ECFMG certification and match in 12 months
I have used this forum intermittently for the past year and I would like to share my experience and timeline. Reading other people's experiences securing a US residency was very helpful.
I have THOUGHT about US residency training for a number of years but only DECIDED in Feb 2014 that I really want this and planned to apply in Sep 2014 to Match in Mar 2015.
I graduated with MBChB in 2005 from a commonwealth country and have a PhD from a British university (2011). I have 2 years of specialist registrar time in my home country in addition to internship and another year in accident and emergency.
I began studying for Step 1 in Mar '14 and took the exam in Jun '14. I had a full time job (>80hr/wk) until end of May. Resource: US World and First Aid . Kaplan notes for biochemistry. Got through 90% of U World and explanations. Timed blocks avg 68%. Real score 229.
CS early July '14. Resources: First Aid and Youtube videos. Passed
CK late July '14. Resources: U World. First Aid (not quite as good as for Step 1). Got through about 2/3 of U World. Timed blocks avg 73%. Real score 250.
Step 3 Jan '15. Resources: U World. Computer simulation cases requires prior familiarity and practice. Did all the practice cases on U World and read around them. Got through half of timed blocks avg high 60's. Real score 235.
4 X 1 month-long US observerships/sub-i
5 X first author publications related to specialty in top tier journals.
Numerous speaking engagements/conferences.
1 X US LoR by ERAS application deadline
2 US neurosurgeons wrote letters to Program Chairs at programs where I was most interested.
Home Chairman known in US and supported me tremendously
Applied 43 programs in a surgical sub-specialty. Received interview / consideration only at programs where I did observerships. Matched at preferred program.
As you can see, my USMLE timeline was very rushed and I barely made it in time for ERAS. My ECFMG certification was only issued in mid-October so this may have compromised my application via screening. My low Step 1 is a reflection of my time out of med school. Although not sure I could realistically have studied any longer. Found Step 2 much easier. I would recommend doing CK soon after Step 1 as there are overlaps. CS was pretty straight forward as English is my first language.
I have been extremely lucky in terms of being introduced to the right people. I worked hard and I generally get along with people. The tight timeline also meant I didn't have a second chance with any of the Steps if I failed any, if I were to enter the 2015 Match.
Thinking back I may have been better off doing this over a 18-24 month period. It was very stressful and didn't allow for any contingencies. Step 1 is very important (can't understand why given it bares no impact on one's ability as a doctor). US experience in whatever form is essential - it gives you credibility and makes things happen as you meet people. I got along well with the residents where I rotated and a couple of them really advocated for me - the program directors put significant weight on the views of the current residents when making the ranklist.
Good luck in your pursuit!
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