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We dive deep into the topic of taking a leave of absence from medical school with Stephanie E. Moss. Stephanie, a medical student who made the decision to take a break between her 2nd and 3rd year, shares her personal journey and offers invaluable insights for students contemplating a similar path. From the various types of leaves available to the key considerations to keep in mind before, during, and after the hiatus, Stephanie provides a comprehensive guide to navigating this crucial aspect of medical education. Whether you’re facing a medical, personal, or academic challenge that necessitates a break, Stephanie’s practical advice and thoughtful perspectives will help you make informed decisions and plan your next steps effectively.

Stephanie E. Moss is a medical student.

She discusses the KevinMD article, “Navigating a leave of absence from medical school: a comprehensive guide.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Stephanie Moss. She’s a medical student, and her KevinMD article is “Navigating a leave of absence from medical school: a comprehensive guide.” Stephanie, welcome back to the show.

Stephanie E. Moss: Thank you, Dr. Pho. Thank you for allowing me to be here.

Kevin Pho: So I think Stephanie’s been on, I think, one or two years ago, talking about leaves of absence, and her most recent article is a guide to students considering one. So tell us what this article is about.

Stephanie E. Moss: Yes. So I had an interesting journey in medicine, as you’ve seen in the other articles. I did take a leave of absence from medical school between my second and third year of medical school, because I was struggling with different health challenges, and then also taking step one.

And one of the big things I noticed is, I wasn’t alone. I felt very alone at first, thinking that I was the only one, but as I started talking with other medical students, I realized that there was a whole bunch of this unforgotten group of students that had, for some reason or the other, had to take a step back from medical school. And a lot of the challenges that I was dealing with, I realized, were not uncommon.

So I got together a group of students that were just in my school. That was about 20 students that were at different grades, between first year in medical school and fourth year, and were taking time off for different reasons.

So after I went back to medical school, I kept getting questions about my journey, and so I was like, OK, these questions are common, and it seems that there’s not a lot of information out there of what to consider when taking leaves of absence, how it will affect your application to residency. So I created this guide. First I created a blog on my website with the longer survey responses, but then I also submitted it to you, to really get the information out there to help these students.

Kevin Pho: All right, so you talk about the two main types of leave of absence, academic and personal. So talk about each of those individually.

Stephanie E. Moss: Yes. So when someone decides to take time off, there is a document that usually schools provide students where they have to select, is this an academic leave of absence or a personal leave of absence?

Academic is usually because they failed too many courses, they have to retake a year, or have failed an exam. We more like to think about that as not really a chosen leave of absence. The school kind of requires a leave of absence.

Versus the personal one, you can do it for any reason. It could still be academic, but that one we consider more your choice. Now, that can be because of health reasons, that could be because of family obligations, could be professional, like you’re going to get your PhD, your master’s. There are a lot of different reasons, I found, that you can select the personal. But those are kind of the two big categories that individuals can choose when they actually decide to make that next step.

Kevin Pho: So when you’re talking to these dozens of medical students who had to take a leave of absence, what kind of resources were available to them at that time, of course before you wrote this helpful guide?

Stephanie E. Moss: Unfortunately, that’s the challenge. I have yet to find information and other people speaking on these, because it is a huge taboo to go beyond the four years of medical school, to go beyond the path.

And so there is tutoring that students can take, but a lot of times the school decides to actually not provide that tutoring because they’re not an actual student. And that is part of the challenge, is when students have to take a leave, they are no longer considered a medical student. So a lot of the resources that they would have received, a lot of benefits, that can be health care, that can be even access to a library to study, are taken away. So unfortunately there aren’t many resources out there of what to do when approached with this situation.

Kevin Pho: So tell us, what are some of the most common or top questions that medical students taking a leave of absence, what kind of questions do they have that you answer?

Stephanie E. Moss: Yes. So the biggest one is finances. A lot of students don’t realize that their financial aid is taken away until it happens. And so that’s a big question, is, how am I going to afford to take time off? Because legally, if you’re not in school, you cannot take out financial aid.

So a lot of questions is, do I have to work? Where can I find a job that will just allow me to work for three, six, nine months, a temporary job that will allow me to pay my rent, allow me to still study for step one or step two, if they’re also studying on their time off? So finances is one aspect.

Another aspect is how to bring it up with your residency when you’re actually applying. And so one of the biggest concerns and fears that a lot of students have is, how am I going to talk to residencies? Will I even be considered? Because I know in the past, it hasn’t been confirmed for this cycle exactly how it worked, but in the previous cycles, program directors could choose whether or not students have longer than four years of school. So automatically, if you have more than four years from your start date to when you graduate, you were taken out, or you were put on a different list.

I’m not sure if it’s still happening, but when I submitted my ERAS application for this cycle, there was a box that I did have to click that said, did you do more than the four years? So that’s a possible area that could discriminate to some extent from other students.

So students are very scared of, OK, will I even have the opportunity to get an interview? OK, then once you get to the interview, how do I talk about this huge, sometimes I call it a red flag, because that’s how sometimes some individuals see it.

And from my perspective, I’ve seen it as a way of growth, a way to really talk about how that experience really challenged me and allowed me to become a better doctor through my own journey. So I like to talk to other medical students to say, you’re not alone with the experience, and there are ways to move forward and to be able to get your degree and to be able to match into a program.

Kevin Pho: So I understand that you’re in your last year of medical school and you’re awaiting the match results. How often did your leave of absence come up during the interview trail?

Stephanie E. Moss: I would say 75 to 80 percent of every single interview I had, something came up. Part of it was because I had a lot of unique experiences during my time of absence, where I worked in a pain clinic, so I could talk about that experience. I also had a lot of financial difficulties and went on Medicaid and food stamps, so that was again an experience where I could share connections with my patients’ struggle with trying to get health insurance. So a lot of different experiences came out of it that I could talk about. But it was definitely a question that came up, of why did you take off, or can you talk more about this?

Kevin Pho: So you talk about how medical students who take leaves of absence, they’re not part of the medical school and stripped of a lot of the support the school gives. Talk about how trying that is emotionally, for not only yourself but the other medical students that you’ve talked to. How difficult is it?

Stephanie E. Moss: Extremely difficult. I’ve had some students that I’ve reached out to that were very emotionally struggling, because of being stripped from their title to some extent, that they had worked so hard to get to, and then suddenly that identity of being a medical student was taken away, and it hit them very hard.

And in the survey that I had, 17 students, the majority said they felt very alone, they didn’t feel emotionally supported. And so a lot of these common statements that they were saying were all surrounding just how alone they felt, and how much they emotionally struggled throughout the process.

Kevin Pho: Now, where do you recommend these students turn to for support, if not the medical school?

Stephanie E. Moss: Each other. I think community is huge. Being brave and trying to ask around to see if some other students are currently on a leave of absence or have taken a leave of absence from their school.

I was surprised how relatively common it was, especially in the past couple years with the pandemic. There was a lot of different reasons that led individuals to need to take extra time away from their graduate medical degree. And so I think it’s important to reach out to the community of other medical students, whether that is through social media or just through the grapevine, try to figure out, OK, who has taken some time off, that way they can get some support and advice for their specific situation.

Kevin Pho: Your article mentions specific specialties that have seen individuals successfully match even after taking a leave of absence. So talk more about those specialties.

Stephanie E. Moss: Those are just a couple specialties. Family medicine, neurology, psychiatry are the ones that I personally know individuals who have had leaves of absence throughout their career and have successfully matched. Hopefully after this cycle, there’s a couple M4s including myself, so we’ll be able to see even more which specialties.

And it’s not that it’s just those specialties that are more accepting. It was just, of the 17 students that I interviewed that had taken a leave of absence, or even individuals who were currently in residency and had reached out to me, that’s how I learned. But it’s really hard to know.

And so I recommend that students talk to their advisors, talk to residents and current program directors, and see, how do they see leaves of absence? Are they more understanding of a holistic application? And just try to see if this is an environment that they’re accepting of. I like to say a little bit of just humanity, more of just the different journeys that individuals can take.

Kevin Pho: Now, according to the survey, what was the experience of some of these medical students after coming back from a leave of absence? How did they reintegrate back with the other medical students, and what was their relationship like with the school?

Stephanie E. Moss: I’m actually pulling up my blog post right now, because I have extended answers from your article, and some of the answers that I received regarding fears after taking the LOA. And I’m quoting them: not matching, applying to residency programs and talking about my leave of absence, this is an issue. Impact on matching into residency. Step one in residency apps. Being able to match because of the LOA red flag. Same reasons, but also I start to feel a little indifference and freedom out of the medical field.

So again, a lot of fears on how will this impact my future career goals going forward.

It is interesting to take time off and come back, because you’re in a new cohort. And so for example, in my situation, my husband and my very good friends kept going on, they got their MD degrees, they’re all in their intern year right now. And I integrated with a new cohort during my third year of medical school, and it was challenging, because I hadn’t gone through this with this community. This group, this cohort, had gone through first year and second year together, and so I didn’t know a lot of the individuals. And now working in a team during third year, where there’s a lot of other medical students together, it’s hard because you do feel like an outsider. And constantly people would be like, oh wait, I don’t remember seeing you in second year. Or maybe because I was vocal about taking a leave of absence, they would say, hey, you took a leave of absence. So just constantly having to explain why I’m different was definitely a part of it.

And then also for other medical students, it was a frequent thing that they were mentioning, just how emotionally they felt distant from their classmates. Because they would still be in the social media groups, team groups together, and so they would see all the highlights and all the challenges, and they were still in the group, so they could see all these different things they were going through, but then they were still the outsider.

Kevin Pho: And just to be clear, you mentioned in terms of turning to support, you did mention peers. But as far as you know, other than you speaking out and posting this guide on KevinMD and your own blog, there is nothing formal, no formal counseling, consulting, that can help these students going through that path?

Stephanie E. Moss: I spoke a little bit with my administration about this challenge, and because of our experience, because there was a huge group of us who together had supported each other, our school is starting to create something to support these students.

During the leave, there was a couple times that I met with a school tutor, academic support, because I was still going through my step one exam. So thankfully I had that opportunity, but not every student was lucky enough to have that resource.

It is always something to recommend, to reach back to your administration and ask, hey, I know that there’s tutoring, can I still get it? Or, hey, my ID doesn’t work for the library and I need a place to study, can I have it reactivated so I can go study? So it is important to try to reach out, because you still are a medical student, even if you’re not paying at the time.

Kevin Pho: We’re talking to Stephanie Moss. She’s a medical student, and today’s KevinMD article is “Navigating a leave of absence from medical school: a comprehensive guide.” Stephanie, as always, we’ll end with some of your take-home messages to the KevinMD audience.

Stephanie E. Moss: I think one of the things that I like to say, I even started saying on my own podcast, is the idea is, you’re not alone. There are a lot of people struggling for whatever reason. It doesn’t have to be a leave of absence, but that doesn’t make you any different. It just means it’s part of your own individual journey.

And just know that there are other students who have struggled but have been successful, and so please use that success as motivation, to know that you can do it, because you deserve to be here. I know that impostor syndrome can really attack you, especially during this difficult time of studying for step one exam and taking a leave of absence. But you’re not alone in this journey, and there are other people that can support you. You just need to ask.

Kevin Pho: Stephanie, once again, thank you so much for sharing your story, time, and insight, and thanks again for coming back on the show.

Stephanie E. Moss: Thank you, Dr. Pho.