Brought to you by the students of the University of Cincinnati College of Medicine
By Sam Kim
Skimming my mini-feed on Facebook, I come across something incredible. I have to try this for myself. Bringing up Google Maps, I type in, “The Shire” as my starting point and (yeah, you guessed it) the destination as “Mordor.” Carefully specifying my wish for walking directions, the jocular Googleans drop the caveat, “Use caution – One does not simply walk into Mordor.”
Watching UCCOM’s Class of 2012 complete their peculiar celebratory rites of passage recently, I was increasingly convinced the warning had broader application (Man, Google is right about everything!). One does not simply become a doctor. There are more than a few obstacles between us and the finish line and that idiosyncratic celebration one of them. Yes, like Horsemen of the Apocalypse, these infamous hurdles have cowed many a MD-hopeful: the USMLEs and the raucous scene I witnessed that day - the “Match.”
Yes, I know it may seem a bit early for most who will probably read this article but I ascribe to the whole “an ounce of prevention is worth a pound of cure” notion (unless the cure is a gross, then I am less dogmatic). A brief overview should hold value even at this juncture.
TERMS TO KNOW BEFORE PROCEEDING:
AOA = Alpha Omega Alpha National Medical Honor Society
o Invitees demonstrate “high academic achievement.”
COMLEX = Comprehensive Osteopathic Medical Licensing Examination *
CS = Clinical Skills
CK = Clinical Knowledge
ERAS = Electronic Residency Application Service
o Kind of like the AMCAS for residency
NBME = National Board of Medical Examiners
o Kind of like AAMC for the MCAT
NBMOE = National Board of Osteopathic Medical Examiners *
NRMP = National Residency Matching Program
o Kind of like Match.com or eHarmony for medical students and residency programs
PGY = Post-graduate Year (e.g. PGY-1 = 1st year of residency or more-colloquially being an “intern” – or perhaps “The year I died a little.”)
ROL = Rank Order Lists
o Kind of like the NBA/NFL draft but with weirder traditions and superstitions
USMLE = United States Medical Licensing Exam
o The infamous “Boards”
o Kind of like the MCAT’s burlier and scarier inked older brother
* These terms typically only apply to osteopathic medical students and physicians but in light of the growing popularity of osteopathic medicine and integrated medical care, it seemed appropriate to include the terms.
USMLEtoMD.com offers a basic timeline calculator to see how the next years can unfold in preparation for applying for a residency. Virginia Commonwealth University School of Medicine also offers an informative document termed “Taking Flight.”
Using my graduation year (2015) as an example the basic time line is laid out:
The ‘standard track’ for an MD 2015 graduate calls for a March 2015 Match Day
o Match Day has traditionally been held in March regardless of the year – we will talk a bit more about what Match actually means.
USMLE Step 1 and Step 2 CK should be taken prior to July 2014
o Allow about 4 weeks for grading
o Step 1 is typically taken the summer of the second year in medical school (i.e. In this example, Summer 2013)
o Step 2 CK scores should be available before July 2014, May or June of 2014 would probably be appropriate.
Register for USMLE Step 2 CS as early as possible after July 2014.
Apply for residency via ERAS on Sept 1, 2014
Sept 2014 – Jan 2015: Interview season
o Though interviews can come in after January, it is rare.
March 2014, Match Day.
Other things to consider (may or not apply to you):
o Couples Match (NRMP will look at your applications as a single-entity)
o Military Match (HPSP students)
o Early Match (typically ophthalmology and urology)
USMLE Step 3 will be taken after medical school (typically during residency)
o Yay. (“I can haz stethoscope?”)
o Summer, take USMLE Step 1
o Summer, take USMLE Step 2 CK.
o Decide on a specialty.
o Sept 1 – Start ERAS.
o Sept to Jan, Interview Season.
o March - Match Day!
What Residency Programs Look For:
(Source – Studentdoc.com)
1. USMLE Step 1 Score
2. Class Ranking/Dean’s Letter
3. AOA Membership
4. Research Experience/Publications
Quick and Dirty on the Tests and ERAS
(Subsequent articles will take a closer look at each step in more detail)
USMLE Step 1 (Source – usmle.org)
- Tests your knowledge on anatomy, behavioral sciences, biochemistry, microbiology, pathology, pharmacology, physiology, and interdisciplinary topics (nutrition, genetics, aging, etc.); a passing score is 188 (out of 260).
- National mean: 225 ± 22 (SD)*
o University of Cincinnati, 2011 (n = 160): 231 ± 20 (SD) (Source – MedOneStop)
USMLE Step 2 CK (Source – usmle.org)
- Tests your knowledge on internal medicine, OB/GYN, pediatrics, preventative medicine, psychiatry, surgery with a focus on diagnosis, prognosis, mechanism of disease, or preventative measures; as pass score is 189 (out of 260).
- National mean: 233 ± 22 (SD)*
o University of Cincinnati, 2011 (n = 158): 238 ± 21 (SD) (Source – MedOneStop)
USMLE Step 2 CS (Source – usmle.org)
- Tests your knowledge of clinical skills in a standardized patient encounter focusing on “Integrated Clinical Encounter” (ICE), “Interpersonal Skills” (CIS), and “Spoken English Proficiency” (SEP). This is a pass/fail (P/F) exam.
- Notably, this test is only offered in five (5) cities:
o Philadelphia, PA
o Chicago, IL
o Atlanta, GA
o Houston, TX
o Los Angeles, CA
USMLE Step 3 (Source – usmle.org)
- Tests your knowledge of medicine in two principal dimensions: clinical encounter frame and physician task. This test reflects a data-based model of generalist medicine practice in the United States. A passing score is 190 (out of 260).
- National statistic: 97% pass rate
o University of Cincinnati, 2006-2009 (n = 142): 99% pass rate (Source – MedOneStop)
Exam Costs as of January 2012 (Source – usmle.org)
• USMLE Step 1: $535
• USMLE Step 2 CK: $535
• USMLE Step 2 CS: $1140
Application (ERAS) in 2012 (Source – aamc.org)
• $85 (first 10 programs);
• $8 each (next 11-20);
• $15 each (21-30);
• $25 each (beyond 30)
When residency programs decide whom they want to date.
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