Considering dropping out

[kgamon8]

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[Osteosaur]

I am sorry you're discouraged by your scores. It sucks your school is blocking you from getting some HPs with those evals. Surely you are not the first person this happened to.

Ultimately you have one year to go and you've put the effort in. You probably have a shot at matching FM or IM somewhere, right? Would you be miserable if that is the case? I guess you ultimately want to see what program directors think of this. But surely letters and comments about you count for something.

If you drop out now you have three wasted years. If you still want to be a doctor you may as well give it a shot. At this point you don't have much to lose relative to what you've already put in.

 

[kgamon8]

I am sorry you're discouraged by your scores. It sucks your school is blocking you from getting some HPs with those evals. Surely you are not the first person this happened to.

Ultimately you have one year to go and you've put the effort in. You probably have a shot at matching FM or IM somewhere, right? Would you be miserable if that is the case? I guess you ultimately want to see what program directors think of this. But surely letters and comments about you count for something.

If you drop out now you have three wasted years. If you still want to be a doctor you may as well give it a shot. At this point you don't have much to lose relative to what you've already put in.

Yes I got a 72 on surgery shelf for example, at my friend’s school anything above a 70 is a HP.

well yes…I wish I had picked a DO school where at least I would be in a more desirable location. It’s been hard being in a PWI
area as a minority and I know I wouldn’t match anywhere near my family. My mom has MS and brother has autism and I feel like I need to support them which is the only reason I would keep going..but training far away and not being able to physically support is tough as well

and I am halfway through M3 year btw. But like I said no chance of HP. And I know I won’t get above the 50th percentile how much I study

 

[hiiiiiiiiiii]

Unless you’re miserable in medicine (not because of grades and scores but because you truly don’t find the field fulfilling) then DON’T drop out. You’re a USMD and could without a doubt match at least a good FM program. You will probably be kicking yourself in the a$$ 5 years down the road when you’re in a huge amount of debt and realize you dropped out mainly because your scores weren’t what you wanted and fell victim to comparing yourself to your peers.

M3 year is the hardest year of med school. Having been through it, I can understand why you’re feeling this way, but you got this man!

 

[kgamon8]

Unless you’re miserable in medicine (not because of grades and scores but because you truly don’t find the field fulfilling) then DON’T drop out. You’re a USMD and could without a doubt match at least a good FM program. You will probably be kicking yourself in the a$$ 5 years down the road when you’re in a huge amount of debt and realize you dropped out mainly because your scores weren’t what you wanted and fell victim to comparing yourself to your peers.

M3 year is the hardest year of med school. Having been through it, I can understand why you’re feeling this way, but you got this man!

I actually love third year it’s more fulfilling then preclinical years but I just realized I can’t have the career I want. I know thats selfish but I will at least be able to physically support my family

 

[drducky.]

I actually love third year it’s more fulfilling then preclinical years but I just realized I can’t have the career I want. I know thats selfish but I will at least be able to physically support my family

What was the career you wanted? If it’s ortho or derm, then yes it’s probably out, but you can easily still be a physician.

 

[kgamon8]

anesthesia, obgyn, EM

 

[kgamon8]

anesthesia, obgyn, EM

And I feel like a sane person would say I’ll take any location any program just to be a doctor. But I am so stressed every day going to rotations and seeing things that I won’t be able to practice. I feel like I’m just playing pretend. I do feel very privileged to have been given this chance it’s just pretty clear that I won’t be a good doc

 

[A-poor-student]

EM is very possible. Anesthesia will be a harder but with a good step 2 who knows

anesthesia, obgyn, EM

 

[solitarius]

What is your school debt amount?

I think you can match at community IM and FM and pediatrics.

 

[kgamon8]

What is your school debt amount?

I think you can match at community IM and FM and pediatrics.

60k

 

[wysdoc]

Ms3

step 1: 205
All my clinicals will be pass. Our school does 20% H 20% HP.

I attributed my low step one to my TSH being 300. But now I think it’s just bc im not a good tester. No matter how hard I study for the shelf I’m 30th percentile.

i get great evals sometimes but then also get 3/5s. I’m not making up for my Step 1 performance.

I’m tired of the midwest and know I’m not a competitive applicant. I volunteer and have some research but that doesn’t even matter with my scores. Should I drop out now or try to use the MD? Like a teaching job? Please any advice would help

If you graduate you still have your MD. Someone has to be in the bottom 20% of the class
Keep your head up, graduate, and apply to residencies in the part of the country that feels more like home to you.

Maybe if you phase out of the research and concentrate on your clinical skills you will have enough time in your day.
How about aiming for Peds and FM?

 

[solitarius]

60k

60k is not insurmountable if you want to bail medicine, but you'll probably need at least a decade to pay that off.

If I were you, I'd consider FM or IM over Peds. EM spots are opening up like there's no tomorrow, but they have a MD supply glut on the horizon.

I'd also talk to your home Ob-Gyn department. If you are male, I know they are very eager to recruit more men into that specialty.

 

[kgamon8]

I really cannot stand IM.. FM is pretty much IM unless rural...also female so there goes Ob..
why not peds?

 

[solitarius]

It's my bias: lower pay, crazy parents, peds culture.

 

[wysdoc]

I really cannot stand IM.. FM is pretty much IM unless rural...also female so there goes Ob..
why not peds?

Peds is flexible and there are a lot of residencies, sounds like a good option

 

[kgamon8]

If you graduate you still have your MD. Someone has to be in the bottom 20% of the class
Keep your head up, graduate, and apply to residencies in the part of the country that feels more like home to you.

Maybe if you phase out of the research and concentrate on your clinical skills you will have enough time in your day.
How about aiming for Peds and FM?

Research is from M1/M2 years. I promise you I spend most of my time pre charting or studying. I’m on peds now, but evals are 50%. I was getting good ones at first now I have a very tough attending who gives threes to everyone

 

[kgamon8]

Peds is flexible and there are a lot of residencies, sounds like a good option

So do you really think there is no chance at OB? I liked NICU but because I was seeing deliveries..

I know I am just complaining at this point. I feel like a good doctor would be happy wherever they went :/

 

[drducky.]

So do you really think there is no chance at OB? I liked NICU but because I was seeing deliveries..

I know I am just complaining at this point. I feel like a good doctor would be happy wherever they went :/

64 matched, 28 didn't match OB with your score

95-27 for EM

55-21 for gas

All these look pretty good for you still.

 

[kgamon8]

64 matched, 28 didn't match OB with your score

95-27 for EM

55-21 for gas

All these look pretty good for you still.

Okay good to know. Do you think these are all community?

How bad will it look that I don’t have any HP or H? im involved on campus and volunteer. But nothing like GHHS, if that matters

 

[drducky.]

Okay good to know. Do you think these are all community?

How bad will it look that I don’t have any HP or H? im involved on campus and volunteer. But nothing like GHHS, if that matters

Probably but beggars can't be choosers.

Going to a MD school automatically gives you like a 10pt Step1 boost over us DOs so don't give up

 

[kgamon8]

Probably but beggars can't be choosers.

Going to a MD school automatically gives you like a 10pt Step1 boost over us DOs so don't give up

I doubt it at least at my school. People I know with lower scores were passed over for DOs. Which I have no problem with, I’m glad it’s evened out at least here

 

[Osteosaur]

Okay good to know. Do you think these are all community?

How bad will it look that I don’t have any HP or H? im involved on campus and volunteer. But nothing like GHHS, if that matters

With a 205 and all passes you can't really be picky about university versus community I don't think. Just be content with getting something you can do for the rest of your life near your family.

 

[Chelsea FC]

With a 205 and all passes you can't really be picky about university versus community I don't think. Just be content with getting something you can do for the rest of your life near your family.

This!!!!! ur happiness is based on your expectations, I readjusted mine when I was struggling as well. At this point I just wanna match and move on with life.

 

[mrbreakfast]

I know people who had way, way worse academic med school careers than you and still matched. As far as I can tell you haven't failed a single thing yet, which puts you in a better spot than you might realize. Are you going to match to your dream program? Maybe not. But you can very likely find a program at which you'd be happy. There are programs which are set up to accept students who may not be the strongest candidates (no offense) and there are plenty of program directors who appreciate that exam scores may not tell the whole story. I'd stick it out.

 

[kgamon8]

There are programs which are set up to accept students who may not be the strongest candidates (no offense)

Are these like FM/IM? I don’t know if that’s what I want to do :/

you guys are right…I feel so down..always wanted to do academic medicine and teach med students…now look at me

 

[M&L]

ok, so i'll give you a bit of tough love thing here, because i dont think you get it...

1. You dont like FM/IM? well, too bad. But you are gonna have to do it anyway. You will try to do your best on step 2, then you'll schedule away rotation in the program that you are competitive in, impress the hell out of them, and get accepted. You will also ask your faculty or a doctor you work with to make a phone call for you to get them look at your application. You dont like FM/IM? do it anyway. Then pick the fellowship you like, and mold your career from there. There are a lot of really cool fellowships in both, and you can do really fun things. You wanted to do academics but arent competitive? You can work with students anyway. You can mentor students in local medical school, offer them shadowing or rotations in your hospital, you can still do research, you can publish. You can make friends with someone from academic place and work with them. You can mentor undergrad students. You can teach other healthcare professionals. we have private anesthesia practice, for example. Not academic. Guy went to community hospital residency. And he is the main teacher/mentor in anesthesia here. and he is AMAZING.
SO, you can do all these things you want, you'll just have to be a little creative.

2. As someone who worked for 12 years before going into medical school, - job markets S*CK!!!! It is SOOOOO hard to find a career that you will make decent money in and that will be safe from job market fluctuations. You have a difficult family situation, - they NEED you. They need your income. There are very limited jobs where you are going to make the money that the doctor will. And it will take you YEARS to build up to a level of career where you can make at least somewhat decent money. If you told me, for example, that before medical school you were a programmer, making 150K, and you are good at it, and now this medical school thing didnt work out, - i'd say, "yeah, leave. You'll be fine". But you arent a programmer, are you? What are you gonna do if if you leave? Go back to school? Teach in community college? Work in a grocery store? You'll have to go back out there, and fight to survive. and you can NEVER undo it. You cant go back to medical school after this if you drop out. your career is over. Dont you think you will regret the hell out of it? When you cant send your sibling to a private school? When you cant hire the best care for your mom when she is sick? When you cant buy them quality groceries? Take them on nice trips? Support them? How are you gonna feel then?

OK so that was tough love. A bit of reality check.

Look, i know you are upset, and disappointed, and you feel like the world is crumbling down around you. I get it. I think a lot of people would feel this way in your situation. You know, i am not religious, but i do believe that everything happens for a reason. Have you ever thought that maybe there is a reason to it? Maybe life is taking you in a direction you are meant to go that you'd never consider otherwise? Dive in, and explore. Apply for FM and IM (both), go to interviews, look at the list of fellowships, and get excited about your future. You will do amazing things, and it is up to you how to do it. you still can teach, you can work for a hospital or private practice. You can do sleep medicine (VERY nice specialty), sports medicine, women's health, you can do addiction treatment (very nice too). You can really help people and make A LOT of family. There is a shortage of FM physicians across the country. After residency you can move ANYWHERE.

YOU WILL BE OK. you will be happy. Just keep going one step at a time. And start making connections and calling people.

 

[JP2740]

Try to match IM at a place that has internal fellowships. Worst case scenario you become a hospitalist and can make 250-300K/year at some places. Kind of middle but still good you can do something like allergy/immuno and not work weekends ever again with an average physician salary. If you go to a place with an internal cardiology fellowship and do really well and do some research you can even become a cardiologist. The step score sucks but not the end of the world if you can match IM. Do some research, make connections esp at your home program, discuss your shortcomings with mentor/home PD and get some real advice.

 

[Dral]

If you do FM, they have an OB component. It won't be the only thing you likely practice, but you could get some of it as well. With FM you can get a job pretty much anywhere and you could probably train just about anywhere too.

I know you said you liked NICU because of the deliveries, but you can get to the NICU by Peds -> neonatal fellowship. That's very doable.

If you travel over to the EM forum and take a look, you'll see they seem to be having an oversaturation problem which translates into new grads not being able to find jobs/good jobs. I see them recommending people avoid the specialty because of it.

For anyone still delusional into thinking emergency medicine has a future

Annals of emergency medicine article Beating a dead horse, but lots of data following some assumptions. Conclusion: we are basically screwed. If you're a med student and 4-5 years from practicing, take a long and hard look at the data. Don't be delusional thinking that this is just SDN...

forums.studentdoctor.net

 

[ACSurgeon]

What would you do if you dropped out? Would it be more fun/prestigious/lucrative than IM or FM? Not sure what other marketable skills or degrees you have, as that would alter how you think about things. If the alternative is a crappy job, you might be more excited about “settling” for IM/FM in a community setting. Just because you can’t be a fancy academic physician doesn’t mean you should go to the other extreme and spend the rest of your days in a cubicle.

also, just because OB is uphill doesn’t mean it’s not doable. You might have to apply to a lot more programs, do an away rotation, do research etc.

 

[kgamon8]

Yes EM is out for sure. I do understand that F M has an OB component. But as much as I like the rotation, I was in a rural spot. I know the scope of FM isn’t as wide in a city. Are FM doing c-sections in larger areas?

If you do FM, they have an OB component. It won't be the only thing you likely practice, but you could get some of it as well. With FM you can get a job pretty much anywhere and you could probably train just about anywhere too.

I know you said you liked NICU because of the deliveries, but you can get to the NICU by Peds -> neonatal fellowship. That's very doable.

If you travel over to the EM forum and take a look, you'll see they seem to be having an oversaturation problem which translates into new grads not being able to find jobs/good jobs. I see them recommending people avoid the specialty because of it.

For anyone still delusional into thinking emergency medicine has a future

Annals of emergency medicine article Beating a dead horse, but lots of data following some assumptions. Conclusion: we are basically screwed. If you're a med student and 4-5 years from practicing, take a long and hard look at the data. Don't be delusional thinking that this is just SDN...

forums.studentdoctor.net

I do think FM is very cool but I think it’s more fun in smaller towns

 

[kgamon8]

What would you do if you dropped out? Would it be more fun/prestigious/lucrative than IM or FM? Not sure what other marketable skills or degrees you have, as that would alter how you think about things. If the alternative is a crappy job, you might be more excited about “settling” for IM/FM in a community setting. Just because you can’t be a fancy academic physician doesn’t mean you should go to the other extreme and spend the rest of your days in a cubicle.

also, just because OB is uphill doesn’t mean it’s not doable. You might have to apply to a lot more programs, do an away rotation, do research etc.

Would be very happy in OB if not academic. Is it possible to do like an intern year in FM and reapply to OB?

 

[Lawpy]

Are these like FM/IM? I don’t know if that’s what I want to do :/

you guys are right…I feel so down..always wanted to do academic medicine and teach med students…now look at me

Wait, you still can though?

 

[meepM3]

The Female Physician my mental health and medicine: a love story

To be honest, I still can’t decide if that title is sarcastic or not. It feels like a love story, but a messy one. I

thefemalephysician.org

 

[deleted1100659]

most premeds and medical students have some sort of life plan...but that plan rarely goes the way they want it. Medical school teaches adaptation and compromise.

You only have 60k in debt. That is amazing. When you graduate you will easily pay off your loans, and you will have money to help those around you, and yourself.

You do not need to go to a top tier program to achieve your dreams. Also sometimes a great audition rotation can really give you the boost you need. You're also an US MD which for sure helps. Dropping out entirely seems drastic, and reactionary to self disappointment; is it your disappointment in yourself that makes you want to drop out, or your lack of passion for this line of work? I think that answer will direct you on what you should do.

 

[wondervisions]

Have you started on levothyroxine? Untreated hypothyroidism can seriously impact your performance.

 

[kgamon8]

Have you started on levothyroxine? Untreated hypothyroidism can seriously impact your performance.

I did but only after getting diagnosed after step. Was very sad and foggy and thought it was anxiety but I was falling asleep during the exam.

i know it’s not just the thyroid though. Like I’ve never gotten above 70s on a shelf

 

[Dral]

Yes EM is out for sure. I do understand that F M has an OB component. But as much as I like the rotation, I was in a rural spot. I know the scope of FM isn’t as wide in a city. Are FM doing c-sections in larger areas?

I do think FM is very cool but I think it’s more fun in smaller towns

I think it will depend on the area, but in metro areas I'm pretty sure they are doing way less OB.

The general gist of things in this thread sounds like you should still pursue what you want to do, but just be prepared for some possible compromise. That's a way better plan than just calling it quits.

You can dual apply at the same time. However, you can also put all your eggs in one basket (OB for instance). If you don't match, you can try to SOAP into FM/IM/Peds or possibly OB. If you don't match or SOAP, you can either try OB again (advise against doing this unless your app gets a big bolster between the two attempts), or try for something like IM/FM/Peds the second time around.

If you don't match OB the first time, you can try to SOAP into a prelim spot and try to get in to OB after that as well. One of my friends did that. She didn't match OB, but got into an intern year. She ended up getting an OB spot that opened up at the institution where she was doing her intern year.

 

[Jesus1]

Consider preventive medicine. Excellent pay, nice hours, needs an IM prelim (or TY year). 2 years after that (MPH + 1 year of rotations). Also consider occupational medicine.

 

[flasheroonie]

1) Your story isn't over. You still have to take step 2 and get LoRs, etc.

2) You still got a 205 while dealing with untreated hypothyroidism? That's awesome! Untreated hypothyroidism could have landed you into a myxedema coma. That's an achievement to be proud of! And you have a great excuse for what happened.

 

[kgamon8]

1) Your story isn't over. You still have to take step 2 and get LoRs, etc.

2) You still got a 205 while dealing with untreated hypothyroidism? That's awesome! Untreated hypothyroidism could have landed you into a myxedema coma. That's an achievement to be proud of! And you have a great excuse for what happened.

LOL I appreciate the sentiment.. But when I talked to the dean (literally yesterday) she said it was more likely test anxiety. I don't know what to believe. But my practice tests were 215-220, so a 205 is not far off. On meds and doing a lot better. I had anemia as well maybe from the thyroid, and got 5 doses of IV iron before my surgery block

I see that LORs are worth a lot for OB, so I will really try. But I know 0 of them rn

 

[Dral]

There is a suggestion that anxiety can be associated with hypothyroidism (yes, hypo), so there is that as well. It could very well be unrelated, but it may be related.

 

[StressfulMD]

I attributed my low step one to my TSH being 300.

I honestly wouldn’t even doubt this one bit. You must be absolutely exhausted. I have Hashimoto’s disease and just got surgery to remove half my thyroid+ 2 parathyroids a couple months back.

I also just recently got on the correct dosage of Levothyroxine after changing it 3 times since the surgery. I’m starting to wake up earlier, sleep later and take less naps than I did. Still tired, but better than before. The highest my TSH ever was was 25 and I literally couldn’t stay awake. I’m shocked more people in this thread aren’t addressing your thyroid issue.

So to start, that TSH level is ridiculously high. The max it should be is 4. Please get on a high dose of Levothyroxine if you aren’t already, and get an anti-TPO antibody blood test for a definitive diagnosis. Convince your doctor to order a thyroid panel every 4 weeks instead of 6 after a dose change.

I’m really rooting for you here because I understand how it is being tired all the time.

Get treated, get on the highest dose you can to save time, and make the case that you were legitimately sick and couldn’t get a high score. You’ve BEEN sick throughout medical school, no wonder your practice exam scores were low too.

Very sorry you’re going through this.

 

[butidontwantto]

Yes EM is out for sure. I do understand that F M has an OB component. But as much as I like the rotation, I was in a rural spot. I know the scope of FM isn’t as wide in a city. Are FM doing c-sections in larger areas?

I do think FM is very cool but I think it’s more fun in smaller towns

idk about c-sections specifically, but the FM doc I scribed with def did deliveries earlier in her career (got tired of the hours over time so she stopped). also my obgyn did FM -> fellowship. These were both in Boston. Might not be super common, but it's not impossible.

 

[Starx]

It is very unfortunate your hypothyroidism was untreated. If it makes you feel less alone I had a similar situation during my Step 1. Undiagnosed dx w/ severe fatigue and brain fog. I ended up barely passing step 1
Just got my step 2 score. 50+ point improvement.

During M3 my confidence plummeted. I let myself think I was the dumbest medical student who didn't deserve to be here. . I saw on residency searchers even FM programs had step 1 cutoffs I was below. As someone who is tbh not great clinically, I was so worried I would not even get FM interviews.

I'm an M4 now applying FM soon hoping I can now get into a good FM program and keep living my life. Is it my ideal specialty? maybe not but maybe with effort you can still get into other specialties. You should still try.

Life sucks sometimes and it is unfortunate when things like this happen during something as big as Step 1, but you can and should still keep going forward.
Don't let your step 1 score make you feel less worthy.
Never be the one to say no to yourself. Let someone else say no to you.

 

[fxndoc]

Program director here- it’s not about the numbers it’s about clinical ability, professionalism, teachability, proactive learning. Many of our best residents rotated with us and matched despite low scores. One of our best passed step one by one point. Showing up unprepared though will definitely hurt your chances. Some people with great scores can’t apply their knowledge and make good medical decisions. Our program plans not to screen by step scores this year, we will be reviewing MSPEs as a first pass screen for red flags.

 

[THEBACKANDFORTH]

Hey you,,, You sound very qualified to practice medicine. Do FM or Peds and really strive to find a program with a culture you will be happy in. Focus on being a good person for you patients and team members, making sound medical decisions for what you do know, and asking when you don't. Having just finished third year as a 30th percentile academic student, I found real success on the wards by just being a solid person, trying hard, knowing it was okay to ask when I didn't know something. There certainly are rockstar medical students, but very few people will knock you for not being that. I really think you will find contentment with medicine by reframing how you view your worth. You will be a solid doctor and can even become exceptional by knowing your limits. and refining your soft skills.

 

[kgamon8]

I honestly wouldn’t even doubt this one bit. You must be absolutely exhausted. I have Hashimoto’s disease and just got surgery to remove half my thyroid+ 2 parathyroids a couple months back.

I also just recently got on the correct dosage of Levothyroxine after changing it 3 times since the surgery. I’m starting to wake up earlier, sleep later and take less naps than I did. Still tired, but better than before. The highest my TSH ever was was 25 and I literally couldn’t stay awake. I’m shocked more people in this thread aren’t addressing your thyroid issue.

So to start, that TSH level is ridiculously high. The max it should be is 4. Please get on a high dose of Levothyroxine if you aren’t already, and get an anti-TPO antibody blood test for a definitive diagnosis. Convince your doctor to order a thyroid panel every 4 weeks instead of 6 after a dose change.

I’m really rooting for you here because I understand how it is being tired all the time.

Get treated, get on the highest dose you can to save time, and make the case that you were legitimately sick and couldn’t get a high score. You’ve BEEN sick throughout medical school, no wonder your practice exam scores were low too.

Very sorry you’re going through this.

Thanks this is validating. My dean didn’t seem to care at all. I feel dumb for complaining. My endo didn’t want to run the antibodies even though my mom has MS

I was on 100mg and my TSH went down to ( 60s while on the surgery block. Getting up at 3 during surgery was awful. I was also anemic likely due to thyroid and that was a mess too. On 125 now and doing better

 

[StressfulMD]

Thanks this is validating. My dean didn’t seem to care at all. I feel dumb for complaining. My endo didn’t want to run the antibodies even though my mom has MS

I was on 100mg and my TSH went down to ( 60s while on the surgery block. Getting up at 3 during surgery was awful. I was also anemic likely due to thyroid and that was a mess too. On 125 now and doing better

Don't ever feel stupid for advocating for yourself! And looks like its time to dump your endocrinologist too.

Glad you're on the medication. And if you're in the MA/RI area, I can recommend you to a good endo and endocrine surgeon if needed--PM me if that's the case.

 

[Matthew9Thirtyfive]

Dude your story is a success story. You had severe hypothyroidism and somehow managed to pass step 1 and pass rotations. You still have step 2 and subIs and stuff. Make sure your thyroid stuff is good to go, sort out your mental health, and rock your subIs. Then do better on step 2, and you are not even close to being out of the race.