What to do during time off?

[Lb1230]

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I'm currently in a tough position: I'm an ms3, and I'm pretty sure that EM is the field that I want to go into. Last year I failed step 1 (I had debilitating test anxiety and had a panic attack during the test) and my second attempt was a very low pass. Because I had to be pulled from rotations to study for my second attempt, my 3rd year schedule got thrown out of whack and now I have about an 8 month gap between 3rd and 4th year. I'm trying out weigh my options to see what would be the most productive use of my time off. I met with the PD at my home program, who strongly disagreed with taking any time off, saying that it's a red flag that I wouldn't be able to overcome. I told him that the gap of time wasn't an option because of the rotations that were pushed back, and he said he'd suggest stretching my 4th year into 20 months and trying to honor as many aways/EM rotations I could fit in that time. My go to plan was research.. I know it's not something that's valued that much by residency programs, but i feel like establishing some rapport with a program and getting a paper or presentation out of the experience can't help. My deans think some hybrid of a few months of research and a few months of extra sub-is would be best. I'm not sure which of these (or some mystery fourth option) would be the most helpful for an application which is essentially starting from behind.. Any thoughts?

 

[Mudpile MD]

Having just gone through the interview trail, my two cents would be to concentrate on doing well in clinical rotations. I did a lot of research during med school. I had 50+ individual interviews (multiple interviews at each program) and we discussed my research in 2 of them. In comparison, my strong SLORs from a well known program was brought up at the majority. This isn't to say my research didn't help me get those interviews, but with your step 1, I think you'd get more bang for your buck by going to more programs and performing well clinically.

 

[The White Coat Investor]

The failed Step I is a huge red flag, especially since the repeat is only barely passing. You definitely have an uphill battle to fight. Your best bet will be a Step II score that is at least average and an honors in your EM rotations. Assuming EM is what you really want to do, I would suggest applying very widely, perhaps even to all the programs.

How'd you lose 8 months? It seems to me the guys in my class with this issue only lost one rotation, and made up for it by taking less electives/time off as MS4s.

There's nothing that says you can't do research AND take some additional EM rotations. Why does it have to be either/or?

P.S. Someone needs to say this, and perhaps you've already heard it, but panic attacks are probably not very compatible with perhaps the most anxiety-inducing specialty out there. Not only do you not know what to expect at work every day before going in, but you don't know what's coming through the doors 5 minutes from now. EPs generally thrive in that type of environment. I'm not sure someone who finds a written test to be a panic-attack-inducing-experience will find long-term career satisfaction in that environment. You may decide to do it anyway, and that's okay, but I think you owe yourself some long, hard thought on this subject. It isn't easy to change specialties down the road.