Jump to content
Premed 101 Forums
shikimate

Please Consider Taking The Usmle.

Recommended Posts

100% agree - and to the naive incoming meds/MS1s saying 'its not necessary': you have NO idea what awaits you. You could fall in love with something in clerkship that has a horrible job market. Or you could fall in love with something with a great job market...but by the time you finish 5+ years of training, that changes. Leaving many doors open is ideal! 

Share this post


Link to post
Share on other sites

Surgical specialty PGY-4 here. I did not consider taking the USMLEs during med school, but it was a mistake.

I intend to do a fellowship in the states after a first fellowship in canada and I therefore decided to take them during my residency. Taking step 1 during my third year of residency was hell. I passed and actually got a good mark, but all the time spent towards USMLE could have been spent to do more useful things like sleeping or other activities of daily living.

Edited by Med0123

Share this post


Link to post
Share on other sites

Not sure I understand the relevance of this. EM is competitive in Canada, yes, but why does that matter? For those interested in EM, there's a natural back-up to remaining in Canada through the FM+1, which, while being competitive, is far more reliable than going to the US and trying to get a difficult 4-year position plus an extra year of training required for Royal College certification back here in Canada. Heck, even if you don't get the +1, you can still work a fair bit of EM if you're willing to go rural. Going the US route, especially on a J1, can easily lead to the difficult situation of being unable to work in the US (due to the J1 requirement to leave the country) but not be able to work in Canada because of insufficient training time, even if you get a 4-year program. 

 

Sure, for those wanting to work in the US, it could make sense to do residency there, but that's a bit of a moot point - of course those individuals should write their USMLEs. For those intending to practice in Canada, US residencies are really not a great option for EM period and there are far better alternatives here in Canada for those that don't match to a Royal College EM program.

 

This is definitely something people looking to do EM in the US shouldn't bank on but I'm curious if the number of years required for Royal College certification will change with the move to competency based models for residency?  Probably something nobody will really know for some time but it'll be interesting to see in the future..

Share this post


Link to post
Share on other sites

This is definitely something people looking to do EM in the US shouldn't bank on but I'm curious if the number of years required for Royal College certification will change with the move to competency based models for residency?  Probably something nobody will really know for some time but it'll be interesting to see in the future..

At the moment Health Canada, due to the Royal college, will NOT sponsor a J1 for a 3 year EM training program. It used to be the case, and you'd top it up with 2 years of fellowship or a chief year etc. But recent changes, mean the Royal college will only accept a US 4 year ACGME EM program, and then essentially any +1 year to top up the training requirement.

 

The issue that arises out of this, is the majority of US EM programs are currently 3 year programs and not 4 year programs. The 4 year programs that remain are generally very competitive, and less likely to offer visas etc etc.  However, there has been word that the US EM training is going to shift from 3 year programs to 4 year programs to be more common - so maybe in 5 years time things will be different.

 

At the moment if you're gunning for EM, you have to go for a 5 year program in Canada, FM with a +1 EM fellowship, or just FM and work rural to gain hours and challenge the +1 EM exam, or just do FM and makeshift EM in rural/in need communities.  

 

If you wanted EM in the US, you'd have to do a 4 year program on J1 or H1b, Or 3 year program on H1B only, as Health Canada will not provide the prerequisite SON for the J1 for 3 year programs.

Share this post


Link to post
Share on other sites

This is definitely something people looking to do EM in the US shouldn't bank on but I'm curious if the number of years required for Royal College certification will change with the move to competency based models for residency?  Probably something nobody will really know for some time but it'll be interesting to see in the future..

 

Don't imagine there would be any major changes in that regard. Competency-based residency programs theoretically lower training times, but the more information comes out about them, the more it looks like that'll be unlikely for most residents/programs. Expected completion times shouldn't really change, at least not in the short term.

Share this post


Link to post
Share on other sites

Slightly off topic but I figured I'd ask,

 

Say one graduates from a Canadian Medical school and then goes on to do their residency in the States.  What would they then have to do to come back and practice in Canada? Would they be privileged in any regard due to completing med school in Canada? 

 

Thanks!

Share this post


Link to post
Share on other sites

Slightly off topic but I figured I'd ask,

 

Say one graduates from a Canadian Medical school and then goes on to do residency in the States.  What steps would they have to take to practise in Canada? Would they be privileged in any regard due to completing med school in Canada? 

 

Thanks!

Not that i know of. Once you get into a residency, its fairly irrelevant what medical school you went to from a practice standpoint. The only thing I can think of is perhaps the minimum number of PGY years requirements for getting a general license in the U.S is more for IMGs than USMGs/CMGs.  But this wouldn't apply to you, since you would obviously finish residency etc.

 

Being a CMG wouldn't really help you with anything versus if you were an IMG being admitted into a US residency. 

 

As for the steps, thats something you can look up when needed and not really fruitful to go through all the steps 1 by 1 given the amount of variables etc at play.

 

 

Share this post


Link to post
Share on other sites

My own thoughts but I honestly don't believe in a blanket "everyone should write the USMLE steps".

 

The cost to write each step is (in USD) step 1:605, step 2 CK: 605, step 2 CS 1280 and step 3: 830 for a total of 3,320 USD in test fees alone. This doesn't include the cost too travel to the tests (step 2 CS can only be written in 5 US cities).

 

While it is a pain in the ass to restudy everything, I would hardly say it is advisable to recommend students to spend 4-5 thousand (Canadian) to have these tests done "just in case"

Share this post


Link to post
Share on other sites

My own thoughts but I honestly don't believe in a blanket "everyone should write the USMLE steps".

 

The cost to write each step is (in USD) step 1:605, step 2 CK: 605, step 2 CS 1280 and step 3: 830 for a total of 3,320 USD in test fees alone. This doesn't include the cost too travel to the tests (step 2 CS can only be written in 5 US cities).

 

While it is a pain in the ass to restudy everything, I would hardly say it is advisable to recommend students to spend 4-5 thousand (Canadian) to have these tests done "just in case"

A year of underemployment as a orthopedics surgeon or some other surgical specialist, is arguably significantly more costly. Cost really shouldn't be a factor at the exam level. Its drops in the bucket to your overall opportunity costs.

 

If you know you want to go for something that has a poor job market, its not a bad idea to be open to taking the USMLEs.

 

If you're set on primary care, you don't need to bother.

 

Or if you at some point want to practice in the US etc.

 

I agree though a blanket statement to take it "just in case" is not advisable. You have to think if it makes sense for your individual situation etc.

Share this post


Link to post
Share on other sites

Pragmatically writing the USMLE is just part of opening more doors for yourself. There are other countries, like Australia, NZ, UK etc that has plenty to offer too.

 

I am of the belief that in this increasingly competitive and mobile global economy, to succeed professionally and financially mobility is a huge asset, in addition to expertise (which by virtue of a Canadian MD you already possess), and an open minded attitude.

 

I appreciate many people are not career or money focused or share the above philosophy, or prefer settlement, family, certain political philosophy etc etc; that's all fine, it's a matter of priorities.

 

You lose some and gain some in every case. You just have to find a pathway that you're confident about, and hopefully it will not leave you with many regrets.

Share this post


Link to post
Share on other sites

Speaking of markets and mobility, anyone know where to find employment stats by specialty? I see a lot data on revenues but I'm looking more hollistic survey like on regional needs and demand, full-time part-time ratio, gender and demographic portrait, trends, etc

Share this post


Link to post
Share on other sites

Speaking of markets and mobility, anyone know where to find employment stats by specialty? I see a lot data on revenues but I'm looking more hollistic survey like on regional needs and demand, full-time part-time ratio, gender and demographic portrait, trends, etc

 

This is specifically for Québec:

 

https://issuu.com/remul4/docs/guide-des-re__sidences_fmeq_15-16/5?e=0/30016461

https://issuu.com/remul4/docs/residency_guide_15-16 

 

Under new health regulations, part time work is discouraged in Quebec (at least for GPs).

Share this post


Link to post
Share on other sites

This is specifically for Québec:

 

https://issuu.com/remul4/docs/guide-des-re__sidences_fmeq_15-16/5?e=0/30016461

https://issuu.com/remul4/docs/residency_guide_15-16 

 

Under new health regulations, part time work is discouraged in Quebec (at least for GPs).

Very interesting. So basically plastic surgeon are some of the very few surgical specialists that are not out of work. I kind of understand this post now lol

Share this post


Link to post
Share on other sites

Maybe Im still too junior but it seems to me like some of the USMLE Step I questions/concepts are fairly low yield/unpractical for clinical practice... I have never been a huge fan of basic science minutiae, and in combination with the fact that I'm considering EM/FM (and would be perfectly content with FM even without +1 EM) would it even be necessary?

 

I personally hate spending a whole lot of money (and effort) studying for something if its going to be stuff that I'll more or less forget after 1 core clerkship rotation. For people who already took Step I, did studying for it (and writing the exam) honestly help with clerkship or clinical practice? If not, I'll much rather focus on preparing for clerkship/clinical electives stuff than waste brainpower on basic science minutiae

Share this post


Link to post
Share on other sites

Maybe Im still too junior but it seems to me like some of the USMLE Step I questions/concepts are fairly low yield/unpractical for clinical practice... I have never been a huge fan of basic science minutiae, and in combination with the fact that I'm considering EM/FM (and would be perfectly content with FM even without +1 EM) would it even be necessary?

 

I personally hate spending a whole lot of money (and effort) studying for something if its going to be stuff that I'll more or less forget after 1 core clerkship rotation. For people who already took Step I, did studying for it (and writing the exam) honestly help with clerkship or clinical practice? If not, I'll much rather focus on preparing for clerkship/clinical electives stuff than waste brainpower on basic science minutiae

It's not the highest yield stuff, but not completely irrelevant either.

 

I'll put it this way - I'm looking at a very similar career path to you and studied for the USMLE. Registered but didn't end up writing as other commitments overwhelmed my time and I wasn't feeling confident enough I had studied enough going into the test. I'm reasonably happy both that I took the time to study - at least in part - for Step 1 and that I didn't write it. It's far from being an optimal way to prepare for clerkship, but it provides structure and motivation to study and there are certainly worse options to prepare yourself for clerkship if you've got the time.

 

That said, I had free time in the summer. If you're in a 3 year program with no summers, I'd put the emphasis on your clinical rotations. They'll definitely be more useful than Step 1 studying.

Share this post


Link to post
Share on other sites

This is an interesting post. It seems to me that there are going to be a lot of medical students and doctors in UK who are looking to practice in US. I have heard alot of good things about practicing medicine in US e.g. vast research opportunities, great culture, great cities, good money, etc.

 

If there are any US medical students or doctors here, could you provide advice on what makes US such an attractive place to do medicine?

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...