1. Residency Programs In The United States

2. U.S. Medical Educational System 4 years College/University MCAT Exam Residency (3 to 7 years) 4 years Medical School 6 years Medical School

3. Residency Programs In The United States The International Medical Graduate (IMG)  Anyone from an accredited 6 year program from outside the U.S.  Includes U.S. citizens with a non-U.S. education  Must be certified by ECFMG prior to patient contact in the U.S.

4. Residency Programs In The United States ECFMG Certification!  Assesses the readiness of graduates of medical schools outside U.S. and Canada to enter U.S. residencies and fellowship programs  Does not guarantee acceptance into programs  Required for licensure testing (USMLE Step 3)

5. Residency Programs In The United States ECFMG AND USMLE USMLE Step 1 USMLE Step 2 USMLE Step 1 USMLE Step 2 (CK +CS) USMLE Step 3 USMLE ECFMG Step 2 Ck Step 2 Cs

6. Residency Programs In The United States ECFMG Certification Requirements Exams  USMLE STEP 1:Medical Sciences  USMLE Step 2: Step 2 CK (Clinical Knowledge) Step 2 CS (Clinical Skills) Credentials  Completion of all requirements for final medical diploma  Receipt of final transcript  ECFMG verification of credentials

7. Residency Programs In The United States USMLE Step 1  Fees: $825  Eight-hour, multiple-choice, computer- based test  Covers basic medical sciences Anatomy Behavioral sciences Biochemistry Microbiology Pathology Pharmacology Physiology Interdisciplinary topics

8. Residency Programs In The United States Step 2 CK  Fees: $840  Nine-hour, multiple-choice, computer-based test  Covers clinical sciences Areas relevant to provision of care under supervision Normal conditions and disease of particular organs Physician tasks: diagnosis, understanding disease mechanisms, establishing diagnosis, care management principles

9. Residency Programs In The United States Scheduling USMLE Steps  Choose an appropriate three month “eligibility period” and testing region.  Send completed paper application and fee to ECFMG or apply online using Interactive Web Application (IWA).  Receive Scheduling Permit from ECFMG.  Register and schedule a testing appointment with Thomson Promteric.

10. Residency Programs In The United States STEP 2 Clinical Sciences (CS)  Purpose of Step 2 CS  Description of Step 2 CS  Registration and scheduling  Scoring

11. Residency Programs In The United States Purpose of Step 2 CS! To ensure that graduates of foreign medical schools demonstrate the ability to gather and interpret clinical patient data and communicate effectively at a level comparable to standard students graduating from U.S. medical schools.

12. Residency Programs In The United States Description of the Step 2 CS  One day, hands-on exam in limited U.S. sites  Fifteen-minute examinations of twelve “standardized patients”  10 minutes to compose the written record of the encounter (Patient Note)  Covers: internal medicine, surgery, obstetrics and gynecology, psychiatry, family medicine and Pediatrics.  30 and 15 minutes break  Tests  Data-gathering skills including medical history taking and physical examination skills in patient note  Communication / interpersonal skills  Spoken English language proficiency

13. Residency Programs In The United States Scheduling Step 2 CS  Fee: $1,200  On-line and paper application are available via the ECFMG website.  Applicants must take Step 2 CS within 12 months of their registration date.  Applicants can select a testing location, subject to availability, at the time of scheduling.  Receive Permit from ECFMG.  Exam is administered at five clinical skills evaluation centers: Atlanta – Georgia, Chicago – Illinois, Houston – Texas, Los Angeles – California & Philadelphia – Pennsylvania.  Check your Online Application Status & Information System (OASIS) https://oasis2.ecfmg.org/

14. Residency Programs In The United States Scoring  Passing performances on all three components in a single administration are required to obtain the overall designation of passing on Step 2 CS.  For ECFMG certification, there is no limit on the number of attempts to enter Step 2 CS.  CS test can not be re-taken within 60 days of last attempt.  CS test can not be taken more than 3 times in any 12-month period.  Results are finalized within 6 to 8 weeks after the examination date.  Scores are reported in a Pass/Fail designation.

15. Residency Programs In The United States Timing of Examinations  Must have completed three years of medical school before applying to take any part of the USMLE: Step 1, Step 2 CS, or Step 2 CK.  Tests may be taken in any order.  All three tests must be passed within a seven- year period.  If all three are passed, results do not expire.

16. Residency Programs In The United States Steps To Residency USMLE Step 1 Step 2 CS Matching Programs DS-2019 Acceptance J1-VISA ERAS Step 2 CK

17. Residency Programs In The United States Finding A Residency Residencies The Graduate Medical Education Directory (Green Book) Accreditation Council for Graduate Medical Education (ACGME) database: http://www.acgme.org/adspublic/ Fellowships International Fellowships in Medical Education (IFME) http://www.ecfmg.org/faimer/

18. Residency Programs In The United States Applying to Residencies  ERAS (Sep. & Oct.)  Apply directly to program directors by using the ERAS (Electronic Residency Application Service).  ERAS transmits residency applications, letters of recommendation, dean's letters, transcripts, and other supporting documents to residency program directors via the Internet. http://www.ecfmg.org.eras

19. Residency Programs In The United States ERAS and Residency Programs  Program coordinators can access the system and check applicants’ requests.  Programs categorize applicants according to:  ECFMG test scores  previous clinical experience,  recommendation letters  community service (volunteer work) etc.

20. Residency Programs In The United States Residency Programs  The applicants are then invited for interviews.  Interview (Nov., Dec., & Jan.)  Applicants need to be qualified to meet the selection criteria. The ACGME endorsed general competencies for residents in the areas of:  Patient Care  Medical Knowledge  Practice-Based Learning and Improvement  Interpersonal and Communication Skills  Professionalism  Systems-Based Practice

21. Residency Programs In The United States The Match  National Resident Matching Program (NRMP)  Applicants rank programs; programs rank applicants  NRMP application is separate from ERAS/program application http://www.nrmp.org

22. Residency Programs In The United States The Match  Applicants have to be aware of the options of Inside the Match and Outside the Match positions. However, it’s up to the program director to allocate positions in and outside the match.  In February, after the interviews the applicants have submitted their program preferences (Rank order list) applicants rank their preferences and programs rank their preferred applicants.

23. Residency Programs In The United States Post Match Scramble  On the Tuesday of the match week (third week of March) a list of unfilled positions is posted on the website.  It is very competitive and all positions could literally be filled within an hour.

24. Residency Programs In The United States Programs  More chances of being accepted in certain specialties such as Internal Medicine, Family Medicine and Pediatrics than other fields like Orthopedics or Ophthalmology.  Regular programs (3 - 4 years) in areas such as Internal Medicine, Family Medicine and Pediatrics take only 3 years, Surgery is 5 years, Psychiatry is 4 years and Neurosurgery is 7 years. For subspecialties like Cardiology, applicants have to take a 3 year program of Internal Medicine and then Cardiology for another 3 years.

25. Residency Programs In The United States Criteria for Acceptance in Residency Programs  Exam scores  Past academic performance  Recommendation letters  Patient Care  Medical Knowledge  Practice-Based Learning and Improvement  Interpersonal and Communication Skills  Professionalism  Systems-Based Practice

26. Residency Programs In The United States Visa Application  Must contact U.S. Embassy/ Consulate once DS-2019 received  Must guarantee intent to return home  Must apply for an interview as early as possible

27. Residency Programs In The United States Steps To Residency USMLE Step 1 Step 2 CK Step 2 CS DS-2019 Matching Programs Acceptance J1-VISA ERAS

28. THANK YOU & GOOD LUCK www.educationusa.state.gov