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Medical Abroad

Set your sights on a post-graduate degree abroad? The complete lowdown

You’ve had enough of the scramble for PG seats, free seats, reserved seats and the lack of proper opportunities in India, even after that. So, you’re looking for greener pastures abroad, most likely in the US. You have 2 options: a) Give the GRE and go for an MS/ Phd in related subjects like Public Health, Genetics, etc. Meaning you take up research or teaching as a career and give up medical practice altogether.
b) Give the USMLE and try to get a residency. This is the tougher of the two routes, and in this article I will share with you the details of the long and arduous procedure that lies ahead should you decide to tread this path

Basics
In order to enter into a residency in Clinical Branch in the US, you have to start another saga of giving the ‘n’ number of exams called the USMLE (U.S. Medical Licensing Exam.). And by residency I don’t mean green card or citizenship. A post graduate course in the US is called a residency. So here is what you have to do.

First, decide the most important thing without which all is futile. Whether you want to do your PG in India or abroad. If you are in two minds, please decide one thing. Otherwise you may land up being a dhobi ka you know what.

Once you are decided on abroad then do as follows:
1) Write to the ECFMG (Educational Commission for Foreign Medical Graduates) in Philadelphia. This is the central agency which handles all the affairs of foreign medical graduates. You can also call them or e-mail them and ask for a brochure. Or download the brochure from the net and read it. (check out www.ecfmg.org or www.usmle.org)
2) Give the USMLE Steps 1 and 2.
3) Give the TOEFL. Don’t study for it.
4) Go to Philadelphia to give the CSA (Clinical Skills Assessment) exam. This is a practical exam where you have to examine mock patients in a stipulated period of time.
5) Apply thru ERAS (Electronic Residency Application System)
6) Apply for a visa. There are 2 kinds of visas available to doctors in a clinical residency once they have secured a position. A J1 visa which is an exchange visitor program. This visa forces you to come back to your home after 7 years for a minimum period of 2 years. People who are not sure whether they want to come back should not ideally apply for this one.

The other visa is the H1B. This is valid for 6 years and has to be renewed every year but gives you the option of applying for a green card later on and you don’t have to return to your home country if you don’t want to.

The hitch is that your hospital where you get a residency should be willing to sponsor the H1B visa for you. And in order to be eligible for this visa you have to give the USMLE Step 3, which is another tough exam. This is in a nut shell what needs to be done. It is a gazillion times tougher and longer than it seems here.

Expense Involved

  • USMLE STEP 1 = $ 725
  • USMLE STEP 2 = $ 725
  • USMLE STEP 3 = $ 570
  • TOEFL = $ 110
  • TOEFL Score Acceptance = $ 40
  • CSA Fees = $ 1200
  • Books ~ $ 200
  • Return Ticket to the US ~ $ 1000
  • Visitor’s Insurance~ $ 300
  • ERAS Registration Fee = $ 75
  • NRMP Registration Fee = $ 90
  • Application Fee ~ $ 700 to $ 1200 or even more
  • LMonthly Expense for Food ~ $ 150 to $ 200
  • I am hoping you have some chachela aur mausela bhai or bahen ka sala with whom you can stay for the minimum period of their nostrils to support you for that period of time. 4-5 months that you need to be there. Otherwise your parents will be paying thru

  • Traveling expenses for interviews ~ $ 200 to $ 50

So overall you are looking at an expenditure of anywhere from $ 6000 to $ 7000. This is assuming you are not paying any rent for living during the 4-5 months for your exams and applications and interviews etc. Now let’s do what everybody does… …CONVERT… comes to approx. Rs 3 – 3.5 lakhs or probably even more. In spite of all this you are still not assured of a residency position. So the risk involved is evident. But if you get a residency, all this is easily recovered in a year or so. This is when you enjoy converting…….

The Major Glitch And Hitch:
You need to go to Philadelphia to give the exam. That means you require a visa. That means you have to queue outside some American consulate at 5 am in the morning. So after you have given your steps 1,2 and TOEFL and sent the 1200-dollar CSA fee, spending around 2800 dollars in toto and months of studying, you still stand a chance of being unable to go to the US to give the CSA. Why????? Becoz your visa application can get rejected. You need a Tourist/ Business (B1/B2) visa to get there to give the exam. The consulate can reject it. In spite of the fact that you may have record shattering scores, you still cannot go to the US, forget getting a residency. This has happened a to hordes of people I know.

Kaplan And Compass:
These are two companies in the US, which run courses for training students for the USMLE. Compass has opened a branch in Bombay behind Leelavati hospital. If you can afford to spend Rs. 55000 for a six-week course for each step, it might just be worth it. They show you video taped lectures of the live lectures conducted in the US. And they give you notes to study from. These are very specific and so you might not have to read textbooks, which give lot of stuff, which is not really required for the exams. If you are richer then you might want to go to the US and do the Kaplan course out there which costs from $ 2500 to $ 5000 for each step. Similar courses are also available for step 3 and the CSA. Most people who have taken these courses have done very well obtaining scores above 90 percentile. So statistically speaking it might be worth it coz scores are what you require to get your foot into the residency program, at least initially.

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