Caribbean Student Navigates Through Rough Waters to the Match
- Step 1 : 212 (first attempt)
- Step 2 CK : 233 (fist attempt)
- Step 2 CS : Pass (second attempt)
- Gap since Graduation: <1 year
- US IMG (Caribbean Medical School Grad)
- First attempt at the match
Here’s the success story a US IMG who had to overcame struggles during his clinical years and a failure on the CS exam and went on to match in Internal Medicine!
Dr. Barone,
Thank you for providing a venue to share my story. I hope it can help present and future medical students that encounter my situation in their individual journey’s to obtain a MATCH!
When I learned that I matched on Monday, my family and I were over the moon!!! Still processing those emotions as we speak. I had fought through so much the last few months that this was a particularly special moment for us.
My story focuses on the latter half of medical school in clinical clerkships to the finish line. I’m a US IMG who recently graduated from a Caribbean medical school. Naturally, we have to jump through many more hoops with additional NBME comprehensive examinations and medical school eligibility criteria before we are able to sit for the USMLE exams. They tell us at the very beginning of medical school that failing a USMLE exam of any sort would be an absolute nightmare because it would drop our chances of matching into residency to 50%. This is something we spend the next four years of medical school avoiding at all costs. Another thing we know as IMGs, is that should we fail an NBME shelf exam during clinical rotations or a USMLE exam it would set our timeline back for finishing medical school and entering the residency match because we have to go through a whole re-registration process with ECFMG, get the scheduling permit, study again, etc.
I got my core rotation schedule for MS3 after passing Step 1 and was so excited to begin. My first rotation was OB-GYN which went by without a hitch, including the shelf exam. But the next three months turned out to be the roughest I had encountered in medical school. While I had learned that I had gotten “A’s” in the rotations from my clinical preceptors, I had failed the next three NBME shelf exams in a row. (Immediately, I started to think, what does this mean for CK, what implications does this have for me on residency applications, will the programs see it and disregard my application?)
For most offshore medical schools at least ¾ of the rotation grade is from your clinical preceptor and ¼ of the rotation grade is from the shelf. I was going to have to retake these shelf exams and if I failed one more shelf exam I would have to sit out of medical school for several extra months and retake the exams the before my medical school would let me start MS4 electives. This instilled a lot of fear in me, because I had charted a meticulous path to the 2018 match.
I was also very scared because I was going into one of the notoriously difficult rotations at my hospital, Surgery. Not to mention, the comprehensive clinical science exam and Step 2 CK were looming on the horizon. Despite all of this, I had to find a way to remain focused.
How in the world was I going to deal with the immense stress of the demanding schedule of a surgery rotation and try and find out what was going wrong in my shelf preparation? I couldn’t afford to fail another shelf. The preceptor for this rotation was on our tail on a weekly basis about the importance of reading and shelf preparation AND he wanted us to log substantial time in the operating room. I was the type of person that always planned my studies ahead between rotations, when one ended and before the next one began. I talked it over extensively with my parents. I was stuck in a rut and I didn’t know how to fix it myself. So, I found a reputable tutoring company for medical students and I started with one-on-one tutoring a couple of hours a week for the next 7 months, it concluded just before I took Step 2 CK.
This tutoring gave me the answer that I needed. In medical school, there are two types of studiers/test takers. Accepting this dichotomy is the first step to fixating on your own goal and working towards it. You are either a great studier/mediocre test taker or a not-so-great studier/exceptional test taker. Some of us fall into the former category including myself. My tutor and I worked together for 7 months and early on he noticed that I was reading the clinical vignettes too fast and missing key facts in the question stem that lead me to choosing the right answer. When we went over the question I had the knowledge base, but I missed information that would have otherwise led me to select the correct answer. So, I started highlighting only key facts in the clinical vignettes on a more regular basis and low and behold, my performance started to get consistently better. This may seem like something trivial, but it had held me back on 3 shelf exams.
Good news! I aced my Surgery and IM shelves, retook the 3 shelf exams which I had missed and passed them with flying colors, and went on to improve my Step 2 CK score 21 points from Step 1! This was where I took my first deep sigh of relief. Despite everything going on, I stayed focused. I made my new timeline work for me and achieved this result. I knew I wanted internal medicine residency and I had to break into the 230s on Step 2 CK to become eligible for it and I nearly cried when I saw my score the morning it was released!
But this wasn’t the last obstacle I had to face. As I progressed into MS4, Step 2 CS was next. I had mixed feelings about this exam. Some of my friends told me that this exam was a piece of cake and they passed it with little preparation and others said do not take it for granted. I ended up preparing intensively for a month with a study partner, simulating practice cases from the first aid book. I went ahead and took the exam, things felt fine on the exam day. On the day the score report came out, my heart sank to the floor. I had failed. I had become that statistic my medical school told us to fear at the very beginning. Immediately my mind started racing to all the consequences. Everything in medical school that I had so carefully built, had it come crashing down with the failure on this exam? I went back to drawing board examining everything I did the first time, talked to my medical school, my parents, and finally decided on taking an intensive 1 week prep course that could tell me exactly where I went wrong. Again, low and behold, the second time I came out successful (a few months of preparation later)!
I am telling you right now, one failure, it is possible to come back from it and come back strong and obtain that MATCH! YOU HAVE TO BE FOCUSED. I did it, some close friends of mine did it, and if you find yourself in this situation, YOU CAN TOO. We all matched and YOU. CAN. TOO. Our match timelines did NOT change. We stayed strong and WE. DID. IT!!
(As an aside, I ended up getting 14 interviews: 8 categorical IM, 3 categorical FM, 1 categorical Med-Peds, 2 pre-match IM.)
Never give up on this dream of becoming of physician. Don’t let any poor exam performance deter you. Things happen, its ok, we are human. These things are fixable. You started this journey and nothing should get in the way of you finishing it! Best wishes.
- Y. R. 3/14/18
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Thanks