CONTENTS Page 1. NOTE
2
2. My Journey
3-5
3. FAQs regarding the application for USMLE Step exams
6-7
4. USMLE STEP 1
8-12
5. USMLE STEP 2CS
13-15
6. USMLE STEP 2CK
16
7. USMLE STEP 3
16
8. United States Clinical Experience (USCE)
17-21
9. Research
22-27
10. Letter of Recommendation (LOR)
28-32
11. Travelling in the USA
33-34
12. Stay/ Accommodation Accommodation
35-36
13. MATCH season
37-39
14. ERAS CV
40
15. FAQs related to programs
41
16. NRMP registration
42
17. Contacting the programs after Sep 15 th
42-43
18. Interview season and FAQs related to interviews
44-52
19. Phone interview
51
20. Post interview communication with the programs
52
21. Factors related to the MATCH
53
22. Contacts in the USA
54-55
23. Rank order list (ROL)
56-57
24. SOAP
57-58
25. What to expect during the interview season?
59-61
26. FAQs asked by the members of the USMLE Page
62-67
27. Personal Statement
68-70
DON’T GIVE UP You may not match this year, you may not match the next year. But, you will have to and for sure will match one season. As, matching can only be delayed and not denied. Provided, you don’t GIVE UP.
NOTE Everything I wrote in this PDF is i s from my personal experience and what I had learnt over the past couple of years from the experiences of those in the USMLE field. All the points or statements I made in the PDF are mere suggestions and in no way I imply i mply you into doing
anything. It’s up-to you how to use the information. In case of any conflicts with your knowledge/perception,, it’s advised to double check with others in the same field. I won’t be knowledge/perception responsible for anything.
The entire journey of the USMLE runs on the foundation of “UNCERTAINITY”. So, the things one might face, learn or experience don’t have a universal application to each and everyone in this field. All the points I make need not hold true for everyone. What works for one may not work for the other.
Raja Chandra
DON’T GIVE UP You may not match this year, you may not match the next year. But, you will have to and for sure will match one season. As, matching can only be delayed and not denied. Provided, you don’t GIVE UP.
NOTE Everything I wrote in this PDF is i s from my personal experience and what I had learnt over the past couple of years from the experiences of those in the USMLE field. All the points or statements I made in the PDF are mere suggestions and in no way I imply i mply you into doing
anything. It’s up-to you how to use the information. In case of any conflicts with your knowledge/perception,, it’s advised to double check with others in the same field. I won’t be knowledge/perception responsible for anything.
The entire journey of the USMLE runs on the foundation of “UNCERTAINITY”. So, the things one might face, learn or experience don’t have a universal application to each and everyone in this field. All the points I make need not hold true for everyone. What works for one may not work for the other.
Raja Chandra
MY JOURNEY NOTE: I am sharing my story mainly for those who go unmatched or thinking of giving up at
every hurdle that comes in the USMLE path. I didn't match at my first attempt, too. We may not have the same problems overall, but I totally understand what you would be going through. I didn’t have any financial troubles ( thanks to my parents and brother), but emotionally it was a nightmare until Mar 14, 2016, considering the fact that even my family wouldn't have been happier with me giving it an another try( can't blame them). Journey: We think we need some help or seniors for securing electives and all. In reality- it’s
just an excuse we give ourselves. Of course, having having them will make it easy, easy, but not having them isn’t the end. I did it all by myself with the help of google. That's one reason I keep answering queries on usmle pages, as not everyone has someone to back to them up. Remember Contacts don't just happen for everyone, you make them!! I started with applying for electives at Yale, Weil cornel, Northwestern and John Hopkins as these were the ones that gave electives then without asking for scores. I didn’t have any help except the company of a friend who is on the same boat. I got Radiology elective at Yale, Weil cornel and northwestern as IM was full. So, I only accepted Yale thinking I can try from IM once I go there. Did 1 month in Radio used to go their ER even in midnight, developed good rapport with all attending (so good that I taught them about cricket and showed videos on youtube in free time) Then secured another month in Cardio. Gave my STEP2CS and came back to India. While my rotations at Yale I emailed tons of doctors at Yale asking for appointments so that I can try for electives in the future. After sending 100s of such emails, I could meet few of them and one worked out. So, I secured my future Observerships before I came back to India. I also called a couple of other universities and hospitals in the US everyday and got a couple of more electives, but couldn’t do them due to other reasons. I came to India gave step1 - got 245. I couldn’t give other exams in time due to various reasons. So, delayed my ck until the residency application time in 2014. As promised earlier, one of the attendings at Yale offered me an Observership in Aug 2014 with no time limit. I came to the US, but because of spending more than 12 hours in the hospital I couldn’t finish reading ck properly and postponed it till Sept 2nd week. I finally gave it and my results came in Oct 2nd week. It was 229. It’s a disaster. But, it was my fault. So, can’t blame anyone but me. In the mean time I again emailed many attendings and started meeting them for research/obsie ipportunities and could get another 2 months in another subspecialty (only 2 months, as I already secured an Obsie for Dec elsewhere). I applied in Oct 3rd week and the 1st iv I got was on Nov 7th. When I sent them an email 2-3 days later asking for interview day itinerary, they replied saying sorry you are not on the list and we sent it by mistake!! The email which first gave me hope now shattered me. I wanted to send them a disappointed email, but instead sent them an email in a polite way saying I understand it’s in human nature to err and so no worries. Also, I said please go through my application now and see if I am eligible. The PC forwarded my application to PD and he gave me an iv. In the next 3 days I got 3 more ivs. In December, I went for an obsie at Allegheny thinking they would give an iv if i do an obsie there. But, the day before I left for Allegheny they sent me a rejection! I wanted to cancel it but I already paid for i t. So, just went there because I
knew if not anything I can make some useful contacts. Allegheny PC usually say they won’t give LOR, but i was able to get one from the GI Fellowship director. Then I didn’t try for any obsies after it for Jan and feb. I got one more iv in dec. I had to go back to India by the end of Jan. But expecting last minute cancellations in Feb, I came back from India within a week. I had very good f eedback from the places I interviewed at. It wasn’t generic and I thought i could match. But, it turned out that I would go unmatched. I was of course in depression, but the second I got to know I didn’t match I emailed the doctors that interviewed me asking for obsie/ research opportunities. I also emailed 100 other places. March 2015: On 16th I got to know I didn ’t match, tried for soap and on 20th it was confirmed
that I will remain unmatched. But, by 23rd match I almost got myself a research position secured at MD Anderson Cancer center. It wasn’t through contacts. It was just one of those 100s of emails I sent out. The attending had asked me to come to Houston for the interview, but I said I won’t be able to and instead requested for a phone iv. He agreed, we talked over phone, I showed interest. He later emailed me that he won’t be able to offer me the position as it is unpaid and so he wouldn’t feel good if I come all the way to Houston just for this. Over the next series of emails, I convinced him that I will manage the logistics. He agreed for it in April and started the paperwork. Not knowing, how this might turn out I reached out to other places also and by march end I had already secured an obsie at Yale again for the month of May, at Albert einstein for June and at UAB for July. Also, in the meanwhile I gave my step3 in April. Since I have these, I postponed my research start date till Sep 2015. I applied for the match on sep 15 this time. I had to go back to India at the end of July 2015 as my 6 months visa expired. I came back in Sept, started research around Sep 2nd week. Initially, my attending at MD anderson wasn’t helpful, the first interaction I had was harsh and I felt bad for the first couple of weeks. The first in person interaction I had with my attending was on day3. He just walked into the room and started talking to me. His very first word - "If you are hear for LORS or any help, just give me your badge and walk away right now". He went on for 10 mins saying things like this. I was shocked and felt bad. I had already worked 28 hours total in the 1st two days and finished a work which was expected to be finished in 2 weeks. More surprisingly, my fellow who saw it all didn’t even utter a single word. I was more disappointed with my fellow. It went on for a couple of weeks. Except for a couple of friends I couldn't even share it with my family (as they were already enough worried about my match!). In the same time, people including my co research intern were getting interviews, but I didn’t. It scared me to hell. What if I don’t match again? What if I don’t even get interviews? I was afraid to have spare time as I would keep thinking about all these. I ended up spending almost 16 hours at research sometimes, until midnight. My first iv came at the end of Sept and within a week I had 8 iv calls. I ended up with 11. Finally, I could take a load off. I continued to work the same way for my attending. By midway, my attending was so impressed that he used to say at least twice a day that " he is very glad that I came to work with him even though he didn ’t agree initially". He started complimenting almost every day and we ended up building a very good rapport. He didn’t even mind a second when I had to travel most of the Nov, dec and Jan for ivs. I didn’t ask him for any LOR, thinking if he likes me he will help somehow. I am glad i took this research as I had something to talk during the ivs. We submitted 3 abstracts for major GI conference and three
are accepted on Feb 16. My attending had volunteered to put i n a good word for me and I was the happiest then. I didn ’t even dream that it would turn out like this. I finished my research work in Feb and came to India. All the emotions from last year failure were running through my mind until March 13 - 8:26 pm, when the happiest news of the lifeti me had come 4 minutes early! I matched. I wasn’t jumping in joy, I wasn’t elated. More than anything, I just felt relieved. I matched into my first choice program! The journey had been crushing, but was fruitful too. Met so many people from different countries and made so many friends. PS: Most of the hospitals don’t offer Obsies as per their official policy. But, I tried emailing
attendings and it worked out. So, don't leave any place. Just, keep trying. One advice: Don’t GIVE UP.
RAJA CHANDRA
FAQs regarding application for steps These are some of the questions I had encountered on multiple occasions from many people. 1. Can we change the testing center from some country to the USA or from the USA to some other country?
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Yes, you can change from any country to another country.
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Just call ECFMG customer care. They will give you a number to which you can fax your request. You will just have to write your details and the request “Please, change my testing center from “current country” to “the country you want”, on a white paper and sign at the bottom.
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If you change your testing center from any other country to the USA, then you will get a refund for the testing center surcharge fee(150$) that was earlier charged in your country.
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If you change your testing center from the USA to any other country, then you will be charged a testing center surcharge fee depending on the country you are changing it to.
2. Can we extend Step1/2ck/3 more than once?
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Yes, you can as many times you want.
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Within the eligibility period, you can change your exam date as many times as you want. If you do it more than 31 days prior to the exam date, then you don’t have to pay any fee. Otherwise, there will be a fee every time you
change the date. -
You can extend the 3 month eligibility only once with a small fee.
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Once the extended 3 month eligibility is also over, then you will have to pay for a new step application fee (entire amount) to get a new eligibility.
3. Does giving a step in the USA is beneficial in getting more marks?
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I don’t think there is any such correlation between the score and USA as the
testing center. 4. Anticipated year of graduation for Step application if you haven’t graduated yet.
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Just put an anticipated date as per your current situation.
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This date can be different when you are applying again for another step exam.
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The only date of graduation that is final and remains in the ECFMG records is the one you submit during credentials verification after graduation.
5. What to mention in the Clerkships section of the application?
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Just leave it blank (or select the option NO) even if you had done clerkships in the USA, unless you got credits for it.
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It is for the American medical graduates or the Caribbean graduates who do clerkships in hospitals other than home school and get credits for it.
6. For Indians: What date should you mention for YOG? Is it internship completion date or date on the certificate?
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You can mention the date of issue mentioned on the diploma.
7. Should I mention it as a break in education if I had gone for clerkships and hence delayed my internship end date?
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No, never mention it as a break in medical education.
USMLE STEP 1 Ideal Duration: 6 months (But, remember it varies from individual to individual) Resources: Kaplan notes, Kaplan Videos, First Aid, Uworld Alternative resources: If you are aiming for high scores 1.
Pathology: (also gives a stronger foundation which would help for Usmle step2 and 3) A. Golijan, Golijan lectures (OR) B. Pathoma, Pathoma videos makes it easier – Easier to study and remember compared to Golijan
2. Behavioral Science/Ethics: A. High yield B. BRS C. Conrad Fischer’s 100 Ethics cases 3. Biostatistics: A. Take the uworld’s additional 25$ subscription for biostats
Practice tests: 1. USWA: Uworld self assessment forms 1 and 2 You will get it for a cheaper price if you buy it along with the usmle question bank. It will be available for access for only 14 days from the time of activating it. Uworld question bank activation and uwsa form activation are two separate things. So, you can buy it along with the question bank, finish doing the q bank and then activate UWSA only when you are ready to give an assessment exam. 2. NBME: Numbered as form 1, 2, 3 and so on. Higher the number – newer the form There are many forms. You should do most of them online and then at least 2-3 latest ones online. The latest forms correlates better with your final score. So, it’s advisable to the latest forms online. Strong advice: Do all the nbme forms and uswa forms. The more you do, the better your final real exam score would be. It will help you in managing time, gives you new information and also helps you how to think fast in tricky situations. If you are lucky, you can see a couple of similar questions in your real exam.
3. OPTIONAL – You can try Kaplan Qbank if you want, but not necessary as the pattern of questions from Kaplan is totally different to that of final exam. You can do it if you have a lot of time and if you want to gain more knowledge. I have seen people getting 260s even with avoiding Kaplan q bank. 4. OPTIONAL – Flash cards for USMLE Step1 – Again it’s not compulso ry but a good way to memorize subject and especially during breaks.
From my experience: 1. UWSA over estimates your final real exam score and NBME underestimates your final real exam. So, ideally your final score would be between UWSA and NBME avg
scores. Now, this is how it is usually correlated. This doesn’t mean your final score shouldn’t be more than that of NBME or less than that of UWSA. 2. Ethics and Biostats questions have more weightage compared to other subjects. So, practice these as many times as you can. Do the same questions again and again, giving importance to the explanations until you get a hang of it. Eg: X and Y had each answered 10 questions wrong overall. Out of those 10 questions, X had answered wrong for 2 Ethical questions, whereas Y had answered wrong for 5 Ethical questions. The final score of X will be higher than that of Y, as X did better with ethical questions. 3. Final real exam questions are more closer to that of NBME than UWSA.
Approach: Common mistakes/misconceptions: Most of us give step1 after final year medical school. So,
when we first open biochemistry or microbiology we don’t remember a bit and hence, we end up studying the notes for days. DON’T DO THAT. DONT’s:
1. Don’t waste your time reading Kaplan/other notes for days or months. 2. Don’t waste time on Kaplan videos for each and every topic or subject. Step wise approach to USMLE Step1: 1. Just give one quick reading for all the subjects. 2. Use Kaplan videos along with the notes if you have trouble understanding or remembering some concepts.
3. After the first read, go through First Aid for USMLE step1. Read it once or twice depending on your individual grasp of information. You should ideally do this all within 2 months 4. Take a 3 month (ideal duration) subscription for Uworld. 5. Do at least 1-2 whole blocks per day. You can do it subject wise or random. You can use tutor mode. 6. Write down the concepts and explanations that are new to you. Go to and fro between Kaplan/first aid and uworld if you forget some topic or if you feel you need to read it in detail again. 7. Mark the questions that went wrong or those you think must be done again for sure. Ideally, you should finish all the questions atleast once in 1 n half months to 2 months. 8. Start the 1st revision. Start using timed mode. This is going to be faster than your first time. Do more blocks per day. At least, 3-4 blocks or more per day and simultaneously read the notes you prepared. You can do all the questions or those you marked during the first time. (I would suggest do them all, as even those you got it right the first time may confuse you now.) You should finish the 1st revision in 15-20 days. 9. Start the 2nd revision. Definitely, use the timed mode. This is the revision where you should focus on managing the time. Do 5-6 blocks per day or more. You can even do 8 per day, which would help you big time with managing the time (of course it depends on how strong your first revision was). As with 1 st revision, do only the questions you marked during 1 st revision or do them all in random. This shouldn’t take you more than 10 days.
10. The last month is very crucial. Day 1 and 2: Start with UWSA form 1. Give it within the time without taking any breaks. Read the explanations once the exam is done. You will get a lot of new info and new questions. So, read them all and note the important points. Spend two days in total for reading explanations along with previous notes or FA. Day 3 and 4: Do UWSA form 2. Again you can expect a lot of new information and questions. Go through the explanations, take notes and take it slow. I suggest starting with UWSA and not NBME because, UWSA gives explanations and NBME doesn’t. So, you can use UWSA as both an assessment tool and a reading tool.
From Day 5 onwards, start doing NBMEs. Do, one per day. Finish all of them or how many ever you want by 2 weeks prior to your final real exam date. Your last couple of NBMEs must be given online. As I earlier mentioned, NBME doesn’t give explanations, so have a reliable group of friends who can help you find the answers quick. 2 weeks prior to exam: 1. Don’t over stress. You have done it all. You did everything you could. 2. Revise the notes you made from Kaplan, Uworld, UWSA and NBMEs. 3. Read First Aid – On the day of the real exam, the things you remember are mostly from first aid and the notes you made and not from Kaplan text books or anything else.
2 days prior to the exam: 1. Relax as much as you can. Watch a movie or tv shows. 2. Sleep as much as you can. Especially the night before the exam. What to expect during the preparation? 1. Starting with Kaplan could be boring – but, don’t lose interest and give scope to long gaps between studying. 2. Since, we usually start studying after final year, most of the knowledge from 1st and 2nd year subjects is already lost. – So, don’t be scared that when everything appears as new information. When you start Uworld: 3. Be prepared to know that what you read from Kaplan will be a lot different to what you are going to be tested. 4. Use Uworld as a LEARNING TOOL. – It’s a very common thing that most of the people get scared and doubt their talent when they answer wrong for most of the questions. Remember, everyone will be on the same page. Don’t be scared. 5. Just as above, your first experience with Uworld shouldn’t be assumed as a test to your knowledge. Just take it as a LEARNING tool. Think it as another text book. Just learn from the explanations given for every question. I am saying this twice because I have seen a lot of people who got scared and lost hope when they got most of the answers wrong. 6. Depending on a person’s IQ the percentage of the questions you get right during your first time with Uworld can be anywhere between 30% to 80% or more. But,
this doesn’t mean that a person in the 30% category can’t score same as the person in the 80% category, if not more in the final exam. 7. During the first REVISION, the % of questions that are correct should be atleast more than 60% - This depends on your hard work during the first time. 8. If even during your 1st Revision your % of correct answers is less than 60%, don’t lose hope. It just means that you would need more revi sions later on. You can still get to 90%+ right answers by 3rd or 4th revision. Resources for Individual subjects: Uword + FA is common for all the subjects 1. Physiology – Kaplan 2. Anatomy + Neuroanotomy – Kaplan 3. Biochemistry – Kaplan 4. Microbiology – I would suggest not to waste time with Kaplan. First aid is more than enough 5. Pharmacology – Kaplan in my experience. But, some do it just from First Aid. 6. Histology – No need to stress from Kaplan. You will learn it from Pathology and Uworld. 7. Genetics – Try genetics questions from Kaplan Qbank too.
KEY: PRACTICE – it’s the only thing that determines your final score. Do as many questions as you can and as many times as possible. Don’t waste too much on reading Kaplan text books. STEP 1 score is very important.
Useful Links: 1. http://www.usmleforum.com/files/forum/2016/4/823217.php 2. BRS – Physiology http://www76.zippyshare.com/v/77914815/file.html
3. Becker Step1 Videos https://mega.nz/#F!TQoTwQzK!crBHQr2_oaZfMujSA27nDg!XVYQlZ5I
4. Pharmacology Flash cards https://kat.cr/kaplan-medical-usmle-pharmacology-and-treatment-flashcards-the-200questions-you-re-most-likely-to-see-on-the-exam-for-steps-1-2-3-unitedvrgt10192286.html
5. Step 1 related https://docs.google.com/document/d/1xP1J0VxJ6yPlAVzrbtitoDYRkLs7XfU7cI0Wcegsy8/edit
USMLE STEP2 CS When to give it?
1. Ideally give it after your clerkship or observership, as you will get to know how to talk to patients in the USA. 2. It can be given before step1 or after. It doesn’t matter. I gave it before step1. Where to give it? Obviously, only in the USA
1. The centre/city doesn’t matter. 2. Philadelphia is considered as a tough center to pass. But, I have seen many foreign medical graduates clear CS from this center. So, don’t be scared if this is the only center that’s available for the dates you want or to chose it if this center is close to where you live. 3. Houston – You can find a lot of people practicing for CS here. So, i t would be a very good option to give your exam here as you will get so many people to practice with in live. You will get a lot of support and assurance – as you will meet a lot of people on the same boat as you. You can work on your accent and mannerisms. 4. Any other city is equally good as long as you have someone to practice with in person. Duration: 3-4 weeks of preparation is more than enough. (I gave it in less than 2 weeks and so
many others, too.) Resources: First Aid is enough. You can try the videos on youtube for clinical examination or cs
videos. There is also a short and concise notes available which is very easy to remember and recall. It was written by someone who took the CS exam in the past. I didn’t even do first aid. I just read these concise notes which are only like 15-20 pages. It has all the questions you need to ask for each symptom and mnemonics to remember them all. You can get it from your friends or other people who gave their CS already. CS course in New York: You don’t need this at all. You can avoid it and save money. Suggestions:
1. Practice is the most important – especially in person with someone. 2. If you are slow with typing: A. Get a desktop keyboard and practice on it. – Not laptop keyboard. B. Spend atleast 2-3 hours every day or more on typing notes.
C. Keep a time limit for typing a certain number of words or a case. 3. 1-2 days before the exam – Don’t overdo it as it may affect your voice. Remember, your voice is very important on the day of the exam. 4. Work on your accent/speech delivery – It need not be American at all. As time is gold during the exam, you will have to talk as quick as possible while making sure that it is comprehensible. So, just work on the tone, speed and delivery.
KEY: Everyone has clinical knowledge, but the most important thing CS tries to test is
1. Most important: How you approach a patient – Especially concern and empathy 2. Your English proficiency – Ability for you to understand the patient and for the patient to understand you. This should be simple. 3. Remember, the patients are actors. So, they will try to test you in every possible way – From wasting time to irritating you. Don’t lose your cool and try to stick to the topic in a way that’s not harsh or rude.
TIPS:
1. Type everything with CAPSLOCK on. It will save some very important “SECONDS or a minute” overall, as you don’t have to switch between small letters and capital letters at the end of every sentence. 2. Knock the door before entering. Remember the name and ask the patient if you pronounced it properly or ask them to pronounce it for you if you find it difficult. 3. Explain the patient everything before you perform any simple kind of physical examination. 4. Closure is important. Explain to the patient your differential diagnosis, what you think it could be, what are the tests you are going to do (explain what’s a CT or endoscopy is in simple terms) and that you would plan the management (by discussing with the patient) accordingly as per the outcome of the results. 5. Whenever the patient gives a history of smoking/alcohol/drugs – Explain them how it can affect the health, advice to quit, ask if the patient is r eady to quit and let them know of the rehab if the patient is ready to quit. It’s best to do it as soon as the patient gives a history, because you might forget to do it at the end along with the closure. If you want to do it at the end, make sure you write it in BOLD letters on the notepad you carry. 6. Smiling is good, but don’t smile when the patient says he is depressed or in pain. 7. Don’t try to shake hands with an emergency case.
8. Use gloves for physical examination rather than washing hands as you will have to wait until your hands become dry every t ime you do it. Also, there is a risk of your hands being too cold for the patient. 9. Your first differential diagnosis must be the most plausible one. 10. Physical examination: Take care to give consideration to patient’s privacy and pain. 11. Never do a private parts examination on either gender, as the case won’t be related to it. What to expect on the day of the test:
1. Be prepared to realize that the 15 minutes inside the patient room will pass like 5 minutes. So, don’t waste time doing unnecessary stuff. 2. It is common for the first one or two cases to not go as planned. It is common to think that you screwed it up or it is common to genuinely screw them up. Don’t let it affect your next cases. Just forget about every case as you leave the room and type the notes. Don’t carry it to your next case. 3. It is a very common feeling at the end of the day to think you would fail for sure. Don’t let it through you into depression. You will be good as long as you stick to basics and not try to do anything out of ordinary. From my experience:
1. I have seen people passing the exam despite failing to give CLOSURE for 4-5 cases. But, try to give closure for all the cases – just don’t worry if are not able to. 2. I have seen people passing the exam despite failing to write all the three differential diagnosis for 4-5 cases. 3. You will pass, as long as you don’t do any blunders – Like coughing in the patient’s face, not showing empathy at all or being rude and so on. 4. People have done it practicing with others over skype. But, I would strongly recommend to practice at least once with someone in person before the exam. Empathy, proper manners, and comprehensible speech delivery – You shall pass.
I am not going to explain this in detail as I already did it for USMLE Step1. The approach is the same. Once you are done with Step1 exam, you will get a hang of it and you are going to become your own master of USMLEs.
USMLE STEP 2 CK When is the ideal time to give it? – It’s best given asap after USMLE step1. It will save a lot of time as your basics would be strong and fresh. Duration: 3 months if given immediately after USMLE STEP1. Otherwise 4-6 months. Resources: MTB 2, MTB3, Uworld Practice Tests: 1. UWSA
2. NBME forms 1-7
USMLE STEP 3 When is the ideal time to give it? – It’s best given asap after USMLE step2 CK. It will save a lot of time as the subject tested is almost same as that of CK. Also, give it before starting residency because residency is already stressed up and you wouldn’t want to add step3 to it. Duration: 2-3 month if given immediately after CK. Even otherwise 3-4 months is more than enough. Resources: MTB3, Uworld, Archer videos Practice Tests: 1. UWSA
2. NBME
TIPS: 1. Give more importance to CCS. Getting most of CCS questions right will improve your final score by many points. 2. Aim for a score above 220, if you are planning to apply for competitive fellowships like GI and Cardiology.
USCE – United States Clinical Experience Types of USCE: A. Clerkship: It is considered hands on clinical experience. You MUST try your best to do this no matter what. Eligibility: You should be a medical student and not graduated yet For Indians: Internship period is still considered as not yet graduated. Advantages: -
The best clinical experience
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This is what the programs look for
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The LORS from this have a great value
B. Observership: Not a hands on, just shadowing another doctor. Eligibility: Either a medical student or after graduation -
Not considered as a USCE by most of the programs
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Some hospitals might let you touch and examine patients, but legally you are not supposed to
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Best to fill the gap between graduation until residency application or end of the season
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A reasonable time spent a big university or a community hospital that takes IMGs into residency is fruitful.
C. Externship: Hands on clinical experience. Eligibility: After graduation -
Some programs doesn’t consider it as USCE as this kind of experience is mostly offered by private agencies or at private clinics.
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The LORS can mention it as hands on.
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Best to do if you haven’t had any clerkships
1. How to get USCE? -
This question irritates people the most when you ask them without even putting minimum efforts.
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The easiest and the first thing to find a USCE is to do a google search.
-
Type something like “Hospitals in the USA offering electives/observerships/externship for foreign medical students”.
Or “hospital name – visiting – visiting international medical students electives”. electives”. -
Finding an Observership is much more easy. Google for random university or community hospitals. Go to their webpage, look for your desired specialty or subspecialty, open the faculty page, check if they mentioned their email ids. Just email them. If you can’t find the email id of the faculty, email the program coordinator or the administrator. If you can’t find any email id then move on to another hospital.
-
You can ask the email ids of the coordinator or the doctors from someone who has done an elective or obsie at that particular hospital. Or ask your friends or seniors who are now residents at that hospital.
-
If, you are in the USA, just walk into a nearby hospital with your CV and talk to the program coordinator. Or email an attending asking for an appointment.
2. Private organizations offering clerkships/externships: I would strongly suggest not to use these for clerkship unless it is a last resort. The best way to t o do a clerkship is by directly applying to university that is providing it. The hospitals provided through these are usually private clinics. A. Americlerkships B. Chicagoclerkships C. Fmgportal
3. Hospitals that offer USCE. -
This is just a small list I remember. Clerkship: All the hospitals prefer TOEFL Without Step scores:
A. Yale - Paid B. Harvard - Paid C. Weil Cornel - Paid D. John Hopkins – Hopkins – Very Very minimal fee E. NIH - Free
With Step scores: A. UNC - Paid B. Jefferson
C. UT southwestern, Dallas D. Cleveland Clinic, Ohio E. Case western, Ohio F. St Joseph, Arizona
Observership: From Observership: From my experience, you can try at any random hospital, especially university based. A. Albert Einstein, Philadelphia B. Allegheny General, Pittsburgh C. USF, Florida D. Moffitt Cancer Center, Tampa E. MSKCC, New York F. Mt. Sinai, New York G. Maimonides, New York H. UAB, Birmingham I. University of Texas, Houston J. Methodist, Houston K. St. Luke’s, Houston L. UNMC, Nebraska M. MD Anderson, Houston N. Duke, NC O. Staten Island University, New York P. Griffin Hospital, CT Q. Tampa General Hospital, Tampa R. St. Vincent, Worcester S. Washington Hospital Center, DC Externship:
A. Jackson park, Chicago B. Heart and vascular institute, Detroit
4. Ideal duration of USCE? -
There is no such fixed duration.
-
3 months of clerkship is the best as most of the programs are now having this requirement.
-
Few programs now have a requirement of 6 months.
-
So, ideal number of months of USCE goes from 3 months to as many as you can.
-
If you are a recent graduate graduate (for eg: graduated graduated 3-4 months or less before September of the year of residency application), then even one or two months of USCE with a couple of good letters is fine.
5. What is your role during a clerkship? -
It’s just like internship or final year medical school.
-
You will get to see patients on your own first, then you will present it to your resident, who will then go to see the patient along with you. Later in the day you will present the same case to the attending (doctor), who would ask you simple questions regarding your thoughts, management and future plan. Then you would see the patient again with the attending.
-
You will get to use the electronic medical records, where you right your findings. Your attending has to sign it before it goes on record.
6. How many months in advance should you apply for a clerkship? -
Apply atleast 6-9 months in advance of your desired month of electives to have a much better chance of securing one.
-
(for Indians) I have seen some people from the north applying in final year MBBS, for the months right after fi nal exams. You can finish your elective during the duration in bet ween finishing final exams and the start of internship. This way, you don’t have to postpone your internship end date by more than a couple of months and also you will be able to apply for the residency match in the same year of internship internship completion (graduation). (graduation). You can apply for clerkships in those programs which don’t need step scores.
7. How many months in advance should you apply for an obsie/externship? -
Suggestions:
Whenever you can. As early as possible.
1. Keep your electives/obsie as widespread( with respect to regions) as possible. Doing an elective/obsie in a particular region can help getting interviews from that region and it also shows that you are willing to go where ever without any preferences. 2. Once you are in the USA, it becomes very easy to find more electives or obsies. 3. Even if you don’t meet certain requirements of a program, there is no harm in contacting them. 4. If they can’t offer you one right now, don’t just leave it there. Send a thank you email for their time and mention to let you know if anything opens up in the future. Be in regular contact. 5. Get done with TOEFL whenever you can. Even if you are not planning to apply for clerkship at that moment. TOEFL score is valid for two years.
USEFUL LINKS: 1. Americlerkships http://americlerkships.org/ 2. Chicagoclerkships http://chicagoclerkships.com/services.php 3. Fmgportal http://fmgportal.com/ 4. List of hospitals http://electives.us/visatype.html
RESEARCH FAQs 1. What are the types of visa on which you can join research? A. Research Volunteer/Intern: B1 visa -
It is an unpaid position.
-
Your visa could be B1/B2, but at the port of entry the customs officer usually stamps B2. So, make sure you ask him to stamp B1 if you are going for this kind of research.
B. Research Assistant: J1 visa -
This could be paid or unpaid position.
C. Post doc: J1 visa -
Paid or unpaid depending on the funds.
-
They usually have a commitment for 2 years. But, sometimes you can break it after an year depending on your attending.
2. What are the advantages of research on B1? -
You don’t have to commit for long term like research on J1.
-
It’s usually for a maximum of 6 months at a time. It could be for lesser
duration depending upon the communication between you and your attending at the time of applying. -
It’s the best one during the interview season as you can travel for
interviews without any obligations. With J1, especially when you are getting paid you are obligated to spend certain number of hours per week and so you will have to manage work hours every time you travel. -
You can leave whenever you want if the project is over or for other reasons. But, out of courtesy and good manners do mention it to your attending beforehand.
3. Some places which are know to give research opportunities. -
John Hopkins – J1
-
Yale – Post doc or volunteer research
-
MGH – Post doc or volunteer research
-
MD Anderson cancer center, Houston – B1
-
NYU, New York – B1
-
MSKCC, New York – B1
-
Maimonides, New York
-
Upenn
-
Creighton, Omaha
-
University of Buffalo, New York
-
UNC, NC
-
University of Louisville – J1 Ashley Reinhart Clinical Research Management Assistant Division of Infectious Diseases University of Louisville 501 E. Broadway, Suite 140B Louisville KY, 40202 P: (502) 852-2824
4. How to get a research position? -
Just like I mentioned for USCE, email every hospital you can.
-
Specifically target the universities as they would be doing research for sure and hence more chances of getting one.
-
Go to any university or community hospital website, find the faculty page, look their profile for research activity, and email the attendings or the program coordinator.
5. What to mention in the email? -
First, remember that every attending in any hospital would be getting thousands of such emails every day.
-
So, have patience. You might have to send 1000 emails before you get one reply. If you are lucky your first email itself might be the one.
-
Don’t just send a generic email.
-
Give a one or two line intro about you, tell them that you are interested in their field (of the attending). Look their profile and mention words related to their field of research in specific. You can tell them that you want to fellowship in the subspecialty and hence this would be very helpful.
-
Mention about the usmle steps you have taken and the scores.
-
Mention any kind of research you had done in the past.
-
Don’t forget to attach your CV.
6. Clinical vs Basic Science research. Which one to choose? Clinical research: -
During the time of the residency application season.
-
When you have time constraints.
-
When you want its effect to be shown soon – eg: You need publications for this application season and you hardly have 3-4 months before sept 15th. Or when you start it around sept and want something by the time you go interviews or by the time of ROL(rank order list) submission in Feb.
-
Not every clinical research guarantees publications in a short span. Choose the attending wisely. When you email an attending, check their profile to see how many publications they have on an average per year or in the last couple of years. If they have many, then it’s more likely that
you will get a publication in a couple of months too. Basic Science research: -
If you have at least one year time before you apply for residency.
-
If your goal is to get into a very good university hospital and time is not a factor. You can even do it at places like Yale or any other big university and match at that place after an year or two. I have seen people matching at Yale and other big places after research for an year or two. Even in fields like Surgery with scores as normal as 230s.
-
So, apply at a big place, but plan at least an year in advance.
-
Again, this doesn’t guarantee matching at that university. It depends on
how well you impress your attending. -
This doesn’t guarantee a publication in that one year, too. But, the
work accounts to something. -
This would help a lot even for fellowship.
7. Does only 1 st author abstract/publication have importance and not others? -
1st author definitely has a great value, especially during fellowship application in that field same as your research.
-
But, any author is good for us at this level (for residency application).
-
It gives you a very good topic to talk during your interviews.
-
So, don’t worry even if its 3rd or 4th author. Anything after 1st is the same.
8. What are the questions that are commonly asked during an interview for a research position? -
Why do you want to do research?
-
What are your plans in the immediate future?
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Why do you want to do research in this particular field?
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Are you applying for the residency match this year?
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Do you have any experience in research? If yes, what was your role?
-
What are you expecting from this research?
-
What kind of role are you willing to play?
-
How long are you willing to commit?
-
How many hours per day/week are you willing to work?
-
How early can you start?
-
Are you in the US? What visa are you on?
-
Can you use Microsoft excel?
-
Are you expecting any pay?
-
If it’s an unpaid research – How are you going to manage living
expenses? Do you have family here? 9. I don’t have any research experience. Would they offer me a position? -
If you are from India, then the attendings totally understand that most of us won’t have any prior research experience since there is not much
importance or resources for research in India. -
I don’t know about the research exposure in other countries. But, not having a prior research experience won’t be a hurdle in finding one.
-
Of course, having a prior research experience is a plus, but not having one is alright.
-
This is why it is very important to show that you are serious by searching for the specific field of interest of the attending doctor and then talking about that with him. Be as specific as possible.
10. What else can I do if I can’t find any research position or how can I get publications in spare time by just sitting at home? -
You can try for case reports during your ele ctives or obsies.
-
Keep in good touch with the residents, fellows or the attendings you worked with. Keep asking them if you can write review articles with them or if you can draft the abstract or the paper they are working on.
-
Find someone in your friends circle, or on the fb groups or usmle forums who is interested in writing review articles. Just find any current interesting topic and write about it. It’s the simplest thing you can do.
You just need to include the name of an attending or some fellow with good credentials in order to increase the chances of your article being accepted.
11. Is research with publications compulsory to match? -
It’s very important if want to match into a university program or a very
competitive community hospital. -
Otherwise, it isn’t compulsory to match.
12. Does research with publications guarantee a match? -
Research with publication only improves your chances of being matched at a university program.
-
It doesn’t guarantee overall matching at a university program or a
community program. -
It definitely adds up to your CV.
-
Matching depends on your overall profile, personality and how you did at the interview.
13. Is research experience without publications waste? -
It is a very common misconception that research without publications is a waste.
-
It’s not!
-
You get to spend a quality amount of time with your attending or PI. This will give him enough opportunity to write you an outstanding LOR. He can even put in a personal word for you via phone or email.
-
It will give you a wonderful topic to talk during the interviews.
-
If your interviewer belongs to the same subspecialty or has similar interests, you score many points there. Even otherwise, your interview will be more than decent.
-
At the end of the day, everything comes down to building “contacts”.
You would be spending many months at one place and hence a lot of scope to make decent contacts. All you need is “one”. -
So, if you have enough USCE already it doesn’t matter even if your
research is starting in September or later (after you already applied for the match).
Suggestions: 1. Know specific details about your attending and his field of rese arch before you talk to him.
2. The person giving you a research opportunity would like you to commit for as long as possible. So, you answer should be a minimum of 6 months commitment. Anything less would lose the attending’s interest. Because, he has to train you and then if you leave
soon he will have train someone else before any work could be done. 3. Mention you would work atleast 8hrs per day and that you would be willing to work on weekends too, if needed. 4. For paid positions, the duration of commitment could be 1 year or more and the working hours might also differ. So, just tell them you would commit for as long as they want (provided you are ok with it). 5. Most of the initial unpaid research is data collection. It’s a very simple thing. You don’t need any experience for this. So, don’t worry. Even if you don’t know how to use excel, it’s ok. You can learn it as you use it.
LOR: LETTER OF RECOMMENDATION FAQs 1. How to get a good LOR?
-
It’s very simple. The doctors in the USA are very friendly. They just
expect you to know basic knowledge. A. Be on time – very important. B. Come to the hospital at the same time your resident or fellows come and leave along with them, even if they ask you to leave early. C. Read a topic, or something related to the cases you see and ask your resident or the attending some intelligent doubts in that topic. This way you are building up a rapport without sounding dumb when they talk about that topic. D. Volunteer to take a case or present a topic. Don’t wait f or them to give you work. E. The way you talk to the patients is very important. F. If you find some interesting case, volunteer to write a case report. It’s the easiest thing you can get published in a short time.
G. Attend all the seminars, grand rounds and morning reports. Don’t miss any. H. Find out if your resident or fellow is working on any paper and request to give you a role in it. I.
Search about your attending on the program website and learn about his field of interest. You can talk to him about topics related to it in free time. Also, see if he is into research and then request for a position if you are interested.
J.
Don’t just talk about subject all the tim e. Talk about sports, movies
or anything that your resident or attending is interested in. You should show your all round personality. 2. How to get a good LOR from an Observership?
-
It’s a common misconception that one can’t get a good LOR for an
obsie as its not hands on. -
You can still get a very good letter by following all the points I said above except for taking cases.
-
You main focus here should be to be on time, attending all seminars, volunteering to present power point presentations or small talks pertaining to the cases whenever you get time.
-
Some attendings may even let you see a patient if you show sincere interest. However, they won’t be able to mention it in the Letter.
3.
My attending changes every one week or two weeks. How can I ask for a letter?
-
YOU ARE NOT ALONE in this aspect. Almost everyone faces this
situation while doing a clerkship, and sometimes during observership. -
So, make sure you utilize every minute of that 1 week or 2 weeks with your attending.
-
Your resident will be with you for the entire rotation depending on his schedule. So, your LOR author will take inputs from your resident or the other attending you would work with for the remaining duration.
-
DON’T HESITATE TO ASK FOR AN LOR. As this might be your only
chance to get a letter or you might face the same situation during your next rotation. -
THE ATTENDINGS TOTALLY REALIZE YOUR SITUATION. THEY KNOW WHY YOU ARE HERE AND WHAT YOU ARE EXPECTING. And as I
said earlier, the doctors here are very friendly. So, more often than not they agree to write you a letter. -
It could be a generic letter, but remember it also might be your only letter! Don’t miss it. You can later decide whether to use it or not if
you get more letters. -
A GENERIC LOR IS A WAY BETTER THAN “NO LOR”.
4. When to ask for an LOR?
-
There are mixed opinions about the timing of the request.
-
Some say ask during the start of your elective and some say ask at the end.
-
I feel the best time to mention is at least one or two weeks prior to your rotation end date. By this time you would have developed enough rapport with your attending and will also give enough time for the attending to assess you more personally.
-
If you are rotating with the doctor for only one week and you need his letter, then just ask on the last day.
5. How to ask for an LOR?
-
Don’t rush into it during the rounds.
-
The best thing to start with is to ask him for an appointment at his office. You can tell him that you would like to discuss about your future plans. No attending would say no to this.
-
During the meet, you can start with the fact that you would be applying for residency in that specialty and that it would mean a lot to have a letter from him. Then, request him if it would be possible for him to write one.
-
Use this meeting to also talk about future opportunities like obsie or research.
-
If you couldn’t ask him in person for the appointment you can email
or his assistant. -
If setting up an appointment wouldn’t be possible because of the time constraints, then just ask him at the end of the day’s rounds.
6. Waived vs Unwaived LOR?
-
Waived means you are giving away your right to see the letter. This will have more value since it is assumed that the author would write an unbiased letter as you won’t get to see it.
-
Unwaived means you have an access to the see the l etter. This will have less value for the above mentioned reason. But, it’s not a
waste letter. -
I STRONGLY RECOMMEND TO TAKE A WAIVED LETTER, unless you
have strong reasons(not just paranoid reasons) to believe that the author might mention something negative about you in the letter. Only in that case take an unwaived letter and see whether you can upload it or not. 7. What constitutes a good LOR?
-
It should be written at a personal level.
-
Any letter would mention good words or praises about you. But, the most important thing that differentiates a good letter from a generic one is the specific examples for those praises. –Eg: It could be as simple as about how you dealt with some patient situation during your rotation.
-
It should describe you in whole. Not just subject related but your overall personality. Eg: Team player, easy to talk to, punctuality, other skills unrelated to medicine.
-
It can mention the presentations or the talks you made during the rotation. Also, if you took part in writing a case report or any research papers.
-
And, finally words like “I would take him into the program if I am the Program director”.
8. I am doing the elective now, but I would be applying for the residency next year. So, when should I take the letter?
-
This is one of the common situations faced by many, especially with clerkships.
-
There is a chance for the attending to forget specific details about you and your work if you ask him write the letter one year later.
-
You have the following options.
a. Take an ERAS token for that particular year, ask the attending to upload an LOR on to the ERAS. Next year when you are applying for the match, you will have to take a new ERAS token and forward the LORs from the previous one. Advantages: This way you can have a waived letter which has all the specific details about you, as the memory of the author is fresh.
b. Let the attending know that you would be applying next year, request him to write an LOR and save it on his desktop or with his assistant and that you would like him to upload it next year. Most often than not, they agree to this. Advantages: Waived letter, includes specific details about you, when he
uploads it next year he can put the current date of uploading on the letter. c. You can ask your attending to write the letter now and take it with you. You can upload it yourself whenever you are uploading it. Advantages: The letter will have specific details about you and you don’t have
to worry about his availability for uploading the letter as you can do it yourself. Cons: Unwaived letter
d. You can tell the attending that you would be applying next year and hence ask him to wite a letter next year during the application time. Cons: There is a major risk that the attending won’t remember specific details
about you. It will most probably be a generic letter. 9. How important is to have a date closer to the applications season on the LOR?
a. It’s good if you can have the most recent date. b. But, in many cases it may not be possible especially when you do electives an year before. So, it’s ok to have an old date since the programs would
understand the gap. c. For observerships which you do after graduation, it’s better to have at l east one LOR with a recent date. If you can’t, then don’t worry.
TRAVEL -
You would be spending a lot of money on this. So, always look for a couple of options and choose the best alternative.
Commute options: Short distance travel:
1. UBER: You can use the following code to get a 20$ off on your first ride. You can use it i n your country, too. Code: derw2 2. LYFT: You can use the following code to get a free ride. Only for first time users. Code: RAJACHANDR538695 It’s better (cheaper and safer) to use these apps instead of the local taxis. Both UBER
and LYFT are equally good. Long distance travel: 1. Greyhound: Advantages: A. Has got bus stations of it’s own, so you will have a shelter. B. Sometimes cheaper than mega bus. C. Even available in small towns or cities. D. Lenient with luggage. Sometimes, they will allow you to have 2 check in bags at no additional cost. E. You can register to accumulate points and get road rewards. Drawbacks: A. Not as clean as mega bus. B. When you book it online, you must have a printout. They won’t allow you to board the bus if you show it on phone. 2. Mega bus: Advantages: A. Sometimes can be very cheap. It can come to as low as 1$ if you are lucky. B. Much cleaner than greyhound. C. Most people prefer mega bus. Drawbacks:
A. Don’t have a bus station. Yes, there won’t be any shelter. You will have to stand road side and they will drop you off on the road side, too. Doesn’t matter if it is raining or cold as hell. Doesn’t
matter if it is afternoon or 2 am in the morning. B. Runs only between major cities. C. Strict with baggage policy. Only one check in is free. You will have to pay for the other when you buy a ticket. If you don’t pay
before, they will make you wait until everyone is boarded and let you in only if there is space to accommodate your extra bag. Common things: Power sockets for every seat (some greyhound buses won’t have it), free Wifi
(though it will be slow), one free carry on in addition to one check in bag. -
If you miss one bus, you can board the next one if there is space. Also, you can board a bus earlier than the one you booked a ticket for, if there is space. ( Note: In case of grey hound- If you talk to the person at the ticket counter in these situations, they will charge a 20$ fee. The best thing to do is to stand in the line to board the bus and ask the driver directly before you get into the bus. He will most probably let you in without any fee. Sometimes he may direct you to the counter.)
3. Amtrak – It is usually expensive. So, try to book as early as possible. There will be a provision to keep your bags, though large check in bags could be a discomfort. 4. Flights: A. Southwest: Register to get offers and rewards. a. Allows free 2 check in bags in addition to a back pack and 1 carryon. b.
Fares are reasonable and can be very cheap sometimes if booked during offer period.
c. You can get a free flight depending on the points you accumulated. B. Spirit Airlines: You can get it for very cheap, sometimes as low as 50$ But, they charge for baggage and sometimes for the seat. The website I commonly use to book flights in the USA: www.kayak.com
(Gives all the available options. But, doesn’t show southwest prices.)
STAY/ACCOMMODATION: Short duration: Especially when attending interviews. 1. Airbnb: It’s a website where you can get rooms for a cheaper rate than the hotel. It’s
the best option for a one night or a couple of nights stay. a. The rooms are usually in an apartment or a house and most often the owners live in the other room. b. You can search for shared or private rooms. c. You can search for the rooms according to the distance from the hospital. d. You can see the photos of the room and house before you book. e. You can read the reviews and then decide whether to take it or not. YOU MUST read the reviews.
f.
It is usually safe. I used it many times without any trouble and so did my friends.
You can use this referral link to sign up in order to get 35$ off on your first booking. You must sign up clicking this link in order to get it.
Link: www.airbnb.com/c/rchandra40?s=8 2. Couch surfing: Like literally renting a couch in an apartment. a. Much cheaper option. b. Read reviews before you book. https://www.couchsurfing.com Longer duration: During electives: It’s best you ask the coordinator to send a list of places where students
usually live.
1. If you are looking for Indian roommates: www.sulekha.com 2. Craigslist: https://www.craigslist.org
a. Beware of the spammers. b. Always ask for photos of the current state of the room and apartment before you book it. They usually keep photos that were taken when the apartment was new. c. You can search for shared and private rooms. d. Take phone number, talk to them and confirm the details.
e. Ideally ask someone in the vicinity to see the room once. It’s ok if you don’t have anyone.
f.
I had used it with no problems. But, I made sure he isn’t a spammer.
3. Rotating room: https://rotatingroom .com a. This is especially for medical field. b. But, in order to contact the person who posted the ad you need to
have a student id. Like the one that end with “.edu” c. So, you can search the site if there is any room you are interested in
and ask someone with a “.edu” email to contact them.
MATCH SEASON -
Application for the Residency match starts on 15 th September.
1. What all should you ideally keep ready by the end of August? -
Make sure your LOR’s are uploaded. Waived LORs take longer to get processed than the unwaived ones. The processing time can be anywhere between 1 day to 2 weeks. The closer it gets to sept 15 th the longer it takes.
-
Have your final draft of PS ready.
-
Have your MSPE/Dean’s letter uploaded (Dean’s letter can be a substitution for MSPE)
-
Your profile photo – keep it as professional as possible.
ERAS CV, PS can be uploaded or updated even in the last moment. There won’t be any processing time for this.
2. How many LORs can you upload? -
You can upload as many LOR’s as you want on to your ERAS account.
-
But, you can assign only a m aximum of 4 LOR’s per program.
3. How many US LORs and how many home LORs should you assign for each program? -
It depends on how many US LORs you have.
-
If you have enough, then I would suggest 3 US LORs plus one Indian LOR from the head of the department of the specialty you are applying to.
-
I say at least one LOR from medical school because it is them who had seen you for years.
4. Should you assign LORs as per region? -
People have different opinions about this.
-
If you feel all your US LORs are equally good, then assign LORs to the program as per the region where you did your electives and where the program is.
-
Eg: If you had done electives in Florida and New York, then use more LORs from the Florida for the programs that are in the south and more LORs from NY for the programs that are in the North East. Of course, this scenario arises only when you have more than 3 US LORs to choose from. Reason: These are just assumptions. A. The author of the LOR might have much bigger influence in the areas nearby or is well known in the hospitals nearby. B. The fact that you did a rotation in that region shows you wouldn’t have a problem moving there.
5. Is applying on Sept 15 th very important? -
Of course, it must be having some advantage for sure. Otherwise, why would all the Program directors and those in the medical field strongly advise you to upload on the 15th itself?
-
TRY YOUR BEST TO UPLOAD ON SEPT 15 TH ITSELF.
6. Does applying on the 16TH, 17TH Sept or by the end of Sept affect your chances to match? -
This is where you should understand not to panic.
-
Applying on sept 15 th is strongly advised, but it doesn’t mean applying a day or a week later means you wouldn’t match.
-
If you can’t apply on the 15 th, then obviously you can’t apply no matter what. So, stop panicking!
-
Applying a day or two later usually shouldn’t make much of a difference.
-
If your scores are good( don’t ask me what is a good score – its subjective), then even applying at the end of sept or oct 1 st or 2nd week wouldn’t affect you much. Again, you are applying la te only because you don’t have any other choice and the circumstances are like that. Don’t postpone voluntarily.
7. When do interviews start coming? -
There is no such fixed date.
-
For some it can start on 16 th, for someone after the 1 st week and for someone in October or November.
8. Does applying late decrease the number of interviews I get? -
As I mentioned earlier, applying a day or two late or by the last week of September shouldn’t affect it much.
-
If you have stellar scores and CV then even applying in Oct 1 st week shouldn’t have a big impact.
-
That said, from my experience I have noticed that a delayed application (esp in October) has an impact on the number of the interviews you get and also on the type of programs you get interviews from. You might miss the IMG friendly ones.
-
This effect is more profound on the people with belo w avg or average scores.
9. I am waiting for a step score. Should I still apply on the 15 th or wait? -
It’s better to apply with at least Step1, Step2CS and Step 2ck scores.
-
If you are waiting for any of the above three scores, then I would suggest you to wait.
-
If your score is coming out on the 16 th sept or by the end of Sept, then it’s better you wait for it.
-
Because, once a program downloads your application it goes through a filter. If that program has a filter for step results, then your application will be filtered out. Most often, they wouldn’t have the time nor would want to review your application again after your score comes out, unless you have a mind blowing step1 score or CV or of course good contacts in the program.
10. Should you wait for ECFMG certification before you apply? -
ECFMG certification needs STEP1, STEP2 CS and CK results.
-
As with scores, if youranticipated ECFMG certification date is within a week from Sept15th or by the end of sept, you can wait until then.
-
There are programs that don’t need ECFMG certification as filtering criteria. You can apply to those in the meanwhile.
-
If the anticipated certification date is in Oct 1 st week or later, then it’s up-to you whether to apply or not. There is no clear opinion about it.
-
ECFMG Certification takes anywhere from 1 day to 2 weeks after the last required step results are out. On an average it usually takes 4 d ays.
During my 1st season, I was waiting for my Step 2ck results and so couldn’t apply until 3 rd week of October. I even waited for the ECFMG certification for the programs that wanted it. It significantly affected the number of interviews I got and the nature of programs that offered me an interview. I didn’t get an interview from even a single IMG friendly program. All the programs that offered me an iv had no IMG in their resident’s list. So, it
was kind of obvious that it was going to be tough to match. I tried contacting programs desperately, but most of them had already given out the interviews by then and had a huge list of whom to send next. From this personal experience, I strongly suggest you to apply as close as possible to Sept 15th. 11. I haven’t got any interviews so far. It’s already mid October. Does it mean I won’t get any? -
It’s a very scary feeling especially when people around you had already got so many.
-
Don’t panic. Just do what you got to do. Email or call program coordinators asking to review your application.
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I got my first interview in November and still had good number by the end.
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I have seen people getting their first in December and still matching.
12. When is the last date to get interviews?
-
There is no such thing.
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You can expect interviews even in February.
-
Most of the interviews that you get from December are usually those which were cancelled by others due to various reasons, especially by AMGs who had travelled enough or couldn’t because of weather snow storms.
ERAS CV -
It is automatically made as you fill your details on ERAS.
-
Make sure you make no grammatical errors.
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DO NOT LIE about anything on your CV.
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Present mailing address: Give your US address. Sometimes programs like to call those that live in the same region.
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Permanent mailing address: I would suggest US address for this too, for the same reason as above. Programs would prefer those who have family or familiar to that region/state.
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Medical school honors/Awards: Mention the awards you got in medical school, like distinctions or gold medals.
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Work experience:Your electives, obsies or externship (internship for Indians). Any job you do outside medical school comes under work experience, too. Give a short description for each work experience. You should mention your role during that time and what all you did. (Eg: procedures you did, that you saw both inpatient and outpatient, any presentations you made, that you used to attend grand rounds, seminars, morning reports, and that you wrote patients record on EMR)
-
Research experience: is where you mention your research related time.
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Volunteer experience: Any volunteer activities you did. Like community service or being part of some organization or volunteer work(not research or obsies) at hospitals.
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Publications: Mention if you have any. There is an option to mention whether they are published or under review.
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Hobbies and Interests: Do not shy to mention any kind of activities which are an integral part of you. Some programs like to see that you have a life outside of studies too. Like sports, dancing, singing, instruments etc. DO NOT LIE.
Sometimes during the interview they can ask you questions related to it or do some of those. Yes, there are people who were asked to dance a bit or sing. -
Language Fluency: Mention all the languages you know
-
Other awards/ accomplishments: You can mention the awards you got in any activities like sports or other competitions.
ERAS APPLICATION:
1. For Indians: What date should you mention for YOG? Is it internship completion date or date on the certificate? -
You can mention the date of issue mentioned on the diploma.
2. Should I mention it as a break in education if I had gone for clerkships and hence delayed my internship end date? -
No, never mention it as a break in medical education.
PROGRAMS related FAQs: 1. When to start searching about the programs? -
The best time is from July as most of the programs update their requirement info by the end of june or start of July.
2. How to search for programs? -
The best thing is to form a small trusted group of people who are applying to the same specialty. It’s better if their scores and profile is same as of yours.
-
From July, divide the regions among yourselves and start collecting information of the programs in those regions/states.
-
Make an excel or google spread sheet mentioning all the requirements of that program.
How to collect the info? -
Open your ERAS and see the programs in every state.
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Go to the individual programs website and look for the residency application criteria. Same time, also open FRIEDA( it’s free) and look for the criteria.
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If there is no particular information regarding visa or any other thing, you can email or call the program coordinator. They usually respond well in July when they are not that busy.
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If you want to spend money, one of you can subscribe for MATCH A RESIDENT and share the fee. You can get program info on this too and you can filter the programs as per your scores, USCE and visa status.
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BE AWARE: MATCH A RESIDENT doesn’t accurately update it’s information every year. Same with FRIEDA. So, always correlate with p rogram’s website. If the website doesn’t mention it then contact program coordinator.
3. How many programs should you apply to? -
It depends on how many programs you can afford.
-
I would suggest apply to all the programs where you fulfil their criteria. Apply to as many as you can.
-
You wouldn’t want to repent later when your friend with low profile or same as yours gets an interview from the program where you hadn’t applied.
AFTER APPLYING TO THE PROGRAMS NRMP Registration: -
Register as soon as possible, before the end of November to avoid late fee.
-
NRMP registration is a must to be able to participate in the MATCH.
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Update your NRMP number on your ERAS profile.
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It’s ok if you forget to update your NRMP number in the ERAS profile by ROL submission date. Programs usually use your FULL NAME and AAMC ID to find you.
1. Can you contact the programs to review your application? If so, when is the right time? -
Of course, you can contact the program coordinators to review your application.
-
One of the biggest misconceptions during the interview season is to NOT contact the program early (like until end of October).
-
You will see a lot of people especially on facebook pages and usmle forums strongly advising you not to contact them. Don’t believe them. Most of those,
especially the ones with fake identities would be just trying to screw with you. They would mislead you to cut down their competition. -
You can start emailing program coordinators from the end of September or preferably first weeks of October.
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The tone of your email should be in a requesting manner.
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You can even call the program coordinators. But, before you rub your information on them, first enquire if they are free and comfortable to talk about your application. Proceed only if they say yes.
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I just stated this from my own experience. I am just clearing the misconceptions. I am in no way forcing you to do it.
2. Does contacting programs increase your chances of getting interviews? -
It definitely can.
-
From my own experience and that of friends’, I have noticed that on an average people who are proactive in contacting programs tend to have more interviews than their counterparts with similar or better profile. This many not hold good for everyone. I am just saying it from the people I came across.
3. I got a rejection after I sent an email to the program coordinator. Is it because I contacted the program? -
This is another biggest MISCONCEPTION.
-
First you should be clear about the objective of emailing the program.
-
THE MAIN GOAL OF CONTACTING A PROGRAM IS “TO REVIEW YOUR APPLICATION” and not “TO GUARANTEE AN INTERVIEW”. As most of the
times, a program might download your application but may not get to review your application since they get nearly around 5000 applications or more. -
So, once you send them an email you should expect one of the following: A. They directly send your email to trash without even opening it. B. They may open see your email, but not respond to it. C. They see your email and review your application. If they like your application they might send you an interview or note it for later. They can send a rejection too for their own reasons, but definitely not because you emailed them. D. They can reply asking you not to trouble them with further e mails. Don’t take it as a rejection. It’s totally understandable for them to say that because of the number of emails and calls they get ev ery day.
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So, if they send a rejection after you sent an email then: It could be just coincidental that the timing of both happened at the same time, or that your email made them review your application and they sent a rejection for the same reasons they would even if you didn’t contact them.
INTERVIEW SEASON 1. When should you be in the USA? -
I would advise you to be in the USA, at least from the 1 st of Oct until end of Feb (Rand order list submission) or Match day ( if things doesn’t go as planned, it’s better to be in the USA for SOAP).
-
If you are in the USA, you can contact programs by telling that you are in the vicinity and so can make it to the interview at a moment’s notice.
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Even in February there are chances to get an interview due to last minute cancellation by others.
2. Where should you be in the USA? -
It’s better you stay close to family as you will be draining your bank accounts during this period.
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Try to stay closer to the east coast, as most of us( IMGs) get maximum of our calls from the North East.
3. What should you be doing during the interview season? -
It’s better if you don’t sit idle.
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Either get into some observership or research.
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During the interviews, the programs would like to know that you are doin g something to better your chances for the residency.
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The most important reason you should be doing something is that it gives you a chance to build up CONTACTS. You never know whom you are going to meet. The person you may meet even in Feb might be the one who’s going to better your chances of matching.
4. Would there be any use if I join any obsie or research after September? -
Definitely, for the above mentioned reasons. Don’t let go any opportunity or don’t stop trying for one.
5. What if I don’t get any obsie or research opportunity? -
Keep trying for one.
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Stay with family if you want to save money.
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Stay with a group of friends so that you can keep yourself updated with all the things going on and also you can practice for interviews.
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Keep practicing for the interviews assuming that you might get one the next day, even if you don’t have one by then.
6. What filters does a program have to screen applications for interview? How do they select a candidate for an interview?
-
It varies from program to program.
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Some programs have filters for step scores, some have f ilters for YOG, some for medical school (yes even for foreign schools),some have for USCE.
-
There is no clear answer as in how one gets an interview.
-
Having many alumni from your medical school in a particular program definitely helps in getting an interview there. It’s because the PD has already seen people from your college and he can assume that you would be good enough, too.
7. How important is YOG? -
You would get more interviews if your YOG is in the same year as the application season compared to those with YOG > 1year. Provided, rest of the profile is almost similar.
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Programs definitely like to see a recent YOG.
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YOG up to 3 years is not a factor to worry about if have decent USCE and LORS.
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It becomes difficult when the YOG crosses 3 years from the application season. It only becomes diff icult, but it doesn’t mean you wouldn’t get interviews or you wouldn’t match.
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There are many people who match with YOG > 5 years. Work on USCE, research, MPH etc.
8. Can first year residents help in getting interviews? -
Yes, the can. They can’t guarantee but the chances are high.
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Of course, it depends on how well the resident knows you, how strong his recommendation is and how much importance the program gives to residents recommendation (varies from program to program).
-
If not anything at least your application will be reviewed for sure.
9. Does last minute interviews (those you get in late dec,jan or feb) or of no use? -
It doesn’t matter when you get it.
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There are people who matched into programs where they got interview call in Feb.
10. Does courtesy interview matter? -
Once you get an interview it doesn’t matter how you got.
-
The chances could be very low if that program doesn’t take IMGs or you genuinely don’t have a good overall CV (not just scores).
11. How to answer during an interview? -
Be honest, but don’t be too honest and give away negative things about you.
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It’s like talking to a girl. You should give the answer the interviewer is expecting and make it appear that honestly it is what you wanted all your life.
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Don’t lie. They are experienced enough and will find it out now or later.
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Know your personal statement and CV in and out and make sure that there are no discrepancies with your answers.
12. What are the questions commonly asked during an interview? A. Tell me about yourself: Don’t bore them with what you already have on your CV. Give a short description about your professional life and then talk about personal side. If there is anything interesting to know about you, your hobbies etc. You can start with “I am xxx, originally from xyz. I worked for so many years, finished all steps and was able to get so many months of USCE or research in the USA. Then start talking about the personal side. B. Why this specialty? This is most important. Have a proper and solid answer. Give at least 3-5 reasons. C. Why our program? This shows how interested you are in their program and whether you did any research before going there. Again, 3 -5 reasons. D. Where do you see yourself 5 or 10 years from now? Your answer should include both professional (If university hospital – you can talk about fellowships and research. If community hospital with no proper fellowships or research – It’s better you don’t talk much about these two. You can mention becoming a primary care physician or a hospitalist) and personal side (like family, kids, your dream house, dream car etc) E. Which fellowship are you interested in? It’s better to tell them you are inclined to certain subspecialty but you are still keeping your options open and that you would like to decide after goin g through different subspecialties in the 1st year of residency. If the interview is at a community program with no fellowships, don’t talk much about fellowships. You can tell you are open to becoming a hospitalist too. F. What are your strengths/What can you bring into this program? Give them at least 3 of your best qualities. Don’t sound too high about yourself. Be humble. Eg: You can say something like “ my friends say that or my parents say that” or “ I have become this or learnt this “. G. Why should we take you instead of others? This is just another way of asking the strength question. First acknowledge other candidates by saying that you are sure they are all well qualified to get an interview. Then you can talk about what you can bring to the program. H. What is your biggest weakness? Any skeletons in the closet? Don’t be too honest and say some irritating thing about you. For eg: don’t say stuff like “I irritate people sometimes” or “I am lazy”. Pick a safe thing which would be common for many people and ideally pick that weakness outside of medicine. Eg: Fear of public speaking is a common one – but make sure to mention you never had any problem with patient interaction and it never affect your
medical life. And also that you are trying to get over it and what you are doing to get over it and how it is not a problem anymore. Another eg: I am OCD about doing things in a perfect way – This is a positive thing in disguise. OR you can say you don’t have any weakness if you don’t know what to say( last resort). I.
What are your hobbies/what do you do in your spare time/ How do you keep yourself calm or from becoming crazy? Don’t lie. They can ask you questions related to it if the interviewer has similar interests. If it’s something that can be done, they can even ask you to do it right there. Like dance, singing or playing drums.
J.
What are you doing now? Tell me more about it. It could be about obsie or research.
K. Do you have any questions for me? This will be asked for sure. Make sure to ask something. But, don’t ask something that is already on the website or mentioned during the presentation. L. Do you have family here? M. Are you married? If yes, where is your spouse? Would he/she move here in
case you match at our program? Do you have kids? Are you planning for kids? (especially for girls) N. How do you deal with conflicts? Have you ever had any conflicts? The best answer to say is that fortunately you never had any conflicts in your medical career with anyone. In case if it does arise then you would deal with it in steps like “acknowledging it, analysing it, devising a plan of action, and if it’s out of hands then seeking help of attendings” – Just an example of how to approach. O. What type of patients are hard to deal with? One of the commonest answer is non-compliant patients. You will have to explain why they are hard and what do you do to deal with them. Another common answer is those without insurance. P. Tell me about an interesting case you came across. Present it in the same way you would present a patient. Q. What are the differences in medicine you noticed in the USA compared to
your home country? R. Is there any subject you think that lacked during your medical school/Are
you satisfied with your medical school or professors? Universal rule: Never talk low of your professors, medical school or country. You should always say things like “they did their best and that you are very happy to have them”. With respect to subject – you can talk about behavioural science as it is not stressed upon much in India. But, make sure to tell that you had learnt it during step1, continuing to learn it and that you don’t have any difficulty now.
S. Why did you take up medicine? You should have a proper answer to this. If you had mentioned this in your PS, stick to the same story. T. Very few programs can ask medicine related questions. They can ask you
direct questions as in how you would manage a situation or they can give a case scenario and ask how you would proceed further. U. Why did you want to come to the USA? What have you noticed so far? V. Is this your first match? If no, why do you think you didn’t mat ch last year?
What have you done to improve your chances this year? W. What would you do if you don’t match this year? Ideally an interviewer shouldn’t be asking these questions. But, sometimes
they do. X. Have you got more interviews? How many? Where did you get? The best thing to do is to give a straight answer without beating around the bush. You are not going to lose anything. But, if you beat around the bush it might irritate the interviewer. Eg: I have x number of interviews, I have at program Y, program Z and so on.
13. Do you need to join any kind of interview coaching? -
It should be your personal decision.
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From my experience, it’s not at all needed.
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All you need to do is practice the common questions with a couple of your good friends.
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You can find ways to answer particular questions on google or youtube.
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You can even find videos on how to behave during an interview.
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You can save tons of money (which you would be needing for applications, travel etc) by preparing on your own.
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You can take tips from your friends who are now residents or from the residents/fellows/attendings at the place you are doing obsie or research.
-
To get confidence read a book:
-
Don’t listen to too many people on forums.
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Thousands of people match every year without joining any iv course.
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If you genuinely feel your confidence is very low/ you are very poor at personal interactions/ you are really bad with words and/or if money isn’t a p roblem: Then join any iv course. It can boost up your confidence and take that stress off you.
14. Do’s and Do not’s during the interview. Do’s:
A. A firm hand shake. Not too soft nor too tight B. Greet, ask how their day is going, show concern for their b usy day
C. Smile all the time D. Make eye contact all the time. E. Sit straight F. Put your phone on silent Do not’s:
A. Do not make your answers appear rehearsed B. Do not tap your hands or feet C. Do not carry too many documents D. Do not rush your answers E. Avoid bad breath (carry a mouth freshener) On the interview day: A. Arrive 10-15 mins before your scheduled time B. Greet everyone including nursing staff or janitors C. Keep smiling all the time D. Avoid using cell phone E. Interact with everyone F. You can eat the food they provide as much as u want. It isn’t considered bad. Just use a mouth freshener every time you eat or drink something.
G. Don’t talk too much or too little H. Pay attention to the presentation – you might find answers about the program
I.
Pay attention to morning reports or seminars. Take down notes to show interest.
15. How many people will be interviewing you? This varies from program to program. -
Most of the time it will be individual interviews . It means only one person interviews you at a time. The number of such individual interviews can range from 1 to many (maximum 3 on an average).
-
Sometimes it could be a panel interview – meaning two to three interviewers at a time in the same room with you. Make sure you address everyone and look at everyone while answering. Don’t ignore anyone even if they aren’t asking any
questions. -
Sometimes it could be a group interview – meaning one interviewer with all the candidates in the same room. Make sure to stand out. The interviewer can ask the same question to each one individually or may just throw a question and wait for someone to answer. Make sure you keep talking something or the other. Don’t sit silent.
-
Some of the places also keep a psychiatrist or a behavioural therapist as one of the interviewers to assess you in depth. Mostly at a university program University programs usually have at least one group interview session. They are more focused on assessing you at a personal level than testing your knowledge.
16. What to carry during an interview? A. You can carry a back pack. B. Carry a portfolio for documents( if you don’t have any documents) C. Carry a notepad and a pen. D. You don’t have to carry any documents unless they specifically mentioned to bring.
E. Just carry an updated CV (preferably one page), timeline of what you have done since graduation, and any research papers you published.
F. Definitely do not carry ERAS CV or score reports. G. Carry any certificates or honours you might want to show. H. You don’t have to carry proofs for anything unless they ask for it. To be safe you can keep it in your back pack, but not needed generally.
17. What to do before the interview day? A. Research everything about the program. Look up their website. B. If you have friends in the program, try to get specific details which you can use during the interview.
C. If you know someone that already went for an interview there, talk to them to get a general idea.
D. If you have time and you are in that area, go around the hospital. If not, open google maps and explore things around the hospital. You can look for good restaurants, things to do around, places to visit and talk about these during the interview day. It shows your interest towards the place.
E. Have your suit ironed, shoes well-polished. F. Most importantly, have a good night sleep and appear fresh. 18. How to schedule interviews? A. Schedule them as per the region. If possible try to schedule all the interviews in the same city/state or nearby states as close as possible. This way you can save a lot of money on travelling. B. Even if the interview is in the same city, keep at least one day gap to relax. It’s ok to have it on two consecutive days if such a situation arises. C. If the programs are far away or in different states, then keep at least a 2 day gap. You will have to account for any delays in flights/buses. Keep one spare day.
D. Try not to keep interviews in areas like Chicago during the peak winter months like December and January, unless you are living there. Also, try not to take a connecting flight that goes through Chicago during these months. That said all this is possible when you get most of your interviews during the start of the season itself. If that happens, most of the interview dates will be available and you can choose them as per your convenience. But, for the interview calls you get in late October or later on, you wo n’t be having so much flexibility in scheduling dates as most of the dates would have b een taken already. Sometimes, only one date might be available and you h ave to either take it, ask them to keep you on waitlist or leave it.
19. Do the programs give us the interview date or do we get to decide? They will give you a list of available dates to choose from. But, if it’s a last minute interview due to cancellations then you won’t get to choose.
20. How many candidates does a program interview? They usually call anywhere between 6-20 candidates per residency position.
PHONE INTERVIEW -
Some programs might do a phone pre-interview first before they select you for an actual in person interview.
-
Otherwise, phone interview is common during SOAP.
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It’s just like a regular interview. It’s a little easier as you don’t have to dress up, don’t have to worry about your expressions.
-
But, you have to take care about the length of y our answers and your tone.
Some suggestions: -
If you are in a loud place, excuse yourself to a quiet room. Even if you are already in a quiet room do this so that you can buy some time to prepare yourself.
-
Use ear phones or Bluetooth.
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Don’t walk around – you might sound out of breath.
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Keep a couple of browsers open on your laptop. Ideally one of those should be google and the other one be program’s website.
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When you type, do it slow. Make sure it’s not audible to someone over the phone.
-
Keep your answers ready. They might ask the usual ones like “tell me about yourself, why medicine and so on”.
-
Your answer’s content should be the same as you would give during an in-person interview, but the length has to be short. No one would like you talking for long about something. Most importantly, they won’t have time to listen.
-
Usually during soap they might ask you one or two medical questions, as they have to select the candidate based on that few minute phone call.
POST INTERVIEW COMMUNICATION: 1. Whom should you send you a thank you note? -
You can email A. Program director B. Program coordinators – they are important C. Your interviewers D. The residents you met on the iv day
2. Should you email or send a hand written thank you letter? -
It’s up-to you. Some pick either one, some do both.
3. Does not sending a thank you email decrease the chances of your match? -
Ideally this shouldn’t affect your match probability.
-
But, it’s better to not to have to worry about this in our already panicky state.
-
So, send a nice thank you email.
4. What should a thank you email/note mention? -
You should be thanking them for the opportunity.
-
You can mention how you felt on the interview day.
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You can mention what you loved about the program.
5. What if they don’t reply to my email? Does it mean they don’t like me or that I won’t match there?
-
It’s very common for them no to reply. Remember, they are BUSY.
-
Also, sometimes they won’t reply because we might misunderstand their courtesy as a vibe for matching at their program.
-
Some might get a reply and some may not. It doesn’t mean anything.
6. Can I send another email showing interest? -
Yes, you can do this.
-
Ideally do it during the start of the ROL submission.
-
You can mention: a. Why you love their program b. That it is your top choice
c. That you are looking forward to working there
7. You can also email the PD/PC/Interviewers updating them about the things that happened after the interview. Eg: publications, step score, green card/ change in visa status. 8. Don’t bug them by emailing them for every festive occasion like thanksgiving, Christmas, New Year.
MATCHING What are the factors that go into one’s match? -
It is a mixture of various things. a. Contacts b. A word from your attending – if they personally email or call c. Interview day performance – Try your best to impress them. Unless, you screw up doing a blunder this won’t affect you in a negative way. d. Scores – Once you get an interview despite your low scores, this won’t be a major factor as the program liked you despite it. e. Overall CV – YOG, USCE, Research( mainly for university o r competitive programs) f.
LORs
g. Whether your interviews are from IMG friendly programs. h. How competitive it is. Like if every candidate that got an interview ranks it number one then it becomes difficult. i.
How many positions they offer.
j.
Of course, luck!
CONTACTS When you say you don’t have any contacts in the USA, if you give up because of it or if you
blame everything on this factor, then you are only ridiculing yourself. -
Yes, having contacts will help in a big way.
-
With a proper strong contact it can be a cake to matching. And, yes you will come across such people. Don’t be jealous of them. Remember, you would have done the same thing
if you had such contacts. -
But, you will also many people reaching the end without any contacts, without even a family member to support in the USA.
-
So, don’t worry about something which you can do nothing about.
CONTACTS don’t just happen for everyone, you have to make them!
-
If you work in the right direction, you can still make many of them. You just have to be on your game all the time and realize that every person could be a potential contact.
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It could be your friend you went to school with, it could be a stranger on fb you met while preparing for steps, it could be a resident you worked with during USCE or it could be an attending you worked with during USCE/research. It could also be a person who shared an uber ride or it could be some random person who sits beside you while waiting to catch a connecting flight in some other country.
-
This sounds like a fairytale. But, this does happen. Be ready to be surprised. Does having contacts help?
-
It definitely does.
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It depends on how strong the contact is, how well he knows you and how much he pushes your application.
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Most importantly it depends on whether he works in a hospital that has residency in the same specialty. Types: a. Spouse – you will most definitely match into their program b. Relatives – If working in the same hospital – strong If working in the same hospital and specialty – very strong If working in private practice and knows someone in the program – varies c. Attending – If that hospital takes IMGs and he puts in a very strong word – you will most definitely match there.
If he is from a big university and emails or calls the program where you have/had interview – Strong d. Residents - Depends on how much they push you. e. Chief resident – Depends on how much he pushes – can be strong f.
Relative of some doctor in the same specialty and hospital as you are applying – Depends on how close you are to that doctor’s relative – could be strong if the relative puts in a strong recommendation and if that doctor is the Program director.
There could be various other types of contacts, too. The above examples are just to give an idea.
Rank Order List -
You can start making the list from mid Jan until the last Wednesday of Feruary.
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The deadline for ROL submission would be on the last Wednesday of Feb. The programs have the same deadline as you.
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You can create a list and keep changing it until the deadline. But, everytime you edit the list make sure to certify it. You will get an email notification saying your ROL has been submitted succefully.
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Start working on your list as soon as possible so that you can do enough research about the programs where you had an interivew.
Misconceptions and the way to rank: 1. Your match probability won't be affected by when you make your list. You can make it on the
last day itself too. But, I would advice you not to do so to avoid panic or software related issues. 2. Can you rank programs that didn't offer you an interview? Yes, you can. 3. Does ranking programs which didn't offer you an interview increase your chances of
matching? No, it doesn't. Let's say you wanted to marry Angelina Jolie and created your wedding invitations accordingly. On the day of the anticipated marriage you can suit up and go to the venue with friends and family, but Angelina Jolie wouldn't turn up. Because, she had no clue that you exist! 4. Should you rank based on where you want to match or based on where you think you have
higher chances of matching? It's advised to rank programs based on where you want to match. 5. What is the difference between ranking based on where you want to match and based on
where you think you have higher chances of matching? Either way, It won't affect your chances of matching overall. But, it decides where you would end up matching. So, rank the program you like the most at the top even if it is Harvard and you are an Img with bad scores. More simplified explanation: Let's say you had 2 interviews, one from Harvard and another one from a community hospital. Scenario1: You love Harvard and so you ranked Harvard as 1st choice. If Harvard ranks you high enough then you will match there. If Harvard doesn't rank you, then the algorithm would check if the community hospital ranked you high enough. If you were ranked high, you will match or else you won't match at all. Scenario2: You love Harvard but you ranked community hospital as 1st choice since you
thought Harvard wouldn't rank you. Now, if the community program ranks you high enough then you will match there and you will lose an opportunity to match at Harvard even if Harvard ranks you number 1 on their list. 6. One of the program that offered an interview (Program D) tells you indirectly that they will
rank you high or gives a vibe that they will take you. But, you were planning to rank Program A,B and C higher than Program D before they sent the email. You are worried about the match
and all you want is to just match and it doesn’t matter where. What should you do now? Should
you rank Program D as number 1? I would suggest still go in the order you earlier wanted to. If Program D is really ranking you high enough, then you can feel happy that you will match no matter what. YOU will match most certainly, but where depends on you now just like I mentioned in the above example. Scenario1: If you ranked Program A,B and C higher than D, then you will match at either A,B or C if they rank you high enough. If they don’t rank you, then you will ultimately match at D if they rank you as they mentioned. Scenario2: You ranked Program D higher than A,B and C just because D said they are ranking you high. Now, if they really rank you high, then you will match at D even though program A, B or C rank you number 1 on their list. In this scenario you are missing an opportunity to match at your most wanted program.
ROL as per the prog ram: -
Just like you the programs also rank its candidates as per their preference. A program will have to rank more than 1 candidate per residency spot in order to fill all their spots. On an average they have to rank around 11 per one spot. This number varies from program to program depending on its competitiveness. Just for explanation: A program like Harvard can fill all its 20(imaginary number) spots with top20 candidates on their list. A community hospital with good fellowships can fill all its 20 spots within their top50 on the list. A community hospital with no fellowships or resources might fill its 20 spots within their top 200.
SOAP: -
Everyone who doesn’t match will be automatically eligible for SOAP.
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Everyone gets an email regarding SOAP 2-3 days before the match results are out. This is a common email for everyone. It doesn’t mean that you will go unmatched.
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There is a very common saying – “ SOAP is a LOST Cause”.
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It is very difficult for an IMG to match in soap as they usually take unmatched AMGs in Soap. But, don’t give up. Try till the end. You could be an exception.
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It’s an NRMP violation for you to contact a program first during SOAP. Wait for
the program to contact you first and then you can call or email them later. If you try to contact them first, they can report you to NRMP. -
It’s better if you can stay in the US during this period as the programs usually contact through phone. Your interview will be mostly on phone. It’s just like an
in person interview, but keep your answers short. -
If you are in your home country, then try to keep your US number active. Call
the customer care to know more details. Ideally, get these details before you leave USA.
What to expect during the Interview Season? SCORES Imp? Number or interviews and matching -
Accept the fact asap that the whole process is UNCERTAIN.
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Be ready to face many depressive circumstances.
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On the good side, you will see new places, meet many people and some of them become your support for the rest of the season and friends for life.
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There is no possible way to explain why someone got an interview and why not the other one.
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Scores are of course very important, but it isn’t the only criteria. If scores are the only criteria then a person with 270s should be getting interviews from almost every program he applied to. But, you will notice that the maximum number of interviews a person with double 270s get is around 30 and that he may not get an interview at places where someone with 230s or 240s got.
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Don’t start comparing with people around you. Don’t question why someone with same scores as you or lower scores than you got a particular interview and you didn’t. I had seen many people doing this and going crazy, despite advising them not to do so. As I said, it is very uncertain. The more you think about these, the more you would worsen your already depressed state.
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It’s good to know about where people are getting their interviews. But, don’t use this information to for comparing. Use this information instead to contact the program coordinator requesting to review your application. Don’t ask the PC why you didn’t get
an interview when they gave it to someone with lower scores than you. -
People don’t like to share where they got an interview as it is very competitive out there. So, be respectful to people on the usmle pages or forums. It’s up-to them whether to share or not. Don’t push it. Be ready to face the fact that even some of your
good friends won’t be sharing any kind of such information. -
People Change – You can’t blame them. Accept this, so that you won’t be disappointed later. It may not hold true for everyone but why take chances? So, don’t rely too much
on anyone or put all your hopes in one basket. For eg: 1: Your seniors or friends who matched last year might tell you that they would get you an interview for sure or try their best. Their excitement on the match day makes them tell you this. But, not everyone would end up helping you. When you contact them during the match season the most common reply would be “Geez, I don’t know man, I will try” or “I am only an intern, I can’t”. Some won’t even respond.
2: You might have helped people while preparing for steps and all. But, once the season starts realize that they may not even remember you anymore.
3. Let’s suppose you didn’t match - The people who contacted you for help during their entire usmle prep or during the match season may not even respond to your messages anymore or wouldn’t be willing to support in any way. They will just ignore
you. 4. This is the most funny situation: You will see quite a few people (after they matched) getting infuriated when you message them for any kind of information or help. They would even go to the length of saying how irritating this is. This is funny because, these are those people who wouldn’t have made it last year if not for somebody’s help.
As I mentioned, this may not hold true for everyone. But, just be ready to accept it. Depend on yourself. There would be many other people who genuinely got busy (intern year could be crazy), tried to help but couldn’t. Respect them. -
You will come across people who would only take as much information as possible but wouldn’t share. You could be one among them. Out of courtesy and good manners, don’t do that!
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Be ready to see a lot TRASH or SPAM on facebook pages or usmle forums. Don’t just blindly believe in everything they say.
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Some of the common scenarios you would come across: Scenario1: X has 240 on step1 and 240 on step2ck, passed CS on first attempt and has a couple of months of Obsie. Y has the same profile as X including YOG. a. You can see X getting 20 interviews while Y only gets 2 or vice-versa. b. You can see both of them getting almost equal number of interviews. It could be 2 or 10 or 20. c. Reason: It’s uncertain. No possible explanation, there will be only assumptions. Scenario2: X has 230 on step1 and 240 on step2ck, passed CS on first attempt and
has a couple of months of obsie. Y has 250s on both steps and rest similar profile as X. X can still end up having much more interviews that Y. From what I came across, X had 10+ interviews while Y only had 3. -
Expect interviews to come any time.
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For some people they start coming from September itself, for some in October and for some in November. I had even seen people who got their first interview in Dec or Jan.
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Some people get all their interviews by the 2nd week of October and some get interviews throughout the season until Feb.
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From December onwards expect an interview to come one day before or on the same day as interview. So, be prepared all the time. This kind of interviews mostly comes to those who live in the same city or the state as that of the program. That’s why having a US address in your ERAS is important.
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You will see people with one or two interviews ending up matched and those with 20+ interviews going unmatched.
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You will see people with 210s or an attempt on CS matching and people with 250s and no attempts going unmatched.
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You will see people not matching in regular match, not matching in SOAP but then getting a call few days later as someone who already matched at that program can’t join
for some reason. -
You can expect visa denial to some unlucky person who got matched. In that case a program usually contacts someone who already has a green card or citizenship. So, those people who don’t need visa can expect a call in June, too.
Questions asked by the members of the USMLE Page 1. Second match guys did u tell the program its your second match and did they ask u? A. I mentioned it in my PS that I didn’t match last year. The interviewers mentioned that they noticed it. At a couple of places where the interviewer didn’t read the PS, they
asked me whether I applied for last match. 2. Im LOR for neuro advisable? A. Only, if you don’t have enough LORs from Neuro. 3. pls mention what extracurricular activities we could add on to our CV and if it is really necessary? A. Please, refer to the ERAS CV section of the PDF to know it in detail. 4. Does IELTS help? A. TOEFL should be enough for electives, unless the hospital specially asks for IELTS. 5. Ways of obtaining HANDS-ON externships other than commercial companies, if any? A. Hardly any proper teaching hospital or university offers this. The only place I know that offers this without going through commercial companies is the Heart and Vascular center in Detroit. May be, jacksonpark hospital in Chicago too. 6. Prospects of matching with only 2 months of observership? A. It depends on your scores, LORs from those 2 observerships and overall CV. Yes, there are people who matched with only 2 obsies or no USCE at all. But, there may or may not have been other factors related to their match and so we can’t just generalize it for
everyone. 7. Prospects of matching without any research experience and publications? A. You will see a lot of people matching with research exp or publications. Again, it depends on the over CV. Also, it might affect where you would end up matching. Eg: A university hospital would like to see research exp. 8. Scores needed to overcome YOG>3 years? A. No one can give a definite answer for this. There is no defined cut offs for scores. The more you can score the better. Also, with increasing YOG the thing the programs worry about is the clinical experience as they wouldn’t like to see away from practicing medicine for long. It’s the USCE and publications which can kind of mask this.
9. Credibility to PDs of locum jobs (shift duties at clinics) as gap fillers while studying for USMLEs? A. It’s definitely better than having a gap. Describe this section in the CV in detail about you role during that particular job. Sometimes, during the interview they will ask you about this just to double check. 10. Importance of having an American accent over a neutral one? A. Doesn’t matter. America has a huge percentage of immigrants who don’t have an American accent. -
It can help if you have an American accent as the interviewers would be happy to know that you won’t have any problem while dealing with American patients.
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Neutral one – it’s definitely not a negative factor as far as it is comprehensible. Don’t worry about the accent and over try it. It will appear fake. I don’t have an American accent at all, but my interviewers told me that they were
surprised to hear such good English and asked me when did I start learning it(could be possible that their expectations were low). 11. How to apply for electives and things one should take care while studying for step 1. A. Please, refer to the USCE and step1 part of the PDF. 12. How to act on interviews? How to act on observerships? A. Please, refer to the USCE and interviews part of the PDF. 13. Information about the types of visa needed, procedure and related info. A. USCE/STEP exams including CS/ interviews – B1/B2 visa. Research: Depends on what the institutions wants or sponsors. Could be B1 or J1 or in rare cases they sponsor H1 B. For the procedure, it’s better to refer to the Government website.
14. Can u pls enlighten a little about EXTERNSHIPS?!! like how and when to apply and what are the requirements for it? A. Please, refer to the USCE part of the PDF. The requirements depend on the hospital you are applying. Contact them for that info or check their website. 15. What are da chances to get gynecology branch being a gynecologist in india and where it is comparitively easy to get in gyn residensy through out usa? A. Sorry, I have no idea about gynecology. It’s better if you can ask someone related to it.
16. Which branches needs less scores? Which places needs less score? A. With the increasing competition and many people getting outstanding scores, the differentiation between branches with regards to scores isn’t possible. I can say peds is
comparatively easy to get compared to IM for a person with low scores, but I am sure peds applicants won’t agree with it. Also, as I mentioned earlier, scores are not the only thing. It’s overall CV that matters.
17. Please explain different forms of USCE such as electives, externship, observership. A. Did that in the USCE part of the PDF. 18. Could you mention about visas. Converting j1 research to j1 clinical or h1b. A. J1 research to J1 clinical is easy. But, it is almost impossible to go from J1 research to H1b for the residency. So, if you are planning for a H1b in residency its better you don’t take up research on J1. Residency on J1 visa:
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Pros: a. Fellowship is easier to get as the number of fellowship positions on J1 are much more, especially the competitive ones like GI, cardio. b. Most of the university programs offer only J1 for residency.
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Cons: a. You will have to sign a bond with your home Government. So, you will have to go back to your home country for 2 years after finishing residency/fellowship or you will have to do a waiver job in the US for 3 years. b. Green card will be delayed when compared to H1 B visa. Even if you end up marrying a US citizen you will have to wait until you do the waiver.
Residency on H1B visa: USMLE STEP3 is a must to get this visa.
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Pros: a. You won’t have the home country rule. b. You don’t have to worry about the waiver job. c. You will get green card faster. You will get it much faster if you end up marrying a US citizen. d. You can still get fellowships like nephrology, endocrinology easily even at great universities.
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Cons: a. Most of the universities don’t offer H1B visa for residency.
b. Competitive fellowships are very hard to get. c. You will pay more taxes when compared to J1. In short: If you are looking for competitive fellowships later on or for university programs, then
go with J1. 19. I have low score in step 1 and now quite dis hearted about step 2, any advice f or low scorers? And also I have absolutely no contacts in US. How much does having US contacts help through all this process? I have been told by many people that I have very less chance of getting interviews because I have no contacts in US. A. First of all, what do you mean by a low score? Scores are subjective. Some people feel they got a low score even after getting 250s. -
You can work on improving your CV by doing electives/obsies and/or research with publications. Good LORs will help you a lot.
No contacts in the USA: Of course, it helps a lot when you have contacts. But, if you are saying you can’t do it without contacts then it’s just an excuse you are giving yourself for not
working hard enough. -
I didn’t have any contacts. I am sure there are many people who don’t have contacts
and still matched. -
So, do whatever you can and stop worrying about something that’s not in your hands.
20. Total cost from studying, steps to match in Indian rupees ? A. It depends on how many months of USCE you did, if it’s free or paid, how much your living expenses are, how many programs you apply to, how many interviews you get and miscellaneous activities. So, it’s difficult to give an exact figure. But, it could be
anywhere between 15k to 30k USD for one time applicant. 21. 1.Step 3 prep time reqd right after ck; 2. Research places ... how to find one good 3. Observership vs university observership vs research A. Refer to step3 part of the PDF for your 1st question and Research related for your 2 nd question. As for Obsie vs University Obsie vs research: a. Obsie at a university hospital and a good LOR from the faculty there can help you big time in getting interviews from the community hospitals in that area or elsewhere. b. Obsie at a community hospital which takes IMGs into its residency program is the best.
Ideally, do both if you can. If you have to pick only one, then find out the chances of matching at that hospital after doing an obsie and then decide. As for obsie vs research: -
This just depends on how much USCE you already have and how much time you have for research at this point.
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If you have 5-6 months of USCE (obsies) or 3 months of hands on USCE(electives) then you can go for research. This is just a suggestion. Talk to others and decide for yourself.
22. How do you prepare for your interviews? How do you plan the schedule? How do you contact them after the interviews? How do you send thank you cards? A. Please, refer to the interviews section of the PDF. 23. Please outline the requirements of an orthopaedic and cardiology residency/externship. A. Sorry, I have no idea about orthopedic residency. Cardiology is a fellowship and not a residency. For externship, please refer to the USCE part of the PDF. 24. I didn’t match this year. What can I do to improve my chances for the next match? A. This can’t be generalized. It depends on the individuals overall CV and what they are lacking in. -
Give step3 if you hadn’t already.
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Get more USCE, preferably in a hospital that takes IMGs i nto its residency.
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If you already have 5-6+ months of USCE, you can try joining research.
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With increasing YOG, the issue that worried the PDs most is about how long it has been since your last proper patient interaction. So, I would say even if you are planning to get into research and already have good number of months of USCE, still do at least 1 or 2 months of USCE.
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Best thing would be to do Obsie while doing research. If the person you are working with is a clinician, then you can shadow him on floors or clinics. You can request them. This would be the best way to get an LOR which includes both.
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Programs definitely want to see what you have done to improve your chances for this year. So, don’t sit idle even for a month. Spend as much time as you can in the
USA. -
Definitely get at least 1 or 2 new LORS.
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Also contact the interviewers from your last season, tell them that you didn’t match
and ask them for any kind of opportunities. This works better if you already made some effort to communicate with them during the last season after the interview.
25. I have an attempt on Step2 CS. What are my chances? -
There are people with an attempt on CS and still went on to match. As with everything, it all comes down to how well you improve your CV to mask this black mark.
26. Step1 score 210,220,230. Will I match? -
People have successfully matched even with scores less than 210 on step1.
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It’s not going to be easy, but it’s not impossible.
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Show a drastic improvement on step 2CK and get good LORs.
PERSONAL STATEMENT -
Some say it is very important and some say they only read it after you are offered an interview.
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Either way, I would say not to take it easy. Just think it as one of those minimum things which we can do to secure our future.
1. When to start writing?
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Start writing it as early possible. Don’t delay. The correct time to start writing or think
about it is NOW. -
You will end up making many drafts and corrections. You would want to make changes even few seconds before applying. You would literally cry if you keep it for the end.
2. How to start writing or what to start with?
I am just talking about how to go about starting to write the initial draft. Not how to start the first line/para of the PS. Just start with some random point and you can build the content around it. -
You can start with why you took up medicine – keep it interesting, like a story.
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You can start with some interesting traits in you.
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You can start with why you want to go the USA for residency.
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You can start why you want that certain program.
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You can start with some failure in your life which you want the reader to know. Search for some sample personal statements online in order to get an idea. DON’T PLAGIARIZE.
3. Can you mention any failures or whether you didn’t match last year?
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Of course, you totally can mention it.
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But, it’s not a compulsory that you mention it. It should be totally based on your own
decision. -
If you decide to mention it, then it is strongly adviced to back it up with what you had done to overcome it or how that experience helped you become better or what it taught you. If you don’t have a solid follow up, then it’s better you don’t mention it.
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I personally had mentioned that I didn’t match the previous year. My interviewers had
liked the fact that I mentioned it in the personal statement. 4. How many words should the PS be?
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Ideally keep it between 550 words to 800 words.
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It’s more about how far you can keep it interesting enough to read than about the
actual word count. -
So, if you feel you need 850 or 950 words for sure to express everything you must, don’t panic. It’s ok to go over 800 words, provided it doesn’t make it boring.
5. What font should be used?
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You will see everywhere mentioning you must use times new roman for it. You can use it while writing in the word document.
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But, when you copy paste it onto ERAS, it will convert it into it’s own font. And you can’t change it there. So, don’t stress about the font.
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Copy paste from a text document to ERAS, rather than from word document. The alignment is better from text doc to ERAS.
6. What should a PS include?
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A best PS is something that is totally unique from the regular format. So, don’t
hesitate to try something out of ordinary. -
The most important thing is the opening. Just like any story or play. Keep it as catchy as possible. You can start with a positive or a negative life incident and describe how it molded you into what you are now or how it inspired you to take up medicine. (It’s just an example. Think of other unique ways.)
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The transitions from one para to another should be smooth. Ideally the flow should be connected. Keep it to max of 5 paragraphs in total.
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Some common things which you can include: Why medicine, why this specialty, why USA, what you learnt about US system during your rotations which made you fall in love with it, your strengths (you can talk about your extracurricular activities like sports, community service etc., if they are an important part of your personality and show it in a way how it could be your strength as a doctor – like team player, leadership qualities and so on) and ideally e nd with why you want to join their program.
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If you want to mention you didn’t match last year you can either open with it or
mention in the middle. But, make sure to mention what you have done after the last season’s match results to secure your match for this year.
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Just don’t repeat your CV in the PS. Don’t talk too much about how awesome you are.
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Everyone has their own opinion. So, don’t ask too many people about how to write or
TIPS:
their opinion about your PS.
