USMLE Stuff (Open Letters, 1)

Initially appeared on doktorko.com 5/10/2005.

Q: I'm about to take my step 1 this May 27, then step 2 ck and cs around early august. Hopefully I receive ecfmg certification around late october then take step 3 by november. I aim to make it to the programs' deadline of dec. 31 (for step 3 results).

Have you already taken step 3? How does it go about exactly? I've read information about it on fsmb and usmle, but frankly its all still fuzzy to me. How did you go about preparing for it? does someone like me who hasn't taken up residency yet have a chance to pass?

I'm looking for commendable IM residency programs in Florida (Orlando, Tampa or Jacksonville). Do you have any recommendations?

A: good luck on your upcoming exams. madali lang yan. if you passed your local boards, the usmle should be a snap. just remember to study 1. preventive medicine (e.g. what screening tests do we give to an otherwise asymptomatic person just based on risk factors?), and 2. the weird diseases that we never see but are extremely common in the states such as sicke cell anemia and idiopathic thrombocytopenic purpura.

regarding step 3, the websites are pretty nebulous. go to a forum site such as www.usmle.net. you will be able to dig up good pieces of advice as well as find a support group you can sound off to if you're so inclined. what i can tell you is this: first you have to apply to take the step 3 (i think you have to prove that you passed steps 1 and 2, though) in a certain state. they each have their own fee and their own requirements. the easiest one to apply to is connecticut. don't worry, you can take the actual test anywhere you want - it's just that one state who will process your papers.

i found the actual step 3 tremendously difficult, mainly because i arrogantly thought that my 1 year of moonlighting experience gave me enough of a clinical acumen to answer clinical questions. focus on outpatient stuff and the things i mentioned above. use that knowledge to top off your stocked knowledge from the local boards and steps 1 and 2 and you should pass with flying colors.

the exam is divided into 2: the first part is a multiple-choice-type-thing much like steps 1 and 2. the second part is a clinical exam where you are given a case you have to manage (like an adventure game).

don't worry about step 3 right now. focus on getting smarter than you already are so you can blast through steps 1 and 2 and make your resume a testament to your brilliance.

i do not know which programs are top-rated. try googling "best residency programs" or "best hospitals" and you should get a rough idea of where you want to go. but take note that your "fit" with a program doesn't hinge on its prestige but on a number of intangible factors (which i can't name precisely because they are intangible). take into account the location (i don't think you'd want to work in downtown brooklyn or the bronx), cost of living, etc. btw, i've heard terrible things about florida. people here say you can't find a good doctor over there. and i think you have to be fairly fluent in spanish because they have large hispanic population.

speaking of spanish, if you can learn it while you're still in the rp, that would be a big plus.