How To Explain Red Flags on Your Residency Applications.

Red flags on your ERAS application can be very anxiety inducing. There is a lot of confusion on exactly what to say and where to say it. Overall, programs get multiple pieces of information from letter writers, USMLE itself, your medical school, etc. In these instances, it is best to use the personal statement to explain your side of the story.

What if you had a Step 1 Failure, Step 2CK Failure, or Step 2CS Failure?

A program will see whether you passed your USLMEs on the first attempt. It’s all in your transcript that is submitted to the program. Thus, this is our suggestion for our clients in their personal statement.
1. Take full responsibility for the failed attempt.
2. Acknowledge and explain the situation and an extenuating circumstances (illness, family emergency). Try to be fact based and not embellish.
3. Explain what you did to rectify the situation and how well you did on the 2nd attempt.
4. Emphasize that you and your medical school professors have no concern about your ability to pass additional licensing examinations or your clinical knowledge – you know now that you have to put in more preparatory time to succeed in test taking.
This is a pretty straightforward explanation. The only wrong way is not taking responsibility and attempting to blame the failure entirely on external circumstances. A strong second attempt score is very helpful. Some wonder if they should even explain the failure in the personal statement. We recommend disclosing. The reason is that Program Directors are looking for reasons to reject you. They can fill their list with only applicants that have passed all USMLEs on the first attempt. But, they are often willing to look over a failed attempt if the reason is clearly laid out and the applicant has shown growth through the process. We believe disclosing on your personal statement is sufficient. Of course, if you’re offered an interview, be prepared to answer questions related to any failed USMLE attempts.

What if there is more than 5 years since your graduation?

This happens very commonly for IMGs. 5 or more years of graduation is a red flag since programs are concerned you’re too far away from your medical school training. This is again something you can address in the personal statement. The suggestions we have is to emphasize the time between graduation where you kept your clinical skills sharp. The best is U.S.-based observerships. You can also mention staying on top of the medical literature having signed up for membership with the American Medical Association and reading medical journals.


What if you had some disciplinary actions related to your medical school education?

This is very individual specific. Sometimes a disciplinary action can mean cheating on a test or unprofessional behavior in medical school leading to a leave of absence. In this instance, you have to carefully consider what other pieces of information a program will receive that relates to this situation. For instance, will a letter of recommendation discuss this? Will the medical school’s Dean letter mention this? How serious is the issue? 

If there is a significant chance that the program will become aware of these issues, we recommend being proactive and disclose in the personal statement. But, if the issue in question was a quiz back in college that will not be in your application at all then it is safe to keep it to yourself.