Taking a leave of absence (LOA) from medical school is a significant decision that involves careful consideration of various factors. In this article, I will consolidate valuable information on types of LOAs, reasons for taking one, and crucial considerations during and after. This information comes from my own experience taking an LOA between my 2nd and 3rd year of medical school, and the results of an anonymous survey of 16 medical students who have similarly taken an LOA. Of respondents, 37.5% took an LOA between the 2nd and 3rd year, and 31.3% took an LOA between their 3rd and 4th year of medical school. Unfortunately, 50% of respondents stated they were not given information from their school on important things to consider. Therefore, this article is written to meet this highly requested need.

Types of LOA

When considering an LOA, students typically encounter two options:

1. Academic LOA: 50% of survey respondents

• Often recommended by the school due to academic challenges such as failing courses or board exams.
• Viewed less favorably by residencies, according to insights from program directors and advisors.

2. Personal LOA: 50% of survey respondents

• Taken for a variety of personal reasons without the need for detailed explanations to the school.
• Requires an explanation in the residency ERAS application.

Reasons for taking a personal LOA

1. Study for USMLE STEP: 56%

• Need greater than the school allotted time for dedicated STEP studying
• Time to request disability accommodations

2. Personal health: 37.5%

• Physical and mental health conditions, disabilities, surgeries, and burnout.

3. Family obligations: 25%

• Starting a family, infertility procedures, postpartum extension, caregiving, marriage, or dealing with a family member’s acute illnesses or disabilities.

4. Professional: 12.5%

• Pursuing research, additional degrees, or seizing unique opportunities in temporary dream jobs.

5. Personal time: 6%

• Travel, enjoying life outside of school

6. Financial: 0%

• Loss of income, student loan challenges, and the need to work

Considerations during LOA

Several critical factors should be considered during an LOA:

1. Finances

• This is the #1 concern, fear, and challenge of students taking LOA.
• Student loans are taken away during LOA, and 38% of respondents who took out student loans didn’t know this was going to happen.
• The result of losing funding resulted in declaring bankruptcy for one medical student.
• Funding options included personal savings, work, family support, and public financial aid assistance programs.
• Be aware of loan repayment obligations and potential eligibility for financial aid.
• 50% of respondents were able to receive outside financial support.
• 54% received financial support from their parents, and 18% from their partner/significant other.
• 56% of respondents had to work a job.

2. Health insurance

• Assess how to finance health insurance during the LOA period.
• Consider out-of-pocket costs and Medicaid eligibility.
• Can sometimes continue the insurance through the medical school but need to pay for an extension of the plan.

3. Disability insurance

• Consider obtaining disability insurance, as it can provide financial support during LOA due to personal health issues and disabilities.

4. Housing

• Determine where you will live during the LOA.
• Consider the possibility of moving in with family.
• Check eligibility for Affordable Housing and Grants.

5. Academic support

• Check if the school provides continued access to academic resources and tutoring services.
• 62.5% of students studied for STEP1 or STEP2 during their LOA.
• 20% of students paid for a private tutoring service.
• 13% of students received tutoring through their school.

6. Emotional support

• Seek advice or mentorship from current or former students who have taken an LOA.
• 60% of respondents said they felt alone or very alone during their LOA.
• 53% of respondents stated “Not at all” to the school providing emotional support.
• Explore mental health resources for emotional support.
  • National Suicide Prevention Lifeline Phone: 988
  • A 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress.
  • Crisis Text Line, Phone: Text HOME to 741-741
  • Serves anyone in any type of crisis, providing them access to free, confidential 24/7 emotional support and counseling they need via text.

Residency application

When preparing for residency applications:

1. ERAS online application

• Be concise and honest about the LOA experience in the designated section.
• Highlight the lessons learned and the meaningful impact on your future career.

2. Interviews

• Understand that some programs may filter out applicants with more than four years of medical school.
• Be prepared to discuss topics surrounding your LOA experience during interviews.
• Specialties offering interviews to respondents who have taken LOA include psychiatry, family medicine, and neurology.
• Demonstrate to programs lessons learned and how the experience provided you skills that will make you a better physician such as resiliency, perseverance, and adaptability.

3. Matching

• Some specialties, such as neurology and family medicine, have seen individuals successfully match after taking an LOA.

Medical student survey results

Pending the final survey results, fears and concerns of students regarding LOAs include worries about not matching, financial challenges, and the impact on residency applications. Insights from those who have taken LOAs include feelings of being behind their classmates, the importance of emotional support, and navigating financial issues.

In conclusion, taking an LOA from medical school requires thoughtful planning and consideration of various factors. By understanding the types of LOAs, reasons for taking one, and essential considerations during and after the hiatus, students can make informed decisions and navigate the challenges effectively.

Stephanie E. Moss is a medical student.