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Road to Residency

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All Paths Lead to Medicine: A Story of Resilience

I once read a quote by Robert Jordan, a novelist who fought against Multiple Myeloma. He said, “Nobody walks a difficult path without stumbling now and again. It didn’t break you when you fell. That’s the important part.” For a struggling medical student, these words speak volumes. As we began planning the structure of this year’s Residency Guide, I began to think about how many of us medical students have stumbled through medical school simply to get from one obstacle to the next.  Many of us began this path because we have a passion for medicine, community, and leadership. During our journey, we have faced obstacles that at times seem bigger than what we believe we can overcome. As we set out on the path of applying to residency, there are many frightening possibilities that are not openly discussed until they actually happen to us. However, as a part of the larger LMSA family, we have the opportunity of meeting individuals who have successfully overcome these seemingly impossible obstacles. There is much strength in our backgrounds, identities, and experiences that we often overlook.

We had the honor of meeting one of the champions who has successfully faced and overcame these mountains and subsequently has gone on to continue making a difference in our communities. In the following essay, you will find the experience of an LMSA community member who went through the SOAP process, reapplied, and successfully matched. We hope this essay encourages you to enter this residency application cycle with a brave heart and a strong mind. No matter how difficult this obstacle may seem, we must remain hopeful in our experiences, motivations, capabilities, and most importantly, to never count ourselves out.

 

[Start Interview]

 

Thank you for being willing  to share your story with us! We know how valuable hearing your story will be for our community.

 

We all have our own individual stories about our experiences in  medicine. Can you share with us your personal story of applying to residency? What were you most proud of in your application/ what were your strengths? What aspects were you most worried about, if any?

 

I took STEP 1 when it was still scored. I barely passed. It wasn’t because I was not prepared for it. I took assessments before sitting for the exam and I was getting scores in the 240-250s range. It did not feel good to have a low score. A lot of people in medicine will tell you not to continue because you have a low score. They told me I wouldn’t be able to match into ***specialty because my score was not competitive. “Don’t keep trying.” Personally, I’ve always wanted ***specialty and I was not prepared to settle for anything else. But that was not the only obstacle I faced. My other issue was being an IMG. I graduated from a medical school in *** that was not well known. The odds were already against me because I did not graduate from a U.S. medical school, and I would need a VISA to be able to do residency here.

 

Then, for STEP 2, the first time I sat for the exam, I failed. When I first found out about this, I was so shocked. I kept thinking, “This can’t be possible” because the last assessment I had taken a week prior to sitting was 278. I had gone into the exam thinking that the worst thing that could happen was that I would score a 250. I already had two red flags in my CV and I just couldn’t accept this. I kept thinking to myself, “This cannot be happening. The exam didn't even feel that hard.”  I left the exam thinking I did well. So I paid for them to rescore my exam, and a month later, they reached out and confirmed my failed score. By this point, my application was due soon and I needed to sit within 2 weeks if I wanted to apply to residency that cycle. I retook it and passed with a 240. I went from failing the exam, to passing the exam with a 240 with 2 weeks of studying.

 

On a personal level, when I took STEP 1, my grandpa had passed away a couple of weeks prior. That was a very difficult time for me. When I took STEP 2 CK, my aunt had passed away one week prior to me sitting for the exam. I would think how much bad luck can you have in your life? People tell you to address the red flags in your application, so when writing my personal statement, I wrote about these issues. I was not optimistic in my essay. I simply stated the facts of what happened and the reasons why I did not do well on these exams. I submitted the application and I got a few interviews, but I didn’t match. I then went on to SOAP, and again, did not match.

 

Following my first application cycle, I reread my personal statement and asked myself “Would I want to meet this person that has a sob story?” Probably not. If you get an interview, it’s because they saw something in your application that interested them, and now they would like to get to know you. Now as a resident, I understand this more. When we are ranking, people say “I remember this person…he did this and that… I remember he was very likable…I remember he was outgoing…or this is someone I would like to work with.” I am a firm believer that your STEP scores don’t determine who you are or how you’re going to do in residency. I got very good ITE scores now, but also, nothing bad is going on in my life. At the end of the day, it’s about resilience and how you deal with the obstacles.

 

When I failed my STEP 2 exam, I went back and analyzed my UWorld. I noticed that my best scores were always on Mondays. I would take Saturday and Sundays off, so my best blocks were when I was well-rested. So I scheduled my exam on a Monday. In addition, because I was going to take the exam in a different timezone, I started to wake up at 4 in the morning, eat breakfast, and start my day at 5 AM. I simulated what the exam day would be like so when the time came to sit for the exam, in my head, it was just like taking a practice exam and I felt more confident. That’s how I got a 240. The fact that I had just failed, decided to take the exam again in 2 weeks, and did well, meant something to me. So the next time I rewrote my personal statement, I wrote about something that is very personal for me. I’m fond of music. I wrote about why I liked ***specialty and how it correlates with music. The song “I will always love you” by Whitney Houston  is actually a cover from a different song. But Whitney Houston gave it a different twist, and you remember her version because of the passion with which she sang it. You would think it was written by Whitney Houston, but it wasn’t. I enjoy music, so I could correlate it to ***specialty. For some people, they can correlate their interest to something, for example, like art. If you write something that you are passionate about, that will interest someone. What I am trying to say is that it’s very important that what you write about is very personal to you. You need to catch their interest in one page. Once they give you an interview, that’s when they will ask you about the red flags.

 

They will ask you about certain parts of your application, but at this point, you already have their interest. Now that I’m a resident, no one asks about my scores. Some of my co-residents know my story, but others have told me I would have never expected you to have those scores. Standardized exams are exactly that–standardized. If you evaluate a fish on how it can climb a tree, it will fail every time. But if you evaluate it on how it can swim, it’s a different story. Same goes for people. Some are not good at taking standardized exam, but that does not mean the knowledge is not there. They may simply not be good at taking tests. There are so many factors that can affect how you take an exam. You just need to find out what your issue is. For me, it was taking it on a Monday. Fast forward to now, I got elected as Chief Resident. Who would’ve thought that this guy that came from ***, got a low STEP 1 score, failed STEP 2, had to retake STEP 2, and is now a Chief Resident at a top residency program.

 

That’s amazing! You mentioned that you applied to SOAP as well. Can you tell me about that process?

 

I did not get a single interview through the SOAP process. For SOAP, you simply don’t know what to expect going into it. When applying to SOAP, you send in all these applications everywhere to all the programs that didn’t fill up all their spots. They see your scores and the process is very technical. They get over 3000 applicants, and within 2 days, they need to make a decision of who they want for those spots. They will look at your application, find out if anyone from their program knows you, and if you rotated at their hospital or at any other nearby program. It all happens so quickly. The day those applications start coming in for SOAP, the program director will read out everyone who applied along with their scores. I don’t even think they read the personal statement. The process is a little bit harder because remember that the programs also have one day to decide who they are going to interview. If you are someone like me who needed a VISA to work in the U.S. and the program doesn’t sponsor working VISAs, I would say don’t apply.

 

How did you navigate your journey as a successful re-applicant? What did you do to strengthen your application?

 

For me, changing my personal statement was the biggest thing. Changing it from a sob story to a story that shows who I am, what my passions are, and relating those passions to how hard I work and how relentless I am. No matter what happens, I will always stick through it and work tirelessly until the end. I no longer told them a sob story. When addressing the concerns on my application, I related the story saying this is what happened and this is what I did to address the issues.

 

During my year off, I started working back home. I don’t think people here can work as physicians without residency, but I worked in an outpatient clinic with a **specialist, so I got work experience. With this, I proved to them that I could put in the work. It’s not the ideal thing to do, but I was doing something. What other people could do is research. Some people do research, start publishing, or do something that will make the program think “We want this one.” You want them to say, "Ok so after he failed, after he didn’t match, what did he do? Did he stop there? What did he do?"

 

In your opinion, is “taking a break” or “time off” bad?

 

If you need it, you need it. The main thing you need in order to do well in a program is to be well mentally. Your mental health will determine if you succeed or not. If you’re not in a good state of mind and you need to take a vacation, take a vacation. It’s not bad. Take time to do things you enjoy. It’s not all studying and working because if you don’t do the things you enjoy you will burn out before you even start.

 

Speaking of mental struggles, can you talk about how this may have affected your well-being?

 

It definitely took a toll on me. I had my episodes of depression. I had to see a psychiatrist and was started on antidepressant medications because I was not sleeping well. I kept trying to learn everything Monday through Monday, not taking days off until the point when I noticed it was taking a toll on my well-being. I told myself I couldn't keep doing this because it was affecting me and how I studied. So after I started taking medications and talking to doctors, I slowly got better. So here I am now. Everyone goes through difficult phases. I think it’s completely normal to go through that phase and feel like you don’t want to do this anymore. You begin to question things like “what am I even studying this for?” “Am I even good enough for this?” It’s impostor syndrome. But here is the thing. You already got into medical school and you are either done with medical school or going through it now. If you feel like you don’t know much, it’s ok because the more you study, the more you’ll realize there’s so much more to learn. It’s completely normal to feel bad, depressed, or sad, and it’s ok to take two days off because you’re mentally exhausted or drained. Being mentally drained is worse than physical exhaustion.

 

I've experienced that myself, so thank you for validating that. Is there anyone who academically supported you and encouraged you to continue your journey? Who did you turn to for guidance?

 

I had personal support from loved ones, but a lot of it, I had to figure out myself. But actually, yes, there is someone. There was one person who gave me the push to continue. He was a *** doctor in ***. Just like I am telling you my story now, he told me his story. He told me to not give up. He asked me the important questions. “Is this what you want to do? What can you do right now in order for you to succeed in the next Match?” While others were telling me to not apply ***specialty and to apply to ***another specialty instead because I wouldn't make it into ***specialty, he would ask me “What can you do to reach your goal?” You see so many things around you–posts on social media, and everything points to say, “Don’t even try.” This is the reason I never posted anything on social media. Most people are going to tell you no. you’re not going to make it with those scores. X, Y, or Z person tried to do it with better scores, and they still haven’t matched.

 

That’s very true. We see this everywhere! I personally know so many medical students who have struggled or are struggling with these exams. But you see them interacting with patients and you see a unique person with a passion to care for others.

 

Exactly. For me, when people were studying, I was out helping patients. They would show me their good scores and I would say “Good for you, bro! I was out helping others.” You can’t compare yourself to others. It would be like me comparing my running speed to Usain Bolt. Of course I won’t be as fast as him! I can, if I train for it, but I’m not going to train for it right now. To compare yourself to others that are studying more is the same thing. Just do your thing! Do what you think is right, and if it’s the right thing, things will turn out well in the end. You have to look for people who will stimulate you and will give you encouragement.

 

Thank you so much. You mentioned that you got into your top program. Congratulations on that by the way–that's the dream! Did you apply broadly? How did you choose the programs you ended up applying to?

 

I applied to just 27 programs. I did my research on the programs. I looked for programs that have a more holistic approach and the ones who accept VISA applicants. I did not apply to programs that would not even look at me. I also reached out to people. I reached out to programs where I did a rotation because those programs would know who I was and would be able to vouch for me. If you excel in a program where you did a Sub-I (Sub-Internship), the residents will be able to speak highly about you. As residents, we don’t know what your STEP scores are. The only people that know about the STEP scores are the Program Directors or the people doing the interviews. So after they finish interviews and application reviews, we do the ranking. They show residents pictures and ask what we think of them. We will speak up and say if we’ve worked with that applicant before. Do something to stand out for them. If you didn’t put in the effort while you were working there, that’s on you. You could be the smartest person on earth, but if we did not like your work ethic, that’s not ok and that’s on you.

 

That's really good advice! Speaking of advice, if you could give advice to anyone going through a similar situation as yours, what would you say?

 

Don't give up. That’s it. Don’t give up. I remember hearing about Michael Jordan having 6 NBA championships. But he didn’t win all the games. You remember the ones he did win, so don’t give up. If you make it, people will applaud that you made it. They don't care how many tries it took you to get there. And you should not care about how many tries it took you. If you try and it doesn’t work, try again. And if it still doesn’t work, try again, and then you analyze, “What did I do wrong that I can improve on? I did not match, so what can I do to succeed next time?” Maybe take STEP 3, maybe start working, maybe do research. You only lose when you stop trying.

 

Take someone who’s well known in the Latinx community as an example: Messi. How many world cups did Messi lose before he got one? But he didn’t give up. He tried. He sometimes said he was going to give up, but he would show up again every time. Every world cup, he came back to try again.

 

And that was such a big celebration when he won!

 

Exactly! And this can apply to everyone. The people who are successful usually try, fail, and then try again. They try in different ways until they make it. Just don’t give up. It will be worth it in the end.

 

[End Interview]

 

It's unfortunate that we are thrust into a position where our medical career is determined by one application process. It’s undoubtedly a stressful process that requires a lot of hard work, consideration, and luck. As we consider the possibilities that can occur during this life changing time, never forget that your career is but one part of who you are as a whole. As the old adage goes, "All paths lead to Rome;" in our case, we can say "All paths lead to medicine."  We wish everyone the best of luck as they embark on this journey to residency. We believe in you and we are so proud to be a part of this community! Si se puede!

 

***Information redacted for anonymity

Special thanks to our resident interviewee. Thank you for your time and for sharing your experiences with our LMSA community. It was an honor for us to share your resilient, encouraging, and inspirational story.

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Thank you to our Gold Sponsor

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Ilia Blas Mendez

VP of Publication

Michigan State University College of Human Medicine

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Thao Le

Co-Author

Michigan State University College of Human Medicine 

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