Applying to Residency with a Red Flag
Written by Andrew Woods
Let’s start by stating the obvious: nobody wants a red flag. Let’s also state the inevitable: red flags happen, but it is less about them happening and more about how you recover from them. Red flags have traditionally been in the vein of low or failed board scores/course grades, leaves of absence, and professionalism violations. While I believe the tips below could apply to any red flag, my experience is with the academic variety, and so I am writing from that perspective. I wouldn’t share this post without being an applicant with a red flag myself, so let me be vulnerable for a second and share some things about myself.
For my first two years of medical school, I was an average to a below-average student. I had a four-year gap between when I ended my undergraduate education and when I began medical school, and the fire hose started at 100mph and I scrambled to keep up from the beginning. Despite that, I never failed any classes and managed to survive…until my last two classes of OMS-2. Rather than dismissing me outright, my school had me remediate my entire OMS-2 year, and thus a red flag was born.
At the moment, it felt career and life-ending, but as I spent some time to regather myself, and as I wrap up an abundant interview season (#blessed), I’ve decided to share what I’ve learned along the way that I hope can help you overcome your own red flag.
You must reassess what went wrong and plan for how to do it right the next time. There is always a root cause for why the red flag occurred. For me, it was my poor coping skills causing bad time management, but for you, it could be something entirely different. It is important to cut yourself some slack during this introspective moment! This isn’t the time to pile on about your shortcomings, but instead the opportunity to reshape and rededicate yourself to the goal of becoming a physician. Reach out to your school and ask if other students have successfully navigated the same red flag, and if they can connect you with them. While what works for others doesn’t always work for you, it is important to get some mentorship for this unique time in your training because this is a road less traveled.
You need a good support system around you. We have all heard “it takes a village,” and overcoming a red flag is no different. When I was first told of my remediation, I kept it to myself. After a couple of days, I realized that I couldn’t be successful doing this on my own, and so I reached out to a core group of colleagues to ask for their assistance. I told them where I thought I fell short, what my plans were to correct those issues, and what I needed from them. For my wife, that meant that keeping me accountable with our “self-care Sundays,” a time that we check in with each other to make sure I wasn’t overwhelmed. For my friends, that meant regular check-ins just to see how things were going and planning a new course when things started to get wobbly.
Realize that some specialties are more forgiving of red flags than others. This hurts to say because the last thing I ever want to do is dissuade someone from pursuing their dreams, but it is also important to recognize since it defines how steep of a hill you have in front of you. I am fortunate that the field of Physical Medicine and Rehabilitation (PM&R) is incredibly forgiving. I have been asked about my remediation during every interview thus far, but it has never been in the context of “you failed and that is bad” and instead has been framed as “you failed and managed to persevere and succeed afterward, how were you resilient during this time?” While I certainly hope every specialty would see the value in someone who overcame adversity, the sad reality is some will immediately filter you out. It is important to understand the averages of your specialty and reach out to those in the field to gather insight about what awaits you. This isn’t the time to abandon your dreams, but it also isn’t smart to ignore the difficulties ahead.
Before interviews begin, figure out how you will explain it. By this point, you have successfully made it to interview season, which means you have passed your board exams, (hopefully) demonstrated your red flag was an anomaly, and so it is time to craft your explanation. As I stated above, despite how forgiving PM&R has been of my red flag, I still get asked about it. I believe I have been successful in explaining what happened by taking accountability for my flaws, explaining the changes I have made to ensure it doesn’t happen again, and then highlighting the positive growth I have gained from the experience and how that will help me thrive throughout residency. You will get better at it the more you talk about it, so do some interview prep with your support system and by your first interview, you will be comfortable navigating the topic!
Applying with a red flag is daunting, but if you take the right steps, it doesn’t have to be a career-ending moment. Although I wouldn’t wish remediation on anyone, my red flag has made me the resilient PM&R applicant that I am today, and I will be a better physician and person because of the experience. I wish that I could go back in time and tell myself that this would be the best, worst thing to ever happen to me, but the next best thing is to help guide those who are going through it now. My DMs are always open for anyone looking for guidance as they navigate their own long and winding road!
**Andrew is currently a 4th-year medical student and the advice provided throughout this post does not reflect the official stance of any organization that he represents or participates in. Engage with Andrew on Twitter @TheAndrewWoods.
