UK2US
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I am currently a third year medic thinking about taking the USMLE next August. I have a few questions that I need the answer to. My current plan is to take the Step 1 and Step 2 exams before the end of medical school, and then take the Step 3 exam during F2, with the aim of applying to start after a year of locuming (F3). Ideally, I'd then want to practice in the US for a decade or so, before returning to the NHS at around 37/38.

1.) Is it worth me even doing F1/F2 - would it make it harder for me to come back to the NHS if I skipped foundation years?
2.) When is the best time to sit my USMLE exams considering my plans?
3.) Is it hard to get a consultant job in the NHS having trained in the US - what is the process for this, would I need to sit the membership exams etc.
4.) Does it matter where I do my residency? ideally I'd want to go to NYC, but assuming I finish residency straight away, can I become an attending straight after this?

I appreciate any answers anyone might be able to offer
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ecolier
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(Original post by UK2US)
...1.) Is it worth me even doing F1/F2 - would it make it harder for me to come back to the NHS if I skipped foundation years?
Do FY1, If you don't complete FY1 and obtain GMC full registration within a certain number of years post-MBBS you'll not be able to practise in the UK again.

2.) When is the best time to sit my USMLE exams considering my plans
A lot of people do it FY1 - CT2. But I have friends who did it as a registrar.

3.) Is it hard to get a consultant job having trained in the US - what is the process for this, would I need to sit the membership exams etc....
It is virtually impossible to get anywhere vaguely competitive or train in any specialty that's got any competition.

Remember, the UK med school curriculum is not designed to assist with taking the USMLE. And IMGs (to the US) are always at the back of the queue, no matter your USMLE score.
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aos.96
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(Original post by ecolier)
Do FY1, If you don't complete FY1 and obtain GMC full registration within a certain number of years post-MBBS you'll not be able to practise in the UK again.



A lot of people do it FY1 - CT2. But I have friends who did it as a registrar.



It is virtually impossible to get anywhere vaguely competitive or train in any specialty that's got any competition.

Remember, the UK med school curriculum is not designed to assist with taking the USMLE. And IMGs (to the US) are always at the back of the queue, no matter your USMLE score.
Do you know if one can apply for residency in the US during F1? And not have to do F2.
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ecolier
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(Original post by aos.96)
Do you know if one can apply for residency in the US during F1? And not have to do F2.
I am not an expert, but applying for residency is separate from your medical career I would imagine?

I also think that after "passing" the USMLE you'd be eligible for some sort of stay in the US, but again I am not sure at all.

@artful_lounger may well know more than me.
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redsoxs
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(Original post by UK2US)
I am currently a third year medic thinking about taking the USMLE next August. I have a few questions that I need the answer to. My current plan is to take the Step 1 and Step 2 exams before the end of medical school, and then take the Step 3 exam during F2, with the aim of applying to start after a year of locuming (F3). Ideally, I'd then want to practice in the US for a decade or so, before returning to the NHS at around 37/38.

1.) Is it worth me even doing F1/F2 - would it make it harder for me to come back to the NHS if I skipped foundation years?
2.) When is the best time to sit my USMLE exams considering my plans?
3.) Is it hard to get a consultant job in the NHS having trained in the US - what is the process for this, would I need to sit the membership exams etc.
4.) Does it matter where I do my residency? ideally I'd want to go to NYC, but assuming I finish residency straight away, can I become an attending straight after this?

I appreciate any answers anyone might be able to offer
I am by no means an expert on this topic, but researched it a little whilst I was at med school so might be able to fill in a few gaps.

1) As ecolier said I think it would be certainly worthwhile completing foundation training, as you will have it as a back-up option if applying to US residencies does not go to plan. Also from memory the application cycles do not match up, i.e. foundation training starts in August, residency programs start at a different time in the year, so that will need to factor in if/when applying.
2) Step 1 is largely pre-clinical so sitting them as close to proximity to your pre-clinical years would be useful, however as said already the UK curriculum does not prepare you for the USMLEs, and will take a lot of additional revision. It used to be that your Step 1 score formed a significant portion of your application, and the perceived wisdom was that an international medical graduate would have to score better than their American counterpart to have any chance of being considered.
3) I'm pretty sure the answer to this is yes, it would be hard/impossible. Your training in the US would not be recognized over here, except I believe in a couple of unique circumstances, I believe the RCOA does recognize US anaesthetics training.
4) I suppose it all depends what sort of specialty you have in mind. Unlike the UK, US graduates apply straight into a specialty, with some more notoriously competitive than others. Each year you do hear examples of exceptional UK grads who have made it on to US residency programs. These tend to be the type of people who have invested a lot of time into the process, you will need to build contacts in the states, receive glowing letters of recommendations etc. Anecdotally I have heard that it is the more prestigious residency programs that are more likely to accept IMGs as they are more familiar with international graduates applying. The US as a whole has a lot more focus on where you graduated from and where you completed your residency which may influence overall how competitive you are when applying to attending posts, but then a lot more variables I'm sure would come into that.

I hope that was vaguely useful, good luck on your journey

PS, my conflict on interest is that I am dual UK/US citizen, graduating from med school in the UK, I remember roughly at your stage I was researching US residency program options but ultimately decided against it. I think there is always going to be an element of the grass is always greener. The UK system is far from perfect but be aware the US training system has far more grueling hours, with far less holiday allotment and is a more litigious environment.
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Anonymous #1
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You don't have to do F1/F2 to get a full gmc licence. I recently listened to a talk from a UK graduate who did plastic surgery training in the US then came back to the UK and is now working as a consultant in the UK.
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