New user here. I apologize if this is in the wrong subsection. Mods, please move as needed.
I'll get straight to the point.
I am a recent US MD graduate. Did not get into residency. Major reasons were beyond my control. But with the continued trend of having more US grads competing with a stagnant number of residency spots, my story is hardly unique.
Anyway, I passed Step 1 and both parts of Step 2, which were required for graduation. I have worked alongside nurses and have a great appreciation for what they do. I thought about going the RN route prior to embarking on the MD adventure.
I understand that becoming an RN will take more schooling. I am certain I can handle it as well as any other person transitioning from a different career into nursing. And the loans required don't scare me. I bet I have more than 99 % of RN students!
What are your thoughts about this? Have you all run into MD to RN folks?
Will my MD background be an asset or liability when it comes to applying for RN schools or RN jobs post-school?
Just a few things to clear up any questions about my background. I graduated from school with an MD degree. I was able to pass Step 1, Step 2 CK, and Step 2 CS. I haven't taken Step 3 yet as that exam is meant for first year residents.
As for why I wasn't able to get a residency:
This is something that those who have not been in my situation will never fully comprehend. There are more and more medical schools opening up each year. Yet the number of residency spots remains stagnant. Getting accepted into medical school was already a brutal challenge. I had no idea that just passing wouldn't be enough to secure a residency spot. During my time in medical school, the number of applicants skyrocketed. Last year, the numbers were 40k applicants for 20k spots. And the number of US grads who can't get a spot is increasing rapidly. There's ongoing discussion about this, but nothing will be done. To most of the medical field, we are the pariahs. Very few in the field are willing to advise or mentor us. My school has stopped communicating with me because I am no longer able to generate any revenue for them. Ever seen the movie Gattaca? I often feel like the main character – one who is genetically inferior competing amongst the elite (an exaggeration, of course – but you get the idea).
Anyway, the increase in the number of applicants vs spots available has caused an increase in the required score to pass each exam. I had to repeat some exams. I have always been an average student who just happened to be the most hard working (ie I was completely financially independent at 18). Unfortunately, that wasn't good enough to avoid struggling in med school. Add to that plenty of things out of my control, and you can sort of get an image of my background. These issues include things like family issues (with law enforcement involved) and my own health issues currently checkups with Oncology q 3 months (and it's just awesome having to stretch those out because I can't afford it). I apologize, but I don't feel comfortable sharing any more than that. And I am not looking for any pity. We've all faced problems. I'm sure some of you have had much worse.
To those who are saying to keep trying:
The chances are far too low to be worth the struggle. The cost of applications is one thing. For someone in my position, I'd have to apply to 150+ programs throughout the country. The application process is about $3k. Then I am responsible for all travel expenses. At the same time, it is very hard to find any decent employment. An MD without residency is worthless. Some believe that we can just go to research or the pharmaceutical industry. This is false. If you were in charge of a research project, would you rather have an MD who was not trained to do research? Or would you rather have a PhD grad whose entire grad education has been about research? If you were in charge of a pharmaceutical company, would you rather have an MD who has basic med school / first year residency level knowledge of medications? Or would you rather have a physician who has gone through residency and practiced and knows practical applications for the drugs in question?
Regarding the loans:
The only reason I am not as distressed about the loans is that I will not be responsible for them come 15 years. You may have heard of the pay as you earn program. With any federal loans (which covers all med school expenses), I just have to pay a certain percentage of my income for the next 15 years and then the loans will be wiped clean. For most successful grads who eventually become physicians, they'll have paid off their debt long before those 15 years. But for the rest of us who will not have that opportunity, we will become society's parasites. I hate what I have become, but I see no choice but to embrace it.
So that's where I am now – 1 year out of school and working a just-above-minimum-wage job in a local hospital. I supplement my income with manual labor outside of my regular work hours. I am friends with several nurses and nursing students. As I love teaching, I started helping some of my nursing student friends with the better understanding of some topics. They appreciate that I am going at the topics in a different direction. Ie. I showed them how to memorize the clotting cascade and all the major drugs related to it – from Heparin to Warfarin to direct factor 2 inhibitors to direct factor 10 inhibitors. Another of my prouder moments was helping them to comfortably understand Potassium and Sodium balance. Ie. know that Hyperkalemia is due to K out of cells (Beta Blockers, DKA / low Insulin, acidosis such as vomiting, or other cell busting events like tumor lysis, rhabdo, injury, etc) or K failing to leave the nephrons (CKD, decrease in Aldosterone production such as Addison's Disease, and anything that antagonizes Aldosterone like Type 4 RTA by Spironolactone, Lisinopril, Heparin, Phenytoin). I even prepared notes for them so they can review and memorize in the most efficient manner. My closest friend of the group told me that it would be a shame for me to just give up on medicine like that. He suggested that I should go into nursing so that I could still be of some use to the medical field.
Sorry if that was too much of a rant. And sorry for any typos or grammatical errors. I am typing all up all of this before my shift starts.
I strongly believe that I can succeed in nursing. I will not have problems with the academics, as I've cut every toxic thing out of my life (including the aforementioned family issues). I am just not sure if the application process will be as painful as getting into med school. And I am not sure what kind of discrimination (if any) I'll face prior to, during, and after nursing school. It's a shame that I can't find others like me. It seems like most of my fellow pariahs / parasites have removed themselves from medicine. One guy is struggling to run his own business. Another returned to his home country (not for medicine).
Have you considered becoming a physician assistant?
There is also some state (Michigan? M something ....) that allows med schools grads to practice along side physicians because they are severely lacking and need the additional help.
Specializes in Psych, Addictions, SOL (Student of Life).
I understand that you are disappointed about not getting a residency but like another has said here I would not thinking adding more student loans to your burden would be helpful. I am the only person I currently know in nursing that does not have any loans to pay. I worked my butt off while in school to be able to graduate debt free and am currently doing a RN to MSN without taking out loans. I had some stock dividends that I cashed out. Stuff I bought for pennies years ago that took off like a rocket in the past five years.
I had a friend who graduated from Med school and had the same dilemma of not getting a choice residency. He ended up sending his resume to every teaching hospital in the Country. and was eventually offered two residencies one on the one of the Dakotas and the other somewhere in Alaska. Definitely not his first choices but he is living in Alaska now and states he may never leave as he really loves it there.
If your scores are truly going to prevent you from getting a residency, there are a few options:
1. Assistant physician (not PA) meant for IMGs or US MDs in Missouri that takes MDs without residency and essentially makes them midlevel providers under physician supervision.
2. Direct entry NP
3. PA school
Even though you respect and admire nurses, I really don't think you would be satisfied being a bedside RN. At least put your knowledge to use as an MD.
I pretty much recommend this for anyone considering nursing as a career but you really need to shadow several nurses. Shadow nurses working in med/surg, critical care, peds, etc. Check out different hospitals at different times. I know you've done these clinical rotations in med school but it's important to see these areas from a nurse's perspective. If you're set on nursing, going the NP route would probably be best with your background. Consider the direct-entry MSN in that case. On a side note, I was excited to see your reference to the movie Gattaca as when I've referred to it most people have no idea what I'm talking about.
I do know a few people who did the MD to RN route, not because they weren't matched with residency, but because 1. Their foreign medical education and experience didn't transfer to the US, so rather than start the process all over, they did an MD to RN route and became CRNA's or NP's. or 2. They simply did not enjoy medicine and truly loved nursing.
Anyway, people here have already offered a lot of suggestions and you know your situation the best, so only you can decide. Personally? If I were in your position, I'd be reaching out to medical school graduates for advice and not nurses. We have no clue what the residency process is like and you can try to explain it until you're blue in the face, but we will still probably tell you to keep trying for a medical residency because we know how hard you worked to get into medical school and graduate. It would be like us asking CNA's what we should do because we didn't pass the NCLEX on our first try…chances are they're going to tell us to not give up and waste our education. If you are still insistent that following through on being matched to a residency just isn't possible, I very much would suggest looking into direct entry NP programs. Ask a few bedside RN's what their plans are, and quite a few will say they want to become NP's. With someone that has your drive, determination, and intelligence to get into, and graduate from, medical school, I just don't think a lifetime of bedside nursing would be fulfilling and that is something to keep in mind.
Lastly, I would also be concerned about the cost of additional education for becoming an RN ESPECIALLY if you aren't a trust-fund baby. I don't know how old you are, so loans may not seem like a big issue, but once you pull out of your 20's and want to do things like start a family or buy a home, they become a HUGE issue. Nursing was a 2nd career for me after I decided to forgo law school. I had a student loan debt of $85,000 from my previous degree. I added another $15,000 to receive my BSN. My student loan payments are about $1,000 a month – some will be paid in 6 years, some in 10, some in 15, and the remaining in 33 years. The 33 year loans are my federal loans and that whole pay as you earn†isn't as black and white as you may think. Yes, it's good now when you're making a low salary, but once that goes up, you'll see that everything changes and you may or may not meet those income requirements. I also believe there is a 10 year loan forgiveness program, but it's not automatic. You have to make 120 consecutive on-time payments (on time being the key phrase here), work at a qualifying facility (meaning you can't leave for greener pastures at year 5), and then submit your application for loan forgiveness (which is not a guarantee). The other forgiveness program I know of is after 25 years, not 15, but I could be wrong. And believe me, no matter what plan you end up on (I opted for graduated repayment on my previous loans and standard on my nursing school loans), you're not going to see too much of that loan forgiven…maybe a couple thousand at best (I think for me it's a couple hundred because my income went from about $35k in social services to about $50k as a new grad RN), but certainly not a significant amount. The only reason I am saying this is because I have been burned by my poor judgment in relation to student loans and I advise everyone to BE SMART WHEN BORROWING!
Just a few things to clear up any questions about my background. I graduated from school with an MD degree. I was able to pass Step 1, Step 2 CK, and Step 2 CS. I haven't taken Step 3 yet as that exam is meant for first year residents. and following . . .
Dear sir:
It sounds to me like you are exhausted, perhaps depressed. At the same time, I find some solace in perceiving that you, unlike many MD's, did not pursue this field for some sort of ego trip. The fact you are willing to assume a nursing role instead of getting your "rightful due" as a physician proves it.
That being said, we have a crying need for primary care physicians who are willing to work in less-well-off places. I implore you to look into getting your residency in a program like the one I mentioned. We need good doctors, ones who will not run off the second residencies end to get some expensive job in the big city. There are millions of poor people who need access to primary care, and many states like mine have no licensing for nurse practitioners.
There might be a reason you did not get into the residency of your choice. Please consider that it might be a message to you.
Become an entrepreneur, and do what you find yourself enjoying doing right now: Teaching.
Record some lectures†and put yourself out there. Charge a small fee for your lecture topic. If you've got a knack for it, and you enjoy it, why not?
You can even offer teaching tapes for med students as well.
Specializes in Allergy/ENT, Occ Health, LTC/Skilled.
I have only known one person who has done this. She was from Russia, where she was an MD, and for whatever reason her education/experience only equaled an LPN in the states. She had a really hard time with it (we were in LTC). That combined with her very Russian personality (ie: in thick Russian accent: Your mother is dead, we must clean her, we need you to step out -- daughter's sobs ensues. No one had told her she had passed yet.) she didn't stay in nursing long. But as long as you are aware you will have a different role a nurse, more loans, and your starting pay etc etc do your thing.
I wish you were my friend during nursing school! What you did for your friends to help them learn sounds wonderful. I have also only known people who were physicians or went to med schools in other countries and had trouble finding residencies in the US. One in particular applied to A LOT of schools and finally got offered a residency in not the greatest area after the 3rd year of applying, but at least finally got one. I would say to just keep applying while doing things you actually enjoy and that will pay the bills in the meantime. I agree with what everyone else said, nursing is such a different scope of practice and there are crazy smart nurses that seem to know everything but maybe don't give up just yet...
I know how hard it is to match. Our local university is trying to get the hospitals to open more spots, but it seems to be a futile battle. They have taken it public, and I'm glad. Many don't know that you aren't guaranteed a residency spot once you graduate med school. That being said, being an RN might not be enough. As others have suggested talk to some schools about N/P or PA routes. Or stick with teaching for now. I cannot imagine the frustration you are experiencing. I wish you the best of luck.
Never heard of it. I would try my best, meaning I would become willing to relocate almost anywhere in order to continue with my chosen health care sector training. Nurses have their own issues and there's no sense in trading your problems for a whole new set. It's better to deal with the 'devil you know'.
jackshepard
4 Posts
Thanks for all the responses.
Just a few things to clear up any questions about my background. I graduated from school with an MD degree. I was able to pass Step 1, Step 2 CK, and Step 2 CS. I haven't taken Step 3 yet as that exam is meant for first year residents.
As for why I wasn't able to get a residency:
This is something that those who have not been in my situation will never fully comprehend. There are more and more medical schools opening up each year. Yet the number of residency spots remains stagnant. Getting accepted into medical school was already a brutal challenge. I had no idea that just passing wouldn't be enough to secure a residency spot. During my time in medical school, the number of applicants skyrocketed. Last year, the numbers were 40k applicants for 20k spots. And the number of US grads who can't get a spot is increasing rapidly. There's ongoing discussion about this, but nothing will be done. To most of the medical field, we are the pariahs. Very few in the field are willing to advise or mentor us. My school has stopped communicating with me because I am no longer able to generate any revenue for them. Ever seen the movie Gattaca? I often feel like the main character – one who is genetically inferior competing amongst the elite (an exaggeration, of course – but you get the idea).
Anyway, the increase in the number of applicants vs spots available has caused an increase in the required score to pass each exam. I had to repeat some exams. I have always been an average student who just happened to be the most hard working (ie I was completely financially independent at 18). Unfortunately, that wasn't good enough to avoid struggling in med school. Add to that plenty of things out of my control, and you can sort of get an image of my background. These issues include things like family issues (with law enforcement involved) and my own health issues currently checkups with Oncology q 3 months (and it's just awesome having to stretch those out because I can't afford it). I apologize, but I don't feel comfortable sharing any more than that. And I am not looking for any pity. We've all faced problems. I'm sure some of you have had much worse.
To those who are saying to keep trying:
The chances are far too low to be worth the struggle. The cost of applications is one thing. For someone in my position, I'd have to apply to 150+ programs throughout the country. The application process is about $3k. Then I am responsible for all travel expenses. At the same time, it is very hard to find any decent employment. An MD without residency is worthless. Some believe that we can just go to research or the pharmaceutical industry. This is false. If you were in charge of a research project, would you rather have an MD who was not trained to do research? Or would you rather have a PhD grad whose entire grad education has been about research? If you were in charge of a pharmaceutical company, would you rather have an MD who has basic med school / first year residency level knowledge of medications? Or would you rather have a physician who has gone through residency and practiced and knows practical applications for the drugs in question?
Regarding the loans:
The only reason I am not as distressed about the loans is that I will not be responsible for them come 15 years. You may have heard of the pay as you earn program. With any federal loans (which covers all med school expenses), I just have to pay a certain percentage of my income for the next 15 years and then the loans will be wiped clean. For most successful grads who eventually become physicians, they'll have paid off their debt long before those 15 years. But for the rest of us who will not have that opportunity, we will become society's parasites. I hate what I have become, but I see no choice but to embrace it.
So that's where I am now – 1 year out of school and working a just-above-minimum-wage job in a local hospital. I supplement my income with manual labor outside of my regular work hours. I am friends with several nurses and nursing students. As I love teaching, I started helping some of my nursing student friends with the better understanding of some topics. They appreciate that I am going at the topics in a different direction. Ie. I showed them how to memorize the clotting cascade and all the major drugs related to it – from Heparin to Warfarin to direct factor 2 inhibitors to direct factor 10 inhibitors. Another of my prouder moments was helping them to comfortably understand Potassium and Sodium balance. Ie. know that Hyperkalemia is due to K out of cells (Beta Blockers, DKA / low Insulin, acidosis such as vomiting, or other cell busting events like tumor lysis, rhabdo, injury, etc) or K failing to leave the nephrons (CKD, decrease in Aldosterone production such as Addison's Disease, and anything that antagonizes Aldosterone like Type 4 RTA by Spironolactone, Lisinopril, Heparin, Phenytoin). I even prepared notes for them so they can review and memorize in the most efficient manner. My closest friend of the group told me that it would be a shame for me to just give up on medicine like that. He suggested that I should go into nursing so that I could still be of some use to the medical field.
Sorry if that was too much of a rant. And sorry for any typos or grammatical errors. I am typing all up all of this before my shift starts.
I strongly believe that I can succeed in nursing. I will not have problems with the academics, as I've cut every toxic thing out of my life (including the aforementioned family issues). I am just not sure if the application process will be as painful as getting into med school. And I am not sure what kind of discrimination (if any) I'll face prior to, during, and after nursing school. It's a shame that I can't find others like me. It seems like most of my fellow pariahs / parasites have removed themselves from medicine. One guy is struggling to run his own business. Another returned to his home country (not for medicine).
Thanks again for listening / reading.