USMLE Step By Step

Amr AbdelbadeeGeneral Practitioner,

Assiut Health Directorate, MOH

What is USMLE?• USMLE stands for the United States

Medical Licensing Examination

• Taken by EVERYONE who wants to work as a doctor in the US – US citizens included

Why USMLE• Apply for USMLE if you want or have plans

to work as a doctor in…o The United Stateso Arab countrieso Most top private hospitals in Egypt (Dar El-

Fouad, World Medical Center, Prof. Sir Magdi Yacoub Heart Center,….)

Is America good for me?

• Yes, if…o You seek a job in top medical institutions in the

worldo You want to learn from the best doctorso Science and knowledge are your primary

concerno You want to live with higher freedom limitso You are good enough in Englisho You are open-minded and accepting cultural

differences

Is America good for me?

• No, if…o Money is your primary concern – Go to the

Gulf!o Religion is a serious issue to you – KSA is good

for a Muslim, or just stay in Egypt!o You can barely speak medical English – Egypt

loves you this way!o Cultural differences are a pain to you – Arab

nations can pay you well while living in a similar culture to ours…

o You’re a girl… sometimes!

Easy enough???• You should think again!

Before you start..• Think about the real

goal of your life• Think about your

opportunities in Egypt• Think about the

benefits and risks of taking the USMLE

• Think about other opportunities worldwide

• Think about your own conditions

Girls and USMLE

• Your Life Plano Family vs. careero Marriageo Ability to travelo Ambition

ARE YOU READY?

USMLE for an IMG• You can apply if your college is present on

their records – IMED• Applications go through the ECFMG Web

Portal• Prepare your documents the right way• Prepare your credit card and load it with

money, lots of it! (about EGP 10,000 in today’s rates)o Don’t have one?! Get one now from CIB

Get Started – Seriously!

• Open an account at ECFMG Web Portal• Costs some money – $65 as of 2014

Step 1• Computer-based MCQ• Taken at a registered Prometric Center• Tests your knowledge in basic medical

sciences• Tests your thinking and interpretation skills• Tests how you may deal with clinical

problems based on the basic science you know

• Tests your patience!

How much does it cost?

$1015 as of 2015

Preparation• Long-Term Plans• Mid-range plans• Short-term plans• Crash plans

Sources• Notes• Videos

Notes• Kaplan Notes• First Aid• USMLEWorld• Kaplan Qbank• PreTest questions• Student notes and summary (Hand-made)

Videos• Kaplan Videos• USMLERx First Aid• Dr. Najeeb• Doctors in Training (DIT)• … and many others

Step 2• Clinical Knowledge (CK)• Clinical Skills (CS)

Step 2 CK• Computer-based MCQ• Taken at a registered Prometric center• Tests your knowledge in clinical medicine• Tests your way of management of clinical

conditions based on your clinical training• Tests your patience….. Really??

How much does it cost?

$1030 as of 2015

Preparation• Kaplan notes & Videos• Master the Boards• PreTest books• USMLEWorld• Kaplan QBank

Step 2 CS• Taken in the UNITED STATES• Take in 5 centers: Atlanta – Georgia,

Chicago – Illinois, Houston – Texas, Los Angeles – California & Philadelphia – Pennsylvania.

Step 2 CS• Fifteen-minute examinations of twelve

“standardized patients”• 10 minutes to compose the written record of

the encounter (Patient Note)• 30 and 15 minutes break• Tests

o Data-gathering skills including medical history taking and physical examination skills in patient note

o Communication / interpersonal skillso Spoken English language proficiency

How much does it costs?

$1505+ Travel costs

as of 2015

Step 3• The last step you need for full medical

practice without supervision• Taken in the United States (via Prometric)• Requires ECFMG Certification and other

requirements by the state licensing board• Two-day MCQ exam

o Day 1: Foundation of Independent Practice (FIP)

o Day 2: Advanced Clinical Medicine (ACM)

How much does it costs?

$815+ Travel costs

as of 2015

The USMLE Exam Registration Process

Registration• Process• Required Documents• PITFALLS!

o Addresso Envelopeo Statuso Letterso Credit Cards

PITFALLS• Your NAME !!!!• Your EDUCATION

STATUS: STUDENT OR GRADUATE !!!!

• College ADDRESS !!!!

• ENVELOPE !!!!• LETTERS !!!!!

Process• Your name must match the name on your

PASSPORT. If you don’t have a passport, get one NOW!

• N.B.: Your passport is REQUIRED for entering the exam center!

Process• Your medical education: College MUST be

registered at IMED (https://imed.faimer.org/) If not, tell your Dean to register with IMED IMMEDIATELY or NONE of your college students will be able to register for USMLE!

Process• IMED Registration is done through the

following address:o International Medical Education Directory

(IMED) FAIMER 3624 Market St. Philadelphia, PA 19104 USA Fax: 215.386.9767 E-mail: imed@faimer.org

• College address: Available at IMED

Process• STATUS:

o Students are studentso Graduates are graduateso INTERNS ( االمتياز !ARE STUDENTS (أطباء

• Expected Dates: Get them from the Student or Graduate Affairs’ Office at your faculty

Required Documents for Exam Registration

Documents for a Student

• Certification Statement (Form 183) – required if your medical school is NOT a part of EMSWP

• Certification of Identification Form (Form 186) – The only form required for students

Documents for a graduate

• Final Medical Diploma in both Arabic (Two copies) and English (Official Translation)

• Score Sheet and Hours in English from all medical schools you studied in

• Certification of Identification Form (Form 186) – not required if you did submit it already within 5 years

• IWA Document Submission Form (Form 187)• ECFMG Medical Education Credentials

Submission Form (Form 344)• Medical School Release Request (Form 345)

Documents for a graduate

• For interns who fall into the Graduate registration trap, you need an official letter from your Dean of Students( والطالب التعليم لشئون الكلية وكيل أو الكلية (عميدstating that you are waiting to finish your internship year before you receive your final medical diploma and other required documents, including your transcripts

Notes for Sending Documents

• If your documents include Form 186 (The FIRST submission), all of them MUST BE SENT from the Dean’s office in your faculty regardless of your status. Ask the Dean’s secretary for a large envelope with the Faculty’s logo and name in English, put all the documents inside it, close it and stamp it from the Chief Secretary of the Faculty ( الكلية (أمين with the Eagle Seal( النسر Or the Highest) (ختمOfficial Stamp in your Faculty). Then, write down the Faculty’s Address (Get it from IMED) preceded with the words “Dean’s Office”.

Notes for Sending Documents

• If your documents don’t include Form 186 or you’ve submitted it already, you can send them from your own personal address without any special procedures.

Notes for Sending Documents

• In all cases, it’s highly recommended to use Express Mail. Choose the best private international courier service in your area. I highly recommend FedEx (usually delivers in 2 or 3 business days) or Aramex (usually delivers in 3 to 5 business days).

• If you want your documents to be delivered fast, DO NOT USE the National Mail in your country. They’re very VERY slow and delivery in time is never guaranteed

Notes for Sending Documents

• ECFMG Address for sending documents:o IWA

ECFMG3624 Market Street Philadelphia, PA 19104-2685 USAPhone: +1-215-386-5900

Irregular Behavior

Scheduling the Exam Appointment

Scheduling the Exam• After completing the Exam Registration

Process, the Scheduling Permit is sent to your email within a month of receiving the paper forms.

Scheduling the Exam• Go to http://prometric.com, Select

“Schedule My Test” from the home page.• Search for USMLE from the providers’ list.• Select the exam you’ve registered for• Select your country (and state for US

residents or travelers within the US). If your country is not available, select the nearest or most accessible country of your choice.

• Select “Schedule an Appointment”

Scheduling the Exam• Agree to the provided agreements• Enter your scheduling number (from the

Scheduling Permit) and the first FOUR letters of your registered LAST NAME

• Select the desired test location. In Egypt, only ONE location is available in Cairo at the AMIDEAST headquarters in Dokki

• Select the most appropriate date for your exam and confirm your appointment

Scheduling the Exam• Print the Scheduling permit and the

appointment confirmation for use at the Exam Day

Common Situations• Rescheduling the

appointment• Appointment

cancellation• Lack of appropriate

date within the eligibility period

Rescheduling / Canceling the Appointment

• Rescheduling or canceling is easy. The steps are similar to the initial registration. Instead of choosing “Schedule an Appointment”, select “Reschedule or Cancel an Appointment” after selecting your exam and country

• Provide the confirmation number (from the previous appointment confirmation email) and proceed as necessary

Rescheduling / Canceling the Appointment

• Rescheduling or cancellation is FREE before 30 days to the initial appointment date.

• Fees incur and increase after that point. For further updated information, check http://www.usmle.org/apply/rescheduling-fees.html

No available date within the Eligibility

Period• It happens when you register a little late

for your exam (only a few months before the eligibility period)

• Try to schedule every now and then. Some people may reschedule or cancel for their own reasons, leaving behind their spots. One of them could be yours!

No available date within the Eligibility

Period• If you’re running out of time, consider

getting an eligibility extension from your registration page at ECFMG. Extension is available at the FIRST DAY of your original eligibility period. It can be done for a fee (about $70)

• A new scheduling permit will be sent to you for scheduling within the extended eligibility period. Good luck!

No available date within the Eligibility

Period• If you still cannot find an appropriate date

or you’re not interested in an extension for your own reasons, consider scheduling your exam appointment in another country that can be easily accessed by you

• For most Egyptians, Jordan (No visa required for short visits), Saudi Arabia and United Arab Emirates are the best available countries if taking an Exam in “Israel” is a sensitive issue to you!

The outcome of the two full steps

Next Steps???

General Advice• STAY CALM! • Stay close to Allah• Plan ahead for your preparations• Start as early as possible (but not too early)• Get yourself proper books, resources, devices

(laptop, tablet,….) and a good place for your studies

• Try some ONLINE exams to evaluate yourself• Find a channel away for your frustration –

Meditate, read the Qur’an, listen to music,…

What if I fail at USMLE?!

Other Opportunities• In Egypt

o Regular Resident (University / MOH / Other places)

o Visiting Residento Deputation / Trainingo Membership of the British Royal Colleges

(MRCP / MRCS / ……)o Military Options (Police, Army)o Egyptian Fellowshipo Private Practice

Other Opportunities• Outside of Egypt

o Arab countrieso Germanyo UKo Australiao France (and other Western European countries)o Eastern Europeo Singaporeo Latin Americao Africa, Central Asia,…..

Take Home Message• USMLE is the most popular foreign

certification for doctors worldwide• It’s not easy to prepare for USMLE, but you

can do it• If you’re concerned about the costs of

preparation, remember that you’re investing in yourself

• If you can’t take USMLE, you still have the rest of the world of opportunities!

Questions ??