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blastoma: MY USMLE STEPS AND MATCH (Path)
作者:USMedEdu
发表时间:2010-01-02
更新时间:2010-01-02
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发信人: blastoma (retino), 信区: MedicalCareer
标 题: MY USMLE STEPS AND MATCH (Path)
发信站: BBS 未名空间站 (Sat Jan 2 00:47:59 2010, 美东)



Many thanks to the friends whoes unselfish contributions make this forum an
invaluable resource for me in the past year. Also, many thanks to S.S. who
gave me strength and hope in the most difficult year of my life, so far.

Let me briefly outline my journey here, and hope it will be useful. Many
people did it better and faster than me, but this is probably the best I can
do. Also let me make it clear that I am not trying to impress anyone here,
but if someone plans to accomplish these things in one year, let me tell him
/her that it is possible.

Profile: 2004 graduate with no clinical experience in China, US PhD
candidate (2004-present, so-so institute), 99/98/CS 1st attempt/83, one
first-author publication in a non-CNS journal, one manuscript with some
interesting data, some intramural awards in the graduate school; first
observership in cardiovascular outpatient clinic (every Tuesday for 2.5
months) and ICU (two weeks, 6hr/day), second observership in surgical
pathology (about 1 month, 4hr/day); two letters from clinicians (both are MD
/PhD, one in cardiovascular medicine, one in surgical path), one letter from
my mentor (MD, was trained in a top pathology program in US, but is a full
time research scientist now).

Time line:
--May: Step 1 (May 30th). The preparation started around the New Year, 2009.
I was very focused on my graduate study before this and thought USMLE can
wait, partly because I didn't know I can match without a green card. I didn'
t know that many residency programs have the 5-year cutoff either. When I
found this out, I was very much on steroid and determined to beat the 5-year
cutoff. 2009 is the year! I spent about 4-6hr per day for the prep, doing
experiments (~8hrs) in the lab until one week before the exam date and
sneaking out on Tuesdays for observership in the cardiovascular outpatient
clinic. Books: FA (read about 4 times); Lipincott Biochemistry (read twice);
never finished the Gojan Path book or mp3; never touched Kaplan. I did some
reading in Cardiology too, so as to impress the attending I was shadowing.
Took graduate level courses in Histology, Genetics, Cell biology and
Immunology in 2004 and 2005. Q banks: USMLERx (January-March, 70%, timed),
UW (April-May, 69%, timed). NBME scores were perfectly predicative of my
final score. Cardio scored high consistently (experience matters!)
--June: told my mentor about the whole USMLE thing on June 1st. He was a
little shocked and uneasy, but was supportive in a way, because my paper
published in 2008 was quite important for him although in a non-CNS journal.
I got his permission to spend two weeks in the cardiovascular ICU for
observership. Doing experiment at the same time in the evening. Did not make
much progress in step 2 prep for the rest of June. I registered for CS
around the end of June, and luckily find a spot in a preferred city in my
time zone two weeks away (July 9th).
--July: prepare for the CS intensively. 3-4hr per day. Went through FA-CS
twice. Typed all the patient notes twice (scored very high on the Notes).
Did not practice interview or PE very much because my medical school in
China offered standard patient education. Passed the CS comfortably on July
9th. Started the observership in Surgical Path on July 15, and registered
for CK for September 18th. Got two letters at that time, from the Cardio
attending (MD/PhD) and my mentor (MD), both letters being quite strong (I
didn't read them though).
--August: I was doing the experiments in the lab (6-7hr/day), working on UW
for CK (3-5hr/day), and attending sign-outs (8-10am), conferences (2-3pm)
and slides preview (4-5pm). No cooking, no gym, no movies! I was completely
overwhelmed. Around the same time, I put together my c.v. and personal
statement (many many drafts by myself, never trusted surrogate writers). Not
surprisingly, my performance in the lab suffered and my mentor ordered that
I terminate my Path rotation to focus on my project. I accomplished about
four weeks of observership by that time. It was very nice of my mentor to
help me get a letter from the head of the surgical path (MD/PhD). And to get
this precious letter, I had an 1-hour conversation with this pathologist
because he actually did not know me very well. He also tested my Path
knowledge at the microscope (another two hours, seriously!), and I did not
blow that opportunity.
--September: took CK on 18th, and failed to become a 99er. The poor
performance was predicted by NBME. I deserved it, because I only did UW
twice (67%, timed), and never read much. I bought the Kaplan notes, but I
read at most 40 pages and then gave up. I did not sent out my ERAS
application in September, and this was because: my letters were only
completely scanned in October, and I decided to wait for my CK score. I
regret I did not send out the application earlier, which probably cost my
number of IVs. However, you never know what would happen to a very
incomplete package.

--October-December: Got CK score and applied to 30 path programs on Oct 7.
Got ECFMG certificate two weeks later and registered for Step 3 on December
1-2. Got the following IVs: Baystate, WashU, Birkshire, Yale, SUNY Downstate
, Albany, Long island Jewish, U St Louis. I went to one interview only, and
I got a prematch offer before my second interview. I accepted the offer and
canceled the rest of the IVs. In this way, I cut down my carbon footprints
and leave the opportunities to the others.

About Step 3: I did the UW twice (60%, timed), but did not have much time to
read the explanations carefully. I read 1/5 of the Crash, but gave up the
rest of it. How can I have time for the luxury? I had to do experiments,
write up the manuscript and prepare for the interview, and I was depressed
and anxious. Obviously, step 3 is not as cramable as step 1, especially to a
person with no clinical experience and did not read much for the CK exam.
The score said it all, and I take the low score as reminder to myself: I
really don't know much.

About the only interview I had, it was very tough. It included a night-
before gathering with the residents, meeting with eleven faculties (at least
30min each), dinner with selected faculties and residents, and a 20-minute
research seminar on the second day. I thought I looked tidy on the interview
day and I smiled a lot. My English got better and better partly because I
was asked similar questions repeatedly. Also for pathology, it was not
difficult to align my academic experience with my career plan in the future.
The seminar I gave might not the best on that day, but I was articulate and
my slides had substance and nice illustrations (proud of my drawings!). I'
ve got "some hardcore mechanisms..." was one of the comments I got.

Anyway, it was like a dream, but it has come true. I know I was lucky and
blessed, and I am also humbled by this whole experience. There are still a
lot to learn. The road in front of me now might not be any easier and the
responsibilities will be huge...But that is why we pursue this pathway in
the first place, isn't it? Again I want to thank the friends on this forum
who gave me the best guide I could possibly get, and I wish the readers who
come after me good luck in your usmle steps and match!

--

※ 修改:·blastoma 於 Jan 2 00:56:15 2010 修改本文·[FROM: 137.53.]
※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 137.53.]

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共有1条评论
1   [USMedEdu 于 2010-01-04 09:59:47 提到] [FROM: 140.]
发信人: hemocell (老军医), 信区: MedicalCareer
标 题: Re: MY USMLE STEPS AND MATCH (Path)
发信站: BBS 未名空间站 (Sun Jan 3 22:18:25 2010, 美东)

Although I really do not have time to write anything now, and I do not have
a Chinese input with my superportable, I still feel that I need to say
something here as a resident matched 21 years after graduation from a so so
medical school in China.

First, I read most of blastoma's post in medcareer (because she is applying
pathology, obviously). I believe that her story is true. And I believe she
will have a bright future in academic pathology. The most important factor
we need to consider is that she graduated from medical school in 2004 and
enrolled in PhD program here in the US right after that. As someone already
mentioned, she also took some basic science courses during PhD study. She
also mentioned in her post, in the short duration of her preparation for
USMLE, she could not finished everything recommended by others, not even
Goljan's pathology course. That actually makes a lot sense to me.

Second, if you are graduated from medical school more than ten years ago,
and you have not take any refreshing courses in the US (in English language)
, you are definitely not able to crash USMLE in one year. For myself, It
took two full years to complete USMLE step 1 and 2(CK/CS). I had a full time
postdoc/junior faculty position in which I do not have any chance to read
any USMLE material at work (8-6), because I had not told my boss about USMLE
untill I got the real paper USMLE certificate.

I totally understand that zhangr01 and lchen7 is trying to make some points
very clear for old CMGs. It is really important for old CMGs to realize the
tremendous challenge when you are starting USMLE. FirstAid is not enough for
you, even Kaplan notes are not enough for you; the first year will be very
stressful.

I also hope blastoma will understand what is going on here. There is nothing
personal; everyone is trying to help our CMG group. I admire your choice
and I fully believe that we need at least some CMGs to become top academic
physician scientist in the United States.

(I do not have time to proof read the post, will change something tomorrow
night)
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 67.152.]

 
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