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A fellow in my program went to Texas for fellowship and she did NOT do USMLE. According to her the program (and Medical Board of Texas) recognized LMCC 1+2 as equivalent.

 

However I should note she was on a J1 visa, and if your goal is H1B, you would need to pass all 3 steps of USMLE.

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Note that actually getting a license to practice after fellowship in the US would also be different. So yes there are some States or programs that won't require usmles for JUST fellowship...what happens if you fall in love with the area or hospital or are offered an amazing opportunity? Then you'd need the exams etc potentially and it would be less then pleasant to have to take them so far removed

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Good point Commons. I've looked through licensing requirements for a few different state medical boards, and while some explicitly states they accept LMCC1+2, many others vaguely talks about "case by case" scenario, some don't mention it at all. Having all 3 steps under your belt would definitely make the licensing process (which is already tedious) easier.

 

Also I should mention some boards like American Board of Pathology specifically require you to have an UNRESTRICTED (not educational, fellowship etc) license in either Canada or USA before being certified. To make the certification process easier one could apply for a cheap state license (eg. 35$ for PA) after completing 3 steps, so your certification in USA wouldn't be dependent on the status of your Canadian license. 

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  • 4 months later...

So I did more research on this and I thought I would share what I found in case anyone was also looking into writing it. 

 

Basically to summarize what I know

1) For residency, step 1 scores are very important. Nothing surprising here. Probably moreso important for a Canadian because we have no grades in med school whereas they do down south. 

2) For fellowship applications, some programs require it and don't accept LMCC 1 and 2 as equivalent. The notion that all you need to do is pass the step 1 is not necessarily true. While many fellowship program directors put a lower emphasis on step 1 scores compared to residency PDs, I got the sense that your scores were still somewhat relevant. Some programs discard any application where an applicant failed any of the steps and had to re-write. Basically what I'm saying is if you're serious about residency in the states, you should work to ace the test. For fellowships, you should not aim for just a bare pass. 

 

Feel free to PM me for tips on writing the exam if you're interested. I'm happy to share after having written it this month. 

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Also I should mention some boards like American Board of Pathology specifically require you to have an UNRESTRICTED (not educational, fellowship etc) license in either Canada or USA before being certified. To make the certification process easier one could apply for a cheap state license (eg. 35$ for PA) after completing 3 steps, so your certification in USA wouldn't be dependent on the status of your Canadian license. 

 

In case any Path people are reading this... I think PA will accept LMCC 1&2 in lieu of the USMLEs, so the USMLEs are not required to obtain an unrestricted PA license for the purpose of writing the ABP (or any other board exam that requires an unrestricted license).

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Some programs discard any application where an applicant failed any of the steps and had to re-write. Basically what I'm saying is if you're serious about residency in the states, you should work to ace the test. For fellowships, you should not aim for just a bare pass. 

 

A counterpoint: I know of someone who failed a step, and still matched to a competitive fellowship in the US.  So, if you happen to have failed a step, please don't let this hold you back from applying to fellowships...

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However I should note she was on a J1 visa, and if your goal is H1B, you would need to pass all 3 steps of USMLE.

 

Worth pointing out that Trump has said he wanted to cancel the J1 visa program.  While it is safe for the current year, it may be cancelled in the future and then USMLEs would be required for a visa...

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Worth pointing out that Trump has said he wanted to cancel the J1 visa program.  While it is safe for the current year, it may be cancelled in the future and then USMLEs would be required for a visa...

 

I wonder if he will actually do that - I mean if I am understanding it correctly that will rather sharply impede a lot of the graduate level research going on in the US. 

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Worth pointing out that Trump has said he wanted to cancel the J1 visa program.  While it is safe for the current year, it may be cancelled in the future and then USMLEs would be required for a visa...

There is no way he will do that, nor will the medical profession allow it - they rely heavily on FMGs on J1s to run many hospitals.

 

He may however, cancel NON-educational related J1s, but even then, i dont see the tech industry bending over and allowing that either. 

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  • 2 weeks later...

There is no way he will do that, nor will the medical profession allow it - they rely heavily on FMGs on J1s to run many hospitals.

 

He may however, cancel NON-educational related J1s, but even then, i dont see the tech industry bending over and allowing that either. 

 

In fact, he's also said in the past he supports increasing J1s because he wants more skilled immigrants in the country. I don't think he would dare touch J1s when the numbers are so low and the tech industry is essentially reliant on them. 

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  • 2 months later...

Well this forum is like a blast from the past. Also I have >300PMs. 

 

I have a few weeks/months this summer. Worth biting the bullet and writing USMLE just to get it over with because I have free time? Or is it not at all worth it if I'm planning on FM in Canada for the forseeable future? What about if i may want to consider working in Germany or New Zealand someday?

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Well this forum is like a blast from the past. Also I have >300PMs. 

 

I have a few weeks/months this summer. Worth biting the bullet and writing USMLE just to get it over with because I have free time? Or is it not at all worth it if I'm planning on FM in Canada for the forseeable future? What about if i may want to consider working in Germany or New Zealand someday?

If you're going to do FM, there isn't much reason at all to do USMLEs. It is more so if you want to back-up with NRMP for competitive specialties. 

 

FM is also more likely to have easier cross-reciprocity, and such. There are few instances where someone would want to go from practicing FM in canada to the U.S, other than personal reasons.  FM in the states is much less desirable compared to the quality of life, renumeration and general set up we have going for us in Canada. 

 

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Well this forum is like a blast from the past. Also I have >300PMs. 

 

I have a few weeks/months this summer. Worth biting the bullet and writing USMLE just to get it over with because I have free time? Or is it not at all worth it if I'm planning on FM in Canada for the forseeable future? What about if i may want to consider working in Germany or New Zealand someday?

 

For FM, probably not worth it, since ABFM is 3 years, so even with a 2 year residency in Canada you cannot be certified as FM in USA.

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For FM, probably not worth it, since ABFM is 3 years, so even with a 2 year residency in Canada you cannot be certified as FM in USA.

This is correct. A canadian fm residency wont be useful in the usa because of the year discrepancy. im not sure if the +1 EM that everyone tends to do would remedy that. but why would you want to go to the us for fm? its apparently way worse in every respect.

 

i still think every student should take the usmles and attempt to get a competitive score higher than 250. its a more important test than the mcat. you never know if youll change your mind about your specialty or need to go to the usa in the future.

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A 250 is a very high score and you will need to dedicate a significant amount of time to study for it to achieve that score, especially since the Canadian system isn't geared towards the STEP. It's even hard for U.S. students to achieve that score (average was 230 this year). If you are looking for a residency in the U.S. then you should absolutely try and destroy STEP. If you are looking for options in the future after residency, just passing it is sufficient.

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  • 2 weeks later...

Can anyone confirm that to apply for fellowships in the U.S, all one needs is a PASS on the step 1 (assuming the fellowship requests the USMLE to begin with)? 

 

It is true, more so for advanced fellowships, I have heard that some IM subspecs may look at your score. The further out from med school you are the less likely they will care about those grades. 

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A 250 is a very high score and you will need to dedicate a significant amount of time to study for it to achieve that score, especially since the Canadian system isn't geared towards the STEP. It's even hard for U.S. students to achieve that score (average was 230 this year). If you are looking for a residency in the U.S. then you should absolutely try and destroy STEP. If you are looking for options in the future after residency, just passing it is sufficient.

 

250 is high but I wouldn't say "very high". Very high is more in the order of 260+. 

 

A 250 is quite doable if you study well. I wrote it in December and received a 240, but I wasn't fully prepared for the exam and I wasn't able to completely go through the Uworld questionbank. Furthermore, as you have very rightly said, the Canadian medical school system does NOT gear you to write this exam. In the US, they have dedicated study time to ace this test and much of their curriculum is geared towards doing well in it due to the pivotal role it plays in selecting residents. 

 

The test is quite basic science oriented. For example, they could present a clinical vignette describing a Group A streptococcus infection, but instead of asking you to identify the organism or selecting a treatment for it/any clinical question, they could ask you something like:

 

What unique protein marker is present in the cell wall of the organism causing the infection described above?

A. Protein A

B. M Protein

C. Hyalauranic acid

D. etc

etc

 

Or for the biochemistry section, they could describe Niemann-Pick disease and ask you what substrate is accumulated in this disorder and list obscure, lengthy molecules you can vaguely identify but probably never bothered committing to memory. In many ways, I am glad we don't have to go through this test in Canada as our education seems to be far more clinically oriented. 

 

For people who like clinical material more, the test can be quite difficult to get through. That said, I go to a 3Y medical school and had no time off to study for this, but was able to do decently well by utilizing the Uworld Qbank and First Aid. Even with that, there was quite a bit of material that I knew I hadn't studied. I ended up writing the test anyway because I really just wanted to pass and get the accreditation. Doing well is not that important unless you want to do your residency in the states, in which case you should write to ace.

 

Re: fellowships, which was my main concern, I found that they still look at the scores. The consensus I've learned from research, looking on different forums and asking around is that bad scores could hurt you but good scores won't help you. 

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That sounds like a decent score!  Nicely done.  Did you have a science background before starting med school?  Besides First Aid, did you look at anything else to fill in the basic-science details, like path?  

 

Hey, yes I did - I had a good background in anatomy and physiology from my undergraduate degree, as well as biostatistic/critical appraisal, which was helpful on the test. 

 

Beyond Firstaid, I just used the basic science textbooks that I had during preclerkship. 

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