IMG Guide to the US Medical Licensing Exam USMLE

USMLE Info and Advice

You Need to Score Big!

If you are an IMG, and especially if you are from a non-Western country or a country that has many unrecognized (not very well known) medical schools (at least in terms of US applications) then you NEED to do really well on the USMLE. US program directors will not have that much to base your performance in medical school on. US students will have clerkship grades as well as basic science grades and credits. Also, program directors will already be familiar with the name and quality of a given US medical school. If your school is unknown in the US (and most of them are!) then you especially need to do well on the USMLE. This will be the yardstick against which the US program directors can compare you against US medical students. Scores which are barely passing are not going to be noticed much, since this is an expectation of all applicants. Don’t settle on a passing grade! While it is quite an accomplishment to pass a medical exam that may not be in your primary language, it’s not going to really make a big statement on your residency application where excellence is expected. A failing score is especially bad on Step 2 since this exam is widely regarded as an easier exam than Step 1 of the USMLE for US Students. Make sure you dedicate enough study time to do well on this exam.

Study, Study, Study

So, you know you have to study hard for this exam. Where can you find resources to study from and should you take a class? There are numerous Step 1 and Step 2 courses available in the US and some available internationally. Some large testing companies like Kaplan do offer USMLE study. Some of these programs are primarily self study or watching video tapes, so you want to be aware of what type of learner you are. If you’re a book learner, then skip the video tapes. If you’re more of an audio/visual learner, then you may want to consider a course, especially if it can keep you on a strict study schedule. If English is not a language that you know well (we’ll talk more about this in the clinical rotation and personal statement areas), then practice taking USMLE style test questions in a timed format. This will force you to push your understanding of both English and medicine in a way that will benefit you come test time.

First Aid for the USMLE Step 3 (First Aid) by Tao Le

Boards and Wards: A Review for USMLE Steps 2&3: A Practical Guide (Boards and Wards Series) by Carlos Ayala

USMLE Pharmacology and Treatment Flashcards: The 200 Questions You're Most Likely to See on the Exam For Steps 1, 2 & 3 by Conrad Fischer

Test Prep

There are numerous books available on the subjects of studying USMLE Steps 1, 2 and the Clinical Skills Assessment. Be sure to visit our Step1, Step 2, and CSA sections for recommendations on books which are popular for preparation. You probably want to have 2 types of books when you study. One type as a general overview (not meant to be one-stop shopping) such as First Aid for the USMLE Step 1 and others related to the individual subjects you’ll be studying for (Biochemistry, pharmacology, microbiology, etc…) If you know of other students or physicians in your area who are preparing for the exam, find a study partner or group, since this can help give you the incentive to study hard. Many US students focus 2-4 months of intense study time at the end of their 2nd year of medical school for Step 1, so make sure you are prepared to put in a comparable amount of time and energy.

You Can Complete the USMLE Out of Order

Most IMG applicants take the USMLE steps 1 and 2 and Clinical skills in order. However, if it has been awhile since you have studied the basics sciences (biochemistry, pharmacology, pathology, anatomy, histology, etc…) you may consider taking your Step 2 CK exam first, since that exam is much more clinical, and may be easier to accomplish if that material is fresher in your mind. Ideally, if you have considered participating in the NRMP Match as an IMG while as a medical student, you can take those exams during a similar period of training in your home country.