If you’re studying for for the USMLE in India, Our medical experts from India have the answers to your top questions below about the USMLE, travel, clerkships, residency programs, and more.
Based on our experience working with international medical graduates, preparing for the Step 1 exam takes 6 to 12 months, Step 2 CK (clinical knowledge) 4 to 7 months, and Step 2 CS (clinical skills) 1 to 2 months. Of course, each of you is unique with different strengths and weaknesses, so the time will vary according to your study style, available time, score goals, fluency in english and current foundation of knowledge in the subjects. We find students often underestimate the time needed to prepare, based upon the experience of a family member or friend who took the exam years ago and prepared more quickly. However, not only has the exam become more challenging over the years, but also the average scores required to be competitive for certain medical specialties have increased. So take your time, and do it right—rushing to take your medical licensing exam or using old resources can have a detrimental impact on your candidacy. Remember: Once you pass the exam, you can’t repeat the exam to attempt a higher score. Programs will also see how many times you attempted the exam, usually eliminating candidates with multiple attempts. For this reason it is essential not only to pass the exam, but to do extremely well on the first attempt.
In our opinion, the sooner the better. Most students who take Step 1 immediately after completing the basic science subjects report that it’s easier to recall difficult subject matter. But depending on how your curriculum was taught and your grasp of the material, it may or may not be optimal to take Step 1 during the summer after completing your basic sciences. Consider some of the points below, and decide what’s best for you. Most IMGs will find that traditional first-year topics are difficult to recall and that behavioral science and US epidemiology are not covered in their school’s curriculum. Further, many students educated outside the US are not exposed to the types of integrated clinical vignettes that appear on Step 1 and are not accustomed to 8-hour computerized exams. Such factors may cause students to delay studying until they’re able to devote their undivided attention on the exam. Full preparation requires not only a firm understanding of the subject matter, but the ability to integrate information across disciplines, apply knowledge to difficult clinical vignette questions, and to maintain stamina and concentration during an 8-hour examination period. This takes diligent practice to master well!
Some US IMGs return during semester breaks to complete a live review course. Although, most non-US IMGs are not able to do this until after graduation when they can attend a Kaplan Medical review course in the US on a student visa, due in part to time constraints during medical school or internship/house surgency.
A common misconception by many Indian medical students is that taking the exam in a particular month will get them a better score. There is no statistical evidence that shows IMG test results are a affected by US students’ test-taking trends. Still, if you’re taking the exam in the US, it’s possible that some testing sites will have less availability in June-August when us students are taking Step 1, so do be sure to reserve your test date in advance if you must test during these months.
If you intend to apply for an elective rotation in the US (which are only available to international students who have not yet graduated), you may need Step 1 as a prerequisite. Keep this in mind when weighing the advantages and disadvantages for taking Step 1 while enrolled in medical school.
When should I complete Step 1, Step 2 CK, and Step 2 CS in order to apply for the Match℠ in time?
Your goal should be to have all scores available by the time you transmit your ERAS(r) (Electronic Residency Application Service) application. Competitive applicants know that their application should be submitted as soon as possible once ERAS begins to accept applications—typically by mid-September. Dates may vary year to year, so check this link for the most current information.
The USMLE strongly encourages Step 2 CS examinees to complete their scheduling before May 31 of the calendar year in which you plan to test. Testing appointments are typically completely filled at least three to four months in advance. If you try to schedule after August 1, you may find that there are no available testing appointments through the end of the year unless there are cancellations. Also, test results can take 2-4 months to become available, so make sure you plan ahead!
I finished an internship (house surgency) last year. Should I take Step 2 CK before Step 1 because of my recent exposure to clinical practice?
After coming out of your internship year (house surgency), it’s a great feeling to finally be working on a clinical level. Because your clinical knowledge is fresh, it’s tempting to take the step 2 CK exam first. Although it may be counter-intuitive, we still recommend taking Step 1 first, and here’s why: Step 2 CK has continued to evolve to include more and more material previously relegated only to Step 1.
If you begin reviewing Step 2 CK first, you’ll inevitably find that your basic science foundation is weaker than you realized, which can slow down your preparation as you backtrack to review step 1 information. This could eventually cause you to miss important Step 2 CK questions on the exam. Our advising experience has shown us that examinees tend to score higher on Step 2 CK after having taken the Step 1 exam first.
Are strong clinical and English skills enough to pass Step 2 CS?
The step 2 clinical skills exam requires each of three components to be passed successfully before acquiring a passing grade:
- Which Match year you’re preparing for
- How much time you have to prepare
- Your academic strengths and weaknesses
Most Indian medical graduates do have good clinical skills (and we obviously speak english!), but the CIS section is still the component that most of us tend to fail, regardless of our english competency.
Good communication skills entail a broad range of abilities, including your ability to convey empathy, create trust, and understand how you’re expected to handle certain difficult scenarios in ways that may be different in India.
Students who prepare for the exam with Kaplan will learn the crucial ways in which successful candidates are expected to communicate and interrelate with patients in the US system of healthcare.