Preparing for USMLE in Australia: my experience

[shan564]

I haven't taken CS, but people at USyd say that it's really easy. Supposedly, if you speak English, you should be able to pass it easily.

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[Pollux]

Hey,
Im an intern in Melbourne about to take the step 2 CS in a few weeks. Completed step 1 and CK with high scores but havent done much study for the CS exam as yet. Just wanted to get an australian trained perspective of what it was like. Is it very similar to our OSCEs? and did you study much for it? Any deficiencies you noticed by training in australia that I should concentrate on?

Ive got the FA and usmleworld subscription for it and I feel like i should pass without problems.

Cheers

Hi,

I think the Australian medical curriculum is pretty good when it comes down to Clinical Skills preparation. The CS exam is very similar to our OSCEs, except that we're expected to complete H&P and patient notes in a very short amount of time. I think less emphasis is placed on the correct techniques of our physical examination because you're graded by simulated patients.

Also, there is a bit of difference in the format of patient notes and the abbreviations commonly used in the US vs Australia. So practice writing out a few PNs to familiarize yourself with the format so you can do it under 10 minutes on the real exam.

Good luck!

 

[Pollux]

Just an update on my Step 2 CK score: 279/99. Very happy about it.

 

[Transition]

Just an update on my Step 2 CK score: 279/99. Very happy about it.

You're just killing Pollux! Congrats!

 

[shan564]

Just an update on my Step 2 CK score: 279/99. Very happy about it.

Wow, congrats! I'm sure I don't need to tell you how awesome that is.

 

[doctalk2]

Hi Pollux, It is really very impressive to see such scores. Wonder if you have related your experience preparing for Step 2, just the way you did for Step 1. A link would be awesome.
thanks

 

[Alphonsine]

Hi Pollux, It is really very impressive to see such scores. Wonder if you have related your experience preparing for Step 2, just the way you did for Step 1. A link would be awesome.
thanks

I second this!

 

[sensei]

Hi Pollux thank you for all the amazing tips;I am planning to take USMLE Step 1; grad 2002 from the Philiipines and currently living in Japan,not practising for almost 5 years and a full time Mom of 2 kids.I don't think I can come back to the Philippines to practice so I would like to get back my career by taking USMLE.I will take your advices how to study .I just have concerns to ask if I plan to take it in December when is the best time to apply for the test,how long it takes to be eligible for the exam;will I start applying now for the test;I already checked my school in IMED;do you know the eligibility period means the 3 months period that they are giving is that the period where you can choose your examination date?
About the books do I need to use the latest KAPLAN LN (2010 edition) I check the price online so expensive whre can I get second hand books? any suggestions?all my books and notes are back in the Philippines and I think are too old to use.Can you give me advise which books/references I really need to buy?Thanks appreciate your help

 

[nirvanathnx]

Hi Pollux..waoo amazing score....wondering hwo did u juggle all those hrs esp on 10000 mcqs on top of ur med school....I was at melb uni myself undrgrad.
Congrats......
From ur great succes, I was wondering get a few tips from you. I am givin gstep 2 Ck very soon in aroudn 2 months so really short fo time now.....What books you recommend and what shdu i foucs more on......this is presuming u arw also preparing for CK.....currently i just started kaplan and doign videos with it. plan is to do UW and FA...so basically Kaplan,UW and FA ...dont relaly think hav tiem for nbmes btu whts ur 2 cents on it.....i have aroudn 9 weeks in total i wud say. 2 months and august week. thnks mate in advance for yoru help......my email is [email protected]

 

[anonymous000]

It was an advantage having studied for that extra year. Not only had Pollux learned a lot within the third-year curriculum itself, but it also gave him additional time to prepare and do practice questions. Enough said.

 

[neulite30]

Which exam did he take at the end of year 3, Step 2 CK? I think that's what is expected.

The bottom line is they emphasize different things here at UQ (and perhaps Australia). The content of Step 2 approaches what is being emphasized here but you must go (very much) out of your way to succeed on Step 1 here.

Remember that Step scores will be the sole equalizer for IMGs and if you're planning on getting a residency in the states you must keep that at the forefront of your mind.

 

[anonymous000]

Which exam did he take at the end of year 3, Step 2 CK?

He took step-ONE at the end of third-year.

 

[cgkc]

I realize this is an old thread but do we know where Pollux went for his residency?

Thx

 

[neulite30]

I realize this is an old thread but do we know where Pollux went for his residency?

Thx

I'll leave it to his discretion whether he wants to volunteer that info on a forum but he's in a path residency in the midwest, I believe.

 

[cgkc]

I'll leave it to his discretion whether he wants to volunteer that info on a forum but he's in a path residency in the midwest, I believe.

Hi Neulite,

Thx for the reply.

Did you manage to get an internship in Aus? Are you applying for the USA match?

 

[Phloston]

I had heard through the grapevine that he had been keen on Duke for pathology.

 

[Phloston]

Which exam did he take at the end of year 3, Step 2 CK? I think that's what is expected.

The bottom line is they emphasize different things here at UQ (and perhaps Australia). The content of Step 2 approaches what is being emphasized here but you must go (very much) out of your way to succeed on Step 1 here.

Remember that Step scores will be the sole equalizer for IMGs and if you're planning on getting a residency in the states you must keep that at the forefront of your mind.

You can see that he most certainly took Step1 at the end of third-year.

He may have also taken 2CK at or around the end of MS3, but regardless, Pollux took Step1 at the end of MS3.

 

[cgkc]

If I manage to finish the residency and get licensed in Aus. Do I have to redo my residency if I decided to go back to the USA to work one day?

Thanks

 

[Winged Scapula]

If I manage to finish the residency and get licensed in Aus. Do I have to redo my residency if I decided to go back to the USA to work one day?

Thanks

It will depend on the specialty.

For example the American Board of Surgeons only gives credit for up to two years of foreign training and that credit is only given by application once you are in a US surgical training program. Other specialties have different rules.

Note that employment in the US almost always stipulates that you be board eligible which requires training in a US residency program. There may be some exceptions for Fellows of the Royal College.

It all comes down to obtaining an independent medical license. With few exceptions, a US medical license requires having done your residency in the US.

Finally there are a few exceptions in which you are employed by an institution, on an institutional license and are generally regarded as an international scholar.

 

[shan564]

It will depend on the specialty.

For example the American Board of Surgeons only gives credit for up to two years of foreign training and that credit is only given by application once you are in a US surgical training program. Other specialties have different rules.

Note that employment in the US almost always stipulates that you be board eligible which requires training in a US residency program. There may be some exceptions for Fellows of the Royal College.

It all comes down to obtaining an independent medical license. With few exceptions, a US medical license requires having done your residency in the US.

Finally there are a few exceptions in which you are employed by an institution, on an institutional license and are generally regarded as an international scholar.

Also, some specialties allow you to do a fellowship after having done a residency overseas. And after certain fellowships, you can get board certified in the US.

 

[Winged Scapula]

Also, some specialties allow you to do a fellowship after having done a residency overseas. And after certain fellowships, you can get board certified in the US.

Students need to be very careful about researching that first and note the phrase, "certain fellowships".

It is true that you may be eligible for some US based fellowships without having done a US residency first. However, that does not automatically translate into being Board Certified.

Everyone needs to do their due diligence and not count on the above being true for all specialties, at all programs, in all states, and at all times (ie, it can change).

 

[shan564]

Yeah... the bottom line is, these things are meant for people who are already fully-trained in another country and are considering a change in geography. You shouldn't consider basing a career plan on this. If you want to practice in the US, do a residency in the US.

 

[neulite30]

Hi Neulite,

Thx for the reply.

Did you manage to get an internship in Aus? Are you applying for the USA match?

Anytime.

I applied for the match, received interview offers but decided to accept an internship offer here in Australia (without a 'return of service' amendment to my contract).

 

[cgkc]

Anytime.

I applied for the match, received interview offers but decided to accept an internship offer here in Australia (without a 'return of service' amendment to my contract).

Is it easy to get rid of the 'return of service' amendment to the contract?

What happens if one were to get a USA residency offer after having started the Aus internship?

Thanks again to eveyones' helpful replies

 

[neulite30]

Is it easy to get rid of the 'return of service' amendment to the contract?

What happens if one were to get a USA residency offer after having started the Aus internship?

Thanks again to eveyones' helpful replies

You cannot get "rid" of a return of service agreement. Because of the shortage of intern spots here in Australia, the government has created commonwealth funded spots to fill the gap. These spots have the caveat, however, of you agreeing to work in an area of need for a specified time. I don't know how long or where that would be.

Your second question is the dilemma many North Americans are faced with. The Match occurs in March, thus you will have already started an internship in Australia by the time you have received your placement in the states. Some suggest requesting a late start from the hospital that they have been placed at in Australia, but in either case you are signing a contract, late start or not. Thus you will be breaking a contract with your employer.

This may or may not mean anything in terms of your career goals. If you plan to come back to work here after a US residency it may have an impact, I can't say for sure though.

 

[cgkc]

You cannot get "rid" of a return of service agreement. Because of the shortage of intern spots here in Australia, the government has created commonwealth funded spots to fill the gap. These spots have the caveat, however, of you agreeing to work in an area of need for a specified time. I don't know how long or where that would be.

Your second question is the dilemma many North Americans are faced with. The Match occurs in March, thus you will have already started an internship in Australia by the time you have received your placement in the states. Some suggest requesting a late start from the hospital that they have been placed at in Australia, but in either case you are signing a contract, late start or not. Thus you will be breaking a contract with your employer.

This may or may not mean anything in terms of your career goals. If you plan to come back to work here after a US residency it may have an impact, I can't say for sure though.

I see, so is it correct to say that the caveat is kind of like a return of service but we just don't know how long or where that would be?

I am also a little confused about the 10-year moratorium. How does the moratorium affect international students who finished med school and residency training in Aus?

Thanks

 

[neulite30]

I see, so is it correct to say that the caveat is kind of like a return of service but we just don't know how long or where that would be?

I am also a little confused about the 10-year moratorium. How does the moratorium affect international students who finished med school and residency training in Aus?

Thanks

Currently, internships are allocated on a state by state basis. However, because of the recent surplus of medical graduate and lack of internship spots to accomodate them the Australian government has stepped in and made agreements with each state to increase the number of spots. These extra, commonwealth-funded spots are different though. These spots require you to serve in an area of need following your internship. I don't have any more details beyond that though.

Regarding the moratorium, here is an excerpt from the Medical Training Review Panel 15th Report:

Restrictions on Practice
Section 19AB of the Act restricts access to Medicare provider numbers and requires overseas trained doctors (OTDs) and ‘foreign graduates of an accredited medical school' from April 2010 to work in a District of Workforce Shortage (DWS) for a period of generally ten years in order to access the Medicare benefits arrangements. This is referred to as the ‘ten year moratorium'.
A DWS is an area in which the general population's need for health care is considered not to be met. These areas are identified as those that have less access to medical services than the national average. They are determined on the basis of a fulltime equivalent measure, which takes into account Medicare billing in the area, irrespective of whether or not local doctors are working in a part-time or a full-time capacity. Areas are defined on a quarterly basis for general practice and annually for the other medical specialties.
On 1 July 2010 the Australian Government introduced the scaling initiative as part of the Rural Health Workforce Strategy. The scaling initiative allows OTDs and foreign graduates of an accredited medical school to receive significant reductions in their restriction period under the ten year moratorium if they practise privately within an eligible regional, rural or remote area. The greatest discounts are available to medical practitioners who practise within the most remote locations in Australia.

Here is the document: http://www.health.gov.au/internet/main/publishing.nsf/Content/5CEA280FF6BD5659CA2579AE0000E151/$File/MTRP15.pdf

It is a fantastic report and gives you objective data about post-graduate training in Australia.

 

[bonoz]

Does anyone know how to contact Pollux? His PM box is full. I would love to get in touch with him.

Thanks

 

[Phloston]

Does anyone know how to contact Pollux? His PM box is full. I would love to get in touch with him.

Thanks

His PM box is full because he no longer checks the thousands of messages that people have likely left him over the years. I believe we've all tried to get in contact with him through SDN, but his profile says he hasn't logged in for a long long time.

 

[neulite30]

Does anyone know how to contact Pollux? His PM box is full. I would love to get in touch with him.

Thanks

In my first year at UQ I sat in on one of his tutorial sessions for boards that he was giving the Ochsner cohort. He made a powerpoint presentation that he handed out that was pretty comprehensive about the USMLE, but most of this information has been stated in one or two of these forums.

I guess it's a good thing I didn't state where he is training, otherwise he might get loads of email enquiries.

 

[shan564]

If you want to know how to get the kinds of scores that Pollux did, just go to the Step 1 forums and look at what everybody is doing. There's nothing special about Australia for that purpose. If you're a high-caliber student and you put in thousands of hours, you'll get the results that he got... regardless of how you do it. If you're not as smart as him or you don't work as hard as him, your results won't be as good. He doesn't have some magic formula to help you avoid those standard routes.

Or you can ask Phloston. He seems to be in line to be the next guy to do the same thing. And he's doing it by putting in a lot of hours.

 

[Phloston]

If you want to know how to get the kinds of scores that Pollux did, just go to the Step 1 forums and look at what everybody is doing. There's nothing special about Australia for that purpose. If you're a high-caliber student and you put in thousands of hours, you'll get the results that he got... regardless of how you do it. If you're not as smart as him or you don't work as hard as him, your results won't be as good. He doesn't have some magic formula to help you avoid those standard routes.

Or you can ask Phloston. He seems to be in line to be the next guy to do the same thing. And he's doing it by putting in a lot of hours.

I took the exam Dec. 14th and still haven't gotten my score back. I called ECFMG. They said maybe this week.

Either way, I would practically bet my life that I'm not going to come even remotely close to Pollux's score. The more days that go by, the more questions I realize I got wrong on the real deal. A few were nothing more than just stupid errors. I would pay big bucks to get those back.

In the beginning, we are all inadvertently naive to think that any bright person could achieve a 276 through mere motivation and dedication.

Based on the NBME exams, I learned that scores mid-260s+ differ by no more than a few questions. It comes down to getting lucky on the three or four minutiae questions and not being careless. There's no way to prepare for that.

I have no idea how Pollux scored as high as he had. Maybe he got lucky and the exam hit his strengths. Maybe he was one of the rare few who managed to not make mistakes on exam day. Or maybe he really was just that brilliant.

Here's one of my favorite quotes from last year's thread:

Well, good luck trying to memorize everything in Harrison's and Robbin's, because there's no way to predict what "low-yield" things will be on your exam. The only sure-fire way to get a 270 is to be extremely brilliant. Similar to what VinnyChase said, very few people can march their way through the review books and qbanks and get a 270. I don't think there is a volume of study that can pull it off, and I don't think if given an unlimited amount of time everyone would be scoring in that range.

When you sit for the exam, there are going to be things you've never seen before, period. No matter how many questions you did, and no matter how many review books you went through. The reality of the situation is that the amount of material you've been able to absorb in the past two years and how you use it, which are largely non-modifiable traits, are what determines what score range you'll hit. No amount of will alone can get you a 270.

By all means, everyone should fight for the best score they can get. But this obsession on these forums will everyone being in the top 0.1% is absurd. It only increases the stress level of all the already nervous people who frequent these forums.

 

[shan564]

For what it's worth, I'm currently on the interview trail, and most interviewers don't seem to give off the impression that "you're an IMG, so you need higher USMLE scores than everybody else." They generally just lump Aussie grads into the same pool as American grads, and an average-ish score is OK for most specialties. Sure, there are some places that won't interview IMGs, but a 260+ won't make any difference unless you want to go into radiology.

For what it's worth, I met a guy recently who went to a lesser-known Caribbean school. He had 250+ on Step 1 and 2CK, and he was still having trouble getting interviews because of his school (even though he was applying to psych, one of the least competitive fields). I had 227 and 242, and I had interviews at most of my top choices.

The point is - a lot of people told me that we'd need super-high scores to make up for the school that we're coming from. I think they were wrong. That is only true if you went to some random school that isn't well-respected.

 

[Greenbayslacker]

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