a-path-to-usmle.pdf

8/18/2019 a-path-to-usmle.pdf

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CONTENTS

Page

1. NOTE 2

2. My Journey 3-5

3. FAQs regarding the application for USMLE Step exams 6-7

4.

USMLE STEP 1 8-12

5. USMLE STEP 2CS 13-15

6. USMLE STEP 2CK 16

7. USMLE STEP 3 16

8. United States Clinical Experience (USCE) 17-21

9.

Research 22-27

10. Letter of Recommendation (LOR) 28-32

11.

Travelling in the USA 33-34

12. Stay/ Accommodation 35-36

13.

MATCH season 37-39

14. ERAS CV 40

15. FAQs related to programs 41

16. NRMP registration 42

17. Contacting the programs after Sep 15th 42-43

18. Interview season and FAQs related to interviews 44-52

19. Phone interview 51

20.

Post interview communication with the programs 52

21. Factors related to the MATCH 53

22. Contacts in the USA 54-55

23. Rank order list (ROL) 56-57

24. SOAP 57-58

25. What to expect during the interview season? 59-61

26.

FAQs asked by the members of the USMLE Page 62-67

27. Personal Statement 68-70


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DON’T GIVE UP

You may not match this year,

you may not match the next year.

But, you will have to and for sure will match one season.

As, matching can only be delayed and not denied.

Provided, you don’t GIVE UP.

NOTE

Everything I wrote in this PDF is from my personal experience and what I had learnt over the

past couple of years from the experiences of those in the USMLE field. All the points or

statements I made in the PDF are mere suggestions and in no way I imply you into doing

anything. It’s up-to you how to use the information. In case of any conflicts with your

knowledge/perception, it’s advised to double check with others in the same field. I won’t be

responsible for anything.

The entire journey of the USMLE runs on the foundation of “UNCERTAINITY”. So, the things one mightface, learn or experience don’t have a universal application to each and everyone in this field. All the

points I make need not hold true for everyone. What works for one may not work for the other.

Raja Chandra


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MY JOURNEY

NOTE: I am sharing my story mainly for those who go unmatched or thinking of giving up at

every hurdle that comes in the USMLE path. I didn't match at my first attempt, too. We may not

have the same problems overall, but I totally understand what you would be going through. Ididn’t have any financial troubles ( thanks to my parents and brother), but emotionally it was a

nightmare until Mar 14, 2016, considering the fact that even my family wouldn't have been

happier with me giving it an another try( can't blame them).

Journey: We think we need some help or seniors for securing electives and all. In reality- it’s

just an excuse we give ourselves. Of course, having them will make it easy, but not having them

isn’t the end. I did it all by myself with the help of google. That's one reason I keep answering

queries on usmle pages, as not everyone has someone to back to them up. Remember -

Contacts don't just happen for everyone, you make them!!

I started with applying for electives at Yale, Weil cornel, Northwestern and John Hopkins as

these were the ones that gave electives then without asking for scores. I didn’t have any helpexcept the company of a friend who is on the same boat. I got Radiology elective at Yale, Weil

cornel and northwestern as IM was full. So, I only accepted Yale thinking I can try from IM once

I go there. Did 1 month in Radio used to go their ER even in midnight, developed good rapport

with all attending (so good that I taught them about cricket and showed videos on youtube in

free time) Then secured another month in Cardio. Gave my STEP2CS and came back to India.

While my rotations at Yale I emailed tons of doctors at Yale asking for appointments so that I

can try for electives in the future. After sending 100s of such emails, I could meet few of them

and one worked out. So, I secured my future Observerships before I came back to India. I also

called a couple of other universities and hospitals in the US everyday and got a couple of more

electives, but couldn’t do them due to other reasons. I came to India gave step1 - got 245. Icouldn’t give other exams in time due to various reasons. So, delayed my ck until the residency

application time in 2014. As promised earlier, one of the attendings at Yale offered me an

Observership in Aug 2014 with no time limit. I came to the US, but because of spending more

than 12 hours in the hospital I couldn’t finish reading ck properly and postponed it till Sept 2nd

week. I finally gave it and my results came in Oct 2nd week. It was 229. It’s a disaster. But, it

was my fault. So, can’t blame anyone but me. In the mean time I again emailed many

attendings and started meeting them for research/obsie ipportunities and could get another 2

months in another subspecialty (only 2 months, as I already secured an Obsie for Dec

elsewhere). I applied in Oct 3rd week and the 1st iv I got was on Nov 7th. When I sent them an

email 2-3 days later asking for interview day itinerary, they replied saying sorry you are not on

the list and we sent it by mistake!! The email which first gave me hope now shattered me. I

wanted to send them a disappointed email, but instead sent them an email in a polite way

saying I understand it’s in human nature to err and so no worries. Also, I said please go through

my application now and see if I am eligible. The PC forwarded my application to PD and he gave

me an iv. In the next 3 days I got 3 more ivs. In December, I went for an obsie at Allegheny

thinking they would give an iv if i do an obsie there. But, the day before I left for Allegheny they

sent me a rejection! I wanted to cancel it but I already paid for it. So, just went there because I


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knew if not anything I can make some useful contacts. Allegheny PC usually say they won’t give

LOR, but i was able to get one from the GI Fellowship director. Then I didn’t try for any obsies

after it for Jan and feb. I got one more iv in dec. I had to go back to India by the end of Jan. But

expecting last minute cancellations in Feb, I came back from India within a week. I had very

good f eedback from the places I interviewed at. It wasn’t generic and I thought i could match.

But, it turned out that I would go unmatched. I was of course in depression, but the second Igot to know I didn’t match I emailed the doctors that interviewed me asking for obsie/ research

opportunities. I also emailed 100 other places.

March 2015: On 16th I got to know I didn’t match, tried for soap and on 20th it was confirmed

that I will remain unmatched. But, by 23rd match I almost got myself a research position

secured at MD Anderson Cancer center. It wasn’t through contacts. It was just one of those

100s of emails I sent out. The attending had asked me to come to Houston for the interview,

but I said I won’t be able to and instead requested for a phone iv. He agreed, we talked over

phone, I showed interest. He later emailed me that he won’t be able to offer me the position as

it is unpaid and so he wouldn’t feel good if I come all the way to Houston just for this. Over thenext series of emails, I convinced him that I will manage the logistics. He agreed for it in April

and started the paperwork. Not knowing, how this might turn out I reached out to other places

also and by march end I had already secured an obsie at Yale again for the month of May, at

Albert einstein for June and at UAB for July. Also, in the meanwhile I gave my step3 in April.

Since I have these, I postponed my research start date till Sep 2015. I applied for the match on

sep 15 this time. I had to go back to India at the end of July 2015 as my 6 months visa expired. I

came back in Sept, started research around Sep 2nd week. Initially, my attending at MD

anderson wasn’t helpful, the first interaction I had was harsh and I felt bad for the first couple

of weeks. The first in person interaction I had with my attending was on day3. He just walked

into the room and started talking to me. His very first word - "If you are hear for LORS or any

help, just give me your badge and walk away right now". He went on for 10 mins saying things

like this. I was shocked and felt bad. I had already worked 28 hours total in the 1st two days and

finished a work which was expected to be finished in 2 weeks. More surprisingly, my fellow who

saw it all didn’t even utter a single word. I was more disappointed with my fellow. It went on

for a couple of weeks. Except for a couple of friends I couldn't even share it with my family (as

they were already enough worried about my match!). In the same time, people including my co

research intern were getting interviews, but I didn’t. It scared me to hell. What if I don’t match

again? What if I don’t even get interviews? I was afraid to have spare time as I would keep

thinking about all these. I ended up spending almost 16 hours at research sometimes, until

midnight. My first iv came at the end of Sept and within a week I had 8 iv calls. I ended up with

11. Finally, I could take a load off. I continued to work the same way for my attending. Bymidway, my attending was so impressed that he used to say at least twice a day that " he is

very glad that I came to work with him even though he didn’t agree initially". He started

complimenting almost every day and we ended up building a very good rapport. He didn’t even

mind a second when I had to travel most of the Nov, dec and Jan for ivs. I didn’t ask him for any

LOR, thinking if he likes me he will help somehow. I am glad i took this research as I had

something to talk during the ivs. We submitted 3 abstracts for major GI conference and three


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are accepted on Feb 16. My attending had volunteered to put in a good word for me and I was

the happiest then. I didn’t even dream that it would turn out like this. I finished my research

work in Feb and came to India. All the emotions from last year failure were running through my

mind until March 13 - 8:26 pm, when the happiest news of the lifetime had come 4 minutes

early! I matched. I wasn’t jumping in joy, I wasn’t elated. More than anything, I just felt

relieved. I matched into my first choice program!

The journey had been crushing, but was fruitful too. Met so many people from different

countries and made so many friends.

PS: Most of the hospitals don’t offer Obsies as per their official policy. But, I tried emailing

attendings and it worked out. So, don't leave any place. Just, keep trying.

One advice: Don’t GIVE UP.

RAJA CHANDRA


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FAQs regarding application for steps

These are some of the questions I had encountered on multiple occasions from many people.

1.

Can we change the testing center from some country to the USA or from the USA to

some other country?

-

Yes, you can change from any country to another country.

-

Just call ECFMG customer care. They will give you a number to which you

can fax your request. You will just have to write your details and the request

“Please, change my testing center from “current country” to “the country

you want”, on a white paper and sign at the bottom.

-

If you change your testing center from any other country to the USA, then

you will get a refund for the testing center surcharge fee(150$) that was

earlier charged in your country.

-

If you change your testing center from the USA to any other country, then

you will be charged a testing center surcharge fee depending on the country

you are changing it to.

2.

Can we extend Step1/2ck/3 more than once?

-

Yes, you can as many times you want.

-

Within the eligibility period, you can change your exam date as many times

as you want. If you do it more than 31 days prior to the exam date, then you

don’t have to pay any fee. Otherwise, there will be a fee every time you

change the date.

-

You can extend the 3 month eligibility only once with a small fee.

-

Once the extended 3 month eligibility is also over, then you will have to pay

for a new step application fee (entire amount) to get a new eligibility.

3.

Does giving a step in the USA is beneficial in getting more marks?

- I don’t think there is any such correlation between the score and USA as the

testing center.

4.

Anticipated year of graduation for Step application if you haven’t graduated yet.

- Just put an anticipated date as per your current situation.

-

This date can be different when you are applying again for another step

exam.

- The only date of graduation that is final and remains in the ECFMG records

is the one you submit during credentials verification after graduation.


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5.

What to mention in the Clerkships section of the application?

-

Just leave it blank (or select the option NO) even if you had done clerkships

in the USA, unless you got credits for it.

- It is for the American medical graduates or the Caribbean graduates who do

clerkships in hospitals other than home school and get credits for it.

6. For Indians: What date should you mention for YOG? Is it internship completion date

or date on the certificate?

- You can mention the date of issue mentioned on the diploma.

7.

Should I mention it as a break in education if I had gone for clerkships and hence

delayed my internship end date?

- No, never mention it as a break in medical education.


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USMLE STEP 1

Ideal Duration: 6 months (But, remember it varies from individual to individual)

Resources: Kaplan notes, Kaplan Videos, First Aid, Uworld

Alternative resources: If you are aiming for high scores

1.

Pathology: (also gives a stronger foundation which would help for Usmle step2 and 3)

A. Golijan, Golijan lectures (OR)

B. Pathoma, Pathoma videos makes it easier – Easier to study and remember

compared to Golijan

2. Behavioral Science/Ethics:

A.

High yield

B. BRS

C. Conrad Fischer’s 100 Ethics cases

3. Biostatistics:

A.

Take the uworld’s additional 25$ subscription for biostats

Practice tests:

1. USWA: Uworld self assessment forms 1 and 2

You will get it for a cheaper price if you buy it along with the usmle question bank.

It will be available for access for only 14 days from the time of activating it.Uworld question bank activation and uwsa form activation are two separate things.

So, you can buy it along with the question bank, finish doing the q bank and then

activate UWSA only when you are ready to give an assessment exam.

2. NBME: Numbered as form 1, 2, 3 and so on. Higher the number – newer the form

There are many forms. You should do most of them online and then at least 2-3 latest

ones online. The latest forms correlates better with your final score. So, it’s advisable

to the latest forms online.

Strong advice: Do all the nbme forms and uswa forms. The more you do, the better

your final real exam score would be. It will help you in managing time, gives you new

information and also helps you how to think fast in tricky situations. If you are lucky,

you can see a couple of similar questions in your real exam.


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3. OPTIONAL – You can try Kaplan Qbank if you want, but not necessary as the pattern of

questions from Kaplan is totally different to that of final exam. You can do it if you have

a lot of time and if you want to gain more knowledge. I have seen people getting 260s

even with avoiding Kaplan q bank.

4.

OPTIONAL – Flash cards for USMLE Step1 – Again it’s not compulsory but a good way tomemorize subject and especially during breaks.

From my experience:

1. UWSA over estimates your final real exam score and NBME underestimates your

final real exam. So, ideally your final score would be between UWSA and NBME avg

scores. Now, this is how it is usually correlated. This doesn’t mean your final score

shouldn’t be more than that of NBME or less than that of UWSA.

2.

Ethics and Biostats questions have more weightage compared to other subjects. So,practice these as many times as you can. Do the same questions again and again,

giving importance to the explanations until you get a hang of it.

Eg: X and Y had each answered 10 questions wrong overall.

Out of those 10 questions, X had answered wrong for 2 Ethical questions,

whereas Y had answered wrong for 5 Ethical questions. The final score of X will

be higher than that of Y, as X did better with ethical questions.

3. Final real exam questions are more closer to that of NBME than UWSA.

Approach:

Common mistakes/misconceptions: Most of us give step1 after final year medical school. So,

when we first open biochemistry or microbiology we don’t remember a bit and hence, we end

up studying the notes for days. DON’T DO THAT.

DONT’s:

1. Don’t waste your time reading Kaplan/other notes for days or months.

2. Don’t waste time on Kaplan videos for each and every topic or subject.

Step wise approach to USMLE Step1:

1. Just give one quick reading for all the subjects.

2. Use Kaplan videos along with the notes if you have trouble understanding or

remembering some concepts.


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3. After the first read, go through First Aid for USMLE step1. Read it once or twice

depending on your individual grasp of information.

You should ideally do this all within 2 months

4. Take a 3 month (ideal duration) subscription for Uworld.

5.

Do at least 1-2 whole blocks per day. You can do it subject wise or random. You canuse tutor mode.

6. Write down the concepts and explanations that are new to you. Go to and fro

between Kaplan/first aid and uworld if you forget some topic or if you feel you

need to read it in detail again.

7. Mark the questions that went wrong or those you think must be done again for

sure.

Ideally, you should finish all the questions atleast once in 1 n half months to 2

months.

8. Start the 1st revision. Start using timed mode. This is going to be faster than your

first time. Do more blocks per day. At least, 3-4 blocks or more per day and

simultaneously read the notes you prepared. You can do all the questions or those

you marked during the first time. (I would suggest do them all, as even those you

got it right the first time may confuse you now.)

You should finish the 1st revision in 15-20 days.

9. Start the 2nd revision. Definitely, use the timed mode. This is the revision where

you should focus on managing the time. Do 5-6 blocks per day or more. You can

even do 8 per day, which would help you big time with managing the time (of

course it depends on how strong your first revision was). As with 1 st revision, do

only the questions you marked during 1st revision or do them all in random.

This shouldn’t take you more than 10 days.

10. The last month is very crucial.

Day 1 and 2:

Start with UWSA form 1. Give it within the time without taking any breaks.

Read the explanations once the exam is done. You will get a lot of new info and

new questions. So, read them all and note the important points. Spend two days in

total for reading explanations along with previous notes or FA.

Day 3 and 4:

Do UWSA form 2. Again you can expect a lot of new information and questions. Go

through the explanations, take notes and take it slow.

I suggest starting with UWSA and not NBME because, UWSA gives explanations and NBME

doesn’t. So, you can use UWSA as both an assessment tool and a reading tool.


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From Day 5 onwards, start doing NBMEs. Do, one per day.

Finish all of them or how many ever you want by 2 weeks prior to your final real exam date.

Your last couple of NBMEs must be given online. As I earlier mentioned, NBME doesn’t give

explanations, so have a reliable group of friends who can help you find the answers quick.

2 weeks prior to exam:

1. Don’t over stress. You have done it all. You did everything you could.

2. Revise the notes you made from Kaplan, Uworld, UWSA and NBMEs.

3. Read First Aid – On the day of the real exam, the things you remember are

mostly from first aid and the notes you made and not from Kaplan text books or

anything else.

2 days prior to the exam:

1. Relax as much as you can. Watch a movie or tv shows.

2. Sleep as much as you can. Especially the night before the exam.

What to expect during the preparation?

1. Starting with Kaplan could be boring – but, don’t lose interest and give scope to

long gaps between studying.

2. Since, we usually start studying after final year, most of the knowledge from 1st

and 2

nd

year subjects is already lost. – So, don’t be scared that when everythingappears as new information.

When you start Uworld:

3. Be prepared to know that what you read from Kaplan will be a lot different to

what you are going to be tested.

4. Use Uworld as a LEARNING TOOL. – It’s a very common thing that most of the

people get scared and doubt their talent when they answer wrong for most of

the questions. Remember, everyone will be on the same page. Don’t be scared.

5.

Just as above, your first experience with Uworld shouldn’t be assumed as a testto your knowledge. Just take it as a LEARNING tool. Think it as another text

book. Just learn from the explanations given for every question. I am saying this

twice because I have seen a lot of people who got scared and lost hope when

they got most of the answers wrong.

6. Depending on a person’s IQ the percentage of the questions you get right during

your first time with Uworld can be anywhere between 30% to 80% or more. But,


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this doesn’t mean that a person in the 30% category can’t score same as the

person in the 80% category, if not more in the final exam.

7. During the first REVISION, the % of questions that are correct should be atleast

more than 60% - This depends on your hard work during the first time.

8.

If even during your 1

st

Revision your % of correct answers is less than 60%, don’tlose hope. It just means that you would need more revisions later on. You can

still get to 90%+ right answers by 3rd or 4th revision.

Resources for Individual subjects: Uword + FA is common for all the subjects

1. Physiology – Kaplan

2. Anatomy + Neuroanotomy – Kaplan

3. Biochemistry – Kaplan

4. Microbiology – I would suggest not to waste time with Kaplan. First aid is more

than enough5. Pharmacology – Kaplan in my experience. But, some do it just from First Aid.

6. Histology – No need to stress from Kaplan. You will learn it from Pathology and

Uworld.

7. Genetics – Try genetics questions from Kaplan Qbank too.

KEY: PRACTICE – it’s the only thing that determines your final score. Do as many questions

as you can and as many times as possible. Don’t waste too much on reading Kaplan text books.

STEP 1 score is very important.

Useful Links:

1. http://www.usmleforum.com/files/forum/2016/4/823217.php

2. BRS – Physiology

http://www76.zippyshare.com/v/77914815/file.html

3. Becker Step1 Videos

https://mega.nz/#F!TQoTwQzK!crBHQr2_oaZfMujSA27nDg!XVYQlZ5I

4. Pharmacology Flash cards

https://kat.cr/kaplan-medical-usmle-pharmacology-and-treatment-flashcards-the-200-

questions-you-re-most-likely-to-see-on-the-exam-for-steps-1-2-3-unitedvrg-

t10192286.html

5. Step 1 related

https://docs.google.com/document/d/1xP1J0VxJ6yPlAVzrbtitoDYRkLs7XfU7cI0-

Wcegsy8/edit

http://l.facebook.com/l.php?u=http%3A%2F%2Fwww.usmleforum.com%2Ffiles%2Fforum%2F2016%2F4%2F823217.php&h=uAQEmzaDYhttp://l.facebook.com/l.php?u=http%3A%2F%2Fwww.usmleforum.com%2Ffiles%2Fforum%2F2016%2F4%2F823217.php&h=uAQEmzaDYhttp://www76.zippyshare.com/v/77914815/file.htmlhttp://www76.zippyshare.com/v/77914815/file.htmlhttps://mega.nz/#F!TQoTwQzK!crBHQr2_oaZfMujSA27nDg!XVYQlZ5Ihttps://mega.nz/#F!TQoTwQzK!crBHQr2_oaZfMujSA27nDg!XVYQlZ5Ihttps://kat.cr/kaplan-medical-usmle-pharmacology-and-treatment-flashcards-the-200-questions-you-re-most-likely-to-see-on-the-exam-for-steps-1-2-3-unitedvrg-t10192286.htmlhttps://kat.cr/kaplan-medical-usmle-pharmacology-and-treatment-flashcards-the-200-questions-you-re-most-likely-to-see-on-the-exam-for-steps-1-2-3-unitedvrg-t10192286.htmlhttps://kat.cr/kaplan-medical-usmle-pharmacology-and-treatment-flashcards-the-200-questions-you-re-most-likely-to-see-on-the-exam-for-steps-1-2-3-unitedvrg-t10192286.htmlhttps://kat.cr/kaplan-medical-usmle-pharmacology-and-treatment-flashcards-the-200-questions-you-re-most-likely-to-see-on-the-exam-for-steps-1-2-3-unitedvrg-t10192286.htmlhttps://docs.google.com/document/d/1xP1J0VxJ6yPlAVzrbtitoDYRkLs7XfU7cI0-Wcegsy8/edithttps://docs.google.com/document/d/1xP1J0VxJ6yPlAVzrbtitoDYRkLs7XfU7cI0-Wcegsy8/edithttps://docs.google.com/document/d/1xP1J0VxJ6yPlAVzrbtitoDYRkLs7XfU7cI0-Wcegsy8/edithttps://docs.google.com/document/d/1xP1J0VxJ6yPlAVzrbtitoDYRkLs7XfU7cI0-Wcegsy8/edithttps://docs.google.com/document/d/1xP1J0VxJ6yPlAVzrbtitoDYRkLs7XfU7cI0-Wcegsy8/edithttps://kat.cr/kaplan-medical-usmle-pharmacology-and-treatment-flashcards-the-200-questions-you-re-most-likely-to-see-on-the-exam-for-steps-1-2-3-unitedvrg-t10192286.htmlhttps://kat.cr/kaplan-medical-usmle-pharmacology-and-treatment-flashcards-the-200-questions-you-re-most-likely-to-see-on-the-exam-for-steps-1-2-3-unitedvrg-t10192286.htmlhttps://kat.cr/kaplan-medical-usmle-pharmacology-and-treatment-flashcards-the-200-questions-you-re-most-likely-to-see-on-the-exam-for-steps-1-2-3-unitedvrg-t10192286.htmlhttps://mega.nz/#F!TQoTwQzK!crBHQr2_oaZfMujSA27nDg!XVYQlZ5Ihttp://www76.zippyshare.com/v/77914815/file.htmlhttp://l.facebook.com/l.php?u=http%3A%2F%2Fwww.usmleforum.com%2Ffiles%2Fforum%2F2016%2F4%2F823217.php&h=uAQEmzaDY


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USMLE STEP2 CS

When to give it?

1. Ideally give it after your clerkship or observership, as you will get to know how

to talk to patients in the USA.

2. It can be given before step1 or after. It doesn’t matter. I gave it before step1.

Where to give it? Obviously, only in the USA

1. The centre/city doesn’t matter.

2. Philadelphia is considered as a tough center to pass. But, I have seen many

foreign medical graduates clear CS from this center. So, don’t be scared if this

is the only center that’s available for the dates you want or to chose it if this

center is close to where you live.

3. Houston – You can find a lot of people practicing for CS here. So, it would be a

very good option to give your exam here as you will get so many people to

practice with in live. You will get a lot of support and assurance – as you will

meet a lot of people on the same boat as you. You can work on your accent

and mannerisms.

4. Any other city is equally good as long as you have someone to practice with in

person.

Duration: 3-4 weeks of preparation is more than enough. (I gave it in less than 2 weeks and so

many others, too.)

Resources: First Aid is enough. You can try the videos on youtube for clinical examination or cs

videos. There is also a short and concise notes available which is very easy to remember and

recall. It was written by someone who took the CS exam in the past. I didn’t even do first aid. I

just read these concise notes which are only like 15-20 pages. It has all the questions you need

to ask for each symptom and mnemonics to remember them all. You can get it from your

friends or other people who gave their CS already.

CS course in New York: You don’t need this at all. You can avoid it and save money.

Suggestions:

1. Practice is the most important – especially in person with someone.

2. If you are slow with typing:

A. Get a desktop keyboard and practice on it. – Not laptop keyboard.

B. Spend atleast 2-3 hours every day or more on typing notes.


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C. Keep a time limit for typing a certain number of words or a case.

3. 1-2 days before the exam – Don’t overdo it as it may affect your voice.

Remember, your voice is very important on the day of the exam.

4. Work on your accent/speech delivery – It need not be American at all. As time

is gold during the exam, you will have to talk as quick as possible while makingsure that it is comprehensible. So, just work on the tone, speed and delivery.

KEY: Everyone has clinical knowledge, but the most important thing CS tries to test is

1. Most important: How you approach a patient – Especially concern and empathy

2. Your English proficiency – Ability for you to understand the patient and for the

patient to understand you. This should be simple.

3. Remember, the patients are actors. So, they will try to test you in every possible

way – From wasting time to irritating you. Don’t lose your cool and try to stick to

the topic in a way that’s not harsh or rude.

TIPS:

1. Type everything with CAPSLOCK on. It will save some very important “SECONDS

or a minute” overall, as you don’t have to switch between small letters and

capital letters at the end of every sentence.

2.

Knock the door before entering. Remember the name and ask the patient if youpronounced it properly or ask them to pronounce it for you if you find it difficult.

3. Explain the patient everything before you perform any simple kind of physical

examination.

4. Closure is important. Explain to the patient your differential diagnosis, what you

think it could be, what are the tests you are going to do (explain what’s a CT or

endoscopy is in simple terms) and that you would plan the management (by

discussing with the patient) accordingly as per the outcome of the results.

5. Whenever the patient gives a history of smoking/alcohol/drugs – Explain them

how it can affect the health, advice to quit, ask if the patient is ready to quit andlet them know of the rehab if the patient is ready to quit. It’s best to do it as

soon as the patient gives a history, because you might forget to do it at the end

along with the closure. If you want to do it at the end, make sure you write it in

BOLD letters on the notepad you carry.

6. Smiling is good, but don’t smile when the patient says he is depressed or in pain.

7. Don’t try to shake hands with an emergency case.


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8. Use gloves for physical examination rather than washing hands as you will have

to wait until your hands become dry every time you do it. Also, there is a risk of

your hands being too cold for the patient.

9. Your first differential diagnosis must be the most plausible one.

10.

Physical examination: Take care to give consideration to patient’s privacy andpain.

11. Never do a private parts examination on either gender, as the case won’t be

related to it.

What to expect on the day of the test:

1. Be prepared to realize that the 15 minutes inside the patient room will pass like

5 minutes. So, don’t waste time doing unnecessary stuff.

2. It is common for the first one or two cases to not go as planned. It is common

to think that you screwed it up or it is common to genuinely screw them up.Don’t let it affect your next cases. Just forget about every case as you leave the

room and type the notes. Don’t carry it to your next case.

3. It is a very common feeling at the end of the day to think you would fail for

sure. Don’t let it through you into depression. You will be good as long as you

stick to basics and not try to do anything out of ordinary.

From my experience:

1. I have seen people passing the exam despite failing to give CLOSURE for 4-5

cases. But, try to give closure for all the cases – just don’t worry if are not ableto.

2. I have seen people passing the exam despite failing to write all the three

differential diagnosis for 4-5 cases.

3. You will pass, as long as you don’t do any blunders – Like coughing in the

patient’s face, not showing empathy at all or being rude and so on.

4. People have done it practicing with others over skype. But, I would strongly

recommend to practice at least once with someone in person before the exam.

Empathy, proper manners, and comprehensible speech delivery – You shall pass.


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I am not going to explain this in detail as I already did it for USMLE Step1. The approach is the

same. Once you are done with Step1 exam, you will get a hang of it and you are going to

become your own master of USMLEs.

USMLE STEP 2 CK

When is the ideal time to give it? – It’s best given asap after USMLE step1. It will save a lot of

time as your basics would be strong and fresh.

Duration: 3 months if given immediately after USMLE STEP1. Otherwise 4-6 months.

Resources: MTB 2, MTB3, Uworld

Practice Tests: 1. UWSA 2. NBME forms 1-7

USMLE STEP 3

When is the ideal time to give it? – It’s best given asap after USMLE step2 CK. It will save a lot of

time as the subject tested is almost same as that of CK. Also, give it before starting residency

because residency is already stressed up and you wouldn’t want to add step3 to it.

Duration: 2-3 month if given immediately after CK. Even otherwise 3-4 months is more than

enough.

Resources: MTB3, Uworld, Archer videos

Practice Tests: 1. UWSA 2. NBME

TIPS:

1. Give more importance to CCS. Getting most of CCS questions right will improve

your final score by many points.

2. Aim for a score above 220, if you are planning to apply for competitive fellowships

like GI and Cardiology.


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USCE – United States Clinical Experience

Types of USCE:

A.

Clerkship: It is considered hands on clinical experience. You MUST try your best to

do this no matter what.

Eligibility: You should be a medical student and not graduated yet

For Indians: Internship period is still considered as not yet

graduated.

Advantages:

- The best clinical experience

- This is what the programs look for

-

The LORS from this have a great value

B.

Observership: Not a hands on, just shadowing another doctor.

Eligibility: Either a medical student or after graduation

-

Not considered as a USCE by most of the programs

- Some hospitals might let you touch and examine patients, but

legally you are not supposed to

- Best to fill the gap between graduation until residency application

or end of the season

- A reasonable time spent a big university or a community hospital

that takes IMGs into residency is fruitful.

C.

Externship: Hands on clinical experience.

Eligibility: After graduation

- Some programs doesn’t consider it as USCE as this kind of

experience is mostly offered by private agencies or at private clinics.

- The LORS can mention it as hands on.

- Best to do if you haven’t had any clerkships

1.

How to get USCE?

- This question irritates people the most when you ask them without

even putting minimum efforts.

-

The easiest and the first thing to find a USCE is to do a google

search.

- Type something like “Hospitals in the USA offering

electives/observerships/externship for foreign medical students”.


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Or “hospital name – visiting international medical students

electives”.

- Finding an Observership is much more easy. Google for random

university or community hospitals. Go to their webpage, look for

your desired specialty or subspecialty, open the faculty page, checkif they mentioned their email ids. Just email them. If you can’t find

the email id of the faculty, email the program coordinator or the

administrator. If you can’t find any email id then move on to

another hospital.

- You can ask the email ids of the coordinator or the doctors from

someone who has done an elective or obsie at that particular

hospital. Or ask your friends or seniors who are now residents at

that hospital.

- If, you are in the USA, just walk into a nearby hospital with your

CV and talk to the program coordinator. Or email an attending

asking for an appointment.

-

2.

Private organizations offering clerkships/externships: I would strongly suggest not

to use these for clerkship unless it is a last resort. The best way to do a clerkship is

by directly applying to university that is providing it. The hospitals provided through

these are usually private clinics.

A. Americlerkships

B. Chicagoclerkships

C. Fmgportal

3.

Hospitals that offer USCE.

- This is just a small list I remember.

Clerkship: All the hospitals prefer TOEFL

Without Step scores: A. Yale - Paid

B. Harvard - Paid

C. Weil Cornel - Paid

D. John Hopkins – Very minimal fee

E. NIH - Free

With Step scores:

A. UNC - Paid

B. Jefferson


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C. UT southwestern, Dallas

D. Cleveland Clinic, Ohio

E. Case western, Ohio

F. St Joseph, Arizona

Observership: From my experience, you can try at any random

hospital, especially university based.

A. Albert Einstein, Philadelphia

B. Allegheny General, Pittsburgh

C. USF, Florida

D. Moffitt Cancer Center, Tampa

E. MSKCC, New York

F. Mt. Sinai, New York

G. Maimonides, New York

H. UAB, Birmingham

I. University of Texas, Houston

J. Methodist, Houston

K. St. Luke’s, Houston

L. UNMC, Nebraska

M. MD Anderson, Houston

N.

Duke, NC

O. Staten Island University, New York

P. Griffin Hospital, CT

Q. Tampa General Hospital, Tampa

R. St. Vincent, Worcester

S.

Washington Hospital Center, DC

Externship: A. Jackson park, Chicago

B. Heart and vascular institute, Detroit

4.

Ideal duration of USCE?

- There is no such fixed duration.

-

3 months of clerkship is the best as most of the programs are now

having this requirement.

- Few programs now have a requirement of 6 months.

- So, ideal number of months of USCE goes from 3 months to as many

as you can.


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- If you are a recent graduate (for eg: graduated 3-4 months or less

before September of the year of residency application), then even

one or two months of USCE with a couple of good letters is fine.

5.

What is your role during a clerkship?- It’s just like internship or final year medical school.

- You will get to see patients on your own first, then you will present

it to your resident, who will then go to see the patient along with

you. Later in the day you will present the same case to the

attending (doctor), who would ask you simple questions regarding

your thoughts, management and future plan. Then you would see

the patient again with the attending.

- You will get to use the electronic medical records, where you right

your findings. Your attending has to sign it before it goes on record.

6. How many months in advance should you apply for a clerkship?

- Apply atleast 6-9 months in advance of your desired month of

electives to have a much better chance of securing one.

- (for Indians) I have seen some people from the north applying in

final year MBBS, for the months right after final exams. You can

finish your elective during the duration in between finishing final

exams and the start of internship. This way, you don’t have to

postpone your internship end date by more than a couple of

months and also you will be able to apply for the residency match in

the same year of internship completion (graduation). You can apply

for clerkships in those programs which don’t need step scores.

7.

How many months in advance should you apply for an obsie/externship?

- Whenever you can. As early as possible.

Suggestions:


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1. Keep your electives/obsie as widespread( with respect to regions) as possible. Doing

an elective/obsie in a particular region can help getting interviews from that region

and it also shows that you are willing to go where ever without any preferences.

2. Once you are in the USA, it becomes very easy to find more electives or obsies.

3.

Even if you don’t meet certain requirements of a program, there is no harm incontacting them.

4. If they can’t offer you one right now, don’t just leave it there. Send a thank you

email for their time and mention to let you know if anything opens up in the future.

Be in regular contact.

5. Get done with TOEFL whenever you can. Even if you are not planning to apply for

clerkship at that moment. TOEFL score is valid for two years.

USEFUL LINKS:

1. Americlerkships

http://americlerkships.org/

2. Chicagoclerkships

http://chicagoclerkships.com/services.php

3. Fmgportal

http://fmgportal.com/

4. List of hospitals

http://electives.us/visatype.html

http://americlerkships.org/http://americlerkships.org/http://chicagoclerkships.com/services.phphttp://chicagoclerkships.com/services.phphttp://fmgportal.com/http://fmgportal.com/http://electives.us/visatype.htmlhttp://electives.us/visatype.htmlhttp://electives.us/visatype.htmlhttp://fmgportal.com/http://chicagoclerkships.com/services.phphttp://americlerkships.org/


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RESEARCH

FAQs

1.

What are the types of visa on which you can join research?

A. Research Volunteer/Intern: B1 visa

- It is an unpaid position.

-

Your visa could be B1/B2, but at the port of entry the customs officer

usually stamps B2. So, make sure you ask him to stamp B1 if you are

going for this kind of research.

B. Research Assistant: J1 visa

- This could be paid or unpaid position.

C.

Post doc: J1 visa

- Paid or unpaid depending on the funds.

-

They usually have a commitment for 2 years. But, sometimes you can

break it after an year depending on your attending.

2. What are the advantages of research on B1?

- You don’t have to commit for long term like research on J1.

- It’s usually for a maximum of 6 months at a time. It could be for lesser

duration depending upon the communication between you and your

attending at the time of applying.

- It’s the best one during the interview season as you can travel for

interviews without any obligations. With J1, especially when you are

getting paid you are obligated to spend certain number of hours per

week and so you will have to manage work hours every time you travel.

- You can leave whenever you want if the project is over or for other

reasons. But, out of courtesy and good manners do mention it to your

attending beforehand.

3.

Some places which are know to give research opportunities.

- John Hopkins – J1

-

Yale – Post doc or volunteer research

- MGH – Post doc or volunteer research

- MD Anderson cancer center, Houston – B1

- NYU, New York – B1

- MSKCC, New York – B1

- Maimonides, New York


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- Upenn

- Creighton, Omaha

- University of Buffalo, New York

- UNC, NC

-

University of Louisville – J1Ashley Reinhart

Clinical Research Management Assistant

Division of Infectious Diseases

University of Louisville

501 E. Broadway, Suite 140B

Louisville KY, 40202

P: (502) 852-2824

4.

How to get a research position?

- Just like I mentioned for USCE, email every hospital you can.

-

Specifically target the universities as they would be doing research for

sure and hence more chances of getting one.

- Go to any university or community hospital website, find the faculty

page, look their profile for research activity, and email the attendings or

the program coordinator.

5.

What to mention in the email?

- First, remember that every attending in any hospital would be getting

thousands of such emails every day.

-

So, have patience. You might have to send 1000 emails before you get

one reply. If you are lucky your first email itself might be the one.

- Don’t just send a generic email.

- Give a one or two line intro about you, tell them that you are interested

in their field (of the attending). Look their profile and mention words

related to their field of research in specific. You can tell them that you

want to fellowship in the subspecialty and hence this would be very

helpful.

- Mention about the usmle steps you have taken and the scores.

-

Mention any kind of research you had done in the past.

- Don’t forget to attach your CV.

6.

Clinical vs Basic Science research. Which one to choose?

Clinical research:

- During the time of the residency application season.


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- When you have time constraints.

- When you want its effect to be shown soon – eg: You need publications

for this application season and you hardly have 3-4 months before sept

15th.

Or when you start it around sept and want something by the time you gointerviews or by the time of ROL(rank order list) submission in Feb.

- Not every clinical research guarantees publications in a short span.

Choose the attending wisely. When you email an attending, check their

profile to see how many publications they have on an average per year

or in the last couple of years. If they have many, then it’s more likely that

you will get a publication in a couple of months too.

Basic Science research:

-

If you have at least one year time before you apply for residency. - If your goal is to get into a very good university hospital and time is not a

factor.

You can even do it at places like Yale or any other big university and

match at that place after an year or two. I have seen people matching at

Yale and other big places after research for an year or two. Even in fields

like Surgery with scores as normal as 230s.

- So, apply at a big place, but plan at least an year in advance.

- Again, this doesn’t guarantee matching at that university. It depends on

how well you impress your attending.- This doesn’t guarantee a publication in that one year, too. But, the

work accounts to something.

- This would help a lot even for fellowship.

7.

Does only 1st author abstract/publication have importance and not others?

- 1st author definitely has a great value, especially during fellowship

application in that field same as your research.

- But, any author is good for us at this level (for residency application).

- It gives you a very good topic to talk during your interviews.

- So, don’t worry even if its 3rd or 4th author. Anything after 1st is the same.

8.

What are the questions that are commonly asked during an interview for a research

position?

- Why do you want to do research?

- What are your plans in the immediate future?


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- Why do you want to do research in this particular field?

- Are you applying for the residency match this year?

- Do you have any experience in research? If yes, what was your role?

- What are you expecting from this research?

-

What kind of role are you willing to play? - How long are you willing to commit?

- How many hours per day/week are you willing to work?

- How early can you start?

- Are you in the US? What visa are you on?

- Can you use Microsoft excel?

- Are you expecting any pay?

- If it’s an unpaid research – How are you going to manage living

expenses? Do you have family here?

9. I don’t have any research experience. Would they offer me a position?

- If you are from India, then the attendings totally understand that most of

us won’t have any prior research experience since there is not much

importance or resources for research in India.

- I don’t know about the research exposure in other countries. But, not

having a prior research experience won’t be a hurdle in finding one.

- Of course, having a prior research experience is a plus, but not having

one is alright.

- This is why it is very important to show that you are serious by searching

for the specific field of interest of the attending doctor and then talking

about that with him. Be as specific as possible.

10.

What else can I do if I can’t find any research position or how can I get publications in

spare time by just sitting at home?

- You can try for case reports during your electives or obsies.

- Keep in good touch with the residents, fellows or the attendings you

worked with. Keep asking them if you can write review articles with them

or if you can draft the abstract or the paper they are working on.

-

Find someone in your friends circle, or on the fb groups or usmle forums

who is interested in writing review articles. Just find any current

interesting topic and write about it. It’s the simplest thing you can do.

You just need to include the name of an attending or some fellow with

good credentials in order to increase the chances of your article being

accepted.


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11.

Is research with publications compulsory to match?

- It’s very important if want to match into a university program or a very

competitive community hospital.

-

Otherwise, it isn’t compulsory to match. -

12. Does research with publications guarantee a match?

- Research with publication only improves your chances of being matched

at a university program.

- It doesn’t guarantee overall matching at a university program or a

community program.

- It definitely adds up to your CV.

- Matching depends on your overall profile, personality and how you did at

the interview.

13. Is research experience without publications waste?

- It is a very common misconception that research without publications is

a waste.

- It’s not!

- You get to spend a quality amount of time with your attending or PI. This

will give him enough opportunity to write you an outstanding LOR. He

can even put in a personal word for you via phone or email.

- It will give you a wonderful topic to talk during the interviews.

- If your interviewer belongs to the same subspecialty or has similar

interests, you score many points there. Even otherwise, your interview

will be more than decent.

- At the end of the day, everything comes down to building “contacts”.

You would be spending many months at one place and hence a lot of

scope to make decent contacts. All you need is “one”.

- So, if you have enough USCE already it doesn’t matter even if your

research is starting in September or later (after you already applied for

the match).

Suggestions:

1. Know specific details about your attending and his field of research before you talk to

him.


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2. The person giving you a research opportunity would like you to commit for as long as

possible. So, you answer should be a minimum of 6 months commitment. Anything less

would lose the attending’s interest. Because, he has to train you and then if you leave

soon he will have train someone else before any work could be done.

3.

Mention you would work atleast 8hrs per day and that you would be willing to work onweekends too, if needed.

4. For paid positions, the duration of commitment could be 1 year or more and the working

hours might also differ. So, just tell them you would commit for as long as they want

(provided you are ok with it).

5. Most of the initial unpaid research is data collection. It’s a very simple thing. You don’t

need any experience for this. So, don’t worry. Even if you don’t know how to use excel,

it’s ok. You can learn it as you use it.


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LOR: LETTER OF RECOMMENDATION

FAQs

1.

How to get a good LOR?

- It’s very simple. The doctors in the USA are very friendly. They just

expect you to know basic knowledge.

A. Be on time – very important.

B. Come to the hospital at the same time your resident or fellows

come and leave along with them, even if they ask you to leave early.

C. Read a topic, or something related to the cases you see and ask

your resident or the attending some intelligent doubts in that topic.

This way you are building up a rapport without sounding dumb

when they talk about that topic.

D. Volunteer to take a case or present a topic. Don’t wait for them to

give you work.

E. The way you talk to the patients is very important.

F. If you find some interesting case, volunteer to write a case report.

It’s the easiest thing you can get published in a short time.

G. Attend all the seminars, grand rounds and morning reports. Don’t

miss any.

H. Find out if your resident or fellow is working on any paper and

request to give you a role in it. I. Search about your attending on the program website and learn

about his field of interest. You can talk to him about topics related

to it in free time. Also, see if he is into research and then request for

a position if you are interested.

J. Don’t just talk about subject all the time. Talk about sports, movies

or anything that your resident or attending is interested in. You

should show your all round personality.

2.

How to get a good LOR from an Observership?- It’s a common misconception that one can’t get a good LOR for an

obsie as its not hands on.

- You can still get a very good letter by following all the points I said

above except for taking cases.


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- You main focus here should be to be on time, attending all

seminars, volunteering to present power point presentations or

small talks pertaining to the cases whenever you get time.

- Some attendings may even let you see a patient if you show sincere

interest. However, they won’t be able to mention it in the Letter.

3. My attending changes every one week or two weeks. How can I ask for a letter?

- YOU ARE NOT ALONE in this aspect. Almost everyone faces this

situation while doing a clerkship, and sometimes during

observership.

- So, make sure you utilize every minute of that 1 week or 2 weeks

with your attending.

- Your resident will be with you for the entire rotation depending on

his schedule. So, your LOR author will take inputs from your

resident or the other attending you would work with for the

remaining duration.

- DON’T HESITATE TO ASK FOR AN LOR. As this might be your only

chance to get a letter or you might face the same situation during

your next rotation.

- THE ATTENDINGS TOTALLY REALIZE YOUR SITUATION. THEY KNOW

WHY YOU ARE HERE AND WHAT YOU ARE EXPECTING. And as I

said earlier, the doctors here are very friendly. So, more often than

not they agree to write you a letter.

- It could be a generic letter, but remember it also might be your only

letter! Don’t miss it. You can later decide whether to use it or not if

you get more letters.

- A GENERIC LOR IS A WAY BETTER THAN “NO LOR”.

4. When to ask for an LOR?

- There are mixed opinions about the timing of the request.

- Some say ask during the start of your elective and some say ask at

the end.

-

I feel the best time to mention is at least one or two weeks prior to

your rotation end date. By this time you would have developed

enough rapport with your attending and will also give enough time

for the attending to assess you more personally.

- If you are rotating with the doctor for only one week and you need

his letter, then just ask on the last day.


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5. How to ask for an LOR?

- Don’t rush into it during the rounds.

- The best thing to start with is to ask him for an appointment at his

office. You can tell him that you would like to discuss about yourfuture plans. No attending would say no to this.

- During the meet, you can start with the fact that you would be

applying for residency in that specialty and that it would mean a lot

to have a letter from him. Then, request him if it would be possible

for him to write one.

- Use this meeting to also talk about future opportunities like obsie or

research.

- If you couldn’t ask him in person for the appointment you can email

or his assistant.

- If setting up an appointment wouldn’t be possible because of the

time constraints, then just ask him at the end of the day’s rounds.

6. Waived vs Unwaived LOR?

- Waived means you are giving away your right to see the letter. This

will have more value since it is assumed that the author would write

an unbiased letter as you won’t get to see it.

- Unwaived means you have an access to the see the letter. This will

have less value for the above mentioned reason. But, it’s not a

waste letter.

- I STRONGLY RECOMMEND TO TAKE A WAIVED LETTER, unless you

have strong reasons(not just paranoid reasons) to believe that the

author might mention something negative about you in the letter.

Only in that case take an unwaived letter and see whether you can

upload it or not.

7. What constitutes a good LOR?

- It should be written at a personal level.

-

Any letter would mention good words or praises about you. But, the

most important thing that differentiates a good letter from a

generic one is the specific examples for those praises. –Eg: It could

be as simple as about how you dealt with some patient situation

during your rotation.


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- It should describe you in whole. Not just subject related but your

overall personality. Eg: Team player, easy to talk to, punctuality,

other skills unrelated to medicine.

- It can mention the presentations or the talks you made during the

rotation. Also, if you took part in writing a case report or anyresearch papers.

- And, finally words like “I would take him into the program if I am

the Program director”.

8. I am doing the elective now, but I would be applying for the residency next year.

So, when should I take the letter?

- This is one of the common situations faced by many, especially with

clerkships.- There is a chance for the attending to forget specific details about

you and your work if you ask him write the letter one year later.

- You have the following options.

a. Take an ERAS token for that particular year, ask the attending to upload an

LOR on to the ERAS. Next year when you are applying for the match, you will

have to take a new ERAS token and forward the LORs from the previous one.

Advantages: This way you can have a waived letter which has all the specific

details about you, as the memory of the author is fresh.

b. Let the attending know that you would be applying next year, request him to

write an LOR and save it on his desktop or with his assistant and that you

would like him to upload it next year. Most often than not, they agree to this.

Advantages: Waived letter, includes specific details about you, when he

uploads it next year he can put the current date of uploading on the letter.

c. You can ask your attending to write the letter now and take it with you. You

can upload it yourself whenever you are uploading it.

Advantages: The letter will have specific details about you and you don’t have

to worry about his availability for uploading the letter as you can do it

yourself.

Cons: Unwaived letter


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d. You can tell the attending that you would be applying next year and hence ask

him to wite a letter next year during the application time.

Cons: There is a major risk that the attending won’t remember specific details

about you. It will most probably be a generic letter.

9. How important is to have a date closer to the applications season on the LOR?

a. It’s good if you can have the most recent date.

b. But, in many cases it may not be possible especially when you do electives an

year before. So, it’s ok to have an old date since the programs would

understand the gap.

c. For observerships which you do after graduation, it’s better to have at least

one LOR with a recent date. If you can’t, then don’t worry.


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TRAVEL

- You would be spending a lot of money on this. So, always look for a couple of options

and choose the best alternative.

Commute options:

Short distance travel:

1. UBER: You can use the following code to get a 20$ off on your first ride. You can use it in

your country, too. Code: derw2

2. LYFT: You can use the following code to get a free ride. Only for first time users.

Code: RAJACHANDR538695

It’s better (cheaper and safer) to use these apps instead of the local taxis. Both UBER

and LYFT are equally good.

Long distance travel:

1. Greyhound:

Advantages:

A. Has got bus stations of it’s own, so you will have a shelter.

B. Sometimes cheaper than mega bus.

C. Even available in small towns or cities.

D. Lenient with luggage. Sometimes, they will allow you to have 2

check in bags at no additional cost.E. You can register to accumulate points and get road rewards.

Drawbacks:

A. Not as clean as mega bus.

B. When you book it online, you must have a printout. They won’t

allow you to board the bus if you show it on phone.

2. Mega bus:

Advantages:A. Sometimes can be very cheap. It can come to as low as 1$ if you

are lucky.

B. Much cleaner than greyhound.

C. Most people prefer mega bus.

Drawbacks:


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A. Don’t have a bus station. Yes, there won’t be any shelter. You will

have to stand road side and they will drop you off on the road

side, too. Doesn’t matter if it is raining or cold as hell. Doesn’t

matter if it is afternoon or 2 am in the morning.

B. Runs only between major cities.C. Strict with baggage policy. Only one check in is free. You will have

to pay for the other when you buy a ticket. If you don’t pay

before, they will make you wait until everyone is boarded and let

you in only if there is space to accommodate your extra bag.

Common things: Power sockets for every seat (some greyhound buses won’t have it), free Wifi

(though it will be slow), one free carry on in addition to one check in bag.

- If you miss one bus, you can board the next one if there is space. Also, you can board a

bus earlier than the one you booked a ticket for, if there is space.( Note: In case of grey hound- If you talk to the person at the ticket counter in these

situations, they will charge a 20$ fee. The best thing to do is to stand in the line to board

the bus and ask the driver directly before you get into the bus. He will most probably let

you in without any fee. Sometimes he may direct you to the counter.)

3. Amtrak – It is usually expensive. So, try to book as early as possible. There will be a

provision to keep your bags, though large check in bags could be a discomfort.

4. Flights:A. Southwest: Register to get offers and rewards.

a. Allows free 2 check in bags in addition to a back pack and 1

carryon.

b. Fares are reasonable and can be very cheap sometimes if

booked during offer period.

c. You can get a free flight depending on the points you

accumulated.

B.

Spirit Airlines: You can get it for very cheap, sometimes as low as 50$

But, they charge for baggage and sometimes for the seat.

The website I commonly use to book flights in the USA: www.kayak.com

(Gives all the available options. But, doesn’t show southwest prices.)

http://www.kayak.com/http://www.kayak.com/http://www.kayak.com/http://www.kayak.com/


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STAY/ACCOMMODATION:

Short duration: Especially when attending interviews.

1. Airbnb: It’s a website where you can get rooms for a cheaper rate than the hotel. It’s

the best option for a one night or a couple of nights stay.

a. The rooms are usually in an apartment or a house and most often the

owners live in the other room.

b. You can search for shared or private rooms.

c. You can search for the rooms according to the distance from the hospital.

d. You can see the photos of the room and house before you book.

e. You can read the reviews and then decide whether to take it or not. YOU

MUST read the reviews.

f. It is usually safe. I used it many times without any trouble and so did my

friends.

You can use this referral link to sign up in order to get 35$ off on your first booking. You

must sign up clicking this link in order to get it.

Link: www.airbnb.com/c/rchandra40?s=8

2. Couch surfing: Like literally renting a couch in an apartment.

a. Much cheaper option.

b. Read reviews before you book.

https://www.couchsurfing.com

Longer duration:

During electives: It’s best you ask the coordinator to send a list of places where students

usually live.

1. If you are looking for Indian roommates: www.sulekha.com

2. Craigslist: https://www.craigslist.org

a. Beware of the spammers.

b. Always ask for photos of the current state of the room and apartment

before you book it. They usually keep photos that were taken when the

apartment was new.

c. You can search for shared and private rooms.

d. Take phone number, talk to them and confirm the details.

http://www.airbnb.com/c/rchandra40?s=8http://www.airbnb.com/c/rchandra40?s=8http://www.airbnb.com/c/rchandra40?s=8https://www.couchsurfing.com/https://www.couchsurfing.com/http://www.sulekha.com/http://www.sulekha.com/http://www.sulekha.com/https://www.craigslist.org/https://www.craigslist.org/https://www.craigslist.org/https://www.craigslist.org/https://www.craigslist.org/https://www.craigslist.org/http://www.sulekha.com/https://www.couchsurfing.com/http://www.airbnb.com/c/rchandra40?s=8


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e. Ideally ask someone in the vicinity to see the room once. It’s ok if you

don’t have anyone.

f. I had used it with no problems. But, I made sure he isn’t a spammer.

3. Rotating room: https://rotatingroom .com

a. This is especially for medical field.b. But, in order to contact the person who posted the ad you need to

have a student id. Like the one that end with “.edu”

c. So, you can search the site if there is any room you are interested in

and ask someone with a “.edu” email to contact them.

https://rotatingroom.com/https://rotatingroom.com/https://rotatingroom.com/https://rotatingroom.com/https://rotatingroom.com/https://rotatingroom.com/


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MATCH SEASON

- Application for the Residency match starts on 15th September.

1.

What all should you ideally keep ready by the end of August?

- Make sure your LOR’s are uploaded. Waived LORs take longer to get processed

than the unwaived ones. The processing time can be anywhere between 1 day

to 2 weeks. The closer it gets to sept 15th the longer it takes.

- Have your final draft of PS ready.

- Have your MSPE/Dean’s letter uploaded (Dean’s letter can be a substitution for

MSPE)

- Your profile photo – keep it as professional as possible.

ERAS CV, PS can be uploaded or updated even in the last moment. There won’t beany processing time for this.

2. How many LORs can you upload?

- You can upload as many LOR’s as you want on to your ERAS account.

- But, you can assign only a maximum of 4 LOR’s per program.

3. How many US LORs and how many home LORs should you assign for each

program?

-

It depends on how many US LORs you have.- If you have enough, then I would suggest 3 US LORs plus one Indian LOR from

the head of the department of the specialty you are applying to.

- I say at least one LOR from medical school because it is them who had seen you

for years.

4. Should you assign LORs as per region?

- People have different opinions about this.

- If you feel all your US LORs are equally good, then assign LORs to the program as

per the region where you did your electives and where the program is.- Eg: If you had done electives in Florida and New York, then use more LORs from

the Florida for the programs that are in the south and more LORs from NY for

the programs that are in the North East.

Of course, this scenario arises only when you have more than 3 US LORs to

choose from.

Reason: These are just assumptions.

A. The author of the LOR might have much bigger influence in the areas

nearby or is well known in the hospitals nearby.

B.

The fact that you did a rotation in that region shows you wouldn’t have aproblem moving there.


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5. Is applying on Sept 15th very important?

- Of course, it must be having some advantage for sure. Otherwise, why would all

the Program directors and those in the medical field strongly advise you to

upload on the 15th

itself? - TRY YOUR BEST TO UPLOAD ON SEPT 15TH ITSELF.

6. Does applying on the 16TH, 17TH Sept or by the end of Sept affect your chances to

match?

- This is where you should understand not to panic.

- Applying on sept 15th is strongly advised, but it doesn’t mean applying a day or a

week later means you wouldn’t match.

- If you can’t apply on the 15th, then obviously you can’t apply no matter what.

So, stop panicking!- Applying a day or two later usually shouldn’t make much of a difference.

- If your scores are good( don’t ask me what is a good score – its subjective), then

even applying at the end of sept or oct 1st or 2nd week wouldn’t affect you

much. Again, you are applying late only because you don’t have any other

choice and the circumstances are like that. Don’t postpone voluntarily.

7. When do interviews start coming?

- There is no such fixed date.

-

For some it can start on 16th, for someone after the 1st week and for someone in

October or November.

8. Does applying late decrease the number of interviews I get?

- As I mentioned earlier, applying a day or two late or by the last week of

September shouldn’t affect it much.

- If you have stellar scores and CV then even applying in Oct 1st week shouldn’t

have a big impact.

- That said, from my experience I have noticed that a delayed application (esp in

October) has an impact on the number of the interviews you get and also on the

type of programs you get interviews from. You might miss the IMG friendly

ones.

- This effect is more profound on the people with below avg or average scores.

9. I am waiting for a step score. Should I still apply on the 15 th or wait?

- It’s better to apply with at least Step1, Step2CS and Step 2ck scores.

- If you are waiting for any of the above three scores, then I would suggest you to

wait.


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- If your score is coming out on the 16th sept or by the end of Sept, then it’s

better you wait for it.

- Because, once a program downloads your application it goes through a filter. If

that program has a filter for step results, then your application will be filtered

out. Most often, they wouldn’t have the time nor would want to review yourapplication again after your score comes out, unless you have a mind blowing

step1 score or CV or of course good contacts in the program.

10. Should you wait for ECFMG certification before you apply?

- ECFMG certification needs STEP1, STEP2 CS and CK results.

- As with scores, if youranticipated ECFMG certification date is within a week

from Sept15th or by the end of sept, you can wait until then.

- There are programs that don’t need ECFMG certification as filtering criteria. You

can apply to those in the meanwhile. - If the anticipated certification date is in Oct 1st week or later, then it’s up-to you

whether to apply or not. There is no clear opinion about it.

- ECFMG Certification takes anywhere from 1 day to 2 weeks after the last

required step results are out. On an average it usually takes 4 days.

During my 1st season, I was waiting for my Step 2ck results and so couldn’t apply until 3rd

week of October. I even waited for the ECFMG certification for the programs that wanted

it. It significantly affected the number of interviews I got and the nature of programs thatoffered me an interview. I didn’t get an interview from even a single IMG friendly

program. All the programs that offered me an iv had no IMG in their resident’s list. So, it

was kind of obvious that it was going to be tough to match.

I tried contacting programs desperately, but most of them had already given out the

interviews by then and had a huge list of whom to send next.

From this personal experience, I strongly suggest you to apply as close as possible to Sept

15th.

11. I haven’t got any interviews so far. It’s already mid October. Does it mean I won’t

get any?

- It’s a very scary feeling especially when people around you had already got so

many.

- Don’t panic. Just do what you got to do. Email or call program coordinators

asking to review your application.

- I got my first interview in November and still had good number by the end.

- I have seen people getting their first in December and still matching.

12. When is the last date to get interviews?


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- There is no such thing.

- You can expect interviews even in February.

- Most of the interviews that you get from December are usually those which

were cancelled by others due to various reasons, especially by AMGs who had

travelled enough or couldn’t because of weather snow storms.

ERAS CV

- It is automatically made as you fill your details on ERAS.

- Make sure you make no grammatical errors.

- DO NOT LIE about anything on your CV.

- Present mailing address: Give your US address. Sometimes programs like to call

those that live in the same region.

-

Permanent mailing address: I would suggest US address for this too, for the

same reason as above. Programs would prefer those who have family or familiar

to that region/state.

- Medical school honors/Awards: Mention the awards you got in medical school,

like distinctions or gold medals.

- Work experience:Your electives, obsies or externship (internship for Indians).

Any job you do outside medical school comes under work experience, too.

Give a short description for each work experience. You should mention your

role during that time and what all you did. (Eg: procedures you did, that you saw

both inpatient and outpatient, any presentations you made, that you used to

attend grand rounds, seminars, morning reports, and that you wrote patients

record on EMR)

- Research experience: is where you mention your research related time.

- Volunteer experience: Any volunteer activities you did. Like community service

or being part of some organization or volunteer work(not research or obsies) at

hospitals.

- Publications: Mention if you have any. There is an option to mention whether

they are published or under review.

- Hobbies and Interests: Do not shy to mention any kind of activities which are an

integral part of you. Some programs like to see that you have a life outside of

studies too. Like sports, dancing, singing, instruments etc. DO NOT LIE.

Sometimes during the interview they can ask you questions related to it or do

some of those. Yes, there are people who were asked to dance a bit or sing.

- Language Fluency: Mention all the languages you know

- Other awards/ accomplishments: You can mention the awards you got in any

activities like sports or other competitions.

ERAS APPLICATION:


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1. For Indians: What date should you mention for YOG? Is it internship completion

date or date on the certificate?

- You can mention the date of issue mentioned on the diploma.

2. Should I mention it as a break in education if I had gone for clerkships and hence

delayed my internship end date?

- No, never mention it as a break in medical education.

PROGRAMS related FAQs:

1. When to start searching about the programs?

- The best time is from July as most of the programs update their requirement

info by the end of june or start of July.

2. How to search for programs?

- The best thing is to form a small trusted group of people who are applying to

the same specialty. It’s better if their scores and profile is same as of yours.

- From July, divide the regions among yourselves and start collecting information

of the programs in those regions/states.

- Make an excel or google spread sheet mentioning all the requirements of that

program.

How to collect the info?

- Open your ERAS and see the programs in every state.

- Go to the individual programs website and look for the residency application

criteria. Same time, also open FRIEDA( it’s free) and look for the criteria.

- If there is no particular information regarding visa or any other thing, you can

email or call the program coordinator. They usually respond well in July when

they are not that busy.

- If you want to spend money, one of you can subscribe for MATCH A RESIDENT

and share the fee. You can get program info on this too and you can filter the

programs as per your scores, USCE and visa status.

- BE AWARE: MATCH A RESIDENT doesn’t accurately update it’s information

every year. Same with FRIEDA. So, always correlate with program’s website. If

the website doesn’t mention it then contact program coordinator.

3. How many programs should you apply to?

- It depends on how many programs you can afford.

- I would suggest apply to all the programs where you fulfil their criteria. Apply to

as many as you can.


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- You wouldn’t want to repent later when your friend with low profile or same as

yours gets an interview from the program where you hadn’t applied.

AFTER APPLYING TO THE PROGRAMS

NRMP Registration:

- Register as soon as possible, before the end of November to avoid late fee.

- NRMP registration is a must to be able to participate in the MATCH.

- Update your NRMP number on your ERAS profile.

- It’s ok if you forget to update your NRMP number in the ERAS profile by ROL

submission date. Programs usually use your FULL NAME and AAMC ID to find

you.

1. Can you contact the programs to review your application? If so, when is the right

time?

- Of course, you can contact the program coordinators to review your application.

- One of the biggest misconceptions during the interview season is to NOT

contact the program early (like until end of October).

- You will see a lot of people especially on facebook pages and usmle forums

strongly advising you not to contact them. Don’t believe them. Most of those,

especially the ones with fake identities would be just trying to screw with you.

They would mislead you to cut down their competition.

- You can start emailing program coordinators from the end of September or

preferably first weeks of October.

- The tone of your email should be in a requesting manner.

- You can even call the program coordinators. But, before you rub your

information on them, first enquire if they are free and comfortable to talk about

your application. Proceed only if they say yes.

- I just stated this from my own experience. I am just clearing the

misconceptions. I am in no way forcing you to do it.

2. Does contacting programs increase your chances of getting interviews?

- It definitely can.

- From my own experience and that of friends’, I have noticed that on an average

people who are proactive in contacting programs tend to have more interviews

than their counterparts with similar or better profile. This many not hold good

for everyone. I am just saying it from the people I came across.


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3. I got a rejection after I sent an email to the program coordinator. Is it because I

contacted the program?

- This is another biggest MISCONCEPTION.

- First you should be clear about the objective of emailing the program.

-

THE MAIN GOAL OF CONTACTING A PROGRAM IS “TO REVIEW YOURAPPLICATION” and not “TO GUARANTEE AN INTERVIEW”. As most of the

times, a program might download your application but may not get to review

your application since they get nearly around 5000 applications or more.

- So, once you send them an email you should expect one of the following:

A. They directly send your email to trash without even opening it.

B. They may open see your email, but not respond to it.

C. They see your email and review your application. If they like your

application they might send you an interview or note it for later. They can

send a rejection too for their own reasons, but definitely not because youemailed them.

D. They can reply asking you not to trouble them with further emails. Don’t

take it as a rejection. It’s totally understandable for them to say that

because of the number of emails and calls they get every day.

- So, if they send a rejection after you sent an email then:

It could be just coincidental that the timing of both happened at the same

time, or that your email made them review your application and they sent a

rejection for the same reasons they would even if you didn’t contact them.

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