Category: USMLE

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USMLE

Pathway to a Medical Residency in USA for IMGs

Pathway to Medical Residency in USA

Are you an international medical student who is planning to pursue a medical residency in USA? If yes, I understand that this may have been a big step for you, as many international medical students are often confused whether to pursue a residency in their home country or abroad.

Great! But, now what? How do I go about it? There are so many exams, research, clerkships…….. how do I go about all this stuff!!!???

Before you freak out, this post provides the most basic overview of the pathway to a medical residency in USA. Throughout the post I will leave links to other relevant sections which have more information.

However, having an overview will help you get a basic understanding of the requirements so you can plan your timeline accordingly.

ECFMG Certification

The Educational Commission for Foreign Medical Graduates (ECFMG) is the organization that deals with the certification requirements for international medical students to be able to apply for a medical residency in USA.

In order to apply for a medical residency in USA, you need to be ECFMG certified.


In order to be ECFMG certified, you need to clear some exams known as the United States Medical Licensing Exam (USMLE). There are various parts to this exam known as the “Steps” and you need to clear the following steps in order to apply for ECFMG certification

  • Step 1 : This computer based exam tests you on basic sciences. You can check out our posts related to USMLE Step 1 here. This exam can be taken in your home country if there is a Prometric testing center (Prometric is the organization that conducts the computer based examination)
  • Step 2 CK : This computer based exam tests you on your Clinical Knowledge. You can check out posts related to USMLE Step 2 CK here. Can be taken in home country.
  • Step 2 CS : In this exam you will examine standardized patients and test your clinical skills as a physician. This examination must be taken in the US. People generally take this exam when they visit the US for elective/ observerships in US.

You absolutely must take these exams in order to be eligible for ECFMG certification.

There is also a Step 3, but it is not required for ECFMG certification and to be able to apply for a medical residency in USA

For most international medical students, the USMLE exams are the biggest milestones on the path to a medical residency in USA.

These exams require you to have a strong understanding of the basic sciences and the clinical subjects. You should also be able to integrate the knowledge and apply it to clinical cases on the exam.

Your performance on these exams are one of the key factors considered by program directors in selecting applicants whom they want to interview.

There are some more requirements by the ECFMG, for example, your medical school should be listed in the World directory of Medical Schools. You can read more about ECFMG certification requirements here.

It’s now time to apply!

Applications to residency programs are made through an online portal called ERAS (Electronic Residency Application Service).

To access ERAS, you will have to purchase an ERAS token which is usually available on the website in June of every year.

Once you purchase the ERAS token, you have access to the ERAS portal that allows you to upload your CV, personal statement , other supporting documents as well as apply to Residency Programs.

You can begin applying to programs on September 6 each application season. Programs can begin downloading your application September 15 onward.

Read more about ERAS here.

Interview Season

After you have submitted your application, residency programs download it based on their selection criteria. The program will view your application holistically and decide whether they want to grant you an invitation to interview at the program.

Interview invitations are generally given out from November to January of each year. This is the time when you will visit the programs where you have an interview call from.

After the interview season is over, you will have to create a Rank order List of the programs you interviewed at. This is basically a preference list of the programs where you interviewed and would like to match at.

The deadline for the submission of this rank order list is generally in February.

The Match

The applicant and the programs both prepare rank order lists that are run through “the match algorithm” that matches candidates and programs based on their rank order lists.

The 3rd Friday of March is generally called the “Match Day”. This is when applicants come to know which program they have matched at.

Conclusion

As I mentioned at the start, this post is a very brief overview of the pathway to a medical residency in the US in its most basic form.

There are a lot of intricacies to this process. Many of these things like research, electives, etc are discussed throughout the website. These things are required to improve your CV and application in order to be a competitive applicant.

Hopefully this post gave you a rough idea of the process. If it helped you, do share it with your friends who may benefit from reading this post.

Read other posts about USMLE here.

If you have any questions, use the comments section below. For personalized consultation and help with your timeline, resources and strategies, fill out the consult request form and I will get back to you.

This article has been written by Dr. Rohit Nathani who is a medical graduate from Seth GS Medical College. Ask your questions in the comments section below.

To submit your USMLE experience, go to the Contribute page. Your experiences can help other IMGs in their journey! You can also email us at theindianmedicalstudent@gmail.com

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Step 1 USMLE

Which is the Best time to take the USMLE Step 1 for IMGs?

Best time to take the USMLE Step 1 for IMGs

The USMLE Step 1 tests you on the basic science subjects namely Anatomy, Physiology, Biochemistry, Pathology, Pharmacology, Microbiology, Bio statistics and Epidemiology and Behavioral sciences. A common question IMGs have is “Which is the best time to take the USMLE Step 1?

The timeline for American Medical Graduates (AMGs) is relatively standard and most AMGs take their Step 1 at the end of their second year in medical school and take Step 2 in their fourth year.

The situation for International Medical Graduates (IMGs) is quite different as the medical school curriculum in your home country may not be geared to taking the USMLE Steps.

This creates a lot of confusion about when to give the exam. Also, your medical school may schedule their own exams throughout the year. Considering all these factors, there is no fixed time when IMGs take the Step 1.

Having completed medical school from India, the tips that I provide in this article are in context to the medical education system in India. I would love to hear your perspectives from different countries in the comments section below. However, these tips can be adjusted to suit the timeline of your home country. Here is what I recommend.

The AMG route – Step 1 at the end of second year of medical school

The first two years of medical school in India cover the basic science subjects mentioned above that are tested on the Step 1. While many IMGs may not even have decided whether they want to pursue their residency in the US, if you have taken your decision early on then this is the best time to take the exam. Here’s why:

  • You are relatively fresh with the basic science subjects.
  • Second year of medical school in India is long (1.5 years) and you have plenty of time to study for Step 1 apart from your medical school exams and clinics.
  • USMLE rules are changing. The board has announced that you will not be able to take the Step 2 CS without first passing Step 1. Note however, that this change will not come into effect before March 1, 2021. Check for announcements on the USMLE website.
  • You will have a strong foundation in the basic sciences which will be an advantage before you enter the clinical years in medical school.
  • It is rather frustrating to come back and study the basic sciences from scratch once you have already entered the clinical years in medical school.
  • Having completed Step 1 early on, you have enough time in the later years of your medical school to engage in research, electives, and other extra curricular activities.

Considering these factors, I think that the best time to take the USMLE Step 1 is at the end of your second year or the beginning of your third year in medical school.

There are two pre requisites to this:

  • You need to take a call early on and decide that you want to pursue USMLE and a residency in the US.
  • You need to be able to make a timeline around the requirements of your medical school and find time to study for Step 1.

Update : Starting in January 2022, the board has decided to score the USMLE Step 1 as Pass/ Fail rather than the 3 digit score. Considering this, it will be best to get done with your Step 1 early on as you just need to pass. Note however, the 3 digit scoring is still valid for those taking the exam before USMLE officially declares the date of the change.

Read our article on the change in Step 1 scoring to Pass/Fail here.

Taking a decision early and planning out your USMLE timeline to fit your medical school schedule can go a long way in ensuring that you have enough flexibility to accommodate everything.

If you have any questions, use the comments section below. For personalized consultation and help with your timeline, resources and strategies, fill out the consult request form and I will get back to you.

This article has been written by Dr. Rohit Nathani who is a medical graduate from Seth GS Medical College. Ask your questions in the comments section below.

To submit your USMLE experience, go to the Contribute page. Your experiences can help other IMGs in their journey! You can also email us at theindianmedicalstudent@gmail.com

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Categories
Step 1 Step 2 CK USMLE

How to be more productive during your USMLE Step preparation

Productivity hacks for the USMLE Steps

Studying for the USMLE Step examinations can be a daunting and often tiring task. You can put in hours and hours of study and still not see a visible improvement in your performance on practice tests. Here are a few tips so that you are more productive in the time you spend preparing for these exams.

Spend more time reviewing

The number of questions solved has been associated with the score one gets on the test. However, not spending enough time reviewing the explanation for the questions is something you should avoid.

Make sure you are reviewing not only why the correct answer is the right choice but also why the other options are incorrect.

It ultimately boils down to UWorld being a practice tool and not a testing tool. Make sure you take down notes or save flashcards from the explanation so you can come back and revise what you have learned.

Be selective about Resources!

It can be tempting to jump from one resource to another thinking that the more you do, the better you will score.

The reality however is that, high scorers are often more selective about the resources that they use. Then make sure you master these resources and know them 100%.

Make sure you spend enough time with First Aid and UWorld.

Have a timeline in mind

Have a rough timetable over the long term and short term. You do not need to account for every minute but, having a structure in your head helps you be more organized.

Also, once you have booked your exam date, try not to postpone it unless you have an emergency or you are doing very poorly on practice tests.

Simulate the testing environment

While solving blocks of UWorld or any other Question bank, make sure you approach each block as though it was your final exam.

Have enough practice solving questions in timed mode. Also, make sure that you have good practice in solving tests which involve multiple systems that is random questions.

It is easy to get the answer if you know the block is only about Cardiovascular system. Train your mind to think of each question as it comes.

Study Groups

If you are someone who studies well with other people, form a study group.

Keep in mind however, to find partners whom you are comfortable with. That means, make sure they aren’t too slow or fast and are at the same general knowledge level as you.

If you find that you are not benefiting from these sessions, be quick to understand and act on it.

Rest and Exercise

This is probably the most important but least spoken about productivity hack. The USMLE exam prep can be a stressful period and can lead to burnout if you do not give your body adequate rest.

Make sure you get enough sleep to wake up fresh and study each morning. Also, any form of exercise, even a short 15 minute walk in fresh air will go a long way in improving your productivity.

If you have any questions, use the comments section below. For personalized consultation fill out the consult request form and I will get back to you.

This article has been written by Dr. Rohit Nathani who is a medical graduate from Seth GS Medical College. Ask your questions in the comments section below.

To submit your USMLE experience, go to the Contribute page.

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Categories
Step 1 USMLE

USMLE Step 1 Pass Fail – Meaning and Impact on IMGs

USMLE Step 1 Pass Fail

In February of 2020, the USMLE parent organizations (FSMB and NBME) approved the change of USMLE Step 1 scoring outcomes from a 3 digit score to Pass/Fail. This post aims to provide a better perspective on this change and how the USMLE Step 1 Pass Fail will affect IMGs.

Major changes made:

  • USMLE Step 1 Scoring from 3 digit score to Pass/Fail
  • You must take Step 1 and Pass prior to taking Step 2 CS
  • The number of attempts on any USMLE exam is reduced from 6 to 4

As you can see the major change is the shift from a 3 digit score on the USMLE Step 1 to Pass Fail.

The USMLE Step 1 Pass Fail will not be implemented before January 2022

Why the change to a Pass/Fail reporting?

The idea was debated several times before it was passed. The main reasons to change from a 3 digit score on the USMLE Step 1 to Pass Fail were:

  • The content tested on USMLE step 1 does not correlate well with how good a clinician you will be. Although you need to have a good understanding of the basic sciences to have solid clinical concepts, knowing them does not necessarily mean that you are a good clinician.
  • Student well being and burnout prevention.

Here are some of the pros and cons of USMLE Step 1 Pass Fail that were discussed and are available on the website.

PROSCONS
USMLE offers highly reliable, objective assessment of relevant competencies. A national standard.A passing score on USMLE demonstrates minimum competency. Pass/Fail reporting suffices for this.
Mitigates the reliability challenges of some medical school assessmentsLicensure requires only a Pass/Fail outcome
May stimulate student preparation more than a Pass/Fail outcomeFocus on numeric scores negatively impacts student well-being
Incremental numeric USMLE performance correlates with other valued measures
e.g., specialty board certification, state board disciplinary actions, improved practice		Standardized test scores best predict other standardized test scores (vs. clinical performance)
Offers a “level playing field” for all examinees, including those from international and new or lesser known schoolsMaintaining 3-digit score reporting may limit diversity within various specialty programs
If no USMLE numeric score exists, and the demand for a national assessment remains, what fills the gap?Maintaining 3-digit score reporting has an opportunity cost due to students’ heavy focus on maximizing USMLE scores (e.g., less time for research, volunteerism)

USMLE Step 1 Pass Fail – Overall Impact

Since its inception, the USMLE Step 1 three digit score was used as one of the main factors in screening residency applicants. With that factor now gone, here are a few things that will become more important.

  • Step 2 CK score. There has been no change in the 3 digit score reporting for Step 2 CK. Step 2 CK is a much better reflector of a good clinician and residency program directors will place more emphasis on the Step 2 CK score.
  • Medical School and Letters of Recommendation. Prestigious medical schools and the quality of letters of recommendations from renowned faculty members will become much more important in differentiating applicants.
  • Research. Although research is currently cited lower on the list of factors that program directors consider while chosing applicants, with the introduction of USMLE Step 1 Pass Fail system, research publications will be considered more strongly.

Basically, you application as a medical student will be looked at in a holistic fashion considering a lot of variables that were originally masked by good Step scores.

How does the USMLE Step 1 Pass Fail affect IMGs?

The short answer is – USMLE Step 1 being Pass/ Fail affects competitive IMGs negatively. (Notice the word competitive.)

If you see the trends of matches in different specialties and compare American Medical Graduates (AMGs) to International Medical Graduates (IMGs) you will notice that for the same spot, an IMG has a higher step 1 score as compared to an AMG.

This Step 1 score was one of the important factors that helped IMGs stand out when it came to competitive residency applications. By removing that factor, the game is now tougher for IMGs.

So what can IMGs do to improve their chances?

Firstly, these changes will come into effect no earlier than January 2022, so if you will be applying prior to 2022, you have no reason to worry.

For the IMGs who will be taking the USMLE Step 1 post 2022, here are some things to keep in mind.

  • If you are reading this and haven’t yet entered medical school, work hard. Try to get into the best medical school that is recognized widely.
  • If you are already in medical school, be awesome. Work hard on your grades to get great transcripts and deans letter.
  • Take Step 1 early. Many IMGs used to take Step 2 CS as their first exam. With the new rules, this will not be possible unless you first finish Step 1. It is best to take your USMLE Step 1 immediately after you have finished you basic science years in medical school. Remember, you only need to pass now, no stress 😛
  • Focus on your clinical subjects and score really well on USMLE Step 2 CK. Check out my book on How to Crack the USMLE Step 2 CK for guidance on how to study for this beast.
  • Keep electives in mind and apply early. You can do hands on electives as a final year student. Apply atleast 6-8 months before you plan to do the elective. Read my posts about electives here.
  • Approach your application holistically. Remember to do research during medical school and publish. Get involved in volunteering and other leadership opportunities.
  • Try to take USMLE Step 3 before you submit your rank order list. This has 2 advantages. One, you have something that distinguishes you. Two, you qualify for an H1B visa if the program offers it.

Although this may seem like a lot and may seem unfair, remember that IMGs have always been a part of the US healthcare system and if you are good, you will find a residency spot.

If you have any questions, use the comments section below. For personalized consultation fill out the consult request form and I will get back to you.

This article has been written by Dr. Rohit Nathani who is a medical graduate from Seth GS Medical College. Ask your questions in the comments section below.

To submit your article, go to the Contribute page.

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Categories
Electives USMLE

Finding Accommodation for Electives

Accommodation for electives USA

Congratulations on getting that elective acceptance letter after months of applications and running in and out of offices to get your paper work in order! But, hold on! You still have to look for accommodation during your elective. Although this may seem like a daunting task, here are a few guidelines to keep in mind.

Things to keep in mind when deciding on accomodation

Location

Remember, in order to make the most of the elective time you have, you need to be able to spend more time at the hospital. So, if it is possible, financially and logistically, try to choose a place closer to the hospital. This is also very important if your rotation requires you to be on call and travel to the hospital at odd hours.

Safety

This is often a huge factor you need to consider when choosing accommodation during electives. Although, safety is quite variable depending on the neighborhood your hospital is located in, it is always better to find out more about this aspect and select your accommodation accordingly. Do not hesitate to reach out to people you know in the city and even the elective coordinator to find out which neighborhoods to avoid.

Although the US is a developed first world country, there are always pockets of bad neighborhoods that you should be aware of. There have been instances where people doing electives have faced safety concerns.

Cost

This is a major factor (especially for IMGs) and is often a trade off with the location and safety aspects. Meaning, locations closer to the hospital and safer neighborhoods are going to cost you more. This is a major expense to consider when you are calculating the total cost of the elective ( Read our article on How much do Clinical Electives Cost? )

Keep in mind though, if you aren’t on a tight budget, it will be a good idea to spend on a good accommodation as you will have the peace of mind being in a safe locality in a foreign land.

Split the cost if possible!

When you get that acceptance letter, reach out on facebook groups or other forums. You will be surprised at how many people are in the same boat as you. Not only will it bring down the cost of accommodation during your elective but you will also have an additional safety net.

Inspect before paying

If you have friends or relatives in the area, have them go and check out the place before you make a payment. Do not always rely on the pictures and information put up on the website by the advertiser.

How do I find accommodation during electives?

The above points gave a brief overview of the factors to consider while looking for places to stay during electives. Here are a few ways to help you find these accommodations!

Talk to Friends/ Family

This is probably the best way to find an accommodation for your elective. Talk to your friends and relatives who live in and around the city where your elective is. They will have an idea of places to stay and will guide you about the safety and other logistical issues.

Ask if is is possible for you to stay with them as a paying guest. Often times you may have a friend living with a few other flatmates, ask if anyone will be out of town and is willing to sublet their apartment to you for a month.


Talk to the elective coordinator

Most often, the elective program will either have a formal accommodation or a list of places that you can try out. These places are generally in the vicinity of the hospital. If it fits your budget, these are good options.

AirBNB

This is probably your best bet after the above two options. The listings on the app are verified and you will have full support from AirBNB in case you run into any troubles.

You can set filters for the place, price range, etc. Remember to read the reviews before. Also, whenever possible look for “superhost” while making a reservation as these hosts are more experienced.

IMPORTANT : Do NOT make reservations outside of AirBNB.

Use this link to get $40 off on your first booking through AirBNB. Check out AirBNBs – Click Here.

Third Party Websites

These are websites like Sulekha, Craigslist, etc. A word of caution, be careful and extremely mindful when booking through these websites. A common fraud is when the advertiser tells you that they are out of town and will not be able to meet you/ show you the house. Do NOT pay money without being sure of the person. Also, always ask for an official contract stating that they are renting out the room to you along with the dates and the amount paid.

Find more articles on USMLE and Electives.

This article has been written by Dr. Rohit Nathani who is a medical graduate from Seth GS Medical College. Ask your questions in the comments section below.

To submit your article, go to the Contribute page.

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USMLE

NEET (Indian PG) v/s USMLE

NEET (Indian PG) vs USMLE

If you are a medical student from India, this question often pops up. What is the difference between NEET (Indian PG) v/s USMLE. The purpose of this article is not to determine which exam is better/worse rather it highlights the fundamental ways in which these two exams are different. Pick the one that works best for you!

1. Cost!

This is the number one factor that must be considered. Giving the USMLE is a long process and apart from the exam itself you are looking at a number of other expenses including electives, interviews, stay abroad, etc.The costs can be exorbitantly high.

2. Sprint v/s Marathon

NEET PG is a one day exam with 300 odd questions over 3 hours spanning 19 subjects. These are the subjects that you cover throughout your MBBS.

People usually begin preparing during their last year (Internship). Think of this as a sprint where you have to have one solid effort to crack this exam.

The USMLE on the other hand is divided into different steps that you need to give before you can apply for a residency – Step 1, Step 2 CK and Step 2 CS.The process is generally quite long. Each exam is between 8-9 hours in duration.

3. The type of Questions

Although both exams test you on the basic stuff that you learn (or are supposed to learn) throughout medical school, they are different in the way the questions are framed.

The questions in NEET PG are generally shorter and ask you a direct question. For example “What is the most common cause of pleural effusion in India?”. You either know the answer or you don’t. Even the conceptual questions can be solved quickly within a few steps since it is a shorter duration exam.

Most questions on the USMLE are presented in the form of a clinical scenario with a brief history and some labs. At the end of this you will be required to make a diagnosis or answer a question. You have to put together multiple steps to have a differential diagnosis and then answer the question.

This article was written to help you get an idea of the ways in which the two exams NEET PG v/s USMLE are different from each other. Ultimately, the goal for you will be to crack whichever exam you choose to take. All the best!

To read more of my USMLE posts click here. You can also check out my eBook on How to Study for USMLE Step 1.

Let us know your thoughts on this in the comments section below. You can also ask us your questions below or email at theindianmedicalstudent@gmail.com

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Resources Step 1 USMLE

How to study Pharmacology for USMLE Step 1 (High Yield Resources)

Pharmacology for the USMLE Step 1 requires you to know just the basics about the commonly used drugs in medicine. Here are a few things that you MUST know about the drug.

  • Which class does it belong to?
  • What is the mechanism of action?
  • What are the uses?
  • What are the side effects?

Apart from this there is very little that can be asked about pharmacology. Be sure to understand the drugs you study in this manner.

Pay special attention to the side effects. The examiners love these questions.

So what resources should you use to study for USMLE Step 1 Pharmacology? Thankfully the list is quite short for this one.

“Must do” Pharmacology USMLE Step 1 Resources

Review videos and notes

Video lectures and notes summarize pretty much all the basics you need to know about pharmacology for the USMLE Step 1.

You can buy these from any of the sources available online (Kaplan, Lecturio, Becker, etc).

If you feel that the videos are very time consuming, you can watch them at a playback speed of 1.5x or more.

If you are someone who prefers to read notes instead of watching videos, stick to that. The notes by Kaplan are concise and easy to understand.

First Aid

This is an absolute essential when it comes to Step 1 prep. There is no bypassing First Aid. This book along with UWorld is your ultimate resource for Step 1.

Be sure to go through Lecturio, Kaplan or any other review material you are using before you start reading First Aid.

The information in First Aid is ONLY the most high yield stuff and it doesn’t really explain concepts. This book is good if you have strong basics and want to have a review of all the subjects from 1 common book.

Every word is super high yield. Pay special emphasis on the mechanism of action and the side effects.

UWorld

Although this goes without saying, the list of resources for pharmacology would be incomplete if we don’t add UWorld. This is an extensive learning tool. Make sure you read the explanations really well.

This is a Question bank with nearly 2500 quality questions. Make sure you solve them and spend enough time reviewing your tests. There is a massive amount of information in each explanation.

If you want to master the resources mentioned above and learn more strategies about how to crack the USMLE Step 1, check out the eBook The ULTIMATE USMLE Step 1 Study Guide for IMGs

Do I need to read Lippincott Pharmacology?

This is a good book to read during the initial years of your medical school to build strong concepts in pharmacology.

However, it is neither required nor recommended that you read this book during your dedicated USMLE Step 1 Prep as this book includes a lot of non high yield material as well which can be very time consuming.

You can also consider making flashcards of the most commonly tested drugs and practice them. There are a lot of ways to study, videos, notes, flashcards, pick what works best for you and stick to it.

Have any other resources that you would like to recommend? Mention them in the comments section below or write to us at theindianmedicalstudent@gmail.com.

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Step 2 CK USMLE

How I scored 265 on the USMLE Step 2 CK – Experience 2018-2019

USMLE Step 2 CK Experience - How I scored 265

We have with us Dr. Rohit Nathani sharing his USMLE Step 2 CK experience and how he scored 265 on the exam.

I am an international medical student from Mumbai, India. I appeared for the USMLE Step 2 CK in December of 2018. Through this post, I want to share my USMLE Step 2 CK experience with the hope that it will help you in your preparation.

I have also written a book titled How to Crack the USMLE Step 2 CK which is available on Amazon Stores all over the world as an eBook. I have discussed my strategies in greater detail in this book.

USMLE Step 2 CK experience

My Background

The last year of medical school in India is formally called as “Internship”. This is a one year training period where we work in the hospital setting and learn skills. To be honest, it is a lot of scut work. It is also very time consuming and tiring as well as dealing with a lot of shit from your seniors.

Anyway, I decided to take my exam during internship because I wanted to get done with the exam before the elective and residency application process would begin.

It was February of 2018 and I decided that I will start studying from March. I still hadn’t recovered completely from the mental exhaustion of giving Step 1. Starting to study for another exam seemed like a daunting task. However, I gathered the courage and decided to find out all that is needed to study for the exam before March when I actually start studying.

What are the resources that I should use?

Unlike Step 1 where everyone gave you the same “First Aid and UWorld” advice, things were very different for Step 2 CK. There are so many different views about the resources to be used that it can leave you confused.

Speaking to people who had given the exam gave me the three most commonly used names of review books – MTB, First Aid for Step 2 CK, and Step up 2 Medicine.

Everyone had used a different combination of resources. However, there was one name common to all – UWorld. So that was one thing I decided I’m going to do for sure.

After going through the pros and cons of the different resources, I decided to do MTB 2 as my review resource.

So, the resources that I used finally were MTB 2 and UWorld. I bought the one year subscription of UWorld because I wasn’t sure when I will be giving the exam and also because you can reset the bank if the subscription is more than 6 months.

I would also recommend using MTB 3 for Pediatrics and ObGy as they are covered more in depth in these books.

To summarize

  • Review Book : MTB 2 (You can also use First Aid)
  • Peds and ObGy: MTB 3
  • Question Bank : UWorld, UWorld, UWorld!

How I studied : USMLE Step 2 CK Experience

I started to review MTB. The book is quite simple and everything is given in the form of bullet points. It is quite easy to understand. However, use this book only to quickly review the topics covered in each section. Do not try to memorize the contents. You will end up spending too much time for something that is not required.

After reading the topic I would solve a block from UWorld. The most important thing about UWorld is making notes once you have finished solving the questions.

Always do the block in TIMED mode only!

I made separate notebooks for each topic of UWorld notes. Make sure to use the flashcards feature of UWorld. They are quick and easy to revise before the exam.

I have discussed about how to solve UWorld, how to effectively make notes and question solving strategies in my book. Since they are out of the scope of this post I will not be discussing them here.

Another important thing I discuss in great detail is the “spaced repetition timeline”. This is basically a way by which you end up revising the stuff you have read and make notes about again and again.

Repeating what you have learnt at regular intervals helps you remember the vast amount of information that you need to know for this exam. This is something that goes a long way to help you on exam day.

August

Balancing prep with internship was difficult. However, I finished my first round of UWorld around August. After this, I took a break for a couple of days and then I reset my UWorld subscription.

I strongly recommend doing a second pass of UWorld since it is impossible to master UWorld in one go. Also it is such an important resource that it would be injustice to do a half ass job on that.

This is also the time I had some confidence that I will be able to give the exam by the end of the year. I went through my timetable and decided that I will give my exam in December since that was a relatively light month for me.

I strongly recommend that you have a rough idea of when you will be able to give the exam depending on your schedule.

2nd Pass of UWorld

The second pass of UWorld was in Random and Timed mode. Although the review process was faster, I still felt that there was a lot of information that I had missed the first time. Since, the notes were already made, I just added the extra stuff.

Tip : Make sure you keep saving your flashcards and make a separate deck for tables and images so that it is easy to revise close to exams.

Booking my test date

Since I had already decided the month in which I will be giving the exam, the next step was to book my test date. I had already started doing UWorld the second time and was fairly sure I will be done by the start of December.

I zeroed in on the 6th of December and started my application process. I would recommend that you give at least 2-3 months so that you can finish the application on time. Keep in mind potential delays at the level of your medical school as well.

Once you book a test date, I strongly recommend that you stick to it so that you don’t risk getting burnt out. This is one more aspect that I have discussed in my book – What is burnout and how to avoid it in your CK prep.

Practice tests

Around a month and half before my exam date I started to take my practice tests. I solved NBMEs 6,7,8 and UWSA 1,2. I scored between 250 and 260 in all of them.

I was now fairly confident about giving the exam on time.

The last month

I spent the last month finishing off the remaining 2nd pass of UWorld, solving practice test, reviewing flashcards, reviewing important information from MTB.

This was also the time that I slowed down my pace a little to avoid the burnout since I had been studying since March along with internship. However, it is important to be consistent and keep studying.

Tip : I would recommend that you take atleast the last week before you exam completely off. This is to make sure you are completely focussed on the exam and you are under less stress that you would be if you were working simultaneously.

Tip : Try not to solve any practice tests 5-7 days before your exam date.

The day before the exam

Under a lot of stress obviously. I tried to keep it under control. I had made some strategies in my head which I went through.

It is important to have in mind how you are going to solve questions, what food you are going to carry, what are you going to wear, how are you going to take your breaks.

Although they may seem trivial, they play a huge role on exam day. Each of these strategies has been discussed in great detail in my book.

Exam day

The exam day. The D day. You are obviously going to be stressed. But, try not to freak out. Have trust in yourself, you have worked a lot.

Remember, this is a 9 hour exam and you are going to be tired (exxxtreeemeeelyy tired) by the end of it. You start off all fresh but by the time you reach the 5th block, you are half dead.

The questions are quite long and the options are really close. Some of them are outright vague. Make sure you manage your time well. The last thing you want is not finishing the block on time.

Then it is almost as if you are solving questions on autopilot. Make sure you take breaks. Carry coffee!

Make sure you have practiced so much that even though you are tired, you solve the question correctly.

When you come out of the exam hall, you feel like the entire life has been drained out of you. It is also normal to go back and think about which questions you are going to get wrong, etc.

You need to actively block such thoughts. No one knows what the right answer was and you did your best. Try to relax. You ahve given one of the toughest exams of your life.

This exam is tough, but with the right knowledge of how to master the resources you have, the spaced repetition timeline and strategies, I think you will do well.

All the best. If you need a more thorough guide about the things I have mentioned, you can find them in my book, click the button below!

eBook How to Crack the USMLE Step 2 CK

If you have any questions, use the comments section below. You can also email us at theindianmedicalstudent@gmail.com

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Step 1 USMLE

USMLE Step 1 Physiology Resources (High Yield)

USMLE Step 1 physiology resources

Choosing high yield USMLE Step 1 Physiology resources will go a long way in building basic concepts that you need to master this subject. But is physiology really even tested on the USMLE Step 1? And what are these high yield resources? Let’s find out.

Why is Physiology even important for the USMLE Step 1?

Unlike the topics like biochemistry and anatomy which involve a lot of memorizing, physiology is conceptual. This means that if you have a mastery over a few concepts, you should be able to tackle these questions on the exam.

Another reason why mastering physiology is so important is that you need to have a good understanding of physiology to really understand pathology for the USMLE Step 1.

How to master USMLE Step 1 Physiology and what Resources should I use?

I am going to give you a comprehensive list of the most high yield resources that are out there as well as when and how to use them.

At the start of medical school

These are the physiology resources that I recommend you use at the start of your medical school. This is when you will be forming your basic concepts. You will also have time on hand so, take this opportunity to really learn physiology.

Guyton and Hall Textbook of Medical Physiology

Although this book may seem like a lot to study, don’t get overwhelmed. When you start reading the book you will realize that everything is explained so simply.

There are diagrams and flowcharts that will simplify what you read. Don’t try to remember every word of the book. Read it like a novel and try to take home the important points only!

Dr. Najeeb’s Video Lectures

If you are an audiovisual learner, this is the best resource for you to build a foundation in Physiology. Dr. Najeeb explains concepts at the most basic level.

His diagrams and his teaching style will make sure you understand every concept.

Here are a few pro tips to keep in mind while watching these videos

  • Make notes during the lectures. It will not be possible for you to watch the entire video again as it is very time consuming.
  • If you find that the lectures are a little slow for you, increase the playback speed to 1.5x or 2x. But make sure you have enough time to think about what he is saying.

Do NOT try doing these videos if you have a deadline. They will take up too much time and you will end up doing too little.

During your dedicated USMLE Step 1 Physiology prep

Kaplan Physiology

If you want to do a quick review of physiology, the video lectures and notes from Kaplan should be your “go to” resource. The high yield points are covered very well.

I recommend that you buy the entire series of notes from Kaplan as you will be needing it for the other subjects as well.

However, if you feel that the amount of information is not enough and you have time on hand, you can use BRS physiology.

BRS Physiology

If you do not have solid concept in physiology from you medical school years and you think the the amount of information in Kaplan is insufficient for you, BRS physiology is what you are looking for.

However, keep in mind that you need not do both Kaplan and BRS Physiology. One will be sufficient.

First Aid

As with all subjects in USMLE Step 1, you will ultimately be studying from First Aid. Since this book is a compilation of all the subjects in one book, it is difficult to explain each concept in detail.

Make sure you are familiar with the basics from the resources mentioned above before you start using First Aid or else you will not be able to do justice to the information in this book.

Although there are a lot more resources out there for you to choose from, limiting your resources to a select 2-3 will help you master what you study.

Want to learn how to master the resources mentioned here as well as a lot of useful tips and strategies on how to ace the USMLE Step 1? Check out our eBook The ULTIMATE USMLE Step 1 Study Guide for IMGs

Do let us know if you come across a resource that you would like to recommend to others in the comments section below. You can also reach out to us at theindianmedicalstudent@gmail.com

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Categories
Electives USMLE

How much will a clinical elective in the US cost?

How much will a clinical elective in the US cost

A lot of international medical students who are looking for US Clinical Experience consider doing electives. These electives give you a feel of what exactly a residency in the US will be like. One of the common questions people have is “How much will a clinical elective in the US cost?”

While the cost of the elective will vary from program to program, as well as where in the US you do your elective, there are a few basic expenses you need to consider.

Below I discuss the cost on an average, just to get a rough estimate of how much your elective can cost you.

The Application Fee

$300 to $500. Some may be as high as $1000 but $500 is a safe bet on an average.

The Elective Program Fee

$1000 to $2500. A few programs do not charge you for the elective. These programs generally require Step 1 scores. ( Check out the article on 6 Clinical Electives with Step 1 scores). Some can be as high as $6000.

Accommodation

$500 to $1000. Depending on which part of the country your elective is in, this is highly variable. For example, a room in New York could easily cost you at least $1000. This number will be lower in smaller towns.

Airfare

$500 to $1000. Again, depending on factors like when you book, which airlines you choose,etc.

Miscellaneous

$500. Consider this additional expense for food and other utilities you will pay for.

As mentioned earlier, the cost of an elective is highly variable depending on a lot of factors.

Considering an average expense of $4000 per month is a safe bet.

If you are looking to have a rough budget for electives, do take all these expenses into consideration.

Find more articles on USMLE and Electives.

This article has been written by Dr. Rohit Nathani who is a medical graduate from Seth GS Medical College. Ask your questions in the comments section below.

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