ERAS & Residency Application, Medical Students, Personal

Time Out: Things to Consider When Taking a Year Off from Medical School

When buried deep in the throes of Step 1 studying or during the 14th hour of a 16-hour overnight clerkship shift, it’s hard to imagine prolonging medical school past the standard four years. For others, a leave of absence (LOA), usually taken between third and fourth years, is imperative for ensuring readiness for the rigors of residency and confidence in committing to a career in medicine.

Taking a LOA has become more common among medical students across the nation. According to the Association of American Medical Colleges (AAMC), there has been a rise in the proportion of medical students who add at least one year to their medical education.1 From earning a graduate degree and pursing professional interests outside of medicine to fulfilling personal/family obligations, or just taking time to recharge, there are a plethora of reasons why students decide to take a LOA. While reasons vary, there are several things every student should consider:

What are your goals for your year off, and how will your planned activities meet those goals?
The interruption in your medical education will be immediately obvious to residency programs, and the first question they will ask is, “Why?” Most residency acceptance committees understand the value and/or necessity of time away for some candidates. However, it’s important to work with your advisors to determine if a LOA is really best for you. Developing a clear plan for meeting your goals and maximizing your time away will keep you on track during your LOA, and it will help you avoid triggering any “red flags” down the road. Regardless of your reasons, during interviews you will need to clearly articulate what you gained from your time away and how it made you a stronger candidate for residency.

What are the financial implications of a gap year?
Whether you’re planning to volunteer, continue taking classes towards another degree or accept a paid position, it is imperative to check-in as early as possible with your loan servicers and your school’s financial aid department. Every student’s financial situation is different, but student loans are nearly universal. Some loans will go into repayment as soon as you drop below part-time student status, while others have a finite deferment period that you may have used during a previous gap year. Furthermore, if you are planning to accept an unpaid position, you will need to start thinking early about how you will cover living expenses without an income or student loans. There are grants and scholarships available for students pursing these experiences. However, these are often highly competitive and applications are due early. Start looking into your financial options for your LOA as early as possible to avoid any surprises.

Will you receive medical school credit for your year off?
Depending on the medical school you attend and what you will be doing during your time off, you may be able to receive medical school credits for experiences while away. If you can stay enrolled as a part-time student, this may also save you from having to start repaying your loans during this year. It’s important to touch base with your dean or advising office well in advance of your departure to determine the requirements for receiving credit, as well as your individual school’s stipulations for taking a year off.

How will you stay connected to your medical school (and medicine)?
Regardless of the length of the LOA, most students end up returning to medical school at some point. There are important deadlines you will need to meet leading up to your restart date (submitting your FAFSA, applying for VSAS, setting up third- or fourth-year rotations, etc.). Stay in communication with your medical school to keep track of these deadlines so you don’t miss out.

It is also important to think about how to stay engaged in medicine during your time away. If you’re planning to do research or clinical work, this may be a non-issue. However, if you choose to pursue opportunities outside the field of medicine, it is crucial to find ways to maintain the skills and knowledge gained during medical school.  Working part-time on a research project, volunteering with an ambulance service or spending time in a clinic are all great ways to stay involved. Periodically touching base with mentors throughout your LOA is a great way to maintain the relationship you built as a medical student. Keep them updated on your activities as this will also make it easier for them to help you organize your MS-IV year, to compile your residency application and to write you a letter of recommendation, if applicable. Furthermore, depending on your school’s academic calendar, you may restart in June or July of MS-IV year, a critical period for completing away rotations and sub-internships. In order to hit the ground running and ace these rotations, consider doing a few “warm-up” shifts with mentors or advisors in your field in the weeks leading up to your official restart date.

Taking a LOA from medical school can be a great opportunity to pursue other professional interests or to rejuvenate your passion for medicine prior to starting residency. Before committing to this path, consider the logistics of your LOA early to prevent unnecessary stress and surprises later. Most important, think critically about how to ensure the time will be worthwhile for you on both professional and personal levels.

Caulfield M, Redden G. Graduation rates and attrition factors for U.S. Medical Students. AAMC Analysis in Brief. May 2014;14(5).

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