USMLE Stuff (Open Letters, 3)

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

Q: I'm thinking of brushing up on my (hopefully retrievable) goldmine of clinical skills by undertaking 2 or 3 moonlight opportunities. I just hope i'd be wellversed enough to explain to the bewildered patient why his dry cough necessitates a neuroexam.

But like i said, i'm getting way too ahead of myself. i'm almost eating up the internet to search for programs and learn the ropes way before i even know if i'll make it. i guess i'm just buoying my self esteem. besides (i rationalize), psyching one's self will really make a difference.

my problem is, i'd be in the states to take ck through step 3. i don't know how i'll be able to solicit Lors then. Can i ask for Lors even without registering with eras yet?

i'm still torn between florida and new jersey. and yes, i'd look into your midwestern advice. moral decay and hedonism are such huge and adamant issues.

A: do not - i repeat, DO NOT - think that moonlighting in any way prepares you for the real world of medicine. it'll help you polish your history-taking skills if you work at it, but by and large what it will do is make you think de-kahon (i.e. come up with the simplest/cheapest diagnostic and treatment plan possible) and expose you to lazy consultants who don't even bother updating themselves on the latest developments. if anything, take one moonlighting gig in a reasonably large hospital with a consultant staff who are in the academe. that way, you get real-world experience with consultants that are knowledgeable enough to stimulate your intellect. plus, you make more than the usual training resident does. this is if you want to get smarter. while making money. if your priority is just to make big bucks, apply to some far-flung hospital in batangas where they pay you oodles of cash to go on duty but mismanage patients horribly (i've seen a "consultant" give a blood transfusion as a "cure" for URTI).

so psyched up ka na para sa exams, which is good. try to answer the sample step 1 exam on the usmle.org website. if you score above >70% correct, you should be right on track. this is equivalent to a 99 rating already (at least it was when i took the exams).

get your LORs now (or at least ask for them now). as long as they are relatively fresh (i.e. written within 3-6 months of your interviews, which would be right about now), there should be no issue. try to have everything on hand by october 1. if you don't have step 3 scores by then, ok lang as long as you have taken step 3 (if you're applying to h1 programs) and can say "i'm just waiting for them to mail me my high grade." i cannot stress this point enough: EACH DAY AFTER OCTOBER 1 THAT YOU WAIT TO HAND YOUR APPLICATION IN DECREASES YOUR CHANCES OF GETTING INTERVIEWED EXPONENTIALLY. unless you have 99-99 scores, were class valedictorian, and have a slew of research papers (you as the primary researcher) to your name.

there is also a dean's letter required. this is different from the LORs, mind.