Friday, April 8, 2016

Dr. Thinker: FAQs asked by the members of the USMLE page

1.      Second match guys did you tell the program its your second match and did they ask u?
A.      I mentioned it in my PS that I didn’t match last year. The interviewers mentioned that they noticed it.  At a couple of places where the interviewer didn’t read the PS, they asked me whether I applied for last match.

2.      IM LOR for neuro advisable?
A.      Only, if you don’t have enough LORs from Neuro.

3.      Please mention what extracurricular activities we could add on to our CV and if it is really necessary?
A.      Please, refer to the ERAS CV section of the PDF to know it in detail.

4.      Does IELTS help?
A.      TOEFL should be enough for electives, unless the hospital specially asks for IELTS.

5.      Ways of obtaining HANDS-ON externships other than commercial companies, if any?
A.      Hardly any proper teaching hospital or university offers this. The only place I know that offers this without going through commercial companies is the Heart and Vascular center in Detroit. May be, jacksonpark hospital in Chicago too.

6.      Prospects of matching with only 2 months of observership?
A.      It depends on your scores, LORs from those 2 observerships and overall CV. Yes, there are people who matched with only 2 obsies or no USCE at all. But, there may or may not have been other factors related to their match and so we can’t just generalize it for everyone.

7.      Prospects of matching without any research experience and publications?
A.      You will see a lot of people matching with research exp or publications. Again, it depends on the over CV. Also, it might affect where you would end up matching. Eg: A university hospital would like to see research exp.

8.      Scores needed to overcome YOG>3 years?
A.      No one can give a definite answer for this. There is no defined cut offs for scores. The more you can score the better. Also, with increasing YOG the thing the programs worry about is the clinical experience as they wouldn’t like to see away from practicing medicine for long. It’s the USCE and publications which can kind of mask this.
9.      Credibility to PDs of locum jobs (shift duties at clinics) as gap fillers while studying for USMLEs?
A.      It’s definitely better than having a gap. Describe this section in the CV in detail about you role during that particular job. Sometimes, during the interview they will ask you about this just to double check.

10.  Importance of having an American accent over a neutral one?
A.      Doesn’t matter. America has a huge percentage of immigrants who don’t have an American accent.
-          It can help if you have an American accent as the interviewers would be happy to know that you won’t have any problem while dealing with American patients.
-          Neutral one – it’s definitely not a negative factor as far as it is comprehensible. Don’t worry about the accent and over try it. It will appear fake.
I don’t have an American accent at all, but my interviewers told me that they were surprised to hear such good English and asked me when did I start learning it(could be possible that their expectations were low).

11.  How to apply for electives and things one should take care while studying for step 1.
A.      Please, refer to the USCE and step1 part of the PDF.

12.  How to act on interviews? How to act on observerships?
A.      Please, refer to the USCE and interviews part of the PDF.

13.  Information about the types of visa needed, procedure and related info.
A.      USCE/STEP exams including CS/ interviews – B1/B2 visa.
Research: Depends on what the institutions wants or sponsors. Could be B1 or J1 or in rare cases they sponsor H1 B.
For the procedure, it’s better to refer to the Government website.

14.  Can u pls enlighten a little about EXTERNSHIPS?!! like how and when to apply and what are the requirements for it?
A.      Please, refer to the USCE part of the PDF. The requirements depend on the hospital you are applying. Contact them for that info or check their website.

15.  What are da chances to get gynecology branch being a gynecologist in india and where it is comparitively easy to get in gyn residensy through out usa?
A.      Sorry, I have no idea about gynecology. It’s better if you can ask someone related to it.

16.   Which branches needs less scores? Which places needs less score?
A.      With the increasing competition and many people getting outstanding scores, the differentiation between branches with regards to scores isn’t possible. I can say peds is comparatively easy to get compared to IM for a person with low scores, but  I am sure peds applicants won’t agree with it. Also, as I mentioned earlier, scores are not the only thing. It’s overall CV that matters.

17.  Please explain different forms of USCE such as electives, externship, observership.
A.      Did that in the USCE part of the PDF.

18.  Could you mention about visas. Converting j1 research to j1 clinical or h1b.
A.      J1 research to J1 clinical is easy. But, it is almost impossible to go from J1 research to H1b for the residency. So, if you are planning for a H1b in residency its better you don’t take up research on J1.
Residency on J1 visa:  
-          Pros:    
a.      Fellowship is easier to get as the number of fellowship positions on J1 are much more, especially the competitive ones like GI, cardio.
b.      Most of the university programs offer only J1 for residency.
-          Cons:
a.      You will have to sign a bond with your home Government. So, you will have to go back to your home country for 2 years after finishing residency/fellowship or you will have to do a waiver job in the US for 3 years.
b.      Green card will be delayed when compared to H1 B visa. Even if you end up marrying a US citizen you will have to wait until you do the waiver.

                Residency on H1B visa: USMLE STEP3 is a must to get this visa.
-          Pros:
a.      You won’t have the home country rule.
b.      You don’t have to worry about the waiver job.
c.       You will get green card faster. You will get it much faster if you end up marrying a US citizen.
d.      You can still get fellowships like nephrology, endocrinology easily even at great universities.

-          Cons:
a.      Most of the universities don’t offer H1B visa for residency.
b.      Competitive fellowships are very hard to get.
c.       You will pay more taxes when compared to J1.
In short: If you are looking for competitive fellowships later on or for university programs, then go with J1.
19.   I have low score in step 1 and now quite dis hearted about step 2, any advice for low scorers? And also I have absolutely no contacts in US. How much does having US contacts help through all this process? I have been told by many people that I have very less chance of getting interviews because I have no contacts in US.
A.      First of all, what do you mean by a low score? Scores are subjective. Some people feel they got a low score even after getting 250s.
-          You can work on improving your CV by doing electives/obsies and/or research with publications. Good LORs will help you a lot.
           No contacts in the USA: Of course, it helps a lot when you have contacts. But, if you are saying you can’t do it without contacts then it’s just an excuse you are giving yourself for not working hard enough.
-          I didn’t have any contacts. I am sure there are many people who don’t have contacts and still matched.
-          So, do whatever you can and stop worrying about something that’s not in your hands.

20.  Total cost from studying, steps to match in Indian rupees ?
A.      It depends on how many months of USCE you did, if it’s free or paid, how much your living expenses are, how many programs you apply to, how many interviews you get and miscellaneous activities. So, it’s difficult to give an exact figure. But, it could be anywhere between 15k to 30k USD for one time applicant.

21.  1.Step 3 prep time reqd right after ck; 2. Research places ... how to find one good 
3. Observership vs university observership vs research
A.      Refer to step3 part of the PDF for your 1st question and Research related for your 2nd question.
As for Obsie vs University Obsie vs research: 
a.      Obsie at a university hospital and a good LOR from the faculty there can help you big time in getting interviews from the community hospitals in that area or elsewhere.
b.      Obsie at a community hospital which takes IMGs into its residency program is the best.
Ideally, do both if you can. If you have to pick only one, then find out the chances of matching at that hospital after doing an obsie and then decide.

As for obsie vs research:
-          This just depends on how much USCE you already have and how much time you have for research at this point.
-          If you have 5-6 months of USCE (obsies) or 3 months of hands on USCE(electives) then you can go for research.
This is just a suggestion. Talk to others and decide for yourself.

22.  How do you prepare for your interviews? How do you plan the schedule? 
How do you contact them after the interviews? How do you send thank you cards?
A.      Please, refer to the interviews section of the PDF.

23.  Please outline the requirements of an orthopaedic and cardiology residency/externship.
A.      Sorry, I have no idea about orthopedic residency. Cardiology is a fellowship and not a residency. For externship, please refer to the USCE part of the PDF.

24.  I didn’t match this year. What can I do to improve my chances for the next match?
A.      This can’t be generalized. It depends on the individuals overall CV and what they are lacking in.
-          Give step3 if you hadn’t already.
-          Get more USCE, preferably in a hospital that takes IMGs into its residency.
-          If you already have 5-6+ months of USCE, you can try joining research.
-          With increasing YOG, the issue that worried the PDs most is about how long it has been since your last proper patient interaction. So, I would say even if you are planning to get into research and already have good number of months of USCE, still do at least 1 or 2 months of USCE.
-          Best thing would be to do Obsie while doing research. If the person you are working with is a clinician, then you can shadow him on floors or clinics. You can request them. This would be the best way to get an LOR which includes both.
-          Programs definitely want to see what you have done to improve your chances for this year. So, don’t sit idle even for a month. Spend as much time as you can in the USA.
-          Definitely get at least 1 or 2 new LORS.
-          Also contact the interviewers from your last season, tell them that you didn’t match and ask them for any kind of opportunities. This works better if you already made some effort to communicate with them during the last season after the interview.
25.  I have an attempt on Step2 CS. What are my chances?
-          There are people with an attempt on CS and still went on to match. As with everything, it all comes down to how well you improve your CV to mask this black mark.

26.  Step1 score 210,220,230. Will I match?
-          People have successfully matched even with scores less than 210 on step1.
-          It’s not going to be easy, but it’s not impossible.
-          Show a drastic improvement on step 2CK and get good LORs.

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