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Writing the USMLE and fellowship/other purposes


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From what I understand, the USMLE is required to apply for residency in the states but is it needed for applying to fellowships in both Canada and states? I'm just unsure about other reasons why one would write the USMLE.

 

Also, do most people do fellowships or is it just for competitive specialties?

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It's not needed for anything in Canada, but might be necessary for some fellowships in the US. Not all though or necessarily that many. I don't really know. I wrote Step 1 before clerkship but still haven't gotten around to writing step 2 CK. It's just an added expense and I don't know how helpful it would be ultimately.

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Some Fellowship programs want you to have the USMLE.

The other advantage of the USMLE is for moonlighting outside the fellowship/residency program. Once you have the USLME Part 3 you have the ability to moonlight if your program allows for it.

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Would doing a fellowship in the states allow you to eventually work there? I've been accepted to an american med school and am still waiting on canadian ones. People have been telling me to go to the american med school if I want to work in the states...but is it possible to still do so via a Canadian med school/residency and american fellowship? I just want to keep my options open

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Would doing a fellowship in the states allow you to eventually work there? I've been accepted to an american med school and am still waiting on canadian ones. People have been telling me to go to the american med school if I want to work in the states...but is it possible to still do so via a Canadian med school/residency and american fellowship? I just want to keep my options open

 

Definitely. By going to a Canadian school and writing the USMLE, you can apply for residency in the US. Although, going to a US school might make you more competitive for the US. I guess it's all about where you want to practice in the future.

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End of M2 is when you write, depends how early you want to start. If you're going for something ultra-competitive, some people tend to start early in 2nd term of M1, by doing spaced-repetition prep.

 

Most probably do it during M2, with more concentrated prep the months before test date - some schools give anywhere from 2 weeks to 2 months off after M2 classes for board prep, or bring in board prep companies.

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Canadians who need USMLE for US fellowships tend to study after M2 (and probably just want to pass).

 

US candidates and those who want to pursue residency in US study during M2, as the Step 1 material is actually very relevant to what you learn in M2. Many students concentrate on studying for Step 1 rather than their classes. Most class nowadays are just pass/fail. Even if there is honours and you didn't get them preclerkship, there is plenty of chances to excel during clerkship/electives and get awesome reference letters. Your Step 1 score plays a much larger role than your preclerkship marks in terms of residency application (provided you didn't fail any courses, and you shouldn't).

 

If you want a competitive specialty in US, ace Step 1, get solid references, and be nice to everyone :).

 

As an aside, when do people usually start studying for the USMLE and when do they take it? (MS1 or MS2?)
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I'm headed into an internal medicine residency with the aim of doing fellowship in the States as my significant other is in a surgical residency planning to do fellowship in the States as well. We're likely going to end up working in the States too given the lack of jobs for my hubby as a urologist. It's not a common thing that most Canadian grads do but I think it is feasible :)

 

I'm writing my Step 2 CK one week after my LMCC in May. A sweet time to do it because I've already written all my NBMEs so I've studied all the subject material and by studying for LMCC, I'm also studying for Step 2 CK. That being said, I haven't done Step 1 and I hear the best time to do that is after first year or second year.

 

Edit: to better answer OP's original question => write USMLEs to keep options of going to the States open, particularly if you're in a small field with limited opportunities in Canada. It's a lot of work now but you'll thank yourself towards the end of residency when you have plenty of (rather excellent) fellowship opportunities in the States!

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  • 2 weeks later...
Edit: to better answer OP's original question => write USMLEs to keep options of going to the States open, particularly if you're in a small field with limited opportunities in Canada. It's a lot of work now but you'll thank yourself towards the end of residency when you have plenty of (rather excellent) fellowship opportunities in the States!

 

Just wondering -- are there fellowship opportunities in the States that do NOT require USMLEs? If so, what percentage of them do not require? Thanks!

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there are fellowships that do not require you to write the USMLE, same as there are some residency programs that do not require it. I can't say anything of the quality of these programs. I have absolutely no clue. A lot of fellowship programs will take you without having written step 1, just step 2 and 3. However, some of these programs may offer the opportunity to stay on afterwards and that, from what I understand, does require step 1 (although this is state specific).

 

I wrote step 1 after 2nd year with the goal of passing. I did it for the simple reason that I don't know what the future will bring and I don't want to close doors this early in the game for an extra couple of weeks of vacation. Our career advisor also told me that whether or not step 1 is required to work is very state specific. I wrote it, passed, and have no regrets. Had I not passed I might have a different perspective. It certainly wasn't a fun day.

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I was wondering the practice material available through the NBME (the 138 questions they have), what kind of % score of that would give you a decent chance to pass? I did it without studying and was wondering how much more I would have to study for Step 1.

 

Thanks!

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Our career advisor also told me that whether or not step 1 is required to work is very state specific. I wrote it, passed, and have no regrets. Had I not passed I might have a different perspective. It certainly wasn't a fun day.

For residency/fellowship requiring a J1 visa = state specific.

For getting a H1B work visa from the federal government to work in your specialty after residency, you absolutely must have all the USMLEs done, regardless of what the individual states require.

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(Just reposting since my post wasn't transfered with the forum upgrade)

 

Having written the exam and gotten my results back (not a great score but a pass nonetheless which is what I was aiming for anyways) I thought I would give my thoughts on writting the USMLE Step 1.

 

I was actually not planning on writing it. I realllllly did not want to study during the summer and wanted to take it easy (and do some part time work on the side). Then after talking to some people I realized that I should write it now and get it out of the way. I did a complete 180 and booked a time to write in July. I took the first two weeks off in the summer just to relax after my final exam of 2nd year. Then I studied for half my summer, and wrote the exam, which is approximately 5 half ass weeks of studying, with days off and some days where I did only 1-2 hours of studying while also working (a job in medical education at my school). The good thing was most of that work could be done from home. So in actuality I probably got approximately a good solid 3 weeks of studying (full time). The good thing is I had about 4 weeks left in summer after writing which let me relax and enjoy it. A lot of people don't want to write the USMLE step 1 because they really don't want to study in the summer and put in that committment (especially after going through the school year). I was one of these people. After changing my mind and writing it (and passing) I gotto say I'm REALLY glad I got it out of the way. Yeah studying can be a pain in the ass especially in the summer, but its only for a short time (especially if all you want to do is pass), and is better than studying during residency (when the basic science stuff may not be as "fresh" in your mind). Also I wrote it because regardless of whether you want to do fellowship, residency or practice in the US its good to cover your bases. Me personally I don't plan on going to the US but I thought it be a good thing to keep my options open (for fellowship or practice purposes). After talking to some people here are some of the things that came up: Want to do residency in the US? You gotto write it (and do well most likely). Want to do fellowships in the US? Some require it and some don't, but if you don't write it after 2nd year and decide later you want to do a fellowship in the US then you will have to write it in residency (which is probably a million times more painful). Want to practice in the US (or at least keep that option open)? Most states actually don't require it to practice (as long as you have full royal college status) BUT there are some VISA issues that can come up without having written your steps and it could cause a big headache if you need to or want to go down. So for these reasons I wrote it to keep my options completely open. And Im glad I did.

So if you are on the fence like I was a year ago (or even a few months ago ahaha) I would say bite the bullet write it and get it over with. Trust me you will be happy you did (if you pass) and itll be off your plate. A lot of people think they will be ruining their summer if they write the USMLE. This is not true. Although you do have to take some time off to study, I know lots of people who still traveled, did research and relaxed and enjoyed their summers! (I'm enjoying my summer just fine). So you can definitely study and still have enough time to enjoy your summer.

Hope this helps some people who are still unsure of writing.

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The answer to this question is dependent on your individual plans. Question 1: do you ever wish to practice in a state which does not recognize the LMCC as equivalent? (Some do and will not require usmle). Question 2: do you wish to moonlight in the US during fellowship in a state which does not recognize LMCC? Question 3: does your dream US fellowship require you to have it? This varies by state, institution, specialty, and hospital.

 

The extreme variability requires each person to do their homework to decide what is right for him/her.

 

In my case, I have no desire to ever live in the US, and I will make more money using vacation to return to Canada to moonlight. I had no issue securing interviews at all of my desired spots (Harvard/MGH, Stanford, Columbia, Johns Hopkins), and ultimately securing my top choice fellowship at Mass General. I have never considered writing the USMLE because for me, in my situation, it would be a complete waste of time and money.

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It doesn't matter if the state recognizes LMCC unless you're an American citizen or have a green card. The federal government requires USMLEs to get a work visa.

 

For an H-1B, agreed.  However, I think you may be able to do a research fellowship (i.e., minimal patient contact) on a TN visa without the USMLEs.

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