MNIkid87,
Hey - I'm a 4th year US medical student, who has a German HNO Assistenzartz as a boyfriend, so hopefully I can give you a little info on the transition from the German to the US system.
As fruitloops mentioned, you can begin a US residency after your PJ. If you have not finished this year yet, I actually highly recommend doing one of your rotations at a US medical school. You would get a good feel of how our system works, as well as have the opportunity to get some letters of recommendation, which are extremely important in the application to US residency positions. As far as I understand, letters of recommendation as we know them don't exist in the German system, but combined with the USMLE scores, are probably some of the most important parts of an application.
Additional information about the praktisches Jahr vs. intern year in the US - the PJ is actually more similar to our 3rd and 4th years of medical school. In the US school system, we graduate from high school at age 18, go to university for 4 years, apply to medical school, and then go to medical school for 4 years. In medical school, we spend the first 2 years in class, then the last 2 years doing practical rotations through internal medicine, surgery, psychiatry, neurology, ob/gyn (Frauenheilkunde), family medicine (Allgemeinmedizin), pediatrics, and several subspecialties. So our intern year, which is just another name for the 1st year of residency, is really the same as your first year of residency.
In terms of the USMLE, you would need to have completed all 3 parts (Step 1, Step 2 CS, Step 2 CK) before applying to a US residency, and if you want to participate in the main residency Match, they have to be completed and all of your schooling certified by the ECFMG (
http://www.ecfmg.org/) prior to applying, which generally happens in the fall of every year. For more information about the Match, see here:
http://www.nrmp.org/. Almost all US residency positions are filled through the Match, which is a central organization through which all of us must apply. Additionally, you will need to take the TOEFL, which is a test of English proficiency. Actually, some US medical schools require you to have taken the USMLE Step 1 before you can do practical rotations there, so you can either take it before, or find a university that doesn't require it to do international rotations.
The strength of necessary USMLE scores will depend on what specialty you are interested in - for example, if you are interested in internal medicine, ob/gyn, psychiatry, etc. you will not need as high of USMLE scores and have a high likelihood of finding a position. However, if you are interested in a very competitive specialty (radiology, ENT, plastic surgery, opthalmology, neurosurgery, urology), you will likely need to come to the US, do a year or two of research, get really good USMLE scores, and then apply for a position through the Match. The more competetive specialties fill virtually all positions through the Match, as opposed to the less competitive, which you can sometimes find a position in outside of the Match.
Ich hoffe, dass die vorerwähnten Angaben Dir ein bisschen geholfen haben. Es gibt keinen deutlichen Vergleich zwischen den amerikanischen und deutschen Schulssystems. Nur am Ende sind wir fast genau ausgebildet
Hoffentlich habe ich die Grundlagen unseres Systems ein wenig erklärt aber wenn Du weitere Fragen hast, kannst Du mir eine private Nachricht schicken. Ich habe viele Gespräche über die Underschiede zwischen unseren Systems gehabt, deswegen habe ich wenigstens eine Ahnung davon!
Tschüss,
Catherine
