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Author: AshBPostPosted:     Post subject: Scoring in USMLE??

As far as i know, questions do not change based on ur performance. They use a random method whereby the computer randomly picks a question from their question bank, which has been divided into categories (subjects and like). It has been programmed to pick at least a fixed number from each category but above that the ratio of various questions can vary.

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


marksA x diffi A = marksB x diffi B

(this is completely my own idea, don't ask for a mathematical or documnentary proofs) icon_smile.gif icon_smile.gif

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.

Author: workPostPosted:     Post subject:

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.

Author: tonaPostPosted:     Post subject:

hi ashB. thx a lot again 4 ur informative list of schlorships.

Author: danaPostPosted:     Post subject:

hey, AshB
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.

Author: AshBPostPosted:     Post subject:

Agreed Dana, as i've already said, the single most important factor for IMGs is our scores. Well between setp1 and 2, i don't know for sure. Any more info is welcome.

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..

Author: kamityPostPosted:     Post subject: scores & USCE

Hey AshB,
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 icon_sad.gif . 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.



Author: AshBPostPosted:     Post subject:

Thanks kamits for giving ur valuable suggestions.

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.

Author: dr_kunalPostPosted:     Post subject: HI

hey there.
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

Author: workPostPosted:     Post subject: hi

hi,ashb and kamity,

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.

Author: danaPostPosted:     Post subject:

hi kamity,
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.

Author: AshBPostPosted:     Post subject: Application to Match without Step 2 CS result???

For all those confused whether we can apply for Match without step 2 CS???

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






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

Hope it helps

Author: fragile_xPostPosted:     Post subject: lets do the math!

well lets not excited......

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

cs fee i think 975$=50,000

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


Author: fragile_xPostPosted:     Post subject:

oh.....i missed a few points i think...

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.

Author: AshBPostPosted:     Post subject:

Thanks Arihant, I hope u've read d estimate given at the start of this thread (in post # 2), which i've given after cosulting a lot of people. My estimate includes minor possible deviations too.

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

Author: fragile_xPostPosted:     Post subject: hii

well my opinions after reading tht r as follows....

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.


Author: fragile_xPostPosted:     Post subject: correction

oops...i meant 350,000

Author: fragile_xPostPosted:     Post subject: my 2 cents!

somethin more to add here.....

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


Author: thinktankPostPosted:     Post subject:

hey ashb thanx for the load of info u have done us all grt favor by clearing out the several nagging Qs in us
god bless u and good luck to u

Author: AshBPostPosted:     Post subject:

Thanks arihant for ur valauble comments. I think u seem to agree with our estimates. Its just that i've kept them on the higher range, so as to be prepared for the unexpected expenses also. I think my estimates r like maximum expenditure possible.

Thanks thinktank for joining in... icon_smile.gif

Author: AshBPostPosted:     Post subject:

And arihant i've tried to rank them in decreasing order of importance. Again thats my own view, not an expert opinion.. icon_smile.gif

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...

Author: drniioPostPosted:     Post subject:

hi ashb !
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....

Author: getkishiPostPosted:     Post subject:

Thank you AshB. Thats a very good information for newbies like me who are yet to decide between AIPG and USMLE. Thanks a lot for ur time and interest to help guys like us.

Author: AshBPostPosted:     Post subject:

Well Drniio, as i said i'm in d same boat as u guys. Its tuf to make it to 2007 match but not impossible. You gotta take into consideration ur own limitations.

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...

Author: drssPostPosted:     Post subject:

nice work ashB...............u just said all needed to know.

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.............

Author: AshBPostPosted:     Post subject:

Thanks drss for ur replies. Actually, i really want to find some time to join some research work. I'm trying to plan accordingly, just not sure of the visa issues.. Hoping for the best..

Author: surr_amcPostPosted:     Post subject:

thnak s ashb that was a very usefull bit of information icon_biggrin.gif

Author: AshBPostPosted:     Post subject:

Welcome surr_amc to the thread. I gather u r preparing for the AMC. Please share any additional info u could provide us regarding the same..
Good luck to u.. icon_smile.gif

Author: surr_amcPostPosted:     Post subject:

yes ash b . i just completed amc part1 andam now applying for part2 .there is a long waiting period for getting my date for amc part 2.

Author: obyokaforPostPosted:     Post subject:

absolutely amazing, Ash B. U know I am from Nigeria, not India and I got a lot of info from this thread. Way to go.
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?

Author: AshBPostPosted:     Post subject:

Hi obyokafor,
Thanks for the appreciation.
Regarding ur question, i don't have an idea of d course content of ur medical curricula but i think u guys have a 6 year MD. see in MLE all steps are interlinked and if one wants a really good score its better to take all steps continously without a break.

Like if u take Step 2 now, u myt have forgotten the pre-clinical and para-clinical subjects and u'll find little time to revise them while doing ur MD. Taking step 1 is also difficult cos u had studied those subjects long back and it'll require some time to read them.

Best would be to take advise from ur seniors in USSR who have taken MLE cos they have good idea of ur course content wrt MLE.

My suggestion though would be complete ur MD and then start preparing for MLE immediately without wasting time. For now u can get some good MLE books on clinical subjects and read them in leisure. That'll orient ur clinical knowledge wrt MLE.

Hope it helps!!

Author: wondergirlPostPosted:     Post subject:

did i tell u asheesh that this article is mindblowing? icon_biggrin.gif

absolutely informative..and really helps one get things in the right perspective!

thanx a ton for this.. icon_biggrin.gif

Author: aujlaPostPosted:     Post subject: thats really expensive to do usmle

i think after all this discussion the truth is in front of everyone that u need so much time and money to put into this usmle
i think this is the job for students who have got lot of money already
its all ur choice students

Author: aujlaPostPosted:     Post subject:

its really good thread ash b
u have really made a lot of effort in this
well just wanted to ask u that what are u preparing for now?

Author: AshBPostPosted:     Post subject:

LOL aulja I'm completely for USMLE now. And as far as expenses are concerned, most people would agree that they r not 'expenses' rather they r an 'investement'.

I agree aulja MLE takes up a lot of time and effort and it really tests ur patience and endurance skills equal to if not more than ur academic skills.

Thanks wonder and aulja for ur kind words.. icon_smile.gif

Author: sravyaPostPosted:     Post subject: hey ashb!

hello ashb,

sorry yaar cudnot meet you in delhi as i joined for gre( as i was not confident abt my score in gre too and there r soo many veterans like shriya n dana who got top scores!so wanted to stand out from the crowd like them in gre icon_wink.gif ), i'm sorry! i cudnot reach u !anyways i wanna small help from u. i filled all the details of IWA application. but while filling credit card details i got a doubt as usual as i'm nuts. icon_wink.gif u know!
so came to my gud old frend for help ashb icon_biggrin.gif anyways can i use a USA CREDIT CARD,coz , they r askin some USA social security number icon_question.gif if i happen to use USA credit card.plzz help me!is that required?

Author: AshBPostPosted:     Post subject: Re: hey ashb!

RxPG :: View topic - How to decide between PrePG Exams and USMLE? How to decide between PrePG Exams and USMLE?
Goto page 1, 2, 3, 4, 5, 6, 7, 8, 9  Next
RxPG -> beforeUSMLE

Author: AshB PostPosted:     Post subject: Scholarships for GRE!!

Guys i found this list of indian institutions that offer scholarships to students aspiring to study abroad. See if it helps..

K C Mahindra Scholarship Trust
c/o Resident General Manager,
Mahindra & Mahindra Ltd., Jeewan Deep Building8 Parliament Street
New Delhi - 110001
Scholarships for school students as well as for higher studies overseas

Singapore International Airlines - Youth Scholarships
Robinson Road
P O Box 746
Singapore - 901446
Scholarships for completing plus 2 education in Singapore

Ministry of Human Resource Development (Deptt. of Education)
External Scholarships Division
ES-3 Section A.1/W.3 Curzon Road BarracksKasturba Gandhi Marg
New Delhi - 110001
This department co-ordinates a large number of international scholarships in specialised and in general areas that are offered to Indians by governments of other countries and by the Commonwealth

I T C Scholarships
Public Relations Dept.
I T C Ltd.I T C Centre, 37 Chowringhee
Calcutta - 700071
Scholarships for higher studies abroad

The Registrar
Nanyang Technological University
Nanyang Avenue
Singapore - 2663
Partial scholarships for higher studies in engineering / computers

Sahu Jain Trust
4th Floor, Times House7, Bahadur Shah Zafar Marg
New Delhi - 110002
Loan scholarships for higher studies in India and Overseas

J N Tata Endowment
Bombay House24, Homi Mody Street
Mumbai - 400001
Loan scholarships for higher studies abroad

Nehru Trust for Cambridge University
Teen Murti House
New Delhi - 110001
Scholarships for higher studies at Cambridge University

Mariwala Trust
411, 4th Floor,
Shah & Nahar Industrial Estate,
Dr.E Moses Road,
Mumbai - 400018
Phone - 4938307/ Fax - 4974074
Loan scholarships for higher studies overseas

Inlaks Foundation
PO Box 2108
Delhi - 110007
Full scholarships for higher studies overseas

Rhodes Scholarship Selection Committee for India
St. Stephen's College
Delhi - 110007
Higher studies at Oxford

Chief Executive
R D Sethna Scholarship Fund
29, H Somani Marg, Fort
Mumbai - 400001
Loan Scholarships for higher studies
sravya wrote:
hello ashb,

sorry yaar cudnot meet you in delhi as i joined for <a href="http://www.rxpgonline.com/forum24.html">GRE</a>
( as i was not confident abt my score in <a href="http://www.rxpgonline.com/forum24.html">GRE</a>
too and there r soo many veterans like shriya n dana who got top scores!so wanted to stand out from the crowd like them in <a href="http://www.rxpgonline.com/forum24.html">GRE</a>
icon_wink.gif ), i'm sorry! i cudnot reach u !anyways i wanna small help from u. i filled all the details of IWA application. but while filling credit card details i got a doubt as usual as i'm nuts. icon_wink.gif u know!
so came to my gud old frend for help ashb icon_biggrin.gif anyways can i use a USA CREDIT CARD,coz , they r askin some USA social security number icon_question.gif if i happen to use USA credit card.plzz help me!is that required?

Hi sravya, hey chill yaar. Just study hard. And actually i don't have any idea of this US credit card issue. But i'm sure u can use an USA credit card cos one of my fren used his uncle's card who was in US. I'd suggest u call up the person to whom this card belongs and find out the required info like social security number. That shud not be a problem, i think. And if still a problem u can always send a draft yaar. icon_smile.gif

Best of studies!!

Author: obyokafor PostPosted:     Post subject:

Hey Ash B , thanks again.
Which books do u suggest. I have seen a long book list on a thread on this website but they are not concise lists. I would definately love a suggestion from you or any other person that has or is preparing for USMLE 1

Author: AshB PostPosted:     Post subject:

Well I'd suggest Kaplan notes, Qbank and Qbook for all subjects. BRS for patho, physio and behavioral sciences. High yield for Anatomy, Embryology, Neuroanatomy. First AID from cover to cover. And Goljan's pathology audio tapes.

Sorry the list sounds big but i've seen d books, they contain only high yield and limited material thats within our reach. icon_smile.gif icon_smile.gif

Further u can refer the following link for more info on books...
Only RxPG members can see links here! Register or Login!
for books

Hope it helps!!

Author: ctahmeedagain PostPosted:     Post subject: when are the interviews held??/?

i m about to start my usmle preparation
i want toknow when the interviews are held for the match
are they held in dec jan feb
or from jan till april....

Author: AshB PostPosted:     Post subject:

Hi ctahmeedagain!! Welcome to USMLE family of RxPG!! icon_smile.gif
Application process starts around October
Interviews around Jan-Feb
Result of match in March
Joining in Jun-July

Also go thru other threads in MLE forum and u'll get all other required info. I hope it helps..

Good luck!

Author: docboy PostPosted:     Post subject:

well! well! well!
this is scary...
sounds like a detailed survey..
so if only 55%of IMGs clearing mle get a residency, u must be having am idea about waht teh rest of them do????!

Author: AshB PostPosted:     Post subject:

Dear docboy,

These 55% are d IMGs who get residency through MATCH. Some take a pre-match. Some get a seat in post match scramble. Rest have to apply next year. Plus it is said that the rate of getting residency is much better for Indians, tho i don't have any data regrading that.

Baaki, i don't know cos i didn't conduct the survey.. LOL Actually this is d data avaialble on different websites. So they might know better. icon_smile.gif icon_smile.gif

Author: fragile_x PostPosted:     Post subject: hmm........

interesting.......if the 55% figures r for residencies through matching process only,then including pre-match & post match scramble,it might well cross 75%.

thts considering tht the figures are for matching only & not the total no. of residency positions procured by IMGs.

plz clear this confusion if possible with the link.

apreciate ur help.


Author: fragile_x PostPosted:     Post subject: here"s ur answer

the rest of the 45% who dont get a residency get PRE MATCH at McDonalds at 12$ an hour........comparable to the salaries offered during residency!


Author: AshB PostPosted:     Post subject: Here's ur reference..

Arihant, yaar i forgot d links from which i read this info, but yes its true that these figures are for the match. If we include prematch, post match scramble, the figure myt be 60-70% or even more.

Though i have found a reference for u, see First Aid-2005 Page 37 Table 4. It will support d datas as i have stated. Hope it clears the confusion. icon_smile.gif

arihant_d wrote:
the rest of the 45% who dont get a residency get PRE MATCH at McDonalds at 12$ an hour........comparable to the salaries offered during residency!


Hmmm... PREMATCH at McDonald's... LOL!! again a funny one from arihant!!! icon_lol.gif icon_lol.gif icon_lol.gif

Author: docboy PostPosted:     Post subject:

thx a lot guys for the support with a special mention for arihant providing info bout the worst case scenario!! keep it rolling.

Author: ujwals PostPosted:     Post subject:

i found this article on net hope this helps

On Being an International Medical Graduate, Tips for Success

Graduates of foreign medical schools have been immigrating to America for decades, filling a healthcare gap and fulfilling their own personal and professional goals. Most have crossed many hurdles to enter medical school in their own country of origin, and face many more on entrance to this country. Once they have completed the residency years, these physicians enter the workforce, attending to not only the medical needs of the population but also by becoming community leaders, educational spokespersons and adding to the richness of cultural diversity that is seen in this country as a whole.

Before being eligible for the residency position sought, the International Medical Graduate (IMG) needs to complete many examinations. During the early 70's, physicians were being actively recruited by hospitals. They were ensured a smooth transition of immigration with support in the areas of visa, family and friends. These actions have changed tremendously over the years. The Educational Commission for Foreign Medical Graduates (ECFMG), which certifies IMGs for entry into US postgraduate clinical training, was formed in 1956. Since then, the IMG has been required to take a variety of examinations exemplified by the following plethora of acronyms, ECFMG, VQE, TOEFL, FLEX, and now USMLE and CSA. All these are used as objective evaluation tools for program directors. The hurdles continue in the form of licensing requirements for the different states here.

The National Resident Matching Program (NRMP) has experienced a significant increase in the number of positions offered over the years. There was a peak in the fill rate in 1997, and now the rate is again beginning to increase. Perhaps some of these shifts could be due to events of 9/11.

* 2004 2002 2000 1997 1993
Positions offered 21,192 20,602 20,453 20,209 20,598
Positions filled 19,391 18,447 19,391 18,007 16,896
% of positions filled 91.5 89.5 89.3 89.9 82.0
% filled by US MGs 57.8 61.1 57.3 55.5 67.4
% filled by n IMGs 22.5 21.0 25.1 30.7 20.6
**% filled by US IMGs 8.0 8.7 8.7 5.6 3.1

*Data from NRMP
**US Undergraduates with offshore medical school training: e.g. Caribbean schools usually have rotations in America.

AMA sources indicate the countries of origin of the IMGs. India is the leading supplier of physicians to the US workforce.

Countries of origin of IMGs % of IMGs
India 19.25%
Philippines 9.6%
Mexico 5.8%
Pakistan 4.4%

It has always been perceived that residencies aim to fill with as many US trained graduates as possible. However, the inevitable occurrence is that many programs need the IMGs to enable their program to function. This may be due to multiple factors including location of program and specialty.

What is it that an IMG applicant can do to enhance his/her chances for an interview?

Application: This is now usually through the computerized ERAS system (Electronic Residency Application Service). One should always check that it is completed correctly and in time.

Exam results: These are always important and are in fact the only objective evaluation that the program has on the application. Many programs will have a minimum score as a criterion. Multiple attempts at the exam do not bode well. It definitely seems worthwhile only taking the exam if the candidate is well prepared and is confident of achieving a high score. Many enroll in review classes before the exam. These classes also serve as good networking and support opportunities.

Medical School: Accreditation of the school is a requirement. It seems worthwhile checking on this before enrolling into the medical school. This is relevant since many Americans of Indian Origin are sending their children overseas for medical education. Also there maybe a licensing deficiency, for example, 4 weeks of psychiatry (this actually often is a blessing, since then the applicant would be eligible for an externship, which will add US experience to the application). The number of years is also often an important criterion.

US experience: This has been increasingly difficult since many states do not allow externships (voluntary experiences where the applicant does have responsibility and direct patient contact). Most programs would like the applicant to have had clinical experience where they can document direct patient contact, including, taking a history and physical and developing an assessment plan. This is definitely preferable to a research position or an observership.

Once an interview has been granted, the program may evaluate the candidate in many areas:

Presentation: A dark suit and well-groomed applicant is acceptable.
Language skills: The interviewer should be able to understand what the applicant is saying. Many program directors cite this as a problem and have advised accent reduction class. They will also evaluate comprehension skills by asking questions which may not be medically related.

Knowledge of the residency: It is important to know a little about the program one is interviewing in. This information is often found on the Internet. The applicant should be able to discuss why that particular specialty was chosen and why that specific program is where s/he wishes to work. There has been a recent study stating that the attrition rate of IMGs is higher than US MGs. ("I'll take what I can get and change into the specialty of my desire later").

Personal goals: The applicant should be able to indicate his/her potential long and short-term goals. This shows an understanding of the medical system
Behavioral skills: The applicant maybe asked questions regarding ability to cope with stress, conflict resolution, teamwork, and work ethics.

Once the candidate has been accepted, there are many adjustments and stresses that they may encounter. After polling many residents and practicing IMG physicians some of these areas that were identified included:

Integration: This obviously varies between programs and individuals.

Cultural differences: This may be social ("I need to go home to my family" vs. "Let's go out for a drink after work"), but this does not suggest one has to relinquish one's identity. Professional differences can occur, for example, in the areas of care of the elderly, informed consent, and end of life issues.

Lack of support: Maybe seen amongst colleagues, (USMG Vs IMG), lack of faculty mentoring, frequent feelings of being the scapegoat and being held to a higher standard. This may all lead to a decrease in self-esteem and less than optimal performance.

Interpersonal skills: The hierarchical system seen in many countries is not as pronounced here, so learning how to appropriately interact with nurses, secretaries, ancillary staff is important.

Computer skills: These can be easily learnt if the applicant is proactive. Consider asking to spend some time in the program before the official start date, to orient on how to look up laboratory results etc.

Behavioral medical skills: Interviewing skills are emphasized during medical school training. There is a system of writing notes, which differs from IMG training, for example S.O.A.P and the P.O.M.R format. Again these are simple techniques that can be learnt prior to the start date.

Often the whole experience can be daunting but the IMG should realize that they have many strengths. They have many attributes and experiences that can be used to enrich any program.

Clinical exposure: The types of syndromes learned in the US may be very different to what the IMG will encounter in residency; for example malaria and malnutrition are not as common in America.

Stamina: Often admission into medical school in the country of origin is much more competitive than here. Along with this, the IMG should realize their strength in taking the challenge of starting afresh in a new country.

Clinical diversity: The IMG is able to broaden the cultural knowledge of the program and often attract patients of different ethnicity to the program. America is the melting pot of the world and a culturally diverse group of physicians can better serve a culturally diverse population.

The applicant should continue to network with seniors of the program, and alumni of their specialty. Medical school associations and national groups such as AAPI (American Association of Physicians of Indian Origin) may aid in guidance for career choices.

What could be the role of AAPI? We were all in this position at some time in our lives; so moral support and encouragement is always a plus. Maybe a list of those AAPI members who have experience in residency teaching can be made available to applicants, so they may get some guidance. Those members that are able to offer "hands on experience" to the applicant, not just "research" could also make themselves available. After the resident has graduated, AAPI may have contact numbers so the newly graduated physician may discuss opportunities for career enhancement, fellowship advice, and practice opportunities. They also maybe able to discuss licensure hurdles.

The number of physicians that are IMGs and of Indian origin are increasing. Many IMGs and USMGs are in fact the children of IMGs and I feel that our role for the next generation of doctors in the workforce needs to be that of continuing encouragement and support. The immigrant IMG should be proud of the challenge they have taken to start new lives in a foreign country. Their hard work and stamina is appreciated by the millions of patients that they serve and the community they benefit.

Renu Mittal M.D. California

Author: ujwals PostPosted:     Post subject:

thanks ashb for really great forum

Author: ujwals PostPosted:     Post subject:

also see
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