STEP 3 Versus US Clinical / Research Experience
US Clinical Experience is the New Step 3 !
It's bewildering how times change - while I am blogging to help people pursue careers here in the US, the reverse is beginning to gain momentum too. Mr. Richard Larison, an American with a accounting bachelors and a Masters of Health Administration graduate from the University of Missouri-Columbia is now the Managing Director (akin to the CEO) of the Apollo Hospitals in Delhi, India. Interestingly the Founder of Apollo Hospitals practiced Internal Medicine in Missouri, too, before he decided to head back to have his own setup. Likewise, the American Hospital of Dubai has quite a few American Board Certified Docs.
And it's nothing new now that American students from various engineering and management schools compete for prestigious summer internships at Infosys in Bangalore, India. The world, as Thomas Freidman says, is truly getting flat.
So, we were talking about taking the USMLE Step 3 versus getting US Clinical Experiences (externships / observerhips / clinical research etc.) . This post rather applies more to candidates who have completed USMLE Steps 1, 2 CK and CS and have some more time until the September application time arrives. I have been reading on and off emails about whether to take the Step 3 CCS first or invest that time in some clinical experience instead .
There is no rigid answer to this dilemma and is something that IMG candidates must work out for themselves, depending on what works out best for them after taking into account the following factors:
1. Most residency programs do not have Step 3 score-limits or Step 3 passing on their screening criteria - rather they look more often for Step 1, Step 2 CK scores, at times for Step 2 CS Passing, besides other resume-augmenters like US Experiences [ Clinical and/or Research]. So logically, if an IMG has some time before applying for the match and has finished Step 1, 2 Ck and 2 CS, the next best thing to do is most likely get started on US experiences for meeting those screening criteria and get those US Letters of Recommendation.
2. May people opine that it's great to get done with the Step 3 within weeks after taking the Step 2 ck, to take advantage of the study momentum granted by Step 2 CK preparations - reason being that you almost study the same thing, but from a different perspective. But let us not forget the logistics here, an IMG can apply for the Step 3 ONLY after being ECFMG Certified - and considering that it take 4 weeks to get your score and an additional 2 weeks to receive the ECFMG certificate, it will be more than a month before you can take the Step 3. Plus, if your last examination was the Step 2 CS, the wait for the ECFMG certificate is gonna be even longer. So, it would be a mistake to plan to wait and get involved with clinical experience only after Step 3.
3. Money wise, a lot of residency programs offer paying for your step 3 fees as a 'perk' So for candidates who either don't need visas or are perfectly comfortable with J1-visas, that's a little tip for some money-saving ;-)
4. Do not forget that it helps to have US Letters of Recommendation when you apply - hence that's another reason to have clinical experiences before you apply to get those LORs on time.
All in all, treat US Clinical experience as the new step 3, have it done before you apply, or at least have it on going while you apply. About Clinical Research - if you have 3 to 4 Months to apply after completing ECFMG Certification, and plan to apply that very year, then research may not be very useful for that year, since it takes time to get significant research activity done - but if you are still a fresh IMG with less than 2-3 years from Medical school, then maybe you could afford to get involved in research, try for residency the same year anyways, but keep the real target as the following year, giving yourself
1. An exceptionally high Step 3 score (in the 90s) may certainlybe good, but IMGs must realize it really is not that easy to crack it without resident work experience and especially if Step 2 CK scores have not been high. It might just be a better time-investment decision to take the Step 3 after good Clinical experience as a resident.
2. H1b aspirants may plan to take the Step 3 early in the game, a few programs may even need you take the Step 3 to be eligible for an interview if you need an H1b - but there is a way around - on your ERAS application, mention both H1b and J1 as your visa choice - you can always take the Step 3 early and make it easy on yourself.
Step 3 Books for Less $$:
- First Aid for the USMLE Step 3
- Crush Step 3
- Swanson's Family Practice Review (Use for Geriatrics and Ethics)
Questions for me ? Use my USMLE - Residency Forum
It's bewildering how times change - while I am blogging to help people pursue careers here in the US, the reverse is beginning to gain momentum too. Mr. Richard Larison, an American with a accounting bachelors and a Masters of Health Administration graduate from the University of Missouri-Columbia is now the Managing Director (akin to the CEO) of the Apollo Hospitals in Delhi, India. Interestingly the Founder of Apollo Hospitals practiced Internal Medicine in Missouri, too, before he decided to head back to have his own setup. Likewise, the American Hospital of Dubai has quite a few American Board Certified Docs.
And it's nothing new now that American students from various engineering and management schools compete for prestigious summer internships at Infosys in Bangalore, India. The world, as Thomas Freidman says, is truly getting flat.
So, we were talking about taking the USMLE Step 3 versus getting US Clinical Experiences (externships / observerhips / clinical research etc.) . This post rather applies more to candidates who have completed USMLE Steps 1, 2 CK and CS and have some more time until the September application time arrives. I have been reading on and off emails about whether to take the Step 3 CCS first or invest that time in some clinical experience instead .
There is no rigid answer to this dilemma and is something that IMG candidates must work out for themselves, depending on what works out best for them after taking into account the following factors:
1. Most residency programs do not have Step 3 score-limits or Step 3 passing on their screening criteria - rather they look more often for Step 1, Step 2 CK scores, at times for Step 2 CS Passing, besides other resume-augmenters like US Experiences [ Clinical and/or Research]. So logically, if an IMG has some time before applying for the match and has finished Step 1, 2 Ck and 2 CS, the next best thing to do is most likely get started on US experiences for meeting those screening criteria and get those US Letters of Recommendation.
2. May people opine that it's great to get done with the Step 3 within weeks after taking the Step 2 ck, to take advantage of the study momentum granted by Step 2 CK preparations - reason being that you almost study the same thing, but from a different perspective. But let us not forget the logistics here, an IMG can apply for the Step 3 ONLY after being ECFMG Certified - and considering that it take 4 weeks to get your score and an additional 2 weeks to receive the ECFMG certificate, it will be more than a month before you can take the Step 3. Plus, if your last examination was the Step 2 CS, the wait for the ECFMG certificate is gonna be even longer. So, it would be a mistake to plan to wait and get involved with clinical experience only after Step 3.
3. Money wise, a lot of residency programs offer paying for your step 3 fees as a 'perk' So for candidates who either don't need visas or are perfectly comfortable with J1-visas, that's a little tip for some money-saving ;-)
4. Do not forget that it helps to have US Letters of Recommendation when you apply - hence that's another reason to have clinical experiences before you apply to get those LORs on time.
All in all, treat US Clinical experience as the new step 3, have it done before you apply, or at least have it on going while you apply. About Clinical Research - if you have 3 to 4 Months to apply after completing ECFMG Certification, and plan to apply that very year, then research may not be very useful for that year, since it takes time to get significant research activity done - but if you are still a fresh IMG with less than 2-3 years from Medical school, then maybe you could afford to get involved in research, try for residency the same year anyways, but keep the real target as the following year, giving yourself
1. An exceptionally high Step 3 score (in the 90s) may certainlybe good, but IMGs must realize it really is not that easy to crack it without resident work experience and especially if Step 2 CK scores have not been high. It might just be a better time-investment decision to take the Step 3 after good Clinical experience as a resident.
2. H1b aspirants may plan to take the Step 3 early in the game, a few programs may even need you take the Step 3 to be eligible for an interview if you need an H1b - but there is a way around - on your ERAS application, mention both H1b and J1 as your visa choice - you can always take the Step 3 early and make it easy on yourself.
Step 3 Books for Less $$:
- First Aid for the USMLE Step 3
- Crush Step 3
- Swanson's Family Practice Review
(Use for Geriatrics and Ethics)
Questions for me ? Use my USMLE - Residency Forum
posted by Digitaldoc, MD at 6:06 PM
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