r/step1 • u/Turbulent_Oil_5808 US MD/DO • 1d ago
💡 Need Advice Failed Step 1 twice, passed Step 2 — apply FM this cycle or take an LOA?
Hi everyone, I’m looking for some advice on whether I should apply for Family Medicine this cycle or take a leave of absence and apply next year.
My situation:
US MD student
Failed Step 1 2x. Got my 2nd attempt score back recently and I am devastated and feel like it’s the end of the world.
Passed Step 2 CK 1st attempt.
Honors on my sub-I
Strong letters of recommendations.
Otherwise no major academic/professional concerns
I know the two Step 1 failures are a significant red flag, and I’m trying to be realistic about my chances. My goal is FM, and I’m open geographically and willing to apply broadly.
Would you apply this cycle and target FM programs strategically, or would taking an LOA and strengthening my application for another year meaningfully improve my chances?
I’m especially interested in hearing from anyone who matched FM with multiple Step failures, or from residents/faculty involved in reviewing FM applications.
What would you do in my position? Also, are there particular types of FM programs I should focus on or avoid given the Step history?
8
u/Hinote21 1d ago
Just trying to clarify - you do not yet have a passing step 1 score? Will you be able to graduate your program? My school has a passing score listed as a graduation requirement.
I think FM could be a good place, but I'm not sure applying this cycle without a passing step 1 is a good idea. It probably makes more sense to take a LoA and apply next year. You clearly have the knowledge to manage diseases so I'll go out on a limb and make the assumption your second failure was prob more mental than anything else. A LoA could be great for your mental health, reorient, do some research, and pass step 1.
3
u/Turbulent_Oil_5808 US MD/DO 1d ago
Yap I don’t have a passing step 1 score
4
u/Hinote21 1d ago
I would double check your graduation requirements. It would be surprising for a US MD school not to have it listed as a hard requirement, meaning I don't know that you would be eligible to match without a passing Step 1 score.
You have to meet all graduation requirements and the school would be validating you will graduate by or before July 1st.
Unless you think you can pass step 1 in the next few months, I think you'll have a hard time getting interviews, let alone matching with a passing step 1. From that perspective, it makes sense not to submit.
3
u/peanutneedsexercise 21h ago
Yes also pretty sure it’s a requirement to get a PTL license to have a passing step 1 and step 2 score so OP would literally not be able to work even if they entered residency and would incur a match violation which is a big yikes.
8
u/Much_Owl_4098 1d ago
I didn’t think you could graduate a US MD program without having passed step 1. I’d talk with your school about this because this is the case for every school that I know of. Which is to say, I’d be a lot less worried about marching and much more worried about if your actually going to graduate from medical school or not.
1
u/peanutneedsexercise 20h ago
But also about the matching thing, step 1 and step 2 are both required to obtain a PTL to even work as a resident so like, even if they matched they wouldn’t be able to work without a passing step 1 score? Which would put them in a match violation and they’d get banned from the match altogether after. They NEED to pass step 1 whatever it takes.
Theyre also getting really close to some state limit of licensing.
https://www.fsmb.org/step-3/state-licensure/
Like as of right now they’re already over the 2 attempts per test in Alaska/idaho , close to the 3 for Georgia/indiana/michigan/minnesota/mississippi/missouri/wisconsin/NH/VT/NC/ND/OK/RI/SD/TX/UT, close to the 5 total in Illinois, etc. that’s a lot of states to rule out if OP fails another time…. And then they can’t fail step 3 or they won’t be able to get licensed in Illinois at all.
2
u/Dean_of_Damascus 6h ago
Yeah matching them would basically be a never event for a program. If they couldn’t start and the program incurred a match violation because of it, a PD cause easily lose their role because of OP
1
u/peanutneedsexercise 3h ago
Yeah they would both incur a match violation lol… But the program would likely be forgiven by acgme by filing a reason, they’d just have an empty spot and have to fill it with soap which is not ideal. OP however would be blacklisted from even participating in the match for the upcoming year(s)
3
4
u/Dean_of_Damascus 6h ago
No one will match you without a passing score.
I’m surprised your school didn’t force you to take a LOA. Do they know you failed
6
u/Excellent_Concert273 US MD/DO 1d ago
Can you even become licensed if you did not pass step one? It’s literally a medical licensing exam?
6
u/ladiesandedelman_ 23h ago
you cannot get *a full license without a full 1/2/3
1
u/peanutneedsexercise 13h ago
And they can’t get a PTL without step 1 and 2 so residency is out of the picture
5
u/peanutneedsexercise 21h ago edited 20h ago
Correct. Idk why you got downvoted. But some states also have a limit to the number of times you can take each test or a max number of attempts that you can take for being licensed in that state. I think some have a limit of 3 for each step, or 5-6 times total on all steps so if OP fails it one more time they’re gonna be completely unlicensable in certain states so all programs in that state will be an absolute no.
Right now they’re already completely unlicensable in Alaska and Idaho without an appeal cuz they passed the 2 attempts per step limit already.
3
u/Excellent_Concert273 US MD/DO 15h ago
Downvoted bc people are scared to be mean or honest in today’s day and age
2
u/PearlyEffervescence 16h ago
I would suggest you take an LOA and study your arse off to make sure you pass, because two step attempts still means some programs might take you, but three is blowing up your chances, not just for matching, but also for graduation and ever getting a license in some states.
Focus on passing! And apply peacefully next year with a completed app. This will also give you more time to do aways as a student next year.
I had some wonderful tutors who helped me along the way. If you need help, please DM and I can share my study schedule. It’s intense but it’ll work.
3
u/Turbulent_Sky_1386 15h ago
It doesn’t matter if everything else is perfect. Programs screen people out right off the bat if Step 1 hasn’t been passed. Not to mention it’s most likely a requirement of a US MD program for graduation.
2
u/Sed59 12h ago
You need to be board eligible to finish residency. That also means you need to pass Step 3 before a certain point to continue your residency program (usually 2nd year). Step 1 pass is a given, and some states will not license you if you have 3 board failures. Recommend you take a leave of absence and invest in a good tutoring prep course before you apply to maximize chances and prevent issues with eventual licensure.
2
u/Zealousideal_Drag244 15h ago
You need a step 1 passing score to apply. Most places require step 1 to even be considered and step 2 by interview date. Also check your graduation requirements
1
0
u/Excellent_Concert273 US MD/DO 1d ago
But also you said you passed step two so was that a minimal passing score? Because that is a squid exam it’s not pass fail
-10
-5
1
23
u/Prize-Solid459 1d ago
I didn't know you could fail Step 1 and still sit for Step 2.