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Started out at a US medical school in 2008

Passed all classes except Pathology which led me to withdraw in 2011

Began at a mid tier Caribbean medical school in 2012 - passed pathology then began studying from 2013 to 2016 for Step 1 due to my huge lapse of time from 2008-2010 during which i took all the basic courses of med school

I was averaging 240-250s on my practice tests

I paid for and completed (in the 230-240 range) around 5-6 NBMEs

I attended Kaplan, listened to the videos, and took notes

I read and understood First Aid and completed Kaplan, UWorld (2x), USMLE Rx, and TrueLearn QBanks

I took the real test in August and scored a 186, basically 6 pts from passing


Now my options are as follows:
- return back to the island to redo courses in order to sit for step 1 again for my current Carib school

- transfer to another Caribbean school (way more shady and bad reputation) - still have to take classes on the island most likely, but also may just let me sit for step 1 after some clinical courses in the US

- transfer to a Polish medical school in hopes they will let me take my Step 1 again

I understand fully that my chances to land a residency are pretty much 0% but with an MD, even from a Caribbean school, I should be able to land a decent teaching job at a high school for around 80-90k or another type of job that requires an MD but not a state license

I have explored other avenues of medicine and due to my age (32) none really interest me on top of the fact that many of these programs are saying my dual honors (university and biology) degree from 2008 is no longer valid due to passing of time:

- NP (2-3 years of nursing school and then 3-4 years to become an NP)

- Anesthesiology Assistant (wants me to retake MCAT - wont accept my USMLE and wants me to take undergrad courses)

- Pharmacy - only a few options (Vegas/Utah) again crap schools unless i take more undergrad courses (think orgo 1 and basic biochem) and take the PCAT if I want to apply

- Vet/Dentist/Lawyer - too difficult, too much work, and not very interested in doing that to begin with

Now I am sitting with 12-15 years of knowledge of medicine with really nothing to do with it and honestly no idea how to proceed further. I have been waiting over 3 months for the decision to retake Step 1 from my Caribbean school. Even after months of emailing, calling and leaving voice mails, a decision has not been reached. It is literally driving me mad and tearing my family apart.
I know most of the replies are going to be snide and rude but if i can get at least a few good responses from people who have been in my shoes or known others in my shoes that would be amazing

No sleep, super stressed, please anyone help
 

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Started out at a US medical school in 2008

Passed all classes except Pathology which led me to withdraw in 2011

Began at a mid tier Caribbean medical school in 2012 - passed pathology then began studying from 2013 to 2016 for Step 1 due to my huge lapse of time from 2008-2010 during which i took all the basic courses of med school

I was averaging 240-250s on my practice tests

I paid for and completed (in the 230-240 range) around 5-6 NBMEs

I attended Kaplan, listened to the videos, and took notes

I read and understood First Aid and completed Kaplan, UWorld (2x), USMLE Rx, and TrueLearn QBanks

I took the real test in August and scored a 186, basically 6 pts from passing


Now my options are as follows:
- return back to the island to redo courses in order to sit for step 1 again for my current Carib school

- transfer to another Caribbean school (way more shady and bad reputation) - still have to take classes on the island most likely, but also may just let me sit for step 1 after some clinical courses in the US

- transfer to a Polish medical school in hopes they will let me take my Step 1 again

I understand fully that my chances to land a residency are pretty much 0% but with an MD, even from a Caribbean school, I should be able to land a decent teaching job at a high school for around 80-90k or another type of job that requires an MD but not a state license

I have explored other avenues of medicine and due to my age (32) none really interest me on top of the fact that many of these programs are saying my dual honors (university and biology) degree from 2008 is no longer valid due to passing of time:

- NP (2-3 years of nursing school and then 3-4 years to become an NP)

- Anesthesiology Assistant (wants me to retake MCAT - wont accept my USMLE and wants me to take undergrad courses)

- Pharmacy - only a few options (Vegas/Utah) again crap schools unless i take more undergrad courses (think orgo 1 and basic biochem) and take the PCAT if I want to apply

- Vet/Dentist/Lawyer - too difficult, too much work, and not very interested in doing that to begin with

Now I am sitting with 12-15 years of knowledge of medicine with really nothing to do with it and honestly no idea how to proceed further. I have been waiting over 3 months for the decision to retake Step 1 from my Caribbean school. Even after months of emailing, calling and leaving voice mails, a decision has not been reached. It is literally driving me mad and tearing my family apart.
I know most of the replies are going to be snide and rude but if i can get at least a few good responses from people who have been in my shoes or known others in my shoes that would be amazing

No sleep, super stressed, please anyone help
I think it would help if you were able to accurately assess where you went wrong and why.

You say you were scoring in the 240-250 range in your NBMEs, why do you think you weren't able to produce the same result in the real deal?
 

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First and foremost: Breathe

It is a huge disappointment. A HUGE crush to your ego and self esteem. BUT, it is not the end of the line for you, at all.
I know that while we are doing this one of the biggest emotional roller coasters is the thought that after all this time and money if this (step1 and licensing) doesn't pay off you could only be qualified for a McDonald's position.

But my answer is two part:
1. A decent living with all this education and no license? Yes. I myself came from a shady Caribbean school and took my test and failed a long time ago and put up my "gave up" sign and switched into clinical research, made a pretty nice living (50K then 70K and walked away at 95K) there are all sorts of opportunities other than research too; health education, science or teaching positions, a couple of more semesters and a gear switch into nursing, sonography and echo, 1 year of business and switch to hospital administration or a multitude of technical work in healthcare where your medical background will get you a decent job you can live well above the poverty line in. As part of the "we didn't pass the Step 1" fringe community you hear and see so many many stories of moving on from the disappointment and building a new dream were you are actually happy in.

That said:
2. 10 years later and a bag of anecdotes of those that did and didn't pass their step 1 I can tell you that for every person that aces their test there are many more that do not. Many many more, specially those graduating abroad. I am back in the race and squeezing my poor FA dry BECAUSE of the stories that never make it into these sites, where mostly those that feel proud post of their accomplishments. I have been in the healthcare system these 10 years and have seen plenty of residents that were studying for years on end, that have taken and failed step 1 way more than once and who even their close friends were like; wow, maybe quitting is ok dude.
And what they all had in common is that by brute force alone they hammered and hammered until they built a way to pass. And what they all have in common today is a current or completed residency post. Yeah, not Harvard, but a post non the less that will put them to work as physicians in the US system at the end of it.

So don't quit. You are almost around the bend. The top is the hardest, close your eyes and keep going...whatever you need to hear, tell yourself because as long as you don't want to give it up, you don't have to. No one but yourself can make you.And before you mention age...I'm 41, my best friend is finishing his Psych residency at 48 and I know many more real life stories of cases like that.
Will it be easy? Hell no. Will it be worth it? You decide. But can you DO it? Hell to the YES.

My advise to help you get there, if you so choose, is that since you already reviewed all of the material find a 1 on 1 tutor ( they range from 20 bucks an hour to the 100s) that will go over FA with you subject by subject and identify and then strengthen your weaknesses by filling in the blanks most of us foreign graduates inevitably have. Not a SP, as although they are wonderful support system they are not focusing solely on YOUR success. Combine that then with UW and flash cards. Wash, rinse, repeat.

Any path you take will be the right one as long as you are on board.
Success and blessings.
 

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It is a huge disappointment. A HUGE crush to your ego and self esteem. BUT, it is not the end of the line for you, at all.
I know that while we are doing this one of the biggest emotional roller coasters is the thought that after all this time and money if this (step1 and licensing) doesn't pay off you could only be qualified for a McDonald's position.

But my answer is two part:
1. A decent living with all this education and no license? Yes. I myself came from a shady Caribbean school and took my test and failed a long time ago and put up my "gave up" sign and switched into clinical research, made a pretty nice living (50K then 70K and walked away at 95K) there are all sorts of opportunities other than research too; health education, science or teaching positions, a couple of more semesters and a gear switch into nursing, sonography and echo, 1 year of business and switch to hospital administration or a multitude of technical work in healthcare where your medical background will get you a decent job you can live well above the poverty line in. As part of the "we didn't pass the Step 1" fringe community you hear and see so many many stories of moving on from the disappointment and building a new dream were you are actually happy in.

That said:
2. 10 years later and a bag of anecdotes of those that did and didn't pass their step 1 I can tell you that for every person that aces their test there are many more that do not. Many many more, specially those graduating abroad. I am back in the race and squeezing my poor FA dry BECAUSE of the stories that never make it into these sites, where mostly those that feel proud post of their accomplishments. I have been in the healthcare system these 10 years and have seen plenty of residents that were studying for years on end, that have taken and failed step 1 way more than once and who even their close friends were like; wow, maybe quitting is ok dude.
And what they all had in common is that by brute force alone they hammered and hammered until they built a way to pass. And what they all have in common today is a current or completed residency post. Yeah, not Harvard, but a post non the less that will put them to work as physicians in the US system at the end of it.

So don't quit. You are almost around the bend. The top is the hardest, close your eyes and keep going...whatever you need to hear, tell yourself because as long as you don't want to give it up, you don't have to. No one but yourself can make you.And before you mention age...I'm 41, my best friend is finishing his Psych residency at 48 and I know many more real life stories of cases like that.
Will it be easy? Hell no. Will it be worth it? You decide. But can you DO it? Hell to the YES.

My advise to help you get there, if you so choose, is that since you already reviewed all of the material find a 1 on 1 tutor ( they range from 20 bucks an hour to the 100s) that will go over FA with you subject by subject and identify and then strengthen your weaknesses by filling in the blanks most of us foreign graduates inevitably have. Not a SP, as although they are wonderful support system they are not focusing solely on YOUR success. Combine that then with UW and flash cards. Wash, rinse, repeat.

Any path you take will be the right one as long as you are on board.
Success and blessings.
Dude, I love you for this.

I have failed STEP 1 once. Took STEP 2CS, passed easly and have been studying for STEP 1 since. Have gotten 220-230 on my NBMEs, did them ALL and recently postponed because I was freaking out the night before my test, didn't sleep even for a second and was basically a zombie. I hated myself for not sleeping, not going to the test. Now I'm stuck with studying for another month (I left the USA for Europe for Christmas).

I felt many times I'm done and **** but kept on pushing.

Yes, not everyone will make it. Some will fail and change their careers but I'd just say, keep pushing.

Your words are not just encouraging bullshit. Your words is something everyone should read. Just keep on going and make sure you DID EVERYTHING to achieve what you want.

Damn, you made my day. Thank you for this :)
 

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Do you have ANY IDEA what went wrong?

If your NBMEs were in 220-240, it's really unlikely for you to fail.

Did you get a full night sleep before the test? Was it stress?

I'd say, make sure you know what happened.
I failed it once too.

I graduated 4 years ago and it was like being hit by a truck. I have already "wasted" lots of time for USMLE.

I felt, though, because I wasn't fully prepared.

I have worked very hard, for months and taking the beast again.

Just figure out what went wrong. Try to fix it and take the exam again.

Don't give up.

Also, as cheesy as it sounds... If you were able to believe in Santa for at least 8 years, you can believe in yourself one more time!
 

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Step 1 is the gnarliest test that any medical student will ever take. Regroup, take a deep breath and keep moving forward. You can still do it! Good luck!
 
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