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USMLE exam; Waiting for the godot

Author: Guest, Posted on Monday, August 04 @ 15:44:15 IST by rxpg  

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USMLE Step 1

Step 3 is not really a mandatory part of the MLE for foreign graduates.

Madras/ Chennai
Mumbai/ Bombay
New Delhi

1. The MLE is not about how detailed your knowledge of specific areas is. It is more about the breadth of your coverage. You need to know some basic things about a lot of stuff, rather than really fine detail about any single topic. After all, its a 15 hour exam, both steps together!

2. Keep the above mentioned concept in mind while you prepare. Try to avoid reading excess info that may not be of too much use, because you may end up being strapped for time. The book list we and Gopal have provided is structured with this in mind.
3. You need some idea of what specialties are available to you as an indian grad, and which ones aren't really accessible. Surgery more or less falls into the latter category, unless you have a track record and persona. Medicine, Psych and Anesthesia are among the more available fields. Peds and Radio are tougher.

We will further update this section soon with info on visa types, CSA, ERAS and NMRP. The last 2 most certainly are 4 letter words in every sense of the term!!

N.B. 1: Access to a computer and internet is critical.

N.B. 2: An international credit card would be very useful.


1. Decide which subject you want to pursue. Input for this decision would be personal preference, and also the fact that internal medicine is the easiest to get. Other relatively easy to get subjects are Psychiatry and Anaesthesia. Surgical branches are a no-no, unless you are extremely ambitious, lucky, willing to slog it out, and . . . wait.

2. Decide upon the geographical region where you will be willing to take an interview. Remember that most FMG friendly hospitals are located on the east coast in NY region and in and around Chicago. And forget California, they have a clause which effectively bars us FMG's. Also look where you have a relative or a friend who would be willing to let you stay with him. Remember that traveling in US is several times costlier than in India and the distances are vast, so you would need a base and you would then need to cover regions around it.

3. Decide which visa you want to go for-- J1 or H1. This is perhaps the most important decision. H1 means you can stay back after residency and maybe eventually get a green card. This is unlikely with a J1 as the rules have changed and in the future it is anticipated that J1 waivers are going to be extremely difficult.

On the flip side, H1 costs a lot more (expect to spend around 3.5 lakh rupees for a J1, while an H1 would cost around 5-5.5 lakh rupees. This is a conservative estimate, the free fall of the rupee is likely to raise this considerably) and as the good hospitals sponsor H1 visa only rarely, you will probably be stuck with a community based hospital. All wise people seem to advise going for an H1 but that does not deter a lot of people including myself from going for a J1. (ed.: we know gopal to be quite a wise man himself!)

4. When do you start doing all this ? At least 1 year before you plan to join a residency, ie, suppose you plan to join in july 2002, start all this dogwork around july 2001.

5. Arrange for reccomendation letters. Try for one from the HOD of the department in your college which you are applying for in US (for eg., if you are applying for medicine get a letter from the HOD medicine in yr medical college). Also from HOD of department where you are passing time after MBBS. Remember, all these things take time.

Compose a good recco and it may help you a lot later. Guide yrself by looking at reccos of yr seniors (yr friends are unlikely to show you) and you may also search for some tips on the internet. A deans letter (one from the principal of yr college would do very well) would be required. Try to wheedle a good letter from yr pricipal but if he is not cooperative, well one just stating that you did yr MBBS from this college and you have a good character (do you ?) will do.

6. Arrange for an ERAS token from ECFMG. It costs $75, and you can print a form from the ECFMG website and fill it up and send it to them. Do this in july.

7. Now check out the various residencies on offer in your selected branch(es). You can do this at FREIDA online. You will get from there a whole list of residencies sorted by branch and geographical region, as also details regarding every program. An absolute must-see before you apply. Especially look for the size of the program, whether it is univ based or community based, the strength of the faculty, the number of applicants last year, the passing rate in board exams, etc. Note down the e-mail addresses, tel. no.s of the programs and their website addresses.

8. Write a letter to all those programs which you think may be worth it, giving info about yrself in brief (please, not yr life story). You may want to give your scores and the year in which you passed out of med school. Say you are interested in --- program and you want to know some things, namely, whether they take FMG's, do they currently have any FMG's in their program (this is important as they are unlikely to consider you if they have never taken an FMG), what visa do they sponsor and any other criteria for applicants. Write to as many programs as you can. No harm comes from it. (ed.: apart from the postage!)

9. You may also call up the programs using internet based telephone, which is totally free and equally illegal, so don't tell VSNL about it. Also visit their websites. However, take the claims of websites with a pinch of salt, as there is a lot of hyperbole on their sites!

10. Most important, ask yr friends and seniors in US about all this. Their advise will be indispensible. Several sites also have lists of FMG friendly programs, notably www.foreignmd.com , but again, be cautious in relying on internet claims.

11. Fill in the ERAS form carefully. It has been entirely net based this year, and will be so in the future. Buy programs on the net itself, this is where an international credit card comes in.

12. Wait for calls. This is what I am doing now, it is like waiting for Godot.

13. All this was the easy part. Now presumably armed with yr calls (and having succesfully scheduled the interviews) you go to the promised land, where it is all snow and cold since it is december or thereabouts. The rest I can tell you after I do it this year.

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