Need some serious Advice

[cool_vkb]

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Hey iam asking this question on behalf of my mom's sister. She is a FMG, she graduated in 1983 and passed her ECFMG Ceftificate in 1983. She is having a valid ECFMG Certified.

Unfortunately she never got a chance to move to USA till 2003. In 1983 there werent USMLE exams. She just had to take an exam and if she passed she would get the ECFMG Certificate. She has renewed her ECFMG Certificate in 2003 and is now possesing a valid ECFMG Certificate but no USMLE scores.

She is having 20yrs of General Practice Experience in rural India. My question was, she tried to apply last year for residency programs but she didnt got any invites (we applied very late and werent that much prepared). In these recent days we found out that one could get a residency even without participating in match or eras. There are pre-matches or matches outside ERAS.

A friend of ours said that there are some residency programs in rural or backward areas in USA where nobody wants to go and they go mostly unfilled.

I request sincerely can anyone plzz guide us or say any link or any program which is not that much desirable by general applicant pool. She doesnt have a preference for any speciality. her main concern is to get selected in Residency program irrespective of location and speciality. Plzz guys any help will be really appreciated.

if you dont want to reply here and want to send a PM, plzz feel free or my email is [email protected]. ANy help will be really appreciated. May god bless u guys.

 

[Faebinder]

Hey iam asking this question on behalf of my mom's sister. She is a FMG, she graduated in 1983 and passed her ECFMG Ceftificate in 1983. She is having a valid ECFMG Certified.

Unfortunately she never got a chance to move to USA till 2003. In 1983 there werent USMLE exams. She just had to take an exam and if she passed she would get the ECFMG Certificate. She has renewed her ECFMG Certificate in 2003 and is now possesing a valid ECFMG Certificate but no USMLE scores.

She is having 20yrs of General Practice Experience in rural India. My question was, she tried to apply last year for residency programs but she didnt got any invites (we applied very late and werent that much prepared). In these recent days we found out that one could get a residency even without participating in match or eras. There are pre-matches or matches outside ERAS.

A friend of ours said that there are some residency programs in rural or backward areas in USA where nobody wants to go and they go mostly unfilled.

I request sincerely can anyone plzz guide us or say any link or any program which is not that much desirable by general applicant pool. She doesnt have a preference for any speciality. her main concern is to get selected in Residency program irrespective of location and speciality. Plzz guys any help will be really appreciated.

if you dont want to reply here and want to send a PM, plzz feel free or my email is [email protected]. ANy help will be really appreciated. May god bless u guys.

I hate to say it... but without USMLE... impossible. Even the programs that don't get filled.. they fill up sooner or later but I doubt any of them will take anyone (even ECFMG certified) without at least USMLE step 1. Think about it for a sec, match is over... scramble is over... post scramble begins.. one program opens up..... 10 people apply....9 passed step 1 and 2 and the 10 person is your mom's sister with no USMLE and no way for the program to measure her medical knowledge....

It's unfortunate but she must take step 1 and 2 (maybe 3 even if she wants some advantage.)

 

[Winged Scapula]

While a residency applicant who possesses ECFMG certification is not required to have taken the USMLE to match into a training program or to obtain a state license, it is helpful - especially in the former situation and for someone who is so many years out of residency.

Your contacts are correct in that there are many residency programs which go unfilled. Unfortunately, some programs would rather be unfilled than to take a candidate of which they are unsure. Taking the USMLE, which would be a nuisance and a bit of an expense for your aunt, allows the programs to see that her medical knowledge is still on par with other residents.

We can argue about whether or not USMLE scores really predict how good a physician someone is; but no one is arguing that the exam, especially Step 1, will be easy for your aunt. It is likely that she is woefully out of date on her basic medical sciences but should do well on the clinical portions of the exam.

The interview and application season for July 1, 2007 residency starts is already well underway, thus your aunt is behind again this year. Now, it is true that she is eligible to sign a contract outside of the match as an independent applicant. However, many programs do not offer these and she has a much better shot at applying to a large number of programs thrugh the match.

Also consider that, again, you are not required to have USMLE scores by the NRMP or state licensing boards (as long as you have taken some licensing exams - ie, FLEX or NBME exams) BUT....applications are processed by administrative personnel who may not know the difference and only check off the box that your aunt's application is incomplete because she didn't have her USMLE scores sent in. Never mind that she never took them and doesn't really need to to be ECFMG certified - its on their checklist so they assume you MUST have to. This is the battle your aunt is fighting.

Also programs might be loathe to take someone who wants a job, any job. That sort of attitude is not really respected in the US medical field. They want to know that she wants THAT job, in THAT town. So she may find some bias against her for applying for any open job.

That said, she should try and narrow down her choices and make a few phone calls to see if applications are accepted from people nearly 25 years out of medical school, without USMLE scores. She can't do anything about the former, but she can take the USMLE and it will improve her chances, IMHO.

 

[cool_vkb]

While a residency applicant who possesses ECFMG certification is not required to have taken the USMLE to match into a training program or to obtain a state license, it is helpful - especially in the former situation and for someone who is so many years out of residency.

Your contacts are correct in that there are many residency programs which go unfilled. Unfortunately, some programs would rather be unfilled than to take a candidate of which they are unsure. Taking the USMLE, which would be a nuisance and a bit of an expense for your aunt, allows the programs to see that her medical knowledge is still on par with other residents.

We can argue about whether or not USMLE scores really predict how good a physician someone is; but no one is arguing that the exam, especially Step 1, will be easy for your aunt. It is likely that she is woefully out of date on her basic medical sciences but should do well on the clinical portions of the exam.

The interview and application season for July 1, 2007 residency starts is already well underway, thus your aunt is behind again this year. Now, it is true that she is eligible to sign a contract outside of the match as an independent applicant. However, many programs do not offer these and she has a much better shot at applying to a large number of programs thrugh the match.

Also consider that, again, you are not required to have USMLE scores by the NRMP or state licensing boards (as long as you have taken some licensing exams - ie, FLEX or NBME exams) BUT....applications are processed by administrative personnel who may not know the difference and only check off the box that your aunt's application is incomplete because she didn't have her USMLE scores sent in. Never mind that she never took them and doesn't really need to to be ECFMG certified - its on their checklist so they assume you MUST have to. This is the battle your aunt is fighting.

Also programs might be loathe to take someone who wants a job, any job. That sort of attitude is not really respected in the US medical field. They want to know that she wants THAT job, in THAT town. So she may find some bias against her for applying for any open job.

That said, she should try and narrow down her choices and make a few phone calls to see if applications are accepted from people nearly 25 years out of medical school, without USMLE scores. She can't do anything about the former, but she can take the USMLE and it will improve her chances, IMHO.

First of all let me thank you guys very much for helping us out. May god bless u.

i know wat u guys are trying to say. Since she already has a ECFMG Certificate it isnt necessary for her to pass all three exams. So basically she has to take these exams just to prove she is competent. and i think she shud do it. as u guys said, its going to be very helpfull.

Is there anyway, she cud just take USMLE-1 or just USMLE-2 and CS skill exam. I mean i dont think she can take all of them in such short time for 2007. IF u were in her place, wat exam u wud take. which exam plays a determental role.

 

[DiveMD]

I am baffled by your poor understanding of the medical education/licensing process. Why don't you go to this websites and read about it?

http://www.usmle.org/
http://www.nbme.org/
http://www.ama-assn.org/
http://www.ama-assn.org/vapp/freida/srch/

 

[Faebinder]

Even if somehow she ends up finding a residency without taking step 1 or step 2 (I can't even imagine how she did that).... She needs step 3 to be able to get her state license.

You can't take step 3 if you have not passed step 1 and step 2. http://www.fsmb.org/usmle_elistep3.html

Basically.. no step 3 means no license and inability to practice. http://www.fsmb.org/usmle_eliinitial.html

 

[cool_vkb]

I am baffled by your poor understanding of the medical education/licensing process. Why don’t you go to this websites and read about it?

http://www.usmle.org/
http://www.nbme.org/
http://www.ama-assn.org/
http://www.ama-assn.org/vapp/freida/srch/

Sir,Wat do u mean u r baffled. I dont understand wat r u saying. i have visited those websites long bfore i came here. You are not understanding what my question was, i suggest u read it once and say me why do u say i have a poor understanding of medical education. She already had a ECFMG certificate, so we were presuming she doesnt need USMLE exams. But as others pointed out that she needs to take USMLE as it shows her competency, iam asking waht exams should she take.

 

[cool_vkb]

.

 

[cool_vkb]

Even if somehow she ends up finding a residency without taking step 1 or step 2 (I can't even imagine how she did that).... She needs step 3 to be able to get her state license.

You can't take step 3 if you have not passed step 1 and step 2. http://www.fsmb.org/usmle_elistep3.html

Basically.. no step 3 means no license and inability to practice. http://www.fsmb.org/usmle_eliinitial.html

Man you guys are not understanding the question, She hasnt started the residency.

If you had obtained an ECFMG Certificate prior to 1984. And if it is still valid then as by the ECFMG , you dont need to write USMLE 1,2 & 3. Basically these exams are meant to obtain ECFMG certicate. She already has it.

The question is whether hospitals accept it or not and give her residency and as some people pointed out, it would be very difficult (or impossible) to determine if she is competitive or not without having any scores, she has to take now USMLE scores just to prove that she is competitive. Apart from this sole reason, there is no other need she has to do write USMLE exams.

 

[cool_vkb]

Even if somehow she ends up finding a residency without taking step 1 or step 2 (I can't even imagine how she did that).... She needs step 3 to be able to get her state license.

You can't take step 3 if you have not passed step 1 and step 2. http://www.fsmb.org/usmle_elistep3.html

Basically.. no step 3 means no license and inability to practice. http://www.fsmb.org/usmle_eliinitial.html

Man you guys are not understanding the question, She hasnt started the residency.

If you had obtained an ECFMG Certificate prior to 1984. And if it is still valid then as by the ECFMG , you dont need to write USMLE 1,2 & 3. Basically these exams are meant to obtain ECFMG certicate. She already has it.

The question is whether hospitals accept it or not and give her residency and as some people pointed out, it would be very difficult (or impossible) to determine if she is competitive or not without having any scores, she has to take now USMLE scores just to prove that she is competitive. Apart from this sole reason, there is no other need she has to do write USMLE exams.

what i was asking was, do u guys know any programs tat are pretty easy and go unfilled were we might apply.

 

[Faebinder]

Man you guys are not understanding the question, She hasnt started the residency.

If you had obtained an ECFMG Certificate prior to 1984. And if it is still valid then as by the ECFMG , you dont need to write USMLE 1,2 & 3. Basically these exams are meant to obtain ECFMG certicate. She already has it.

The question is whether hospitals accept it or not and give her residency and as some people pointed out, it would be very difficult (or impossible) to determine if she is competitive or not without having any scores, she has to take now USMLE scores just to prove that she is competitive. Apart from this sole reason, there is no other need she has to do write USMLE exams.

No, you dont understand the system my friend. ECFMG certificate does not require step 3 (but now unlike in the past, it does require step 1 and 2 CK&CS). Step 3 is required to get a license. Step 1 and 2 are required to take step 3. There is no avoiding the USMLE. Having an ECFMG certificate is not enough for you to get a medical license in any state.

Many IMGs finish step 1 and 2 and get their ECFMG certificate and apply to residency without step 3. Step 3 is of course required if you want to get an H-1 visa.... but if you are a US citizen or a permanent resident then you dont need it to begin residency.

 

[cool_vkb]

No, you dont understand the system my friend. ECFMG certificate does not require step 3. Step 3 is required to get a license. Step 1 and 2 are required to take step 3. There is no avoiding the USMLE.

Many IMGs finish step 1 and 2 and get their ECFMG certificate and apply to residency without step 3. Step 3 is of course required if you want to get an H-1 visa.... but if you are a US citizen or a permanent resident then you dont need it to begin residency.

Sorry boss! plz accept my sincere appologies. now i got it👍

 

[Winged Scapula]

Unfortunately, it appears that the NBME has changed its requirements to take Step 3. Formerly one was allowed to use old exams (ie, FLEX) to fulfill the requirements to take Step 3 which is required in *most* states to gain a license (some may allow you to take a different exam to assess your capabilities, but this is generally only true if you have ever held a license in the US or Canada). The current status:

Formerly Administered Examinations

The NBME certifying examinations, Part I, Part II, and Part III, and the Federation Licensing Examination (FLEX) Components 1 and 2 are no longer administered. Use of the former NBME Parts or FLEX Components to fulfill eligibility requirements for Step 3 is no longer accepted. If you have passed all or a portion of these examinations and have never been granted a medical license by a US medical licensing authority, you may take any Step(s) for which you are otherwise eligible.


So it appears that even if she didn't want to take all 3 steps to apply for residency, she's going to have to anyway to eventually get licensed in the US (since she can't take Step 3 anymore with her old examination scores). Perhaps she should sit out 2007 and use the time to study for all the exams, and apply next year for 2008.

 

[erichaj]

Before there was a USMLE there was flex and other exams. Just out of curiosity, in order for her to get an ECFMG certificate, didnt she have to to take one of those set of exams?

Also, if she did, then can't she use them?

It may take longer to go through the whole process of proving you are capable of practicing medicine in the US than to just study for the USMLE and take them.

Steps 2 and 3 should not be too hard since she is a practicing doctor. Step one will take some studying.

She can take a any number of review courses for the different steps.
From what I understand most physicians in India do well on these exams because they use similar technology and protocols to treat their patients in india.

 

[cool_vkb]

Before there was a USMLE there was flex and other exams. Just out of curiosity, in order for her to get an ECFMG certificate, didnt she have to to take one of those set of exams?

Also, if she did, then can't she use them?

It may take longer to go through the whole process of proving you are capable of practicing medicine in the US than to just study for the USMLE and take them.

Steps 2 and 3 should not be too hard since she is a practicing doctor. Step one will take some studying.

She can take a any number of review courses for the different steps.
From what I understand most physicians in India do well on these exams because they use similar technology and protocols to treat their patients in india.

The flex was started in 1984. she got her ECFMG exam in 1983. she said tat it was a 1 day exam in which u wud get a "PASS" or "FAIL" result. if u pass the test, then u have the ECFMG Certificate.

and then there was a VQE exam (something like a j1 visa) which if u wud passed wud help u in obtaining a US visa.

But past is past, she has decided today to appear for Step-2 first (she saw the books and review materials and she thinks she can manage tat). after this she will take Step-1.

Thank you guys for ur valuable information. god bless u.

 

[Faebinder]

The flex was started in 1984. she got her ECFMG exam in 1983. she said tat it was a 1 day exam in which u wud get a "PASS" or "FAIL" result. if u pass the test, then u have the ECFMG Certificate.

and then there was a VQE exam (something like a j1 visa) which if u wud passed wud help u in obtaining a US visa.

But past is past, she has decided today to appear for Step-2 first (she saw the books and review materials and she thinks she can manage tat). after this she will take Step-1.

Thank you guys for ur valuable information. god bless u.

yeah life has become 10 times more difficult now.

 

[Winged Scapula]

The flex was started in 1984. she got her ECFMG exam in 1983. she said tat it was a 1 day exam in which u wud get a "PASS" or "FAIL" result. if u pass the test, then u have the ECFMG Certificate.

and then there was a VQE exam (something like a j1 visa) which if u wud passed wud help u in obtaining a US visa.

But past is past, she has decided today to appear for Step-2 first (she saw the books and review materials and she thinks she can manage tat). after this she will take Step-1.

Thank you guys for ur valuable information. god bless u.

Sounds like a good plan - if she really wants to work here, while taking the steps may be painful, it will give her the best (and perhaps only) chance to do so.

best of luck!