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Voluntary Withdrawal From Medical School...Please Read and Advise

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Recovery2014

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How you guys doing,


I was hoping to get some feedback on my situation as well as guidance and direction on my next steps moving forward. I attended a good medical school in the US from 2004-2010. I did average on Step 1 (210). I had a 3.0 GPA my first two years and received all B's during my clinicals during my 3rd year. Around the beginning of my 4th year, a personal problem started to grab a hold of me and affected me in areas of my life that it hadn't had a huge impact on before. To be transparent, I struggled with a bad addiction problem. I went to treatment at the beginning of my 4th year after coming clean about a substance abuse problem then came back after a couple months and completed most of my 4th year while trying to control my addiction. Then, during my last rotation (my sub-internship) I was struggling with depression (which I know today was more a result of guilt, shame, and remorse because I was using again in a clinical setting) and got honest about my relapse so my school gave me another shot at treatment. Also during this time I failed Step 2 as I was unable to focus long enough to take a 9 hour exam due to the substances I had to take to prevent withdrawal. Long story short, the treatment did not work and I ended up voluntarily withdrawing from the curriculum in August 2010 at the recommendation of my medical school. I stayed on a maintenance therapy for my addiction (methadone) after that and slipped into a deep depression. In November 2014, after reaching a point of utter despair, I accepted help and went into an extremely intensive rehabilitation program for 16 months. I have been sober now for 20 months and am starting my masters in Public Health in August. My dream ever since I was a kid is to be a doctor and I am finally at the point where I can safely start to explore my options of re-entering the curriculum. It has been 6 years since I have been in the curriculum and I realize that my chances are slim but would regret not fully exploring my options. I have been told by my addictionologist that I have a disability that is covered under ADA. I have multiple points of contacts in my medical school who are willing to help. I have numerous people, both physicians in recovery and medical professionals involved in my treatment, which are advocating my re-entry into medical school. Fortunately, I was never caught doing anything I wasn’t supposed to and my attempts at treatment were both voluntary. I have no criminal record. I am $225,000 in debt and have no medical degree to show for this. Technically, there were extenuating health problems that lead to my voluntary withdrawal not my inability to perform academically. I am looking forward to getting my Masters in Public Health and have medical knowledge and training that no one can take from me and, for that, I am grateful. In fact, I have to remember every day that I am grateful to have survived my addiction and have a firm foundation in recovery. I am ok with the reality that being a doctor may not be in my future and am open to other career paths in health care. I am aware of the Step exams having to be finished in a 7 year period, of the LCME requiring that I finish my coursework in 6 years, and of my MCAT score only being good for a 10 year period. Yes, I know this is an uphill battle. And please, I don’t want this to get into a debate of “Addiction is not a disease”. I realize that I screwed up a wonderful opportunity that not many people get a chance at. I am fully aware that this is the greatest failure in my life up to this point. I have worked hard to overcome this and move forward. Any advice that you guys have moving forward would be greatly appreciated. Thank you!
 
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I don't have any advice unfortunately, as I am only an M4 myself. But I truly wish you the best of luck in this endeavor. It sounds like you've overcome a lot and have gotten yourself to a well-functioning place with the help of treatment. I guess the only thing I would ask to help clarify your story is, are you planning to try to rematriculate into your old medical school? Or would you need to apply to medical school all over again? That bit was just a little unclear to me.
 
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hallowmann

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    Hmm. So what exactly do you want to do, return to med school? I'm not sure what the USMLE/NBME rules are for retaking after 10 years. If you pass, I am under the impression you can't retake it, but I'm not sure if there is a time limit for that.

    Either way it seems like you'll have to start from scratch due to the LCME 6yr limit. If you can't retake the USMLE Step 1 (you'll have to to take them all in 7 years), then your best bet might be DO. You'd have to retake the MCAT and apply. Then you can take a whole new set of licensing exams (COMLEX) in the appropriate timeframe and get licensed.

    I'm honestly not sure how DO schools will take your history, but depending on how you frame it, some school might give you a chance. Non-trad and reinvention stories are kind of loved by some adcoms, and to be honest you don't lose much by trying (a few hundred for the MCAT, a few thousand to apply to almost every DO school). It might even help to get an LOR from faculty at your old MD school.

    Obviously no matter what its an uphill battle. I honestly have no idea if you'll be successful, but I don't see why it would be impossible. Maybe @Goro could have some info/advice.

    Either way, congratulations on getting to where you are now in treatment, I hope it continues. Good luck, I hope that you find success and happiness.
     
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    Goro

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    I am truly sorry to hear of OP's plight. I recently learned of a close relative's substance abuse issue, so this hits home for me.

    That said, OP is too high risk for relapse, and I suggest that s/he given it their best shot, and it's time to move on. Sometimes you have to cut off an arm to save a life.



    Hmm. So what exactly do you want to do, return to med school? I'm not sure what the USMLE/NBME rules are for retaking after 10 years. If you pass, I am under the impression you can't retake it, but I'm not sure if there is a time limit for that.

    Either way it seems like you'll have to start from scratch due to the LCME 6yr limit. If you can't retake the USMLE Step 1 (you'll have to to take them all in 7 years), then your best bet might be DO. You'd have to retake the MCAT and apply. Then you can take a whole new set of licensing exams (COMLEX) in the appropriate timeframe and get licensed.

    I'm honestly not sure how DO schools will take your history, but depending on how you frame it, some school might give you a chance. Non-trad and reinvention stories are kind of loved by some adcoms, and to be honest you don't lose much by trying (a few hundred for the MCAT, a few thousand to apply to almost every DO school). It might even help to get an LOR from faculty at your old MD school.

    Obviously no matter what its an uphill battle. I honestly have no idea if you'll be successful, but I don't see why it would be impossible. Maybe @Goro could have some info/advice.

    Either way, congratulations on getting to where you are now in treatment, I hope it continues. Good luck, I hope that you find success and happiness.
     
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    W19

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    You should also explore the PA/NP option because it will be extremely difficult to enroll back into a US med school... Good luck!
     
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    lymphocyte

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    I am ok with the reality that being a doctor may not be in my future and am open to other career paths in health care. I am aware of the Step exams having to be finished in a 7 year period, of the LCME requiring that I finish my coursework in 6 years, and of my MCAT score only being good for a 10 year period. Yes, I know this is an uphill battle. And please, I don’t want this to get into a debate of “Addiction is not a disease”. I realize that I screwed up a wonderful opportunity that not many people get a chance at. I am fully aware that this is the greatest failure in my life up to this point. I have worked hard to overcome this and move forward. Any advice that you guys have moving forward would be greatly appreciated. Thank you!

    Three things:

    1. I'm so sorry for what you've been through.
    2. 20 months sobriety!!! Congratulations!!
    3. "Other career paths in healthcare":

    Re-entering medical school + residency is a long, uncertain, painful and stressful process that risks relapse. Your health might not be worth it. But healthcare is a massive industry. Others can speak to the clinical work (like PA/NP), but there are many great non-clinical options too. For example, there's a huge demand for consultants with clinical exposure and some knowledge of biostatistics (like you would get from that MPH). Definitely don't need a license. Starting salary is around 120K with great benefits, and you can titrate your efforts up or down the corporate ladder as you feel comfortable. Other options include working in the pharmaceutical industry, healthcare administration, public health... Lots of great options. You had the guts and brains to get into medical school, and then you had the guts and brains to get help. You've come a long way. I wish you the best of luck.
     
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    Promethean

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    Bless you. You have had a hard road.

    I have someone very near and dear to me whose post-graduate medical education was ended by mental illness, and that lead to a period of substance abuse that further diminished the possibility of return to medicine as a field. For a while, she explored avenues to resume her training, but ultimately decided that completing an entire residency, even if that were a possibility for her, was off the table because of the potential that the stress and physical/emotional demands of the program could disrupt her recovery and lead to relapse.

    After much careful consideration, her plan now is to pursue either a PA program or to go the NP route, once she has the appropriate support system in place to nurture her through such a program. Either option would let her finally be able to provide care to patients in a framework if this is more conducive to her well-being.

    There are other pathways open to you, if the physician track is closed you. You might not have the same degree of autonomy as a PA or NP, but that isn't such a bad thing in this situation. Having supervision and support is not a bad place to be. Both of those tracks also provide income opportunities that would make your loans more manageable.

    You can make a good case for getting back in, and with the right mix of contacts and legal advice, you might just pull it off. I'm cheering for you, no matter what!
     
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    mymembernames

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    LCME requires US MD students to graduate within 6 years of start date? Or am I reading this wrong?
     
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