USMLEs.....

virtus

Hi there,

I have heard that many Irish Docs go overseas to do residencies in the states and that the requirements involve doing exams called USMLEs.

How hard is it to do USMLE exams?
Has anyone on this board been succesful?

From what I have heard the best and the brightest generally go over, and that its a major boon to their career. How true is this and does it somehow fasttrack you to a consultant post?

lonestargirl

I can answer some of your questions regarding the process of USMLEs and getting to the US, I'm currently in the US with my DH (an Irish graduate of an Irish medical school) who is doing surgical residency.

There are two different routes through which Irish doctors go to the US, both will require your USMLEs.

1) Most common (IMO) is to doing SHO and SPR in Ireland and then head to the US for a 1-2 year fellowship.

2) Going straight to the US from college, or after intern year, and doing residency training in the US. This has the advantage of shortening your training to 4-5 years. However it has some drawbacks: it's quite difficult to get it; you get paid about $40,000 for a 80+ hour work week; there is a lot of paperwork (and fees!) involved in moving.

Bear in mind that if you go over for residency you will probably be on a J1 that has the 'two year rule' attached, i.e. you must reside in your home country for two years following the expiry of your visa before you can be granted another visa for the US. If you have Step 3 of your USMLEs you can get a H1B visa which does not this requirement - except your residency program will have to sponsor you for this visa and very few are willing to do this.

For details about taking the USMLEs themselves and exam content head over to the forums at Student Doctor Network.

sillymoo

Anyone know if you need to have done the Step 1 to do an elective in the US between 4th and final year?

Also if you are on a training scheme in Ireland and you have to do some of your training in the US would you have needed to have done the Steps?

We had a talk on the USMLE's yesterday and it looks like something I would like to avoid unless needed.

Echani

virtus wrote: »

Hi there,

I have heard that many Irish Docs go overseas to do residencies in the states and that the requirements involve doing exams called USMLEs.

How hard is it to do USMLE exams?
Has anyone on this board been succesful?

From what I have heard the best and the brightest generally go over, and that its a major boon to their career. How true is this and does it somehow fasttrack you to a consultant post?

I'm an Irish student in 4th med, I did my USMLE step 1 in August. Going to the US isn't my top priority but rather a door I'd rather leave open, so I set a limit on studying to 5-6 weeks... it was pretty brutal, 9+ hours study every day most days; and even more in the last 2 weeks. I was doing a bunch of practice tests which were showing decent scores, but there's never any sense of comfort going into that exam - there's simply too much they can ask you, you'll never know it all. And for the same reason, when the exam is finally over, people often don't know whether they failed miserably or aced it.

That said, I came out with a score I'm delighted with, and the door to the US hasn't closed yet. It also sets you up pretty well for 4th/5th med... I'm attached to a metabolic disease team in paediatrics at the moment, and most of the conditions I'd barely have heard of if not for sitting Step 1.

imported_guy

lonestargirl wrote: »

I can answer some of your questions regarding the process of USMLEs and getting to the US, I'm currently in the US with my DH (an Irish graduate of an Irish medical school) who is doing surgical residency.

There are two different routes through which Irish doctors go to the US, both will require your USMLEs.

1) Most common (IMO) is to doing SHO and SPR in Ireland and then head to the US for a 1-2 year fellowship.


Bear in mind that if you go over for residency you will probably be on a J1 that has the 'two year rule' attached, i.e. you must reside in your home country for two years following the expiry of your visa before you can be granted another visa for the US. If you have Step 3 of your USMLEs you can get a H1B visa which does not this requirement - except your residency program will have to sponsor you for this visa and very few are willing to do this.

on the 1st issue, if you do the fellowship you still cant work in the USA, as a doctor without completing a residancy programme (from what i have heard)

and on the visa issue, there are ways around the "2 year rule" thing you can work in the veteran programme or something (forgot its name, it pays rubbish but you get to stay in america) and there are some other ways around it as well


actully i heard/read most stuff on here http://www.internationaldoc.com/ great info about USMLEs and the american system

quote from the site

While you can do your basic medical training in your home country and join a US fellowship, you will not be able then to practice as a Cardiologist, as you cannot be 'board certified' without completing a residency first

lonestargirl

imported_guy wrote: »

on the 1st issue, if you do the fellowship you still cant work in the USA, as a doctor without completing a residancy programme (from what i have heard)

True, I didn't make this clear in my post. The majority of Irish doctors who go to the US do so only for fellowship and then return to Ireland. If you want go to the US permanently you must do residency there.

imported_guy wrote: »

and on the visa issue, there are ways around the "2 year rule" thing you can work in the veteran programme or something (forgot its name, it pays rubbish but you get to stay in america) and there are some other ways around it as well

Again this is true but it is not a given. At the moment it is possible but it is an exception to the visa rule and you can't guarantee that you will be able to get a VA job.

Don't get me wrong I love being in the US, but it is difficult for non-US medical graduates to match especially if you don't have a great Step 1 score.

imported_guy

lonestargirl wrote: »

True, I didn't make this clear in my post. The majority of Irish doctors who go to the US do so only for fellowship and then return to Ireland. If you want go to the US permanently you must do residency there.



Again this is true but it is not a given. At the moment it is possible but it is an exception to the visa rule and you can't guarantee that you will be able to get a VA job.

Don't get me wrong I love being in the US, but it is difficult for non-US medical graduates to match especially if you don't have a great Step 1 score.

actully i just heard something interesting from a cousin of mine, who is doing a fellowship in cardiology in america, he did MRCP part 1 and 2 in UK and landed a 3 year cardiology residency in america i think he was saying something about him getting exemptions based on his MRCP 1 and 2 and he is doing a 2 year fellowship now, and he didnt have to go back to UK either somehow, forgot to get the details

PeterMC

Hey everybody

Hoping to do the USMLEs next Summer after finishing third year. Will have finished Path, Pharm and all the basic sciences at this stage. I'm just wondering if anyone here has done them already and how hard they found the difference between the course content and what they had learnt in the "Irish System" to what is expected by the USMLEs?

How long did it take to study? If you could do it over - would you have preferred to spend more or less time studying?

Thanks in advance!
Peter

lonestargirl

imported_guy wrote: »

actully i just heard something interesting from a cousin of mine, who is doing a fellowship in cardiology in america, he did MRCP part 1 and 2 in UK and landed a 3 year cardiology residency in america i think he was saying something about him getting exemptions based on his MRCP 1 and 2

There is no cardiology resdidency, it's fellowship training only following an internal medicine residency. He may well have been let off the prelim (or intern) year because of his training in the UK.

imported_guy wrote: »

and he is doing a 2 year fellowship now, and he didnt have to go back to UK either somehow

If you go on a J1 your visa can be extended to cover fellowship too, it's only once you finish 'training' that you must leave. He may well have gone over on a H1B which is an immigrant visa.

sillymoo

Had a Kaplan talk about USMLE's this morning and it did not make the decision about taking them any easier. Would love to take Step 1 and get a fantastic score, so I would have the option of doing residency in the US if I decided to in the next few years.

However the pass rate is really high - 185 which is 75% of the questions right. Just to pass. Wow.

I think it comes down to whether you want to do residency in the states. Its a tough exam and if you fail it, you cant hide it and it will affect your application, no matter how well you do in your university exams.

Medstudent

sillymoo,

I was just wondering what you meant by. . . . " it affects your application no matter how well you do in university exams"

Do you mean if you have to repeat it and then apply to the states your application will be affected, or do you mean applications to posts in Ireland will also be affected??

imported_guy

Medstudent wrote: »

sillymoo,

I was just wondering what you meant by. . . . " it affects your application no matter how well you do in university exams"

Do you mean if you have to repeat it and then apply to the states your application will be affected, or do you mean applications to posts in Ireland will also be affected??

your USMLE score/history is based on a system like the CAO, if you fail lets say the first step once or twice, it will be kept on the record and the places you apply to will see your fail score as well as your pass score

USMLE is not needed for applying for jobs in any place other than america.

sillymoo

Medstudent wrote: »

sillymoo,

I was just wondering what you meant by. . . . " it affects your application no matter how well you do in university exams"

Do you mean if you have to repeat it and then apply to the states your application will be affected, or do you mean applications to posts in Ireland will also be affected??

I mean that they rate your step scores very highly and rarely would take your university marks into consideration. When they are going through the applications, its the step scores they look at. If you fail one of the steps, it will show on your application and would be hard to even get an interview.