Usmle Old IMG experiences

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Hello Fellow IMGs:

My Name is Gabriel Ruiz, I am a foreign graduate and I would like to share my story; perhaps, it will help someone go through those, sometimes dark moments, we as IMGs go trough in the path to fullfil our dream. This is a long post, so take your .

Who I am

I graduated in 1998 from and was not able to start my right away. In my country, residencies are not paid, so the majority of have to live with their parents or be sponsored by their wifes/husbands, coming from a humble family, and being single, that was not my situation.

I immigrated to the US in 2002, and started to re-learn English, those were tough times, no job, no english, and not a single clue about to continue with my education. Finally after spending 2 years learning english and understanding the intrincacies of the ECFMG Certification – Match I decided to start, by then I was already 28 Years old, been out of for 5 years, and the worst part, I wanted to do Surgery.

Talking to a lot of people, I quickly realized that things were going to be harder than I thought, I got a job as a computer programmer (!), and started from there, the long hours in front the computer, so far from what I love (my ) made every day a difficult task. after a couple of months fighting against the routine I was able to get started.

Setting up goals

The first thing I did, which, I think was key to success, was to stablish a detailed , all the way from Step 1 to . I joined several forums and was aquainted with the general timing of the exams, I learned that in order to be ready and on , I would need to have my last done by the end of September (1st Rule of thumb), and that would allow me to start my by june Next .

I decided to go in order, Step 1, CK, CS, that mean that I would tackle the hardest one first and would work my way through Step 2 without much problems.

Step 1

I decided to for a full 8 months for 1, and here comes my second rule of thumb for the USMLE: You will never be as ready as you would like to be for the Exam, just set a timing goal and adhere to it, if you wait to set the dates for the once you are ready, most likely that is going to be more than what you really need.

After gathering the materias, I took the 150 just to see and gauge an starting point. The results were not any , I was close to 38%!!! in some of the areas, and my best was not better than 60%. I took the decision to distribuite the as follows:

6 months reading the Kaplan Lecture notes (3 Huge by then)
1 month reading and reviewing First Aid
1 final month exclusively doing .

In between I started doing the Kaplan Qbank in tutor mode, that helps a lot, but in the end that final month was to be done simulating the actual conditions of the , in weekdays I use to do timed blocks of 50 and in the weekends try to do as many blocks as possible. In the final days of review I was doing an average of 75% in , enough to the Exam, I took the in the end of 2004 and got 85. It was not the I would like to have, but I was relieved it was over.

Getting into a hands on possition – Possible?

Just after getting my results on the , I was told by a friend that there was a position available for Foreign Graduated Physicians in a Hospital in Miami, the position is called House Physician, the state of Florida let people like me work as physician, mostly doing History and Physical in that either are going to surgery or are admitted in the wards. I was able to secure a position and started seeing again. Check in your state with the local department of , they may have this type of position available.

Step 2 -

I Started to for Step 2 a few weeks after taking Step 1. for 2 I used only Kaplan Lecture notes and USMLEworld, after reading the I did every single one of the 2000+ , and was able to repeat at least 800 of them. My final for USMLE World was 58%, I was confident that this would guarantee at least 90 in the . I spend 5 months preparing the , and I still remember taking Step 2, Everything seemed so easy, I got 92, almost 93.

Having fun, that’s what matter

By then I had been on my job as a physician for 6 months, doing at least 12 – 15 Cases a day, Step 2 CS was going to be a breeze, I prepared the for 15 days, mostly reading the material of First Aid, and the USMLE video, took the in Atlanta, in September, Last , just as I had envisioned 2 years before… The first was difficult, because I was very nervous, as soon as I exit trhough the door, somehow I realized that my dream was fulfilled, there were only 11 doors, between me and my ECFMG certificate, I just needed to have some fun in between. Results arrived 4 weeks later, I was a certified physician now.

Here comes the difficult part… maybe not

Getting into Surgical was going to be hard, I knew, my scores were not perfect, I had no research , and my age (30) and the after my graduation (7 years) was a handicap in my application, but first I needed to get the Letters of recommendation, and after receiving 2 negative from attendings, I was able to get letters, from the chairman of the Surgical department at my hospital, a prominent Laparoscopic surgeon and the director of the hospital.

Next was to compose my Personal Statement, it got to be something that while being true to myself also allow me to get the attention of the committees, I received help from a friend who was able to capture my ideas, and at the end the result was better that I was hoping for. I applied for a whooping 92 programs nationwide on the national matching , spending close to $2000 in the process, I did this trying to cover my deficiencies with a massive ammount of applications.

and then I started to receive emails from the different programs, the first 30 Emails were negatives, something like “thank you very much for applying, but you are not getting an here” It was November last , when a friend told me that someone got into surgery after completing an Observership in a very big and important hospital in my city. despite everybody telling me that it was going to be near impossible to get a position in such that institution, I decided to try to sign up for an observership.

I was lucky enough to fill a position of someone who had already signed up but was unable to attend, that was the only spot that was available for the next 6 months in the trauma unit of the hospital, I was there 3 months, Dec, Jan and Feb, working around the clock with the Surgery intern and the Senior Resident.

At the same I applied for in that hospital, and talked to the Senior Resident, letting him know that I wanted to stay for my . Somehow, they called me for , I was astonished. it was the end of 2005 when I got my , minutes before I was going to talk to the director, the Senior resident Popped in and talked to him privately for a couple of minutes. My was a breeze.

Now, after writing this, I am heading to Jackson Memorial Hospital in Miami, FL; to finish the paperwork and to do the physical, I signed the contract in December,2005; 3 months before the , and I will be starting my in General Surgery in June… Although I am anxious, I know that everything is going to be all right, I am confident that with hard work and the help of who is now my wife, that has supported me since I was in my country, I am going to be able to go through my , being successful, but most of all, having fun, enjoying it, as I have enjoyed every single of the way, experiences, that happen only once, but last for a life .

By the way, I was called by 13 different programs across the nation, never went to a single .

Gabriel Ruiz, MD


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  • Balwant Manda
    thanks 4 sharing ur exp. anything can be done by hard work nd u prove it.best of luck......
  • lateef
    thanks for the nice story.wishing u all the best for your residency,however,i want to find out if u had a green card cos it can make a lot of difference.
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