Taking a Leave of Absence (LOA) From Medical School
In this post, I have consolidated information on taking a Leave of Absence (LOA) from medical school, what you should consider before taking one, and how to discuss an LOA in your residency application.
The information below comes from my own experience taking an LOA between my second and third years of medical school, as well as the results of surveys of medical students who have similarly taken an LOA.
In my first survey of 17 medical students, 53% of respondents reported that they were not given adequate information from their medical school about important things to consider before taking an LOA.
This article was created to help fill that gap.
If you would like to share your own experience, fill out this anonymous survey created in collaboration with Tufts Medical School.
Poster on LOA Presented at the 2025 American Psychiatric Association Meeting
Required vs. Voluntary Leaves of Absence
Not every Leave of Absence happens for the same reason.
Some LOAs are required or strongly recommended by a medical school, while others are initiated voluntarily by the student.
School-Required or Highly Recommended LOA
A medical school may require or strongly recommend an LOA when a student:
- Has failed multiple courses - Needs to repeat part of the curriculum - Needs to repeat an academic year - Needs additional time to prepare for a board examination - Needs to retake a board examination after a failure
Based on conversations with residency program directors and advisors, a required LOA may be viewed differently than an elective or voluntary LOA during residency applications.
In my survey, 53% of respondents reported taking this type of LOA.
Voluntary LOA
A voluntary LOA can be taken for many different reasons.
This is usually considered the student's "choice" to take a leave.
Depending on the school's policies, students may not necessarily need to disclose the specific reason for the LOA to their medical school.
However, applicants may later need to address an interruption or extension in their medical education during the residency application process.
In my survey, 35% of respondents reported taking a voluntary LOA.
***When taking an LOA, students may be asked by their medical school administration to formally designate the type of leave they are taking. Policies vary by institution, so make sure you understand how your school will classify your LOA.***
Reasons Medical Students Take a Leave of Absence
Students take LOAs for MANY different reasons.
The following reasons were reported through my surveys, individual interviews, and research.
Studying for USMLE STEP Exams — 59% of Respondents
Some students need more dedicated study time than their medical school provides.
Common reasons include:
- Needing additional dedicated study time for Step 1 - Needing additional dedicated study time for Step 2 - Needing time to request disability accommodations - Needing to retake a board examination after a failure
Medical schools traditionally provide a limited dedicated study period, and some students simply need additional time.
Personal Health — 41% of Respondents
Health-related reasons included:
- Acute mental health conditions - Chronic mental health conditions - Acute physical health conditions - Chronic physical health conditions - Disability-related needs
Burnout — 35% of Respondents
Burnout can significantly impact a student's physical health, mental health, academic performance, and overall ability to continue training.
For some students, temporarily stepping away from medical school provides time to recover and reassess their needs.
Family Obligations — 24% of Respondents
Family circumstances may include:
- Caring for an ill family member - Serving as a caregiver - Family emergencies - Supporting a partner or child - Other significant family responsibilities
Professional Opportunities — 12% of Respondents
Students may take time away for:
- A unique professional opportunity - Research - A dream job or position - Academic opportunities - Other professional development
Some students also need to work because they cannot qualify for additional student loans or do not have someone who can serve as an endorser.
Others may need to financially support themselves, their family, or their partner.
Personal Time — 6% of Respondents
Some students simply need time away from medical school to focus on life outside of training.
A Leave of Absence does not always have to result from a crisis.
When Do Medical Students Take an LOA?
Among respondents:
- 41% took an LOA between their second and third years of medical school - 29.4% took an LOA between their third and fourth years of medical school
The timing of an LOA may depend heavily on why the leave is being taken and the structure of the student's medical school curriculum.
Considerations Before Taking a Leave of Absence
Taking an LOA affects much more than your graduation date.
Before taking one, I strongly recommend thinking through your finances, student loans, health insurance, housing, academic resources, and emotional support.
Q: How Will You Finance the Months or Year Off?
This was the #1 concern, fear, and challenge reported by students taking an LOA.
Funding options reported by students included:
- Personal savings - Employment - Family support - Partner support - Public assistance programs
Scroll down to Part 5 of this blog post about finances in medical school.
Student Loans During an LOA
This is EXTREMELY important to discuss with your financial aid office and student loan servicer before taking a leave.
Students reported significant confusion about what happens to their student loans during an LOA.
Depending on your enrollment status and loan terms, taking an LOA may affect:
- Eligibility for new student loans - Existing student loan deferment - Your repayment grace period - When repayment begins
In my survey, 38% of respondents who had student loans reported that they did not know beforehand that taking an LOA would affect their student loan funding.
Because policies can vary, speak directly with your school's financial aid office and your individual loan servicer BEFORE beginning your leave.
Financial Support During an LOA
Among respondents:
47% were able to receive outside financial support.
Among those receiving outside support:
- 50% received support from their parents - 16.7% received support from a partner/significant other - 8.3% received support from other family members
Additionally, 53% of respondents had to work during their LOA.
Jobs included:
- Tutoring - Research - Medical assisting - Fitness instruction - Babysitting - Other part-time or full-time employment
The financial consequences can be significant.
One medical student reported ultimately declaring bankruptcy because they could no longer afford their living expenses after losing access to student loan funding.
Q: Do You Qualify for Financial Assistance?
Depending on your financial circumstances, consider investigating whether you qualify for local, state, or federal assistance programs.
Programs may include:
- SNAP - Utility assistance - Housing assistance - Medicaid - WIC if you or your partner is pregnant or you have a young child - Other local or state assistance programs
Eligibility requirements vary, so make sure to check the current requirements in your state.
Q: How Will You Pay for Health Insurance?
Do NOT forget about health insurance when planning an LOA.
Questions to ask include:
- Can you remain on your medical school's health insurance plan? - Will you have to pay the premium yourself? - Can you join your spouse or partner's insurance? - Are you eligible for Medicaid? - Do you qualify for another health insurance option?
My medical school allowed me to remain on the student health insurance plan, but I had to pay for it out of pocket.
For approximately nine months away from school, my insurance cost around $4,000.
Q: Do You Have Disability Insurance?
Most residency programs recommend or provide disability insurance to residents because nobody knows when a visible or invisible disability may temporarily prevent them from working.
However, disability insurance is discussed much less frequently with medical students.
Check with your medical school to determine whether your student benefits include disability insurance and whether an LOA related to a medical condition may qualify for benefits.
Some student disability insurance plans may provide monthly benefits while a student is unable to participate in school because of a qualifying disability.
Benefits vary significantly by plan.
See an example of the benefit offered at Loyola Medical School in Chicago.
Q: Will You Need to Move Back Home or Live With Family?
Housing became a major issue for several students in my survey.
Multiple students reported needing to give up their apartment or housing and move in with family because they no longer had student loan funds available to pay rent.
Some students also had to move across multiple states and pay moving and travel expenses out of pocket.
Consider:
- Can you continue paying your current rent? - Can you temporarily live with family? - Will moving affect your ability to study? - Will you need to pay for moving expenses? - Do you qualify for affordable housing or housing assistance?
Some students struggled significantly with housing costs and reported being at risk of eviction because they were unable to make rent payments on time.
Q: Will You Still Have Access to Your Medical School's Academic Resources?
Ask your school whether you will retain access to:
- Campus - Libraries - Study spaces - Tutoring - Academic advisors - Learning specialists - Student email - Online educational resources - Question banks or other institutional subscriptions
Access to these resources can vary significantly during an LOA.
Here are my related blog posts:
Study Resources for Medical School — Part 2
Failing a Quiz, Test, Course, or Year of Medical School — Part 3
Q: Have You Considered Requesting Disability Accommodations?
If a physical, psychological, learning, or other disability has contributed to your academic or standardized testing difficulties, consider whether accommodations might be appropriate.
This was a major part of my own journey.
You can read my Guide to Applying for Accommodations for the MCAT, USMLE, and COMLEX for more information.
Q: Will You Need to Pay for Tutoring or Step Preparation?
If your LOA involves preparing for Step 1 or Step 2, remember that studying itself can become expensive.
In my survey:
- 59% of students studied for Step 1 or Step 2 during their LOA - 19% paid for a private tutoring service - 13% received tutoring through their medical school
Expenses can include:
- UWorld - Practice NBME examinations - Study courses - Private tutoring - Exam registration - Exam rescheduling fees - Other study resources
Make sure these expenses are included in your financial plan.
Here are my suggestions on how to study for Step 1 and avoid another failure.
Q: Are There Other Students Who Have Taken an LOA at Your School?
Finding another medical student who has gone through this process can be incredibly helpful.
At my medical school, we created a GroupMe that included approximately 30 students who had previously taken or were currently taking an LOA.
Having that community helped reinforce an incredibly important message:
YOU ARE NOT ALONE.
Ask whether your school has:
- Peer mentors - Student organizations - Group chats - Alumni mentors - Wellness groups - Students willing to discuss their experiences privately
Sometimes the most helpful information comes from someone who has already navigated the same process.
Q: Does Your Health Insurance or School Cover Therapy and Counseling?
An LOA can be emotionally difficult.
It can bring feelings of:
- Shame - Isolation - Anxiety - Uncertainty - Fear about residency - Fear about finances - Feeling "behind" your classmates - Loss of identity - Burnout
Consider whether your school or insurance provides access to therapy or counseling during your leave.
I have also compiled mental health resources, including books, podcasts, videos, and other support options.
If you or someone you know is experiencing a mental health crisis:
988 Suicide & Crisis Lifeline: Call or text 988
Crisis Text Line: Text HOME to 741741
Emotional Impact of Taking an LOA
The emotional consequences of taking an LOA should not be underestimated.
In my survey:
60% of respondents said they felt "alone" or "very alone" during their LOA.
When respondents were asked how emotionally supported they felt by their medical school during their LOA:
56% selected "Not at all."
No respondents selected the highest rating for feeling "very emotionally supported."
This is one of the reasons I believe medical students need more resources, mentorship, and transparency around taking a Leave of Absence.
The "Choice" of Taking an LOA
Calling an LOA a "choice" can sometimes oversimplify the circumstances surrounding the decision.
A student may technically sign paperwork identifying the leave as voluntary while simultaneously facing:
- Health problems - Financial instability - Academic difficulties - Disability - Family responsibilities - Burnout - Board examination failures - Housing insecurity
For many students, the decision is much more complicated than simply deciding to take time off.
Survey Responses & Advice From Medical Students Who Took an LOA
I initially sent this survey to a group of approximately 30 medical students at my school who had taken an LOA during the previous four years.
I also shared the survey with M2, M3, and M4 students and interns in case there were students who had taken an LOA whom I did not personally know.
Finally, I sent the survey to several medical students I had met through conferences and social media who had also taken an LOA.
The initial survey received responses from 17 students.
Q: What Fears Did You Have About Taking an LOA?
Students responded:
"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 without my student loans."
"Negative impact on residency applications."
Q: What Fears Did You Have After Taking an LOA?
Students responded:
"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."
Q: What Are Some Things You Wish You Knew Before Taking an LOA?
Students responded:
"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 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."
How Do You Discuss an LOA in Your Residency Application?
Watch Video: youtu.be/u4rQd7YWRyc?si=7nTFTyhVP64DMMjp
On the 2023 residency application, applicants were asked:
"Was your medical education/training extended or interrupted?"
The response was limited to approximately 510 characters.
With so little space, you need to be SHORT AND SWEET.
My advice:
- State the facts clearly - Be honest - Avoid overexplaining - Take ownership when appropriate - Provide important context - Include what you learned - Explain how you grew from the experience - Demonstrate that the circumstances have been addressed when applicable
Try to include one or two sentences describing what you learned and how the experience contributed to your development as a future physician.
If additional context is appropriate, you may also be able to discuss the experience elsewhere in your application, such as your personal statement, activities, or an Impactful Experiences section, depending on the application year's format and requirements.
Q: Will Taking an LOA Hurt Your Chances of Matching Into Residency?
This is understandably one of the biggest fears students have.
I was told by a residency director that programs may have the ability to filter applicants based on the length of medical school training. Because an LOA can extend medical school beyond four years, this raised concerns for me while applying.
However, taking an LOA does NOT mean that you cannot successfully receive residency interviews or match.
When I applied to residency, I applied to 44 programs and received approximately 20 interview invitations despite having taken an LOA.
I also received rejections and did not hear back from some programs. It is impossible for me to know whether my LOA played a role in each individual program's decision.
Interestingly, I was rarely directly asked:
"Why did you take an LOA?"
Instead, interviewers often asked about experiences surrounding that period of my life because it represented a significant point in my medical journey — medically, financially, professionally, and academically.
Specialties Where Students With LOAs Have Successfully Received Interviews or Matched
Survey respondents reported receiving interviews in specialties including:
- Psychiatry - Family Medicine - Neurology
I also personally know individuals who have taken LOAs and successfully matched into:
- Neurology - Family Medicine - Psychiatry - Internal Medicine
An LOA does not automatically prevent you from becoming a physician.
How to Frame Your LOA During Residency Applications
The goal is not simply to explain that something difficult happened.
Demonstrate what you learned from the experience.
Consider highlighting skills such as:
- Resilience - Perseverance - Adaptability - Self-awareness - Asking for help - Advocacy - Improved study strategies - Better understanding of your health - Empathy for patients experiencing adversity
Your LOA is one part of your medical journey.
How you reflect on it and what you learned from it can be just as important as the fact that it occurred.
_____________________________________________________________________
More Resources on Residency Applications
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
More About My Personal Leave of Absence Journey
For more specific information about my experience taking an LOA, you can read:
"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 a Medical Student From a Lower Socioeconomic Status (SES)"
"Addressing the Red Flags in My Residency Application"
Listen to my Podcast Episode on KevinMD Podcast
This anonymous survey was created in collaboration with Tufts Medical School.
If you would like to meet to discuss your unique situation, LOA, academic challenges, or residency application, sign up for my personalized coaching here.
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