Things to Keep in Mind When Considering a Residency in the United States

So, you are an International Medical Student/Graduate who decided to pursue your Residency in the United States or if you are still unsure about the entire process and weighing your options between USMLE vs. Home Country Residency, the following post discusses a few key points that you should know and take into account before embarking on this journey:

1. Understand the Entire Process and Timeline

USMLE is both figuratively and literally, one of the lengthiest examinations across the world, with the time duration of 8 hours for Step 1 and 9 hours for Step 2 CK. Now if that sounds daunting, take into account it can take somewhere between 6 to 12 months to effectively prepare for each step examination. The goal of this blog is not to scare you, rather get you better acquainted with the entire journey and the process, so you are better prepared for what lies ahead.

In order to apply for Residency in the United States, you need the following prerequisites:

a. Passing USMLE Step 1 and Step 2 CK with preferably a high score.

b. Passing USMLE Step 2 CS examination.

c. Having 3 Letters of Recommendations (LORs) from US Clinical Faculty.

d. Certification from the ECFMG (Educational Commission for Foreign Medical Graduates)

You can take the USMLE Step 1 and Step 2 CK anywhere in the world, but in order to take Step 2 CS and to gain US clinical experience and LORs, you have to travel to the US.

2. Clarity

First and foremost, before embarking on this tiresome journey, you need to have absolute clarity as to why do you want to pursue a residency in the US vs your home country. Now the reason can vary from person to person, for some, it might be a better clinical training, better healthcare infrastructure, research facilities, lifestyle factors, or simply the desire to experience a new culture, whatever your reason to pursue the USMLE is, make sure it is crystal clear in your head.

3. Persistence

As previously stated, it is a long process that takes anywhere between 18 months to a few years, depending upon the individual, and involves a lot of variables. Nobody can define a ‘perfect application’. However, the most crucial factors that the residency program directors take into account are your USMLE Step scores and attempts, US specialty-specific LORs, MSPE (Medical School Performance Evaluation), Personal Statement, Research, Publications, and extra-curricular interests. Therefore, although high scores on your Step examinations increase your probability of matching into your desired specialty, they do not guarantee it and you should work on all aspects of your application.

4. The Early Bird catches the worm

The age-old adage holds true for the USMLE process, as the sooner in your medical school you decide to pursue the US Residency, the earlier you can start building a wholesome application.

This is because starting early, you can build up your resume throughout the medical school, and furthermore, it substantially decreases the time and money invested in the process.

To explain this further, since USMLE Step 1 tests the knowledge of your basic sciences, it is advisable to take it right after the first two years of the medical school as the basic science subjects are fresher. Moreover, there are many institutes that provide free electives to international medical students on the basis of Step 1 and TOEFL scores, which considerably decreases the expense of the entire process.

Starting early, you can also better prepare for your Steps and aim for competitive scores and plan your US Clinical Experience, both of which are highly desirable for a good application.

5. Expenses involved

It is imperative to acknowledge that USMLE is an expensive journey and involves a lot of overt and covert costs. Please check out the story where I have broken down the entire process with fees at: https://medium.com/@milirohilla210/expenses-involved-in-the-usmle-journey-to-the-us-residency-57b2a6f8af90

From the surface, USMLE indeed appears to be a long and tedious process, however, in the long run, the time and expenses involved would appear as a mere investment to a better future as a practicing physician in the United States.

Good luck and Happy Studying!

Sources:

1. USMLE Official website. https://usmle.org/

2. US Clinical Electives. http://electives.us/

3. ECFMG FEES. https://www.ecfmg.org/fees/

4. Image Source: https://usmle.org/