A couple of questions from an IMG

[maieutic]

Hey, I've been wondering about a few things that confuse IMGs in general (at least where I am)

1.The USMLE step 1 will now have a maximum limit of 4 attempts. However, what counts as an attempt? A lot of IMGs apply, and end up not taking the exam (ie they dont even show up to the prometric center) due to not being ready on time. Does this count as an attempt, or does one need to have started the exam to have it count as an attempt?

2.From May, the USMLE step 1 is changing. Additional questions on communication skills will be added. I'm aware that this area, as well as ethical and legal issues, are covered somewhat in UWorld and FA. Despite this, I've always felt this was my weakest areas (probably most IMGs will agree with this), since culturally, I'm wired to think differently in many situations. My question is, how do AMGs study these subjects? Is there any book they go through during M1 and M2, or, just like IMGs, its just what FA and qbanks have?

Thanks!

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[Pinocytosis]

My take on your questions:

1) Hearing/reading anecdotes about skipping/missing your exam will not count as a fail, or even an attempt. Only if you start the exam.

2) I would imagine the vast majority of US medical students prepare for these questions, along with ethics, by getting stomped on by QBanks, learning from it the best we can, and then hope we remember it for step 1. There are themes you can grasp on the "best thing to say"-type questions (i.e. try to ask open-ended questions, try to not sound condescending, etc.), but the number of questions they can ask is limitless. If I recall, B&B has an okay-ish ethics video series. Also, it would be worthwhile to use First Aid for additional information on laws/regulations (i.e. next of kin, Jehovah's witness patients, etc.)

Best of luck.