too rejected me after turning in my step scores after my interviews. The best/only advice I have received to date is to try to get a score in the 90s on the step 3.

I have also considered doing a residency in preventive medicine, but I am not sure about what kind of careers or financial outlook I would have in this speciality. There is very little clearcut information about this area of medicine on the internet, but after dealing with all of the drama regarding scores and that being the main selection critera in anesthesiology and other specialties, I really don't want to practice anesthesia anymore. At least in preventive medicine, I could get a MPH in health policy/management and then I could enter the business side of medicine (I think or maybe I need a MBA too....geesh!!???) I'm not sure how competitive preventive medicine programs are and how much of a role my step scores will play in securing this residency. Any advice anyone could give would greatly be appreciated as I am currently at my wits end! By the way...... I have good grades from med school, excellent LORs from intern year and med school, excellent dean's letter, and great interviewing skills.

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[peppy]

I don't know enough about preventive medicine to help with that, but sorry to hear that you have faced such problems trying to do what you want to do.
It sounds like you've tried to get into several very different specialties. Is there a particular reason that you aren't interested in trying to get a spot in something like family medicine? I know it would not be ideal, but at least it would be a job, you could tailor your lifestyle after practice to be what you want it to be, and you'd have the opportunity to do some procedures in that field.
Hope that things work out for you.

 

[VersedGuy82]

In regards to family and internal medicine.......Please don't take me wrong for saying this, but from my rotations in med school, I think I would be very unhappy if I had to sit in an office everyday telling people over and over to watch their salt intake and to check their blood sugars daily when they leave right out of your office and go chow down at the nearest burger spot. I think there is a need for doctors who want to do this type of work, but I know it would make me miserable.

 

[Top Gun]

I hate to say this, but the problem, and you probably already know this, is that you've been applying to very competitive specialties, that, with your USMLE scores, are definitely out of your league. I'm not familiar with preventive medicine residencies, but if you want to continue your medical career, you're better off trying to find a relatively noncompetitive residency to match into. Besides, your med school rotations don't tell your the whole story about family medicine or internal medicine. You may actually find you like those specialties.

 

[Faebinder]

Take step 3. Pass it. You will have an advantage, and can get a license and moonlight while applying.

 

[mercaptovizadeh]

I'm a US medical school graduate that always wanted to be an anesthesiologist. However, I failed my step 1 and then passed with a 75 on my 2nd attempt. After this I went on to take step 2ck and pass on 1st attempt with a 78. Then on step 2cs, I failed the 1st attempt and passed on the 2nd attempt. I just finished a PGY-1 preliminary surgery internship. However, I am currently unemployed and have had no luck at obtaining an anesthesiology spot. I applied to every anesthesia program in the country last year and received rejections from all the ones I heard back from. I then applied to a few pgy2 spots in pmr and radiation oncology and got 3 interviews, but they too rejected me after turning in my step scores after my interviews. The best/only advice I have received to date is to try to get a score in the 90s on the step 3.

I have also considered doing a residency in preventive medicine, but I am not sure about what kind of careers or financial outlook I would have in this speciality. There is very little clearcut information about this area of medicine on the internet, but after dealing with all of the drama regarding scores and that being the main selection critera in anesthesiology and other specialties, I really don't want to practice anesthesia anymore. At least in preventive medicine, I could get a MPH in health policy/management and then I could enter the business side of medicine (I think or maybe I need a MBA too....geesh!!???) I'm not sure how competitive preventive medicine programs are and how much of a role my step scores will play in securing this residency. Any advice anyone could give would greatly be appreciated as I am currently at my wits end! By the way...... I have good grades from med school, excellent LORs from intern year and med school, excellent dean's letter, and great interviewing skills.

Just do family medicine. You can tailor it to what you like. There are family med docs who do a ton of procedures, tests, etc. - this may not be good medicine - but they make more than many anesthesiologists and rad oncs. You might have to live in the boonies where there aren't doctors around to develop this sort of practice.

 

[mwest]

In regards to family and internal medicine.......Please don't take me wrong for saying this, but from my rotations in med school, I think I would be very unhappy if I had to sit in an office everyday telling people over and over to watch their salt intake and to check their blood sugars daily when they leave right out of your office and go chow down at the nearest burger spot. I think there is a need for doctors who want to do this type of work, but I know it would make me miserable.

I understand where you're coming from but this is over-hyped. While you'll see patients like this, there are many who are motivated & seek your help. Also many patients present with an acute problem and do get better.
BTW I am in a cardiology rotation and they still face the same problem as primary care does- patients who've had 2 stents placed in one year due to compliance issues, etc.
You better learn how to displace yourself from patients' personal issues if you wish to continue practising medicine.

 

[kralwok]

have you looked on the acpm website? you can become a resident member (costs a small amt of money) and get a mentor if you are serious about preventive medicine. i am in the same position as you (completed pgy-1 in medicine but did not get a derm spot) and have researched it some but am not sure how competitive it is. have you tried contacting program directors and asking them that question? i do know that they have just received a huge amount of federal funds for preventive medicine residency programs, so you are interested at a good time. i guess what it comes down to is whether or not you would be willing to give up practicing medicine. if you really enjoy patient contact, it might not be the field for you since it would be hard to practice medicine with only a PGY-1 year of patient contact.
don't do family or internal if you think you would not like it. you will feel trapped and will become bitter!

 

[ZuperZtar]

I'm a US medical school graduate that always wanted to be an anesthesiologist. However, I failed my step 1 and then passed with a 75 on my 2nd attempt. After this I went on to take step 2ck and pass on 1st attempt with a 78. Then on step 2cs, I failed the 1st attempt and passed on the 2nd attempt. I just finished a PGY-1 preliminary surgery internship. However, I am currently unemployed and have had no luck at obtaining an anesthesiology spot. I applied to every anesthesia program in the country last year and received rejections from all the ones I heard back from. I then applied to a few pgy2 spots in pmr and radiation oncology and got 3 interviews, but they too rejected me after turning in my step scores after my interviews. The best/only advice I have received to date is to try to get a score in the 90s on the step 3.

I have also considered doing a residency in preventive medicine, but I am not sure about what kind of careers or financial outlook I would have in this speciality. There is very little clearcut information about this area of medicine on the internet, but after dealing with all of the drama regarding scores and that being the main selection critera in anesthesiology and other specialties, I really don't want to practice anesthesia anymore. At least in preventive medicine, I could get a MPH in health policy/management and then I could enter the business side of medicine (I think or maybe I need a MBA too....geesh!!???) I'm not sure how competitive preventive medicine programs are and how much of a role my step scores will play in securing this residency. Any advice anyone could give would greatly be appreciated as I am currently at my wits end! By the way...... I have good grades from med school, excellent LORs from intern year and med school, excellent dean's letter, and great interviewing skills.

Accept your fate as an IM/FM/Psychiatrist/Obgyn. It will sting your ego at first, but you will get used to it. If you want to be a specialist you can do IM and specialize.

 

[VersedGuy82]

I will definitely try the mentor section on the ACPM site. I do enjoy patient contact, but I care about providing meaningful people to people's lives through healthcare. I feel like I could probably do this on much larger scale through preventive medicine/health policy and management. I've watched hospital CEOs and medical director pretty much dictate patient care and I feel like I would really be able to help patients get the care they really deserve as human beings.

However, I'm not sure which route is the best? Does anyone know the difference between the MPH in health policy/management, a MHA, and a MBA. I mean, which one would truly allow you the best opportunity at getting a job as a CEO of a hospital, a medical director at a pharm company, or a CEO job at a major healthcare insurance company?

 

[sam1999]

However, I'm not sure which route is the best? Does anyone know the difference between the MPH in health policy/management, a MHA, and a MBA. I mean, which one would truly allow you the best opportunity at getting a job as a CEO of a hospital, a medical director at a pharm company, or a CEO job at a major healthcare insurance company?

There are so many foreigners who get into residency into USA. I have seen people getting into residency with little English and USMLE transcript worst than you. Hello with multiple failures on USMLE and little US clinical experience. You already done 1 year. Try applying for 2 year IM for FM programs as some programs may give you credit for you first year of surgery. One mistake you probably have done is, even though you are Prelim Intern but you could have done that year as categorical so that you can be considered for 2 year in other specialities. I have seem people going to IM after one year of surgery internship.

You have already 1 year of experience. If you really want to do anesthesia or practice medicine then consider doing 1 year of research like starting now. Talk to some of program directors as they may not want you but will be willing to give you some advice. You are already unemployed so consider doing unpaid research in case you can't arrange paid one. Your research does not has to be in Anesthesia as it can in CVS like arrthymias etc. So think related fields. Ask your surgeons where you have worked as most of them would know some anesthesia dude.

There is a list circulating at this same sub- forum (general residency issues) about IMG friendly programs so try applying there in Anesthesia or IM or FM so at least you have 1 year of research for this year and for next year you have some thing to get going. Apply to those programs which only sponsor J1 or like Green card or US citizenship. As most hot shot IMG want to get H1 visa and these programs are very picky so they know what to look for.

As for MBA or to run the hospital or insurance company. Most CEOs don't have MD degree (I could be wrong) as it is not required. MBA is really crowded field and with this economy good luck finding a job. Do some thing like IM or FM if you can't get Anesthesia then at least you have something to fall back in the future if your business plan does not work.


so as far the salt and wt advice to every patient. As IM specialist you can choose to work as hospitalist. Great life style. Go to hospital turn on pager and once sign off no more pager.

 

[Winged Scapula]

The OP is NOT eligible for PGY 2 in FM or IM after doing a Prelin Surgery year. While he might get credit for some SICU time the vast majority of Surgery does not meet the internship training criteria of either FM or IM. He will most likely have to do the ENTIRE 3 years.

 

[Llenroc]

In regards to family and internal medicine.......Please don't take me wrong for saying this, but from my rotations in med school, I think I would be very unhappy if I had to sit in an office everyday telling people over and over to watch their salt intake and to check their blood sugars daily when they leave right out of your office and go chow down at the nearest burger spot. I think there is a need for doctors who want to do this type of work, but I know it would make me miserable.

Beggars can't be choosers. You'd be lucky to get any categorical spot.

Otherwise good luck flipping those burgers for said obese visitors to the IM clinic.

 

[Old_Mil]

I'm a US medical school graduate that always wanted to be an anesthesiologist. However, I failed my step 1 and then passed with a 75 on my 2nd attempt. After this I went on to take step 2ck and pass on 1st attempt with a 78. Then on step 2cs, I failed the 1st attempt and passed on the 2nd attempt.

Family Medicine, Psychiatry, PM&R, possibly Pathology.

At least in preventive medicine, I could get a MPH in health policy/management and then I could enter the business side of medicine (I think or maybe I need a MBA too....geesh!!???)

Yes - however, you may want to wait a bit and see how all this "reform" shakes itself out. If things head down the track they're currently heading, the opportunities in private sector medical-related management will be drastically reduced.

By the way...... I have excellent LORs from intern year and med school, excellent dean's letter, and great interviewing skills.

Unfortunately, such things are all subjective. For better or worse, board (and inservice exam scores) are really the only objective measures of where a student/resident is.

 

[Taurus]

In regards to family and internal medicine.......Please don't take me wrong for saying this, but from my rotations in med school, I think I would be very unhappy if I had to sit in an office everyday telling people over and over to watch their salt intake and to check their blood sugars daily when they leave right out of your office and go chow down at the nearest burger spot. I think there is a need for doctors who want to do this type of work, but I know it would make me miserable.

Well, FM or IM is better than no job at all.

 

[lowbudget]

Don't do FM. If you can't handle the breadth of basic science knowledge, barely passed the most basic knowledge of clinical medicine, and couldn't pass an evaluation of your clinical skills that simulates the clinic setting, you're not going to do well in FM. Or you'll be sued off your butt.

Pick something a little bit more narrow so you can devote your attention to 1 specialized body of knowledge. Just because FM has unfilled spots and your test scores are bad doesn't mean that FM is the right place for you. Don't do that to yourself or your patients.

If you have real good subjective evaluations, chances are you're a good person, plays well with others, works hard, and have charisma. Sounds like Preventive Med or Public Health might be the right place for you. It's a mixes medicine with public policy, and has an advocacy/lobbying bent to it. Great for people with people skills and leadership capabilities.

Keep looking. I have faith you'll find your place.

 

[VersedGuy82]

Thank you lowbudget, I believe your comments are so right on; you could possibly be the Dalai Lama! The prev medicine/healthcare policy& mgmt has me at the same level of excitement that I felt about anesthesia. I really can see myself being very happy without a pager in an office working on a larger scale to make sure people's healthcare needs are adequately and effectively met.

Even though healthcare is being drastically reformed, there will always be pharm companies in need of medical directors and hospitals in need of leaders (chief executive and chief medical officers). If I go through the route of prev medicine, I will also be board certified in a specialty which will give further credibility to my academic strengths (that are not there with my current step scores). Then if I can't find a job after the prev medicine residency, I can always go back and do my 3 years in anesthesia and programs may be able to look past the low step scores/failure in light of my possessing a mph and board certification in prev med. Also, in 2-3 years from now, anesthesia may be much less competitive (in light of current healthcare reforms).

I heard an excellent quote from Fran Drescher in regards to living her life after she was diagnosed with uterine cancer. "Sometimes the best gifts come in the ugliest packages." Maybe being shut out of anesthesia will position me to be a true leader in healthcare. Not sure yet, but I will hold on for this ride and see what happens!