Survey Responses & Advice
LOA & Residency Application
In this post I have consolidated all the information on taking a Leave of Absence (LOA) from Medical School and how to discuss it in your residency application. The below information comes from my own experience taking an LOA between my 2nd and 3rd year of medical school, and the results of multiple surveys of medical students who have similarly taken an LOA. The first survey (17 respondents) which found that 53% 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.
If you would like to share your experience fill out this anonymous survey created with collaboration with Tufts Medical School.
Poster on LOA Presented at the 2025 American Psychiatric Association Meeting
The school usually requires or "highly recommends" a LOA
Usually because one has failed too many courses, has to retake a year, or has to retake a board exam.
This is seen not as favorably by residencies (confirmed by multiple Program Directors and Advisors)
53% of survey respondents
Can be for ANY reason (see below)
Usually considered a "choice" to take a leave
One does not need to explain WHY to their school
35% of survey respondents
Do have to provide an explanation in the Residency Application Process (see below)
***When one takes a LOA from medical school, one must sign a piece of paper from administration check marking one of these two options
Here are some reasons students have reported taking a LOA in the survey, individual interviews, and through online research
Study for USMLE STEP: 59% of respondents
Necessitate a greater time for dedicated STEP studying than the school's allotted time frame Step1: usually 2 months provided for dedicatedStep2: usually 2 - 8 weeks available as Elective time during M4 year
Step1: usually 2 months provided for dedicated
Step2: usually 2 - 8 weeks available as Elective time during M4 year
Time to request disability accommodations
Need to retake the exam after a failure
Personal health - 41% of respondents
Acute mental health condition
Chronic mental health condition
Acute physical health condition
Chronic physical health condition
Burnout - 35% of respondents
Family obligations- 24% of respondents
Acute Illness or Disability
Professional - 12% of respondents
Special or unique opportunity in dream job/position
Unable to qualify for student loans nor have an endorser
Work to financially support self, family, or partner
Personal Time - 6% of respondents
Enjoy life outside of school
Of respondents 41% took an LOA between 2nd and 3rd year and 29.4% took an LOA between their 3rd and 4th year of medical school.
Considerations before taking an LOA:
How will you finance the months or year off?
This is the #1 concern, fear, and challenge of students taking a LOA
Funding options included personal savings, work, family support, and public financial aid assistance programs.
Scroll down to Part 5 of this blog post about finances in medical school
Student Loans:You are not allowed to take out Federal Student loans when you are on a LOAYour student loans will need to start being paid back after 6 months of LOA Can extend the holding period by contacting your loan provider and having the school send a form saying when you will return to schoolStudent loans are taken away during LOA 38% of respondents (5/13) who took out student loans didn’t know this was going to happen
You are not allowed to take out Federal Student loans when you are on a LOA
Your student loans will need to start being paid back after 6 months of LOA Can extend the holding period by contacting your loan provider and having the school send a form saying when you will return to school
Can extend the holding period by contacting your loan provider and having the school send a form saying when you will return to school
Student loans are taken away during LOA 38% of respondents (5/13) who took out student loans didn’t know this was going to happen
38% of respondents (5/13) who took out student loans didn’t know this was going to happen
47% of respondents were able to receive outside financial support
50% received outside financial support from their parents, 16.7% from their partner/significant other, and 8.3% from family
53% of respondents had to work a job such as (tutoring, research lab, medical assistant, fitness instructor, babysitting, etc.)The result of losing funding even resulted in declaring bankruptcy of a medical student because they could no longer afford to pay for their living expenses without their student loans
53% of respondents had to work a job such as (tutoring, research lab, medical assistant, fitness instructor, babysitting, etc.)
The result of losing funding even resulted in declaring bankruptcy of a medical student because they could no longer afford to pay for their living expenses without their student loans
Do you qualify for any financial aid assistance through city, state, or federal programs?
Food stamps (SNAP) Application if you have NO family financial support or external income is under $0
State or city utilities Support
WIC: If you or your partner is pregnant or have a young child
How will you finance Health Insurance?
Do you have a partner that you can go on their plan?
Some schools allow you to remain on the same plan but you will need to pay out of pocket. For example mine cost $4,000 for 9 months off of school
For example mine cost $4,000 for 9 months off of school
Are you eligible for Medicaid?
Most residency's recommend and provide disability insurance to residents because one never knows when a visible or invisible disability can arise which could impair you temporarily from working
However, rarely do medical schools recommend, provide, or encourage students to get disability insurance
The AAMC mandates medical schools have disability insurance available as a benefit to students but this is not advertised to students
Most plans provide: $1,500/month to 1st & 2nd year medical students on LOA$2,000/month to 2nd & 3rd year medical students on LOA
$1,500/month to 1st & 2nd year medical students on LOA
$2,000/month to 2nd & 3rd year medical students on LOA
See an example of the benefit at Loyola Medical School in Chicago
Do you need to move back home or with a family member?Multiple students reported needing to give up their lease or housing to move in with family because they did not have the student loans to pay for rentSome students had to travel multiple states and pay out of pocket for travel and moving expenses
Multiple students reported needing to give up their lease or housing to move in with family because they did not have the student loans to pay for rent
Some students had to travel multiple states and pay out of pocket for travel and moving expenses
Check eligibility for Affordable Housing and Grants
Some students struggled so much with affording housing that they were at risk of being evicted for being late on making rent payments
Does your school provide you continued access to academic study spaces and tutoring services?
Here is my Blog Post about:Study Resources for Medical School (Part 2)Failing a quiz, test, course, or year of medical school (Part 3)
Study Resources for Medical School (Part 2)
Failing a quiz, test, course, or year of medical school (Part 3)
Have you considered Requesting Disability Accommodations
Do you need to pay out of pocket for tutoring or Step preparation?
Here are my suggestions on how to study for STEP1 and Not Fail
59% of students studied for STEP1 or STEP2 during their LOAPreparing for STEP is expensive because you have to pay for each practice test and practice questions (UWorld) which can be around $500 totalEvery time one re-schedulees the STEP exam there is a $100-200 fee
Preparing for STEP is expensive because you have to pay for each practice test and practice questions (UWorld) which can be around $500 total
Every time one re-schedulees the STEP exam there is a $100-200 fee
19% of students paid for a private tutoring service
13% of students received tutoring through their school
Are there any current or previous students at your school who took an LOA who can provide you advice or mentorship?
We created GroupMe for Medical Students in our school which included around 30 students who have been on or are currently on an LOA which has been helpful to remind ourselves that "You are NOT ALONE"
Does your health insurance or school cover therapy and counselling services?
I like The STIGMA App to connect with other individuals suffering from their mental health and receive anonymous text & video receive messages of hope
Here is a list of Mental Health resources I have compiled including books, podcasts, videos, and moreNational Suicide Prevention Lifeline Phone: 988A 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress. Crisis Text Line, Phone: Text HOME to 741-741Serves anyone in any type of crisis, providing them access to free, confidential 24/7 emotional support and counseling they need via text.
National Suicide Prevention Lifeline Phone: 988A 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress.
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 741-741Serves anyone in any type of crisis, providing them access to free, confidential 24/7 emotional support and counseling they need via text.
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.
Study Results:60% of respondents said they felt alone or very alone during their LOA
60% of respondents said they felt alone or very alone during their LOA
56% of respondents responded “Not at all” (1) vs 0% responded "very emotionally supported" (5) to the school providing emotional support during their LOA
The "Choice" of Taking an LOA
Survey Responses & Advice:
I sent out a survey to my student group of ~30 students who have taken an LOA at my school in the past 4 years. I also advertised the survey to the current M2,M3, M4, and Interns in case anyone took an LOA and I didn't know about. I also sent the survey out to a couple medical students which I had met at conferences and social media who had taken an LOA from medical school.
Final Results: from 17 students who responded
Question: What fears did you have about taking an LOA?
"Financial. Also I am incredibly close to my classmates and I was afraid I wouldn’t graduate without their support."
"Possible red flag on application to residency."
"Impact on matching into residency and lack of financial support"
"Financial and if I could achieve academically"
"How I would pay for housing, food, and health care with out my student loans"
"Negative impact on residency applications"
Question: What fears do you have after taking an LOA?
"Applying to residency programs and talking about my LOA-this is still an issue."
"Impact on matching into residency"
"Step 1 and residency apps"
"Being able to match into residency because of the LOA red flag"
"Same reasons, but also that I started to feel a little indifference and freedom being out of the medical field"
Question: What are some things you wish you knew before taking LOA?
"You will feel behind since your class will be 'ahead'"
"How alone I would feel. The stigma around it."
"Financial aid changes and having to pay back to the school for loans I had already taken out and used"
"More information on how an LOA would impact my future career, especially the perception of an LOA by residency program directors"
"Understanding how to navigate the financial issues with discontinued loans"
"I unfortunately was caught in more financial struggle than I imagined and my school was going through a curriculum change that has made me have to start third year later than I thought"
On the 2023 Residency Application this box was included: "Was your medical education/training extended or interrupted?" (510-characters)
Since it is only 510 characters you have to be "short and sweet"
Make sure to state facts and are honest
Make sure to include 1-2 sentences of what one learned and how the experience was meaningful to their future career as a physician
One can always include more in their personal statement, activities, and box for "Impactful Experiences" 750 character limit (with spaces)
I was told by a Residency Director that they can filter by students who have had NO MORE than 4 years of medical school, this means that an individual who has taken an LOA (an extra year of medical school) would be filtered out
Out of the 44 programs I applied I have received ~20 interviews even though I have taken an LOA. However, I did receive rejections and haven't received replies from residency programs that might have filtered me out for my LOA
Rarely have I been out-right asked about my LOA, but I have been asked about the topics sounding my LOA experience since it was a significant time point in my medical journey (health, financially, professionally, and academically).
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.
Here is a list of specialities which I personally know individuals who have taken LOAs and have successfully matched:NeurologyFamily MedicinePsychiatryInternal Medicine
More Resources on Residency App
More on My Podcast: "Life as a Patient-Doctor"Blog Post: Disability Disclosure in Residency Applications Blog Post: Applying to Residency A Strategic Guide for Medical Students
For more specific information on my personal journey taking a LOA you can read the following blog posts:
"The Decision Whether to Extend my Leave of Absence (LOA) from Medical School"
"How one’s identity can be shaped through life's traumas, struggles, and failures"
"Financial Realities of Being in a Medical Student in a Lower Social Economic Status (SES)"
"Addressing the Red Flags in my Residency Application"
Listen to my Podcast Episode on KevinMD Podcast:
This anonymous survey was created with collaboration with Tufts Medical School
If you would like to meet to discuss your unique situation sign up for my personalized coaching here.