USMLE Preparation Tips

USMLE is a series of 3 exams step-1 step-2 and step-3 which lead you to us medical licensure. step-1 and 2 can be taken in India and Pakistan or most countries in the world through sylvan technology centers. it is a computer test.

CSA (clinical skills) test is required by foreign med grads (FMG) to get their ECFMG certificate. it is only conducted in Philadelphia, USA.

If an FMG passes step-1 and step-2, English (TOEFL) and CSA, he is eligible for applying to a residency program in USA. which is believe me is really hard to get unless you have superb scores on the steps.

Step-3 can be taken only in USA. it is usually taken during the first year of residency but some states including New York, New jersey, Louisiana, Tennessee and some other allow foreign med grads to take this exam without residency. When you pass step-3 you are eligible to apply for licensure in USA but 99% of states ask you to finish the residency requirement before applying for licensure.

General things for USA system and residency:

1. My personal experience says that you should do house job (INTERNSHIP) preferably at;
   • Agha Khan Hospital, Karachi, Pakistan.
   • Civil Hospital, Karachi, Pakistan.
   • Jinnah Hospital, Karachi, Pakistan
   • King Edward Medical College - Hospital, Lahore, Pakistan
   • AIMS, Delhi, India
   Or some very recognized hospital in your country wherever you belong to. If you are already in US, then try to get some experience in research (preferably Clinical) because research experience puts a very good impression on your resume. Try to get your name on some publications (Research paper).
   
   
2. Most of the times it is observed that the opening question of the residency interview is "What have you been doing since your graduation". So you have to tell them that after your graduation you have been involved somehow with your profession (medicine). If you are an old graduate (more than 5-7 years), then you have to be prepared well for these kind of questions and believe me unless you answer this question satisfactorily, your chances of getting an offer for residency are less.
   
   
3. Before coming to USA learn computers, at least the word processor soft-wares and the Internet related stuff.

For more details about Residency Personal Statement, we have collected a number of useful links.

• Personal Statements Residency Guide
• Beyond Med School: Residency Personal Statements
• WSU Department of Pathology Residency Program FAQ
• Information for International Medical Graduates
• Interview, Personal Statement and CV tips

General Strategies

1. The REVIEW COURSES, it is important especially when you do not have a group of friends preparing for the course or don't know how, what and where to start. If you are a very old graduate (5-7 yrs.) then I would strongly recommend these review courses.
   Interface offers preparation classes click for more details.
   
   
2. Try to stick to one book for each subject. Do not try to jump on different books and waste time. Do not try to change books and be the master of one subject. This exam is not the exam of your knowledge but it is just to check how you apply your knowledge. If this is your 2nd or 3rd attempt, then plz. Read the same books, which you read previously unless they are 3-4 yrs older editions.
   
   
3. Do as many MCQs (multiple choice questions) as you can, try to time yourself because timing is everything (45-55 seconds/MCQ).
   
   
4. READ THE LAST LINE OF MCQ FIRST SO THAT YOU KNOW WHAT IS BEING ASKED. The 10 line question is sometimes waste of time, so read the last line first to have an idea whether it is about diagnosis, management or some other thing.
   
   
5. No one can know everything that is asked on this exam. Be honest with yourself about what you do and do not know. Knowing that you do not know something gives you more of a sense of control on the exam and makes you less likely to panic when you encounter the material and/or waste time on questions you are not likely to get correct. When you come to a question that you know that you do not know, simply mark your favorite answer choice and move on!

Study Planning
Best time to take the step-2 exam is during the House-job (internship) because the clinical knowledge is at the peak. After completing the internship, study for 3-4 months for step-1 exam and for CSA, I would recommend at least 2-3 months of Observership/ Extern-ship at a teaching hospital in USA.

1. 3-4 months is sufficient time for either step 1 or 2. Before starting try to get all the materials (books and helpful notes), so that you should not waste time after that.
2. Make sure that the difficult subjects and topics should be revised at least twice, once in the beginning of prep. and then later near the exam.
3. After starting your studies and picking up the pace (after 1 week), try to do 60 MCQs/day with timing. Do the MCQs in the morning when you are fresh and do them actively not passively. Read the explanation of only those MCQs, which are doubtful or you have correct them by chance. The best way to do an MCQ is to read the question and then try to mark an answer for that, only after you have marked the answer look for the correct answer from the answer list and explanation.
4. Increase the no. of MCQs to finally 180/day in one sitting, 3 hrs just like original exam. By going this way, you will make a habit and would find it easy on the day of exam.
5. Throughout your preparation days, do not over study or over burden, just keep up your pace and go according to the schedule (7-9 hrs./day at least).
6. As you are approaching near the exam day, cut down your hours of study in last 10 days and make sure that "YOU SHOULD NOT READ A SINGLE WORD ON THE DAY BEFORE THE EXAM". In the last ten days make a habit to see the histo/patho diagrams, ct-scans and x-rays (2 hrs./day).
7. In the last 10 days, you should only concentrate on MCQs, I would say no theory at all.

During the Exam

1. Never give up during the exam until the last question. Do every question with full attention and concentration and never think that you are going to fail. Always go to the exam with an open mind and positive attitude that you will pass it.
   
   
2. During the exam, if you think that you are doing every 3-4 question correct for sure then it is pretty normal. Nobody knows all the questions for sure, it is always a game of chance and intelligent guessing. If you do not know an answer just mark an answer and keep going. Do not stuck at any stage. Normal probability is that you will correct every 3-4 question for sure. Think Positive.
   
   
3. During lunch time, do not eat too much, other wise you will feel dizzy and sleepy in the next session. Just take some light food and coffee. If you feel sleepy, just go out to bathroom and wash your face with cold water and come back fresh again.
   
   
4. Best thing to do during lunch time is to look at the pathology, dermatology and radiology pictures because they are mostly asked in the afternoon session. Do not get disappointed if your friends have corrected some questions and you have marked them wrong. It's normal.

By Dr. Junaid
Please email at interface.education @gmal.com your comments about these tips.