In order to attain residency in U.S.

1.An ECFMG certification which entitles you to participate in residency.

Requirements :
A medical degree , Medical college transcript, USMLE scores and this exams have to be passed
within 7 year.
And there are about 51 licensing boards in US.

2. After acquiring this ECFMG certification, And giving the exams, The student is undergoes residency
program for about 3-5 years accordingly following the Match or NRMP. This is in accordance with
ERAS i.e Electronic residency application system.

3. Every july , The residency program starts. Check out the NRMP website and download the
program director survey and factors.

4.So, After giving the step 3 , One secures the state licensure . After this, One can pursue the
fellowship i.e advance or subspeciality training for about 1-3 years.

5. Go on
http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-
online.page

You will be able to find the approach and information of residency and fellowship prorgams,
requirements etc.

6.Exam facts :

Step 1 : 8hr exam
No. of questions :322 ! ( 46 per block = 78 sec per question on avg).
Each block , You have 1 hr time.
You will be broadcasted a 15 min tutorial on how to go about the exam before you take the seat.
Break time is 45 min, So the quicker you do , The more you get the break time.

So we are asked to experiment thee test and make adjustments.

Score : Passing score 188 ( upto 185) , Mean is 220 and maximum score 300 but 270 has been
reported to be so far the maximum score.
So, to pass this , One need to answer 60-70% of questions.

What about the questions ?
The high yielding subjects are 3 P'S : Pathology, Physiology and Pharmacology.
Single best answer methodology
Some experimental questions and this are not in grouped in anyway .

Step 2 :
Clinical knowledge : 9hr exam
Focus is on Differential diagnosis and initial treatment

How many questions ?
355 !
Maximum of 45 per block = 82 sec per questions on avg.
The recent score was 196 .
Internal medicine constitutes 60% of step 2.

Step 2 :
Clinical skills.
This is a simulated clinic where one encounters 12 standardized patients ( 11 graded).
Your encounter time 15 min.
The student is graded in 3 areas : 1. Communication and interpersonal skills (CIS) . 2. Integrated
clinical encounter (ICE)
3.Spoken english proficiency (SEP).

Exam taken only in Philadelphia, Chicago , LA, Houston, Atlanta

Step 3 :
Patient management : A 2 day exam.
States offering NY,GEORGIA , ILLINOIS, many more.
This is again an MCQ'S & clincial case simulations cases.

USMLE QUESTION FORMAT :
Step 1 :
They are classified as
1. single jump where you are questioned on memory base like what is the drug of choice for oral
thrush in an HIV individual ? Amphotericin ? Nystatin ? fluconazole ? ketakonazole etc?
2. Double jump : Here the same above question is presented like a case, 45 year old HIV patient with
oral thrush , Male and exisiting ailments, On laboratory test , What are the findings you find ? and
their corresponding options .
3. Triple jump : Same orientation of question like double jump, but they ask you about the MOA of
the drug what you give here.

So most of the questions are of double and triple jump type.

STATISTICS :
8000 position available for IMG's according to 2012 NRMP match.
11,027 had applied in 2012.

Position of IMG's are in higher populated areas like NY, PHILADELPHIA, N.J, FLORIDA, CHICAGO AND
L.A.
Percentage of Primary speciality option available are by IMG are

Internal medicine - 37%
Family Medicine - 27%
Pediatrics - 28%
Psychiatry - 32 %
Anaesthesia - 28%
obs - 17%
Surgery - 20%
Radio - 19%

What scores for what residency ?
Family medicine -213.
Psychiatry - 214
Anesthesia - 226
Neurology - 225
Internal medicine - 226
Patho-226
Neuro surg - 239
Derma - 244
Plastic surgery - 249
Pediatrics -221.

Coming to 70 /30 rule for residency ?
What is this ?
Let us go , Get them.

USMLE RESULTS & NO. OF ATTEMPTS
LOR
CLINICAL EXPERIENCE IN USA.
This constitutes of about 70%

While, 30% is about your interview i.e job interview and personal statement.
Other criteria : Year of graduation from medical school and post graduate activities.