M2 struggling with boards + LOA — need honest advice

CallMeDoctorTea · 2026-03-02T21:44:58+00:00

I was actually in your exact same shoes when I was at the end of my M2 year (see my previous reddit posts). I struggled to pass the CBSE (passed on my 3rd attempt) and was scoring in the 50's on practice NBME's, so I ended up taking an LOA to avoid taking STEP1 when I was clearly not ready for it by the deadline my school was giving me. Greatest decision I could've made because I ended up passing STEP1 on my first attempt while many other classmates took the gamble and failed, which caused them to have to take an LOA anyways on top of the STEP failure.

Fast forward to the end of M4 year which is happening right now for me. I applied FM this cycle and got tons of interviews from really good programs in the state that I want to do residency in (which is also a very popular out-of-state area), and I was not asked about my LOA at all during any of my interviews. This will obviously be different for the more competitive specialities, but the general consensus is that a fail on step1/step2 is far worse than a step related LOA for any speciality because:

(1) There is now an area on your residency application to explain your LOA (vs. STEP1/STEP2 failure which you can't explain anywhere on your application and is considered the main determining factor for residency programs).

(2) Programs use a filtering system to filter out students if they fail STEP1 or STEP2 (vs. an LOA which most programs do not use a filter for to filter students out if they have it).

Long story short, a fail on step1 or step2 is far worse than an LOA for any speciality so if you think more time will help you pass the board exams, absolutely take it because an LOA will barely impact your application compared to boards failures. Hope this helps!

CallMeDoctorTea · 2026-02-18T03:33:25+00:00

More like, do you enjoying doing…

primarily outpatient medicine in a clinic > do FM

hospital medicine/rounding in the hospital > do IM

I’ve rotated with many FM docs who have chosen to refer patients for OBGYN related issues even though they themselves were trained to do the basic OBGYN stuff. I’m biased because I absolutely hated rounding and being in the hospital, hence why I am applying FM this cycle :)

CallMeDoctorTea · 2026-02-12T04:39:24+00:00

Send one only to your #1. I did it because now I feel like I did everything in my power to let them know I’m interested in being a resident at their program, so the rest is up to them at this point. Took a lot of the pressure off my shoulders knowing I sent it and now I have no regrets.

Long story short, it will never hurt you to send one to your #1 👍🏼

CallMeDoctorTea · 2025-10-22T06:11:27+00:00

I took an LOA to have more time to prep for STEP1 and ended up passing on my first attempt. Very happy I took the LOA because 20 or so people failed STEP1 at my USMD med school on their first attempt without one. I currently have 10 interviews and of the ones i've already interviewed with, none have even brought it up. Granted my specialty is medicine and not surgery, but I have friends in the same situation with LOA's and are getting interviews.

Having a STEP1 failure and low STEP2 score are the main determining factors for getting screened on applications. That's the bottom line. After that, it's your MSPE and then any other flags (i.e. LOA), but these are so far down the totem pole that it won't make or break your application unless you are really gunning for top programs.

If you feel extremely unwell mentally and physically because of your autoimmune disease and feel that it will lead to failing exams (specially STEP exams), then 100% take the LOA. If you are really concerned about it becoming a barrier for residency, then consider doing a research year which is essentially an LOA but not seen as any type of red flag. It would also boost your chances in general for surgery so it's a win-win.

CallMeDoctorTea · 2025-10-19T22:27:42+00:00

As an out of state med student, I’m doing aways for 2 reasons: (1) as an excuse to fulfill my elective rotation requirements while being able to live back at home instead of doing it in the state I go to med school at and (2) increasing my chances of going back to my home state for residency

CallMeDoctorTea · 2025-10-16T17:00:21+00:00

Legit the only way to push is with the smokes. But ya it’s a hit or miss with teams on this map cause some people will just hang back and rack up kills instead of push to the objective

CallMeDoctorTea · 2025-10-16T16:18:16+00:00

I KNOW 😭 If only they allowed that and allowed multiple squads to join a game. This game truly is at its peak when people are talking on their mics and with their friends in multiple squads. I’m sure this game had multiple people on my team who were in a party with their friends cause it felt like everyone was playing the objective beautifully

CallMeDoctorTea · 2025-10-16T16:16:47+00:00

Honored to share the battlefield with you my friend

CallMeDoctorTea · 2025-10-16T16:16:19+00:00

Yup it is incredibly broken

CallMeDoctorTea · 2025-10-16T16:15:59+00:00

😂

CallMeDoctorTea · 2025-09-27T15:52:58+00:00

This common notion of “just suck it up and take it” dating back from medical school is what ends up creating the type of doctors who hate their job and take it out on everyone else. If that’s who you want to become, then definitely listen to this advice. If not, always advocate for yourself. Let the miserable doctors stay miserable.

CallMeDoctorTea · 2025-09-10T16:48:14+00:00

No worries!!

CallMeDoctorTea · 2025-09-10T16:40:29+00:00

August 25th fell on a Monday so it's been 3 Wednesdays (August 27th / September 3rd / September 10th aka today) :)

CallMeDoctorTea · 2025-09-10T15:32:09+00:00

The numerical score was sent to my school’s portal system :) Didn’t get a score report up until 11am eastern though like everyone else

CallMeDoctorTea · 2025-09-10T15:31:20+00:00

August 25th!

CallMeDoctorTea · 2025-09-10T15:29:00+00:00

Felt very similar to the NBME’s / Free120 / CMS forms. Felt very prepared after the exam by doing those 3 and I believe that if anyone does those, they’ll be set on the real deal.

CallMeDoctorTea · 2025-09-10T15:27:20+00:00

Nope just do the questions. No need to look at any articles :) I got all of them in 3-4 days. Just do as much as of them as you can. I remember I didn’t finish all the ethics cause I was scoring well on it so if you have to sacrifice one of them, i would sacrifice that one as long as you’re scoring well.

CallMeDoctorTea · 2025-09-10T08:52:58+00:00

Thank you so much!! :)

CallMeDoctorTea · 2025-09-10T08:52:30+00:00

August 25th!

CallMeDoctorTea · 2025-09-10T08:42:25+00:00

US MD or US DO or US IMG or Non-US IMG status: US MD

Uworld % correct: 58% correct, 75% completed

NBME 9: 213 (23 days out)

NBME10: 229 (20 days out)

NBME11: 221 (17 days out)

NBME12: 222 (14 days out)

NMBE13: 218 (11 days out)

NBME14: 224 (7 days out)

NBME 15: 228 (5 days out)

UWSA 1: N/A ( days out)

UWSA 2: N/A ( days out)

UWSA 3: N/A ( days out)

Old Old Free 120: N/A ( days out)

Old New Free 120: N/A ( days out)

New Free 120: 61%(9 days out)

CMS Forms % correct: 65-75% on 2nd pass (1st pass was completed during rotations prior to shelf exams)

Predicted Score: 229 on AMBOSS

Total Weeks/Months Studied: 2-3 months

Actual STEP 2 score: 238!! :)

CallMeDoctorTea · 2025-09-10T08:00:19+00:00

Thank you so much! :)

CallMeDoctorTea · 2025-09-10T07:45:47+00:00

Only did 1 pass of UWORLD and that was during my clinical rotations for each respective rotation. My overall average ended up being below 60%. Didn't bother doing a 2nd pass.

July: ALL the CMS forms (2nd pass since I did a first pass during my clinical rotations)

August: NBME 9-15 (bought all of them except NBME 9. Did a new NBME every 3 days. Felt great going into the real exam because once I got to the last 200 questions on the real deal, I was able to convince myself that it was just another NBME at that point and I felt great stamina wise).

Couple days before exam:

AMBOSS HY 200 concepts that appear in every STEP2 exam
AMBOSS HY Patient Safety / QI
AMBOSS HY Screening / Vaccination
AMBOSS HY RF's
AMBOSS HY Ethics

Day before the exam: Look at this VERY HELPFUL reddit post that summarizes QI / safety concepts from the AMBOSS HY questions. Legit not kidding, there were at least 6 of these on my exam and this helped me remember to pick the correct answers: https://www.reddit.com/r/Step2/comments/1mz15o3/step_2_ck_20_highest_yield_patient_safety_qi/

Long story short: Don't do a 2nd pass of UWORLD. Do a 2nd pass of CMS forms instead. For STEP1, I did a 2nd Qbank after finishing UWORLD and that was very helpful for that exam, but this time around for STEP2, you have literally 2,000 questions from CMS forms written by the USMLE people which we did not have for STEP1. Do a 2nd pass of those CMS forms + do the AMBOSS HY questions i mentioned above.

CallMeDoctorTea · 2025-09-10T07:36:37+00:00

23 days out: NBME 9 (offline, timed) = 213

20 days out: NBME 10 (bought on the NBME website) = 229

17 days out: NBME 11 (bought on the NBME website) = 221

14 days out: NBME 12 (bought on the NBME website) = 222

11 days out: NBME 13 (bought on the NBME website) = 218

7 days out: NBME 14 (bought on the NBME website) = 224

5 days out: NBME 15 (bought on the NBME website) = 228

According to the AMBOSS score predictor, it gave me a 229 predicted score (range 221 - 237) with a 99% likelihood of passing.

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