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* Failed USMLE Step-1
  indianimg1991 - 03/13/19 09:14
  I am an old IMG. I finished my MBBS in 2017. I have done a few electives, so I have some USCE and 3 LORs. Although, before going for the electives, I made the mistake of taking USMLE Step 1 and I didn't plan it properly. This meant that I took the exam when I was short of time and I hadn't prepared well enough. I gave it 6 months of irregular studying and not a lot of NBMEs. I know my mistakes and I know how I can improve on them.
Over the course of the last two years, I have involved myself in a lot of extra curricular social work.
My question is, if I take the Step 1 again, and I get an average score through out, what would my chances be of matching in a fairly low competition residency like Family Medicine? Also, are there chances of me matching into Internal Medicine? I know that is a little far fetched, but one can always hope. Or should I give up on USMLE altogether?
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* Re:Failed USMLE Step-1
  wishyouluck - 03/13/19 11:29
  You have not mentioned anything about your plan for Step 2. Note that you will also need Step 2 CK and Step 2 CS both if you need to match in US as an IMG.

Now, let's try to answer your question based on my understanding and following assumptions when you apply for a match:

Step 1 (2nd attempt) = average
Step 2 CK (1st attempt) = average
Step 2 CS (1st attempt) = pass
YOG This further damages your chance because Carib graduates will be favored more even if they have slightly lower stats than you.

I assume you need visa? -> I hope you don't need visa otherwise, your chances are very very low.

Now, USCE --> How much USCE do you really have? If it is just a few months since your graduation in 2017, it is not much. Something is better than nothing but there will be plenty of Carib graduates/US IMGS with ALL their rotations in US and they will be ahead of you (with everything else about you is average)

Social work/Volunteering --> This is good to have but you have to justify where have you spent each month since your graduation in 2017? That is 3 years. Can you prove that you have something meaningful during this time and it will result in you being a stronger physician? If there are loopholes here and nothing concrete then your chances take a hit for sure.

LORs --> Have to make sure those LORs are STRONG. There is a difference between "I think he will make a good physician" vs "I have absolutely no doubt that he will make an excellent physician and will add tremendous value to your program"

HERE is what I think:
Someone with multiple step 1 attempts + with older degree + from India WILL need better than avg step 1 scores on 2nd attempt. WILL also need impressive step 2 scores (1st attempts)
. WILL need all other aspects of the CV SOLID!. WILL need strong LORs. WILL need impressive interview skills.

IF you can have all that, then you still have a less than 30% chance to match in a LOW end COMMUNITY program in FM/IM. Basically you have ALOT more chances of not matching than matching.

Of course, you will have to apply to over 300 programs. This will cost you in excess of $10K just in applications.

You have to ask yourself, are you willing to do all this and can quickly recover financially/mentally if you do not make it.
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* Re:Failed USMLE Step-1
  indianimg1991 - 03/15/19 08:14
  Thank you so much for taking the time out and posting such a detailed answer.
Responding to your questions, I would say after giving my Step 1 I was a little anxious and scared and refrained from taking any more step exams. I was a little sceptical about my ability to score well, and was also scared about how bad even more attempts would look on my CV. I feel fairly confident in my ability now, and I think I can get a slightly above average score in the remaining steps. I won't go so far as saying I am going ace all of them, but I would like to think that I won't fail at the very least.
About the Visa, I'd say I don't have one yet. I have a 10 year multiple entry visitor/ business visa, but that's about it and I am guessing that wasn't what you were hinting at.
Regarding USCE, I had done three electives in Emergency Medicine, Cardiology and Radiology. Please note that this was before I gave my Step 1 and I was grossly underestimating how badly I would do on it. But I would say I have pretty solid LORs from all three regardless.
You're right, ultimately I have to decide how much of a risk I am willing to take, both financially and mentally. I feel like I would be better suited if I did a residency here in India first, and finished the remaining steps in the meantime. That way I'll have a few more publications and a lot more clinical experience on my hand. Do you think that's a good idea?
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* Re:Failed USMLE Step-1
  zhangji - 03/15/19 09:47

a quick question: I am currently using Kaplan lecture notes videos of 2008 and I used Kaplan lecture notes book of 2018 in my preparation because I can not buy Kaplan lecture notes videos current version alone (Kaplan does not sell videos alone).

do you think that is ok or do you have any suggestion?


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* Re:Failed USMLE Step-1
  roxysandy - 03/17/19 14:06
  i think @wishuluck is honest and clear.
Now it is upto you, whether you wish to go for your dream or not?
sometimes looking at result - is a way of "escape"?
who would you rather be?
someone who didn't even attempt whole heartedly and will rather sulk whole of your life?
or someone who tries, gives in your best, irrespective of the outcome, i.e - getting matched or not.

it is upto you?

every journey is unique and you need to find your way by yourself.
Start by keeping the expectations very low, and do what is necessary - just prepare wholeheartedly.

if you start, the journey will take you somewhere.

USMLE Preparation will never go to waste. this will help you for other exams as well. only formats change, liver remains liver, bronchitis stays bronchitis.

best wishes,, n dont give up. you are still so young. 2017 isn't that old.
prepare, pass step 1 with good marks, then get onto some publications, build up your CV.
But no expectations. but even if there is 5% chance of matching, go for it, try. but try your best.

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