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niceshrp

Why write the USMLE?

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I am currently a second year in a medical school in Canada, and many people are saying that they are going to write the USMLE for the fellowship purpose?

 

I was just wondering why people write USMLE, given that it takes a whole summer of preparation?

 

Is it a good idea to write the exam without aiming for a high score but to pass "just in case"?

 

Thanks in advance,

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If you want to do residency in the states, aim for a high score.

If you want to do a fellowship, I don't think the score matters as much, but try for a high score.

If you want to work in the states after finishing your training, just pass the thing. Little or no studying needed if this is your only goal. Know your 3 Ps (physio, pathology, pharm) and you'll easily pass it. No need to study all the cell bio, biochem, genetics and stuff.

 

Doing it to keep your work options open isn't a bad idea. I have done USMLE steps 1-3 so it's nice to know I have the choice to move if I ever saw a good opportunity.

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So there's two issues with working in the states.

 

#1 - Some states absolutely require USMLEs for licensure. No way to get around it so you will have to do it for these states.

 

#2 - Other states will accept your LMCC exams in place of the USMLEs. If you have US citizenship that's great, but if you don't, you will have to apply/be sponsored for a work visa. Unfortunately to get a work visa, my understanding is that the federal gov't requires you to have the USMLEs done, even if the state you're applying to work in doesn't require it.

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So there's two issues with working in the states.

 

#1 - Some states absolutely require USMLEs for licensure. No way to get around it so you will have to do it for these states.

 

#2 - Other states will accept your LMCC exams in place of the USMLEs. If you have US citizenship that's great, but if you don't, you will have to apply/be sponsored for a work visa. Unfortunately to get a work visa, my understanding is that the federal gov't requires you to have the USMLEs done, even if the state you're applying to work in doesn't require it.

 

That is my understanding as well. I personally know two people who have run into issues with case #2. One resident ended up declining a great fellowship, and another one took the fellowship, but agreed to go unpaid. (Often, the program will not warn the applicants of this issue because they deal with Canadians so infrequently).

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That is my understanding as well. I personally know two people who have run into issues with case #2. One resident ended up declining a great fellowship, and another one took the fellowship, but agreed to go unpaid. (Often, the program will not warn the applicants of this issue because they deal with Canadians so infrequently).

 

Thats an option? You can actually go unpaid in a fellowship????

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So there's two issues with working in the states.

 

#1 - Some states absolutely require USMLEs for licensure. No way to get around it so you will have to do it for these states.

 

#2 - Other states will accept your LMCC exams in place of the USMLEs. If you have US citizenship that's great, but if you don't, you will have to apply/be sponsored for a work visa. Unfortunately to get a work visa, my understanding is that the federal gov't requires you to have the USMLEs done, even if the state you're applying to work in doesn't require it.

 

Thanks for the explanation - I've been doing some research but since everything is state-specific it's hard to get general info. I'm lucky because my SO is a dual citizen and could sponsor me, so the citizenship part isn't a barrier. He's also in law, and most of the states he could practice in seem to accept LMCC exams (with the exception of Cali?). I haven't looked into it in detail since I think I'd rather stay in Canada, but I was more curious about what might happen down the road. :)

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Does anyone know of the exact procedures for doctors who completed their residency in Canada, but wish to do fellowship/find work in the US?

 

Do you always have to apply for work visa through your provincial govt? Also, how easy is it to such a visa?

 

It seems like there aren't enough jobs for everyone here, and I'm open to a move to the states if I can do the kind of medicine I want there.

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I emailed someone that did their training in Canada (finished FRCPC) and then went to the U.S. for a fellowship and work. This person is a practicing specialist in Canada right now, but has worked in the U.S. Here is their response:

 

If you do all your training in Canada and pass exams I.E. FRCPC board certified this training is usually recognized in the US and the USMLE are not required. I have a full medical license to practice in California without ever writing the USMLE.. that being said it is state dependent. If you want to do a residency in US (ie training before fellowship) USMLE would be required. Fellowships it probably depends on the state (not sure about this), but the two or three states I was considering (California, New York, Mass) did not require USMLE and I was accepted to do a fellowship with my FRCPC qualification.

 

As far as I know, Canadian training is highly recognized and the training is viewed as equivalent and you would be eligible to write the American board exams. There are always work visa issues which can get tricky especially if you do a fellowship in the USA on a J1 Visa in which you are supposed to return to Canada for a min of 2 years after the fellowship.... you can apply for exceptions but it becomes a little more tricky unless the hospital where you did the fellowship is willing to sponsor you etc etc.

 

P.S. This person did not have a green card

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I emailed someone that did their training in Canada (finished FRCPC) and then went to the U.S. for a fellowship and work. This person is a practicing specialist in Canada right now, but has worked in the U.S. Here is their response:

 

 

 

P.S. This person did not have a green card

 

Thanks ACHQ! Much appreciated. :)

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If you are at all considering staying in the US, don't go down for fellowship there on a J1 visa (ie the kind you can get without USMLEs). There is a two year period that you have to leave the US for after your J1 expires, before you can start working again stateside on a different visa (ie an H1B). I heard from a former residency colleague that their lawyer had found a way around this restriction (they did fellowship in the US and then got offered a job in the US), but then I heard through the grapevine that this person was still stuck in Canada waiting for visa issues to be ironed out, almost one year later.

 

This person did not have their USMLEs and did a fellowship in California, with a Cali Medical License, but tonnes of Cali fellowships require H1B visas (for which you need USMLEs) due to the fact they bill for their fellows' work. I was in the process of completing my USMLEs during my fellowship application process and 3 of the 4 Cali locations I applied to told me no way without my USMLEs done. Do research specific to what you are interested in, if you know what you want to do.

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The way I see it, get it done now and save yourself a bunch of annoyance if you ever do move. It's much easier to write and pass the thing during med school than 20 years down the line if you wish to move to the US or even have to. My dad did his boards in the UK and had to rewrite all the Canadian exams when we moved here. Let's just say studying for basic medical exams when you're 50+ and have been practicing solely within your speciality for 30+ years isn't quite as easy as you would remember from your 20's ;). So I'm writing that stuff and just getting it out of the way if it's ever needed....

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The way I see it, get it done now and save yourself a bunch of annoyance if you ever do move. It's much easier to write and pass the thing during med school than 20 years down the line if you wish to move to the US or even have to. My dad did his boards in the UK and had to rewrite all the Canadian exams when we moved here. Let's just say studying for basic medical exams when you're 50+ and have been practicing solely within your speciality for 30+ years isn't quite as easy as you would remember from your 20's ;). So I'm writing that stuff and just getting it out of the way if it's ever needed....

 

Don't your USMLE's expire within 7 years time though?

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Don't your USMLE's expire within 7 years time though?

 

Good point, I didn't know that. Apparently you need to take steps 1-3 *within* 7 years of each other to get a certificate of equivalence for the US. Once you have that though, it never expires. I've also heard that the US may start accepting the LMCC's? That would be ideal really

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I would say, just do the USMLEs!!

 

1. Knowledge is fresh in your head. You have no idea how hard it is to do residency, including call and many other commitments, while trying to study the Krebs cycle, microbi, detailed physiology, all over again... Stuff that is in no way relevant to your current rotations...

2. You never know where you'll be in 5-7+ yrs.

3. Your job may require it by that time -- many programs now do "require" fellowships, often in the US.

4. Timing would work out better.

 

To expand on #4

- Step 1 after 2nd yr

- Step 2 CK with LMCC near end of 4th yr

- Step 2 CS with LMCC 2 during PGY2

- Step 3 sometime ...

 

Thus if you plan to do these exams as above, they will fit right in with the studying you'll be doing anyways -- eg you'll need to review OBGYN, psych, peds, etc at the end of 4th yr med for the LMCC anyways ...

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Anyone have any experience working with NGOs overseas and if they would require USMLE? I'm thinking MSF, Red Cross, etc. For emergency aid work I could see it being less necessary, but I imagine development work and other longer-term positions would probably require it.

 

I know lots of local teams will go overseas on short month-long clinics, but I'm interested in development, possible (employment?) with NGOs, and interdisciplinary work with established organizations. I guess it couldn't hurt to do the exams...

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Hi guys. I had almost the exact same questions, so I'm glad it got answered.

 

1)I wanted to know how hard is it to study for the step 1? (I just have trouble accepting to study during my last summer before clerkship). I Basically just want to pass because I doubt I'll really go to work in the states but it's just to keep my options open for personal(boyfriend lives in the states) reasons.

 

2) is the USMLE good for life after you passed the 3 steps? Or if you don't actually use it, as in work in the states after an X amount of years it expires?

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