Failing USMLE Step I and how to get beyond it.
For many second year medical students, the prospect of taking USMLE Step 1 is looming “large” on the horizon. You have completed three semesters of pre-clinical science and the first step toward licensure as a physician rapidly approaches. Along with the exam and its preparation comes the thought of what will happen if you fail this exam. Statistics show that somewhere around 1/4th of people who take this exam, will not pass on the first try. While failing this exam happens, it’s better to consider that 3/4ths of the people who take this exam will pass.
So what happens if I fail?
If you fail, you generally have the option of re-taking the exam. Most medical schools in this country will have you do some remedial work and will have you sit for the exam a second time with little consequences (from the school’s standpoint) other than damage to your ego. If you fail Step I once, you can still practice medicine and you can still graduate from medical school. You have likely knocked yourself out of the moderately competitive to competitive specialties but you can still have a very satisfying career in the less competitive specialties.
The first thing that you have to do, if you open your test score report and find that you have not passed, is immediately figure out where you were deficient. The USMLE score report comes with a breakdown of where you lost points. You should immediately start your review in your weakest subjects/items. The next thing that you want to do is speak with your Dean of Education so that you can get an idea of the time frame that you have to submit a passing score. Some schools want a passing score on Step I before you can begin third year clinical rotations and some will allow you to complete a rotation that you have started.
Don’t make the grave mistake of attempting to do clinicals and study for Step I. If you failed this exam once, you need to put your entire attention into a thorough and adequate preparation for this exam. You can’t afford two failing scores here and thus, drop/delay your clinical rotations until you have passed Step I. It’s not going to be easy or quick in terms of preparing for a retake so don’t try to rush this process. As bad as one failing score looks, two failing scores can really kill your chances for a solid residency match.
Get the idea out of your head that you “are not good at standardized tests” or “that your career in medicine” is over. You just cannot afford this type of thinking. Your whole attitude needs to be focused on the task at hand, which is, passing Step I. If you cannot focus for a couple of days, then take that time to relax and let yourself come to terms with your circumstances but, depending on your school’s schedule, you likely need to get back into the study mode fairly quickly. Take some time to come to terms with your non-passing score but don’t let a non-pass set you into a “tail-spin” that prevents you from doing your best on a second attempt.
The other mistake that many medical students will make is believing that because they were able to do well in their medical school coursework, they are a “cinch” to pass Step I. This is not always the case as since I have been involved in academic medicine, it’s not always the students with the weaker academic records that fail but those who have a “false sense of security” because of their academic record. Make no mistake, Step I takes some preparation and review no matter how you scored in your coursework. Be prepared to give Step I, the attention that it needs no matter how much you want to enjoy your time off from coursework.
Another thing that you likely need to do is enlist the assistance of your Dean of Academic Affairs. There is no medical school in this country that has never had a student fail Step I. Your Dean of Academic Affairs can offer some assistance in getting your study methods on track. There may be great resources available at your school that you will be able to access since you have a failure on Step I. Be sure to find every resource (many likely free) that is available to you.
Another mistake that many students make is looking at the pass rates of a previous class and thinking that there is no way that you can fail. If the Class of 2008 has a 100% pass rate and you are the only member of the Class of 2009 that fails, that 2008 pass rate hasn’t helped you much. Passing or failing Step I is a personal matter and not class (or school) dependent. Either you have prepared well and performed well or you have not. These are individual characteristics and not school characteristics.
What kind of residency can I get with a failure on Step I?
If you pass on the second try, score some solid performances in your clinical rotations and perform well on Step II, you have a shot at a very good residency. No, you are likely not going to match into Derm, Ortho, Rads and Ophtho but you have a shot at solid programs in just about everything else if you post a good performance in things after your failure. Sure, it’s not the best situation that you have failed this very important exam but your career is not over. There is still a substantial amount of “medical school” in front of you that will provide an ample opportunity to show that a non-pass on Step I (on your first attempt) was an aberration rather than a characteristic of how you perform. Some options may not be there for you but more options exist than you would believe. You simply have to get this behind you and move on with what you have left.
Getting and keeping your head together
Again, your first priority is to do whatever you need to do to pass this exam. You cannot afford to wallow in blame but need to gather your reserves and get busy. Sure, it seems like everyone you know passed without difficulty but you didn’t pass and you have to pass this exam. The thing “is what it is”. The reality is that while this hurts; it’s not fatal. You can take this opportunity to learn what kind of reserve you have and how to thrive in adversity. These are characteristics that any residency program director would be happy to have in an incoming resident. Get your thinking together; enlist the help of your Deans and get this exam behind you. Performance on one license exam does not define your entire medical career unless you allow this performance to define your and your career. Sure, it’s important but in terms of percentages, most people pass comfortably on the next try and move on to good clinical rotations and residency spots.
Final Thoughts
If you find that you failed Step I, get your resolve together to:
- Get in contact with your academic Dean and Dean of Students.
- Find out what options are there for you to allow you to focus on getting ready for your retake.
- Put that non-pass into perspective and behind you; what have you learned “not” to do?
- Get the idea that your “medical career is over” and that you can’t match into a good residency program out of your head.
- Prepare efficiently and properly so that you do not find yourself failing your re-take (or any other licence step ) exam.
This is not about you as a person, physician or anything else. You simply didn’t pass Step I and you resolve to prepare and pass with a significantly better score on the retake.
Hello, I am a US IMG. I scored a 207/78 in my step1. I didn’t think I gave it my all due to other problems beyond my control. My desire has always to match into Emergency Medicine. I was wondering if my goals have been dashed by this score. I was also wondering if I can match in Internal Medicine with this score. ( IM being my 2nd choice). To be honest, I do not even know what specialty I can match in with this abysmal score. Thank you so much for addressing my question. I appreciate all your work.
To Thierry:
Emergency Medicine is a very competitive specialty for an American graduate because of the prized lifestyle and because of the limited number of residency positions(not very many compared to IM, FM). In general, very few IMGs (American citizen or otherwise) end up matching in Emergency Medicine. There are more Internal Medicine slots out there but you need to research programs very carefully as many have minimum cutoff scores for IMGs. Your best bet is to research programs where you might be competitive and apply there. You need to apply to a fairly large number of programs as your IMG status is going to be a bit of a liability even though visa issues will not. In any event, make some phone calls to programs, explain your Step I score and ask them if they will consider you. It is likely that some community IM programs won’t have a problem with your score since you broke 200 on one take. You can also study for and do an outstanding job on Step II both CS and CK. Take these early so that those scores will be in before you apply for the match.
To sum up: I don’t think that EM is going to work out for you (even if you scored extremely high on Step II CK/CS) but IM should be possible especially if you research programs where IMGs have been accepted in the past. You didn’t fail Step I but you can help yourself by acing Step II (CK and CS) which will make you a bit more competitive that just applying to IM with your Step I score. Good luck.
Hi drnjbmd,
I am IMG of 41 yrs of age, completing my pulmonology fellowship in UK, I got step 1 214 (90), step 2 234 (97), passed my cs all first attempt, I have post graduate degree in India, MRCP, MRCP ( pulmonology). I have graduated in 1997. My main problem was at medical school, I have to repeat my coursesrepe. Does this effect my residency programme for internal medicine and subsequent pulmonology fellowship. I am moving to USA for personal reasons. Regards CM
To CM:
I am not sure that you repeating courses in your medical school will affect you as much as your graduation date of 1997. Most residency programs will not take persons who have graduated more than 5 years ago. You should make some inquiries.
I’m US senior , failed step1 once and passed it with 194/79 and took step2 CK passed it with 194/75. My med school grades are pretty much reflective of my steps. I’m filling depressed b/c it seemed to me I will end up doing something that I hate most such as family med, internal med or psych. My plan is to apply broad for anesthesia. Is there any hope for anesthesia residency for me? should I just forget anesthesia and start coping with family med or psych, which I hated most during my 3rd year rotation.
To Reddick:
You should spend some time with the anesthesia program coordinator at your school who can look over your credentials and give you an honest appraisal as to your competitiveness in that specialty. It’s one of the more competitive specialties because of lifestyle and you don’t want to end up with no match and no residency position. You are going to need to do one year of preliminary medicine before beginning your anesthesia thus you have to like something about medicine if you perform anesthesia in any event. I would certainly follow the advice of your anesthesia program coordinator/chairman and make some inquiries into programs. There are no “less-competitive” anesthesia programs out there but you can figure out where you stand. You can also make sure that you do an anesthesia “audition” rotation early in your fourth year and do an outstanding job in that rotation so that you can get a strong letter of recommendation. I won’t tell you that you are going to face an uphill battle but you should go into that battle with the most objective information and appraisal of your competitiveness. Good luck.
You should thoroughly investigate your Plan B residency as again, you need to make sure that you are not trying to scramble around looking for a position. If you convince yourself that you hate Specialty B or Specialty C, you probably won’t end up liking Specialty A very much either.
Hello! I am an IMG, I finished medical school in 12/2007.I have no US experience because after I finished I got married and had 2 kids. I sterted residency in pediatrics in my country but things are not that well there and we came back to the US with my husband and family to start over. He finished in 2004 and he was in his 3rd year of ortho residency. He just took step1 and passed with 190. I am currently studying but find it very hard. Just took nbme and got very low score (170). I use UW and FA. what do you think our chances are for residency?
To Kal n:
With no US experience (read contacts), it’s going to be difficult to get into residency here. Many programs have specific cuts levels for IMGs which are usually around 200. The other problem is that many programs do not want to you be more than 5 years from medical school graduation which is rapidly approaching for you and has passed for your husband. Your best bet is to get some US experience and research programs that will be willing to take a chance on you. Good luck.
I am a 40 yo IMG graduated in 2004 i did a residency in nuclear medicine in spain and i have step1: 210 step 2: 226 (both first attempts) do you think i have a chance for matching IM, FM or Psych?
To Rubin:
You need to research residency programs as it’s been almost 8 years since you graduated from medical school. Many residency programs will not consider anyone who is more than 5 years out of medical school. You should contact programs that interest you and find out if you qualify since you are not a recent graduate. Good luck.
I am an IMG ,graduated in 2007 and just wanted to do 1 or 2 years of fellowship as an experience in general surgery in US.i was told that i needed to do all the USMLE steps to be able to do my fellowship. hence i did my step 1 and fail.
Now iam getting conflicting stories about whether i have to complete and pass all the steps 1 , 2 and 3 to be able to do fellowship.
could you please clarrify.
thank you
RJ
To RJ:
You need to contact your fellowship program. They will have the information that you seek. Depending on the type of fellowship that you are looking for, you may need to be eligible for an unrestricted license in the United States (need USMLE Steps 1, 2CK & CS, 3). If you only need to be eligible for a training license (USMLE Steps 1, 2CK & CE) then you likely would not need Step 3. Again, you need to speak to your program about this. Good luck.
I am an IMG, graduated in 2007. I passed step two but failed step one. Have I any hope of residency? I feel like giving up…
To Carlos,
You need to research some programs that will take IMGs who have failed Step I. You may also need to do an observership and perform very strongly so that you can get some strong letters which can offset that Step I failure. Do be aware that many programs will not consider a person who is more than 4 years out of medical school. Do some research on programs. You should also find programs where you may have contacts who know you well and can vouch for your clinical skills. You need to more fast though.
Hi
I am an IMG, two yrs out of med school. I am planning to pursue USMLE for int med/surgery.
But I hv nothing to show on my CV, no USCE, electives, observers or publications. What do you think are my chances of matching in 2013, and how should I go about it???
Thanks
To BDN:
As an IMG, it’s going to be difficult for you to match without any US experience or contacts. You need to get moving pretty fast as you have to have passing scores (one take) on USMLE and you need US experience. The other thing that you need to keep in mind is that most places do not want more than 3-5 years post medical school graduation thus you have a very short window to get your credentials/experience in place. Good luck.
I’m at top 15 med school in US, not IMG. My med school requires I just have to sit for the exam (Step 1 and 2). I’ve unfortunately put both off and plan on graduating in May 2012. I’m studying for Step 1 now and have been for a month or so. I can take Step 2 CK, CS in May before graduating, as long as I have sat for it. I want to know which is worse given my time constraints: sitting for exams (1 and 2), and if worst comes to worst failing any of them, then retaking and doing much better (230′s) or just pushing now and scoring mediocre (200-210).
Please help bc my stress levels are maxed out.
To J:
Regardless of what medical school you attend, failing any of the steps of USMLE can be problematic. Getting a second score, even if it’s 260 is not as good as passing outright. USMLE is not the MCAT which means that “do-overs” are very costly no matter what your second score turns out to be. Rather than stress, you need to plan a sound strategy to get these exams behind you successfully. No matter how much one stresses or doesn’t stress, you don’t have the luxury of wasting time on stress. Work consistently and systematically to get these exams done without question. If you fail these exams, any score after that score becomes mediocre. Good luck.
I am a IMG 2007, working in a hospital in the united stated in the pediatric emergency department as a M.A. , I’m about to take the step 1 for the first time, but I failed in the nbme self assessment test, I can’t reschedule cause, already did it, do you think is better to cancel the appointment? and the fact that I graduate in 2007 will affect me? and working in the hospital will help??
To Denisse:
Don’t take USMLE (any step) unless you are thoroughly prepared for this exam. If you failed the NBME Assessment Test, you likely do not have the knowledge base to pass USMLE. You need to be sure that having graduated from medical school in 2007 will not affect you getting into residency. You are more than 3 years out of school and that might be a problem for some residencies. Also, if you fail a USMLE Step or if you don’t score high enough to meet the requirements for IMGs you will have a tough time getting into residency. This is why you can’t afford to fail any USMLE Steps and should attempt to score as high as possible. Good luck.
Can i get job in america after step 2—-
To AMEN,
You can’t work in the United States in medicine without a license. You won’t be eligible for licensure without all steps of USMLE.
Hi,
First, thanks SO much for your time in answering questions here. I am a foreign graduate and failed Step 1 first try. Now, if I pass Steps 1 and 2, how to do you see my chances of going into a Psych specialization?
Thanks again so much for your help.
To Wanda:
You need to select the programs that you apply to very carefully. Look at their websites especially their requirements for IMGs/FMGs. Some programs will not accept IMG/FMG applicants with any failures but others might. Look at the match rate for the previous year so that you might find programs that didn’t fill who might not care about your Step I failure. You may be able to contact a few of those where you can secure a position outside of the Match. Good luck.
i passed step 1 on 2nd atttempt with 188/75.what are my chances for residency
To Mirabel:
Your “chances” for residency depend upon many variable including: the specialty that you expect to enter. When you graduated from medical school. The programs that you apply to (some won’t consider an IMG that has failed any of the USMLE steps or have strict score cutoffs for IMG). You need to research (can do this on the web) into the programs and specialty of interest to you. You may need to have US clinical experience (observership) and you may need to have graduated from medical school within the last 3 years. Do some research, make sure that you have strong letters of recommendation from physicians who have worked with you and know your clinical skills well. You also likely need to take and pass the other USMLE Steps before you can enter the match. Good luck.
Thanks for the response.I ve not yet graduated from med school ,im still in my third year,i was just asking the question cos i ve failed step 1 once and on my 2nd attempt i scored 188/75.i know i still need to finish other steps and so on,and that it depends on what residency i want.i m just asking ,is there still hope for me,with my 2nd attempt score of 188 for any residency at all,should i go ahead and take step 2 and 3 or should i lose hope of any residency in the states.In summary with a 2nd attempt score of step 1 of 188,if a get a good step 2 and step 3 score ,good LOR and USCE,would that make up for my step 1 and give me any residency at all in the states.
To Mirabel:
The answer is still the same. Programs and specialties vary in what is required for IMG/FMGs. You have to do some research and not fail anything else to maximize your chances of getting a residency in this country in anything.
well i dont care any residency or program i get into,i dont mind,even family practice,anyone at all is okay for me,i dont have any choice now.so if i do a research and dont fail other steps ,i still have a chance of getting into any kind of residency or atleast some programs regardless of what it is.also what kind of research can i do and how long does it normally take?
To Mirabel:
You can’t wait too long to enter residency. Some programs want you to have graduated from medical school within 3-4 years of entering residency. This is especially true of Family Medicine programs. If you elect to do research, you can’t spent too much time doing research or you won’t qualify because of the time between medical school graduation and eligibility to enter. Sure, it may appear to be easier to enter “any” specialty but you need to choose something and work very hard (and efficiently) to make yourself eligible to enter that something.
i passed step on 2nd attempt with 188/75,i am an IMG,what are my chances for residency
I can tell you all that there is hope after failing step 1 or scoring average on step 1. I had 188 on step 1 and I was devastated when I received my score. drnjbmd advice was helpful by suggesting that I figure out why I did not do well on the exam. I know that the exam did not represent my level of knowledge like most of my results in medical school. I am a student that like to take time to do things and understand in depth the details of every subject but exams are not set for indepth knowledge to that degree. I realized later that I need to save my energy and just do what is expected from me in exams. When taking step 2ck and my other med school exams, I study with less aggression but was more focused on the objectives of each course. For step 2ck, I focused on the u-world Q-bank like most of my peers had done and I did not open the first aid book because it is not written in depth enough for my understanding. I did found another review book (master the boards) that was concise yet in depth with a better way of explanation. In a nut shell, I scored 236 on the step 2ck, my goal was 235. I did not get a lot of interviews for my residency of choice and I applied to an alternate program and got the same number of interview as my residency of choice. I got 10 interviews all together in family medicine and Ob/Gyn. I do not know where and in what I will match but I feel good about myself after my step 2ck. I must say that I did not take my exam till November and it did hurt my chances of getting interviews. What I learned from that is that when people say take your step 2 early, it means take your step 2 in June, or July. I also feel that I did better on my exam because I was not in the vicinity of my major stressor(s) when I took the exam (figure out what your stressors are and stay away from them if you want to progress in medical school).
Hi drnjbmd,
I’m a 3rd year at a US allopathic school. I failed Step 1 with a 183 and then passed with a 207. I’d like to apply to Pediatrics. Do you think I still have a good chance of matching? Do you have any advice on how to convey that I’m still a good candidate and get interviews? Would it make sense to take Step 3 before applying? How many programs should I think of applying to and what types of programs would be within my reach? Thanks.
To Yoda:
You have passed Step I which is good. You can greatly help your case by taking Step II as early as possible and passing it on the first try with a solid score. Step III doesn’t count for much since most people take it after graduation and the match. Right now, you should concentrate on doing well in your rotations (honor Pediatrics for sure); take and Pass both parts of Step II on the first try and apply broadly. If you don’t fail any more USMLE Steps and your clinical grades are pass to honors, you should be able to match into all but the most competitive peds programs. Make no mistake, that failure on Step I will be a factor but it becomes less of a factor if you do well from here on out.
I am a resident in pathology. After passing Steps 1 and 2 with average scores, I failed Step 3. This was pretty devastating to me since I have had no difficulty with USMLE exams previously, and I have had some things happening in my personal life that has made it very difficult to study. I am wondering what the long term consequences will be for me now that this failing score is permanently on my USMLE record. Will this score prevent me from obtaining a fellowship or a job in the future? Any thoughts or advice?
To pathMD:
If you are already in residency, failing USMLE Step 3 is of little consequence other than the cost of the test. Of course, you can’t be licensed until you pass Step 3. Yes, people do fail Step 3 but you have to find a way to get this exam passed so that you can get your unrestricted license to practice medicine. Do be aware that some states have a 7 year rule which means that you must pass Step 2 within 7 years of passing Step 1 or you have to go back and retake Steps 1 and 2. As long as you don’t get hung up with that problem, study what you need to study and get Step 3 behind you. Be sure to correct what you need to correct before you attempt the exam again. Most employers will want you to have an unrestricted license in some state when you apply for a job at the end of your residency. Your state license board will have a transcript of your USMLE attempts and passes but other than that, you should be fine once you get the exam passed. As for fellowship, your in-training exam scores will count in that selection process. Make sure you pass those exams and do any papers/projects that your residency requires.
I went to school in the caribbean graduated 2010. I have Failed Step 1 twice and am about to give my third attempt. I know i need to focus on taking this exam but cant help but think about the future. I want to know if i have any chances at all in just matching for a residency in family medicne or pediatrics. Otherwise should i just quit before i waste anymore time.
To Leena:
The question becomes, “What are you going to do with a degree and no license to practice medicine in this country?” Whether you match or not doesn’t make much difference if you can’t pass the licensure exams. It isn’t likely that you are going to be very competitive for any residency until you pass Step I and Step II of USMLE. Most residency programs would not invite you for interview without Step I and II (most folks in this country have taken and passed those exams) thus you are somewhat forced to “focus” on what you need to do to pass USMLE regardless of “the future”. Focus on one step at a time and then look at your options after that.
Hi Njbmd,
I am a first year student. I did horribly on two exams and there is no way I can possibly pass these two courses. Do you think it is better to just fail these 2 courses and continue with my class or request a LOA and leave with no grades on my transcript? I am worried because if I fail anything else I will have to repeat a year.
Thanks,
Chris
To Chris:
Much depends on the reasons for your failures. If you are just not ready for the level of work that you must achieve in medical school, then you are better taking a LOA (if you are eligible for this), correcting your deficiencies and coming back with the tools to do well in your coursework without exception. If you were ill and just couldn’t put in the time that it takes to get the work done, then you are likely to be able to pass these courses with remediation and continue with your class. I would encourage you to take a long and objective look at why you failed and discuss your situation with your Academic Dean. If you are severely academically deficient, your chances of doing well enough on any remediation is quite unlikely, thus, you put yourself in a position to eventually fail out of school completely unless you “shore up” your deficiencies before you move on. Trying to graduate with your class doesn’t isn’t a sound reason for taking the remedial route unless you are very sure that something (illness, family emergency) prevented you from getting your work mastered.
Do keep in mind that even with no grades on your transcript, you will be asked in residency application if it took you more than 4 years to complete medical school. While this isn’t much of a problem for less competitive specialties, it might be problematic if you are interested in a more competitive specialty. With that said, failing two classes and remediating might also affect your residency choices as you won’t have a high rank in your class and you might have difficulty with Step I. Again, have an objective and rational discussion with your Academic Dean and make the best choice for you to get your coursework mastered so that you can move on. If you elect to take the LOA, keep in mind that no patient will every ask you how many years it took you to complete medical school thus in terms of patient care, it won’t matter very much but there are consequences to both options thus you need to be sure that you make the best decision that will enable you to make the most of your career and have the highest level of success in the future. Good luck.
Just a short note to say that I really like your articles; as a married mature student in fourth year I’m struggling at the minute but you’ve got some great advice and a ‘no bulls**t’ approach (if you’ll excuse the phrase) that is quite inspiring. Great stuff.
Did u apply for match?
To Shaik:
I definitely entered the match and matched in General Surgery at a very strong university surgery program.
hello,
where did u go to med school how did u study for step 1
To Shaik:
I went to an allopathic medical school in the United States. My main method of study for USMLE Step I was to completely and thoroughly master my coursework without exception. During first and second year, I focused on every class and cut no corners when it came to study. You can find other posts about my study habits which were consistancy and constant work every day with prep for each class and review after each class.
I had a scholarship fellowship between my second and third year thus, I had to focus my review and efficiently review for that exam. I concentrated on the subjects that were well-represented on USMLE (pathology, pharmacology and physiology). In physiology, I focused on a strong review of respiratory, cardiac and renal physiology with review of gastrointestinal physiology. In pharmacology, I focused on CNS and autonomic pharmacology with a strong review of immunomodulators and antibiotic classes.
I had about two weeks to review since my fellowship required that I take USMLE Step I early. I certainly recommend that you spend more than two weeks reviewing for Step I but I divided my review into 50-minute sessions (6 per day) with 10-minute breaks. The last session of my day was spent doing questions from Kaplan’s Q-Bank. I did 50-questions at a time and mixed them as the exam would do. If I missed a question, I would look at the subject matter and make a note of why I had missed that question. I also looked at the manner in which the questions were written rqther than memorize answers to specific questions.
On the day before the exam, I filled out an index card with my biostatistical formulas and pharm formulas only. That card was for last minute memorization so that I could quickly write those formulas on my dry-erase board when I entered the testing room. After I wrote those formulas, I could relax and do the questions. I also made sure that I slept well and ate lightly. I didn’t take anything except a water bottle with me to the exam center. I did have some energy bars but didn’t eat them as once I was on a roll, I didn’t want to stop. When I left the center, I felt that I knew some things well and had no idea of other things on that exam. It turns out that I did well on the exam and passed with a very solid score (the highest at my medical school). I certainly can’t tell you how I was able to achieve this but I was happy to pass and move on.
i am IMG , I TOOK STEP 1 AND FAILED BUT RETAKE IT AND PASS WITH 77 , AFTER THEN I START TO PREPARE FOR CS WHICH IVE FAILED TWICE NOW AND CK ONCE WITH A SCORE OF 73 , I DONT WHAT WENT WRONG WITH ME . PREPARING FOR EACH EXAM TOOK ABOUT 6MONTH . I AM CONFUSED, DEPRESSED… DO I HAVE ANY CHANCE OF RESIDENCY? SHOULD I JUST QUIT?