USMLE, residency and USCE Q&A

This post is a Q&A compilation of various questions I’ve received over the past several months, broken up into categories.

Getting into residency

How can I figure out how competitive I would be for matching in certain specialties (eg. to get into a surgical residency)?

You can take a look at the most recent NRMP report to find out data about what characteristics successfully matched applicants had compared to those who did not match (you can go to the NRMP website by clicking here). The nice thing is that the data is divided by specialty.

The limitation to the data is that it only shows numbers. While numbers are important, I think that one should take a more holistic approach when defining what makes a candidate competitive. I’ve written about this multiple posts that you can access here.

USMLE issues

Is it worth going through with all of the exams as an IMG who failed a Step and then passed with a low score on the second time around?

Failing a Step does not eliminate your chances of getting a residency spot in the US. However, as getting into residency is competitive, a failure will mean that you have a smaller chance of matching (for data, you should look at the NRMP reports, which shows the average number of USMLE attempts for those who match and those who do not). If you are okay with knowing your chance of matching may be significantly lower, but you want to keep trying, then I think in general you should.

Match timeline

Is there a good timeline available to know when Steps 1 and 2 need to be taken by to be eligible for the upcoming match?

Surprisingly, this information is not easily available (to my knowledge). The best thing is to understand the entire process by reading the most up-to-date ECFMG and USMLE booklets. In addition, there are good factsheets on the NRMP website (through the NRMP applicant toolkit webpage). In addition, Kaplan currently has a free “Residency Roadmap” for IMGs that gives a 2-year timeline (including when to schedule and take the Steps). You do need to go to their website and provide some details to them such as your email. Once you do that, then you can download the roadmap. I haven’t verified the accuracy of the timeline myself so please make sure you do thorough research to understand the most current requirements.


Is it necessary to have a Step 1 score before applying to an observership?

Observerships have a wide range of requirements for eligibility. Some may require Step 1 score or ECFMG certification, while others will not.

Is there an optimal duration for an observership (eg. is 4 weeks good enough for a good letter of recommendation?)

I would suggest as a rule of thumb to consider at least 4 weeks in an observership for your supervisor to get to know you adequately and for adequate exposure to the clinical setting. There are some things to consider when thinking about doing observerships to get letters of recommendation. You can read articles about this through the USCE page on this website.

Is there a good place to find information about when an International Medical Student should apply for electives in the US? What about best places to apply for certain specialties (eg. surgery)? Total expenses for accommodation and admission fees?

I’ve written an article on this here and that may be a good starting point for you.

Sponsored Resources:

Start the conversation!