Pathway to Medical Residency in the US

What we will cover -

 Why Obtain Medical Licensure in the US?

 Application Process and Timeline
 Tips to Increase your Odds
 Understanding the USMLE
 Study Plan Strategies
 How Kaplan can help!

*
Benefits of obtaining a Residency in USA:

Faster pathway to
specialization: All candidates
usually 3 – 5 enter the same
years application pool

Help fill the

Competitive anticipated doctor
salaries shortage in the United
States!
 Source:
Physician
Weekly 2018 Average Physician Compensation
 We NEED IMG’s in the US!
• International medical Number of Non-US
Year
graduates (IMGs) IMGs that Matched
comprise 25% of the U.S.
2019 4,028
physician workforce* 2018 3,962
2017 3,814
2016 3769
• AAMC predicts a shortage of 2015 3641
about 45,000 primary care 2014 3630
physicians and 46,000 2013 3602
surgeons and medical 2012 2772
specialists during the next 2011 2723
decade. 2010 2883

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*http://www.faimer.org/research/workforce.html
Source - NRMP
*
 Where Do I Start?

United States Medical Licensing Exams

USMLE® (Exams students have to take – USMLE Step 1, Step 2CK,
Step 2CS and Step 3)

Education Commission for Foreign Medical Graduates

ECFMG® (Students needs to first create an account with ECFMG – then
they are approved to take USMLE exams)

Electronic Residency Application Service

ERAS® (How students apply to different hospitals)

National Residency Matching Program

NRMP® (Selection process for fitting students into hospitals)

*USMLE is a joint program of The Federation of State Medical Boards of the United States, Inc. and the National Board of Medical Examiners. The ECFMG¨ is a registered trademark of the
Educational Commission for Foreign Medical Graduates. The NRMP is not affiliated with Kaplan. Electronic Residency Application Service (ERAS¨) is a program of the association of American
Medical Colleges and is not affiliated with Kaplan. Test names are the property of the respective trademark holders, none of whom endorse nor are affiliated with Kaplan.

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Navigate through the Application Process

ECFMG ERAS NRMP

• Register through • Apply through Eras

ECFMG
• USMLE Scores •Submit your Rank
• Verify Medical Order Lists
Degree • Personal statement

• Pass USMLE Step 1, • CV / Experience /

Certifications •Enter Match
2CK, 2CS
• Receive ECFGM • Photograph
Certification • Letters of
recommendations
• List of Programs you will
apply to

Test names and other trademarks are the property of the respective trademark holders. None of
7 the trademark holders are affiliated with Kaplan.
 Planning your
Match Calendar

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USMLE Timeline For IMG’S
MED SCHOOL PREPARE FOR USMLE EXAMS WITH KAPLAN MATCH RESIDENCY

Match
Receive medical happens
degree from 3 – 12 Months 3 – 9 Months once per
year in 3 – 5 Years
recognized
March
medical school
1-2 Months
Applications
submitted in
September
USMLE Step 2 CS

RECEIVE ECFMG CERTIFICATION

USMLE USMLE USMLE

Step 1 Step 2 CK Step 3
Can be taken before
Residency to strengthen
application and for visa
purposes

Test names and other trademarks are the property of the respective trademark holders. None of
9 the trademark holders are affiliated with Kaplan.
Important Match Dates to Remember

Apply for Residency Token at

June
ECFMG.org / Download ERAS Guide

July My ERAS Opens

All supporting documents (Letters of
Recommendation) need to arrive at ECFMG Aug
to have available to ERAS by mid-September 1st

Sept
Start of applications
6th

Interview Season Nov -

Jan

Feb Submit Rank Order List

Mid
Match Week March
 65% of Interviews given by end of October

2018 NRMP Program Director Survey

Tasks you must complete
• USMLE exam prep 1, 2 CS, 2 CK
• Schedule AND receive your score results
• Decide what specialty to apply
• Research where you will apply
• Search for US clinical experience opportunities
• Solicit LORs (Letters of Recommendation)
• Submit documents to ERAS
• Prepare ERAS application
• Complete your US clinical experience
• Check on your visa status
• Prepare for interviews
Don’t forget to plan your Step 2CS early

Step 2 CS 2019 Reporting Schedule

Testing Period Reporting Period

For examinees who test: Reporting start date Reporting end date

January 27 - March 23 April 24 May 22

March 24 - May 18 June 19 July 17

May 19 - July 13 August 14 September 11

July 14 - September 7 October 9 November 6

 How successful are
IMG’s in the Match?

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 2019 Match Rate by Applicant

Applicant Type Number of Active Applicants/ Matches % Matched

US Allopathic Seniors 18,925 / 17,763 93.9%

US-IMGs 5,080 / 2,997 59.0%

Non-US IMGs 6,869 / 4,028 58.6%

http://www.nrmp.org/wp-
content/uploads/2016/04/Main-Match-Results-and-Data-
2016.pdf
 Match Rate % Trend

US IMG NON US IMG

2019 59 58.6
2018 57.1 56.1
2017 54.8 52.4
2016 53.9 50.5
2015 53.1 49.4
2014 53 49.5
2013 52.8 47
2012 49.1 40.6
2011 50 40.9
2010 47.3 39.8

http://www.nrmp.org/main-residency-match-
data/
 More Interviews = Higher Chance of Matching

A recent NRMP study shows that the

“number of contiguous ranks” was the
single best predictor of Match success.

Matched = 6.4
Unmatched = 2.3

NRMP 2018 Match Data

 How do I get
Residency
interviews?

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2018 NRMP Program Director Survey
2018 NRMP Program Director Survey
What are programs looking for?

● USMLE scores and # of attempts

● Year of medical school graduation
● Evidence of any US clinical experience
● Strength of Letters of Recommendation (LORs)
● Personal Statement
● Conduct and interaction during interviews
US Residency Program Selection Process

•1st cut: USMLE scores

•2nd cut: Application package
•3rd cut: Interviews
•4th cut: Rankings decided
USMLE SCORES
NON US IMGs*

Avg. Step I scores for

• Matched = 234
• Unmatched = 221

Avg. Step 2CK scores

• Matched = 240
• Unmatched = 228

POINTS MATTER!

http://www.nrmp.org/main-residency-match-
data/
•IMGS with a 260 on Step 1 have over an 80% Chance of Matching
 Less than 200 21%
200-209 31%
210-219 37%
220-229 50%
230-239 66%
240-249 79%
250+ 89%

2017 and 2018 Match - Internal Medicine (Non US -IMG)

http://ww.nrmp.org/main-residency-match-data/
 Non US IMG
# # Step 1 Score Step 1 Score - Step 2 Score - Step 2 Score -
Match Unmatch - Match Unmatch Match Unmatch
ALL SPECIALTIES 3269 2910 234 221 240 228
Anethesiology 115 67 240 221 244 228
Dermatology 12 15 238 230 246 232
Diagnostic Radiology 69 88 241 232 243 236
Emergency Medicine 27 35 229 219 234 228
Family Medicine 240 342 220 212 231 223
General Surgery 62 173 242 236 249 240
Internal Medicine 1917 1403 236 222 241 228
Neurology 168 130 236 224 240 227
OBGYN 36 73 231 228 237 237
Pathology 151 70 230 219 233 224
Pediatrics 288 166 230 213 238 224
Physical Medicine 8 19 238 221 242 231
Psychiatry 123 198 222 216 232 224

http://www.nrmp.org/main-residency-match-
data/
 US IMG
# # Step 1 Score Step 1 Score - Step 2 Score - Step 2 Score -
Match Unmatch - Match Unmatch Match Unmatch
ALL SPECIALTIES 2248 1990 222 212 232 222
Anethesiology 114 56 231 222 237 230
Diagnostic Radiology 40 31 239 226 242 233
Emergency Medicine 72 76 232 222 241 230
Family Medicine 519 458 211 207 225 219
General Surgery 61 122 237 228 245 236
Internal Medicine 911 690 225 210 234 220
Neurology 60 48 227 214 234 223
OBGYN 57 65 229 216 238 228
Pathology 65 34 226 213 230 221
Pediatrics 189 67 221 211 232 221
Physical Medicine 18 33 226 217 235 226
Psychiatry 102 242 214 207 227 217

http://www.nrmp.org/main-residency-match-
data/
 Decide where to Apply - Do your Research!

Top 10 Most IMG Friendly States

1.New York (1,384 IMGs)

2.Florida (529 IMGs)
3.Michigan (496 IMGs)
4.Pennsylvania (462 IMGs)
5.New Jersey (399 IMGs)
6.Texas (378 IMGs)
7.Illinois (360 IMGs)
8.Ohio (341 IMGs)
9.California (290 IMGs)
10.Massachusetts (242 IMGs)
2018 Match
 Understanding the
USMLE

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 USMLE EXAMS
Step 1 Step 2CK Step 2 CS Step 3

Tests on the ability to gather Understanding of clinical

Understanding the underlying Assessment and application information, perform physical science considered essential
mechanism of disease & initial of patients initial diagnosis examinations, and for the unsupervised practice
diagnosis. and treatment communicate findings. of medicine

Basic Sciences Clinical Knowledge Clinical Skills Patient Care

Anatomy
Behavioral Science Communication and Internal Medicine
Internal Medicine
Biochemistry Interpersonal Skills Pediatrics
Pediatrics
Microbiology Spoken English Proficiency Surgery
Surgery
Immunology Physical Exam and Patient OBGYN
OBGYN
Pathology Note Psychiatry
Psychiatry
Pharmacology
Physiology
2 Day Exam –
8 Hour Exam 9 Hour Exam 12 Patient Encounters Multiple Choice Questions and
7 Blocks 8 Blocks Only given in the US Clinical Case Simulations
280 question maximum 318 question maximum

Passing Score: 194 Passing Score: 209 Pass / Fail Passing Score: 196
Pass Rate: 73% Passing Rate: 75% Passing Rate: 81% Passing Rate: 84%

Passing Rate for IMG’s – Combination of First and Repeat Test Takers
USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the
National Board of Medical Examiners (NBME)
Step 1 Evolution
Single Jump, 1980’s

Which of the following structures is most likely

affected in Alzheimer disease?

A. Amygdala
B. Caudate nucleus
C. Hypothalamus
D. Hippocampus
E. Superior colliculus
 Step 1 Evolution
Double Jump, 1990’s

A 72-year-old woman is brought to her physician by her

husband. He states that she is having trouble recognizing
her grandchildren, and is having increasing difficulties in the
planning and executing her daily activities. Furthermore, she
is having a more difficult time recalling the names of
common objects. Which of the following structures is most
likely affected in this patient?

A. Amygdala
B. Caudate nucleus
C. Hypothalamus
D. Hippocampus
E. Superior colliculus
Step 1 Evolution (Triple Jump, today)

A 72-year-old woman is brought to her

physician by her husband. He states that
she is having trouble recognizing her
grandchildren, and is having increasing
difficulties in the planning and executing
her daily activities. Furthermore, she is
having a more difficult time recalling the
names of common objects. He states that
he often finds her wandering around the
A 72-year-old woman is brought to her physician house with an
by her husband. “absent”
He states that she islook
having on her face.
trouble recognizing her grandchildren, and is having increasing difficulties in the planning and
executing her daily activities. Furthermore, she Which
is having a of
morethe following
difficult structures
time recalling the is most
names of common objects. He states that he often finds her wandering around the house with an
“absent” look on her face. Which of the followinglikely affected
structures in affected
is most likely this patient?
in this
patient?

○ A ○ A
○
○
B
C
○ B
○ D ○ C
○
○
E
F ○ D
○ E
○ F
 Exam Strategy Considerations

● Just passing will not give you the competitive edge

● Competitive programs want both steps passed on 1st
attempt
● Exams may not be retaken to improve scores – Scores
valid for 7 years
● Residency programs use USMLE scores to filter at the very
start of the process
● Availability of Step 1, Step 2 CK and CS scores in time for
application is crucial to getting interviews
 “What’s the best
way to get a high
score?”

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Follow a Study Plan!
- Provide structure to your preparation time
- Approach content areas strategically to maximize
your score
- Plan to have content study time and question
practice time
- Learn how to learn from your mistakes
Things to consider when making a
study plan
- Individual strengths and weaknesses
- Prevalence of subject area on test
- Necessary stages of preparation
- Amount of time to test day / Study time per day
- Learning style
- Other personal obligations
Balance Content Study with
Practice Questions

Content
Questions

Topical
Question Review Test Simulation

T i m e

Assessment at logical intervals

 WHY KAPLAN?
Contact:
Lic. Julia Rivera
Kaplan Medical Coordinator
809-722-4076-WA

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