How to Do Postgraduate Medical Education in the USA

This article will explain the steps a medical student has to go through to get into residency in USA. This will explain things from an international student point of view, ie people who studied elsewhere and want to pursue higher education in USA.

1. Decide early. Medical school is a vast and fascinating world. During the initial years many students may not have the idea on whether,where and in which branch to do a post graduation. But try to develop your goals as early as possible. Best time will be by the first year and the eleventh hour would be by the internship /house-surgency period.

2.Contact your seniors. Try to find out who all among your seniors have gone for the same, try to contact them. Find out if the option is feasible for you, taking your personal side into consideration. This would include finance,family relations etc.

3.Understand the qualifying process. This is the most difficult part for international students. This article is mainly for these details which are not properly explained elsewhere. The qualifying exams are called USMLEs – United States Medical Licensing Examinations. There are four exams in total – Step 1, step2 ck, step 2 cs and step 3. The first two can be written in all countries but the last two can only be written in US.

4. For writing the exams, you have to register with the ECFMG – Examination Commission for Foreign Medical Graduates. this organization helps with the initial application and details. The various pdf links in their beautiful site gives all necessary information regarding the paper works to be done. This is one site to depend upon for all your doubts on the entire process.

Step 1 – this exam is centered around the subjects learned during the first three years of medical school. ie anatomy, physiology, biochemistry, microbiology, pharmacology and pathology. In addition, there are three more subjects to the list – epidemiology, psychiatry and ethics. The best time to write the exam would be after your third year.

USCE – Us clinical experience – This is perhaps the most important criteria for getting a seat in residency. For international students, the clinical practices in Us will be a little bit different from what has already been seen. Hence for you to be seriously considered for residency, it is always important that you have had some sort of clinical experience in US. This includes electives, externship, observership, research or volunteering. The benefit of each is in the same order with electives being your best option. Elective – doing part of your internship in US. This is possible and a lot of international students do apply and do electives in US medical schools every year. Externship – this is for people who have already graduated from medical school. you can follow a doctor working in US and can involve yourself in clinics. Observership – you can follow and observe a doctor in US but you cannot deal directly with the patients. In addition, you can be part of any research experience or be a volunteer at any free clinics. The longer you have any USCE, the better your chances are. The duration is more important than the type of USCE.

step 2 ck – ck stands for clinical knowledge. this exam is based on topics learnt in the final year – medicine,surgery, obg, pediatrics,epidemiology and ethics.

step 2 cs – cs stands for clinical skills. this exam tests your practical skills, communication and bedside manners. This exam is currently given only in US. Hence many of you will have to apply for a visiting visa to go to US for the exam.

ECFMG certification – Once the above exams are passed, you will be certified by the ECFMG and a very impressive certificate will be awarded to you for the same. By this, you are eligible for applying for residency.

ERAS – After the previous steps are over, this site should be used to study about the various residency programs in US. Study each program website and create a list of programs where you want to apply. This is also the software through which you will apply for residency.

  1. Match – The process of applying to programs, being called for interviews and finally the match between your list of desired programs and the programs list of candidates. The details of this complicated process can be obtained from the site of  NRMP.
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    Residency – Post graduation in US. The duration depends on your branch of specialization.You can write Step 3 either during residency or before that during the match season. completing step3 before match will make you eligible for work visa as against student visa.

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    SOAP – In case you don’t match, there is another procedure called SOAP. the unfilled colleges and unmatched candidates try to contact each other. Every year many students get placed through match and also through SOAP.

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    Fellowship – After residency, you can go for fellowship or you can practice what you have learnt. There are many who go for fellowships and many others who join as hospitalist.