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Hey guys, I go to Mac and am considering a not so competitive surgical specialty. I could probably match relatively easily if I wanted to, but I am concerned about the potential ramifications after residency. I plan to write the USMLE, as it could be useful considering the surgical job market in Canada and may also be useful for future fellowship opportunities as well. However, because of Mac's curriculum structure, I am struggling to find opportunities to study for it. As such, I am considering taking an enrichment year (essentially making med school a four-year ordeal). In my extra year, I plan to do more research projects, while also studying for STEP 1. 

Has anyone here done this, or knows someone who has done this before? Is it feasible?

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Some of my classmates did an extra year during clerkship to do a research masters in their desired competitive field to increase their chances of matching. It needs to be discussed with the school and given permission, and it's totally ok to do. You could very much study for USMLE during that but you will not be given any time off for it and expected to maintain normal output on your research project, which you can imagine is fairly intensive to finish in one year.

Alternatively, if you do residency in Canada but still want to keep your options open to work in the US you can write the USMLEs then which would make you fellowship eligible, and the bonus is that it doesn't matter what your score is much at that point, as long as you pass (although I think step 1 will be pass/fail by then).

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  • 1 month later...
On 3/5/2021 at 11:49 AM, thecoolmedstudent said:

Hey guys, I go to Mac and am considering a not so competitive surgical specialty. I could probably match relatively easily if I wanted to, but I am concerned about the potential ramifications after residency. I plan to write the USMLE, as it could be useful considering the surgical job market in Canada and may also be useful for future fellowship opportunities as well. However, because of Mac's curriculum structure, I am struggling to find opportunities to study for it. As such, I am considering taking an enrichment year (essentially making med school a four-year ordeal). In my extra year, I plan to do more research projects, while also studying for STEP 1. 

Has anyone here done this, or knows someone who has done this before? Is it feasible?

Late to this but wanted to chime in.

I know of people doing enrichment years but those were mainly to match into Derm, Plastics, Ophtho or Rads.

Step 1 has historically been the main challenge for Canadians, especially with Mac's curriculum. However, Step 1 is going to be pass/fail as of January 2022 so I'd just take it when it goes P/F. The minimum score for a pass on Step1 is a 194 which corresponds to approximately the 5th percentile of US MD test takers. Since it's P/F, no one will know if your knowledge is lacking and you barely scraped a P or if you're a pharmacology and pathophysiology god and would have scored 260. While a score of 200 might have previously been a black mark for a US fellowship, the P/F grading scheme makes it a non issue going forward.

As for actually getting a P, considering that the median MCAT of a US MD students is 511 with a standard deviation of 6.5, just aiming for a pass shouldn't be too difficult. There's a high degree of correlation between the MCAT and Step1. If you did well on the MCAT, you should pass Step1 with a couple of months of studying.  IMO, you shouldn't be too worried about failing if you have a decent science background from undergrad. You probably don't need to take a year off to study for it.

Step2 is scored. However, it's clinical knowledge and there's a greater degree of overlap between the Canadian and the US clinical curriculum so it shouldn't pose the same sort of challenge that Step1 does.  You could probably take it at the same time as the LMCC and prep for both at the same time.

You can't take Step3 before graduation so no point in thinking about it.

Also I just wanted to add that the main reason that folks going to the US need the USMLEs is mainly due to visa , licensure, and malpractice insurance reasons. You can't get an H1B without completing the USMLEs and that's the main form of employment visa. So it's more a case of having the boxes ticked for work reasons than needing a great score for employment. It's a different story if you want to try to match down there for residency though.

 

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