IMG vs. American students on Step 1

[md2bsoon]

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What is the average score for an IMG and an American med student on Step 1.
What do you think is the reason for this discrepancy?

 

[Jim Picotte]

The average for Step I in May was 216 from prior posts in this forum. All my score reports for Step I through Step III give this average as "First-time examinees from U.S. and Canadian medical schools." I have no idea what the average IMG score is and I'm curious to what the score report actually says. Looking at statistics on passing percentages U.S. and Canadian grads do very well while IMG's don't do as well. Last year 92% of 1st time takers from U.S. and Canadian schools passed while only 64% of IMG students did. Some of this is because of language I'm assuming and likely some is because of the medical school curiculum and experience with the U.S. health care system we have.

Also, very very few U.S. grads spend over one month studying for Step I and very few spend over a week studying for Step 2 and Step 3 while IMG's sometimes spend many months studying for each one of these steps.

 

[md2bsoon]

I agree mostly with language and curriculum differences as being major causes of this trend. Though, to be sure it would be nice to know how well students competent in English from medical schools with similar curriculum do on Step 1, in order to exclude these differences and ascertain whether it is the quality of medical education in the USA.

 

[Mig24x]

I think language plays a role but not that big, here in Puerto Rico there are three med schools and PR main language is spanish with english been its secondary language and still 2 out of these 3 schools have passing rates >90% and the other is >85%. the three schools are lmce accredited, so i think curriculum is more of an answer to this dilemma. Where i study we have one month off to study for this test which im waiting patiently (yeah right) for the scores to arrvie.

 

[theodore]

I wouldn't say that the language is a major problem. When you start studying for this test you know it's gonna be in English, so I don't think that people would consider taking it if they didn't have a firm grasp of English. Anyway, the terms involved are mainly medical and rather simple. I mean, one doesn't have to have a profficiency in English to understand what's being asked.
I wouldn't also think that the curriculum is a big problem. Maybe THE WAY we are taught things is different. I for example never looked at the"clinical feautures" of any disease while studying pathology for my course exams, because noone was going to ask about them, although I did go through Robbins cover to cover. On the contrary, most of the questions in step 1 were exactly about these paragraph-long clinical features. Not only in pathology, but in general.
The other thing is the MCQ format of the test. I firmly believe that plainly memorizing is much harder than having to face MCQ'S. One could argue that MCQ'S can be made very hard, and I would agree on that. However, the purpose of USMLE isn't(in general) to trick you,and statistically you will have some questions right anyway, so this argument doesn't have a big value here.So why IMG's do worse than AMG'S in a theoretically easier form of examination? BECAUSE THEY ARE NOT USED TO IT. Laugh if you have to, but I know a lot of people that claim that they had to re-learn basic sciences backwards, and I'm one of them. It's simply very difficult to deal with an exam form you probably have seen only a couple of times(if ever) in your life, and even more difficult to compete against students who have ;earned everything they know following this form. Personally I think that the American approach is better(and much more fun) than the European, but this doesn't mean it's harder, it's just...different.
Finally, I think that there's a psychological issue too. American students HAVE to pass this exam while IMG'S are looking for an option that will bring them to the next level. I mean, sure, US is undoubtedly the best place around to get your training done, but it's not a dead end for an IMG, it's just the best option available. For an IMG to pass this exam is a big success, while for an American student is an OBLIGATION, which says a lot about the motivation of each group.

 

[BellKicker]

Originally posted by theodore
American students HAVE to pass this exam while IMG'S are looking for an option that will bring them to the next level. I mean, sure, US is undoubtedly the best place around to get your training done, but it's not a dead end for an IMG, it's just the best option available. For an IMG to pass this exam is a big success, while for an American student is an OBLIGATION, which says a lot about the motivation of each group.

Theodore, I agree with most of your post but this last bit makes no sense. I would say that the USMLEs are way more important for IMGs. I've spent years here knowing no matter how I do on my exams, it won't matter. The only thing they'll look at in the US is the steps. It makes sense, too. I don't know Greek grades but I bet they're not the A through F system.

I actually think some groups of IMGs from some areas, like India for instance, score better than US students.

 

[Surgery2Do]

Language is not the problem. The difference is US students are focused on what is tested and they are taught it very well.

For example you have to know 3 or 5 things before you can answer the questions and if students are trained what to look for then of course they will do better.

This is not an IQ test you have to know the material and know it the way they test it.

The Professors teaching the US students write the exam for the USMLE and this gives them the advantage over IMG's.

An IMG does not have any idea what they may ask on the test and the US students are taking a US exam, so of course they know where to focus because their school knows how to focus the students for the exam.

If you are an IMG you are at a hugh disadvantage and should just keep on trying. As for scores it really does not matter much unless you want a residency in Derm or Radiology.

Good luck and just keep on studying.

 

[md2bsoon]

Originally posted by BellKicker
I've spent years here knowing no matter how I do on my exams, it won't matter. The only thing they'll look at in the US is the steps.

Surely the scores are very important, but do not underestimate all the other factor that come into play to obtain a spot in residency, which may as well be critical. Your scores from your foreign medical school probably do not have any value, due to differences in grading system and others, but what you have learned certainly does. Don?t forget how much Americans value letters of recommendations and how important the interview process is, so motivation and intelligence are just as important.

 

[md2bsoon]

Originally posted by Jim Picotte
Also, very very few U.S. grads spend over one month studying for Step I and very few spend over a week studying for Step 2 and Step 3 while IMG's sometimes spend many months studying for each one of these steps.

The thing is that an AMG starts studying for this exam when he enters medical school, and takes the test when all is still fresh in his head. Most IMGs, in contrast, take the test many years after the basic science component of their school, and the fine details that are irrelevant to clinical practice tend to be forgotten. How much time do you think you would need to review things that you saw 6 or more years ago on a test of this magnitude?

 

[theodore]

I think that we're looking at the same thing from a different angle here. What I meant is that an IMG that passes the boards is seen by his classmates as a genius, a very hard worker, a nerd, you name it, I've personally heard all of these, both in my face and behind my back. This isn't so suprising if you take into account the effort it takes to do it, and the fact that in general the most competitive IMG's are the ones that will CONSIDER taking these exams. And if out of this group of students half fail, then it's only normal that passing is considered a major achievement. But when ALL the American students have to take it, and 90%pass it, it's easy to imagine what is thought of those who don't make it(unfairly in my opinion, but that's another story)/
Grades in Greece are form 1-10, but I'm studying in Hungary, where it is 1-5.
By the way, a Greek SDNer was asking me if I know anything about specialisation in Sweden, and I reffered him to you, since you're the only Swede that I know and it looks like you wouldn't mind giving some advice.Hope you don't mind, anyway you're not obliged to answer. Don't know if he already contacted you..