What to do step 1 fail and how to navigate this?

[swagmcchickenfan]

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Hi everyone, I’m a USMD at a California T30 medical school. I took Step 1 and did not pass due to ongoing personal circumstances. In short, I was not in the right headspace and tried to push through. Ultimately that did not work out, and I took some time off to regroup. I retook it and I did pass. I know that there are implications for this and that my options will be limited. Unfortunately, as much as I wish I could go back in time to change this I can’t. I’ve since transitioned back into my clinical duties and have received glowing feedback from my attending, residents, and faculty. When I first started medical school, I was initially interested in anesthesia but later discovered ENT by accident and fell in love. I would be happy with either and I know it’s an uphill battle. My mentors are not aware of the step 1 failure as I am a bit embarrassed but are aware that I took some time off and were supportive of me. My school’s advisors have beaten around the bush when I try to talk about applying to either and so I am a bit nervous as to how to move forward. Without a step 2 score it’s hard to say but given my current performance on my shelves and the grades I’ve received, I would say that I am doing well. Aside from this step 1 failure I consider myself a well rounded applicant with plenty of translational research as well as leadership and volunteering. I’m doing my best to prepare for step 2 in hopes of compensating for this.I wonder if this is something I have to accept and give up on or if there’s a chance I can still pursue either specialties. And if so, how will away rotations work as I know I’ll be screened out by many programs? I’m trying to plan ahead as I wrap up my M3 year (my schedule is a bit out of sync because I started rotations, took time off and re-entered later in the year). Not sure if its relevant, but I have strong ties to CA. Thanks for your advice.

 

[Lost in Translation]

ENT would be a really, really tough application with a Step 1 failure. You would have absolutely crush Step 2 (like, 270+), and have multiple first-author pubs and abstracts/posters in ENT, and honors pretty much all of your M3 rotations. Having all of those is probably “good enough”, but even then, you’re going up against many other students who have all of that without a Step 1 failure. It’s possible, but only slightly more possible than a camel passing through the eye of a needle. And if any one of those three is not true, I’d forget about ENT.

Anesthesia is more attainable with a more above-average appearing application but not a guarantee either.

 

[EthylMethylMan]

Agree with above. I’d say the best middle ground between dreaming and settling would be to dual-apply anesthesia and a low-tier specialty (EM, FM, peds, etc.). ENT has an abundance of applicants with no major red flags, so I don’t think it’d be worth shooting that shot.

 

[janprincetondoc]

Anesthesia and ENT are impossible with step fails. You are limited to family med community im peds

Not trying to be mean, but to plan ENT or anesthesia away research etc would be a waste of time and money

 

[janprincetondoc]

ENT would be a really, really tough application with a Step 1 failure. You would have absolutely crush Step 2 (like, 270+), and have multiple first-author pubs and abstracts/posters in ENT, and honors pretty much all of your M3 rotations. Having all of those is probably “good enough”, but even then, you’re going up against many other students who have all of that without a Step 1 failure. It’s possible, but only slightly more possible than a camel passing through the eye of a needle. And if any one of those three is not true, I’d forget about ENT.

Anesthesia is more attainable with a more above-average appearing application but not a guarantee either.

Not really tough, impossible. Be realistic. Even anesthesia is basically impossible with a fail. More and more schools open every year, more apps. Tougher competition for non primary care fields

 

[RockClimberMed]

Anesthesia and ENT are impossible with step fails. You are limited to family med community im peds

Not trying to be mean, but to plan ENT or anesthesia away research etc would be a waste of time and money

100% Agree. Coming from ENT applicant without a Step 1 failure and still feels nearly impossible to compete these days.

 

[Starr_key]

My unpopular advice is shoot your shot. I recommend talking to your mentors and seeing what they say. Yes, you will have to show that you won't fail boards and do well on STEP2.

I don't agree with "STEP1 fail=only IM, Peds, FM." I know people who failed STEP1 and matched into ortho, academic IM, psych, etc. It is definitely a hill you have to overcome and yes, the danger of not matching is of course there, but I think if you have connections and that's your only blemish, it can be overcome.

No one @ me.

 

[MDMechEngr]

OP: Your home program is your best shot at Anes or ENT. Do really well on Step 2 and give it evertthing you got at your home program sub-i. Charisma and good looks will help you also, if you got game. If theyt really really like you, you got a shot. GL.