Medical training in the USA Guide
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United States Medical Licensing Exams (USMLE) - Required for application
- USMLE Step 1 (Basic sciences),
- USMLE Step 2 CK (Clinical Knowledge) and Step 2 CS (Clinical Skills).
- USMLE Step 3 is an additional exam, which is not a requirement for applicants but needs to be taken at some point, usually within the first year of Residency.
Steps 1 and 2 CK are multiple choice computerized exams that can be taken in Thessaloniki, Greece throughout the year, except for the first 2 weeks of January.
Step 2 CS is an oral/ case simulation exam which can be taken only in 5 test centers in the US (Philadelphia, Atlanta, Chicago, Los Angeles, Houston).
- USMLE Step 2 CK (Clinical Knowledge) and Step 2 CS (Clinical Skills).
- USMLE Step 3 is an additional exam, which is not a requirement for applicants but needs to be taken at some point, usually within the first year of Residency.
Steps 1 and 2 CK are multiple choice computerized exams that can be taken in Thessaloniki, Greece throughout the year, except for the first 2 weeks of January.
Step 2 CS is an oral/ case simulation exam which can be taken only in 5 test centers in the US (Philadelphia, Atlanta, Chicago, Los Angeles, Houston).
Preparative material for the USMLE exams
The books that are suggested below contain the information that a USMLE candidate needs to review in order to be prepared to take the USMLE exams. The candidate needs to review these books carefully and comprehend the content. It is of significant importance to focus on diagrams and graphics, since, on the actual exam, interpretation of those diagrams is commonly tested or required in order to reach the correct answer.
USMLE Step 1
1) Gross Anatomy- High Yield (Dudek)
2) Neuroanatomy- High Yield (Fix)
3) Embryology- High Yield (Dudek)
4) Behavioral science- High Yield (Fadem) και Underground Clinical Vignettes (Swanson)
5) Pathology- BRS (Schneider)
6) Physiology- BRS (Costanzo)
7) Microbiology- Clinical Microbiology Made Ridiculously Simple (Gladwin)
8) Pharmacology- Lippincott Illustrated Reviews (Howland, Mycek)
9) Biochemistry- Lippincott Illustrated Reviews (Champe, Harvey)
10) First Aid for the USMLE STEP1 (Bhushan)
Advice for Step1: Pay extra attention to the book “First Aid”. Keep studying it simultaneously with the books suggested above. When studying the different discipline areas e.g Biochemistry, Pharmacology etc try to make notes of missing information on the First Aid in the corresponding areas. After you finish your study you will have created an excellent review book which is going to be the only review book to use in the last couple of weeks before the exam, given that time constraints do not usually allow for further study or review of all the books.
USMLE Step2 Clinical Knowledge
1) Internal Medicine- Kaplan Lecture Notes
2) Surgery- Kaplan Lecture Notes
3) Pediatrics- Kaplan Lecture Notes
4) OB-Gyn- Kaplan Lecture Notes
5) Psychiatry/Epidemiology/Ethics- Kaplan Lecture Notes
6) Step- Up to Medicine ( as an adjuvant to the other books)
Additional advice for Step2CK:First Aid for Step2 CK also exists but its ratings on the Internet is not great. Since 2007 more editions have come up and this book may have been improved.
USMLE Step2 Clinical Skills
1) First Aid for the USMLE Step 2 CS
Additional advice for Step2Cs:Apart from the book that is suggested here, live practice with a partner is strongly recommended and is considered to be the best way of preparing for the exam. Find somebody who would be interested in being your patient for a few days and work with him/her…it is fun and extremely helpful. It can be ideally done in the US a few days before the date of the exam. First aid for Step2CS is all that someone needs in order to pass the exam. Step2 CS result is only reported as Pass/fail; no numerical grade is disclosed.
Videos with physical exam on USMLE World may also be useful for preparation. These are mostly recommended to candidates who graduated from medical school long before taking the test. The physical exam that needs to be performed during the exam is really basic, brief and focused and a thorough and meticulous exam is not recommended because it may consume a good deal of the limited time the candidate has in order to do an introduction, a history taking, physical exam, counselling and closure.
Final preparation
Question Banks (QBanks)
Kaplan QBanks
USMLE World
QBanks include a great deal of questions in a format similar to the actual test. Answering these questions (timed and untimed mode) and studying the correct but also the wrong answers is extremely useful and “high-yield” for the preparation.
The QBanks need to be used as a learning tool and not only as a way to assess one’s own knowledge background (there are special tests for this purpose, see below).
National Board of Medical Examiners (NBME) self-assessment test
It is important for the candidate to take one of the 4-5 simulation tests that NBME provides only for Step1 and Step2CK.
NBME is a Board that selects the questions that are tested on USMLE and the Medical Boards. Their simulation tests consist of questions that have been tested on previous exams in the past and therefore these resemble the actual questions.
The “NBME forms” are supposed to be predictable of the score that the candidate will get in the actual exam.
The test is available online (Select “Enter the NBME Self Assessment Interactive website”).
Finally, before the exams, it is recommended that the “sample tests” that the USMLE website provides are done, too. These are 2-3 tests that correlate very well with the actual exam
Summary of material and time for preparation for USMLE
Step1: Books+ Qbank+ NBME test+ USMLE website testsà >6-8 months
Step 2 CK: Books (Kaplan Lecture Notes)+ Qbank+ NBME test+ USMLE website testsà 4-6 months
Step2 CS: 1 book (First Aid for Step 2 CS) + live practice ± USMLE world physical exam videosà 1 month
Application process
Period for application submission (on-line): September of each year
Application material:
- Preferred hospitals.
- Preferred specialty of the candidate.
- Curriculum Vitae.
- USMLE score results.
- Letters of Recommendation.
- Personal statement (brief text describing the candidate’s motivation of pursuing a residency in the US).
Application material:
- Preferred hospitals.
- Preferred specialty of the candidate.
- Curriculum Vitae.
- USMLE score results.
- Letters of Recommendation.
- Personal statement (brief text describing the candidate’s motivation of pursuing a residency in the US).
Interview & Selection process
Period of interviews: Mid-October to late-January.
Selection: In late January, after the candidates have completed the process of interviewing, they submit online a rank list with the hospitals where they had an interview in an order of preference. At the same time, the Program Directors of the hospital residency programs submit their own rank list of preference of the candidates that they interviewed. The data get processed by a software which finally indicates which hospital and specialty each candidate “matched” to, the so called “Match”. The Match results are disclosed by the end of March.
Selection: In late January, after the candidates have completed the process of interviewing, they submit online a rank list with the hospitals where they had an interview in an order of preference. At the same time, the Program Directors of the hospital residency programs submit their own rank list of preference of the candidates that they interviewed. The data get processed by a software which finally indicates which hospital and specialty each candidate “matched” to, the so called “Match”. The Match results are disclosed by the end of March.