1 and a half year gap before Clerkships... Still chances of Matching? Somebody same situation?

[MedCar@]

I am an IMG from a Caribbean Medical School (Ross University). I need guidance related to a topic that is giving me anxiety and is interrupting my mental ability to study for step I.

I took 1 semester off (Jan-May 2017) before finishing my last semester of basic sciences on 2017 to solve a very urgent situation in my family (life or death - suicidal brother) I did not have any other option. Then I solved the situation and finish my second year strong in the summer semester ( May-Aug - an option given at Ross University).

My plan was to pass COMP and study for 3 months and given my COMP result of 205 and my residency choice: psychiatry, it was more than enough time to achieve a competitive score... but then life threw me a huge curve ball...

My country Puerto Rico was hit by 2 hurricanes and Puerto Rico was declared a disaster zone on October 7, 2017. This completely interrupted my study period and put me behind for almost 4 months. Although I studied with the FA it was ineffective; I decreased my score by 11 points because w/o electricity, internet, water services it was very, very hard to "effectively" study for Step I.

Another semester from Sept. to Jan. has passed and I re-started my USMLE Prep at the beginning of February, now with electricity, internet and the benefit of UWorld MCQ's. Now, here is the problem in order to pay for this services (UWorld and the Kaplan course) I've been working part-time because the financial situation was complicated by these unexpected events. It is taking me time to improve my score and based on my preparation plan I will finish UWorld by the end of June. I will take the Step I in July and continue to my Clerkships in September. If this does not work my last chance is to start clerkships in November, but I'm working for this to not happen...

If you summed up everything we are talking about a Gap of aprox. 1 and 1/2 year before starting Clerkships. For those who understand the process of residency and have gone through it... How can this affect me (Residency-Psychiatry) given the circumstances because to be realistic this is not the typical gap planned for USMLE Study and Research?

Thanks in advance.

Note: Given the nature of RUSM curriculum I had to do a Withdrawal (W) after 6 months of the hurricane because it is the maximum time RUSM give to us to take the exam. Right now, I reapplied and they accept me back with 6 more months to study for the exam.

All these gaps will make me finish my M.D. in a time period close to 6 years. The thing is that this pisses me off a lot; it was not my plan, I am a very humble and competitive person and this is like the most unexpected thing in the world for me. Your help will be appreciated.

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[bedevilled ben]

I am an IMG from a Caribbean Medical School (Ross University). I need guidance related to a topic that is giving me anxiety and is interrupting my mental ability to study for step I.

Hey there. I'm a Caribbean IMG as well and starting my PGY-3 year in psychiatry next week. I'm also involved a bit in our resident recruiting process. I think you know that this is not going to be viewed positively by most programs, so I'm not going to insult your intelligence and say it's nothing. Couple of pertinent points here:

1). You haven't taken your Steps yet. You really need to crush this. A 225 is not going to fly here. You need to play this numbers game, and the best way to get more people looking at your application for the Match is going to be a good Step 1 and 2 score. Have a look at the Residency Program Director Survey data for the NRMP 2016. You'll note that the Step 1 and Step 2 CK are both pretty high on the list (Step 1 being the #1 ranked factor!)

2). Also note, that "Gaps in medical education" is somewhere down around #20. It's not irrelevant, but it's also not likely to be a deal breaker for most programs.

3). You will have an opportunity to address this in your personal statement, which is also a highly-ranked factor (especially in Psychiatry,) as well as in your interview. Your explanations of the gaps are reasonable. These are great opportunities to talk about "overcoming challenges" in your education, or making yourself stand out as a unique applicant. You also have a personal stake in mental health given your family connection, which also shows dedication to your specialty.

4). Psychiatry has historically been less competitive, however this appears to be changing the last 2 Match cycles and it seems our secret is finally out. You'll need to account for this in your application strategies. You will want to apply to as many programs as you're financially able to with a realistic chance of acceptance. (I applied to >90 programs, last I checked there were about 250 accredited programs)

5). Psychiatry is very friendly towards non-traditional or unusual paths to medicine. We value life experience heavily, and the interview and PS is a big part of that.

6). Good letters of rec and networking can go a long way, too. Find realistic hospitals that accept IMG's and try to do Sub-I's there early on in 4th year to show yourself off to the program. Network and build relationships with the residents in the program if you can. When application time comes around, reach back out to those people and let them know. Most people like helping other people out.

So long story short, you're far from sunk. You have an uphill battle ahead of you, but if you do well on Steps, get good clerkship evals, get good letters of rec, and apply intelligently and broadly, you have a pretty reasonable chance still. In the meantime, your goal needs to be to crush the Step 1 and then work hard in your clerkships.

 

[JohnWood15]

Great advice Ben,

You could have easily taken a negative approach to answer this student but you offered up some real objective advice here.

It would be nice to see more advice like this in future posts on the Caribbean forum.

 

[MedCar@]

Thank You! I really appreciate your time. I'll do everything to achieve this goal!

 

[MedCar@]

Great advice Ben,

You could have easily taken a negative approach to answer this student but you offered up some real objective advice here.

It would be nice to see more advice like this in future posts on the Caribbean forum.[/QUOTE

There are multiple approaches to situations in life but when you look at the "details" there is always the best explanation for a specific setting. Ben gave me the most correct and better explanation given my situation. Real life is hard and unpredictable even for hard workers... and you will learn that you cannot always be right even if you feel so and due to this everything that appears in your mind should not be said or written...