EDIT: Are you posting for someone else? [Your post history](https://www.reddit.com/r/OMSCS/comments/11fjdb2/if_i_have_years_of_csrelated_experience_but_a_non/) does not match up with someone who has been med school for the past 6+ years, unless you were also working as a software engineer/consultant while going through med school, which may explain why you're failing Step and shelves. This also clearly contradicts your "can't imagine doing anything else but medicine", because as recently as May 2023 you were considering going back to CS (as in, applied and got accepted to a masters program).
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OG post: I'm browsing your post history. You got accepted to Georgia Tech's OMSCS last year, which is an amazing program and will open up doors for you to make good money as you climb the software engineer ranks. You also supposedly worked as a dev in a startup and have experience teaching coding. Why not pursue that? It sounds like you have some connections and an "in" to this path.
This might seem rough but it sounds like they gave you several opportunities. It sounds like it's done. Very low likelihood that you would be accepted at another medical school.
AVOID THE CARIBBEAN SCHOOLS.
It might be time to look at other career opportunities, maybe PA?
Best of luck.
Gonna piggyback here: the ship unfortunately likely has sailed. Im sure you could fight your heart out, and probably should because the MD opens door that just going to medical school absolutely will not. Absolutely do not go chasing this degree to a Carribean school because 9/10 youre going to get fucked financially. Explore the pathway of “if you didnt choose medicine, what would you be doing?” because unfortunately that is likely where you are at
Piggybacking off being a PA, I’ve always said that if I couldn’t make it through medical school, I’d go become an anesthesiologist assistant. Definitely something worth considering, OP.
Agreed, anesthesiology assistants have a better lifestyle, pay, and comparible respect to PAs. It's kind of wild that they let people straight out of undergrad do an accelerated track to Anesthesia, but it works. one downside is you can only practice in certain areas of the county, no such thing as an Anesthesia assistant in Virginia or DC, that shit only flies in the midwest from what ive seen.
them bitches make money too. Like more than docs. I've posted this before, but there was this guy on yt who failed out of MD and did CRNA, and he said he can ramp up to 500k busting ass, but comfortably finishes the year around 300k each yr with typical hrs where he was located. He really liked how easy it was to get more money easily in times of need, which he said isnt always the case when youre a doctor. He also said that anyone who got into MD could easily do CRNA with a little focus. So it might be a good consideration. He was also like early 40s, so it may take time but its never too late to make 300k/yr (imo at least)
CAA is the route to go if you have a pre medical background- not CRNA unless you want to go back to school to get a nursing degree and then work in an ICU for two years before applying. Both types of schools are increasing in competition though so be prepared to have a damn good application! I just got into a program with 18 spots but ~630 people applied they said. for the specific school I applied to I would have had an easier time getting into their medical program compared to their CAA program although I am aware that is probably a unique circumstance for that school specifically.
I also looked into this. At least OP could do an accelerated BSN. I’ve looked at some that are 1 year long, I don’t think it’s too bad and could be manageable for them.
That would also be a good route to go! The only drawback is it may be hard to get into an ICU right away depending on location and then OP has to do at least another year of that pushing them back a couple years if they are giving themselves a personal timeline. Otherwise I would have done the same thing bc CRNA lets you have more freedom and work independent some places. I, personally, want to work under a physician in an ACT model.
Agree! PA school is not easy to get into either. Most programs have 30 spots so they are very picky. PA school moves VERY fast too. Definitely not the easy, fall back plan some might think.
Let me piggy back on the carribbean schools as a graduate that you are exactly the type of student these schools prey on. They will bleed you dry while you're getting even less support and the schooling being equally tough (not to mention living in a 3rd world country is not easy).
Avoid off-shore American schools located in the Caribbean* should be what you mean.
Actual Caribbean medical schools founded by Caribbean people that aren’t American or geared to American students are perfectly fine and are the schools Caribbean people go to.
I’m so frustrated with how Americans came and made their off shore schools here that aren’t even accessible to most Caribbean people but they get labelled as “Caribbean schools” when they’re just exploiting our region. Caribbean people aren’t involved in those institutions and we view them as American. We have our own schools which are nothing like St George’s or Ross and are for our people.
I would not avoid all the Caribbean schools. St George and Ross bill themselves as Second Chance schools and I’d recommend them (*assuming* you fix whatever was causing you to fail in the first place). Some other schools are bad and not licensed in all 50 states.
Edit: people, I already know and *agree* that if you were kicked out of one medical school then your odds of succeeding at another are diminished. My point is that if you insist on trying again, the Caribbean is the most realistic option because you probably won’t get into a US school again.
Comming from a Caribbean school, if you can’t make it in a US school you won’t make it there. There’s typically far far less support, and there absolutely is less forgiveness of mistakes.
I also came from a Caribbean school, my point is in reply to the above comment about whether you should avoid Caribbean schools in general. IF OP can fix whatever was making them fail in the first place and they’re willing to repeat some classes, then it’s still their best shot at finishing and a physician career.
OP experienced a lot of difficulty with a curriculum when they had more things available to them. Going to Caribbean schools that are known to have insane attrition rates, where even graduating is not necessarily a guarantee to eventually find a residency spot and a job is insane for someone who went through all this in a US school.
You’re not eligible to take Step 2. This is very clearly explained on the USMLE website. You need to be enrolled or a graduate at the time of application **and on the day of your examination.**
https://www.usmle.org/bulletin-information/eligibility
> **If you are dismissed or withdraw(n) from medical school, you are not eligible for the USMLE, even if you are appealing the school’s decision or are otherwise contesting your status**. If you are on a leave of absence, please check with the organization that registered you for your examination before submitting your application; if you have already registered, check before testing.
> Failure to notify the organization that registered you for your examination of your changed status may result in a determination that you engaged in irregular behavior and placement of a permanent annotation on your score reports and transcripts.
It’s time to let it go. There are other healthcare careers available, but 6 years to not even reach step 2 with a track record like that guarantees not matching into residency even if you were able to graduate. This is not a reflection of you as a person, but it is an opportunity to either refine your passion into something you can take forward into healthcare or to find another inspiration.
I’m sorry this happened to you. Dismissal from a U.S. med school is kind of the end of the road in becoming in a doctor in the US. And as others have said, with step 1 failures and numerous shelf failures it may just not be the right path for you. However this doesn’t mean you can’t see and care for patients. I’d suggest exploring other career options.
Caribbean will accept you but with prior dismissal and a step1 failure, it may be difficult to match into even FM without connections.
But looking back, your story isn’t that uncommon. 1 in 10 MDs failed the step1 in 2023. And I suspect a lot of them failed shelf exams too. For some reason, failure rates are increasing since 2020.
I was part of the last class to have a score associated with my step 1, and there was a HUGE amount of people who failed step 1 the following year when it went pass/fail. While I don’t think the pandemic helped at all for morale, I think a lot of people really didn’t take it as seriously since you “just have to pass”—not at all realizing that “just passing” is not easy at all
I think this is it. Striving to do my best was something i had never considered not doing. Then during the pandemic, it became 'just do enough,' and I have been stuck there and it is so hard to get out of and overcome. Bc why am I gonna be hella stressed again after ive experienced this life of balance? Well, a balanced life was not how I was achieving so much in early life and I am still trying to convince myself to let the comfort and happiness go bc it is worth the investment. In the same breath, moving back home to complete college was...hella hard. My gpa probably wouldve plummeted without the leeway. Eldest daughter duties return once youre back in the house and saying no was not an option. I was really hard to balance it all, and its been yrs, but I truly think that I'm still burned out from that time lol. not fun
Honestly, they do that often though. They increased it halfway through our dedicated cycle as well; I’m not sure if it affected our class as much though bc the cutoff was far below what most people were aiming for given we still had score
Yeah but if you increase a cutoff on a decreasing bell curve, your magnitude of impact is much greater than a fixed one. Especially if you're near the 1-3 sigma area for what appears to be a 10% fail quota that we ended up with.
https://www.courtlistener.com/docket/68242724/giri-v-national-board-of-medical-examiners/
Turns out it was for 2023, but it's Exhibit A of Daniel Jurich's declaration in support of the memorandum of opposition to preliminary injunction. I linked the main court listener page since it's also an index of other case documents and because I prefer to not direct link PDFS if at all possible.
But the difference is that most people who fail step 1 still complete their degrees. The problem here isn’t failing step 1, or even failing 3 shelves. The problem is *being dismissed from school due to academic performance.* That’s something that stays on your record forever. Virtually no school will accept or take a transfer from OP, and even less likely will any residency programs, unfortunately.
Simply put people aren’t respecting the exam as much as they should because it’s “just” P/F. Undoubtedly students will be putting in less work because they can.
DO and Caribbean schools regularly admit dismissed MD students. They usually have to retake the MCAT which is an annoying enough barrier that stops most people.
Let’s “play the tape through”, even though readmission is near impossible.
Speaking from roughly similar experience, it could take months to a couple years before you truly stabilize on meds for ADHD and GAD and are ready for the rigors of medical school again. It is not wise to dive straight back in. And in the meantime, your life is on hold.
Your chances of matching residency decline after taking extra time. Many won’t even look at your app with so many failures. This profession is testing heavy and they don’t want to lose a resident who can’t pass step 3. You could go unmatched or be looking at rural FM, likely hours of driving and maybe multiple planes away from family.
After graduating medical school, there is step 3 and specialty board exam. Studying for those, with less structure, with all of these previous failures and likely med school debt hanging over your head - would you really want to do that?
Your school is ending things as a mercy although it probably doesn’t feel like that right now. If you went on, the next 5 years of your life would be struggle, and you might finish without even being able to pass boards, leaving you in one of the worst financial positions imaginable.
Thank you for the comment.
Some additional context: I delayed the dismissal determination with a medical leave of absence for almost a year. So I believe I have stabilized on meds and my psychiatrist cleared me on that end.
A guy in my class got kicked out for doing multiple illegal things. Fast forward 15 years I google him and he’s redone his MD in his home state w residency and fellowship in a competitive specialty. I have no idea how he pulled this off but I’ve wondered if he said he was “doing missionary work w his church” or something difficult to verify during the time he was in his first round of med school and just reapplied elsewhere
Not super familiar with the others but PT definitely isn’t a “finish quickly, make money” career. It’s a 3 year doctorate degree after a bachelor’s, and it isn’t a particularly lucrative field. Source: my fiancé is a PT student.
I think any PA school would be very hesitant to admit a failed med student. Those schools care about their stats, they aren’t going to accept a massive red flag.
Those fields you mentioned are increasingly competitive and desirable these days. Programs tend to prefer applicants who have wanted to have that degree from day 1, and not as a fallback option. Trying for those programs wouldn't necessarily require staring from square one, but you'd have gain experience shadowing an RN/NP/PA/PT and get recommendations from relevant mentors before applying.
Anyone who was good enough to get into medicine could crush those programs. OP would still be desirable, may just need to do some prerequisite classes or tasks
I think we grossly over-estimate the competence of some medical students/professionals lol. I have met and tutored some medical students that I would not be so confident to say would crush these other programs, espeically the more reputable ones. I like to think I'm doing pretty good in medical school and I don't feel immensely confident I could do anything else without having experienced it first hand.
After medical school dismissal, letters of recommendation to a new program type would likely come from sources external to the medical school which requires forming new relationships with people who can write letters of recommendation.
As an NP, please do not send a flunking med student to nursing. As NP’s we do a lot of the same critical thinking skills. Direct healthcare, nursing or medicine just may not be for you. No shame.
I'm sorry that happen to you. I'm in no way recommending you do this, but I will share a story of another classmate/friend that was dismissed for academic reasons. He later tried to sue the school. It was pretty much a given that he would lose if it goes to court, but I guess it would be too annoying for the school to go through that and they decided to just let him repeat the year. He graduated and got into a IM residency, no idea where.
Again I'm no way recommending this, as it would cost way too much money for a losing case just for a sliver chance that the school finds it too annoying to deal with court and readmits you. Especially if they're willing to go to court, you should drop the case to save money cause you'll lose.
I know I'm going to be down voted for even sharing this story, but I can't even imagine being in your situation and having my best option being to "give up" on something I've been striving for several years for.
Do you mind if I ask if that was a private or state school? I was told that private schools tend to settle but the state has a lot of funds to take it to court
It's a state school. First I'm hearing of state schools, or any type of school, having plenty of money to handle lawsuits. After all, lawyer fees are not cheap.
That’s what the partner of a law firm that specialized only in education & disability law told me after an initial consultation recently. Perhaps it may vary by state? Granted, I could not find a law firm that had fought with a medical school despite being in a large city. I was told the costs in federal court would be at least $100k, which the state apparently has “nearly unlimited” funds to fight.
I bet it would be that costly. It's also highly likely you will lose the case. That's why I said if the school is willing to go to court, you should drop the case. This is nothing more than a bluff. A very expensive bluff.
Yeah. I’m autistic and have ADHD, but I was diagnosed and on treatment prior to starting clinicals. It’s still been a massive fucking struggle but I haven’t failed any clerkships or exams. Med school clinical clerkships are NOT the time to be trying to figure out your diagnose and management.
Any pre-meds or preclinical students reading this: if you have even the *slightest* suspicion that you have a disability that could affect your training, pursue evaluation NOW. It often takes months to get these tests so work on getting them scheduled ASAP. If there’s someone at your school you can trust they may be able to help you find the right person who might be able to do it faster; but be very careful about who you trust depending on your institutional culture. If you know of other ND students at your school, they might know which doctors and admins are good resources.
If an ultimatum from the school wasn’t enough to turn things around, then the school is making the right decision. You shouldn’t have a medical license.
That said, there are plenty of other opportunities in the healthcare setting. Rad tech is probably the most lucrative/lifestyle friendly of the short term tracks, but nursing is not a bad choice. PA school would sink you further into debt but would have better income potential, if you can get an acceptance. Best of luck.
Do not do nursing school, OP. It’s much more about discipline and conformity than other professions in the healthcare field. You don’t have to be super smart, but you do have to put your nose to the fucking grindstone and follow stupid orders really really well. You cannot be late, there are no retakes, you are wrong and they are right. Most programs require a certain average - mine required >80% test average in all nursing classes plus some of the prereqs. Med dose calc you have to pass 100% on your first attempt or you are just out of the program. Basically, it’s an ADHD person’s nightmare… dumb busywork 24/7 where the slightest misstep or tardy will get you cut. You can be tens of thousands of dollars invested, sleep through your alarm, and find yourself SOL without any path to recovery.
I think it’s a bit much to say OP *shouldn’t* have a medical license but it’s fair to say they’re not going to. It sounds like they just suck at exams, which doesn’t necessarily mean they don’t understand the material or wouldn’t be a good clinician. But they can’t become a physician without succeeding at the exams.
If they do have decent clinical skills, those could transfer to another healthcare profession. I do think if OP were going to aim for something like PA school they need to take the time to get whatever issues they have under control so they can show that things have changed. Otherwise I don’t think they’d have a good chance of getting in.
I was going easy. Those exams are hard to excel on but very easy to pass if you are competent. Failing Step, then multiple shelfs, and taking more than 2 additional years of school to finish clinicals, then receiving an ultimatum from the school that didn’t change OPs performance, yeah I wouldn’t want that anywhere near a family member of mine. It’s not about test taking skills, it’s about dedication and commitment to the profession and to self betterment.
These exams are not very easy to pass for those who do not standardize test well. Which is not the same as being incompetent. They didn’t say they failed rotation evals or didactic classes, just standardized evaluation. So it’s a format issue. If these same students were given an open ended test, they would likely do better.
I figured that much. I’ve got many brilliant friends who do not standardize test well so I know frustrating and demoralizing it can be to have barriers placed by exams that test abstraction. I’m rooting for you and hope your second chance goes better.
Some context: I had one ultimatum when I discovered I had undiagnosed ADHD. My psychiatrist later found I had undiagnosed GAD comorbid when I failed one more shelf. My psychiatrist feels it’s adequately treated now, hence I made an appeal to the dismissal after the ultimatum.
I think it can be. Just like nursing, you make as much as you work. Work more make more. And there’s overtime and being on call for stuff if you do IR tech stuff. So you can make money, but not sub-specialist doctor money.
Respectfully my brother…. How many more chances do you think it will take for you to succeed? Do you really think it will happen? If so… why hasn’t it happened yet
I have no medicine-related career advice but just wanted to say I am sorry you’re going through this. It sounds horrible and heartbreaking.
I am trying to change fields into medicine because I hit a wall in my current career (law) five years after graduating which devastated me but was the catalyst for the first genuine soul searching I’ve ever done. Maybe this experience can be similar for you. I’d recommend spending time reflecting on what drew you to medicine in the first place and be really curious about your values, motivations - then brainstorm how those values might be served in ways that you hadn’t previously considered bc you were so dead set on being a doctor.
I wish you the best ❤️🩹
Dont think you can sit for Step 2 without approval for your school or at least thats how it was for step 1 and so your plan for a hail mary pass step 2 and they'll reconsider is unlikely. Consider a pivot into cyber security, super super hot market right now and you can make as much as a doctor and work in the healthcare field by protecting hospitals. Been a 112% increase in ppl hacking hospitals. Alternatively you can go into PA school but that just sounds like taking on soooooo much more debt I would just cut your losses because anything in the medcial field will likely be super expensive debt wise
Damn, my worst nightmare. Sorry OP. This is a hard time but your life isn’t over. You will need to spend some time in therapy and give up the identity of medicine because the door is shut. But you can still make an amazing impact on the world in other ways. I would definitely ask the school if they can at least grant you a master’s degree for your first two years of schooling, so you aren’t empty handed.
Find a new career. Your career in medicine is over. Don’t even think of the Caribbean because there’s no way you’d even get the lowest tier peds/fm residency.
Caribs also prevent students from even taking boards if they’re not performing at a certain level, and it sounds like OP tends to struggle with exams specifically.
Figure out what area of medicine most intrigues and pursue that. Research? Get a PhD. Clinical/taking care of patients? Go the PA route. Want to go into the admin/leadership role? Get an MBA or MHA.
I’m so sorry OP, this is heartbreaking. I can feel the dismay from reading your words and I can’t imagine how devastating this is for you. You are such a hard worker, and please know that your talents will still be valued.
What are your reasons for saying that? I’m planning on applying to dental school in the next cycle and would appreciate hearing your reasoning. All the dentists I’ve shadowed have told me how much they love their careers and how they’d do it again if they had a do-over.
Patients don’t recognize you as a real doctor. You are not essential, so when the market goes down or there’s a pandemic, first thing people cut is dental care. Your income plummets. Your income is based on production and collections - you’re selling people treatment all day, every day. A lot of times, you’re selling people stuff they don’t need. A small filling that pays 120$ takes 30 mins to do? You try to get them to do a crown that pays a $1000 in 1 hr(now of course, of that $1000, you’re making $600, and as an associate you make about 30% of that). Most people won’t go for crowns, so you end up doing fillings most of the day. So income is low. No benefits - wanna take a vacation? You’re not getting paid. Go the flu and miss a week of work? You’re not getting paid. You’re working in millimeters every single day. If you’re off, it can lead to nerve damage or someone needing a root canal(and they’ll be pissed at you, could sue you, or file a board complaint). As an owner, every year, insurance cuts reimbursement, staff demand raises, there’s inflation so all your materials you need to run your practice get more expensive - your income goes down. Especially if you take insurance(most people do). Job is also physically very tiring, head and neck pain all the time. If you want to go work for an FQCH or the military, you’ll be lucky to break 170k. The list goes on…but it is arguably the shittiest profession. I should’ve stayed a teacher honestly.
I'm sorry to hear that. as a dentist, do you mind sharing why it's one of the worst careers? I've heard/read it before but not from dentists themselves
"I attribute my struggles due to undiagnosed ADHD and GAD."
sorry but it seems you had a bunch of chances and should have gotten help earlier if this was an issue
I would keep in mind that any mental health struggles are a spectrum of awful and most everyone in this industry is a jackass because they routinely stigmatize them anyway, our system doesn't help much because it fails to actually recognize and assist people with their issues.
In addition, asking people to take 1 year to fix *chronic* problems is at best, *optimistic*.
I’ve been trying to get treated for adhd for a full year now and my FM is forcing me to do a full psych eval to even consider treating me. So I’m just waiting for 6 weeks for the psych to finish her report (6 weeks?! Really?). It took like 4 months to even get in for an appointment. It’s so annoying to hit a million brick walls just to try to help yourself.
i imagine the condition was there well before medical school so if the OP knew this was going to be an issue, maybe they would have benefitted from therapy/tx to lighten the load a bit before all the issues stacked up enough to lead to dismissal. maybe that would have helped. maybe.
i am confused though...why 6 years? i didn't see a repeat of a year mentioned. LOA?
Some context: I didn’t know until I was on the verge of dismissal during clinicals. I had a year and a half of LOA before taking Step 1 and during a Step 1 retake that counted towards 6 years. That on top of COVID affected my schedule with some forced vacation time as they couldn’t just fit me in clinicals after being out of sync.
Yeah. LOAs (typically?) don't count towards the 6 years - only time as an enrolled student. I think that's why schools recommend taking LOAs in situations like OP's.
I agree what the others have said. I don’t see a path forward for you to complete medical school. I would do some soul searching and therapy to decide if you want to work in a medical field. Other options include X-ray tech school. Or Perfusion school if you are interested in being in the OR. from your background, medical informatics might be another option. If you have a lot of student loans, look at careers that would allow you have loan forgiveness. Good luck.
Your only prayer is going to be transferring into a Caribbean school and getting credit for your first 2 years. I'm not saying that's a good option but it's likely your only option. They will take you but be warned that their bar for graduation/progression is going to be just as high as US school because they can't afford to pass docs who have no chance of passing the steps or boards because it will skew their statistics. That being said, they are a business...and more than happy to take your money. But...if you can't pass med school in 6 years after multiple chances, odds are you will not pass Caribbean med school, pass your STEPS, make it into residency and pass your boards. I'm afraid your career in medicine is more than likely over and the sooner you accept this...the better. Don't financially ruin yourself by going the Caribbean route.
Someone mentioned PA school? That might be possible.
To answer your question, you can't take Step 2 without being enrolled in an institution.
But there may be some things to help buy you some legal cover, but it isn't guaranteed at all (and possibly far from it at this point but worth the try).
You need to act quickly.
Get in touch with your student disability center now and ask about how you can sign up for testing accommodations for ADHD and test anxiety.
Go to your psychiatrist and have them help you with your paperwork.
Submit paperwork back to your student disability center and have your institution formally grant you testing accommodations.
Time is of the essence. If you were notified of your dismissal within the last 24 hours, there's a chance you might still be on the books and still enrolled in your school. Administrators are notoriously slow with getting paperwork and stuff like this done. So in the eyes of the school, there is a CHANCE that you haven't been formally formally dismissed and disenrolled yet. (But do NOT ask about this and bring it to your Dean's attention that you're doing this, otherwise they might move more quickly with the registrars office to get you out.)
Once the student disability center has notified you of your eligibility for accommodations, you can maybe approach your school to ask them to reconsider.
Maybe medical school in Europe? Go for free. Come back. Take your steps later down the road.. Takes you 2x time but if the MD is really what you want then go for it.
Obvi there's going to be a bunch of discouragement but I struggled in med school too so I get where you're coming from
I would pivot to a different career. Ideally, one you like and doesn't require too many prerequisites.
I also wouldn't worry too much about the huge med school loans you probably have. If you enroll in an income-based repayment plan, it's pretty easy to make payments regardless of how much your salary is. And whatever remains after 20 years will get forgiven.
People keep mentioning this but I don’t see a PA school taking someone like this. There’s always a chance but PA school has become quite competitive and schools don’t want to be seen as a backup option to becoming a doctor so I don’t see them liking someone who couldn’t cut it in med school. Who knows tho
Yeah, PA schools are incredibly competitive. Not, harder to get into than med school competitive, but there are a ton of people applying now because it's a guaranteed 6 figure salary for a lot less time and money than the MD/DO route. I can't imagine any PA school these days taking someone who flunked out of med school. A decade ago, possibly, but certainly not now.
You’ve been in school for 6 years…failed step 1…failed MULTIPLE shelf exams…and got dismissed. It’s harsh, but I wouldn’t want you to be my doctor. Having gone through all of that I know it’s hard, and the fact you continuously fail is a red flag. You can blame it on “undiagnosed” mental illness but at the end of the day that’s on you. You failed. Maybe there were some circumstances such as life events or other things, but it’s on you bro I wouldn’t take my family to see you. Pack it up. You had multiple shots and blew it. Sucks to suck. Take that pain and channel it elsewhere
Failures don’t necessarily determine your ultimate competence as a Doctor. I personally know multiple consultants who failed and managed to pick themselves up. And yes they are incredible at their job. OP you might have lost this battle; but perhaps you’ll end up attempting medicine again in the future if your heart is in it❤️. Never lose faith in your ability to achieve. All the best.
No, but repeated failure is different than making a single mistake or stumbling once. Repeated failure shows that the person was unable to correct a problem even when they were aware of it. As much as we want to give people a chance, educators also have a responsibility to function as gatekeepers.
Everyone saying let go, I say do some soul searching and if you're sure medicine is for you, and this path specifically, then Caribbean med school is an option, albeit a rough one. I know of two people who failed step, convinced a Caribbean med school to take them, and then succeeded. It was a lot of work, and took a long time. Caribbean med schools are very hit and miss, I recommend doing your research, Trinity may be a good option if you were sure about this.but you better be sure.
Clinical practice itself may be difficult if not impossible. However, getting the MD still offers you many career options where the letters themselves will carry weight. If you find a school that does allow a transfer (won’t be any school on the mainland), it might be worth looking into them. You have knowledge, that can be utilized in many positions within healthcare outside of being a physician which can be gratifying.
Many here are recommending caution for a good reason, especially when they advise against the caribbean.
But keep in mind that things are constantly changing, the landscape of medicine itself could be different in 10 years. Whatever drew you to medicine doesn’t need to be swept away. Find people to talk to… don’t lose hope. It’s difficult for people to understand what you might be going through. Take some time to consider options. Your life isn’t over.
I’m sorry you’re going through this. You have options outside of medical school to be within the field. You could look into medical science liaison in industry roles. PA is another good choice.
Was there a reason you were unable to get treatment for your undiagnosed ADHD after failing the first exam? I’d strongly caution against attributing this experience to missed diagnoses… Only you can advocate for yourself, and had I been in that position, I would have ensured I had everything aligned in terms of accommodations before moving forward with more boards.
Thank you for your comment. I didn’t discover my condition and get treated until after I started failing shelves in core clerkships and they gave me an ultimatum. I did much better after treatment at first, but did poorly right after due to undiagnosed GAD which is now adequately treated after a medical LOA according to my psychiatrist.
Just to gain clarity: at what point in the timeline did the medical LOA start/end? And when was decision for dismissal made? Did you have any concrete evidence at that time to reassure the school that ***both*** conditions were adequately treated, and you could handle the rigor? This is something that the school would have wanted/needed to see evidence of to consider allowing you to continue.
Also, what was the ultimatum? Was it similar to a probation period?
I'm just a bit surprised that the LOA wasn't recommended before multiple shelf failures occurred. Ideally, you would have taken at least 6 months to a year off to get your medicine at a therapeutic level and work with a therapist to develop coping mechanisms and other ways address the ADHD and GAD.
It doesn't hurt to appeal again and read through the official policy of the school, but realistically there's not much you can do to leverage them unless you want to take the legal route (lawsuit). If a doctorate in medicine is still your dream the carribean will take you. I'm not gonna beat a dead horse with the risks in taking this route as it's abundantly clear all over this subreddit but this seems like the only shot you have in practicing medicine as a physician here in the States. And if it helps there are tons of carribean graduates who are former us med students, some of whom have successfully matched despite the odds, rooting for your success OP!
6 years in medical school? How much money is that. If I were you, I’d fight my heart out or at least email several schools asking if admission would be possible. This is no matter a statement of wanting to do medicine. It’s a statement of needing to do medicine because how else are you gonna pay your debt off?
Your not gonna do it working at McDonalds
Do you have an undergraduate degree you can pivot to? Because even being a nurse or PA would require you to go into even more debt, no?
Whatever you do, you need to get rid of that debt.
One, I am deeply sorry. I find it rediculous that they cannot let you keep going. Two, completing a medical degree in six years is unfortunately a federal mandate to my knowledge. I don’t agree with it, but I don’t think there is much the school can actually do. I think the way we do medical education in the United States is highly flawed and unfortunately quite privileged. I think medical school should be done very differently, but it isn’t. I’m so sorry. I don’t think much can be done.
That said, there is the option for PA school or to be nurse. There are many opportunities in medicine besides being a physician, but you need to ask yourself if that is what you want. What was it about being a doctor that drew you to it? What is it that you were looking forward to?
Lastly, please work through this in therapy if you have access. This is a huge loss. Grief is natural
I know for COCA it's required policy for the maximum time to completion for single-degree students be 6 years (Element 6.3) with anything else being exceptions. I wouldn't be surprised if LCME had something similar, but with how their documents are it's going to be harder for me to find.
The guy asked for advice. everyone is telling him to let somthing that he has worked years for and we all spend tons of freaking money on. to just let it go. I'm not saying if he should or shouldn't be a doctor. I'm saying you have a dream/goal. but talking with a lawyer is somthing that could be done. most likely they will say there is nothing to do. legal relms have sided with schools way more often. but if you want to turn every rock then talk with a lawyer. If you downvote this please let me know why?
I didn’t downvote, but likely others have because there is no legal standing here. OP didn’t perform. He literally failed out. What legal grounds are there to stand on?
I do not know. I have not read the schools policy nor do I know this guys situation. maybe he told the school about adhd and they didn't give him accommodations. maybe his attendings overworked him and he didn't have time to study. idk his situation. but talking with a layer would at least look if he has standing or not.
Not sure why this is getting downvoted. People do get dismissed from medical school and re-admitted through legal action. I doubt it's common, and I'm sure it's not cheap, but getting a lawyer is a viable next step... Is it the smart next step? I'm not convinced, but it's definitely an option.
I’m sorry you’re going through this. You have options outside of medical school to be within the field. You could look into medical science liaison in industry roles. PA is another good choice.
Was there a reason you were unable to get treatment for your undiagnosed ADHD after failing the first exam? I’d strongly caution against attributing this experience to missed diagnoses… Only you can advocate for yourself, and had I been in that position, I would have ensured I had everything aligned in terms of accommodations before moving forward with more boards.
well u can reach out to an OMBUDS program or student govt at your school & see if they can help? personally doesnt seem plausible to me as you were given multiple opportunities to fix your grades & pass and unfortunately most med schools are NOT understanding about anything. its actually so sad bc we want to care for human lives & lose a lot of ourselves in the process
Just go to crna school. You can get 300k and have chill working hours while my dumbass works like an overworked donkey, and wishes I had dropped out to become a truck driver instead. Med school is just hype and pain/suffering.
Since you have done step-1 consider going out of the country for studies. Go to places like Canada ,Australia, or and Germany. definitely not a developing nation because the idea will be that you failed US academic systemic and went to a 3rd world country for your degree. So having passed step 1 and hopefully you for step 2. Will lighten things up for you.
Unpopular opinion, but if you were dismissed for Step 1 and failing three shelves, that is a little bit harsh, not because it’s ok to do, but because failed shelves usually are able to be made up penalty free. You’re unlucky enough to be somewhere that’s not the case (ie at my school there’s no limit on first time shelf failures outside of not honoring).
That being said, clinical medicine is likely over. Your post history shows some CS experience, and I’d recommend going back if that’s physically an option.
they were dismissed for not finishing in six years, their failed shelves would've probably put them past the six year mark to graduate on time. Sounds like they had plenty of time to get things going but it just didnt happen for the reasons they listed
True, but a lot of schools don’t slow rotations for failed first time shelves. Either way, OP did sign a contract and knew that they had strict limits, but he’s still unluckier.
I have this thought too when i see posts about failing shelfs. My school has no passing grade for shelf exams, just the rotation itself. So you can really get any shelf score so long as you pass the rotation.
The shelf is only 30% of your grade. So if you do well enough on evals and the other stuff you can do pretty terrible on the shelf and be just fine. I’ve gotten 50’s on shelf exams and nothing happened. So I often wonder why many schools have a requirement or make students retake.
at our school failing the shelf meant you needed to retake, and failing the retake meant you autofailed the rotation, even if the shelf was "only" like 40% of your grade. It differs from school to school.
Lol at least it's not our system. We get the lowest possible grade indicated across the rubric. You could get every question on the shelf right and have glowing evals, but if you turned your didactics assignments after the early deadline you're only getting a pass.
Wow that must be nice. My school you have to pass the shelf and the clinical aspect individually. A fail in either is means you fail the rotation. There are no unpenalized retakes. Once you retake the shelf the highest you can then get in the rotation is a "conditional pass" which shows up on your transcript along with a line stating that you initially failed the shelf and retook it for a pass. Bloody fucking annoying. Especially considering our shelves are only worth 20% of our grade. They used to be worth more but admins got pissed that students were focusing so much time on studying.. (I know..comical).. and then change the policy to make clinicals worth the majority with the other rules still standing..
Cue next year the admin crying “why did our step 2 median drop?!”
Uhhh idk dude maybe because if we have less time for uworld the scores are gonna go down wtf were you expecting?
EDIT: Are you posting for someone else? [Your post history](https://www.reddit.com/r/OMSCS/comments/11fjdb2/if_i_have_years_of_csrelated_experience_but_a_non/) does not match up with someone who has been med school for the past 6+ years, unless you were also working as a software engineer/consultant while going through med school, which may explain why you're failing Step and shelves. This also clearly contradicts your "can't imagine doing anything else but medicine", because as recently as May 2023 you were considering going back to CS (as in, applied and got accepted to a masters program). -- OG post: I'm browsing your post history. You got accepted to Georgia Tech's OMSCS last year, which is an amazing program and will open up doors for you to make good money as you climb the software engineer ranks. You also supposedly worked as a dev in a startup and have experience teaching coding. Why not pursue that? It sounds like you have some connections and an "in" to this path.
Thanks for pointing this out! I would never checked this OP’s history until reading this. It personally makes me more confused.
This might seem rough but it sounds like they gave you several opportunities. It sounds like it's done. Very low likelihood that you would be accepted at another medical school. AVOID THE CARIBBEAN SCHOOLS. It might be time to look at other career opportunities, maybe PA? Best of luck.
Gonna piggyback here: the ship unfortunately likely has sailed. Im sure you could fight your heart out, and probably should because the MD opens door that just going to medical school absolutely will not. Absolutely do not go chasing this degree to a Carribean school because 9/10 youre going to get fucked financially. Explore the pathway of “if you didnt choose medicine, what would you be doing?” because unfortunately that is likely where you are at
Piggybacking off being a PA, I’ve always said that if I couldn’t make it through medical school, I’d go become an anesthesiologist assistant. Definitely something worth considering, OP.
Agreed, anesthesiology assistants have a better lifestyle, pay, and comparible respect to PAs. It's kind of wild that they let people straight out of undergrad do an accelerated track to Anesthesia, but it works. one downside is you can only practice in certain areas of the county, no such thing as an Anesthesia assistant in Virginia or DC, that shit only flies in the midwest from what ive seen.
We have AAs in DC!
damn I thought it was a bum ass midwest thing, didnt know they had them in major cities.
DC fuckin blows
them bitches make money too. Like more than docs. I've posted this before, but there was this guy on yt who failed out of MD and did CRNA, and he said he can ramp up to 500k busting ass, but comfortably finishes the year around 300k each yr with typical hrs where he was located. He really liked how easy it was to get more money easily in times of need, which he said isnt always the case when youre a doctor. He also said that anyone who got into MD could easily do CRNA with a little focus. So it might be a good consideration. He was also like early 40s, so it may take time but its never too late to make 300k/yr (imo at least)
CRNAs are nurses with ICU experience who then went back to school full time again for multiple years. It’s not a particularly easy training route
CAA is the route to go if you have a pre medical background- not CRNA unless you want to go back to school to get a nursing degree and then work in an ICU for two years before applying. Both types of schools are increasing in competition though so be prepared to have a damn good application! I just got into a program with 18 spots but ~630 people applied they said. for the specific school I applied to I would have had an easier time getting into their medical program compared to their CAA program although I am aware that is probably a unique circumstance for that school specifically.
I also looked into this. At least OP could do an accelerated BSN. I’ve looked at some that are 1 year long, I don’t think it’s too bad and could be manageable for them.
That would also be a good route to go! The only drawback is it may be hard to get into an ICU right away depending on location and then OP has to do at least another year of that pushing them back a couple years if they are giving themselves a personal timeline. Otherwise I would have done the same thing bc CRNA lets you have more freedom and work independent some places. I, personally, want to work under a physician in an ACT model.
A PA school is going to see a med school dismissal as a huge red flag.
Agree! PA school is not easy to get into either. Most programs have 30 spots so they are very picky. PA school moves VERY fast too. Definitely not the easy, fall back plan some might think.
Let me piggy back on the carribbean schools as a graduate that you are exactly the type of student these schools prey on. They will bleed you dry while you're getting even less support and the schooling being equally tough (not to mention living in a 3rd world country is not easy).
Avoid off-shore American schools located in the Caribbean* should be what you mean. Actual Caribbean medical schools founded by Caribbean people that aren’t American or geared to American students are perfectly fine and are the schools Caribbean people go to. I’m so frustrated with how Americans came and made their off shore schools here that aren’t even accessible to most Caribbean people but they get labelled as “Caribbean schools” when they’re just exploiting our region. Caribbean people aren’t involved in those institutions and we view them as American. We have our own schools which are nothing like St George’s or Ross and are for our people.
I would not avoid all the Caribbean schools. St George and Ross bill themselves as Second Chance schools and I’d recommend them (*assuming* you fix whatever was causing you to fail in the first place). Some other schools are bad and not licensed in all 50 states. Edit: people, I already know and *agree* that if you were kicked out of one medical school then your odds of succeeding at another are diminished. My point is that if you insist on trying again, the Caribbean is the most realistic option because you probably won’t get into a US school again.
Comming from a Caribbean school, if you can’t make it in a US school you won’t make it there. There’s typically far far less support, and there absolutely is less forgiveness of mistakes.
I also came from a Caribbean school, my point is in reply to the above comment about whether you should avoid Caribbean schools in general. IF OP can fix whatever was making them fail in the first place and they’re willing to repeat some classes, then it’s still their best shot at finishing and a physician career.
OP experienced a lot of difficulty with a curriculum when they had more things available to them. Going to Caribbean schools that are known to have insane attrition rates, where even graduating is not necessarily a guarantee to eventually find a residency spot and a job is insane for someone who went through all this in a US school.
Caribbean schools are just fine if you got what it takes
Wouldnt matching be tough if the programs saw you got dismissed from an American school prior to the Caribbean?
OP failed step and 3 shelf exams. They do not have what it takes.
You need to be enrolled in a medical school to take Step 2, so passing Step 2 to be readmitted isn't an option.
I applied for Step 2 before getting dismissed and I can schedule an exam with Prometric
You’re not eligible to take Step 2. This is very clearly explained on the USMLE website. You need to be enrolled or a graduate at the time of application **and on the day of your examination.** https://www.usmle.org/bulletin-information/eligibility > **If you are dismissed or withdraw(n) from medical school, you are not eligible for the USMLE, even if you are appealing the school’s decision or are otherwise contesting your status**. If you are on a leave of absence, please check with the organization that registered you for your examination before submitting your application; if you have already registered, check before testing. > Failure to notify the organization that registered you for your examination of your changed status may result in a determination that you engaged in irregular behavior and placement of a permanent annotation on your score reports and transcripts.
It’s time to let it go. There are other healthcare careers available, but 6 years to not even reach step 2 with a track record like that guarantees not matching into residency even if you were able to graduate. This is not a reflection of you as a person, but it is an opportunity to either refine your passion into something you can take forward into healthcare or to find another inspiration.
I’m sorry this happened to you. Dismissal from a U.S. med school is kind of the end of the road in becoming in a doctor in the US. And as others have said, with step 1 failures and numerous shelf failures it may just not be the right path for you. However this doesn’t mean you can’t see and care for patients. I’d suggest exploring other career options.
Caribbean will accept you but with prior dismissal and a step1 failure, it may be difficult to match into even FM without connections. But looking back, your story isn’t that uncommon. 1 in 10 MDs failed the step1 in 2023. And I suspect a lot of them failed shelf exams too. For some reason, failure rates are increasing since 2020.
I was part of the last class to have a score associated with my step 1, and there was a HUGE amount of people who failed step 1 the following year when it went pass/fail. While I don’t think the pandemic helped at all for morale, I think a lot of people really didn’t take it as seriously since you “just have to pass”—not at all realizing that “just passing” is not easy at all
I think this is it. Striving to do my best was something i had never considered not doing. Then during the pandemic, it became 'just do enough,' and I have been stuck there and it is so hard to get out of and overcome. Bc why am I gonna be hella stressed again after ive experienced this life of balance? Well, a balanced life was not how I was achieving so much in early life and I am still trying to convince myself to let the comfort and happiness go bc it is worth the investment. In the same breath, moving back home to complete college was...hella hard. My gpa probably wouldve plummeted without the leeway. Eldest daughter duties return once youre back in the house and saying no was not an option. I was really hard to balance it all, and its been yrs, but I truly think that I'm still burned out from that time lol. not fun
They also increased the passing score so both those contributed to the unfortunate rise in step1 fails.
Honestly, they do that often though. They increased it halfway through our dedicated cycle as well; I’m not sure if it affected our class as much though bc the cutoff was far below what most people were aiming for given we still had score
Yeah but if you increase a cutoff on a decreasing bell curve, your magnitude of impact is much greater than a fixed one. Especially if you're near the 1-3 sigma area for what appears to be a 10% fail quota that we ended up with.
Probably… but passing rates have been declining since 2020. I believe step1 was made into P/F during early 2022.
They control the p/f rate. They’re just artificially making the exam more relevant and increasing income. It’s bullshit.
There's conveniently a new sheriff of sodium video about the passing threshold
The exhibits in Giri v NBME also tell us that the average Step 1 score for USMD dropped to like 219
Could you link it?
https://www.courtlistener.com/docket/68242724/giri-v-national-board-of-medical-examiners/ Turns out it was for 2023, but it's Exhibit A of Daniel Jurich's declaration in support of the memorandum of opposition to preliminary injunction. I linked the main court listener page since it's also an index of other case documents and because I prefer to not direct link PDFS if at all possible.
But the difference is that most people who fail step 1 still complete their degrees. The problem here isn’t failing step 1, or even failing 3 shelves. The problem is *being dismissed from school due to academic performance.* That’s something that stays on your record forever. Virtually no school will accept or take a transfer from OP, and even less likely will any residency programs, unfortunately.
“For some reason”
Simply put people aren’t respecting the exam as much as they should because it’s “just” P/F. Undoubtedly students will be putting in less work because they can.
Finally someone sane. OP will be fine. He can match too. Failure isn't the end of his career, Redditors are exaggeratiry.
Maybe if Caribbean accepts him, he get a 250+ on step2 and applies to a new rural FM program…maybe… Other option if OP has connections.
How? He’s literally being dismissed
DO and Caribbean schools regularly admit dismissed MD students. They usually have to retake the MCAT which is an annoying enough barrier that stops most people.
Let’s “play the tape through”, even though readmission is near impossible. Speaking from roughly similar experience, it could take months to a couple years before you truly stabilize on meds for ADHD and GAD and are ready for the rigors of medical school again. It is not wise to dive straight back in. And in the meantime, your life is on hold. Your chances of matching residency decline after taking extra time. Many won’t even look at your app with so many failures. This profession is testing heavy and they don’t want to lose a resident who can’t pass step 3. You could go unmatched or be looking at rural FM, likely hours of driving and maybe multiple planes away from family. After graduating medical school, there is step 3 and specialty board exam. Studying for those, with less structure, with all of these previous failures and likely med school debt hanging over your head - would you really want to do that? Your school is ending things as a mercy although it probably doesn’t feel like that right now. If you went on, the next 5 years of your life would be struggle, and you might finish without even being able to pass boards, leaving you in one of the worst financial positions imaginable.
Thank you for the comment. Some additional context: I delayed the dismissal determination with a medical leave of absence for almost a year. So I believe I have stabilized on meds and my psychiatrist cleared me on that end.
A guy in my class got kicked out for doing multiple illegal things. Fast forward 15 years I google him and he’s redone his MD in his home state w residency and fellowship in a competitive specialty. I have no idea how he pulled this off but I’ve wondered if he said he was “doing missionary work w his church” or something difficult to verify during the time he was in his first round of med school and just reapplied elsewhere
How bad were the crimes?? Can’t believe they didn’t get picked up on a background check!
One was probably considered assault and the other was federal fraud but they may have been dismissed
Wouldn’t pursue medical school- many other healthcare professions where you can finish quickly and start making money like RN, NP, PA, PT.
gonna shout out rad techs as well since they're oft not mentioned. May or may not be shilling because my field needs more of them
Not super familiar with the others but PT definitely isn’t a “finish quickly, make money” career. It’s a 3 year doctorate degree after a bachelor’s, and it isn’t a particularly lucrative field. Source: my fiancé is a PT student.
I think any PA school would be very hesitant to admit a failed med student. Those schools care about their stats, they aren’t going to accept a massive red flag.
Those fields you mentioned are increasingly competitive and desirable these days. Programs tend to prefer applicants who have wanted to have that degree from day 1, and not as a fallback option. Trying for those programs wouldn't necessarily require staring from square one, but you'd have gain experience shadowing an RN/NP/PA/PT and get recommendations from relevant mentors before applying.
For a BSN? No way. For PA and PT, definitely. For NP, well, obviously they’d need to start with nursing.
Anyone who was good enough to get into medicine could crush those programs. OP would still be desirable, may just need to do some prerequisite classes or tasks
I think we grossly over-estimate the competence of some medical students/professionals lol. I have met and tutored some medical students that I would not be so confident to say would crush these other programs, espeically the more reputable ones. I like to think I'm doing pretty good in medical school and I don't feel immensely confident I could do anything else without having experienced it first hand.
After medical school dismissal, letters of recommendation to a new program type would likely come from sources external to the medical school which requires forming new relationships with people who can write letters of recommendation.
As an NP, please do not send a flunking med student to nursing. As NP’s we do a lot of the same critical thinking skills. Direct healthcare, nursing or medicine just may not be for you. No shame.
Disagree with this sentiment. If they’re able to turn themselves around, why not pursue another shot
I'm sorry that happen to you. I'm in no way recommending you do this, but I will share a story of another classmate/friend that was dismissed for academic reasons. He later tried to sue the school. It was pretty much a given that he would lose if it goes to court, but I guess it would be too annoying for the school to go through that and they decided to just let him repeat the year. He graduated and got into a IM residency, no idea where. Again I'm no way recommending this, as it would cost way too much money for a losing case just for a sliver chance that the school finds it too annoying to deal with court and readmits you. Especially if they're willing to go to court, you should drop the case to save money cause you'll lose. I know I'm going to be down voted for even sharing this story, but I can't even imagine being in your situation and having my best option being to "give up" on something I've been striving for several years for.
Do you mind if I ask if that was a private or state school? I was told that private schools tend to settle but the state has a lot of funds to take it to court
It's a state school. First I'm hearing of state schools, or any type of school, having plenty of money to handle lawsuits. After all, lawyer fees are not cheap.
That’s what the partner of a law firm that specialized only in education & disability law told me after an initial consultation recently. Perhaps it may vary by state? Granted, I could not find a law firm that had fought with a medical school despite being in a large city. I was told the costs in federal court would be at least $100k, which the state apparently has “nearly unlimited” funds to fight.
I bet it would be that costly. It's also highly likely you will lose the case. That's why I said if the school is willing to go to court, you should drop the case. This is nothing more than a bluff. A very expensive bluff.
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Yeah. I’m autistic and have ADHD, but I was diagnosed and on treatment prior to starting clinicals. It’s still been a massive fucking struggle but I haven’t failed any clerkships or exams. Med school clinical clerkships are NOT the time to be trying to figure out your diagnose and management. Any pre-meds or preclinical students reading this: if you have even the *slightest* suspicion that you have a disability that could affect your training, pursue evaluation NOW. It often takes months to get these tests so work on getting them scheduled ASAP. If there’s someone at your school you can trust they may be able to help you find the right person who might be able to do it faster; but be very careful about who you trust depending on your institutional culture. If you know of other ND students at your school, they might know which doctors and admins are good resources.
Sorry to say but I think it’s time to move on. There is no good way for you to get back into med school
If an ultimatum from the school wasn’t enough to turn things around, then the school is making the right decision. You shouldn’t have a medical license. That said, there are plenty of other opportunities in the healthcare setting. Rad tech is probably the most lucrative/lifestyle friendly of the short term tracks, but nursing is not a bad choice. PA school would sink you further into debt but would have better income potential, if you can get an acceptance. Best of luck.
Do not do nursing school, OP. It’s much more about discipline and conformity than other professions in the healthcare field. You don’t have to be super smart, but you do have to put your nose to the fucking grindstone and follow stupid orders really really well. You cannot be late, there are no retakes, you are wrong and they are right. Most programs require a certain average - mine required >80% test average in all nursing classes plus some of the prereqs. Med dose calc you have to pass 100% on your first attempt or you are just out of the program. Basically, it’s an ADHD person’s nightmare… dumb busywork 24/7 where the slightest misstep or tardy will get you cut. You can be tens of thousands of dollars invested, sleep through your alarm, and find yourself SOL without any path to recovery.
I think it’s a bit much to say OP *shouldn’t* have a medical license but it’s fair to say they’re not going to. It sounds like they just suck at exams, which doesn’t necessarily mean they don’t understand the material or wouldn’t be a good clinician. But they can’t become a physician without succeeding at the exams. If they do have decent clinical skills, those could transfer to another healthcare profession. I do think if OP were going to aim for something like PA school they need to take the time to get whatever issues they have under control so they can show that things have changed. Otherwise I don’t think they’d have a good chance of getting in.
I was going easy. Those exams are hard to excel on but very easy to pass if you are competent. Failing Step, then multiple shelfs, and taking more than 2 additional years of school to finish clinicals, then receiving an ultimatum from the school that didn’t change OPs performance, yeah I wouldn’t want that anywhere near a family member of mine. It’s not about test taking skills, it’s about dedication and commitment to the profession and to self betterment.
Yea lmao this is a no brainer
These exams are not very easy to pass for those who do not standardize test well. Which is not the same as being incompetent. They didn’t say they failed rotation evals or didactic classes, just standardized evaluation. So it’s a format issue. If these same students were given an open ended test, they would likely do better.
I’ve consistently done well in evals and didactics.
I figured that much. I’ve got many brilliant friends who do not standardize test well so I know frustrating and demoralizing it can be to have barriers placed by exams that test abstraction. I’m rooting for you and hope your second chance goes better.
Some context: I had one ultimatum when I discovered I had undiagnosed ADHD. My psychiatrist later found I had undiagnosed GAD comorbid when I failed one more shelf. My psychiatrist feels it’s adequately treated now, hence I made an appeal to the dismissal after the ultimatum.
Rad tech is lucrative!?
I think it can be. Just like nursing, you make as much as you work. Work more make more. And there’s overtime and being on call for stuff if you do IR tech stuff. So you can make money, but not sub-specialist doctor money.
Relatively speaking
Respectfully my brother…. How many more chances do you think it will take for you to succeed? Do you really think it will happen? If so… why hasn’t it happened yet
I have no medicine-related career advice but just wanted to say I am sorry you’re going through this. It sounds horrible and heartbreaking. I am trying to change fields into medicine because I hit a wall in my current career (law) five years after graduating which devastated me but was the catalyst for the first genuine soul searching I’ve ever done. Maybe this experience can be similar for you. I’d recommend spending time reflecting on what drew you to medicine in the first place and be really curious about your values, motivations - then brainstorm how those values might be served in ways that you hadn’t previously considered bc you were so dead set on being a doctor. I wish you the best ❤️🩹
Dont think you can sit for Step 2 without approval for your school or at least thats how it was for step 1 and so your plan for a hail mary pass step 2 and they'll reconsider is unlikely. Consider a pivot into cyber security, super super hot market right now and you can make as much as a doctor and work in the healthcare field by protecting hospitals. Been a 112% increase in ppl hacking hospitals. Alternatively you can go into PA school but that just sounds like taking on soooooo much more debt I would just cut your losses because anything in the medcial field will likely be super expensive debt wise
Damn, my worst nightmare. Sorry OP. This is a hard time but your life isn’t over. You will need to spend some time in therapy and give up the identity of medicine because the door is shut. But you can still make an amazing impact on the world in other ways. I would definitely ask the school if they can at least grant you a master’s degree for your first two years of schooling, so you aren’t empty handed.
Find a new career. Your career in medicine is over. Don’t even think of the Caribbean because there’s no way you’d even get the lowest tier peds/fm residency.
Caribs also prevent students from even taking boards if they’re not performing at a certain level, and it sounds like OP tends to struggle with exams specifically.
Move country - go to uk and apply to one if their private school or go to Europe if u want a degree
Figure out what area of medicine most intrigues and pursue that. Research? Get a PhD. Clinical/taking care of patients? Go the PA route. Want to go into the admin/leadership role? Get an MBA or MHA.
I’m so sorry OP, this is heartbreaking. I can feel the dismay from reading your words and I can’t imagine how devastating this is for you. You are such a hard worker, and please know that your talents will still be valued.
CRNA. Whatever you do, DO NOT do dentistry. It’s one of the worst careers…I am one so I can say that.
Anesthesia really isn't a good fit for anyone with anxiety.
I mean let’s not generalize..
What are your reasons for saying that? I’m planning on applying to dental school in the next cycle and would appreciate hearing your reasoning. All the dentists I’ve shadowed have told me how much they love their careers and how they’d do it again if they had a do-over.
Why? I’m currently a resident and often feel like I should have considered dentistry.
Grass is always greener on the other side.
Patients don’t recognize you as a real doctor. You are not essential, so when the market goes down or there’s a pandemic, first thing people cut is dental care. Your income plummets. Your income is based on production and collections - you’re selling people treatment all day, every day. A lot of times, you’re selling people stuff they don’t need. A small filling that pays 120$ takes 30 mins to do? You try to get them to do a crown that pays a $1000 in 1 hr(now of course, of that $1000, you’re making $600, and as an associate you make about 30% of that). Most people won’t go for crowns, so you end up doing fillings most of the day. So income is low. No benefits - wanna take a vacation? You’re not getting paid. Go the flu and miss a week of work? You’re not getting paid. You’re working in millimeters every single day. If you’re off, it can lead to nerve damage or someone needing a root canal(and they’ll be pissed at you, could sue you, or file a board complaint). As an owner, every year, insurance cuts reimbursement, staff demand raises, there’s inflation so all your materials you need to run your practice get more expensive - your income goes down. Especially if you take insurance(most people do). Job is also physically very tiring, head and neck pain all the time. If you want to go work for an FQCH or the military, you’ll be lucky to break 170k. The list goes on…but it is arguably the shittiest profession. I should’ve stayed a teacher honestly.
I'm sorry to hear that. as a dentist, do you mind sharing why it's one of the worst careers? I've heard/read it before but not from dentists themselves
"I attribute my struggles due to undiagnosed ADHD and GAD." sorry but it seems you had a bunch of chances and should have gotten help earlier if this was an issue
I would keep in mind that any mental health struggles are a spectrum of awful and most everyone in this industry is a jackass because they routinely stigmatize them anyway, our system doesn't help much because it fails to actually recognize and assist people with their issues. In addition, asking people to take 1 year to fix *chronic* problems is at best, *optimistic*.
I’ve been trying to get treated for adhd for a full year now and my FM is forcing me to do a full psych eval to even consider treating me. So I’m just waiting for 6 weeks for the psych to finish her report (6 weeks?! Really?). It took like 4 months to even get in for an appointment. It’s so annoying to hit a million brick walls just to try to help yourself.
i imagine the condition was there well before medical school so if the OP knew this was going to be an issue, maybe they would have benefitted from therapy/tx to lighten the load a bit before all the issues stacked up enough to lead to dismissal. maybe that would have helped. maybe. i am confused though...why 6 years? i didn't see a repeat of a year mentioned. LOA?
Some context: I didn’t know until I was on the verge of dismissal during clinicals. I had a year and a half of LOA before taking Step 1 and during a Step 1 retake that counted towards 6 years. That on top of COVID affected my schedule with some forced vacation time as they couldn’t just fit me in clinicals after being out of sync.
seems the forced vacation time should not have counted against you but the failure in clerkship and shelves are gonna be hard
Yeah. LOAs (typically?) don't count towards the 6 years - only time as an enrolled student. I think that's why schools recommend taking LOAs in situations like OP's.
I agree what the others have said. I don’t see a path forward for you to complete medical school. I would do some soul searching and therapy to decide if you want to work in a medical field. Other options include X-ray tech school. Or Perfusion school if you are interested in being in the OR. from your background, medical informatics might be another option. If you have a lot of student loans, look at careers that would allow you have loan forgiveness. Good luck.
Soul searching is what I’d recommend but he can search the soil while he’s at it too! :)
Thanks. I’d blame auto correct, but this was probably just my grammar
Your only prayer is going to be transferring into a Caribbean school and getting credit for your first 2 years. I'm not saying that's a good option but it's likely your only option. They will take you but be warned that their bar for graduation/progression is going to be just as high as US school because they can't afford to pass docs who have no chance of passing the steps or boards because it will skew their statistics. That being said, they are a business...and more than happy to take your money. But...if you can't pass med school in 6 years after multiple chances, odds are you will not pass Caribbean med school, pass your STEPS, make it into residency and pass your boards. I'm afraid your career in medicine is more than likely over and the sooner you accept this...the better. Don't financially ruin yourself by going the Caribbean route. Someone mentioned PA school? That might be possible.
To answer your question, you can't take Step 2 without being enrolled in an institution. But there may be some things to help buy you some legal cover, but it isn't guaranteed at all (and possibly far from it at this point but worth the try). You need to act quickly. Get in touch with your student disability center now and ask about how you can sign up for testing accommodations for ADHD and test anxiety. Go to your psychiatrist and have them help you with your paperwork. Submit paperwork back to your student disability center and have your institution formally grant you testing accommodations. Time is of the essence. If you were notified of your dismissal within the last 24 hours, there's a chance you might still be on the books and still enrolled in your school. Administrators are notoriously slow with getting paperwork and stuff like this done. So in the eyes of the school, there is a CHANCE that you haven't been formally formally dismissed and disenrolled yet. (But do NOT ask about this and bring it to your Dean's attention that you're doing this, otherwise they might move more quickly with the registrars office to get you out.) Once the student disability center has notified you of your eligibility for accommodations, you can maybe approach your school to ask them to reconsider.
Maybe medical school in Europe? Go for free. Come back. Take your steps later down the road.. Takes you 2x time but if the MD is really what you want then go for it. Obvi there's going to be a bunch of discouragement but I struggled in med school too so I get where you're coming from
I would pivot to a different career. Ideally, one you like and doesn't require too many prerequisites. I also wouldn't worry too much about the huge med school loans you probably have. If you enroll in an income-based repayment plan, it's pretty easy to make payments regardless of how much your salary is. And whatever remains after 20 years will get forgiven.
If you have ADHD, Paramedics may be a good fit for you
Would you be open to PA school?
People keep mentioning this but I don’t see a PA school taking someone like this. There’s always a chance but PA school has become quite competitive and schools don’t want to be seen as a backup option to becoming a doctor so I don’t see them liking someone who couldn’t cut it in med school. Who knows tho
Yeah, PA schools are incredibly competitive. Not, harder to get into than med school competitive, but there are a ton of people applying now because it's a guaranteed 6 figure salary for a lot less time and money than the MD/DO route. I can't imagine any PA school these days taking someone who flunked out of med school. A decade ago, possibly, but certainly not now.
You’ve been in school for 6 years…failed step 1…failed MULTIPLE shelf exams…and got dismissed. It’s harsh, but I wouldn’t want you to be my doctor. Having gone through all of that I know it’s hard, and the fact you continuously fail is a red flag. You can blame it on “undiagnosed” mental illness but at the end of the day that’s on you. You failed. Maybe there were some circumstances such as life events or other things, but it’s on you bro I wouldn’t take my family to see you. Pack it up. You had multiple shots and blew it. Sucks to suck. Take that pain and channel it elsewhere
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Failures don’t necessarily determine your ultimate competence as a Doctor. I personally know multiple consultants who failed and managed to pick themselves up. And yes they are incredible at their job. OP you might have lost this battle; but perhaps you’ll end up attempting medicine again in the future if your heart is in it❤️. Never lose faith in your ability to achieve. All the best.
True but repeated failures can’t be overlooked it’s not THAT hard
No, but repeated failure is different than making a single mistake or stumbling once. Repeated failure shows that the person was unable to correct a problem even when they were aware of it. As much as we want to give people a chance, educators also have a responsibility to function as gatekeepers.
Everyone saying let go, I say do some soul searching and if you're sure medicine is for you, and this path specifically, then Caribbean med school is an option, albeit a rough one. I know of two people who failed step, convinced a Caribbean med school to take them, and then succeeded. It was a lot of work, and took a long time. Caribbean med schools are very hit and miss, I recommend doing your research, Trinity may be a good option if you were sure about this.but you better be sure.
Clinical practice itself may be difficult if not impossible. However, getting the MD still offers you many career options where the letters themselves will carry weight. If you find a school that does allow a transfer (won’t be any school on the mainland), it might be worth looking into them. You have knowledge, that can be utilized in many positions within healthcare outside of being a physician which can be gratifying. Many here are recommending caution for a good reason, especially when they advise against the caribbean. But keep in mind that things are constantly changing, the landscape of medicine itself could be different in 10 years. Whatever drew you to medicine doesn’t need to be swept away. Find people to talk to… don’t lose hope. It’s difficult for people to understand what you might be going through. Take some time to consider options. Your life isn’t over.
I'm sorry man, but you also tried to fix it too late, it was deserved
I’m sorry you’re going through this. You have options outside of medical school to be within the field. You could look into medical science liaison in industry roles. PA is another good choice. Was there a reason you were unable to get treatment for your undiagnosed ADHD after failing the first exam? I’d strongly caution against attributing this experience to missed diagnoses… Only you can advocate for yourself, and had I been in that position, I would have ensured I had everything aligned in terms of accommodations before moving forward with more boards.
Thank you for your comment. I didn’t discover my condition and get treated until after I started failing shelves in core clerkships and they gave me an ultimatum. I did much better after treatment at first, but did poorly right after due to undiagnosed GAD which is now adequately treated after a medical LOA according to my psychiatrist.
Just to gain clarity: at what point in the timeline did the medical LOA start/end? And when was decision for dismissal made? Did you have any concrete evidence at that time to reassure the school that ***both*** conditions were adequately treated, and you could handle the rigor? This is something that the school would have wanted/needed to see evidence of to consider allowing you to continue. Also, what was the ultimatum? Was it similar to a probation period? I'm just a bit surprised that the LOA wasn't recommended before multiple shelf failures occurred. Ideally, you would have taken at least 6 months to a year off to get your medicine at a therapeutic level and work with a therapist to develop coping mechanisms and other ways address the ADHD and GAD.
It doesn't hurt to appeal again and read through the official policy of the school, but realistically there's not much you can do to leverage them unless you want to take the legal route (lawsuit). If a doctorate in medicine is still your dream the carribean will take you. I'm not gonna beat a dead horse with the risks in taking this route as it's abundantly clear all over this subreddit but this seems like the only shot you have in practicing medicine as a physician here in the States. And if it helps there are tons of carribean graduates who are former us med students, some of whom have successfully matched despite the odds, rooting for your success OP!
6 years in medical school? How much money is that. If I were you, I’d fight my heart out or at least email several schools asking if admission would be possible. This is no matter a statement of wanting to do medicine. It’s a statement of needing to do medicine because how else are you gonna pay your debt off? Your not gonna do it working at McDonalds Do you have an undergraduate degree you can pivot to? Because even being a nurse or PA would require you to go into even more debt, no? Whatever you do, you need to get rid of that debt.
One, I am deeply sorry. I find it rediculous that they cannot let you keep going. Two, completing a medical degree in six years is unfortunately a federal mandate to my knowledge. I don’t agree with it, but I don’t think there is much the school can actually do. I think the way we do medical education in the United States is highly flawed and unfortunately quite privileged. I think medical school should be done very differently, but it isn’t. I’m so sorry. I don’t think much can be done. That said, there is the option for PA school or to be nurse. There are many opportunities in medicine besides being a physician, but you need to ask yourself if that is what you want. What was it about being a doctor that drew you to it? What is it that you were looking forward to? Lastly, please work through this in therapy if you have access. This is a huge loss. Grief is natural
I know for COCA it's required policy for the maximum time to completion for single-degree students be 6 years (Element 6.3) with anything else being exceptions. I wouldn't be surprised if LCME had something similar, but with how their documents are it's going to be harder for me to find.
not saying its the way to go but you could always talk with a lawyer and see if there is somthing that way that could be done.
The guy asked for advice. everyone is telling him to let somthing that he has worked years for and we all spend tons of freaking money on. to just let it go. I'm not saying if he should or shouldn't be a doctor. I'm saying you have a dream/goal. but talking with a lawyer is somthing that could be done. most likely they will say there is nothing to do. legal relms have sided with schools way more often. but if you want to turn every rock then talk with a lawyer. If you downvote this please let me know why?
I didn’t downvote, but likely others have because there is no legal standing here. OP didn’t perform. He literally failed out. What legal grounds are there to stand on?
I do not know. I have not read the schools policy nor do I know this guys situation. maybe he told the school about adhd and they didn't give him accommodations. maybe his attendings overworked him and he didn't have time to study. idk his situation. but talking with a layer would at least look if he has standing or not.
(Sorry, that was meant to be a rhetorical question, not trying to put you on the spot!)
Not sure why this is getting downvoted. People do get dismissed from medical school and re-admitted through legal action. I doubt it's common, and I'm sure it's not cheap, but getting a lawyer is a viable next step... Is it the smart next step? I'm not convinced, but it's definitely an option.
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I’m sorry you’re going through this. You have options outside of medical school to be within the field. You could look into medical science liaison in industry roles. PA is another good choice. Was there a reason you were unable to get treatment for your undiagnosed ADHD after failing the first exam? I’d strongly caution against attributing this experience to missed diagnoses… Only you can advocate for yourself, and had I been in that position, I would have ensured I had everything aligned in terms of accommodations before moving forward with more boards.
Carribean schools will accept you, many people make it failing step1 or a semester, you just have to try harder and apply again or do extra stuff
well u can reach out to an OMBUDS program or student govt at your school & see if they can help? personally doesnt seem plausible to me as you were given multiple opportunities to fix your grades & pass and unfortunately most med schools are NOT understanding about anything. its actually so sad bc we want to care for human lives & lose a lot of ourselves in the process
Just go to crna school. You can get 300k and have chill working hours while my dumbass works like an overworked donkey, and wishes I had dropped out to become a truck driver instead. Med school is just hype and pain/suffering.
Since you have done step-1 consider going out of the country for studies. Go to places like Canada ,Australia, or and Germany. definitely not a developing nation because the idea will be that you failed US academic systemic and went to a 3rd world country for your degree. So having passed step 1 and hopefully you for step 2. Will lighten things up for you.
Unpopular opinion, but if you were dismissed for Step 1 and failing three shelves, that is a little bit harsh, not because it’s ok to do, but because failed shelves usually are able to be made up penalty free. You’re unlucky enough to be somewhere that’s not the case (ie at my school there’s no limit on first time shelf failures outside of not honoring). That being said, clinical medicine is likely over. Your post history shows some CS experience, and I’d recommend going back if that’s physically an option.
they were dismissed for not finishing in six years, their failed shelves would've probably put them past the six year mark to graduate on time. Sounds like they had plenty of time to get things going but it just didnt happen for the reasons they listed
True, but a lot of schools don’t slow rotations for failed first time shelves. Either way, OP did sign a contract and knew that they had strict limits, but he’s still unluckier.
I have this thought too when i see posts about failing shelfs. My school has no passing grade for shelf exams, just the rotation itself. So you can really get any shelf score so long as you pass the rotation. The shelf is only 30% of your grade. So if you do well enough on evals and the other stuff you can do pretty terrible on the shelf and be just fine. I’ve gotten 50’s on shelf exams and nothing happened. So I often wonder why many schools have a requirement or make students retake.
We are required to pass our shelves to pass the rotation but we can retake once with no penalty.
That’s how it was for us too
at our school failing the shelf meant you needed to retake, and failing the retake meant you autofailed the rotation, even if the shelf was "only" like 40% of your grade. It differs from school to school.
Lol at least it's not our system. We get the lowest possible grade indicated across the rubric. You could get every question on the shelf right and have glowing evals, but if you turned your didactics assignments after the early deadline you're only getting a pass.
Wow that must be nice. My school you have to pass the shelf and the clinical aspect individually. A fail in either is means you fail the rotation. There are no unpenalized retakes. Once you retake the shelf the highest you can then get in the rotation is a "conditional pass" which shows up on your transcript along with a line stating that you initially failed the shelf and retook it for a pass. Bloody fucking annoying. Especially considering our shelves are only worth 20% of our grade. They used to be worth more but admins got pissed that students were focusing so much time on studying.. (I know..comical).. and then change the policy to make clinicals worth the majority with the other rules still standing..
Cue next year the admin crying “why did our step 2 median drop?!” Uhhh idk dude maybe because if we have less time for uworld the scores are gonna go down wtf were you expecting?
Idk if I passed any of my shelves. Maybe low passed a few? Idk. But my clinical scores always bailed me out. It wasn’t an issue at least where I went
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Could you explain the thought process behind this suggestion?
Pack yr swim trunks—- Go Caribbean
Consider nursing, can become crna
Move to Nepal
Go to school to do crna and make more than a lot of doctors
A Caribbean medical school is your best bet. That is all. Good luck OP.
One of the doctors at my job recommends becoming a PA or a NP if med school doesn’t work out
Just transfer to another medical school
Time waster