Jump to content
Premed 101 Forums

Can Someone Explain To Me The Difficulties Of Usmle?


Recommended Posts

There has never a topic that elicit such different opinions than this one for me. Now that I am going to study in US soon. I am beginning to think about the process more carefully. When I was asking around, people gave me very different opinions on USMLE.

 

On the one hand, many people I know at McGill did USMLE as if it is an afterthought and seems to pass with good grade within two weeks of their MCCEE. The same can also be about a lot of people I met when I visited US med school campuses.

 

On the other hand, I read so many comments from people on SDN about how terrible their grades are or how they just failed the exam. Some of them were even AMG themselves. This is what scares me very much.

 

Now, I am hoping whether it is possible any one here can explain to me just how terrible or normal the exam is. What is it like really?

Link to comment
Share on other sites

The USMLE has many parts. Step 2 CK is similar to MCCQE/LMCC so a lot of people do it at the same time and it's not that hard. However, Step 1 is brutal; all about basic science and memorization (bacteria, drugs, you name it). It's a super long and meituclous exam that many, many people fail. Don't write it unless you intend to SERIOUSLY study.

Link to comment
Share on other sites

SDN is your friend. Everything you need to know about the Step exams are there.

Step 1 is a beast.  


Many Canadians that take it, do it for fellowship purposes - and for that all you need is a pass, which still isn't something you can just walk into unless you were the top of your class. 

But to actually apply to US residencies, you need good scores. And that takes weeks of dedicated prep time. 

Link to comment
Share on other sites

There basics to USMLE prep comprise a study method called UFAP, which basically constitutes a question bank (UWorld), a review book called First Aid (like a Toronto Notes, but more for basic clinical sciences), and a pathology review book/video combo called Pathoma.
 

The majority of people use these resources in preparation for the USMLE Step 1.

I don't know much about Step 2CS or CK or Step 3; I haven't gotten there yet.

 

Link to comment
Share on other sites

The exam is not that bad, i think people make a big deal about it because they have nothing else to talk about as med education consumes their life

 

i think the hype/ pressure adds up because of the large IMG pool, who all need a 250 to open even the lowest of doors for residency training.

 

Uworld is really good,i recommend that for anyone.the qs have great explanation and refs too!! great learning tool

Link to comment
Share on other sites

The exam is not that bad, i think people make a big deal about it because they have nothing else to talk about as med education consumes their life

 

i think the hype/ pressure adds up because of the large IMG pool, who all need a 250 to open even the lowest of doors for residency training.

 

Uworld is really good,i recommend that for anyone.the qs have great explanation and refs too!! great learning tool

Misinformed. The average score for IMGs was something like 230 according to NRMP data. It was a little lower for US-IMGs

Link to comment
Share on other sites

Misinformed. The average score for IMGs was something like 230 according to NRMP data. It was a little lower for US-IMGs

Lol, your calling out someone who actually went to a US med school.

 

The average is just that an average.

 

People with 210s and 220s are matching rural FM or at community IMG mills as IMGs.

Link to comment
Share on other sites

That's still a far cry from "all of them needing a 250". If they all needed a 250, the average of successful IMGs would be just that.

I understand that you were being hyperbolic but people might not understand.

And hey, some might not be that upset with a community residency or rural FM. Still a pathway to a job right?

Link to comment
Share on other sites

I wonder if the people you talked to at McGill did the Step 2 CK and got good grades in their 4th year, which is not that surprising. I'd be very surprised if they all did Step 1 and got good grades. Step 2 CS and CK is not hard to pass once you've done clerkship and NBMEs to simulate the style of question.

 

Step 1 is not hard to pass, but very difficult to do well, I am sure SDN has extensive discussion on why that's the case (and remember you only get ONE chance to ace it!)

 

The question is whether you just need a pass (eg. Canadian grads who want HB1 for fellowship/jobs), or you must ACE it to get into a competitive residency (ie. NRMP without CaRMS)

Link to comment
Share on other sites

 

I wonder if the people you talked to at McGill did the Step 2 CK and got good grades in their 4th year, which is not that surprising. I'd be very surprised if they all did Step 1 and got good grades. Step 2 CS and CK is not hard to pass once you've done clerkship and NBMEs to simulate the style of question.

 

Step 1 is not hard to pass, but very difficult to do well, I am sure SDN has extensive discussion on why that's the case (and remember you only get ONE chance to ace it!)

 

The question is whether you just need a pass (eg. Canadian grads who want HB1 for fellowship/jobs), or you must ACE it to get into a competitive residency (ie. NRMP without CaRMS)

 

Why is it that you only get one chance to ace it? Is it looked unfavorably upon if you did it twice?

Link to comment
Share on other sites

Why is it that you only get one chance to ace it? Is it looked unfavorably upon if you did it twice?

You cannot retake it if you pass.

 

Hence why some people sometimes say..its better to have failed it, then marginally passed (assuming something horrible happened like a off day due to personal issues etc).  At least with a fail on step 1, you can come back and recover by prepping properly the 2nd time, or removing the personal life factor and do well again. It will still be a black mark, but probably much better than a marginal pass.

Link to comment
Share on other sites

Misinformed. The average score for IMGs was something like 230 according to NRMP data. It was a little lower for US-IMGs

The average score has been between 228-32 now, these are NRMP stats, the average includes ALL test takers.

There has been NO usmle data points for IMGs only. There is USMLE scores ranges for those that matched, that have IMGs and AMG seperated (http://www.ecfmg.org/resources/NRMP-ECFMG-Charting-Outcomes-in-the-Match-International-Medical-Graduates-2014.pdf).

 

THIIS IS ALSO 2014 and theres a 2 pt yearly increase

Data pg 11: http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

 

if you understood what i was saying trying to say was this:an average canadian IMG with 230 is going to have majority of programs incl rural community FM closed on their face, let alone any decent uni programs, and assume they dont match into a prelim spot--- which makes IMGs desperate to have 240-250 range score to have a comfortable number of spots for interviews and a successful match. This is for primary care alone -- I have seen IMG cutoff scores for FM/IM programs at 230, while there is no cutoff for AMG (if youd like more information,FRIEDA is your sources, incl programs websites). A 250 cutoff is NOTHING out of the ordinary for a mid/top Uni IM program for an AMG. 

 

An IMG needs above the average to have a comfortable chance at a match. 

 

which bring me to what i was trying to say to say, the usmle is of utmost importance to IMGs.Many Canadian opt to go to IMG route,most talk about the magnitude for a have successful score and the stress of it. As I said before the test is not that difficult and gets blown out of proportion for this reason.

Link to comment
Share on other sites

I agree, I would be sweating if I got a 230 on Step 1. I couldn't imagine the stress of the last 2 years of med school with a 230 as an IMG, worrying about matching.

 

But I stand behind my point that saying 250 all-or-nothing is a bit a hyperbolic. Majority, sure. I realize I'm being pedantic/literal, I'm just trying to avoid alarmism.
 

Link to comment
Share on other sites

Just a FYI that Canadians are not considered IMGs in the US Match. However, the limited data available (CaRMS matches before NRMP, therefore many Canadians never go into NRMP) suggests a lower percentage of match (~70%).

Canadian Medical school grads would generally require a visa(unless dual), so in that sense they have a similar limitation as IMGs/FMGs. 

 

From a "prestige" perspective, probably much more preferred than IMGs/FMGs all things equal, but still "less" than a AMG who doesn't need a visa.

Link to comment
Share on other sites

Canadian Medical school grads would generally require a visa(unless dual), so in that sense they have a similar limitation as IMGs/FMGs.

 

From a "prestige" perspective, probably much more preferred than IMGs/FMGs all things equal, but still "less" than a AMG who doesn't need a visa.

I disagree. They still do better than IMGs in the match.

Link to comment
Share on other sites

I disagree. They still do better than IMGs in the match.

To be fair its hard to definitively say, since the numbers are so much smaller. But yes, on the surface they should do much better and have more options than IMGS in the US match. But the one consistent part that stays the same is needing a Visa. Generally though, there are some places that will provide a visa for a AMG and not a IMG, so perhaps it would be the same for a CMG v.s. IMG.

 

Edit: My original statement didn't disagree with your reply FYI. I said they do have similiar limitations, but would generally be more preferred than IMGs/FMGs all things equal

Link to comment
Share on other sites

To be fair its hard to definitively say, since the numbers are so much smaller. But yes, on the surface they should do much better and have more options than IMGS in the US match. But the one consistent part that stays the same is needing a Visa. Generally though, there are some places that will provide a visa for a AMG and not a IMG, so perhaps it would be the same for a CMG v.s. IMG.

 

Edit: My original statement didn't disagree with your reply FYI. I said they do have similiar limitations, but would generally be more preferred than IMGs/FMGs all things equal

And there are places that would provide H1Bs to Canadians and not IMGs. I believe Stanford is one of them

Link to comment
Share on other sites

And there are places that would provide H1Bs to Canadians and not IMGs. I believe Stanford is one of them

Yep exactly, so a CMG is probably better off than an IMG, but still not as favourable as an AMG or someone who simply just doesn't need a visa at all

 

But the problem is, Canadian med grads generally aren't going to get a H1B visa anyways - as you would generally have to sit out a year, since you MUST have Step 3 in order to get an H1B. And you generally can only write STEP 3 after you graduate (there are some workarounds too this, but timing is still extremely tight). Generally most non-AMGs who want H1B, have to sit out a year. AMGs (So any internationals like Canadians who attend USMD or USDO programs) can get a special OPTI visa for PGY1 while they prep the materials necessary for H1B.

Link to comment
Share on other sites

I went to an USMD school (in a border state) and I can assure you the ONLY schools Americans (even in the medical field) have heard of are McGill and maybe U of T. Even then, they have no idea how hard it is to get into a Canadian school. I haven't found a single person in medical administration who have ever heard of Mac, Western, Queens, etc... I was recently asked by an attending why I am coming back to Canada for residency when all of Canadian medical graduates come to the US for a FM residency. Perplexed, I later realized he thiught the Canadian grads who went to Caribbean med schools were Canadian medical grads XD. Another attending thought queens and Mac were schools in the Caribbean lol. The biggest issue is that American schools emphasize reputation and they don't realize Canadian schools are fairly consistent in quality and competitiveness. Thus, a U of T or McGill grad (They all think McGill is the Harvard of Canada btw) will be viewed much more fondly than other schools.

Huh thats weird, i guess everyone has different experiences.

 

At my US med interviews, whenever we started the interview days going around asking where everyone was from - they always remarked about McMaster and Calgary "models" of education and the MMI process, when it came to one of us Canadian interviewees intro'ing ourselves.

 

 

Link to comment
Share on other sites

I agree with you certain schools are very well known niche communities for their strengths in that field. You mentioned Mac and MMIs, and I would say Foothills hospital in Calgary is equally famous in the neuro interventional radiology for their research in stroke as well as UBC in the retina community. But, I haven't met too many people outside of those niche fields who knew about the non Toronto/McGill schools the same way we know the stanfords and yales and harvards.

 

With that said Canadian med students are some of the brightest in the world and will have impressive CVs to show for. I just wanted to temper some of their expectations because the way Canadian schools are viewed in the states may not be as glowing as they might expect if they didn't come from U of T or McGill.

Agreed - but from what most people say, that isn't as important as say strong STEP scores and LORs anyways. It's a moot point if you went to UofT or wherever, but have very poor STEP scores and LORS etc.

 

Its something you can't really change anyways(the school you attend) once already begun, so its not worth spending too much time thinking much of it.

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...