Medical Residency

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Residency Programs
In The United States
Residency Programs
In The United States
U.S. Medical
Educational System
4 years College/University

MCAT
Exam

Residency (3 to 7 years)
4 years Medical School
6 years Medical School
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.

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)
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

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

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

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

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.
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
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.
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

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/
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.
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.
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
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/
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
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.
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

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
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.
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.

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

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