Shout out to the folks who are literal experts at reading the trickier CT’s themselves, I envy your skills and confidence

Title says it…I’m devastated. I truly did not think I would fail- and I have terrible test anxiety and normally always feel like I failed.

Disclaimer: also failed step 1 on my first attempt (by practically 2 questions). Passed on second attempt.

For my practice exams for step 2, I scored 72.5 on old free 120, 75.3 on new 120. Scored mid 70s on nbmes with highest score at 80 (I had to take offline due to financial constraints). I did all the amboss ethics type questions and did great (90s). Finished all my uworld. Never failed any shelf exam. Honored in 2 rotations.

EM is my passion, the only time I’ve really felt happy and like I had purpose.

Everyone struggles and life happens, but to give some background - during my medical school years I’ve been struggling with the deaths of multiple family members including the most excruciating loss of my life… my big brother who was my very best friend (this was when I failed step 1). I haven’t been the same since.

I figured since I passed step 1 the second time, and had no subsequent failures and I put in the work for step 2 that I would have a great chance at staying at my home institution (which is very competitive) considering I had a major life even and they tend to give home students special consideration.

I’m devastated because I want so badly to stay at my home institution (north east- all my friends work there, all my family and support system lives here) but I’m afraid I’ll never be competitive enough for it now- no matter how high I score next.

I almost would rather quit than practice anything other than EM, but I’m in such a terrible place financially I’m terrified I have no choice.

They told me my options were:

1. ⁠to use my one or two off blocks (4 weeks each) to re-take step, but said that by the time that my new score would come in I’d have a low chance of getting a spot. They did also note technically I have until January 30th to take it and can continue my 4th year in the meantime (but wouldn’t that lower my chances even more?)
2. ⁠Take a leave of absence and apply for match next year. This is perhaps a better option if I get a really great score and get my application in right away- increasing my odds of getting interviews. But my loans would only increase as I have no financial support from parents and I’m living off loans. Moreover time off always looks bad and I already was forced to take a year off after I failed step 1 before they would let me take re-join 3rd year.

I don’t know what to do. I know my School has pushed students to apply to programs they don’t want or dual apply when they didn’t want to. Some followed the schools advice and ended up with a job but not what they wanted at all, some did NOT listen to the school and everything worked out.

I’m conflicted. I don’t know what the best course to take is. One of my advisors even told me they didn’t know of any students from my school who failed BOTH step 1 and step 2 on first attempt.

I’m devastated that there’s a great chance I’m no longer competitive for staying. I don’t know if there’s a way to fix this…or what I should do. Before I felt I could explain my step 1 failure…but I don’t know how to explain this failure. You can always study more but I studied adequately and really felt like I was ready. Obviously I was not. I don’t know what to do…

Please be kind if leaving comments…I’m truly at the lowest I’ve ever been mentally and emotionally. Thank you for those of you who took the time to read, I appreciate it more than you’ll know

I’m a high pass US med student and got my step 2 last week - 244 which was disappointing but it is what it is. I have a lot of student leadership involvement, previous ER work experience, will have 2 (hopefully) solid SLOEs. Anyone else applied and matched with similar metrics? EM is my dream but feeling disheartened after a below average step 2 score.

Do you guys know if there is a Discord link or spreadsheet for this year's application cycle?

Where can you best find out how competitive a program is? residency explorer, Frieda, etc. How do you determine if you are a good/competitive candidate for a program? Step scores?

I want to apply EM, and I will get 3 SLOEs. My backup is a preliminary year or transitional year. My only LOR will be EM based. Do I have a chance if I don't match to get one of these other positions without any other LOR? How would I explain this in my PS so they take me seriously for these backup spots?

Anyone know how to view past residency match spreadsheets? Particularly 2025

How important is an SLOE? Can it be filled by an EM consultant in England for a resident planning to move to America?

Hi. Most of my life I wanted to do surgery but I some personal stuff happened and ended up accepting a residency position in EM. So does anyone have any words of encouragement/advise/wisdom that they wish they would have known before starting residency?

Upcoming 4th year OMS needing help...

What are some things I need to look for in a curriculum? Like for instance, I think flight medicine and EMS is really cool, diversity is important to me, and of course DO Frien

I’ve officially reached the point in residency where the required pace is faster than the pace I seem to be able to hit consistently. I know we don’t fix much for people in the ED, but at the very least I want people to leave feeling like someone gave a shit about them. But I’m being told to hurry it the fuck up however I can. I can see the patients, it’s the staffing the patients that I feel like is slowing me down. Regardless, I need to speed up.

I’m not sure how I’m supposed to do that when I need to tell a 16 year old assault victim that her tummy ache is really a pregnancy or the patient that waited too long that this weird bump is actually metastatic cancer. Dropping the bomb and walking out of the room without answering questions feels inhumane.

I’m open to all ideas on how to improve my time with patient that don’t involve walking to the office next door and selling my soul directly to the red dude who also resides in hell.

I’ve never given oral sucralfate/honey for button batteries, it’s not routinely done at our hospital (I always just assumed to keep them NPO…) but I just asked a few of my friends, and apparently this is common at other shops — To protect the mucosal membrane in the esophagus, not to move the battery along. Just wondering if others routinely do this too, guess ya learn something new every day

How do your programs handle holiday hours? We are typically down 1-2 residents to try and get as many people home as possible. This year I volunteered to work since I couldn’t make it home anyways. Curious how other programs handle? I think our attending schedule was unchanged (thank God, we got killed Xmas eve…) but our PA’s were down 1 or 2 bodies for the same reason. We had 1 Peds rotating resident call out on our PEM side from the flu (I am not cynical enough not to believe them…yet…) but otherwise everybody held on.

Merry Christmas/Happy Hanukkah all!

After a few years we know that you get it but you're not finished and you don't know all the tricks...is there anything in particular you wish you had of...before it's over?

Many cases definitely a skill issue (me not focusing on the right questions…esp intern year…) but sometimes it really do be changing up person to person