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    Hi there,

    Currently a first year medical student I (know it's early days but these things need planning!) seriously contemplating doing the USMLEs after talks with various doctors and medical students.

    A bit of research into it taught me that these exams are extremely expensive, and very intense - and because US graduates are given priority for residency places, realistically I need to be scoring very highly if I want to get into a decent place if and when the time comes. I don't want to spend all that money on these exams and only get a mediocre score (and therefore a mediocre residency).

    Has anyone here taken the USMLEs or currently in the process of taking them?
    If so, I have a few questions:

    1) How did you save up the money to pay for them?
    2) How long in advance did you study for each step?
    3) What year of medical school / training did you take each step?
    4) What textbooks and resources did you use?
    5) What general advice do you have for someone thinking of taking them?

    Thanks in advance
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    Worrying that even first year medical students are planning their way out of working as a doctor in the UK :/

    I'm afraid I don't know the answers to your questions; hopefully there is someone on here who has done them. I know someone who did USMLE as final year and another in F1. First Aid for the USMLE Step 1 is a popular book.
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    (Original post by alicexelizabeth)
    Worrying that even first year medical students are planning their way out of working as a doctor in the UK :/

    I'm afraid I don't know the answers to your questions; hopefully there is someone on here who has done them. I know someone who did USMLE as final year and another in F1. First Aid for the USMLE Step 1 is a popular book.
    I know it's quite ridiculous, but I think it's important for us to be able to explore all of the options available. Who knows, I might not even pass my med school exams and end up in a completely different degree in the next five years, haha!
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    There might be someone here who can help with USMLE prep but I don't know that this is a particularly well trodden path at the TSR. There are many other fora in which US and international medical students discuss the various parts of the USMLE. You could start at www.usmle-forums.com if you don't get very much back from the TSR.

    Personally I think the US is a very strong option if you are willing to front load the investment of effort - the USMLE is difficult, getting a residency position is competitive (particularly for IMGs), and residents are worked extremely hard. That said, training is much shorter (emergency medicine only three years post-graduation !!), doctors are afforded much higher social status than in the UK, and attending salaries are twice (if not three times) as high as in the NHS.

    Step 1 is the score that is most important because the majority of US students have only completed this part when applying for residency - it is therefore the only objective score that can be used to directly compare applicants to each programme.
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    (Original post by Bezoar)
    Hi there,

    Currently a first year medical student I (know it's early days but these things need planning!) seriously contemplating doing the USMLEs after talks with various doctors and medical students.

    A bit of research into it taught me that these exams are extremely expensive, and very intense - and because US graduates are given priority for residency places, realistically I need to be scoring very highly if I want to get into a decent place if and when the time comes. I don't want to spend all that money on these exams and only get a mediocre score (and therefore a mediocre residency).

    Has anyone here taken the USMLEs or currently in the process of taking them?
    If so, I have a few questions:

    1) How did you save up the money to pay for them?
    2) How long in advance did you study for each step?
    3) What year of medical school / training did you take each step?
    4) What textbooks and resources did you use?
    5) What general advice do you have for someone thinking of taking them?

    Thanks in advance
    The medical school Reddit is a good resource. It's almost all us students so they discuss it a lot and have lots of info!


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    Hello,

    I wanted to start this thread to gather advice on this and compile conveniently it
    in one place for UK med students. I know this whole process requires a lot of planning and that there isn't a whole lot of support.

    I've done some research on USMLE and here's a few things I've grasped:

    - It is EXTREMELY hard for UK students, even Step 1
    - You need to be at least in the 80th percentile, ideally 90th to secure a residency
    - Even with very high scores some specialities are out of reach for IMGs

    Resources people have used for Step 1:

    - First Aid Book
    - Microbiology made ridiculously simple
    - BRS Pathology
    - BRS Physiology
    - USMLE World Question Bank (or the Kaplan Question Bank)

    Does anyone here know when is the best time to sit USMLE Step 1 as well as Steps 2CK and 2CS, if you're doing a 6 year course (BSc in 3rd year)? Any advice for anyone could offer on the whole process would be greatly appreciated.
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    At the end of your BSc year, the reason is theres a lot of stuff not covered and you can self study that in your 3rd year. The alternative is after your 4th year, its up to you.
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    Some random thoughts:

    Your Step 1 score matters most as it's the single point of comparison with US medical students who often have only completed Step 1 by the time they apply. It makes sense to complete this after your pre-clinical phase but, perhaps even more importantly, at a time that you can commit many hours to extra studying, e.g. after a summer vacation.

    IMGs are at a disadvantage - some programmes do not consider them at all and others only look at IMG applications after those from domestic students. You are at a disadvantage compared with US students from the outset, although some programmes are more open minded than others. I certainly know IMGs that have matched into surgical residencies at famous US teaching hospitals.

    It's not necessarily true that some specialties are inaccessible to IMGs. It is possible to "break in", particularly if you aren't also insisting on working in Boston, Miami, or San Francisco... The specialties that are popular for applications in the US aren't the same as those in the UK. Dermatology, radiology, cardiology, and orthopaedic surgery are very popular as the lifestyle and remuneration are very good.

    It's important to have a high Step 1 score but there are also points available for other things (publications, presentations, prizes, etc). Again US students are at an advantage as they will have been at university for at least 8 years (4 years undergraduate + 4 years medical school) by the time they qualify. This doesn't mean they can't be beaten if you are a little single minded about things.

    The system is also very corrupt with letters of recommendation going a long way and supervisors making telephone calls to vouch for their favourite students... At a minimum you will need to spend your elective in the US and give some thought to visiting for short observership placements as well. This will give you a chance at securing letters of recommendation from US attendings as well as some insight into US healthcare.

    Most IMGs that successfully match are awarded a preliminary ("prelim") rather than a categorical residency. Prelims are one year spots that give you an opportunity to work in the US system and gain meaningful letters of recommendation from US attendings. Some programmes have a good track record of offering their prelims a categorical spot at the end of the year. However, most IMGs work for 12 months in one programme before moving into a categorical spot (in another place) for the duration of the training.

    Although the US Match is a central process, interviews and selection for posts are all organised locally. If you apply for 150 programmes, you might be invited to 15 interviews and these could be at any time (over a period of a few months) and anywhere in the US. This will demand a large commitment both in terms of your time and money. In pure monetary terms, matching in the US will pay you back this investment many times over throughout your career.

    If I were doing this, I would be tempted to finish FY1/FY2 in the UK and then spend a year one some kind of research scholarship in the US. That would mean you could retreat to UK training if necessary (having had a fun year and earned some extra CV points) but would give you a US base from which to launch your US applications. As training in the US is so much shorter than in the UK, even this convoluted route would see you "finished" years before you would have finished training in the NHS.
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    (Original post by MonteCristo)
    Some random thoughts:

    Your Step 1 score matters most as it's the single point of comparison with US medical students who often have only completed Step 1 by the time they apply. It makes sense to complete this after your pre-clinical phase but, perhaps even more importantly, at a time that you can commit many hours to extra studying, e.g. after a summer vacation.

    IMGs are at a disadvantage - some programmes do not consider them at all and others only look at IMG applications after those from domestic students. You are at a disadvantage compared with US students from the outset, although some programmes are more open minded than others. I certainly know IMGs that have matched into surgical residencies at famous US teaching hospitals.

    It's not necessarily true that some specialties are inaccessible to IMGs. It is possible to "break in", particularly if you aren't also insisting on working in Boston, Miami, or San Francisco... The specialties that are popular for applications in the US aren't the same as those in the UK. Dermatology, radiology, cardiology, and orthopaedic surgery are very popular as the lifestyle and remuneration are very good.

    It's important to have a high Step 1 score but there are also points available for other things (publications, presentations, prizes, etc). Again US students are at an advantage as they will have been at university for at least 8 years (4 years undergraduate + 4 years medical school) by the time they qualify. This doesn't mean they can't be beaten if you are a little single minded about things.

    The system is also very corrupt with letters of recommendation going a long way and supervisors making telephone calls to vouch for their favourite students... At a minimum you will need to spend your elective in the US and give some thought to visiting for short observership placements as well. This will give you a chance at securing letters of recommendation from US attendings as well as some insight into US healthcare.

    Most IMGs that successfully match are awarded a preliminary ("prelim" rather than a categorical residency. Prelims are one year spots that give you an opportunity to work in the US system and gain meaningful letters of recommendation from US attendings. Some programmes have a good track record of offering their prelims a categorical spot at the end of the year. However, most IMGs work for 12 months in one programme before moving into a categorical spot (in another place) for the duration of the training.

    Although the US Match is a central process, interviews and selection for posts are all organised locally. If you apply for 150 programmes, you might be invited to 15 interviews and these could be at any time (over a period of a few months) and anywhere in the US. This will demand a large commitment both in terms of your time and money. In pure monetary terms, matching in the US will pay you back this investment many times over throughout your career.

    If I were doing this, I would be tempted to finish FY1/FY2 in the UK and then spend a year one some kind of research scholarship in the US. That would mean you could retreat to UK training if necessary (having had a fun year and earned some extra CV points) but would give you a US base from which to launch your US applications. As training in the US is so much shorter than in the UK, even this convoluted route would see you "finished" years before you would have finished training in the NHS.
    Loads of useful info, thanks! I think the FY1 route is the way to go, and doing USMLEs during Med school would be best. In terms of Step 1 prep, how long does preparation usually take? Spending my summer between 4th and 5th should be long enough, right?

    Also, do you know how important USMLE Step 1 is for securing an elective? I have heard a lot places ask whether you have taken it or not. When would you recommend taking Steps 2CK and CS?
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    (Original post by Hazard82)
    In terms of Step 1 prep, how long does preparation usually take? Spending my summer between 4th and 5th should be long enough, right? Also, do you know how important USMLE Step 1 is for securing an elective? I have heard a lot places ask whether you have taken it or not. When would you recommend taking Steps 2CK and CS?
    I won't attempt to answer most of these questions as I've not prepared for the USMLEs myself. I just returned from a research year in the US where all of my colleagues were IMGs going through the matching process.

    I guess the obvious time to sit Steps 2CK and CS would be around the time of medical school finals as they aim to test clinical knowledge and skills.

    It might be worth pitching USMLE-specific questions at www.usmle-forums.com.
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    Hi guys. Myself and my partner are both 4th/5th year medical students. I am aware you need to take the USMLE exams to work in the US. My partner (soon to be husband) is the one who really wants to work over there. We are both currently in UK medical schools. My fear is only one of us passing the USMLE process (i.e me not making it). So my question is, if one person out of married couple has passed all the hurdles of exams & secured a job, will it be easier for their spouse to also get a job once there? We are both UK citizens. Or have we no option but both of us pass the USMLE or we don't go at all?

    Thanks
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    Yes, USMLEs are essential, no way around it. However, just about passing USMLEs (say 200) means that you essentially have a very small chance of securing a job, and I mean tiny. If you guys want to do this, I would suggest you really get on it and make sure you get at least average step 1 scores, otherwise the chances of matching in the same place as IMGs will be pretty low as far as I can see. My friends who are going down the USMLE route are all doing electives in the US.

    Finally, make sure at least one of you is cool with family or internal med, or at worst gen surg. Tiny numbers of IMGs match into the competitive specialties - the stats are out there and for plastics, for example, the mean number of papers per matched IMG applicant was above 10.

    Also be aware of the visa requirements and know how you want to approach this. J1 requires STEP3 I believe, H1B is very quickly oversubscribed and needs a lot of planning.


    IMG = international medical graduate, which you guys are.
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    Is it about time that we started a sticky for students asking about the USMLE and moving to the US? I feel as if I'm about to type out the same post that I've written a few times already over the last couple of weeks.
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    Hi Everyone,

    I'm interested in trying to sort out a medical elective in America for May-August 2017 time and I was wondering is anyone had any experience in applying for them?
    I know they're uber competitive and you're supposed to apply quite early. But looking at few websites, some of them say they're only accepting applications six months before and might only get back to you a few months before the elective, is that what other people have experienced? Does it help to know people/e-mail people at the hospital?

    Thanks in advance!
    P.S I haven't done STEP 1 in case that's helpful
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    I wonder roughly what's the total approximate cost of doing everything from step one to getting a residency place.
    The cost is really putting me off of it.
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    Name:  Steps.PNG
Views: 906
Size:  15.0 KB Step 1, Step 2 CK, Step2 CS remember Step 2 CS must be taken in US so extra costs will arise (flights, accommodation)
    (Original post by Jckc123)
    I wonder roughly what's the total approximate cost of doing everything from step one to getting a residency place.
    The cost is really putting me off of it.
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    H1b visa requires Step 3. J1 visa will require returning home for 2 years after completing residency.

    (Original post by AnonymousPenguin)
    Yes, USMLEs are essential, no way around it. However, just about passing USMLEs (say 200) means that you essentially have a very small chance of securing a job, and I mean tiny. If you guys want to do this, I would suggest you really get on it and make sure you get at least average step 1 scores, otherwise the chances of matching in the same place as IMGs will be pretty low as far as I can see. My friends who are going down the USMLE route are all doing electives in the US.

    Finally, make sure at least one of you is cool with family or internal med, or at worst gen surg. Tiny numbers of IMGs match into the competitive specialties - the stats are out there and for plastics, for example, the mean number of papers per matched IMG applicant was above 10.

    Also be aware of the visa requirements and know how you want to approach this. J1 requires STEP3 I believe, H1B is very quickly oversubscribed and needs a lot of planning.


    IMG = international medical graduate, which you guys are.
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    TSR Support Team
    (Original post by MonteCristo)
    Is it about time that we started a sticky for students asking about the USMLE and moving to the US? I feel as if I'm about to type out the same post that I've written a few times already over the last couple of weeks.
    Thanks for the idea. I've merged a lot of the recent posts about this as there have been a number of helpful posts recently (including yours).
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    Hi just wondering if it's possible to apply directly to residency programmes in the US after graduating medical school? instead of applying for foundation programmes .

    Cheers
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    Yes but it requires a lot of commitment and advance planning... including completing their exams (the USMLEs), applying for visa sponsorship through the ECFMG (www.ecfmg.org), ideally spending some time in the US (e.g. on elective), and traipsing around the country for lots of different interviews (this process is not centralised). As residencies in the US are competitive (particularly for applicants trained in other countries), you will probably want to apply for US residencies as well as the foundation programme so that you have options if you don't match in the US (or are sent to rural Iowa...).
 
 
 
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