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Goto page 1, 2, 3, 4, 5, 6, 7, 8, 9 Next Well when i got stuck between Indian Pre-PGs n USMLE, i thought i was alone, but with time i've come to realise that there are many docs like me who're in this dilemma, whether to go for AIPG (by this mean indian Pre-PGs) or USMLE. I met a lot of seniors and friends and took their advice and in this process I've gathered a lot of info regarding varying aspects of this eternal question AIPG or MLE?? So in this thread I’ve tried i've tried to compile whatever info i have, including my own views regarding aforesaid aspect. Of course i've used facts and views from other relevant posts as well. I request all to add whatever info is deficient here.. In keeping with the tradition of RxPG, any additions, suggestions, comments are welcome. That would help us get a broad view of the realities we face and help lot of us to decide, whats the right course for us. But remember, these are my own views and I’ve penned them down just to help out people like me. I may be wrong at a point and I apologise in advance for that. Lets start with the first and basic question, that is which one is better.. We'll take factor by factor... 1. Home advantage- [tex]With AIPG you have an advantage of home country, being close to family - Its very hard to spend years abroad and many students become home sick becos you don't find many people with our culture. Students, too much attached to their families might find it very difficult there when u celebrate diwali/holi/Eid alone. But then Indians abroad do form their own little groups and celebrate all festivals together.[/tex] 2. There is a risk of being treated as 2nd citizens at the USA. [tex]But then regional, caste n creed considerations do exist in india too n sumtimes are grave enough. I know people who had to leave their PG seats when limits of discrimination were crossed. So its not a very strong factor.[/tex] 3. Risks - [tex]In AIPG, Selection means a seat n If u get a seat, u will surely complete a PG. But clearing MLE even up to Step 2 CS doesn't guarantee a residency slot. You may return bare handed or may have to compromise with a branch you don't like, for the whole life.[/tex] 4. Expenditure - [tex]At least in the short run, expenditure for AIPGs runs only in few thousands. But for MLE it is in the tune of 5-8 lacs (details later). But again in the long run MLE people earn lot lot more than their indian counterparts. So it can be considered to be an investement.[/tex] 5. Visa? Mera no aayega??  - [tex]This is the most critical factor for MLE. You may be denied visa even after getting 99 in both steps, that too for no reason at all. The situation these days is pretty rosy, but we gotta remember the fact that its very very unpredictable. 12 months or so from now when we apply, what the situation may turn out to be, only god knows. So never decide solely on the fact 'My senior got the visa, so will i'. Same is true for vice-versa.[/tex]
6. Working conditions - [tex]MLE definitely scores over AIPG on this aspect. You'll get very good working conditions even at the lowest ranked program at US. No need to comment on the situation in india. Still i'd like to remind you here you'll be faced with lack of infrastructure n lab facilities, poor clientelle, general bias AGAINST medical community, Very frustrating payscales, broken/malfunctioning instruments, filthy hospitals. Conditions in private setup are better but then most people prefer govt jobs. In private sector you earn well only as a consultant, buts it would be 7-10 years at least before you get a consultant job at a good hospital.[/tex] A distinct disadvantage in US is that you have to be thouroughly professional. Any laxity and you are always at the risk for litigations (specially true in surgical branches). You should be willing to give best service to the patient there cos pts there are well educated and well informed. Don’t forget that the number of litigations in India is on a sharp rise. Every other day you can read about patients, relatives, local politicians storming and mobbing the hospitals on small so called lapses. Episodes of manhandling of docs is also increasingly common. 7. Earnings - Do i need to elaborate??? In the US, even during residency (in the tune of $45k per annumn) you earn more than most of us wud earn here 5 years post-PG. Its very frustrating when during PG you're given 6K and you have to look towards your parents for support. After PG, you're offered 8k/14k/20k at private hospitals. Or if you do SRship it runs from 15k-25k at the max. Post residency payscales in the US are in the tune of $ 1 lac plus p.a. 8. Job satisfaction - Well its very subjective and variable. But most people who are in the field agree that it’s highly frustrating in majority of India. According to them Few reasons why: * Yours pt has more faith in local quack/compounder than you * Pt Compliance is very poor due to illiteracy , poverty etc. But the blame of failure of treatment will always be on you. * If you prescribe an investigation it’s always unnecessary in pts view * Indian pts are highly reluctant to pay your meagre consultation fees * Even after specialising you have to work as a GP becos of lack of facilites you can't make specific diagnosis or perform big procedures (barring big centres) * Payscales are not commensurate with the quality of your qualification and work There are hundreds more. In summary, here you feel incapable of applying the hard earned knowledge properly leading to dissatisfaction. While in US, you get paid well, plus ample facilities at most hospitals n lietrate pts. who don’t worry about expenses (also due to health insurance) allow you to try to provide the best treatment according to your judgement. 9. MCI Recognition - MCI doesn't recognise PG from US, so you would be counted as an MBBS in govt setup, even after residency from US. So your scope in india is restricted to private hospitals. Its a good option but competition among US returned docs is increasing day by day, so it myt not be a cakewalk on return from US. 10. Time spent - Well its a big issue at hand. Definitely here you have a chance to get into PG early concurrently with your batchmates. While if you go for MLE, you myt be delayed by 2 years. By the time you’ll join your residency your friends myt be in final year PG. But i look at it differently, In india we myt start the race early but what'll be the situation only 5-6 years from now. With the kind of earnings in US you'll have accumulated more money than your friends here, even after deducting what you'd spend for MLE. Careerwise, as far as i know, a fresh PG from US wil get at pays least equal to, if not more, than an Indian PG after doing SRship for 5 years, of course only in private hospitals. 11. Choice of branch – Well if you are hell bent on surgical branches, reconsider your decision for MLE cos its tough to get them (not impossible mind it). To get them you need very high scores, good LORs (Letters of Recommendation), USCE (US Clinical Experience), some research background etc. Even if you take surgical branch, you might be a bit discriminated (not in all programs), plus Asians are more at risk for litigations. I know a senior who left surgery within 2 months due to aforesaid reasons. 12. Exam itself – Well MLE is definitely easier than AIPG. MLE study material is: * Significantly Less exhuastive * Less ambigous * Clinically oriented * More of conceptual * Hence involves less cramming So, if u find cramming difficult, love clinical cases, have spent more time at wards than at your study table, you are more likely to love studying for MLE. 13. Indian PG + prep for MLE simultaneously??It requires a lot of patience for MLE aspirants specially cos lot of risks are involved at multiple points. Plus its very very tough to prepare for AIPGE and MLE simultaneously, both myt get spoiled cos remember, in MLE scores are very very important n you can't improve scores once you’ve cleared a step. Yes, starting PG and then preparing 4 MLE is possible and many people do it but it is associated with following difficulties: * You gotta prepare for AIPG if you don’t get selected this year, which means 1 additional year. * During PG its hard to find time to study, of course depends on branch and college * You won't be able to join any coaching if reqd. * A small disadvantage is that a few programs prefer recent medical graduates or at least who have passed within past 2 years. This incurs a loss of at least a few more programs which u can apply for.[/tex] Thanks for reading till the end...er... i mean if you are still awake... |
| confusedashell wrote: |
| Hi ashb,
Superb.. Got more info from u than I get from my batchmates in a whole year!So hv u started preparing.. .My decision will be after <a href="http://www.rxpgonline.com/forum2.html">AIPGE</a> ..Hope its not too late.. Best o luck n tilnxttime |
Hi confused, I'm in d same boat as u and for this very reason i compiled this info cos i knew what aspects confuse us. I too will start for MLE after AIPG. Stay and touch and keep visiting and posting in this forum. That will help us all..
| Quote: |
| The post PG scenario in India is BAD!Even if U hve a post graduate ( these days super speciality counts), from a premiere institute, life after pg is tough, very tough and u may be payed in peanuts after slogging for hrs.
Unless u have a home setup, medical practice (especially good ethical practice) has become very very difficult in India. |
drss wrote:
| Quote: |
| just adding to ur deatils i just wanna share with u pple that am presently working as a med officer in a phc.nd the points u discussed FOR USMLE r nothing but the truth.at the ground level working condition is miserable.in college days i was always for staying here nd serve the country but after working inside the system i am desperate to leave this job at the earliest |
Well all seem to agree on this aspect..
Vineet wrote:
| Quote: |
| I've written it elsewhere but wud again repeast that PLEASE
PERSONALISE UR DECISION N NOT GET SWAYED AWAY BY OTHERS >>> BOTH PLACES HAVE THEIR OWN CONS AND PROS.. |
What vineet has said is VERY VERY important. U gotta decide ur own priorities cos in d long run u myt regret if u've taken a superficial decision. I think this is a very big step and shud be decided after taking ur family and well wishers into confidence.
| Quote: |
| now we have a task of ONLINE TIMELY DISCUSSION HERE hence participate in that and get benefitted..... and benefit others |
I request all MLE aspirants to cooperate and post more and more doubts and info..
dsha wrote:
| Quote: |
| But even in the US, most PGs have to go in for fellowships after say internal Medicine . |
I dnt know what exactly dsha meant but still, at least financially u r not worried if fellowship adds to ur study years. Plus doing fellowship, which is equivalent to superspecialisation, increases ur chances of getting better jobs later.
all this has been very useful . fantastic thread i must say.
to add a few points..
for patho revision before exam Goljan audio is a MUST. nothing beats dr goljan . he is the best! and in addition if u have time go thro' his patho review notes.. they r good though have lot of extra stuff . Goljan high yield is also gr8.
Robbins is important, but not good enough unlike all india. Even after being thorough with robbins there is a possibility u wont be able to answer quite a few Qs.. Reason: format of Qs is very different. so better to keep solving Qs side by side while preparing.
Kaplan lect notes are very good. Pharmac ( Dr Trevor rocks!) is amazing. Neuroanat is good too. Immuno is a must. Beh Science is a must do.
rest all from the list mentioned at the start of the thread is enough.
As regards residency options....
" Surg is difficult ( not impossible) " ... oft repeated line i hear from many people. What exactly they mean by not imposible beats me. I know of people with 99% in both steps, step2CS cleared but still no surg. Strong LOR and USCE is a must. LORs we can manage from our prof ( they r more than obliging to have their name printed!). But Folks USCE is a headache. If u planning to do paid attchments be ready to shell 50k at least... plus few months on ur timetable for it... but still no guarantees.
I am NOT .. i repeat I AM NOT trying to dissuade aspiring surgeons from taking the steps. But knowing what u r up against beforehand will save a lot of anguish and frustation later.
@ people planning to take steps after All india.. a word of advice if u dont mind. plz dont think ab things like these. they will only divert ur attention away from task on hand( ALL INDIA ). Life is frustating presently for all of us
..
Am no sage to advice . But cldnt stop dng so.
Hope u pple dont mind. If i hurt somebody.. my apologies beforehand.
USMLE is as much about extensive planning as about studies! And plans extend for years! Plz dont work on a tight schedule. be prepared for unexpected delays. Its a long journey boss!
be patient .
I wish all success to you.
sorry folks
| hjorq wrote: |
| hi all.
for patho revision before exam Goljan audio is a MUST. nothing beats dr goljan. in addition if u have time go thro' his patho review notes.. they r good though have lot of extra stuff. Goljan high yield is also gr8. ...so better to keep solving Qs side by side while preparing. Kaplan lect notes are very good. Pharmac ( Dr Trevor rocks!) is amazing. Neuroanat is good too. Immuno is a must. Beh Science is a must do. rest all from the list mentioned at the start of the thread is enough. |
| Quote: |
| As regards residency options....
I know of people with 99% in both steps, step2CS cleared but still no surg. Strong LOR and USCE is a must. |
Well i'd like 2 add. A senior of mine got surgery this year. He tells me that in surgery about 10% of residents are IMGs.. Maybe that's y i feel its difficult but not impossible..
| Quote: |
| USMLE is as much about extensive planning as about studies! And plans extend for years! Plz dont work on a tight schedule. be prepared for unexpected delays. |
| Quote: |
| But Folks USCE is a headache. If u planning to do paid attchments be ready to shell 50k at least... plus few months on ur timetable for it... |
Plz note, its an important info both timewise as well as moneywise...
And hjorq, ur post wasn't longer than mine at least..
.
Thanks 4 sharing ur valuable views and info..
most banks do not ve any provision 4 loans 4 usmle expences...says they must see the letter of acceptance 4rm the foreign univ/college to grant the loan(which is relevant only 4 degree courses!)
m planning to go via GRE. plz,also post some info for the same, esp suggest me a course thats easy, less credits, less money, more chances of TA, name of uni, and a program that adds to my resume in MLE.
thanks once again.
I'm sure there must be sum channel. I'll let u know if i get sum info. Best wishes till then..
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Regarding scoring u gotta remember the following facts:
* Score is decided on d difficulty level of the questions which have been pre-rated.
* Set ur target to get 75-80% questions correct if u desire score in high 90s.
* I'll try to put my interpretation in this way. Suppose A and B both get score 99. This dusn't imply that both have same marks.
marks x diifficulty = score = 99
Hence,
marksA x diffi A = marksB x diffi B
(this is completely my own idea, don't ask for a mathematical or documnentary proofs)
So if u get an easy paper, u gotta get more questions correct to get a good d same score and vice versa.
**** One more fact (courtesy: hjorq) for those aiming to get into high 90s A gud three digit score is more indicative of ur performance than the 2 digit score. 249 and 262 both get 99 centile. Hence 2 guys, both with 99, the one with higher 3 digit score has performed better.
the thread by u is really very informative!
ashb ,can u please elaborate on gre route for mle.
what r the advantages n disadvantages for an mle aspirant
taking u the gre route.
another great post.But I would like more info on the step 2 score importance.How far can we rely on this piece of information.Surveys can be quite misleading sometimes.
Coz for us IMGs the steps score are most imp.
Very few of us can get USCE and Research experience.So all we have in our hands is the step scores and we need to work on that.
All i think is i'll try my best to get d best possible scores, to the best of my ability. Knowing whether step 1 or 2 is important won't change my scores if i try to put in my best!!!
Plus i forgot to add:
Step 1 scores are particularly important if u r planning for surgical branches..
That is really a very important piece of information. It will be very helpful for a lot of peopl to make important decisions.
I would like to add a few of my own experiences here in the US...
It is not impossible to take mle in a very short time, as i finished all 1, 2 & cs in 3 months totally. But I dont think it was a good idea, as my scores are suboptimal. 8-9 months would be the optimum, to get a good score. But then again if u r in high 80s & 90s it is all the same unless u r trying for an extremely competitive program. Taking CS early is definately a very important factor to get more interviews, as the results take a lot of time to be out.
Now i am on a Multiple entry B1/B2 as u have said. But being on an F1 for MPH or something else would be definately more useful, not from the degree point of it, but the time u get to spend in the US, when u r free to do a USCE, esp, externships. It is very hard for a B1/B2 to get an observership or an externship
. Also, I personally feel being on an F1 as a student will improve ur personality skills & communication skills to help at the interviews. So instead of studying back home without doing anything else, it would be better if u can manage to be on an MPH or something else.
BUT THEN AGAIN, THIS IS ONLY MY PERSONAL OPINION. I ADVISE THOSE READING THIS, TO COME TO A DECISION ONLY AFTER CONSIDERING ALL YOUR OPTIONS IN TOTAL.
adios,
kamits
Actually we guys really need advise from experienced people like u.
Can u please elaborate on the problems u faced in getting externships due to B1/B2 visa??
If possible plz share ur experience on how did u manage to get visa for step 2 cs.
thanks ashB, and others for this wonderful thread. u have done an exhaustive research and made things easier for others.
i'm confused as hell as to what to do. when i joined internship i was hell bent to clear aipg. i joined DAMS for coaching...
but now i'm more inclined toward going abroad......
i've considered so many thing..... aspect in us, australia.... so much so that doing mba also came to mind. i should be studying now reading mudit khanna and cramming up things.... but my mind wanders to other things..... mainly usmle. its my first attempt at aipg this time, and i know i won't get a rank(don't think i'm pessimist, but i know where i stand).
so soon after aipg i'll re-evaluate thing and reconsider my decision(75% of which i've already done subconsciously).
kepp in touch,
thanks again for this info......
keep rocking
kunal
its another nice thread from u ashb,thats great!
kamity, please do post what sort of difficulties u faced to get usce on b1/b2 visa and also how did u managed to get the visa for cs.also,kamity please clear whether step2cs is required when u apply for residency.
thanx a lot for that post.
Its really important for us to have first hand information about these things.
And Im happy to note that u encourage the MPH way.coz very few ppl are supportive of it.I totally agree that instead of sitting at home, if u can get a degree in US in the same span, its much better.
Plz let us knw how did ur visa interview go and about step2 cs too.
thanx.
The ECFMG(r) Reporter
An E-Newsletter for International Medical Graduates Pursuing Graduate
Medical Education in the United States
Issue Seventy-Two - February 3, 2005
**********************************************
IN THIS ISSUE:
IMGS WAITING FOR STEP 2 CS RESULTS SHOULD PROCEED WITH MATCH
REGISTRATION AND RANK ORDER LISTS
**********************************************
IMGS WAITING FOR STEP 2 CS RESULTS SHOULD PROCEED WITH MATCH
REGISTRATION AND RANK ORDER LISTS
If you plan to participate in the 2005 Match, and you completed Step 2
CS testing on or before December 31, you should proceed with Match
registration and the completion and certification of your rank order
list, even if your Step 2 CS result is not yet available. The National
Resident Matching Program (NRMP) deadline for registration and
certification of rank order lists is 9:00 PM, Eastern Time, on February
23. The NRMP communicates directly with ECFMG to confirm eligibility to
participate. Therefore, your exam results may be available to the NRMP
in time for you to participate in the Match even if you have not
received them by February 23. However, you will not be allowed to
participate if you have not registered and certified your rank order
list.
******************
Hope it helps
lets do the math here.....
step1 815$=38,500(including credit card surcharge).
courier etc.=1000
books for step1=5,000
step2 fee 40,000
courier=1,000
books=5000
cs fee i think 975$=50,000
airticket=40,000
step 3 fee=ranges from 650 to 750$ depending on the state where one takes the exam = 40,000 max.
25$ per application for match.if u apply to about 50 places....1250$=60,000
if u get interview from 10 of them(lucky u!)....hmm.....lets say 100$ for tht so...1000$ max. including the so called heavy duty phone calls. thts 50,000 for attending the interviews.
plus visa fee of lets round about to 10,000
grand total comes out to be 3,40,500.
wat the hell....lets make some extra phone calls too! lets add another 10,000 worth of phone calls......3,50,000.
none of this includes staying in US for 4-6 months.cuz many ppl r assume who prepare for US have someone they know to crash into their places,thr r some who do not,& for them the expenditure would be naturally higher..by how much......is anybody"s guess(depends whr ur stayin wat ur eating,how ur passing ur time).
hope this helps
any aberrations or advice r most welcome
adios!
its ur own choice to do kaplan coaching or not....doing it would considerably enhance ur expenditures.65,000 for each step.but,so would travelling in british airways business class.both of them fruitless cuz one can procure kaplan materialanyway in india at a fraction of the price.
add book costs for CS & STEP3( which i forgot).
online tests like Q BANK r not needed either if u can get ur hands on the pirated CD containing them.
We'd be greatful, if u point out any aberration, in ur view, in that estimate. So that we may reach a conclusion of consensus.
Plus i'd like to add one more info..
If we wanna consult a visa consultant for guidance on how to appear for visa interview, we gotta pay Rs. 5,000-10,000
the main diff is whether a person has some place to crash land in US aka relatives.cuz living in motels plus eating drinking,ocaasional recreation for 4-6 mnths does has its costs.u said 200,000 for it.but again as i said it,most usmle aspirants tht i have come across do have a relative of some sort,albiet distant.
online mock tests.....10,000...usually not needed.as i pointed out,most of us dont believe in copyright!
H1B attourney....hmm....doesnt the employer pay for the visa processing? maybe the candidate can also offer to pay for it,maybe it increases one"s chances,not sure.
i have stated higher figures already for step3,overheads(booze,ISD calls.....u can get an hour in 7-8$ is it?& net is even cheaper & better option,minor issues really).
the plane tariffs have decreased bout 40,000 now.
so if u have a place to stay......3,50,00
if u dont.....500,000-550,000.
adios!
regarding the imp. factors needed for residency....did u state them in decreasing order of imp.??? in tht case...USCE & LORs r sure more imp. than research without doubt.very very few freash graduated from india have any research to their credit which clearly indicates tht scores r paramount as u too said.
nice,informative posts,good work
adios!
god bless u and good luck to u
Thanks thinktank for joining in...
But that ranking is not rigid, u know cos diff programs have their own priorities. So that ways leaving the MLE scores, other top 3 myt shuffle positions depending on program and branch...
u've done a great job........... thanx a lot.....
u said that we'd have to complete upto Step 2 CS by september , to be eligible for the 2007 match, which seems very difficult if we decide to start preparing after AIPG... that means a long wait till 2008...
So have u decided to go ahead and wait ? and what do u plan to do till then ? ur view on this would help me , and many others....
But whats imp is, give highest priority to getting good scores. At least thats what i'm looking at. Becos 1 year won't hurt much. Imagine being stranded with a score where either u get a non-clinical branch/program not of ur choice or no residency at all!!!! So i guess, just analyse all d factors and decide if u can take all d steps before September.
Plus also consider d visa factor. Suppose u don't get a visa at ur first attempt, that wud crash all ur plans to complete it in time. If u'r sure of visa issues and can work hard, 2007 match is not impossible. So decide wisely...
nd ya u can join a job with sm research work ass with it till 2008 match time here......this may not be feasible with most of the pple here but it may help u sm way or other......sm of my frnds r doing that.
just carry on............
see u later.............
Good luck to u..
I am quite young in this IMG thing as I am currently in my 5th year of medical school in USSR. I was going to do PLAB before abd I have decided that it is a no go area so i am going for USMLE.
It's a long process so do you advise me to start now cos I plan to train there ,do their foundation program,(JHO).
SO what do you adivse? to take USMLE next year, stage 1 for a start or to wait till I finish?
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