Plan B: past MD degree, starting PA school?

[whyster]

Hello people, 

 

I am writing for suggestions and counsel on a Plan B about a career in healthcare. 

 

11 years ago I finished medical school. I passed USMLE Step 1 after 4 tries, but could not pass the USMLE Step 2 after six tries, which was this past May.  Now they have made changes in which no one will be allowed past the 6th try.  In other words, I have shut myself out of the MD career field. 

 

I wonder if any forum members are in this situation or anyone knows of others that have gone through this and successfully finished and obtained a work as a PA? 

 

I have gone through the various phases of depression, self flagellation and regrets, and see a no way out of the mountain of student loan debt. 

 

Any pointers would GREATLY be appreciated. 

[TangoDown]

Just out of curiosity, unless it's too personal, was there an extraordinary circumstance(s) that caused you to fail the STEPs so many times?

[wjm7]

I unfortunately have no idea how all of this works, but could you potentially look into practicing abroad?  I'm sure licensing laws vary somewhat.

[primadonna22274]

Your multiple step failures are a flashing red light. PANCE is very much like step 2 (much more similar than step 1). The vast majority of physicians pass all 3 steps on the first try. Statistically, if you can't pass the second time, your chances of passing at all are bleak. Unfortunately you've witnessed this first-hand.

I'm not optimistic about your chances for PA with those step failures. Gotta be honest, as someone who has done both PA and med school, you MUST be able to pass the tests. It's the nature of the beast.

Are there other careers in the helping professions that interest you? Explore them.

Best wishes.

[whyster]

No overt reasons such as family emergency, health reason. 

On most tries, I have come close to passing.  Time management issues during test. 

I know applying for PA schools, I'll have to come face to face w this issue. 

 

I know some PA schools will not allow for other professional degrees. 

[primadonna22274]

If there is anything i learned in med school it's how to take a test with time to spare. You really gotta step that up.

[bradtPA]

 

I know some PA schools will not allow for other professional degrees.

 

They will not care about your professional degree as much as they will care about the reason for your failure to complete your training. There are plenty of foreign medical grads that have been accepted to PA programs.

 

Your other problem is your prerequisites are too old for many schools by now; you may have to retake a lot of science courses just to be eligible to apply for something that IMHO you will have a low chance of getting accepted into.

[TangoDown]

Maybe you'd have better luck with an NP program?  Could do a direct entry program, though you'd probably need to take at least a year of nursing prereqs to be eligible.  Still, probably easier to get into an NP program, depending on which it is.  Cold call a couple of programs without mentioning your specific info and ask.

 

Job hunting in your situation might be a different story, and I think ALL NP programs are moving to doctorate in a year so the additional cost might not be worth it considering your already exuberant debt load.

[ventana]

Honestly if you are running out of time in the test and this is the reason for failing. Go get tested for a learning disability! Maybe you have a processing delay that is sig? Not sure it will help in any way though

 

How about law school? Practicing atty with an MD is good

 

Also look at working for an insurance company as a claim reviewer or senior case/claim adjuster

 

Honestly skip PA school, to many struggles

[primadonna22274]

I thought of LD too (at the very least should have been tested and if appropriate received extra time for tests) but the horse is so far out of the barn now it's in the next town over.

 

[Febrifuge]

Hey, it's never too late. I had ADHD for about 25 to 30 years before nearly failing Pharmacology II was the event that prompted my school to refer me to tutors, coaches, and eventually a psychiatrist who got me diagnosed, treated, and then magically 20 points higher on every test from then on.

 

Sometimes I think of how close I was to washing out, and how easily I might have gone to a less supportive program, or decided to be more stubborn and less accepting of help. In fact, I used to look at the MD students' workload and dream about being one of them instead... but I bet my adaptive tactics would have failed at USMLE time for sure. I feel for this guy, and definitely echo the advice to get tested already.

[KMD16]

Sounded like you attended one of many carribean school & cheated your way through school & now you're paying for it. Not buying your story. Simply cross out medicine as a career.

[EMEDPA]

hate to mention this to you but PA school exams and boards are a lot like usmle step 2 and 3 with almost NOTHING from step 1.....

[cinntsp]

No overt reasons such as family emergency, health reason. 

On most tries, I have come close to passing.  Time management issues during test. 

I know applying for PA schools, I'll have to come face to face w this issue. 

 

I know some PA schools will not allow for other professional degrees. 

 

Sorry, but it is very unlikely you would pass the PANCE.  I think most schools will realize this if you apply.

[Timon]

Pacemaker Tech makes $95k starting in California & the training is cheap and fast. Just throwing that out there.

 

Any way to get into research, pharmaceuticals, or biotech / legal / policy / consulting?

 

I'd definitely would consider the advice given above as well.

[ventana]

The only wiggle room I can see is if you fall under ADA protection......   then and only then might you be able to somehow use it to your advantage

 

 

as for the $$$ side

 

if you are trying to pay of med school and PA school loans on PA income, you will be broke for the rest of your life.....

 

Honestly go into medical business or maybe hospital Admin (go get a part time MBA) and then you can run the show....

 

The BEST instructor I had in PA school was an MD who grad med school, did research and never did even an intern year.  He was amazing and I was lucky to have him as and instructor.  You still have the MD degree, you just need to figure out how to use it.

[SocialMedicine]

I would use the MD degree in a different capacity. healthcare consulting ? pharmaceutical industry ? hospital mgmt. ?  you can spin it where nobody knows you could not pass the STEP, rather sought to help patients in a different way. I would imagine PA school will be just as much a challenge. Some of the easier to get into/newer schools are experiencing high fail rates food for thought.

[Guest Paula]

How does someone graduate from medical school and not pass Step 2?  Are all USMLE tests done after you graduate and taken during residency?

 

I'm confused.

[EMEDPA]

step 1 is done after ms 1

step 2 is either done after ms4 or as an intern. step 3 is done as an intern or as a pgy-2.

[primadonna22274]

How does someone graduate from medical school and not pass Step 2? Are all USMLE tests done after you graduate and taken during residency?

 

I'm confused.

My school would not graduate someone who hadn't passed both steps 1 and 2. In fact, my school would have dismissed the student who couldn't pass either step by the third attempt. It's specifically stated in the student handbook that successful completion of both COMLEX Level 1 and 2 (both parts, a clinical knowledge portion and physical exam portion) are required for graduation.

I suppose it's possible that there is an MD school that doesn't have such a strict requirement but it seems unlikely to me as well.

Step 3 USMLE/Level 3 COMLEX are taken after graduation and before the middle of 2nd year residency. A postgrad program can dismiss a resident who is unable to pass step 3 within a specified time frame.

I didn't mention earlier that I hardly studied for level 2. I did a few hundred practice questions and took a practice exam and did well on all my shelf exams. I smacked that exam with a 98th percentile (whoa...) and I'm absolutely confident that I owe that success to more than a decade of making medical decisions as a PA. In fact, I am sure that any PA who passed PANCE/PANRE could pass step 2 (definitely for USMLE step 2, minus the osteopathic portion of COMLEX level 2 because they haven't learned it) by a comfortable margin. The exams are very similar. Taking a couple hundred exams over 30 months of med school and the extra 15% I learned in med school and rotations added a few hundred points to my score. (Note I didn't say step 1 as that exam is totally unlike PANCE/PANRE. No way could I pass that exam without M1. PAs don't learn that level of minutiae nor do they need to.)

[KMD16]

step 1 is done after ms 1

step 2 is either done after ms4 or as an intern. step 3 is done as an intern or as a pgy-2.

E! Step 1 done after basic science & step 2 done ms3 before ms 4 not after.

[Guest Paula]

Gee, wish I could take step 2 just to see if I pass and then start a residency!!!!   Do physicians need MS1 minutia?

[EMEDPA]

E! Step 1 done after basic science & step 2 done ms3 before ms 4 not after.

Same at DO programs?

Thought was different(?).

[primadonna22274]

Step 1/Level 1 is taken at the end of M2 for both MD & DO programs. Some of us osteopathic students take both USMLE and COMLEX. For DO students, COMLEX is mandatory and USMLE may offer an edge to programs who don't know how to interpret a COMLEX score. For me, it would have been better if I hadn't taken USMLE as it was slightly below average whereas my COMLEX 1 was nearly 2 SD above median. I did take the USMLE with a very and cold lol but also it's a different exam.

Step 2/Level 2 is taken somewhere late in M3 or at least by mid-M4, after passing all the core rotations and NBME shelf exams (OB, peds, FM, IM, psych, surgery. It's not required for residency apps but a strong score may help as it demonstrates clinical knowledge and understanding of management. Much less minutiae.

Now to the poster who asked if physicians NEED M1 minutiae: YES. At least once in a while. You may not care that there are several different varieties of inherited von Willebrand's disease--all you really care about is that the platelets don't work well--but it's useful to know that the mechanism is different from inherited and acquired vWF disease. Etc etc ad infinitum.

My contention is that SOMEONE on the team needs to know the minutiae and it better be the physician. Of course we will never know it as well as the PhD scientists and some docs will need to know a lot MORE minutiae--especially medicine subspecialists. We all have to learn it because we don't know what we want to do yet (most of us). Minutiae is certainly trimmed from some accelerated programs (for instance the LECOM Primary Scholars Program accelerates didactic so they wrap up M2 in Feb to start rotations in March. We didn't have a shorter didactic for APAP but trimmed some clinical rotations (electives). Unfortunately we still have to do all the core rotations which we already did in PA school for we PAs there is a lot of redundancy. I was able to set up "specialty" electives in core slots e.g. Nephro, Geriatric inpatient and Hospice/Palliative med for IM; Geriatric psychiatry instead of general psych; another hospice for my sub-I; an extra inpatient month for FM; etc. so we had some flexibility in scheduling rotations in our areas of interest.

 

[KMD16]

^^ agreed. USMLE step 2 are usually not required for residency application. Can't speak much of DO program steps.