Updated: Jun 22, 2020
This post is intended for students that are 𝐣𝐮𝐬𝐭 𝐬𝐭𝐚𝐫𝐭𝐢𝐧𝐠 their USMLE preparation to doctors that are 𝐚𝐩𝐩𝐥𝐲𝐢𝐧𝐠 this year!!
Some points are easy to improve, other ones require time and hard work, and some other ones you can only do on a specific time of your carrier.
So it's very important that everyone reads this!!
1. 𝐒𝐓𝐄𝐏 𝐒𝐂𝐎𝐑𝐄𝐒
Get GREAT Step scores
I won't talk about this much, since it's the one thing that everyone will tell you, and 𝗺𝘆 𝗽𝗼𝘀𝘁𝘀 𝗮𝗿𝗲 𝗮𝗯𝗼𝘂𝘁 𝘁𝗲𝗹𝗹𝗶𝗻𝗴 𝘁𝗵𝗶𝗻𝗴𝘀 𝘁𝗵𝗮𝘁 𝗻𝗼 𝗼𝗻𝗲 𝘁𝗲𝗹𝗹𝘀 😃
If you have attempts or low score in one exam, 𝐚𝐢𝐦 to get an excellent score in the next one. Also Step 3 is ALWAYS a plus!
I made a post previously with 50 Hospitals where IMGs can rotate in American hospitals.
Covid-19🦠 issue: I know now it’s difficult times due to the current pandemic, I heard that some hospitals are starting to accept students for in site rotations and other ones offer tele-rotations.
I’m not a fan of tele-rotations, but if you really need to apply this cycle and that’s the only way you can get your US LORs, then there is no option and you will have to do it.
Even though most of them are expensive, it’s not the same as if you are in campus seeing patients. But as I mentioned, if you want to apply this year, that’s the option.
Always remember your goal here is to impress your attendings and aim to get GREAT PERSONALIZED LORS! 🙌 ✉️
I'll talk with my PD after I meet him again July 1 about his insights about tele-rotations and make a post about it.
Doctors probably won't specify when they write your LOR that it was a "tele-rotation".
They will say that you saw patients, how knowledgeable and nice to work you are, ways that you impressed them, how you always went that extra mile, etc.
I don't think that will clarify that "tele-rotation", since that's not the main point of a LOR.
The main point is talking about you, how great your are, nice to work with, etc.
Also when you fill out ERAS, you will put "observership" or "clerkship".
Once you are in your interview they may or may not even ask you about it.
I'll soon make a live instagram video on @doctor.sebas clarifying everything about tele-rotation.
𝐈𝐬 𝐢𝐭 𝐛𝐞𝐭𝐭𝐞𝐫 𝐭𝐨 𝐝𝐨 𝐚 𝐥𝐨𝐧𝐠𝐞𝐫 𝐞𝐥𝐞𝐜𝐭𝐢𝐯𝐞/𝐞𝐱𝐭𝐞𝐫𝐧𝐬𝐡𝐢𝐩 𝐚𝐭 𝐨𝐧𝐞 𝐩𝐥𝐚𝐜𝐞 𝐨𝐫 𝐚 𝐬𝐡𝐨𝐫𝐭𝐞𝐫 𝐨𝐧𝐞 𝐚𝐭 𝐦𝐮𝐥𝐭𝐢𝐩𝐥𝐞 𝐡𝐨𝐬𝐩𝐢𝐭𝐚𝐥𝐬?
It really depends, if you will get 2-3 amazing, personalized LORs from that program and can also get involve in research, then take that longer-elective option. By going to multiple hospitals, you also boost your chances of making more/wider connections.
𝐑𝐨𝐭𝐚𝐭𝐢𝐨𝐧𝐬 𝐢𝐧 𝐈𝐌𝐆𝐬 𝐩𝐥𝐚𝐜𝐞𝐬
Pros: You will make connections, they will get to meet you, and you impress them well enough, you can match with them!
👉This is the option that I recommend the most to 𝐨𝐥𝐝 𝐠𝐫𝐚𝐝𝐮𝐚𝐭𝐞𝐬 or people with 𝐚𝐭𝐭𝐞𝐦𝐩𝐭𝐬/ 𝐥𝐨𝐰 𝐬𝐜𝐨𝐫𝐞𝐬.👈
Cons: If you are applying to multiple places, LOR from this places won’t count as much a LOR from a top Hospital.
𝐑𝐨𝐭𝐚𝐭𝐢𝐨𝐧𝐬 𝐢𝐧 𝐓𝐎𝐏 𝐡𝐨𝐬𝐩𝐢𝐭𝐚𝐥𝐬
Pros: A LOR from this places will help you a LOT, even though we probably won’t match there, it will still help you TONS!
Eg, I got my LORs from Cedars Sinai, #8 hospital in the USA. I really impressed the doctors and they wrote amazing LORs.
Getting LORs from a top place WILL make you a difference, even if they don't won't take you there for residency!
I knew that I would’t match at Cedars since I was doing my research in plastics, and applying to OBGYN, I didn't work much in the OBGYN department, and also they haven’t accepted IMGs for the last 10+ years!
•Rotations in community, IMG friendly hospitals will give you a chance to impress those doctors and match with them.
•Rotations in TOP hospitals will give you a chance to impress those doctors, and match in other hospitals with their LORs.
3. 𝐋𝐄𝐓𝐓𝐄𝐑𝐒 𝐎𝐅 𝐑𝐄𝐂𝐎𝐌𝐌𝐄𝐍𝐃𝐀𝐓𝐈𝐎𝐍𝐒
Get great, personalized, from US doctors. Programs really don’t care much if we were chair of a deparment in our home contry, or pretty much anything that we did there (except research and residency to some degree).
They don’t know the hospital or the way we do things in our home countries. They want to see that you gained the trust, and impressed US physicians. This is the most important fact after our Step scores.
Also those LOR must be AMAZING!
“Generic” Letters of recommendation are trash. PDs can tell right away when the doctor knows you well and was impressed by you, or he just copied and paste the letter and just changing the name.
If you didn’t do a rotation, then do research and get them that way, or contact family, friends or even people that went to your same medical school and try to see if they can offer help you out with this on some way.
I know a lot of you don't know anyone that pursued this journey and don't have any contacts or connections. It happened to me, and I made groups and chats with students and doctors from my country and now we are the first ones from that group to match, being 7 argentinains matching in different hospitals in the USA :)
Always remember to help yourself and others along your journey!💖
If you are applying for IM or FM then it’s not that very necessity, it will definitely help though. But don’t worry too much about it. It will help you to make contacts, and build a strong CV for sure!
If you are applying to a surgical or another competitive specialty, then research is almost a must.
5. 𝐑𝐄𝐒𝐄𝐀𝐑𝐂𝐇 𝐅𝐄𝐋𝐋𝐎𝐖𝐒𝐇𝐈𝐏
If you are applying for a surgical specialty some programs love to see tons of publications. I wouldn't waste extra time though, time is precious - waste is wisely. Don’t commit for too long if you won’t get much out of it.
👉If you are a repeat applicant, then you can get a research fellowship to make contacts, and build a strong CV for sure.👈
𝐃𝐨 𝐈 𝐡𝐚𝐯𝐞 𝐭𝐨 𝐝𝐨 𝐫𝐞𝐬𝐞𝐚𝐫𝐜𝐡 𝐢𝐧 𝐭𝐡𝐞 𝐬𝐚𝐦𝐞 𝐬𝐩𝐞𝐜𝐢𝐚𝐥𝐭𝐲 𝐭𝐡𝐚𝐭 𝐈’𝐦 𝐚𝐩𝐩𝐥𝐲𝐢𝐧𝐠 𝐭𝐨?
Not necessity, as IMG’s we take what we can. If you can that’s great, you can’t you are still getting the experience and getting some publications!
∙ Eg, I did research on heart transplant and then on Plastics & Reconstructive surgery, and applied to OB/GYN.
6. 𝐏𝐄𝐑𝐒𝐎𝐍𝐀𝐋 𝐒𝐓𝐀𝐓𝐌𝐄𝐍𝐓
Make sure you really work on it, start from now if you are applying this cycle. I made on my page on what to do till application day and how to use FREIDA.
I will soon make a post on write a 𝐏𝐞𝐫𝐬𝐨𝐧𝐚𝐥 𝐒𝐭𝐚𝐭𝐞𝐦𝐞𝐧𝐭 and what kind of 𝘄𝗼𝗿𝗱𝗶𝗻𝗴 you should use.
Make sure to have many doctors and also non-doctors reviewing it.
APPLYING TO MORE THAN ONE SPECIALTY
If you are applying to 2 different specialties then you have to make 2 different PS, and get LORs that mention you interest in that specific speciality.
For each speciality that you apply, you need to make a personal statemen, mentioning why you choose it and why you will be excellent at it.
If you apply to Internal Medicine and Family Medicine, ask the doctors that are writing your LOR to make them unique for each one.
You will also need a LOR from a doctor of that speciality and just for that one.
If you apply to OB/GYN and General Surgery.
You can do this: Get a LOR from a general surgeon just for surgery
Get a LOR from a OB/GYN just for OB
The other two can be from any other doctor, and just tell them to change the speciality that you are interested.
Applying to Neurology & Neurosurgery
Make sure to get one from a Neurologist just for Neuro, one from a neurosurgeon just for neurosurgery
The other two can be from other doctors, that just change the specialty that you are applying.
It doesn't always have to be like that also, I applied for OB/GYN and I had 1 from a OB/GYN doctor, 1 from a plastic surgeon, and 1 from a cardiologist.
As IMGs we need to take what we can, making the MOST out of everything - ALWAYS!
As I mention previously, I'll make a Youtube video on how to work on your Personal Statement & clarify this one more time.
7. 𝐕𝐎𝐋𝐔𝐍𝐓𝐄𝐄𝐑 𝐖𝐎𝐑𝐊
Many people will tell you that volunteer doesn’t count. Well let me tell you something, starting as a volunteer and working my way up making connections and meeting people is what eventually got me my research position, externship, publications and LORs. You can read on my previous post on how I got my research position.
8. 𝐘𝐄𝐀𝐑 𝐎𝐅 𝐆𝐑𝐀𝐃𝐔𝐀𝐓𝐈𝐎𝐍
As you already know, YOG does matter to some hospitals and they have a cut of depending on how long ago you finished medical school
Some programs only accept fresh graduates. Eg, 1-2 years out of medical school, another programs 2-4 years/ <5 years.
But overall, I would say like around 60% don’t look at that. (Correct me if I’m wrong).
Now I will tell you something a lot of people do with their YOG.
I didn't know about this when I was a student and also I wouldn't be able to do it myself since I had to graduate and get my license to work in my country ASAP to start making money, since at that time I didn't have almost any money during because I stoped working and my savings were over.
This is what a lot of people do:
They postpone their graduation to study for the steps and also to still be able to do clerkships.
Why do this?
•Point #1: They will study for the steps while "still in med school", take the exam and then look as they "just finished school". The thing here is that you total time in school will be prolonged and PD might ask you about this, but I still see a lot of people doing it.
•Point #2: As a student you can get so many more Hospitals to rotate and be hands on. Due to liability issues it's very hard to find a "hands on" rotation after you finish school and they are way more expensive after you graduate.
I have a post about 50 hospitals to find rotations in the USA.
9. 𝐇𝐎𝐌𝐄𝐓𝐎𝐖𝐍 𝐑𝐄𝐒𝐈𝐃𝐄𝐍𝐂𝐘
I mean hometown residency if you already did your medical residency in another country outside the USA.
𝐃𝐨𝐞𝐬 𝗶𝘁 𝐡𝐞𝐥𝐩 𝐭𝐨 𝐦𝐚𝐭𝐜𝐡?
I would say yes - most of the times helps, especially for surgical specialties.
𝗡𝗼𝘁𝗲: If you have hometown residency some programs consider your YOG by the time that you finish your residency, so that’s good news for all the IMG specialists out there!
10. 𝐂𝐎𝐔𝐑𝐒𝐄𝐒 & 𝐀𝐖𝐀𝐑𝐃𝐒
Try to take courses and win awards that will improve your CV.
I posted a way to get free ACLS, BLS and PALS.
You can find it on my highlighted stories on my Instagram @doctor.sebas and follow step by step.
It’s not by AHA. But it’s good to learn life support and also you get the certificate 🙂 and it’s free!
I think very good thing even though it’s not aha. ERAS doesn’t specify that it has to be by AHA. They just ask if you have it and you can say YES! Once you start residency your Hospital Will pay for those same courses by AHA :)
11. 𝐌𝐏𝐒𝐄 - 𝐆𝐫𝐚𝐝𝐞𝐬 𝐢𝐧 𝐂𝐥𝐞𝐫𝐤𝐬𝐡𝐢𝐩𝐬 -𝐂𝐥𝐚𝐬𝐬 𝐑𝐚𝐧𝐤𝐢𝐧𝐠
These factors will mainly count if you are an AMG.
IMGs should’t worry about this much really, but if you got great score/ top class ranking/ honors student I’m sure it will make a difference too, everything good here that adds up makes a difference!
Remember that the way to make a castle is by piling up small bricks ;)
12. 𝐏𝐑𝐄𝐋𝐈𝐌𝐈𝐍𝐀𝐑𝐘 𝐘𝐄𝐀𝐑
Many programs offer this, mainly for surgical specialties and that’s a way a lot of IMGs get into the system. It means that they offer you only a PGY-1 year in the program; and then you will have to continue your PGY-2 in another place or maybe there if you are lucky and a spot opens up. A lot of doctors than don’t find a PGY2 position after their prelim year, would apply again to a residency program, but this time categorical. Since now they have 1 year of USCE experience, it will boost their chances of getting a categorical spot.
Something that not many people know is that it’s "FREE" to apply for a preliminary position if you applied for a categorical in that same program through ERAS.
This is how it works:
You choose the categorical position in ERAS, but also select the preliminary one, and you will only have to pay for one!! I didn’t know this until the moment that I submitted my ERAS payment!! No one ever told me before.
I explain more about difference between categorical & prelim on a previous post.
Work on your english accent, try to sound very good and understandable.
Many people take courses on how to improve the english accent. If it’s necessary, do it.
It’s another way to improve a CV and will also help you BIG TIME for you STEP 2 CS exam.
If you can learn an extra language will also help.
Eg, if you are applying in NY and know Spanish it will definitely help. If you are applying in Michigan and know Arabic will help also.
14. 𝐕𝐈𝐒𝐀 𝐒𝐓𝐀𝐓𝐔𝐒
Don't requiring visa will help in some degree. But still there are plenty of IMGs friendly hospitals that sponsor it.
Eg, 33% of the residents in my hospital require visa.
Also I have friends that met their love of their life, married, got a GC, and applied for residency as a green card holder.
15. 𝐄𝐗𝐓𝐑𝐀𝐂𝐔𝐑𝐑𝐈𝐂𝐔𝐋𝐀𝐑 𝐀𝐂𝐓𝐈𝐕𝐈𝐓𝐈𝐄𝐒
•Make you a better CV
•Be more unique
•Be a person more interesting to talk to during an interview and in life in general.
Your hobbies are also something that people underrate, but I would say that they are important too and say a lot about you.
If you traveled ✈️🗺️to 20 countries, or you can make bread🥖 and pasta from scratch, if you read tons of books📚, made a prothesis with 3D printing🖨️, have a yotube channel 📽️where you teach something to people, if you played professional sports 🏊♀️🤸🏿♂️🤺, etc.
These are all things that will make you stand up and sound different, bringing that extra spice to the table.
16. 𝐘𝐎𝐔𝐑 𝐖𝐎𝐑𝐃𝐈𝐍𝐆
Believe it or not, the way you write and phrase your experience on your CV will change it big time.
If you want to check out my previous posts on www.doctorsebas.com I pasted the exact way that I phrased my work, research and volunteer experience on my ERAS CV.
I will soon make a free course video on how to MAKE a CV step by step and I will talk about this also.
17. 𝐘𝐎𝐔𝐑 𝐏𝐄𝐑𝐒𝐎𝐍𝐀𝐋𝐈𝐓𝐘
This is something that no one is thinking about, but it will help a lot at the moment that you are interviewed, and you must consider it.
As I mention on a previous post:
Start with being nice, humble, willing to help and approach people, also be approachable and kind to others! People can tell when you are doing something because you really mean it , or to take advantage of the situation (specially interviewers).
I know in medical school a lot of people are into themselves, very competitive and don’t like to share things.
THIS IS REAL LIFE, WE ARE HERE TO HELP THE WORLD AND OTHERS.
•If your friend needs your notes because he couldn’t show up to class:
SHARE WITH THEM.
•If someone doesn’t understand a concept that you know very well:
EXPLAIN IT TO THEM.
• If you find out but something important:
DON'T KEEP IT TO YOURSELF.
Program directors and the other interviewers can sense you right away when you are a greedy person, that human that only moves their butt if they need something for themselves.
Please if you are committed to this USMLE journey, also commit HELPING OTHERS!
These are all ways to IMPROVE a CV, as mentioned I will soon make a free course video on how to MAKE a CV step by step. But in order to fill it up, you need to work on these things!!
I’ll also soon make a free course on how to improve your interviewing skills and everything about interview season.
If you are a fresh graduate, unmatched applicant, or have low scores, then you can take some time to work on your CV to the FULLEST! 🤾🏻♂️🤾🏻♂️🤾🏻♂️
I understand that now we can't do much due to COVID, and some students can't apply this year because they don't have their STEP 2 CS and they don't fall into any pathway
ECFMG stated on their website that the 5 pathways options are only for this year applicants.
I would recommend those people to work on their CV for next year.
You can work and boost any point that I mention previously, don't just stay home playing games, "waiting for a miracle to happen" or a "hit or luck".
Miracles happen to those that work hard for them, not to those that just wish for them. 💫💫 💪🙏 💥💥 🙌 ☀️☀️
Positivism, staying focused, disciplined, not listening to negative comments, working hard and remember your purpose is what will make you get there!
I know also that this year seems kind of a lost year for some people, and means we are adding one more gap in our CV. But if you work on the things that I mentioned - It won't be considered a "GAP time" or a "RED FLAG".
Covid is not an excuse to not improve your CV, of course you can justify not having US rotations or research due to Covid and PD will understand that completely.
But they won't understand why you didn't improve all the aspect of your CV!
Some people after all this hard work will call that you "have luck", they don't know how much sweat, tears, pain and gain are behind that "luck" that they are talking about.
Guys one more thing:
Please do learn how to search and find information by your own, the reason I created my page is to put everything together here. But I get tons of “google questions” that you can eaily find the answer by pasting it on google; If you want to impress people, do your homework first!
It’s not about impressing me or not, I don’t care about that, but if you get used to doing your own research and your own homework, that’s the way that you:
WILL IMPRESS the DOCTORS and get GREAT PERSONALIZED Letters of Recomendation.
I’m not telling you it’s going to be easy. I’m telling you it’s going to BE WORTH IT.
Also make sure to read all my previous posts on www.doctorsebas.com, It’s all USMLE, consice stuff, that I wrote to help you be different, make the difference, and have everything that it takes to MATCH in the USA!
Another point that I look for when writing my posts is to help you to evolve and become a better version of yourself, more kind & humanistic.
Hospitals are not looking for ROBOTS 🤖 to see their patients. They are looking for HUMANS with a big heart 💖, empathy and kidness 🙌
As you probably have seen in other pages, you won't find anywhere else all this info together, knowing this stuff ahead of time will help you and your mates.
Support my work & help your friends by sharing my post with them on groups :)
Love you all!💖🤗
Thank you for all your nice messages with so much love & support! 😍🙏
Sebastian Arruarana, MD
Fb: Doctor Sebas