#usmle questions

[nextstepsusmle]

Title: USMLE Preparation - Next Steps

Description: Prepare for the USMLE with expert guidance and comprehensive resources. Ace your exams with Next Steps tailored study plans, practice questions, and tips for success. For more details Register Here: https://nextstepscareer.com/usmle-steps-preparation/

[starrynightsforever]

I was reading the test day rules for STEP 1 last night, and apparently no jewelry is allowed in the testing room except wedding rings. So, it's fine for you to cheat on and/or record medical licensing exams as long as you're married.

[medicosis]

Can you answer today’s question 🙋‍♂️?! Q: If my kidney’s tubular cells detach into the tubular lumen leading to obstruction and pigmented cell casts production, what kind of necrosis is this?! 🤔…#kidney #doctor #nurse #physician #physicianassistant #medicine #medical #medschool #fact #question #usmle #nclex #usmle https://www.instagram.com/p/CrU34pCOKls/?igshid=NGJjMDIxMWI=

[recallmastery]

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[rcmclachlan]

15 for the newest ask writing game you posted!

"It's okay. E-Evan, it's okay," Tommy wheezes, cracking a smile, and Buck's hands tremble where they hover over his chest. He's too afraid to touch anything. He saw a picture of something like this in one of Hen's textbooks when he'd helped her study for an exam. Fig 1. Open pneumothorax, it had said. A prime example of a sucking chest wound. Note the foaming of blood around the edges of the open chest cavity: the air pulled into the puncture will create a froth. This type of trauma is almost always fatal.

Buck can't tell if the blood is frothing or if he's just crying too hard that it's fucking with his vision. He can see the red in Tommy's teeth, though.

"It's okay," Tommy breathes. There's a whistle in his voice that isn't supposed to be there.

"It's not," Buck sobs, like it's been torn out of him, like his lungs are collapsing right alongside Tommy's. "S-Stop talking, you fucking idiot. Just breathe out, okay? Breathe out, Tommy."

When Tommy does as he's told, more blood bubbles on his lips. Buck wants to taste it. Instead, he shoves his own balled-up shirt against the wound and uses his full weight to keep Tommy from tearing himself open further.

He just has to hold it together until Hen and Chim get there. They'll know what to do. They'll fix this.

"You're not gonna end up in a textbook, Tommy," Buck promises through clenched teeth. "I won't let you be a question on the USMLE."

Tommy's lashes flutter a little like he's trying to stay awake, but he manages to hold Buck's gaze. He covers Buck's hands with his own. They're completely steady.

[sanskari-kanya]

Rating my professors

Dr. Nini : 5/5

Sweetest, softest, pookiest ever. She is the only reason I actually made my peace with Anatomy. She also gave me extra credits last semester. Always smiles when i see her even if she’s not teaching me this sem. She has a pet bunny whose photos she used to show us regularly.

Dr. George : 0/5

His accent is beyond human comprehension. Looks like the lite version of Chris Evans. Fucked up my credits last semester. I hate physiology thanks to him. Refuses to give ppts or materials too. For some reason i see him everywhere; elevators, supermarkets, cafeteria literally everywhere. Was gonna give him 2/5 but I did surprisingly well on today’s physiology test :)

Update : In front of everyone, he said don’t bother becoming a doctor if you can’t study (I couldn’t answer a question) He loses all the points and my respect goodbye

Dr. Ana : 5/5

Literally a Barbie. Blue eyes, straight blonde hair, internal medicine residency, cracked USMLE and a good fashion sense; what more does a 🎀 girl 🎀 need? The sheer fear of letting her down when she takes my weekly viva makes me study her subject a little too much of determination. Give it a few more months, she’s gonna be my girl crush.

Dr. Natia : 3/5

Homegirl has no value of time. She comes after 4:30 for a 4 pm lecture. Awkward way of teaching Radiology but I must be a clown to judge a radiologist with 10 years of experience. I wonder why she deducted 0.2 from my credits (i bunked)

I’ll leave the rest for part 2 because y’all may or may not be interested in my yapping.

[religion-is-a-mental-illness]

By: Apunaja

Published: Mar 19, 2024

I just watched this clip of Don Lemon interviewing Elon Musk, where Lemon pushed back on Musk’s claims of DEI policies impacting the quality of medical care and insisted that there is no evidence that standards are being lowered in medical programs in the pursuit of diversity goals. It was infuriating to watch. The word ‘gaslighting’ repeatedly came to mind.

I don’t know if Lemon genuinely doesn’t know the facts about this issue, or if he is deliberately misrepresenting the inconvenient truth, but as anyone who has been paying attention to this issue can attest, it is indisputable that standards are indeed being lowered, in myriad professional and educational contexts, for the express purpose of increasing the racial diversity of that group’s membership. What makes it hard to believe that Lemon isn’t being disingenuous about this is that in so many of the cases where this is happening, the proponents of the policy openly state that the reason they are changing their standards are in order to increase representation of minorities. Of course, they don’t call it “lowering standards for diversity”. But when you get rid of a testing requirement, or lower the passing grade, or modify the entrance qualifications to deliberately allow lower performing black and Hispanic students entrance, you are by definition lowering standards for the sake of diversity and equity, no matter how you spin it.

It’s high time for the false claim that ‘promoting DEI doesn’t adversely impact standards’ to finally be put to rest. In the interview, Lemon said he looked forward to people providing evidence of the claim, so I’m going to attempt to do that here, to lay out unambiguous evidence of educational and professional standards being compromised for the sake of DEI. I’m going to first focus on the area of medicine, which is what Lemon was specifically talking about, and then I’ll get into many other arenas where we can see this happening.

In a 2022 City Journal article, the esteemed Heather Mac Donald describes a required medical exam being altered (both in its subject matter and its grading) to allow for more students to pass:

At the end of their second year of medical school, students take Step One of the USMLE, which measures knowledge of the body’s anatomical parts, their functioning, and their malfunctioning; topics include biochemistry, physiology, cell biology, pharmacology, and the cardiovascular system. High scores on Step One predict success in a residency; highly sought-after residency programs, such as neurosurgery and radiology, use Step One scores to help select applicants. Black students are not admitted into competitive residencies at the same rate as whites because their average Step One test scores are a standard deviation below those of whites. Step One has already been modified to try to shrink that gap; it now includes non-science components such as “communication and interpersonal skills.” But the standard deviation in scores has persisted. In the world of antiracism, that persistence means only one thing: the test is to blame. …The solution … was obvious: abolish Step One grades. Since January 2022, Step One has been graded on a pass-fail basis.

Further in the article, she explores how med school entrance standards have been adjusted to increase the number of minority students entering even though their grades were far lower:

In 2021, the average score for white applicants on the Medical College Admission Test was in the 71st percentile… The average score for black applicants was in the 35th percentile—a full standard deviation below the average white score. The MCATs have already been redesigned to try to reduce this gap; a quarter of the questions now focus on social issues and psychology. Yet the gap persists. So medical schools use wildly different standards for admitting black and white applicants. From 2013 to 2016, only 8% of white college seniors with below-average undergraduate GPAs and below-average MCAT scores were offered a seat in medical school; less than 6% of Asian college seniors with those qualifications were offered a seat, according to an analysis by economist Mark Perry. Medical schools regarded those below-average scores as all but disqualifying—except when presented by blacks and Hispanics. Over 56% of black college seniors with below-average undergraduate GPAs and below-average MCATs and 31% of Hispanic students with those scores were admitted, making a black student in that range more than seven times as likely as a similarly situated white college senior to be admitted to medical school and more than nine times as likely to be admitted as a similarly situated Asian senior.

Later on she recounts a further example of reducing standards to increase diversity at a top-tier institution:

The University of Pennsylvania medical school guarantees admission to black undergraduates who score a modest 1300 on the SAT (on a 1600-point scale), maintain a 3.6 GPA in college, and complete two summers of internship at the school. The school waives its MCAT requirement for these black students; UPenn’s non-preferred medical students score in the top one percent of all MCAT takers.

The article details many more examples of diversity efforts impacting the quality of the curriculum, admissions, faculty hiring, research funding, accreditation, publishing, and other aspects of the medical education arena. I strongly encourage you to read it in full here.

But where did all these changes stem from? A 2020 Quillette article reveals how these policies were a result of a long-running campaign to increase diversity:

…in 2009 the body that accredits medical schools, the Liaison Committee on Medical Education (LCME), touched off a parity panic across the med school landscape by issuing stern new guidance on diversity. In order to remain accredited, declared LCME, medical schools “must” have policies and practices in place that “achieve appropriate diversity.” …In the wake of the LCME’s watershed edict, working groups were convened, budget line items were created, and high-profile hires were made to facilitate diversity boosting and community recruitment. A main stumbling block seemed to be minority candidates’ poor performance on gatekeeper exams like the MCATs.

Once the unstoppable force of diversity activism met the immovable object of disparate MCAT scores, activists focused their efforts on reducing the MCAT’s significance and incorporating tests that were not based on cognitively demanding subjects like actual medical knowledge in favor of things like emotional intelligence, empathy, and communication:

The primary selling point of SJTs was thus that they allowed schools to consider factors other than such blind metrics as a straightforward ranking of applicants’ college grades and MCAT performance. The MCATs themselves were revised in 2015 to give meaningful weight to areas of the social sciences.

The amazing thing about all this is how, if you just listen to their own words, these activists are totally open about how they need to lower the standards to increase minority representation. Here’s one such statement from an advocacy group admitting that expecting minority students to meet the same academic standards everyone else is held to holds back diversity:

…a huge obstacle to diversity is that most medical schools have the same criteria for all applicants. To get a medical student population that is representative of the general population requires more than simply accepting applicants of color who have the same grades and MCAT scores as White applicants…

Their solution? Lessen the importance of the MCAT in applications.

While on the topic of medical schools, consider this chart, highlighting the likelihood that students in different racial groups are granted entrance to medical schools, based on their grades. It echoes Mac Donald’s claims above, and indisputably reveals that a low performing student has a much higher chance of getting in when they’re black versus being any other race.

Another way of looking at that same data is in this chart:

This 2023 Newsweek op-ed unambiguously advocates for the MCAT to be abolished as an entrance requirement in order to increase diversity:

A panel representing the American Bar Association (ABA) recently voted to eliminate the LSAT as an admissions requirement for law schools. The main reason for doing this: to increase diversity in law schools. The Association of American Medical Colleges (AAMC) should follow the lead of the ABA for medical school admissions by removing the Medical College Admission Test (MCAT) as a requirement.

Here’s a similar Washington Post piece proposing that the MCAT be changed to a pass/fail test. Why? In the author’s own words: “This is a crucial step if the medical profession is to diversify its physician ranks.”

There are further examples that could be provided, but I think this suffices to prove Elon’s claim. Copious examples of deliberate efforts to lower standards in medical education for the express purpose of increasing diversity. Mr. Lemon, do you find this evidence sufficient to acknowledge that Elon’s assertion was correct?

But it gets worse. As I said above, the problem of lowering educational and professional standards to increase diversity is not just an issue in the medical field. Campaigns pursuing this agenda are occurring all over society. Mr. Lemon, please bear with me a bit longer and allow me to provide further evidence of just how widespread this phenomenon actually is:

1. In Oregon, the state decided that students don’t need to prove mastery of reading, writing or math to graduate, citing harm to students of color. This a result of a law passed in 2021 which the governor’s office explained as follows:

…suspending the reading, writing and math proficiency requirements while the state develops new graduation standards will benefit “Oregon’s Black, Latino, Latina, Latinx, Indigenous, Asian, Pacific Islander, Tribal, and students of color.”

2. In order to address "racial disparities" and "inequities" in grading, Portland Public Schools are trying "equitable grading practices" that bar teachers from assigning "zeros" to students who cheat or fail to turn in assignments.

3. In Minnesota, they’ve decided to stop giving F grades in order to “end systemic racism”.

4. In San Diego, because too many minority students were failing compared to white students, the school decided to address the problem not by improving the pedagogy but by… changing how they graded students. “The grading changes are part of a larger effort to combat racism,” they explained.

5. NJ chose to lower the minimum passing score on the state’s high school graduation test. Why? Among other reasons given was this appeal to diversity:

One board member who supported lowering the passing score suggested that it was “unfair” to “Black and Latino students” to require underperforming students to demonstrate a higher level of proficiency in reading and math before graduating.

6. In Arizona, a student dean felt that it would “promote equity” if he stopped grading students essays based on the quality of their writing. (This sounds similar to an effort by a student org that called for ‘Black Linguistic Justice’ and demanded that they not be graded by the standards of ordinary English, what they referred to as ‘white linguistic supremacy’. 🤷‍♂️)

7. Along similar lines, Rutgers decided to deemphasize traditional grammar ‘in solidarity with Black Lives Matter’.

8. It’s not just the US embracing this insanity. In the UK, instructors at Hull University were told to overlook students’ grammatical errors as part of an “inclusive marking policy”. And for a similar reason, the University of the Arts in London has told its staff to ‘actively accept spelling, grammar or other language mistakes that do not significantly impede communication’.

9. Please read this detailed article at The Free Press about the new California math initiative that sacrifices mathematical education for diversity goals. This new framework seems primarily motivated by concerns that too many students are sorted into different math tracks based on their natural abilities, which leads some to take calculus by their senior year of high school while a disproportionate number of black and Latino kids don't make it past basic algebra. So their solution is to prohibit any sorting until high school, keeping gifted kids in the same classrooms as their less mathematically inclined peers until at least grade nine.

10, Those same lowered math standards are being implemented in Cambridge, MA:

Udengaard is one of dozens of parents who recently have publicly voiced frustration with a years-old decision made by Cambridge to remove advanced math classes in grades six to eight. The district’s aim was to reduce disparities between low-income children of color, who weren’t often represented in such courses, and their more affluent peers.

11. In order to advance their DEI agenda, the creators of the bar exam are changing the famously difficult tests that lawyers have to pass before they are allowed to practice. How are they doing so? In their own words (emphasis added):

…we take seriously the need to work toward greater equity in all that we do as a testing organization, and we actively work to eliminate any aspects of our exams that could contribute to performance disparities among different groups.

A WSJ article investigating these changes reports:

Based on the diversity workshop at the NCBE conference, it means putting considerable emphasis on examinees’ race, sex, gender identity, nationality and other identity-based characteristics. The idea seems to be that any differences in group outcomes must be eliminated—even if the only way to achieve this goal is to water down the test. On top of all that, an American Civil Liberties Union representative provided conference attendees with a lecture on criminal-justice reform in which he argued that states should minimize or overlook would-be lawyers’ convictions for various criminal offenses in deciding whether to admit them to the bar.

12. Of course, the obvious question presents itself: why bother changing the bar exam to allow more people to pass it if you can just get rid of it entirely? And that’s exactly what some states are doing. Just a few days ago, the State of Washington decided to no longer require lawyers to pass the bar exam. Why? It was hampering diversity.

The Bar Licensure Task Force found that the traditional exam “disproportionally and unnecessarily blocks” marginalized groups from becoming practicing attorneys and is “at best minimally effective” for ensuring competency.

13. The Washington State decision follows in the footsteps of Oregon, which stopped requiring the bar exam last year.

14. Taking the bar happens at the end of a law student’s journey. What about at the beginning, when they are taking the LSAT? No worries, diversity initiatives are lowering the bar there too! The American Bar Association voted in 2022 to stop requiring the LSAT for admission to law school. Why?

“In the grand scheme of things, folks of color perform less well on the LSAT than not, and for that reason, I think we are headed in the right direction,” Leo Martinez, an ABA council member and dean emeritus at University of California, Hastings College of the Law, said at the meeting.

15. In related legal arenas, Delaware chose to improve the diversity of its legal community by instituting a few changes of its own. Some of the changes, “which ultimately aim to also increase the number of Black and Latino judges”, include lowering the passing grade, halving the number of essays, and other competency requirements being relaxed.

16. Similar changes have happened in California, for the explicitly stated reason of increasing diversity:The California Supreme Court, which oversees the state bar, agreed to lower the passing score for the exam, a victory for law school deans who have long hoped the change would raise the number of Black and Latino people practicing law.

17. A 2015 NY Times headline: Study Cites Lower Standards in Law School Admissions. Why are they lowering standards? Answer: “…they need flexibility in selecting students to assure a diverse population of lawyers.”

18. Just like with med schools, law school acceptance rates are biased towards minorities. An analysis of admissions data data revealed that being from an under represented minority group (URM) boosted one’s chance of acceptance to a law school quite dramatically:

Almost every school we cover shows an increased chance of admission to URM applicants, with higher boosts for higher-tiered schools….As you can see in Table 1a, law schools typically give a 7% boost to URM applicants. In other words, a URM applicant who is exactly equal to a non-URM candidate, including all other factors we control for, is 7% more likely to be admitted to any law school than a non-URM equivalent. This number is a whopping 498% in the Top 14, 126% in the Top 25, and 52% in the Top 50 law schools.

Just as is happening in the legal and medical arenas, the practice of increasing minority numbers by eliminating entrance exams that ensure professional competency is happening in other professions too. Some examples of that:

19. In Washington, DC, officials considered getting rid of their social work exam over concerns that it failed too many people of color.

20. A required test for math teacher certification in Ontario showed significant racial disparities in the success rates of those taking it. As a result of the disparity a court ruled it unconstitutional and teachers were no longer required to take it. (The ruling has since been overturned.)

21. A similar case occurred in NY whereby prospective teachers had to take an Academic Literacy Skills Test. But because disproportionate numbers of black and Hispanic applicants failed it, the test was eliminated.

22. In a similar lawsuit, NYC had to pay out $1.8 billion to former teachers who failed a certification test. Why? The test was deemed racially biased since a disproportionate number of the failures came from minority teachers.

23. In 2015 the FDNY was pressured to modify its certification requirements to increase gender diversity, and for the first time ever passed a woman who failed a physical test that until then all fire-fighter applicants needed to pass.

Fire Commissioner Daniel Nigro told a City Council hearing on the FDNY’s efforts to recruit women that he had changed FST requirements to lower obstacles.

24. A few months ago, a fascinating article appeared on this very platform exposing how the FAA deliberately lowered the testing requirements of flight controllers for the express purpose of increasing diversity. The consequences for the industry were, unsurprisingly, appalling:

A report on FAA hiring issues found that 70% of CTI administrators agreed that the changes in the process had led to a negative effect on the air traffic control infrastructure. One respondent stated their "numbers [had] been devastated," and the majority agreed that it would severely impact the health of their own programs.

25. Of course, a well-known area where standards have been lowered in the pursuit of DEI is in how colleges have stopped requiring applicants to have taken the SAT. I can’t begin to list all the colleges that have dropped the SAT entrance requirements in the name of equity (although many hid the decision behind the excuse of Covid), but according to this list, it’s over a thousand schools. A few prominent names that instituted the policy are Columbia, Yale, Princeton, Stanford, Harvard, MIT, UCLA, and SUNY. (However, in recent months, a few of those institutions have reversed the policy and now require it again.)

26. Among all the many cases where destructive DEI policies are being implemented, possibly the most disturbing arena of all is when actually talented and capable students are purposefully denied opportunities that can help them excel. An example of this in action is the numerous school districts that have chosen to remove “Gifted and Honors” classes for the stated reason of increasing equity. Some examples:

Culver City, CA:

Troy, MI

Barrington, RI

New York and this too

Seattle, WA

Vancouver, Canada

27. If they’re not eliminating the Honors programs entirely, many schools are simply dropping the entrance requirements so that they are open to anyone, thereby diluting their very purpose. Some places this has already happened:

San Francisco

Boston, MA

Montgomery County, MD

New York City

Fairfax, VA

The result of these admission changes? Massive increases in students failing. For example:

…at the John D. O'Bryant School of Mathematics and Science, just 50% of seventh graders met or exceeded expectations in math, down from 85% as recently as 2019. Nor was the Boston Latin School, the crown jewel of the system, immune: Just 70% of seventh graders either met or exceeded expectations in math, down from 94% three years ago.

28. Even the military is affected by demands to lower standards to increase diversity (albeit gender diversity, not racial). The Army actually removed a physical test because not enough women were passing it:

On Monday, the Army ended its requirement that soldiers do at least one leg tuck — where they hang from a bar and pull their knees up near their shoulders — as part of the new physical fitness test, as it became clear that many troops, particularly women, were unable to do it.

29. Speaking of gender diversity, Oxford University decided that because not enough women were passing their math and computer science examinations, they would add more time to the exam to help them. (Apparently, it didn’t even help.)

30. Oxford also decided to let a History test be taken at home in order to increase the number of women passing.

31. And because too many men were getting top grades in a classics course over the women, Oxford also decided they had to overhaul the entire course in order to bridge the gender gap.

32. Across the globe in Australia, the University of Technology Sydney chose to boost their gender diversity by allowing female students to enter its engineering and construction courses with lower grades than the males.

33. Back in 2016, a doctoral student at the University of North Dakota actually published a paper suggesting that STEM courses be made more inclusive of women by making then “less competitive,” so maybe that’s where the above universities got their inspiration from?

34. The lowering of educational standards for the sake of diversity is happening in arts education too. Consider how auditions were scrapped at a Brooklyn performing arts school in favor of a lottery. Why? Diversity!

The Department of Education says standards like auditions — or test scores and grades at other schools — block access for underprivileged kids, and the new policy will diversify student bodies across the district.

The above examples are just a sampling of the many instances of the pernicious trend of DEI deliberately compromising the standards of performance to advance its agenda. Public figures and pundits like Don Lemon need to stop repeating this lie that there is no downside to promoting these policies. On the contrary, it’s imperative that everyone recognize how these Harrison Bergeron-like policies directly lead to a deterioration of our educational outcomes, an undermining of our scientific, technological and medical progress, a diminishing of our professional competencies, and a fraying of our societal cohesion.

It’s time for DEI to DIE.

==

Don 🍋 is astonishingly dumb.

[kylejsugarman]

i really am the laziest motherfucker on earth, just sitting here waiting for pictures of aaron to come to me. if he really wanted me to view him, he wouldn't be on the game awards. he would be inside my computer's uworld usmle style question subscription

[thinkabled]

Final Year Exams, STEP 1, STEP 2 & Research Internship done in 6 months✅

My Story:

I decided to embark USMLE journey last November, got ECFMG applied and started UW for Step 1 late December 2023. I continued Step 1 prep for 2 weeks and then took a break for my university exams. In the beginning of February, I got a bizzare idea of prepping for Step 2 thanks to reddit and Free 120 of STEP 2.

So, I took UW STEP 2 in Feb. Everyday for a month, I did 2 blocks of STEP 1 & 1 block of STEP 2 system-wise. I had to stop for a month in March due to university exams. I jumped back on STEP 1 & 2 immediately after exams, this time, doing 2 blocks of STEP 2 and 1 block of STEP 1.

For STEP 1, I relied only on UW and First Aid. No NBMEs. No other resources. For STEP 2, I used UW and Inner Circle notes. No anki even though Tzancki deck was instilled on the notes.

By end of April, I was done with 90% UW STEP 1 and 60% STEP 2 UW. I sat 15 days dedicated for STEP 1 and gave exam on May and got the PASS. Took a vacation for 2 weeks and then returned back to STEP 2 prep.

I did UW upto 95%, shifted to CMS forms, did 2 each for main subjects and started NBMES. NBMES were all in 250s range except for 13 and 14 which hit 260s. I used to work full time as a research intern during June and do 80-160 questions a day. I also did a review of Inner Circle notes once during the whole month.

Dedicated:

In the month of July, I sat 3 weeks dedicated where I did AMBOSS High Yield qbank and articles. In the final weeks, I went through NBMEs once again, and reviewed the notes.

I also did AMBOSS HY 2nd pass. Did ethics screening vaccination quality and biostats from Amboss.

As for DIP, I listened to high yield stuff but only reviewed the Antibiotics and Palliative podcast in the end.

Day before Test:

Went through all NBME diagrams, did AMBOSS Ethics and Quality, quickly read through ethics articles, did Free 120 two days before the exam.

Test Day:

I was quite relaxed and had my breakfast. The exam felt fairly straight. I took breaks after every 2-3 blocks. Drank water during each break and took a toilet break. Thats all. I finished most blocks with 10-15 minutes to spare and did a 2nd pass of all the questions.

ACTUAL SCORE: 269

Overall, after solving 12k questions, I am happy to complete my fourth year exams, STEP 1 and STEP 2 together in a span of 6 months while being a student and full time research intern.

I am happy to give back to this community and would love to support and finance my further journey with paid mentorships for STEP 1 and STEP 2. If interested, check out here: https://lnkd.in/gwMDWR_9

My Learning Resources: https://lnkd.in/grGsSQnt

My YouTube: https://lnkd.in/gMcGWiUe

My Newsletter: thinkabled.com/cerebrate

Take care.

#usmle #img #step1 #step2 #match2025 #usmleimg #neurology #imresident #matchcycle #nrmp #usce #research

[lastlycoris]

Sounds like you really don't like NPs.

I answered a question similar to this before, and my answer hasn't changed. Perhaps my opinions are stronger now. Probably going to get flamed for this post, but oh well.

--

I can appreciate the NP that is working within their scope of practice and that has 10-20 years of clinical nursing experience under their belt. They have the clinical experience and the additional education to support their practice. This is how an NP should be.

I do not appreciate the NP that goes to some online school right out of college, pass their 3 hour test at the end, and enter the workforce with a minimum of clinical experience and proceeds to insist they know as much as a doctor knows and should be treated as such.

News flash. You don't.

Just the bare minimum when comparing family medicine doctors and nurse practirioners (basing this on the Primary Care Coalition articlr):

Just preclinical hours alone - all the science basics - a doctor will have 2700 hours while the NP may have 800-1600 hours of training.

Clinical years a doctor would have around 6000 years during med school, which sounds right. Compared to a NP, which is 500-1500 hours.

And doctors have to go through a residency, which adds 3 years minimum or close to 9000-10000 hours. NPs do not need to go through residency.

Altogether, the differences in training comes close to 15000-20000 hours. Or if we are comparing training years at minimum, the doctor stays in training for an extra 4 years.

Not to mention that selection is stricter for a doctor, less than 10% that apply get to go to med school. The testing is far harder and more rigorous too, stating with the MCAT which you take to get a chance to get into med school and followed by the USMLE which is a series of three tests throughout med school that you have to pass to become a doctor. Oh, and then boards at the end of residency. I'm not including shelf tests for med school either.

So why are NPs in hot demand then?

They're cheaper to hire than a doctor. Nursing also have a big lobbying arm to try and increase the scope of NPs, but at the same time, they don't want anything specificly defined because once they do, NPs will be judged by the same standard as other doctors (often lawsuits have a component of "would a similar practirioner in the field make the same mistake?"). And given the differences in training, that's a huge liability for an NP to take, but so long as the scope is vague, they can always go "sorry my training didn't fully cover this" and get reduced penalties or get off scot-free.

I feel nursing has the responsibility to crack down on these diploma mills that exist just to earn money and only give a substandard education as a result. It is a joke that an NP can graduate with a minimum of clinical experience and then can prescribe, diagnose, and treat patients in the states that allow full practice. After all, I've met some with huge holes in their education like the ones I'm working with now.

I've also read some articles where NPs demand pay parity with doctors aka they feel they deserve the same pay as doctors. Only they fail to realize that if the pay is equal, who are they going to hire? The highly trained one or the possibly mininal trained one. Naturally the hospital is going to hire the one that won't get them sued if they had to pay the same wage. This is what you call shooting yourself in the foot.

Their fellow nurses don't respect these new diploma-mill NPs, mostly because they act like they're better than them, which is not a good way to make friends.

It's just a huge cluster fuck. And it's something hospitals want to perpetuate because NPs are cheaper - and it's easy for them to go "an NP is just as good as a doctor" despite all the above I've stated. Most of the "studies" that show equivalent or better care from NPs usually are either from nursing (conflict of interest) or have some major confounding factor (like the NPs actually having a supervising doctor).

I could probably rant more but lunch is almost over, and the clinic must go on.

[prasadmedicals]

How to Get a Medical Residency in the USA as an International Medical Graduate

Choosing to the medical residency for IMG medical students in USA is the best opt. With world-class training opportunities and state-of-the-art facilities, landing a coveted US residency spot allows you to advance your skills and expertise to the highest level.

However, getting a US medical residency as an IMG involves a step-by-step process with many requirements along the way. By understanding and following the key steps, you’ll place yourself in the best position to match into your desired residency program.

1) Register with the USMLE

Your first step when applying for US residency positions is registering with the United States Medical Licensing Examination (USMLE). The USMLE is a three-step exam assessing an IMG’s medical knowledge and clinical skills. It is a core requirement when applying to US residency programs.

Registering is an easy process online via the USMLE website. You’ll need to create an account and provide background information on your medical education and credentials. This allows you access to schedule test dates and testing center locations.

Registering with the USMLE is the vital first step for IMGs seeking US medical residencies.

2) Pass the USMLE Exams

The next step is successfully passing all required USMLE exams. These are challenging, marathon tests covering a wide range of topics. Thorough preparation through dedicated study time and practice questions is a must.

The USMLE step structure is:

Step 1 - Assesses core concepts in basic medical sciences. Often taken after 2nd year of med school.

Step 2 CK - Focuses on medical knowledge application in clinical settings. Taken during 3rd year typically.

Step 2 CS - Evaluates clinical and communication skills through interactions with standardized patients.

Scoring well on your USMLEs signals to residency programs your strong medical knowledge foundation. It also indicates readiness for the fast-paced rigors of a US residency.

Many IMG applicants space out their exam schedule over a 1-2 year timeframe. Create your own prep timeline backward from desired residency start dates.

Allow plenty of dedicated study time to pass the USMLE exams.

3) Get Valuable Clinical Experience in the USA

In addition to tests, US residencies want applicants exposed to the American healthcare system and culture.

Gaining clinical experience in the US through observerships and clinical electives are a big advantage. These allow you hands-on learning of workflows, systems, treatments, technologies, patient populations, documentation, communication norms and more in American hospitals and clinics.

Observership organizations like Prasad Medical Center (+1 718-774-6060) assist IMGs in securing observership positions across the country. Be sure to research and understand program eligibility terms before applying.

Even a few weeks of US clinical experience can give that important edge among competitive applicants.

US clinical experience highlights adaptability to American medical norms.

4) Register with the AAMC

The Association of American Medical Colleges (AAMC) has two key systems you must access during your application process:

MSPE (Medical Student Performance Evaluation) – Official record of medical education including grades, rankings and assessment.

ERAS (Electronic Residency Application Service) – Centralized online application portal distributing all materials to selected residency programs.

Register with AAMC early to get your credentials verified, understand each platform and have ERAS documentation ready when application season starts.

Connecting with the AAMC is essential throughout the residency hunt.

5) Pick your Residency Programs

When deciding which residency programs to apply for, start broad. Identify specialties matching your interests, strengths and USMLE scores. Use online directories to make a list of reach, reasonable match and safety options across several states or regions.

Factors like location competitiveness, program size, IMG match history and curriculum emphasis can help you categorize options. Have a few safety choices with higher IMG acceptance rates.

Research programs thoroughly to have residency options at each level.

6) Get your ECFMG Token and Register with ERAS

Once programs are selected, activate your ECFMG (Educational Commission for Foreign Medical Graduates) token. This allows ERAS to verify your test scores, credentials and identity when applying.

Next, access your MyERAS applicant profile. Add your exam history, experiences, publications and other credentials that programs will review.

Double and triple check all entries for accuracy before submitting to avoid costly mistakes or delays.

MyERAS is your central application hub throughout the residency process.

7) Finalize Documentation and Submit ERAS Application

With your MyERAS profile complete, finalize all required documentation:

Personal statement

Medical school transcripts

MSPE Dean’s letter

Letters of recommendation (3+)

School catalogues

Proofread all materials thoroughly before uploading to ERAS by the deadlines. Activate program selections and assign supporting documents for each.

Carefully prepare all pieces of your ERAS application package.

8) Medical Residency Interview

With a strong application submitted early, interview offers should follow!

Interview formats vary widely across residencies. Common options include one-on-one, panel interviews, multiple mini interviews (MMIs) and virtual interviews.

Careful preparation is key. Research programs, polish answers to common questions, hone your communication style, dress professionally and send prompt thank you notes.

Treat travel associated interviews as 24/7 assessments of fit. Be gracious, avoid complaining and share your passion for medicine and interest in the program.

Interviews are critical to sealing a residency position – make the most of them!

9) Register with the NRMP

After interviewing, register with the National Resident Matching Program (NRMP) by late January. Creating your NRMP account starts the matching process based on how you rank programs and how they rank applicants.

The yearly Match Day in mid-March reveals results simultaneously to applicants across the country. This coordinated effort fills nearly 40,000 residency roles each spring.

Understand match statistics for given specialties and programs to set realistic expectations before this nerve-wracking day!

Learning match nuances helps ease the anticipation leading up to Match Day!

10) Residency Post-Match Focus

If matched, congratulations on achieving that coveted US residency program spot! Notify all relevant parties, celebrate thoroughly and handle any needed visa application processes.

Review program details to address required paperwork, licensing, preparations or moving requirements before start dates. Share excitements and ask graduated residents for advice as you transition to this intense but rewarding new chapter!

For those not matched, don’t be discouraged! Strategize about strengthening certain areas of your application and discuss options with mentors. Often success comes with perseverance and giving yourself the best opportunities the following year.

We hope this overview gives international medical graduates more clarity on the pathway to getting a US medical residency. While challenging, thousands achieve this goal annually through careful planning, dedication to preparation, and showing your passion for serving US patient populations.

If you still need assistance securing clinical experience or have any other questions along your journey, don’t hesitate to contact the knowledgeable team at Prasad Medical Center at (+1 718-774-6060) or visit https://www.prasadmedicalcenter.com/ We wish you the best of luck in achieving your American medical career dreams!

[reidsbookclub]

I heard ur in medical school. any advice for someone that is making up their mind?

hi there. -- first and foremost make sure its something you really want I've witnessed some class mates get to third year and now our fourth year and after having so many loans realize that its not what they wanted but rather what their parents wanted. Make sure it's something you want. best way to make sure if it's something you want to do is to shadow doctors! -- keep in mind that you will have to be studying hard constantly but don't let it wear you down. -- don't compare yourself to others and their journey or the time they've spent in school. -- you'll be taking lots of test like the MCAT and the USMLE (if you're American) and while yes you need a good score don't let the score define you. It does not represent how good of a doctor you will be --have a hobby outside of med school. Med school will wear you down at times and it might seem silly but when I tell you something as simple as writing a fic has helped me SO MUCH mental health wise. -- don't be afraid to ask for questions and/or help

[emgoesmed]

Hi , i love your blog. Everything always looks so perfect. So i wanted to ask you for some advice, i am an IMG , and have recently done my residency(medicine) back in my home country In south east Asia. So my background knowledge is not so bad. Life happened (some not so good events) and i needed to move to US. I dont think am in for studying for step 1 right now but i think i ll be able to study for step 2 CK. I wanted to ask you if one can do well on step 2 ck by doing uworld. I am worried the most about pedes gyne surgery, cuz its been a while i have studied these subjects. Could you please recommend what extra sources should i use for pedes gyn surgery. And if those are as heavily tested on ck as medicine. Any advice on sources , timeline or anything really would be helpful. This is the only social media platform i av right now and i dont know who else to ask. I would be really grateful for any advice.

Hi!

UWorld is the main question bank that US med students use to study for USMLE step 2 CK. It is a great learning tool because the question/answer explanations are very thorough.

Medicine is about 50-60% of the exam, Surgery is 25-30%, Pediatrics is 20-25%, OB Gyn is 10-20%, and Psychiatry is 10-15%.

For surgery, I recommend De Virgilio's case book; the surgery portion of the exam is less about the actual surgeries and more about medical management of pre- and post-op, and indications for surgery.

I didn't have a very good resource to study for Pediatrics or OB Gyn, but recommend looking on Reddit for ideas. You don't need an account to do so. Search for posts about what helped people succeed on their shelf exams during third year, since those are specialty-specific resources.

One IMG I know who is in Internal Medicine residency in the US told me his study strategy was to complete UWorld and then do the entire Amboss question bank over several days prior to his exam because he just used a free trial period lol. I know other US students who did both question banks and got great scores (260+) as well.

I hope this is helpful! Best of luck in studying for your Step exams and don't hesitate to reach out if you have any more questions, I'll try my best to answer or point you towards helpful resources. :)

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