USMLE and Matching

S
 Timeline:
Matching the year of your graduation

Step Step
ECFMG
2CK 2CS

Step 1: This should be taken the June-October following your 2nd year. Step 2CK
should be taken before August of your 4th year. Youre step 2CS must be taken
before the end of October of the year you plan to apply for matching, or at least
scheduled for a date at the time of interview.
 Timeline:
Matching the year after your graduation

Step Step
2CK 2CS

Step 1: You may take your step 1 either in October, December, or at the end
of your third year, and as late as 4th year. Youre step 2CK may be done
during your US rotation for your 4th year or after you graduate. Your step
2CS should be done before the October of your matching application year.
 Examples:
Ideal matching dates

S Admitted to school in 2010

S Sign up for ECFMG certification October-January

S Finish 2nd year in 2012

S Take Step 1 June, 2012

S Take Step 2CK before the end of July, 2013

S Take Step 2CS before the end of October, 2013

S Submit matching application by September 1, 2013

S Interview between October-February 2013.

S Residency begins Spring 2014

 Dates

S Step 1 can be taken any time after your completed second

year. If you are irregular for second year, you must complete
that year before you can apply for your Step 1.

S Step 2CK scores MUST be released by the end of

September of your 4th year. This means that you need to
take your Step 2CK at the end of your third year, and latest
at the end of your fourth year.

S Step 2CS scores are not generally required by residency

programs, but they do require that you be signed up for a
testing date at the time of interview.
 Example:
Match for the year after your graduation

S Admitted 2010

S 2nd year completed 2012

S Sign up for ECFMG certification approximately 6 months prior to

when you plan to take your exams.

S Take your Step 1 at the end of your 3rd year or during your 4th
year.

S Take your Step 2CK and 2CS after you have graduated. Step 2CK
taken BEFORE the end of July after your graduation and sign up
for Step 2CS to be taken within a year of your graduation date.
 Dates

S Take your Step 1 in the middle of your third year or while

you are doing your US rotations in your 4th year.

S Take your Step 2CK after graduation, but before the end of
July. Scores must be released by the end of September in
order to be eligible for matching on September 15.
What happens if I am irregular?

S Use this time to study for your step. It may look bad on
your transcripts, but if you score very well on your Step 1,
being irregular isnt really a big deal.

S On your residency application, if you have an irregular year

or LOA, you will have a chance to explain why. You must
claim all circumstances in which you were irregular or if
you LOAd.

S Transfers to other schools also must be claimed and you will

have an opportunity to explain why.
 What happens if I LOA?

S The same applies as for those who are irregular. Use this
time to study for your step. If the cause of your LOA is a
personal matter, when you interview, you can say why you
LOAd. This may help you, as it builds character.
 Signing up for ECFMG

S Sign up for your ECFMG ID at ECFMG OASIS:

https://secure2.ecfmg.org/emain.asp?app=oasis

S As of January 2012, there has been a $50 fee implemented

on all new ECFMG ID sign-ups.

S Each step of the process to become ECFMG certified takes

about 2-3 weeks. There are 2-3 applications you must fill out
before you can sign up for any exams. Any time you see a
new application to fill out, fill it out. Sign up early and
check regularly. ECFMG will not notify you if a new
application is available.
 Signing up for your exams

S Apply for a testing window for your exam at the ECFMG

IWA: https://secure2.ecfmg.org/emain.asp?app=iwa

S Each window consists of 3 months. Please note that you

cannot sign up for a window earlier than 24 months after
the month of your admission date. This means that if you
started your school June, 2012, you cannot sign up for an
exam window starting earlier than June, 2014. The first
eligible window period for you would start June, 2014,
onwards. You will be required to pay for your test when you
sign up for your window.
 Cost of exams

Step 1: $820
Step 2CK: $820
Step 2CS: $1,440
Additional examination fee if you take your test in Asia:
Step 1: $150
Step 2CK: $165
Window extension: $65
Step 2CS rescheduling fee: $0-$400 depending on the date of cancelation
 After you apply

S After you apply, on your IWA, there will be a form 187 that you
must print out and bring to Imelda.

S You will also be emailed a form 186 within a few days of your
application submission, which you also much bring to Imelda.

S When you see Imelda, you will need the following: Form 187,
Form 186, a 2x2 picture, NOT STAPLED. Imelda will glue it for
you. P200 for the school to send a certification of your academics,
and p1600 if you want the school to ship all this information to
ECFMG for you. You may opt to do this on your own, but just
leaving everything with Imelda is more convenient and normally
everything goes without a hitch.
After you have filled out your
paperwork

S Now, its just a waiting game. This process takes about 3-4
weeks. After you are approved, you will receive and email
telling you that they have approved your application. They
will also inform you if your window is approved or not as
well.

S NOTE: Once you have submitted your forms 187 and 186,
you will not need to do this again. These forms are valid for
6 years, so any subsequent exam sign-ups will not require
you to repeat this process.
 Signing up for your test day

S Once your window has been approved, you will be emailed

a scheduling permit. On that permit, there will be a link to
proceed to the Prometric site to sign up for your actual test
day: www.prometric.com/USMLE

S You must bring this permit with you on your test day, or you
will not be allowed to take your exam.
 Step 1

S Ideally, Step 1 is taken after your 2nd year and as late as in

the beginning of your third year.

S The most important is to make sure that you are ready to

take your exam. You need to be honest with yourself. You
must prepare to the best of your abilities. You will never be
ready to take this exam, but you can prepare as best you
can. If you cant say that youve done that, then dont take
your exam.
 Step 2 CK

S Ideally, this is taken before starting clerkship or shortly after

starting clerkship. To be frank, you will have no time during
clerkship to study for Step 2 CK, so the best time to take it
would be prior to starting clerkship. This shortens the time
you have to prepare. Clerkship begins in April, which means
you would have to take your Step 2 CK at the end of
March. That means studying for your Step while classes are
on-going. This means sacrifice. You will sacrifice your
grades and your social life.
 Step 2 CS

S You can take this at any point during your clerkship, but it
MUST be done in the US.
 What to expect on test day

S Step 1 is an 8-hour, 7 blocks of 46 questions exam. Step 2

CK is a 9-hour, 8 blocks of 40-46 questions exam. You will
get 1 hour of break to use as you see fit within your 8 or 9
hour exam.

S Each block is an hour long, and you have an hour of breaks

to use at your discretion. You may opt to take a break after
every block or you may skip your breaks and continue with
your exam.
 Breaks

S You have an hour that is all inclusive for bathroom breaks and
lunch. My recommendation is to take a break after every block.

S Check-in and check-out. Every time you check out, you must scan
your fingerprints, show your ID, and sign out with your signature
and the time you clocked out. You are not allowed to bring
anything from inside the test room to the outside. When you
check-in, you must show your ID, scan your fingerprints, sign in,
get pat down, and pull up your sleeves.

S For me, this was the most grueling part of the test. On top of
testing endurance, you have to go through the stress of airport
security. My opinion is that this was more stressful than the actual
exam.
 Snacks and hydration

S Dont forget to eat and drink. This seems like a no-brainer,

but when it comes to the stress of test day, you might not eat
because of nerves, and you might not drink for fear of
having to pee too often. Keeping your body fueled and
hydrated staves off early test burnout. Pick things that are
easy to eat on the go. Juice boxes, boxed or bagged drinks
are good choices, as you can chug them down while you
walk to the bathroom. It gives you both hydration and
sugars that your brain needs in the limited break time you
have.
 Jackets and earplugs

S Bring your own earplugs. Testing centers differ when it

comes to noise levels, but bring your own ear plugs, just in
case. With high stress situations, things that grind your gears
will really grind your gears.

S Dress in layers. Try to get jackets that zip. Wear at least 2-3
different layers. Since we live in the tropics, were used to
being warm all the time. The ambient 70F of the testing
centers become quite chilly as the test goes on. Note that
you are not allowed to remove items of clothing in the
testing center, hence the zipper.
 Test day tips

S These exams are exams of endurance. Keep that in mind as

you are preparing to take these exams.

S Dress in layers. Keep warm. Those testing centers are cold.

S Keep hydrated and fueled. Dont forget to eat and drink

when you can. You need it.

S Be well rested the night before. Youve spent months

preparing for this exam. You dont need to be nervous.
 Test day tips

S Wake early and empty your bowels and bladder. Even then, your
nerves may get to you in the testing center, and you may find
yourself having to go to the bathroom after every block. Thats ok.
Take your breaks.

S Some proctors are nice, and some proctors are high strung. Dont
let them get in your way. This is your day, this is your test.

S It is important to take a deep breath after every block. Calm

yourself. Dont stress over questions in the block you just finished.

S When you get to the last few blocks, you will be tempted to say
screw it, I just want to go home. Dont do it. Youve worked too
hard for too long to just throw it away. These last few blocks
determine your grade. Pull through!
 Preparing for your exams.

S First Aid

S Uworld

S NBME

S Kaplan videos

S BRS
 First Aid

Use this throughout your first and second year. It gives

you the salient points that are high yield. It should
really be used as a backbone to build on.
Kaplan videos with First Aid: These were my mainstay
in 2nd year. This is enough to get you through both
school and Step 1, but you wont top either. Youll do
relatively well, but in order to top either school or the
exam, you need to have other resources.
 BRS

This is good for school as well, but it just

augments or repeats First Aid in terms of Step 1.
 Uworld

This is an invaluable tool. It preps you for the format of the actual
tests as well as how they want you to think and what kind of
diseases you will see. However, Uworld does concentrate more on
zebras then horses, and can become overwhelming very quickly.
Take notes while doing assessments.

(This was my primary source of learning and information for both

Step 1 and Step 2.)

Word of advice: If you dont score well when you start, dont give
up! Just chug through! Dont let it discourage you and make you
quit. You can do it! Youve gotten this far, you can go farther!!
 NBME

Each test is 4 blocks long.

Do 1-3 of these just to gauge how you would do on an
actual exam. This is purely optional, as you cant go over
the answers to all the questions or the reason as to why
your answer was wrong.
My recommendation is to buy 2 tests, which means 8
blocks, and use them to simulate test day. Complete the 8
blocks and allot yourself 1 hour of break broken down as
you see fit. This will give you a feel for how test day will go
as well as realistically project your score.
 Prometric sample test

S You can choose to take a sample exam at your Prometric

center to see how the test center is, what the check-in and
check-out process is like, how the program works, etc. I
highly recommend this. You will want to know how test day
will go so that you are fully prepared for what to expect. As
I stated before, the checking in and out process is the most
stressful part of test day, so its beneficial to be prepared and
know what it will be like.
When should I start studying?

You should begin seriously studying 6 months prior to

when you plan to take your exam.

If you plan to take you exam around March-June, you

should start studying around the time of Sem break. This
means actually doing Uworld questions and using First
Aid as your Primary source. Read First Aid at least 2-3
times through. Everything you need to know is in there.
When should I start studying?

There are 3 types of programs that you can do:

8 months: This is for those who want to take it slow and
require a little more time to master certain topics.
6 months: This is the typical program. Youre comfortable
with the topics, but you want to be thorough.
4 months: This is the accelerated program. Maybe you
signed up for your test day late and now youre out of
time. Now you need to hustle and make sure you have
everything down.
How much does prepping cost?

Amazon:
S First Aid: Step 1 2013 $44.08
S First Aid: Step 1 2012 - $38.33
S First Aid: Step 2CK 8th ed - $42.18
S Kaplan Medical USMLE Step 2 CS:
Complex Cases - $59.99
How much does prepping cost?

Uworld:
 How much does prepping cost?

NBME:
Regular self-assessments cost $50 per assessment. If you want
the expanded feedback, it will cost $60 per assessment. When
you purchase your test, you will be able to pick whether or not
you want to have a self-paced or timed assessment.
The expanded feedback will breakdown what you are weak in,
but neither the regular or expanded feedback will allow you to
review your incorrect answers. I would recommend the regular
$50 assessment, as I did not find the $60 expanded assessment
helpful
 Matching

You apply for your residency token. Go to

ECFMG OASIS:
https://secure2.ecfmg.org/emain.asp?app=oasi
s

On the left hand margin, there are links and

options. From here, you apply for your
Residency token here:

With this token, you go to the

AAMC site to apply for a residency
application account.
 Matching

Just as IMGs sign up for the USMLE through ECFMG, we

match through ECFMG ERAS AAMC:
https://www.aamc.org/students/medstudents/eras/

You apply for your residency token on ECFMG OASIS. With

that, you go to AAMC and apply for an account where you
can have all your letters of recommendation, personal
statements, and CV uploaded and sent to residency programs.
 Letters of recommendation

When uploading your letters of recommendation, you need to have

your token and an AAMC account. From there, you will register and
finalize professors who will be uploading letters for you. From there,
they will be assigned an ID number that links their letter to your
account. All they have to do is follow the instructions on the printout
you will give them with the AAMC ID number.

ECMFG ERAS allows you to upload your own letters of

recommendation via post office. Go to the same link that you used to
apply for your token. On the left hand since, there will be an upload
link. From there, you can upload your picture, LoR, and PTAL
(California letter).
 Matching requirements:

S Letters of recommendation

S Step 1 scores

S Step 2CK scores

S Step 2CS sign up

S MSPE

S Deans letter

S Transcript

S Personal statement
 MSPE and Deans letter

S The MSPE (Medical student performance evaluation) and Deans

letter are submitted by the Deans office. The MSPE is P200 PRIOR to
graduation, and P700-800 after graduation. The Deans letter has no
cost. Please note that you much write your own MSPE and submit it
to the Deans office. Templates may be found online.

S The transcript completed by the Registrars office and is P400 prior to

graduation and P800 after graduation. They submit this to the Deans
office, who uploads it to ERAS.
 Match application

S Be sure to check in regularly on your application to see what

you need to submit in order to turn in your application on
time.

S When you are ready to finalize all your documents, go to

your application and certify that it is ready to send to
programs. Once you do this, you will no longer be able to
change anything in your application, so be sure there are no
errors prior to certification.
 Personal statement

This is a very important part of your application that should

not be taken lightly. Start writing early. Brainstorm. Youre end
product will be drastically different than your first draft, so
dont be concerned when you feel your personal statement
requires a lot of editing.

Your friends are a great resource. Ask them to give you advice
and insights. They can be the key to a great personal statement.
They see you in a way you cant see yourself, and their insights
are invaluable. The Young Alumni Development Program also
provides you with mentors that guide you.
 Matching

The matching program is through NRMP site: http://www.nrmp.org/

This is completely separate from ERAS and ECFMG. You use this site to
obtain the results of match, but you apply for match itself with ERAS and
AAMC. You do not need a diploma for you to apply to different residency
programs. You do need a diploma to obtain your ECFMG certification,
which you should have at the time of the start of your residency. Deadline
for matching submission is September 15th. Replies from programs can
begin as early as mid-September, but most of the larger programs wait
until October 1 to start looking at applications, since this is when the
MSPE is released and when all the US medical graduates will begin
applying.
 Matching: the process

The first step is applying to each program that you want. A good
resource is MatchaResident.com. You pay a fee per specialy,
input your scores and other bits of information, and it matches
you to programs that are well suited for your criteria. ERAS
charged per group of applications it sends out for you.

The next step is hearing back from the hospital for an interview.
You then must fly yourself out (at your own cost) and provide
your own accommodations for your interview. Power dress the
way a lawyer would. A complete suit is absolutely necessary. Be
presentable and well groomed.
 Post-interview

After you have your interview, each program determines if they

want you. You rank your top 10 hospital programs you want,
and they rank their choices. If you choose a hospital that has
chosen you, you are matched into their program. I dont know
what happens if you are accepted to more than one program. I
heard it has been random, and Ive heard it was based on your
rank/their rank.
 If you dont match

If you are not accepted to any of the hospitals you have ranked
in your top ten programs, then there is a period called the
scramble, where you contact other hospitals you have
interviewed with to see if they want you. Previously, this was
over the phone, but now it is online.

At the end of this period, you either match of you dont match.
If you dont match, you have to wait another year to apply for
the program again.
 End

Although I highly recommend staying on track, not matching

or not staying on the timeline is not the end of the world.
Although it is better for you to stay on the same timeline as
medical students who attend an American medical school, be
sure that you do what is required when youre ready. Be sure
that you can do your best and give everything youve got before
you commit.

Good luck!