USMLE timeline for IMGs

 ​Most of us might have heard about the myth that USMLE is a very long journey and takes years together to get certified and match. Although, I agree that it is a slightly longer process, having the right timeline and planning things in the right order is crucial to finish the USMLE in an effective and fastest duration.
 
Single timeline/strategy may not be the best for all of us. Depending on where we stand in our medical career(medical student or intern or graduate), the time we can dedicate, the opportunities that we have for research, volunteering, or USCE varies and hence the strategy to get to the match should be different. We have given you three different strategies here one each for medical students, interns and graduates to not just get through but ace this path to match and do it with minimal gaps/extensions.
 
Lets divide the whole timeline into
1. Getting started to getting application ready
  • For medical students
  • For interns
  • For graduates
2. The Match
 

Getting started to getting application ready

Medical students
So deciding on this journey as a medical student has a huge advantage and gives you a lot of time in hand to plan and execute the strategy.
 
The milestones that you need to plan and get through in your journey will be majorly the usmle exams, USCE, application, the match and minor things like research and volunteering. The strategy for medical students would be as below:

​The Start
Right from first year or even second year of medical school is a very good time to start preparing for the USMLE step 1. This gives you an opportunity to orient yourselves early on in your career to USMLE style of preparing rather than doing it for medical school and then redoing it in the USMLE way again. For more details on when and how to prepare for the USMLE in medical school watch the video here

Taking the step 1
Third year of MBBS is a good time to take the step 1, as you are fresh from basic sciences and the academics are less hectic compared to final year. Try to finish step 1 with 2-3 months to spare in third year so that you have enough dedicated time to do well in third year exams as well.


Taking the Step 2 CK, applying for USCE and Step 2 CS
  • Final year is a good time to start preparing for the Step 2CK as the subjects in final year are the same ones that are tested in CK.
  • Plan to take the Step 2 CK towards the ending of first half of internship(+/- 1 month time off before the exam).
  • Apply for clerkships and Step 2 CS(a new prerequisite to apply for CS is to pass step 1) soon after you have the result of step 1 in final year, schedule them during the second half of internship(i.e after CK).
  • Applying in the final year is helpful as clerkships and step 2 CS will have long waiting times and also it's better to take the step 2 ck before you leave to the US so that you don't break the flow of preparation.
 
Clerkships and Step 2 CS
  • Complete the scheduled clerkships and step 2 CS(preferably after 1-2 rotations) during second half of internship.
 
Getting ready for the application
  • Come back from the US to finish the rest of the internship, graduate and get ECFMG certified. The most important part of the timeline is that you should be ECFMG certified and application ready by September 15th(or whatever is the application start date for the year's match).
  • Simultaneously start preparation for step 3 and plan to be ready with the results by september 15th(application start date) or atleast December. This will give you a great edge in the match process and possibility of getting a H1B visa program.
 
Research and volunteering
  • ICMR projects, summer research fellowship programs are some of the research opportunities that medical students can work on in India. Finding a research mentor/guide in the medical school and working on projects is also a good idea and will help you get some hands-on experience and papers published.
  • Join and volunteer for organisations in medical school, NGO’s, Doctors without borders, during PSM rural postings etc.
Interns
It is never late to start preparing for the usmle and intern year is a common time when most of the international medical students start their preparation. So keep the spirit high and focus on your goals and you will do it in time.

The start and Step 1
Start preparing for the step 1 right from the start of intern year. Although step 1 might take around 7 months to finish, with intern year it is possible to complete it in 9-11 months with some focus and determination. Do not take time off at the beginning, start your preparation continuing intern year with +/- 1 month time off before the exam.


Taking the Step 2 CK, applying for USCE and Step 2 CS
  • You need to be a student to be able to do electives(hands-on), so don’t take the graduation, take time off from internship and prepare for CK and take the CK exam in 6-7 months.(Don’t worry if thats not possible, we have an alternative plan at the end)
  • Apply for clerkships and Step 2 CS after receiving step 1 score and schedule them after the CK exam.

USCE and Step 2 CS
  • Complete the electives and CS exam during the next 6 months.
 
Getting ready for the application
  • Come back from the US to finish the rest of the internship, graduate and get ECFMG certified. The most important part of the timeline is that you should be ECFMG certified and application ready by September 15th(or whatever is the application start date for the years match)
  • Simultaneously start preparation for step 3 and plan to be ready with the results by september 15th(application start date) or atleast december. This will give you a great edge in the match process and possibility of getting a H1B visa program.
 
Research and volunteering
  • Finding a research mentor/guide in the medical school and working on projects is also a good idea and will help you get some hands-on experience and papers published.
  • Ask for research opportunities during rotations in the US. This is extremely valuable.
  • Join and volunteer for organisations in medical school, NGO’s, Doctors without borders, during PSM rural postings etc.
 
Alternative plan for interns and difference between them
  • You can stick to the above plan if that works for you.
  • If you think extending the internship by 1 year won't be possible then:
  1.  Search for clerkships that do not require a step 1 score(Ex: UIC, Harvard, Yale, Stanford etc.) and apply to these program at the beginning of internship(along with step 1 prep) and schedule them after your step 1 exam.
  2. Apply for Step 2 CS as soon as you have the step 1 result
  3. Complete clerkships and CS after step 1 and come back and finish the rest of the intern year and graduate.
  4. In this plan you do not have minimal extension of internship for a valid reason to do clerkships and CS. But you may miss a few clerkship programs which need a step 1 score.
 
 Graduates
The next common scenario is planning and preparing for the usmle as an international medical graduate. Although you may need a different strategy and a need to be ready with step 3, it's not as hard as you may think it is.

Step 1
  • Start preparation for step 1 and plan to take it in 7-9 months
  • Verifying your medical credentials early may be helpful and saves time towards the application deadline.
  
Taking the Step 2 CK, applying for USCE and Step 2 CS
  • Start preparation for step 2 CK and finish the exam in 6-7 months.
  •  Apply for clerkships and Step 2 CS after receiving step 1 score and schedule them after the CK exam.
 
USCE and Step 2 CS
  • Complete the observerships/externships and step 2 CS in 5-6 months
 
Getting ready for the application
  • You will automatically be ecfmg certified if you are done with step 1, CK and CS and your medical credentials have been verified. The most important part of the timeline is that you should be ECFMG certified and application ready by September 15th(or whatever is the application start date for the years match)
  • Step 3 is an asset to your application and may be more useful for someone with gaps/longer yog. So plan to be ready with Step 3 score before september 15th(application start date). It also gives you scope to get matched into a H1B visa program.
 
Research and volunteering
  • Ask for research opportunities during rotations in the US. This is extremely valuable.
  • Working as a research assistant in medical research labs, hospitals will help you get hands-on research experience and publications.
  • Join and volunteer for NGO’s, Doctors without borders etc.


The Match timeline
The most critical aspect here is to ensure that the ERAS CV and personal statement for residency are well done, without errors and reflect the quality the programs expect. Take time to write a good ERAS application and PS- this is a major issue. Students push it out too much and in the end they do a shabby job. Mistakes in your ERAS CV and personal statements can come back to haunt you. They can prove very costly.  Start early and keep improving the ERAS CV. Target first draft by late July. Personal statement can be more time consuming for some students but it is a very important part of your application.

You really need to spend time and effort to research programs- Sarthi list, Frieda, Resideny explorer etc.

You will need extensive research when you reach out to the programs later in the season- when you email them, call them. The knowledge comes in very handy. Programs like it. You will save time in IV season. Plan this well.
Between July and late Aug you also need to make sure your Letters are uploaded along with the MSPE. Delays are common in the last few days before the application day as the system gets overwhelmed by the sheer volume. Also don’t wait for the last few days to ask your attending about uploading the LORs. They are also quite busy and it could delay your LORs.
Another activity during the July-mid sept timeframe is preparing and sending interest letters/emails to programs and this will take time.
We ofcourse help you in all aspects of the match- be it ERAS CV, personal statement, program list. Click here to check out up our services 
 
Try your best to be ECFMG certified by Aug. While not required to apply, there is no harm in completing the paperwork and finishing it off before application
The D day is Sept 15. Try your best to apply by Day 1.  
In a typical season interview invites will start in last week or 10 days or September and interviews go on till mid Feb- again, if the programs go back to onsite interviews, you will be required to attend these, so must be physically present in the US.
 
Ofcourse prepare well for the interviews. can be the make or break for your residency chances. For many of you residency interviews may be the first formal interviews you may face. But that does not mean you can’t perform well. It will need a lot of practice. What you will need is to start thinking about your experiences- from medical school, work, volunteering and so on. These experiences- will give you the content to answer most of the questions- for example around team work, leadership, mistakes, success and so on. Again, don’t leave the preparation till you get the first interview invite. As you are working on your CV and personal statement, the content for many of these interviews focus areas should be gathered.
  
It iss all about Controlling the controllables. Time is precious start early. USMLE match takes time, commitment and execution of well thought out plans.