Hey, Mike here.
How are we doing so far? By now you should have a better idea what IMGs need to do if they want to do well in this exam and get into a US medical residency program. That was the first thing I needed to find out before I can even start planning how to tackle this exam.
It was also clear that the odds are really stacked against IMGs and much more so against old IMGs. Makes you wonder why with all the problems old IMG have with this exam and matching, why I even bothered to continue with my USMLE journey.
Actually, I struggled with that Issue myself. I had started thinking about taking the USMLE way back in 2001, but it wasn't until 2004 that I seriously started to consider it a strong possibility. Even then it wasn't until September of 2005, that I started prepping seriously for the Steps.
Fear was a factor. Fear of change. Fear of failure. All the negativity didn't help. From the forums. From other old IMGs who failed. Even from my own family. The fact that I was considered a "success" in my home country makes it even harder to decide to plunge into the unknown. It would have been easier if I was a complete failure. But choosing between what is good enough for something that may or may not be better is actually a pretty hard decision to make.
So why did I chose to sit for the USMLE Step 1 even if I knew all the problems and disadvantages I faced as an IMG? In order to understand why I did what I did, you need to know more about me. In fact, I had to determine who I am really, before I can truly know what I want. And only after I have figured out what I really wanted, can I have the necessary motivation and determination to get it done.
Knowing yourself is the beginning of all wisdom.
Let me tell you a bit about myself.
I graduated way back in 1989, number 30 in a class of 144 at the top medical college in our country. I had wanted to go to the US to undergo residency training, but due to financial and family reasons, was not able to go. I had sat for the FMGEMS and passed both exams. I got the second highest score in our graduating class. About a hundred of my classmates actually proceeded to undergo residency training in the US.
I had been accepted into an ENT residency program in the top university hospital in our country, however, again due to financial and family reasons, I was unable to continue training since in our country at that time, residency training did not involve financial compensation.
So, I opened my own clinical practice and started seeing patients. It wasn't long afterward before I got some partners and expanded the clinic into a multi-specialty clinic with diagnostic laboratory. From one branch with 9 employees, it had grown to 6 branches with over 120 employees including about 2 dozen physicians seeing over 100,000 patients a year 10 years later.
So it wasn't because I could not make it in my home country as one program director implied during one interview. Actually being a success made it harder to decide to jump into the unknown. Why rock the boat?
By 2001, after over 10 years of running the chain of multi-specialty clinic and diagnostic laboratory, I handed it over to a colleague to run and just stayed on as one of the staff physician and member of the board of directors.
That is when I began to start thinking about my aborted dream of going to the US for advanced medical training. I guess if it was just about the money, then I should have just forgotten about my unfulfilled dream and enjoyed my life.
I mean, I had enough money to work part-time, travel and enjoy my life. Semi-retired before age 40. As my mother likes to say, why ask for pain. Be a glutton for punishment. Why let the sun beat on you, when you can rest in the shade.
But, have you ever had a dream that remains unfulfilled because of circumstances out of your control? Have you ever wondered what you would do if you were given a second chance to fulfill it.
They say that the only thing worst than the pain of failure is the pain of regret. To look back when you are old and in your deathbed and wonder about if-I-only-hads and what-could-have-beens.
Money is no longer a problem. With no family to worry about, for me it's now or never. Even with all the horror stories going around about old IMGs and how hard it is to pass the USMLE let alone match, I decided that I needed to give it a try. Or I would regret it for the rest of my life.
I won't lie. I was afraid. Fear was palpable. Fear of failure. Fear of the unknown. My reputation as someone who has never back down or failed an exam is about to be put to the test.
In fact fear was such a big factor that it wasn't until summer of 2004, that I finally decided to sit for the USMLE . Like everyone, I purchased my first copy of First Aid for the USMLE Step 1.
It didn't take long for me to realize that that was just the start. And that if I only relied on First Aid, I probably would not pass this exam much less ace it. I had to buy tons more books and other study resources. In fact if I had used its resource guide to choose what study materials to use, I would have fared just as bad.
After 15 years out of medical school, it wasn't easy to get back to studying. So if you have a hard time studying, you are not alone. I remembered, the first time I started reviewing Anatomy. To my horror, I realized I fell asleep even before I had finished the first chapter. It was that bad.
So I had to actually sit myself down and asked myself the tough questions. Are you or are you not going to do this. I guess I just needed to psych myself up. Actually, aside from my pride, I had nothing to lose. If I failed, I would be exactly where I am. If I succeeded, then I can move forward knowing what I have accomplished.
Don't fear Failure. Fear being in the exact same place next year as you are today.
There is a saying, "Don't fear Failure. Fear being in the exact same place next year as you are today."
Even then, it wasn't until September of 2005, that I got my act together and started reviewing in earnest. And it was 7 months later on April 2006, that I sat for the USMLE Step 1 and the rest as they say is history.
So the first step to success in the USMLE is to know yourself. As Sun Tzu stated in the Art of War, "Know your enemy, know yourself and in a thousand battles, you will never know defeat".
By understanding the reason why you need to do this exam, to pass this exam, it actually becomes easier to do well in this exam. Because you know the reason why you are doing this. Why you need to succeed at this.
I hope I have been quite helpful in what you need to accomplish in order to succeed in your USMLE journey and what you need to do to successfully enter into a US medical residency.
Til next time,
PS. Next issue we will be discussing about Notes and Flashcards.
An in-depth written guide on how to prep better and score higher for the USMLE Step 1. Read the book. Better Prep. Easier Exam. Higher Scores,
A 48-module lecture seminar on how to prep better and score higher for the USMLE Step 1. Listen to the Lecture. Better Prep. Easier Exam. Higher Scores.