8/2/10

A Guide to Gaining Access to US Medical Residencies for Foreign Medical Graduates


Introduction

Graduates of foreign medical schools face a long, expensive process when they decide to pursue a residency program or fellowship in the United States. Aside from investigating programs, obtaining visas, and narrowing down specialties, candidates must obtain certification from the Educational Commission for Foreign Medical Graduates (ECFMG), the body that determines whether prospective students are equipped to enter US programs.
The ECFMG assesses a candidate's eligibility through a battery of tests and credentials checks, including the following:
  • Medical school diploma from a school and graduating year listed in the International Medical Education Directory (IMED);
  • United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) examinations; and
  • USMLE Step 2 Clinical Skills (CS) examination.
Collecting these documents to seek approval from the ECFMG is also often a prerequisite to obtaining a license to practice medicine in the United States.
Although the requirements might sound daunting, preparing well before the final year of medical school gives the candidate the best chance of getting into the right program at the right time. Studying for examinations and gathering the needed applications and certifications will ease the process. Moreover, factoring in the price of test preparation courses, photocopying, and postage and the time and expense involved in travel to test centers will help ensure a smoother, less stressful passage.


Application and Documentation

Before applying for the first test, candidates should know that one's medical school and graduation year must be listed in the IMED in order to qualify for ECFMG certification. Applicants must have, or anticipate receiving, 4 credit years: academic years for which credit has been given toward completion of the medical curriculum at an IMED school.
Submitting the application to schedule the USMLE Step 1 test marks the beginning of the certification process. The ECFMG is in charge of receiving and tracking all foreign applications, issuing each person an identification number that should be used in subsequent correspondence.
Applicants must first complete the ECFMG's online authentication process. Begin by visiting ECFMG's Overview of Online Services. The process consists of 2 parts: online application and authentication, followed by completion of either the Certification of Identification Form (Form 186) or the Certification Statement (Form 183).
For the online application, candidates will need access to a computer with a printer. In addition, they will need an e-mail address and either a valid credit card (Visa, MasterCard, or Discover) or a checking account at a US bank and a valid US driver's license or Social Security Number in order to pay the fee for the USMLE examination. They will also be asked to choose a period during which to schedule their examination.
The application requires information about clinical clerkships, as well as names and addresses of medical schools attended, attendance dates, and any credits that have been transferred to the medical school that awarded or will award the degree. Medical school graduates should be ready to provide their education credentials with this initial examination application. Those who are still students must send medical education credentials as soon as they graduate and receive their diplomas and transcripts.
Candidates have 14 days to complete the online application and examination fee. When the online application is complete and the fee paid, the system will generate the Certification of Identification Form (Form 186, which is for applicants enrolled in medical schools that participate in the ECFMG's Medical School Web Portal [EMSWP]) or the Certification Statement (Form 183, which is the paper certification for applicants who are students enrolled in medical schools that do not participate in EMSWP]). The forms must be completed by the candidate and an authorized official of the candidate's medical school or a consular official, first class magistrate, notary public, or commissioner of oaths.
Recent graduates who have not yet received their diplomas require a certificate from the dean, vice-dean, or registrar of their medical school, stating that all of the requirements to receive the diploma have been met and the date on which the diploma will be issued.
Along with the certification forms, students and graduates must be ready to turn in 2 copies of a diploma and 1 full-face, passport-sized color photograph. The ECFMG will also request transcripts from one's medical school, translated into English.
When the completed the application has been received, the candidate will be issued a USMLE/ECFMG number. Candidates can use their USMLE/ECFMG number to register for other tests and to check their status at the USMLE's Interactive Web Application.

USMLE Step 1 and Step 2 CK

USMLE Step 1 and Step 2 CK are computer-based multiple-choice examinations. They must be taken at Prometric examination centers, which are located worldwide. For 2010, the base fee for Step 1 is $740; it is also $740 for Step 2 CK. Additional charges will vary by country. For more information, please check ECFMG's International Test Delivery Fee Surcharges chart.
Information on where to take the test can be found at these links:
Europe, Middle East, and Africa:http://www.prometric.com/USMLE/EMEAAP.htm
Step 1 tests applicants on anatomy; behavioral sciences; biochemistry; microbiology; pathology; pharmacology; physiology; and interdisciplinary areas, including genetics, aging, immunology, nutrition, and molecular and cell biology.
Beginning in May 2010, Step 1 will be divided into 7 blocks with a total of 336 questions. Participants are allotted 1 hour to complete each block. The minimum passing score for Step 1 is 188.
Step 2 is divided into 8- to 60-minute blocks and has a total of 352 questions. The test takes 9 hours, with a 45-minute break. The minimum passing score is 184. Step 2 requires interpretation of tables and laboratory data; imaging studies; photographs of gross and microscopic pathologic specimens; and results of other diagnostic studies in internal medicine, obstetrics and gynecology, pediatrics, preventive medicine, psychiatry, surgery, and other areas relevant to provision of care under supervision.
Most Step 2 CK test items describe clinical situations and require that test-takers provide 1 or more of the following: a diagnosis; a prognosis; an indication of underlying mechanisms of disease; and the next step in medical care, including preventive measures.
Familiarity with the format of the examination and the subject matter is key. Visiting the USMLE Web site will give applicants a good overview of the depth and breadth of the test, but online preparation courses may be wise investments.

Step 2 CS

The USMLE Step 2 CS examination tests students and graduates on their ability to collect information from a live patient, perform physical examinations, and communicate these findings to patients and colleagues. The test simulates a physical examination, using actors who are trained to portray real patients. The test can be taken only in the United States at 1 of the 5 Clinical Skills Evaluation Centers, located in Atlanta, Georgia; Chicago, Illinois; Houston, Texas; Los Angeles, California, and Philadelphia, Pennsylvania.
The Clinical Skills test looks at a candidate's ability in 3 major areas: the integrated clinical encounter, communication and interpersonal skills, and proficiency in English. In the integrated clinical encounter, candidates are evaluated on data gathering (taking a history and conducting a physical examination) and documentation (making notes and summarizing the encounter, diagnostic impression, and work-up). In the communication and interpersonal skills component, evaluators assess the candidate's questioning skills, information-sharing skills, and professional manner and rapport. Finally, evaluators assess the foreign medical graduate's English-language skills in the context of a physician-patient encounter.
Step 2 CS is graded on a pass/fail basis. The fee for the examination is $1295.
When all medical school documents have been received, fees paid, and examinations passed, the ECFMG will issue applicants a paper certificate. For those who have applied to residency programs through the Electronic Residency Application Service, updates will be transmitted automatically to the candidate's program.
As can be seen, obtaining ECFMG certification can be an expensive, complicated process. However, those committed to furthering their studies through a residence program or fellowship in the United States will find it easier if they keep these points in mind:
  1. Begin thinking and planning well before the final year of medical school.
  2. Set aside time for study and at least $2775 US for test fees (see http://www.ecfmg.org/fees.html for a list of fees for commonly encountered ECFMG services).
  3. Become familiar with the structure and subject of tests.
  4. Write to ECFMG for updated information, or visit their Web site.



regards, taniafdi ^_^
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8/2/10

A Guide to Gaining Access to US Medical Residencies for Foreign Medical Graduates


Introduction

Graduates of foreign medical schools face a long, expensive process when they decide to pursue a residency program or fellowship in the United States. Aside from investigating programs, obtaining visas, and narrowing down specialties, candidates must obtain certification from the Educational Commission for Foreign Medical Graduates (ECFMG), the body that determines whether prospective students are equipped to enter US programs.
The ECFMG assesses a candidate's eligibility through a battery of tests and credentials checks, including the following:
  • Medical school diploma from a school and graduating year listed in the International Medical Education Directory (IMED);
  • United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) examinations; and
  • USMLE Step 2 Clinical Skills (CS) examination.
Collecting these documents to seek approval from the ECFMG is also often a prerequisite to obtaining a license to practice medicine in the United States.
Although the requirements might sound daunting, preparing well before the final year of medical school gives the candidate the best chance of getting into the right program at the right time. Studying for examinations and gathering the needed applications and certifications will ease the process. Moreover, factoring in the price of test preparation courses, photocopying, and postage and the time and expense involved in travel to test centers will help ensure a smoother, less stressful passage.


Application and Documentation

Before applying for the first test, candidates should know that one's medical school and graduation year must be listed in the IMED in order to qualify for ECFMG certification. Applicants must have, or anticipate receiving, 4 credit years: academic years for which credit has been given toward completion of the medical curriculum at an IMED school.
Submitting the application to schedule the USMLE Step 1 test marks the beginning of the certification process. The ECFMG is in charge of receiving and tracking all foreign applications, issuing each person an identification number that should be used in subsequent correspondence.
Applicants must first complete the ECFMG's online authentication process. Begin by visiting ECFMG's Overview of Online Services. The process consists of 2 parts: online application and authentication, followed by completion of either the Certification of Identification Form (Form 186) or the Certification Statement (Form 183).
For the online application, candidates will need access to a computer with a printer. In addition, they will need an e-mail address and either a valid credit card (Visa, MasterCard, or Discover) or a checking account at a US bank and a valid US driver's license or Social Security Number in order to pay the fee for the USMLE examination. They will also be asked to choose a period during which to schedule their examination.
The application requires information about clinical clerkships, as well as names and addresses of medical schools attended, attendance dates, and any credits that have been transferred to the medical school that awarded or will award the degree. Medical school graduates should be ready to provide their education credentials with this initial examination application. Those who are still students must send medical education credentials as soon as they graduate and receive their diplomas and transcripts.
Candidates have 14 days to complete the online application and examination fee. When the online application is complete and the fee paid, the system will generate the Certification of Identification Form (Form 186, which is for applicants enrolled in medical schools that participate in the ECFMG's Medical School Web Portal [EMSWP]) or the Certification Statement (Form 183, which is the paper certification for applicants who are students enrolled in medical schools that do not participate in EMSWP]). The forms must be completed by the candidate and an authorized official of the candidate's medical school or a consular official, first class magistrate, notary public, or commissioner of oaths.
Recent graduates who have not yet received their diplomas require a certificate from the dean, vice-dean, or registrar of their medical school, stating that all of the requirements to receive the diploma have been met and the date on which the diploma will be issued.
Along with the certification forms, students and graduates must be ready to turn in 2 copies of a diploma and 1 full-face, passport-sized color photograph. The ECFMG will also request transcripts from one's medical school, translated into English.
When the completed the application has been received, the candidate will be issued a USMLE/ECFMG number. Candidates can use their USMLE/ECFMG number to register for other tests and to check their status at the USMLE's Interactive Web Application.

USMLE Step 1 and Step 2 CK

USMLE Step 1 and Step 2 CK are computer-based multiple-choice examinations. They must be taken at Prometric examination centers, which are located worldwide. For 2010, the base fee for Step 1 is $740; it is also $740 for Step 2 CK. Additional charges will vary by country. For more information, please check ECFMG's International Test Delivery Fee Surcharges chart.
Information on where to take the test can be found at these links:
Europe, Middle East, and Africa:http://www.prometric.com/USMLE/EMEAAP.htm
Step 1 tests applicants on anatomy; behavioral sciences; biochemistry; microbiology; pathology; pharmacology; physiology; and interdisciplinary areas, including genetics, aging, immunology, nutrition, and molecular and cell biology.
Beginning in May 2010, Step 1 will be divided into 7 blocks with a total of 336 questions. Participants are allotted 1 hour to complete each block. The minimum passing score for Step 1 is 188.
Step 2 is divided into 8- to 60-minute blocks and has a total of 352 questions. The test takes 9 hours, with a 45-minute break. The minimum passing score is 184. Step 2 requires interpretation of tables and laboratory data; imaging studies; photographs of gross and microscopic pathologic specimens; and results of other diagnostic studies in internal medicine, obstetrics and gynecology, pediatrics, preventive medicine, psychiatry, surgery, and other areas relevant to provision of care under supervision.
Most Step 2 CK test items describe clinical situations and require that test-takers provide 1 or more of the following: a diagnosis; a prognosis; an indication of underlying mechanisms of disease; and the next step in medical care, including preventive measures.
Familiarity with the format of the examination and the subject matter is key. Visiting the USMLE Web site will give applicants a good overview of the depth and breadth of the test, but online preparation courses may be wise investments.

Step 2 CS

The USMLE Step 2 CS examination tests students and graduates on their ability to collect information from a live patient, perform physical examinations, and communicate these findings to patients and colleagues. The test simulates a physical examination, using actors who are trained to portray real patients. The test can be taken only in the United States at 1 of the 5 Clinical Skills Evaluation Centers, located in Atlanta, Georgia; Chicago, Illinois; Houston, Texas; Los Angeles, California, and Philadelphia, Pennsylvania.
The Clinical Skills test looks at a candidate's ability in 3 major areas: the integrated clinical encounter, communication and interpersonal skills, and proficiency in English. In the integrated clinical encounter, candidates are evaluated on data gathering (taking a history and conducting a physical examination) and documentation (making notes and summarizing the encounter, diagnostic impression, and work-up). In the communication and interpersonal skills component, evaluators assess the candidate's questioning skills, information-sharing skills, and professional manner and rapport. Finally, evaluators assess the foreign medical graduate's English-language skills in the context of a physician-patient encounter.
Step 2 CS is graded on a pass/fail basis. The fee for the examination is $1295.
When all medical school documents have been received, fees paid, and examinations passed, the ECFMG will issue applicants a paper certificate. For those who have applied to residency programs through the Electronic Residency Application Service, updates will be transmitted automatically to the candidate's program.
As can be seen, obtaining ECFMG certification can be an expensive, complicated process. However, those committed to furthering their studies through a residence program or fellowship in the United States will find it easier if they keep these points in mind:
  1. Begin thinking and planning well before the final year of medical school.
  2. Set aside time for study and at least $2775 US for test fees (see http://www.ecfmg.org/fees.html for a list of fees for commonly encountered ECFMG services).
  3. Become familiar with the structure and subject of tests.
  4. Write to ECFMG for updated information, or visit their Web site.



regards, taniafdi ^_^
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