Dismissed from AUA College of Medicine

[Loststudent299]

I was recently dismissed from AUA after failing to pass the Comprehensive Clinical Sciences Shelf Exam(CCSE) which is now required to pass with a 83 or higher with max 5 attempts. I started Premed in 2006, basic sciences in 2008. Passed USMLE Step 1 with a score in the 230s in 2011, Failed my first attempt at Step 2 CS in 2013, completed clinical rotations in December 2014. After failing the CS, my interest was shot, became depressed, and I decided to avoid anything related to medicine for 2 years and I sat for the CCSE 4 times scoring in the 60s(without studying). In Jan 2016 I was warned that if I had not passed the CCSE, Step 2 CK and Step 2 CS by June 2016, I would be dismissed. I attempted the CCSE twice and failed to score above 79. I was dismissed in June. I appealed the dismissal and was subsequently readmitted and given a deadline of 9 months to complete and pass the CCSE with 83 or higher, pass step 2 CK and step 2 CS all by 9 months. I began to study Kaplan until December 2016 but I was only scoring in the 50th percentile in the question bank while struggling with depression. I gave onlinemeded.com a shot and it helped my performance quite a bit and I scored in the 70th percentile in Uworld Qbank first attempt. I was planning on taking the CCSE in March but due to family issues, I wasn't able to sit for it. I was dismissed in April and given a chance to appeal. I took a practice exam and scored a 570 (253 usmle equivalent) on the NBME practice exam in April in order to show that I am capable and able to sit for the CCSE. However, my appeal was denied and now I am looking for any recourse. I was thinking my best bet is to apply to another Caribbean medical school and complete and pass the remaining steps as soon as possible since I only have 1 year left to complete all the Steps before my Step 1 score expires and obtain an MD. Or worse start undergrad all over since I started the premed program straight out of High School. I would appreciate any advice for saving my medical career. I am also scheduled to see a mental health professional for my history of depression.

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[bedevilled ben]

I would appreciate any advice for saving my medical career. I am also scheduled to see a mental health professional for my history of depression.

I think you need to step back and be realistic about your educational career thus far. What is your end goal? Do you want to practice clinical medicine? Do you want to practice in the US/Canada? Because right now, those are non-starters. You have a failed Step 2 CS, your Step 1 score is ancient, and you've yet to take CS or CK. Compounding that, you have a huge time gap in your education. You've been given multiple opportunities by the school to address your deficiencies and you haven't been able to do so. No credible school is going to accept you into MS4, and even if they did you likely wouldn't have time to complete CS and CK before your Step 1 score expires. Even if you did, by some fluke, manage to take CS/CK in time and graduate, what then? No residency program is going to touch you with an application timeline like that. Right now, without an undergraduate degree, I'm not sure you could find a reputable medical school that would let you re-enroll from MS1 and start all over again.

I think getting some professional help for your mental health is a good start. Figure yourself out first. If you still really think medicine is right for you, then reach out to some other schools and see if they will let you transfer in with advanced standing. You will still need to repeat MS3 and MS4. You will almost certainly have to retake Step 1, and you will really need to crush it, along with Step 2, and I would highly recommend taking Step 3 as well before applying for residency. Keep in mind that your chances of Matching are still going to be very low. You will need to be really aggressive to make this happen.

I'm not sure your medical career can be effectively salvaged at this point unless you have no other life-obligations and are indiscriminately wealthy. I shudder thinking of the interest your loans must be accruing.

 

[Loststudent299]

I think you need to step back and be realistic about your educational career thus far. What is your end goal? Do you want to practice clinical medicine? Do you want to practice in the US/Canada? Because right now, those are non-starters. You have a failed Step 2 CS, your Step 1 score is ancient, and you've yet to take CS or CK. Compounding that, you have a huge time gap in your education. You've been given multiple opportunities by the school to address your deficiencies and you haven't been able to do so. No credible school is going to accept you into MS4, and even if they did you likely wouldn't have time to complete CS and CK before your Step 1 score expires. Even if you did, by some fluke, manage to take CS/CK in time and graduate, what then? No residency program is going to touch you with an application timeline like that. Right now, without an undergraduate degree, I'm not sure you could find a reputable medical school that would let you re-enroll from MS1 and start all over again.

I think getting some professional help for your mental health is a good start. Figure yourself out first. If you still really think medicine is right for you, then reach out to some other schools and see if they will let you transfer in with advanced standing. You will still need to repeat MS3 and MS4. You will almost certainly have to retake Step 1, and you will really need to crush it, along with Step 2, and I would highly recommend taking Step 3 as well before applying for residency. Keep in mind that your chances of Matching are still going to be very low. You will need to be really aggressive to make this happen.

I'm not sure your medical career can be effectively salvaged at this point unless you have no other life-obligations and are indiscriminately wealthy. I shudder thinking of the interest your loans must be accruing.

Hello.Thank you for your advice. I do not have any student loans. My parent are encouraging me to become a professional anything and will(are) financially support me in whatever I choose to do. That being said, if I do manage to transfer to another medical school, obtain an MD and complete the boards within the next 2-3 years, does becoming aggressive and taking maybe another 1-2 years to put myself out in front of a lower tier residency program, doing research on the side, showing my passion and clinical knowledge to a program director give me a fighting chance at being accepted into a residency program? Worst case scenario, Would I be kidding myself if I started undergrad all over again in hopes of being accepted into a us medical school with them knowing that i had been dismissed from a caribbean medical school previously?

 

[bedevilled ben]

Hello.Thank you for your advice. I do not have any student loans. My parent are encouraging me to become a professional anything and will(are) financially support me in whatever I choose to do. That being said, if I do manage to transfer to another medical school, obtain an MD and complete the boards within the next 2-3 years, does becoming aggressive and taking maybe another 1-2 years to put myself out in front of a lower tier residency program, doing research on the side, showing my passion and clinical knowledge to a program director give me a fighting chance at being accepted into a residency program? Worst case scenario, Would I be kidding myself if I started undergrad all over again in hopes of being accepted into a us medical school with them knowing that i had been dismissed from a caribbean medical school previously?

It is possible if you're okay with a family medicine residency in an isolated part of the US or willing to go to Puerto Rico and do an unpaid internship. If money is not an option, you have nothing else tying you down, you're under the age of 30, and if you've really changed your outlook on your career, I would seriously consider starting from scratch at a US university and then try to get into a US medical school. As for whether you tell them about your previous dismissal from a Caribbean medical school, I will leave that to others to comment on. If you don't have US loans, I'm not sure how a US school would know if didn't explicitly tell them, but I am not a program director nor am I privy to the how in-depth they review candidates' history.

 

[ScottTenorman54]

Wouldn't the National Student Clearinghouse show OP's full educational history?

 

[aformerstudent]

Wouldn't the National Student Clearinghouse show OP's full educational history?

Nobody really checks that dude.

 

[gyngyn]

Nobody really checks that dude.

Actually, we do.

 

[Goro]

As an aside, for every thread about the Carib where someone posts "I know a Carib grad who's now a [fill in specialty here], I will have to post one of these threads. The latter far outnumber the former.

OP, your medical career is over. Time for Plan B.

 

[aformerstudent]

Actually, we do.

But your school also doesn't look at IMG's right? Not every PD will have time to go over all those applications with a fine toothed comb. I'm just saying. I'm not advocating lying.

 

[gyngyn]

But your school also doesn't look at IMG's right? Not every PD will have time to go over all those applications with a fine toothed comb. I'm just saying. I'm not advocating lying.

My program does not consider IMG's. I am in a university that has many programs.
Certainly, the medical school routinely checks the clearinghouse.

 

[aformerstudent]

My program does not consider IMG's. I am in a university that has many programs.
Certainly, the medical school routinely checks the clearinghouse.

I heard that a PD only has a short period of time to look at each app. I think they would probably be focusing on the numbers and really digging back into educational history would not be something they would do assuming they were satisfied with the numbers.

As a side note, perhaps your program may want to consider IMG's in the future. You might be pleasantly surprised with some of the talent.

 

[gyngyn]

I heard that a PD only has a short period of time to look at each app. I think they would probably be focusing on the numbers and really digging back into educational history would not be something they would do assuming they were satisfied with the numbers.

As a side note, perhaps your program may want to consider IMG's in the future. You might be pleasantly surprised with some of the talent.

OP's educational history is exactly the type that might lead to such an inquiry at programs that are familiar with offshore students.

There is an abundance of excellent domestic applicants.

 

[aformerstudent]

There is an abundance of excellent domestic applicants.

That may be so but it's always good to have an open mind.

 

[Goro]

Where's @aProgDirector when you need him???

 

[bannie22]

I think if you have all the money, time, and are truly dedicated. Then yeah, sure keep going at it.
Your chances are slim and I think it is fair to be very concerned at this time because its not normal to be failing so many times a test that most people pass without preparing for.

 

[NotAProgDirector]

I've been watching this thread, didn't think I had much useful advice to offer. But, here goes anyway.

First, the 7 tear limit. This is an interesting and confusing issue, because there are two different issues that get tangled up. First, the ECFMG requires that your Sep 1 / 2CK / 2CS all be completed within a 7 year window. So, as the OP has pointed out, they will now need to retake Step 1 because by the time they could possibly take either Step 2 again, it will be more than 7 years old. So any new carib school that takes you is going to see this, I don't know if they are going to just allow you to take Step 1 again -- but they certainly might.

The other 7 year rule has to do with licensing authorities. Most of those want all of the steps, including Step 3, completed in 7 years. Interestingly, US grads in the same situation (long time since Step 1) have a bigger problem -- you can only retake a step once someone outside of the USMLE says so. The OP will have the ECFMG request the retake. A US grad need to actually match into a program, and then ultimately have the state board of medicine require the retake, so you can imagine that residency programs aren't keen on taking someone who, in the future, needs to retake Step 1. But this is not the case for the OP, so let's move on.

Assuming that another carib school will take the OP, and assuming that they then go on to pass the USMLE, what are their chances of getting a residency spot? It's hard to say. "Not good" is a fair assessment, but it really depends. If the OP were to do very well on their retakes, they could then present the story that they were young / inexperienced / not ready for medical school, then matured, and now is performing at their "real" performance level. Some programs might consider such a candidate. If the OP barely passes, or fails yet more steps, then it just looks like they have poor performance. Getting back into medical school would also give them more clinical experience.

As far as quitting and coming back to college in he US, and then trying for medical school again, that seems like a long shot. As mentioned, many US schools may not consider you if you've already been in medical school once. Residency PD's will definitely not look deeply into your past -- we'll believe what you put in your application. But medical schools probably will. And, if you were to actually somehow to get into medical school in the US and then omit this other school you attended previously, and it was discovered, you'd probably be fired for fraud. There's no hiding it in any case -- your USMLE transcript will clearly show that you were in medical school in 2011.

So, continuing is high risk. If your parents are footing the bill, then perhaps there's little risk to you. But, my (limited) experience is that parents are often willing to support their children, up to a point. You should discuss this with them, make sure they know how risky proceeding is. Worst case scenario is that you proceed with another medical school (if you can find one to take you), fail out again, and your parents cut you off to further funding of your education -- then you have nothing, no college degree, no MD. Instead, perhaps the best option is to stop the path towards an MD, come back to the US for an undergrad degree, and then see where that leads you -- MD or elsewhere. At least then you have options.

 

[pharmadentist]

This is a situation I sympathize with. You walked the walk to try and become a physician - that is respectable. But issues came up - that is the game of life. I will try to offer what advice I can, but before that, go and give your parents a hug. They are really doing what no-one else would, sticking with you both personally and financially even in trying times like this. I give my input with the assumption that you'll be able to put down probably thousands of dollars to push through this conundrum which you are in.

I believe that it is risky and quite frankly, dumb, just to give up on the MD degree you have spent your last few years going for, to start from basically scratch on an undergrad degree. On that note though, you need to understand that even getting a residency at this point in the US, is going to be an uphill battle. I personally believe that in the game of numbers, its not realistic to think about a getting a residency at this point. Sure you can try, but going forward in the short term, it doesn't seem likely.

However, I think you NEED to salvage the MD degree. Somehow, you need to push through that. I would recommend looking at institutions like USAT/IUHS/Oceania. These are distance learning programs, granted, but have a history of taking Medical Professionals wanted to switch into becoming a Physician, and I also think there are students who have transferred from bigger Carib schools - just due to cost or family obligations. I would recommend IUHS or USAT just for the sake of cost.

I say this not with the intention that you are going to get a residency. It is unlikely at this point. But that you salvage an MD degree. In regards to USMLE's, I'd recommend something like this:

PASSING SCORE GUARANTEE

Where at least you can get a "guaranteed" pass.

Once you're on track to pass Medical School, I think the main thing is definitely apply for residency spots, but also look at other opportunities, and also being aware that getting a residency will be very, very difficult. Specifically, a Coding bootcamp, for example, could be an option. These programs are a few weeks and quite expensive, but basically get you into the Tech industry due to strong skills built and if you choose the right one, strong connections with industry. Basically, these programs make you a professional and job-ready programmer in a matter of weeks.

I think this could be a "substitute", for residency training, at least initially. With an MD degree under your belt, I'm sure Health/Medical IT companies, which seem to be really wanting talent (to an extent with people who don't have anything close to these skills are being hired), would really value you. This could be the first step into a career.

From that point, 2-3-4 years in, you can rebuild yourself, your confidence, your career, etc, and maybe try for a residency again in a related field. Or if not, they're always opportunities to be found in Informatics, and I think you can do really well. These industries are happy getting people straight out of bootcamps with no degrees, so with an MD, I think the potential is great.

@aProgDirector above, has a very realistic view on things, and very truthfully says (and I quote):

"If your parents are footing the bill, then perhaps there's little risk to you. But, my (limited) experience is that parents are often willing to support their children, up to a point. You should discuss this with them, make sure they know how risky proceeding is."

I agree fully; Your parents may not be willing to continue financing you forever. You need to show them a real course of action, and let them know I guess, that spending money of things like a new Medical school, USMLE prep courses, and coding bootcamps, will be costs they will need to pay if you go down that route, but that have tangible benefits at the end.

So I wish you the best, and I hope you can make it through. Once again, I commend your effort, and hope that in a few years, you can look back to all of this with a fulfilling career, knowing it ended up working out.

 

[bedevilled ben]

Once you're on track to pass Medical School, I think the main thing is definitely apply for residency spots, but also look at other opportunities, and also being aware that getting a residency will be very, very difficult. Specifically, a Coding bootcamp, for example, could be an option. These programs are a few weeks and quite expensive, but basically get you into the Tech industry due to strong skills built and if you choose the right one, strong connections with industry. Basically, these programs make you a professional and job-ready programmer in a matter of weeks.

I think this could be a "substitute", for residency training, at least initially. With an MD degree under your belt, I'm sure Health/Medical IT companies, which seem to be really wanting talent (to an extent with people who don't have anything close to these skills are being hired), would really value you. This could be the first step into a career.

From that point, 2-3-4 years in, you can rebuild yourself, your confidence, your career, etc, and maybe try for a residency again in a related field. Or if not, they're always opportunities to be found in Informatics, and I think you can do really well. These industries are happy getting people straight out of bootcamps with no degrees, so with an MD, I think the potential is great.

I don't share your optimism. An MD degree from a US school, with a technical or business degree background is one thing. You could probably leverage that into a lucrative job in the healthcare industry without completing a residency. But an off-shore MD obtained over a decade with a questionable track record, and no other marketable skills, or even an undergraduate degree, and no connections to industry? Opportunities for that, at least in the US and Canada, are going to be thin on the ground. Especially since OP hasn't exactly shown a history of being proactive and aggressive. That reputation needs to be rebuilt from the ground up, IMHO.

 

[pharmadentist]

I don't share your optimism. An MD degree from a US school, with a technical or business degree background is one thing. You could probably leverage that into a lucrative job in the healthcare industry without completing a residency. But an off-shore MD obtained over a decade with a questionable track record, and no other marketable skills, or even an undergraduate degree, and no connections to industry? Opportunities for that, at least in the US and Canada, are going to be thin on the ground. Especially since OP hasn't exactly shown a history of being proactive and aggressive. That reputation needs to be rebuilt from the ground up, IMHO.

That has elements of truth to it as well. These fast-track coding bootcamps (at least the high end/reputable ones) do have connections with industry though (generally pretty strong ones). The thing is, doing one of those bootcamps can in and of itself get you a good job, and so the MD would just look good on a resume for perhaps applying to Health IT or Health related software positions. I worked in that industry (IT and Health Informatics) myself, so I know first-hand that there is potential.

Starting all over with an undergrad degree, for example, really throws away years of the OP's life. I mean he said 2006! That was 11 years ago! I think he just needs to finish up. Yes, I agree the opportunities and the degree itself will probably be useless, but with a supplement like a bootcamp - it can probably be more marketable.

I understand your opinion though. I would've said the same thing, the only thing that makes me hold my optimism is the fact that having worked in that industry, I saw first-hand that is a dearth of skilled professionals. So much so, a simple 3-4 month bootcamp, can really get you far. My unit in particular seemed to be rather aggressively hiring, so much so that we hired a guy with a Music degree I believe who only had an interest and was willing to learn. So there are opportunities, and the MD behind your name can only help I feel. Sure its an off-shore MD, but the stigma attached with that is a little less in the Tech industry since those guys aren't so familiar IMO with medical education in general. Sure, not having a residency will ring a bell, but there are ways to off-shoot that.

Anyways thanks for the input. Your opinion is very valid and the OP needs to consider it.

 

[ThoracicGuy]

<snip>
However, I think you NEED to salvage the MD degree. Somehow, you need to push through that. I would recommend looking at institutions like USAT/IUHS/Oceania. These are distance learning programs, granted, but have a history of taking Medical Professionals wanted to switch into becoming a Physician, and I also think there are students who have transferred from bigger Carib schools - just due to cost or family obligations. I would recommend IUHS or USAT just for the sake of cost.

I say this not with the intention that you are going to get a residency. It is unlikely at this point. But that you salvage an MD degree. In regards to USMLE's, I'd recommend something like this:

<snip>

Distance learning programs are a poor substitute for a medical school and will give you trouble even having a chance at residency. If the OP goes that route, ANY hope at a residency is gone.

 

[pharmadentist]

Distance learning programs are a poor substitute for a medical school and will give you trouble even having a chance at residency. If the OP goes that route, ANY hope at a residency is gone.

Well, I'd disagree at the notion of not having a chance at residency. People who graduate, do get residencies, so one can't really make the judgement. Is it harder? Yes. Impossible? Not so based on people who've done it.

Is it a very, very, very risky decision? Yes. As of now I am not going around suggesting it, IF, you want to be a practicing Physician.

If you read my post though, I did not speak of the OP getting a residency as the feasible plan of option. At the bottom of my post you quoted, it states:


"I say this not with the intention that you are going to get a residency. It is unlikely at this point. But that you salvage an MD degree."

Thanks for the input nonetheless.

 

[ThoracicGuy]

Well, I'd disagree at the notion of not having a chance at residency. People who graduate, do get residencies, so one can't really make the judgement. Is it harder? Yes. Impossible? Not so based on people who've done it.

If you read my post though, I did not speak of the OP getting a residency as the feasible plan of option. At the bottom of my post you quoted, it states:


"I say this not with the intention that you are going to get a residency. It is unlikely at this point. But that you salvage an MD degree."

Thanks for the input nonetheless.

An MD degree from a distance learning 'school' won't really give him any benefit either. It will just drain his bank account more.

 

[pharmadentist]

An MD degree from a distance learning 'school' won't really give him any benefit either. It will just drain his bank account more.

Fair enough. But I mean the OP has spent like 11 years in this process. Just getting the MD may be good at least psychologically. Starting over with an undergrad degree may not fare any better unless the degree is in CompSci or something. But that'll also have a cost.

I think a career change needs to be considered for OP (i.e. an MPH, Coding Bootcamp, Masters in Biology/Teaching/Education), but I don't thinking dropping the MD at this point does anyone any good.