Withdrew 6 months from graduating, need help/advice about transferring/reinstatement.

[Formermedstudent]

Hi everyone,

I tried to find analogous examples by searching but nearly every thread seemed to deal with folks withdrawing very early in their careers or with very different medical histories.

Bottom line: I'd love to hear any advice or help that can be offered for my attempt to become reinstated/transfer following a withdrawal for illness, especially if you know of similar cases.

2 years ago, I withdrew from a US M.D. program during my M4 year prior to interviewing anywhere for residency. Though technically I "withdrew voluntarily in good academic standing," I would have been unable to satisfy the graduation requirements of my program, namely, a strict 6 year statute of limitations, dated from matriculation, within which a student must graduate. I took a 2 year LOA for alcoholism at the start of my M2 year. My illness made my M1 and pre-LOA M2 years really awful, manifested by professionalism concerns (no disciplinary action) and a C average. After returning from my LOA, I did great: Class rank #1 in M2 & M3 years, 260s on Step 1, exemplary professionalism, and I actually enjoyed medical school. I relapsed again early in the M4 year and the time required for convalescence would have seen me exceed this statute by a few months. Even had this not been an issue, my problems would have probably eventually necessitated a LOA or withdrawal during residency. An upsetting and demoralizing experience to be sure.

Now my disease is stably managed & my health is excellent. I understand psychiatric/substance abuse disorders are looked at differently by school administrations than other medical problems, and I'm sure that given my history some probably reduce me to a "candidate who has already proved unfit twice," but I still desperately want to finish my training and practice medicine.

My request for reinstatement at my original program is pending review. I am also trying to transfer to other US M.D. programs. Just looking for any help or advice about transferring/reinstatement, especially if you or anyone you know has dealt with this. Sorry about the length and thank you in advance.

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[studentxx8800]

Damn man, seriously feel for you. I don’t have an answer although my instinct is that it is unlikely you can make it back into medicine with a withdrawal and hx of substance abuse. I really hope I am wrong and you make it back into the profession cause somebody like you deserve another shot. Hope the best for you man

 

[Goro]

Hi everyone,

I tried to find analogous examples by searching but nearly every thread seemed to deal with folks withdrawing very early in their careers or with very different medical histories.

Bottom line: I'd love to hear any advice or help that can be offered for my attempt to become reinstated/transfer following a withdrawal for illness, especially if you know of similar cases.

2 years ago, I withdrew from a US M.D. program during my M4 year prior to interviewing anywhere for residency. Though technically I "withdrew voluntarily in good academic standing," I would have been unable to satisfy the graduation requirements of my program, namely, a strict 6 year statute of limitations, dated from matriculation, within which a student must graduate. I took a 2 year LOA for alcoholism at the start of my M2 year. My illness made my M1 and pre-LOA M2 years really awful, manifested by professionalism concerns (no disciplinary action) and a C average. After returning from my LOA, I did great: Class rank #1 in M2 & M3 years, 260s on Step 1, exemplary professionalism, and I actually enjoyed medical school. I relapsed again early in the M4 year and the time required for convalescence would have seen me exceed this statute by a few months. Even had this not been an issue, my problems would have probably eventually necessitated a LOA or withdrawal during residency. An upsetting and demoralizing experience to be sure.

Now my disease is stably managed & my health is excellent. I understand psychiatric/substance abuse disorders are looked at differently by school administrations than other medical problems, and I'm sure that given my history some probably reduce me to a "candidate who has already proved unfit twice," but I still desperately want to finish my training and practice medicine.

My request for reinstatement at my original program is pending review. I am also trying to transfer to other US M.D. programs. Just looking for any help or advice about transferring/reinstatement, especially if you or anyone you know has dealt with this. Sorry about the length and thank you in advance.

I can't sugar coat this, Your medical career is over.

 

[NotAProgDirector]

You know you have an uphill battle ahead of you.

Your best chance is going to be back where you withdrew. They know you, and they might be willing to make an exception for you. You should first throw yourself on their mercy and hope for the best. Although you could try to force them to take you back, perhaps by claiming this was an ADA disability that they did not accommodate, I don't think that's a great idea -- plus it sounds like you withdrew rather than being terminated, so you probably lose that argument.

After that, you can try with other schools but I doubt you'll have much luck. First of all, COVID has created a huge problem with schools -- too many students and not enough rotation spots. No one is going to want a new student. Very unlikely, but if there was a new medical school that was in the "ramp up" phase, then they might have less students in their clinical years than they ultimately plan for and perhaps they might take you -- but new schools want success stories, and you're a risk.

After that, you're looking at the Caribbean. That will add yet another red flag to your file. I doubt any of the top Carib schools would take you, so you'd at best be looking at a second string school. They would probably make you repeat all of 3rd year. You will probably find someone to take your money if you look.

I think the next question to ask is, if successful, then what about residency? This is going to be another tough hurdle. From the outside, here's your story: Got into medical school, alcoholism + poor performance, took a 2 year LOA, "Totally under control, ready for return to school", 1.5 years of work followed by relapse, left school, 2 year LOA, "Totally under control, ready to return to school". Are programs really going to believe that you're not going to relapse again? For programs it's a bigger risk than for your school -- your school gets to keep your tuition, and doesn't matter if you stop showing up. A program will need to keep paying your salary on disability, yet still pay someone else to do the work you were scheduled to do. Plus there's the medmal concern. Plus some people still see alcoholism as a moral failing.

I do wish you the best of luck. It's not going to be easy, and probably going to be impossible. I'd recommend meeting with the Dean at your original medical school if they will do so.

 

[Microshaft]

Just curious, how stably managed do you think your issue is, and what are the chances you will relapse again?

 

[frenchyn]

I am just a medical student so take my words w grain of salt...and don’t bash me everyone.

It thinks it really depends on how long stable you are with your problem...if you have Been clean for a long time and maybe you can have a letter of your doctor that says you are stable and risk of relapse is low before you go make your case. Obviously, it is a challenge in your case but I believe everyone should get second chance and as long as you can show that 1. You put work into it 2. Your chance of relapse is very low 3. You have a solid plan that this won’t happen again 4. Maybe you have your own personal story that leads to alcohol use? Start with a solid 1-4 and approach someone at your school. Reach out to different people though because obviously not everyone believe second chance. It will be an uphill battle and a lot of proving to do to people, but if you really want it and are willing to put in the work, you won’t know if you don’t try. But also have a back up plan. Good luck!!!

 

[deleted480308]

I am just a medical student so take my words w grain of salt...and don’t bash me everyone.

It thinks it really depends on how long stable you are with your problem...if you have Been clean for a long time and maybe you can have a letter of your doctor that says you are stable and risk of relapse is low before you go make your case. Obviously, it is a challenge in your case but I believe everyone should get second chance and as long as you can show that 1. You put work into it 2. Your chance of relapse is very low 3. You have a solid plan that this won’t happen again 4. Maybe you have your own personal story that leads to alcohol use? Start with a solid 1-4 and approach someone at your school. Reach out to different people though because obviously not everyone believe second chance. It will be an uphill battle and a lot of proving to do to people, but if you really want it and are willing to put in the work, you won’t know if you don’t try. But also have a back up plan. Good luck!!!

This is a third chance.

Go ahead and ride out the appeal with your school, go ahead and do the work of asking other schools. I say that because having the degree would be a nice payoff for the tuitiob spent.

having said that, as a resident I would argue against hiring you in a rank meeting. Too many red flags and there are tons of “safer” options when sorting through candidates. I’m nit trying to pile on, just trying to give you a realistic expectation. If I were you and got the degree I would apply to everyprelim and fm/im program I coukd find and cross my fingers. I’d call every non-desireable location and explain my situation and just tell them I needed a chance. They probably still won’t but that is what I would do

don’t let the status of school/residency define you. You can still do others things in life if you protect your health well enough

 

[deleted915325]

Again just a medical student but I think the biggest hurdle will be getting back into medical school. Once you are in and have your degree, then I could see you marching into something like a community psych or community FM program. This is if you make it back into your USMD school. If you fail to make it back into your old school and eventually end up in the Caribbean, then chances are much more bleak as the red flags pile on.

In any case, good luck! I feel for you, but in all honesty, it’s going to be an extremely rough up hill battle and I fear the stress might cause another relapse so be very careful.

 

[Mad Jack]

Odds aren't good, but as others have said, your only real hope is this school taking you back, but even then matching is unlikely. And honestly my biggest worry is that residency would lead to another relapse, as it is far more challenging than what you've already been through. I'm sorry you're struggling with this, and wish you the best moving forward

 

[Newhorizons21]

I would read about Leigh Sundem to see just how hard it is to get a second chance in Medicine regarding addiction issues.

Leigh Sundem Memorial Scholarship | Center for Addiction Recovery | Georgia Southern University

Leigh Sundem, MD, was one of the most gifted, driven, inspiring, and authentic individuals to ever graduate from Georgia Southern University. Her story is one of incredible resilience, dedication, and compassion. It was Leigh's wish that her family and friends find a way to honor her death, and...

jphcoph.georgiasouthern.edu

 

[IMGASMD]

I would read about Leigh Sundem to see just how hard it is to get a second chance in Medicine regarding addiction issues.

Leigh Sundem Memorial Scholarship | Center for Addiction Recovery | Georgia Southern University

Leigh Sundem, MD, was one of the most gifted, driven, inspiring, and authentic individuals to ever graduate from Georgia Southern University. Her story is one of incredible resilience, dedication, and compassion. It was Leigh's wish that her family and friends find a way to honor her death, and...

jphcoph.georgiasouthern.edu

Super sad.

 

[Mass Effect]

As a psychiatrist, I'll speak up. First of all, I have to dispel the myth that anyone can speak on the OP's behalf about chances of relapse. That's not a thing. We don't do "chance of relapse" speculation, particularly in order to clear him/her for medical training. What we do is talk about what the OP has done to get and stay sober and what the sobriety plan is going forward.

OP, I really hope your school gives you a shot. I think that if you can graduate from some medical school, you have a shot at residency in a year or two. Here's what I'd do, assuming you get your MD or DO:

Apply to the match. You may not match, but you need to apply.

If you don't match, become a recovery coach. Get real clinical experience with those fighting addiction. Take some courses in substance abuse and addiction counseling if you can afford it. See if you can get a Master's in this if it's easily attainable/doable for you. If not, maybe you can do some research in it with a mentor or your own addiction counselor.

Weave together one hell of a personal statement about what you've been through, how far you've come, and your dedication and commitment to helping others.

Your application will likely be looked at only by psych (and only if you frame at as wanting to go into addiction psych) or FM/IM programs.

I think this is realistically your best shot at becoming a residency-trained physician.

One thing you should also know if you don't already is that any state willing to train you in residency will likely require you to enroll with your state's physician health program. Look these up because they're controversial. Ordinarily, I would say run as fast as you can from these, but in your case, I don't think you have a choice. You will likely have to work with the php in order to become a doctor.

I do think you have a chance. You just have to sell your application right, cross your fingers, and pray.

 

[MedLife20]

I would read about Leigh Sundem to see just how hard it is to get a second chance in Medicine regarding addiction issues.

Leigh Sundem Memorial Scholarship | Center for Addiction Recovery | Georgia Southern University

Leigh Sundem, MD, was one of the most gifted, driven, inspiring, and authentic individuals to ever graduate from Georgia Southern University. Her story is one of incredible resilience, dedication, and compassion. It was Leigh's wish that her family and friends find a way to honor her death, and...

jphcoph.georgiasouthern.edu

This story was sad and it makes me angry. Years after recovery and people didn’t give her a chance. 99th percentile MCAT, high level of performance in medical school, and by all accounts was well respected among peers and mentors. And that still wasn’t enough? Unbelievable. How much does it take to get away from your past? I get the caution in some cases but this girl was well beyond her time of addiction. Many years later. The stigmas are real. Another example of to keep as much as you can private. Whether it is mental illness or addiction. I know some things were on her record but as much as possible don’t tell others if you have a past even if it is apart of your why medicine story.

 

[deleted480308]

This story was sad and it makes me angry. Years after recovery and people didn’t give her a chance. 99th percentile MCAT, high level of performance in medical school, and by all accounts was well respected among peers and mentors. And that still wasn’t enough? Unbelievable. How much does it take to get away from your past? I get the caution in some cases but this girl was well beyond her time of addiction. Many years later. The stigmas are real. Another example of to keep as much as you can private. Whether it is mental illness or addiction. I know some things were on her record but as much as possible don’t tell others if you have a past even if it is apart of your why medicine story.

It’s innaccurate to say “people” never gave her a chance. She applied to ortho and EM which are both very competitive.

she could have had a medical license already in many states. The story is sad enough without mischaracterizing it

 

[MedLife20]

It’s innaccurate to say “people” never gave her a chance. She applied to ortho and EM which are both very competitive.

she could have had a medical license already in many states. The story is sad enough without mischaracterizing it

When you don’t match 3 times what else am I supposed to say? And EM isn’t that competitive. She only applied Ortho once. Looks like she did really well in Med school. With her success she should have been able to match somewhere in EM. It’s the stigma of her past. No mischaracterization about what I said.

 

[deleted480308]

When you don’t match 3 times what else am I supposed to say? And EM isn’t that competitive. She only applied Ortho once. Looks like she did really well in Med school. With her success she should have been able to match somewhere in EM. It’s the stigma of her past. No mischaracterization about what I said.

When you have a known huge red flag, you have to apply like you know that. This wasn’t a problem of no one giving her a chance

 

[samac]

I think your only chance is going to be getting reinstated into your school. It’s been 2 years since you withdrew, correct? I think it’s going to be an uphill battle because you’re so far from clinical training. I don’t know what kind of terms they would set, but if you have to repeat all clinical training I wouldn’t be surprised. Another consideration is licensure, many states require all steps to be completed within 7 years, you’re at least 3 years out from step 1 now right? Still need step 2 and then step 3. Just something to consider that there is no chance of starting over elsewhere unless you want to eliminate a significant number of states.
I wish you the absolute best though and hope your school pulls through for you.

 

[Formermedstudent]

I appreciate each of your responses & well wishes, especially from those of you who approached the question without sentiment and used a critical eye - this would be a third chance after all. Thanks also to those of you who offered advice about what to do should a school actually accept me.

I was unaware of Dr. Sundem's story. Very heartbreaking and probably ought to be instructive to me. Though I sympathize with the poster who asked what it takes for others to get over one's past, "a wise man proportions his belief to the evidence" and in my case that evidence is pretty damning.

As said above, to comment on an individual's chance of relapse is to engage in pure speculation. From a population standpoint, the chance of relapse is >2SDs even with intervention; relapse is part of what fully characterizes the disorder. I carry out a plan to stay sober today, and make no promises, which sounds unreassuring but is grounded in reality.

In my bid for reinstatement I detail what that plan is and volunteer to enroll in our state's php, submit to random & continuous testing, acquire fitness for duty attestations from psychiatric providers, etc.

I agree that my best chance lies with my home institution. I've not yet looked outside the US, but am willing to go to pretty great lengths to finish (Caribbean/DO would be fine with me) , though I probably wouldn't start as an M1 again; another 4 full years of tuition is financially impossible for me.

Thanks again everyone. I welcome any further comment.

 

[studentxx8800]

I appreciate each of your responses & well wishes, especially from those of you who approached the question without sentiment and used a critical eye - this would be a third chance after all. Thanks also to those of you who offered advice about what to do should a school actually accept me.

I was unaware of Dr. Sundem's story. Very heartbreaking and probably ought to be instructive to me. Though I sympathize with the poster who asked what it takes for others to get over one's past, "a wise man proportions his belief to the evidence" and in my case that evidence is pretty damning.

As said above, to comment on an individual's chance of relapse is to engage in pure speculation. From a population standpoint, the chance of relapse is >2SDs even with intervention; relapse is part of what fully characterizes the disorder. I carry out a plan to stay sober today, and make no promises, which sounds unreassuring but is grounded in reality.

In my bid for reinstatement I detail what that plan is and volunteer to enroll in our state's php, submit to random & continuous testing, acquire fitness for duty attestations from psychiatric providers, etc.

I agree that my best chance lies with my home institution. I've not yet looked outside the US, but am willing to go to pretty great lengths to finish (Caribbean/DO would be fine with me) , though I probably wouldn't start as an M1 again; another 4 full years of tuition is financially impossible for me.

Thanks again everyone. I welcome any further comment.

Have you considered what's the financial implication of the extremely small possibility that you can finish your medical degree (Caribbean most likely) but have no residency prospects (taken everything in account)? I think that would be even greater than redoing 4 years of med school and that arguably won't change your chance of getting a residency either.

 

[Mass Effect]

I agree that my best chance lies with my home institution. I've not yet looked outside the US, but am willing to go to pretty great lengths to finish (Caribbean/DO would be fine with me) , though I probably wouldn't start as an M1 again; another 4 full years of tuition is financially impossible for me.

You have as much a shot at DO schools as you do MD schools -- slim. Caribbean schools will be happy to take your money though.

 

[samac]

Have you considered what's the financial implication of the extremely small possibility that you can finish your medical degree (Caribbean most likely) but have no residency prospects (taken everything in account)? I think that would be even greater than redoing 4 years of med school and that arguably won't change your chance of getting a residency either.

From my understanding he would run into significant issue with licensure if he restated an MD program somewhere since he’s taken step 1. He wouldn’t fit in the 7 year requirement.
BUT if we was able to get into a DO school the licensure requirements would’ve rely on comlex and wouldn’t have that issue. Absolutely wouldn’t be able to transfer though, it’d be a restart.

 

[studentxx8800]

From my understanding he would run into significant issue with licensure if he restated an MD program somewhere since he’s taken step 1. He wouldn’t fit in the 7 year requirement.
BUT if we was able to get into a DO school the licensure requirements would’ve rely on comlex and wouldn’t have that issue. Absolutely wouldn’t be able to transfer though, it’d be a restart.

Yeah, I just want to point out the apparent naivety in OP post regarding the fact that OP won't want to redo med school because of cost but seemingly unaware of the even greater financial risk of attending Caribbean medical school to finish a medical degree in light of an already extensive red flag history. Just want OP to not make any more foolish decisions that would ruin the rest of OP's live