Greetings, thanks again for writing, as will understand our organization, AHPSI, Hispanic Health Professionals Association, receives immigrants from different countries, our work is done mostly to those living in USA.

When you decide to immigrate to New York or New Jersey, you can count on our services to work recommendation, or to interview for medical residency, but really we can not guarantee any position.

What we can guarantee some visibility, referrals, introduction to our contacts, but assurance of obtaining residency position is not guaranteed.

Count on us when you decide to immigrate to USA.

For Medical Professionals like yours USMLE examination, approved, we recommend the following:

                           As  We can contribute in achieving your goal in USA.

A.We recommend, know our mission and goals. http://www.ahpsi.org

B.Understanding our academy AHPSI–USMLE, you can invite them to offer classes at the Academy.

C.  Apply for the «Clinical Research» Position, the Lincoln Hospital, Bronx, New York, which will allow you to receive income, and also get more experience to apply to medical residency.

D.Our association also can recommend to you in some medical residency programs, for hospitals in New York.

E.Actively participate as a volunteer in our program Health Fair «Decide to be Healthy«, in New York, New Jersey, Pennsylvania. Lawrence MA New

F.Becoming an active member of our association, paying the annual membership.

We want to clarify that we are a non-profit institution, 501 C, 3, Tax exempt, our basic goal in enforcing the dream of our members health professionals, striving for a better and faster insertion into the health system, of USA, We depend on their experience, knowledge, as a  Active member

The individual efforts of each member is important in achieving your goals.

USMLE- 25 Consejos prácticos para su preparación.

Por el Dr.Jaime Navarrete.

Contacto: Informacion sobre nuestros cursos del USMLE, Llamar al: 1-888-277-1288, 917-403-9220, info@ahpsi.org., Nuestra asociacion Hispana de Profesionales de la Salud, Inc NY, Ofrece tambien asesoria a sus miembros  los cuales han aprobados sus examenes del USMLE, Favor llamar al: 1-888-277-1288. , 917-403-9220., nota aclaratoria, nuestra humilde academia  de preparacion del USMLE,  es integrada por medicos Voluntarios los cuales  ya aprobaron sus exámenes, tales como la Dra.Izri Martinez, Dr.Adrian Lugo, Dra.Jeannette Marte,  este programa es un completivo para  la presentacion final de su exámen ,le recomendamos  en avance tener de por si un material adelantado  de su programa de estudio,  siempre sugerimos hacer donacion economica a este programa.

Este articulo  fue enviado como colaboracion para al Dra.Leticia Nicole Nuñez, voluntaria de nuestro programa de de revision del  Usmle, la Dr.Nuñez, actualmente esta finalizando  su residencia medica, una consejeria  individualizada siempre es recomendada por nuestros expertos, de manera voluntaria., estamos a sus ordenes!!

About Dra.Leticia Nicole Nuñez

Graduada con Honores,[Magna Cum Laude, en La universidad Iberoamericana, de Santo Domingo, Republica Dominicana .

USMLE, Certified, elegible para realizar programa de residencia medica, en USA.
Instructora ,Asesora, academia del USMLE, del ahpsi.

International Medical Graduate from Dominican Republic.

Graduated with honors, magna cum laude, from the Universidad Iberoamericana, UNIBE, Santo Domingo, Dominican Republic.

Dra.Leticia Nuñez, Su experiencia desde la Perspectiva Dominicana

La Dra.Nuñez, comparte su experienciapresentando el examen del USMLE, Necesario para un medico extranjero, graduado en exterior..

FAQ about USMLE from the perspective of an International Medical Graduate[/ALIGN]

What is the USMLE?

The USMLE is the United States Medical Licensing Exam. It is a three-step national standardized test for medical licensing in each of the 50 states and outlaying territories. All MDs are required to take the test to become licensed and practice medicine in the United States.

Who administers the test

The USMLE is sponsored by a committee consisting of representatives of the Educational Commission for Foreign Medical Graduates (ECFMGSM), the Federation of State Medical Boards (FSMB) of the United States, the National Board of Medical Examiners (NBME), and the public. The Composite Committee establishes policies and procedures for the USMLE program. The USMLE website is at http://www.usmle.org.

Can I bypass the USMLE and still become a physician?
Some medical schools require that you take and pass the USMLE in order to graduate. Technically if your school does not have that requirement, you can become a physician without taking the USMLE. However, you will not be licensed to practice anywhere.

Why do residency programs require the USMLE?

Medical schools have different grading standards which cannot easily be compared, so program rely on the USMLE to compare the academic strengths of each applicant.
The USMLE is not the only factor in selection. Obviously grades, letters of recommendation and where you went to school are key factors in granting interviews.

Which USMLE is the most important for residency?

The most important USMLE score is the first one. When you’re applying for residency, you will often not have the results of your second USMLE test. However, if you apply for fellowships after residency, they will want to see all 3 steps of the USMLE. Generally you will want to put a lot of effort into the first two steps of the USMLE to maximize your score.

How can I do well on the USMLE?

Most medical students have mastered the skill of taking multiple-choice tests, which is how they got into medical school in the first place!

How much will I spend to get into Residency starting from the application for step 1 exam ?
This is an estimate of all the expenses made during a typical 2 years USMLE-to-Residency Journey, as of season 2010-2012. Please note, this is precisely that, an approximation, and not intended to be exact. The purpose is to give you an idea of the magnitude of a very important aspect of the USMLE journey: finances. We believe that if you have an idea of what to expect in terms of the money required, you can prepare ahead and face those obstacles without much problem. Equally important, realize how imperative is to take and pass all tests in a timely fashion and without rescheduling. Failing an examination, no-shows, rescheduling test dates, and changing eligibility periods will inevitably bulk even more the expenses. Make your USMLE preparation your number one priority!

Medical school transcripts and other official documents costs vary widely from school to school. Same goes for translator’s fees, plane tickets, hotel fees, etc. Official copyrighted materials and courses have been included in this assessment. Many other expenses have not been taken in consideration, specially small, but significant expenses such as transportation to a library, daily food, additional books or courses, getting your documents rejected and having to buy them again, re-translate them and resend them via Fedex.

We do not encourage illegal copies of copyrighted material (piracy) in this forum. Do note that this courses and materials are included in the TOTAL expenses. Cost can be cut off if you count with free prep as an excelent tool for memebers of ASHPI association. All depends on how much you plan to spend on preparation.

ECFMG Application and Credentials Certification: The journey to residency begins

 ECFMG Certification Application: $50
 Documents for ECFMG Certification: Medical School Transcript $8 + Copy of Diploma Certification $5
 Traslation of Documents for ECFMG Certification: Medical School Transcript $36 + Copy of Diploma Certification $15.
 FEDEX: $48.
 Documents for Credentials Certification: Medical School Transcript $8 + Copy of Diploma Certification $5
 Traslation of Documents for Credentials Certification: Medical School Transcript $36 + Copy of Diploma Certification $15.
 Fedex: $48.
TOTAL: $202

Step 1 Preparation And Examination Fees:

 Kaplan Course Step 1: ~$2500 dollars
 Kaplan Qbank (included in Course if paid): (1 month) $100, (1-12 months) $200
 USMLE World STEP1 Qbank: (60-days) + Self-assessment Form 1 and 2 (2-weeks each): $175
 Doctors in Training Step 1: $795
 First Aid Step 1 2012: $45
 NBME: $60 (each)
 Step 1 Examination Fee: $930

TOTAL: $4705

Step 2 Clinical Skills (CS) Preparation And Examination Fees:: “Hi Mr. Johnson, my name is Dr….”
 First Aid CS 2012: $50
 Plane Ticket: $500
 Hotel/food: $200
 Step 2 CS Examination Fee: $1,375 dollars
TOTAL: $2125

Step 2 Clinical Knowledge (CK) Preparation And Examination Fees: “Which of the following is the best initial test?”

 Kaplan Course Step 2 CK: ~$2500 dollars
 Kaplan Qbank (included in Course if paid): (1 month) $100, (1-12 months) $200
 USMLE WORLD STEP2 CK Qbank: (60-days) + Self-assessment Form 1 (2-weeks) $155
 Master the Boards CK: $35
 NBME: $60 (each)
 Step 2 CK Examination Fee: $945

TOTAL: $3895

Step 3 Preparation And Examination Fees: “What is the most appropriate next step in the management of this patient?”

 USMLE WORLD STEP3 CCS + MCQS (60-days) + Self-assessment Form 1 (2-weeks) $210
 Master the Boards USMLE Step 3: $40
 NBME: $60 (each)
 Step 3 Examination Fee: $830
 Plane Ticket: $400 (can be taken in Miami, PR, etc.) *Many take this test during the interview season, so if you do, could save a couple of bucks in plane tickets and stay.
 Hotel/food: $200

TOTAL: $1740

ERAS Application and Interviews: Suit up!

 ERAS TOKEN: $90
 Electronic Transmission of USMLE Transcript for ERAS: $70 per ERAS season
 NRMP Match Registration Fee: $50
 ERAS Supporting Documents: Medical School Transcript $8
 Translation of ERAS Supporting Documents: Medical School Transcript $36
 FEDEX: $48
 Residency Programs Applications (60 programs): $1110

 Interviews (including food, transport, stay -hotels only when no other option-plane tickets, all on a limited budget): ~$2,000 (Very variable. Depends mostly on the number of interviews, states to travel, and time span. Can go from ~$1000 for 1-2 interviews in the same state or city, to ~$3,000 if >10 interviews in different states)
TOTAL: $3412

Visa Application:

 J-1 Visa Sponsorship: $455 if first time applicant.
 H1B: Most sponsoring programs will cover the expenses. Premium processing is optional and the fee is around $1300. Some programs will cover premium processing fees.
TOTAL: $455 (J-1 visa)

GRAND TOTAL: US $16,534 this is an approximate number , I personally did it with less than US $11,000, I did a lot of self study to cut off some costs.

The Basic …

Step by Step how to get the ECFMG number

Here are the steps that you have to follow when registering for the first time with ECFMG in order to apply for USMLE.

First of all check if your medical school is listed in IMED (La lista de Escuelas de medicinas aprovadas ) if it’s not you should inform your medical school immediately. To check the IMED list go here https://imed.faimer.org/

Before applying it’s recommended to read the eligibility requirements available in this web page ECFMG 2011-2012 Information Booklet – Examination Requirements

1- USMLE ID
The first step ever is to obtain a USMLE Identification Number also called USMLE ID or ECFMG ID this is done by going to this webpage https://secure2.ecfmg.org/usmleidrequest/usmleidrequestnavigator.aspx
After you enter your information such as name, email, address, etc they will send you an email giving you your ECFMG ID (8 digits number) and a password to access the online services.
Wait one week and if they don’t send you the email (check your junk folder also) then call them +1 (215) 386 5900.
This USMLE ID is yours forever and you should record it in a safe place (not on your Kaplan lecture notes or FA or anything else… Like your «Cedula» forever… lol

2- IWA application
Before logging in to IWA make sure of the following:
 Your Internet access is live and continuous (electricity or Internet outage may prove disastrous)
 Your printer is ready and has enough papers.
Using your ECFMG ID and password you can log in to IWA and begin the application process. You can do that by going to this page https://iwa2.ecfmg.org
After logging in you will be asked to fill out online forms (be very careful while filling these) and if for any reason you are stumbled upon a question that you don’t know the answer immediately, you can save the application and log out and come back to at a later time. Then you will be asked to print out some forms that you have to fill by hand and then send by mail to ECFMG.

When i was filling this application i already have all the documentation from my university, so i can feel free to fill the «Clerkship, Intership, Rotations, etc… » because they ask you the exact date of each one.

Que formularios necesito?

3- Forms

– Form 344 is a check list of what documents you have to attach.
– Form 345 is medical school release request (basically you are allowing ECFMG to obtain your information from your medical school). Two copies needed of this form.
– Form 186 these are forms that let ECFMG make sure that you (your name and a your photo) are in fact existent and that this is your signature and this is your ECFMG ID. These forms may have to be signed by your medical school official and/or by a notary public, for detailed information about these forms please read The Complete Guide to ECFMG Forms

To sign Each form, depends on the university, they requires from you to be present and sign it infront of the official of your university.

4- Documents

The documents that you will be sending with these forms are
 Medical school diploma + translated if it is not in English
 Two passport sized photographs
 Some other documents might be needed (like for example if you have transferred credits)
All of those Document have to be translate of course to ENGLISH, There are a lot of good translator or «Judicial Translators out there» but the one we use is.. Violeta Ricard ( 809-565-6838 ) by the time we use it that was her phone number… ( This is a non paid publicity lol ) She is good and really helpful.

5- Send the forms and documents

Now that you collected and filled all these documents and forms you should send them to ECFMG Philadelphia office (address will be given to you in the forms and during the online application).

Please be advise, that you got 2 ways of sending the papers to ECFMG, the first 1 is by your Medical School, because your «Principal» or «Decano» have to sign it and then you leave the documents to your school and they will send it to ECFMG, Must of us have to pay the shipping cost. The other way is do it by yourself which means you have to pay to legalize all the documents after the «principal of your school sign it» i think this is the way that most of the people choose when they are out of the country. ( We all choose the first one – Med School send it for us )…

6- Wait for confirmation

ECFMG will tell you by email and by mail that they have received your forms and documents then they will send forms to your medical school asking them to verify your medical school credentials and also requesting your final medical school transcript (if you are a graduate) from them.

It will take like 3-8 weeks for you to receive the confirmation… Just wait,, there are a plenty of pages ahead of you… so go study…. =)

7- ECFMG to Medical School Forms

These forms you do not have access to it and you are not allowed to send them to your school, The ECFMG will send them.
They will send one copy of your 345 to tell the school that you allowed them to ask about you.
They will also send your Diploma (that you initially sent to them see step 4 above) and they’ll ask the school to authenticate it.

They will also send a form called (Verification of Medical Education) the questions in that form are these;

 what was the requirements before you entered the school
 how many weeks of medical education you completed
 what degree was awarded (if you are a graduate)
 asking to verifying the attached diploma
 dean or other authorized registration officer’s signature, date, and name
 any interruptions or extensions in your medical education
 any disciplinary probation you had or currently have
 any professional misconduct that you have during your school years
 any negative reports about you in the school
 any limitations or special requirements by you

8- Medical School to ECFMG

Your medical school would have to respond to these forms and should also send your final medical school transcript (in English, if not you will be asked to pay for the translation fees).
The last two steps may take several months! However, if your school participate in the ECFMG Medical School Web Portal then it may take only few days.

9- OASIS

After waiting for steps 7 and 8 above to finish you are now ready to check your status by logging in to OASIS (using your same ECFMG ID and password). The link is this https://secure2.ecfmg.org/emain.asp?app=oasis
When logged in look at the left hand side panel and click on «Medical Education Credentials and Standard ECFMG Certificate» and the status that you should be happy with is this «Medical education credentials received and verified», any other status means that you’re not done yet.

10- Apply

Once you received that status you can now apply for any step you like using IWA or OASIS.
The fees for the exam has to be paid at this point. Current fee requirements are listed in this web page ECFMG | Selected Fees

Note that you are applying for an eligibility period not for exact exam date.
The eligibility periods are three months for all exams except CS it’s 12 months.

11- Scheduling Permit

When you finish applying online you’ll get a scheduling permit with permission confirmation number and exam registration ID that you should print out and take it with you to your exam. (note there is no more orange slips that you have to wait for in the mail as before).

12- Prometric

After receiving a confirmation email and mail from ECFMG for your application status (Scheduling Permit) you can then go to Prometric website and choose your exam date (of course within your eligibility period).

Here’s the link to Prometric website Prometric Services: Testing and Assessment
Notes:

 These steps are general and there might be significant variations depending on your special circumstances.

 Be very careful while filling any form online or offline as they will held you responsible for any little thing you say and it’s very difficult to change thereafter.

 Processing times varies with the time of the year and on how fast your medical school responds to ECFMG.


 Again, Highly Important to Fill out everything Step by step , double check, triple check… If You set something wrong like your name … they will held you responsible and will charger you and that’s not the big deal… is that they will make you proof that the «new» thing you are saying… is the real one…
Some links that might help :
ttp://www.usmle.org/

http://www.ecfmg.org/

http://www.usmleworld.com/

Personal Experience what material did I use according to the exam?

Step 1

My Study Plan was as follows:

I studied 8-14 hours everyday (only 4-6 on Sundays) very consistently for 6-7 months. My suggestion is take some breaks, including some weekends off when you feel burned out (did this one or twice during my prep).

In my opinion, you should stop working if possible .

1. Kaplan Lecture Notes and Videos: my recommendation with this is do it as fast as you can. Understand every concept, but you do not need to memorize everything (I didn’t), but definitively understand it. Also read Microbiology Made Ridiculously Simple (good images that will stick in your head) at that time along with Kaplan Micro.

2. Kaplan Qbank:. In my opinion, not essential but overall good.

3. First Aid: the highest yield book that I used. 1st read out of 3. Also kind of reviewed Kaplan Lecture Notes again at the same time, to annotate everything I thought was important and lacking in FA (use tiny handwriting, as you will need more space for notes later). The idea is to make FA your primary book. Never opened Kaplan books again.

4. Doctors In Training : very good program overall. Great if you need to reinforce your pharmacology and they definitively make you memorize a lot of HY concepts and topics. They make you go through FA entirely, so this counted as the 2nd read for FA.

5. First Aid: Quickly read first aid again (3rd time) before entering UWorld.

6. USMLE World: best learning tool ever. This must be done in random, timed, non-specific subjects, non-tutorial and with complete 46-Q blocks. Do NOT make the mistake of doing it by subject or tutorial. This is important because the final score is a good predictor of your performance in the real deal. Very similar questions to real test, but way harder. The idea is to get over-prepared, and you wil if your scores are good enoughl.

7. First Aid: last read before exam. Probably what helped me the most as I had all my Kaplan, DIT and Uworld annotations in it. At the same time I annotated every piece of information that I wasn’t familiar with in a sheet of paper and reviewed it the day before the exam.

8. NBME: Must take at least 3 forms in separate days before the exam , the forms 11-12-13 are the most accurate .

Day before the test:

Reviewed some of my notes. Couldn’t stop reading until 8:00 pm. Had a light dinner, watched a movie and took a relaxing tea which I knew would help me relieve the anxiety. Had some trouble falling asleep but eventually did at ~11:00 pm.

Test day:

Got there really early to avoid traffic and get a parking space. People at Prometric center were really nice. Blocks went smoothly. Took breaks between every block. If you are addicted to coffee like me, beware that there might not be a coffee machine available. In my case it was broken, so not getting my boost after lunch REALLY affected me in the 5th block. I was very sleepy.
Overall, I felt confident. It was NOT EASY, but I felt well prepared. About 70% were easy for me. I marked between 5-8 questions per block that either I wanted to read again or I had no clue (1-3 per block). Fortunately, I had between 5-10 minutes left in every block. I trained myself during UW for this. It’s what I like to call the «30-30» rule: be at question 30 by minute 30. This allowed me plenty of time in the test to not only review those marked questions, but even all questions.

Final words: exam is very doable. If you follow a similar study plan, which is a working formula, you will get over-prepared for 80% of the exam content, and will feel confident during the test. Get a great study partner (thanks dude!) and be consistent. This has been a life-changing journey for me and I’m sure will be the same for you. GOOD LUCK!

]STEP 2 CK[/SIZE]

Your preparation for CK is going to depend on your knowledge base of Step 1.
You have to ways to prepare , I call them the extended way and the short way, its upto you to decide which path suits you best .
Extended Way (you got an average not so good score on Step 1)
6- 9 months of studying
Kaplan Lecture Notes and videos for CK (excelents but very time consuming)
Master The Boards by Conrad Fischer for CK
Doctors In Training & Step Up
2 question banks: UWorld/Kaplan
Short Way ( you did excellent on step 1 and took it a few months back)
4 months of hard studying 8 – 12 hours daily
Master The Boards by Conrad Fischer for CK
DIT & step up

1 question bank : Uworld

STEP 2 CS

Basically all I used was First Aid for CS 4th edition and CSE videos ( helped a lot) and a study partner.

Remember to choose your date with anticipation ,because this test is only given in 5 states in the USA. For more info : http://www.usmle.org/step-2-cs/

Note: By the time you pass your step 1 ,Step 2 CK and Step CS you will be given the ecfmg certificate . Studying for step 3 right away is mainly for visa H1 sponsorship. Although you must take step 3 during your first year of residency. Bening and IMG and having completed the step 3 by the time application season starts puts you in a even more competitive position.
• How to Study Actively?

One of the most common problems when people are studying for long periods of time is that they fall into passive, almost mindless mental habits. Eyes dutifully move over the lines of print, but not much goes into long term memory. Even worse, if the information is being reviewed, it already looks familiar, so you can easily fool yourself into thinking ‘Yes–I remember this–I know how this works.’ Unfortunately, following along when the information is all laid out on the page and being able to call the relevant information from memory when you are dealing with a question on that material later are not the same thing. Even when you know a lot, you may apply the wrong information to an item, or get confused about what applies from what you recall. Here are some tactics that you can use to study more actively, which all require doing something with the information, rather than simply reading through it with the intention to remember.

Look over some practice questions on a topic you are about to review first.
If it’s been a while since you studied a topic, you may not actually be able to answer the items yet, but just reading the question, to get a clear sense of what’s being asked is your goal here. After you finish looking at the items, traces of what was called for by the items will linger in your memory, making the question-relevant information jump out once you begin reviewing this content.

Make key aspects and relationships stand out in your study notes.

Most people take notes when they review. But if you aren’t careful, it’s easy to just write down without really thinking about the information. To make those study notes really work for you, take a few minutes to look over the kind of material you are about to review. Is it describing several disorders that present similarly? Are there key lab tests that tell you which disorder you are dealing with? Do the disorders hit different groups of patients (the very young, post-menopausal women, certain ethnic groups, for example)? Can you generate a way to compare and contrast the varieties of disorders, showing how they are similar and different from each other? Once you have a clearer sense of the kind of information you are dealing with, decide how to represent the key aspects on paper in a way that highlights these aspects. Techniques for doing this can include:

1. Using boxes with arrows to show the ordered steps of a process or sequence of events.
2. Color highlighting your notes, e.g., pink for lab data information, blue for presenting symptoms, yellow for incidence (who gets it), green for morphological changes, etc. Now when you look over pages of notes, you can scan all the pink to see how the anemias differ in terms of their labs, for example.
3. Use a tape recorder to make summary notes instead of paper. You can even ask yourself questions, leaving a pause after for later listening and self-quizzing. By forcing yourself to articulate what you want to remember in your own words, you are more likely to remember the key points and you have a portable study aid to plug into later, in the car stereo while you are driving or using a Walkman to listen to while you do chores or take a walk.

4. Make charts of related groups, such as the types of meningitis. Rows for each type, columns to show the bug, presenting findings, typical lab results, prognosis, etc. Color code as necessary to make exceptions and shared features and key aspects stand out.

Switch activities to stay mentally alert

If you are sitting at your study table and find that you are just spinning your mental gears, stop what you are doing and do something else. You might switch to a different kind of material as a break (shift from internal medicine to psychiatry, or from Microbiology to Physiology, for example). Look at a clinical website on the study topic for a change of pace. You can also try doing a few practice items on the material, then look up the related material in your review source to understand the correct and each incorrect answer. Now, what you read is relevant to an actual question and this will help you take in the information because it is perceived as more meaningful than just reading page after page in the book.

Find a study partner to do questions out loud

If you are enrolled in a Kaplan Center, find someone who is willing to sit with you for an hour or two several times a week. Agree in advance what topic you want to focus on, then take turns doing items out loud, reading the stem out loud, stating what you think is being asked, and talking through your reasoning as you evaluate all the possible answer choices. The other person should listen for reading or reasoning mistakes and give feedback. Then switch roles and you give the feedback. Don’t get bogged down in fine details while dong this, however. The goal of the session is to refine how you interpret and reason with what you already know, not to worry about checking out every little detail. Use the question explanations when you get stuck because neither of you recalls, or just skip that question and move on. This is an excellent way to practice applying what you know and to improve your accuracy in understanding and reasoning through test questions.

From my personal experience Disicipline must rule in every step of the way.
Good Luck!

Dra.Leticia Nicole Nuñez…..

Mas Informacion sobre nuestros cursos del USMLE, Llamar al: 1-888-277-1288, 917-403-9220, info@ahpsi.org.

Clases Martes y Jueves, 6:00PM-9PM, Hospital Linconl, Bronx, NY. http://www.ahpsi.org