Common Problems Of the Old IMG in USMLE Prep

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Common Problems of the Old IMG
Common Problems of the Old IMG

There are many problems that the typical Old IMG faces when preparing for the USMLE. It is important for the Old IMG to be aware of this fact. As these problems of the old IMG has a big impact on the way he should plan his prep.

An Old IMG is anyone who has been 5 years out of medical school. Some have remained in clinical practice, while some have been out of practice for a while. Meanwhile the typical USMLE taker is a fresh graduate or third year medical student.

While it is true that an Old IMG will have a harder time, prepping for the USMLE, it is not an impossible task. While it is true Old IMG will as a group have a lower score than fresh graduates, getting 99’s is not impossible as I and a few Old IMG’s have shown. The most important thing is to have a good study plan and prep properly. And so long as the common problems of the old IMG is addressed, they should have no problem doing well.

What are the factors that usually affect the Old IMG?

First, there are knowledge factors that trouble the old IMG. Old IMGs graduated a long time ago. In my case I remained in clinical practice, but a lot of others have been out of medical practice for some time. A few have never been in clinical practice. These results in the following problems.

  1. Relearning What Has Been Forgotten Due to the time that has passed since medical school, most old IMG have forgotten the details of the basic and clinical medical concepts tested in the USMLE. Therefore there is a need for them to study longer than the usual USMLE taker. This was absolutely true for me.
  2. Obsolete Knowledge. Again due to passage of time, some of what the typical Old IMG knows may be obsolete and he may have to unlearn them in order to learn the more modern medical knowledge tested in the USMLE. Due to advances in medical knowledge, what I thought was medically correct has changed.
  3. Old IMGs may have some specialized knowledge which unfortunately is irrelevant for the USMLE. For those who were in practice, you may have kept up to date through CME’s but focused on your field of specialty. USMLE is about general medical knowledge and a lot of times, those specialist knowledge do not even appear in the examination.

Second, there are prep factors that trouble the old IMG. It’s been a long time since we graduated from medical school, meanwhile the average USMLE taker is a third year medical student or a fresh grad. The result is the following problems

  1. Have Not Studied for Exams for a Long Time. They have not studied continuously for sometime. It takes time to get used to studying for long hours at a time. It requires concentration. Most medical students are used to long hours of study. Most Old IMG’s have not studied long hours for years. Therefore it takes time to get used to studying long hours again. Studying long hours is crucial to doing well in the USMLE. I remember falling asleep with the books open the first time I tried to study anatomy.
  2. Old IMGs are not used to taking exams. It’s been sometime since they participated in any written examinations. Taking examinations is also in part a skill. Therefore, not having taken long examinations for some time can affect your actual performance in the exam. You have to get used to the time pressure, the type of questions, the format of the exam and the user interface. It has been years since most Old IMG’s have sat for long examinations while medical students eat, live and sleep exams.
  3. Lack of Reviewers and Prep Materials for old IMGs. Most of the Reviewers and Prep Courses available are geared towards the typical USMLE taker which are either fresh graduates or third year medical students. Since old IMG have unique problems that need to be addressed, they need reviewers and specific courses  that are geared to their special needs. Yet this is unavailable in the market. In fact, I had to pick and choose and tweak them to suit my needs.
  4. Lack of Study Plans for old IMGs. For Old IMGs who wants to study on their own, there is a lack of formal study plan that will fit the typical old IMG. Most of the study plans discussed in forums are for the the typical fresh graduate or third year medical student and therefore inapplicable for the Old IMG.

Lastly, there are more social and motivational factors that trouble the old IMG. In fact there are so many motivational and social problems facing the old IMG, that there is a special section for it. Start with the article “Social and Motivational Issues of the Old IMG” and proceed from there.

Therefore, there is a need to be aware of these basic problems and plan around them.

We will discuss the various solution the Old IMG can do to address the specific problems stated above in future post. You may want to subscribe to our email list so you can be informed of future blog posts. (Remember if the text is blue and underlined, it means posts have been written and you can access them by clicking on them).

 

 

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17 thoughts on “Common Problems Of the Old IMG in USMLE Prep

  • September 28, 2010 at 6:33 am
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    Hi,
    I am an old IMG who graduated 6yrs ago and never practiced medicine. I took CK2 2yrs ago (without doing step 1 first) but failed and now contemplating of taking it again. I know I did not study hard and did not prepare well beforehand that’s why I flanked. But after following your blog and reading all your posts, I think I can do it. Thanks for enlightening me thru your blog. I think I can pass or maybe ace it, as you would say, with the proper preparation and study.
    I’m married and have a daughter who just started going to school. I want to start studying again. My question is, do I have to do step 1 first before doing CK 2? Or just go ahead and do step 2 ck again since I have studied it before and do the necessary adjustments. I know for myself that I don’t have a good foundation in what you call the Learning Phase. I also have been reading, not really studying, all the kaplan review books if I have spare time. So do you think studying for step 1 will be much better than studying for CK2? Which one do you think will be best for my me? Thanks.

    leon

  • October 11, 2010 at 5:34 am
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    Hi leon,

    Replied to your email,

    Askdoc

  • October 29, 2010 at 2:27 am
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    Hi,
    Really glad to find that someone is remembering old IMG. I’m 5 years out of school and didn’t practice.
    I trying to study for STEP 1 now, but really realizing that I’m trying not studding. I got all kinds of books and video material but you are correct that i can’t get it all together by myself.
    Yes a lot of forgotten but knowledge is coming back here and there.
    You are very correct that long hours of studding are very hard to handle, and get 50% of book a day (how most of the schedules are saying) is impossible.
    I’m thinking about enrolling in your program, but would you recommend refreshing all in my head first by reading what i already got?
    Thanks

  • February 10, 2011 at 10:18 am
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    dear doc, r u willing to start usmle step 2 ck preparation and when? thank u for this very useful information.

  • February 16, 2011 at 3:21 am
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    hi askdoc, it’s about 6 weeks to my exam…5years postgrad IMG, FA 3 times, UW twice…Goljan once…would you say that is good going? any tips PLEASE?
    Thank you so very much…

  • February 16, 2011 at 3:22 am
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    for step 1…THANK YOU…

  • February 19, 2011 at 5:39 am
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    Hi samer,

    Cannot guarantee when I can come up with a step 2 CK prep course, but will definitely start one before the end of the year.

    Askdoc

  • February 19, 2011 at 5:45 am
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    Hi ira,

    What is your qbank scores and what is your NBME? Based on my experience and thousands of students I have advised and observed. Very iffy. Unless you are a genius.

    Askdoc

  • May 5, 2011 at 10:12 am
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    Good afternoon Askdoc,

    I completed my basic sciences in Mexico two years ago. I had a date of March 28th for Step 1 when my wife went into premature labour, at 26 weeks, two nights before the exam. The twins are doing better now so I plan to hit the books again.

    Before the birth of the twins I completed FA twice and did USMLE-World once with scores ranging from 34-52%. I took USMLE-World a second time scoring, depending on subjects, 54-82%. I felt that their was some answer recognition there so I am not sure what my actual range would be. My NBME scores were 162 (test#4), 172 (#1) and 178 (#3). After reading some of your blogs I realize that I will have to change up on my strategies.

    Understanding that I had six weeks off for the twins and and knowing my aforementioned scores and progression, what are your thoughts and recommendations? I would like to sit for Step 1 in July.

    Regards,
    Brion

  • May 9, 2011 at 3:08 am
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    Hi Brion,

    Even if you are just after passing this exam, 6 weeks may not be enough. The problem is its two years since you completed basic sciences, therefore using FA alone is not going to be enough for you. Most people using FA with Q banks alone for review are third year medical students who have just completed their basic sciences and therefore with all concepts fresh in their mind. You need a more detailed review than what you have done so far and 6 weeks will not be enough. Sorry. As to repeating qbank questions. When I did it the first round, I averaged 82%. When I repeated the questions I averaged 99%. When I bought a new qbank, I was back to 82%.

    Askdoc

  • May 16, 2011 at 2:28 pm
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    I am an old IMG and now a Pharmacology PhD student in the US, so I’m not very far from the topics but still don’t remember most of the stuff. It’s still too hard for me to begin and I’m now procrastinating for several months. Besides, the PHD is demanding and doesn’t leave me much time but still I’m determined to take and pass the exams and start residency after graduating from here.

    Could you please tell me what are the best sources for step 1? Kaplan or something else?

  • September 9, 2011 at 4:51 am
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    imimpressed by ur site.its been 2andhalf yrs i completed my medicine. and there is no proper preperation. at this point of time is this the right decision to take steps. plz advice.

  • November 9, 2011 at 12:37 pm
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    Hello there Askdoc,thank u for giving me some inspiration to go ahead and give the usmle a try.I am a very old IMG ,2001 graduate and worked 6 years before moving here to the USA end 2007 and am trying to sit the USMLE step 1 ,initially it was for Feb 2012 but now am thinking of moving it back.Started studing since August 2011 just after getting My Medical Assistant diloma ,tryng to get in the medical field in USA hoping that it can count as US clinical experience for residency appplication,was going to give up USMLE and just start all over again from Med SChool since i am an old IMG and that is ranked so low already but after reading your blog you gave me hope ,and now am aiming for 99 for all my steps for a chance at a residency here in the USA,but i have a few questions,did you get into a residency program here in the US and how hard or easy was it for u? and what materials did u use for your prep.Thank u

  • November 26, 2011 at 9:52 am
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    Hi Pou,

    First, no I did not go into a residency in the US. The reason I took the USMLE was I thought I was going to be moving to the US for family reasons. I decided I don’t want to work in any other field but medicine, so I took it. But after finishing my Steps, my reason for going to the US in the first place was no longer there. So I faced the decision of going to the US just to be a physician in the US or staying where I was with my family. I chose family. Anyway, based on experience of other old grads who got residency in the US and there are many, its not easy, but its doable. Of course the higher your score, the more interviews you get. But understand, your chances are always lower than fresher grads, but its not 0 either. As for materials used, too many to be listed here. Go through my blog and you will read about some of the study materials I used.

    Askdoc

  • November 30, 2011 at 11:27 am
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    Hi,
    Thanks for this article. I’m in the process of studying. Hmm of course I know this all information but… I will be honest I didn’t find any understand in some forums. Actually it really disturbed me and I spent much time to get in the form and start to study. And now I can see the results – they are rising. Who knows If I met your article before I would save my time? So I recommend for old graduates – carefully read the article, accept this info and ignore ambitious opinions from young step takers – you will save your nervous and you will spend your time more effectively for the study.

  • August 18, 2012 at 8:50 am
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    Hi

    I did my graduation in 1992,Now I’m established as an Paediatric Orthopaedic Surgeon. After my Masters(5 yrs course) in Orthopaedics, I did a fellowship in India & scientific observership in USA in Paed Orthopaedics. Now for family reasons I’m going to settle in USA in few yrs time. I want to weigh my possibilities of becoming a practicing Doctor in USA ( As a Surgeon or a Physician). Since my Graduation I always had been in clinical practice. Would u kindly review & tell me about my prospects?

  • December 18, 2012 at 10:45 pm
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    Hi- I read your website and appears interesting. Failed part one and need to retake. IMG grad in 2004 and will retake. I simply did not have enough time to study, maintain a practice (6 offices) and be a husband and father. I am willing to put in the time and effort and your course appears to be what may assist. Many say why? Maybe ego- who knows? But I find that I must pass and that is it. I agree with the younger students and grads having a more accessible knowledge base and I accept that I am burning all ends at this time; however, that is normal. Would appreciate more info regarding your courses and any additional advice. Would like to enroll right after the new year. Thanks- Scott

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