Licensing Exams USMLE MCCEE/MCCQE

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Licensing ExamsUSMLEMCCEE/MCCQE
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Licensing Examinations

• United States
• USMLE Step 1 (US Medical Licensing Examination)
• USMLE Step 2 Clinical Knowledge (CK)
• USMLE Step 2 Clinical Skills (CS)
• USMLE Step 3
• Canada
• MCCEE (Medical Council of Canada Evaluating Exam)
• MCCQE Part 1 (Medical Council of Canada
  Qualifying Exam)
• MCCQE Part 2

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Taking these tests

• USMLE (Steps 1 and 2)
• Should be taken by everybody
• WHY?
• Canadian students should be aware that it is much
  easier to get a residency (at this point in time)
  in the United States when compared to Canada
• MCCEE / MCCQE
• Should be taken by those who would like to do a
  residency in Canada
• MCCEE must be taken before MCCQE and cannot be
  taken until 9 months prior to graduation

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Outline

• USMLE Step 1
• Can be taken any time after second year
• What is it?
• What does it test?
• When should I take it?
• How should I study for it?

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Step 1 What is it?

• The purpose is to determine if an examinee
  understands and can apply important concepts of
  basic biomedical sciences, with special emphasis
  on principles and mechanisms underlying health,
  disease, and modes of therapy

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Step 1 What is it?

• Its a one-day, 7-hour, multiple-choice exam,
  that you take in blocks of 60 minutes
• Each block consists of 50 questions
• Items tested will vary randomly from subject to
  subject

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Step 1 7 core subjects

• Anatomy
• Biochemistry
• Includes Cell biology, genetics (molecular and
  macro), metabolism and nutrition
• Behavioural Sciences
• Psychiatry, psychology, epidemiology, sociology
• Microbiology/Immunology
• Physiology
• Pharmacology
• Pathology

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What does it test?

• principles and mechanisms underlying health,
  disease, and modes of therapy
• These are typically integrated across the 7 core
  disciplines
• The exam expects you to know the what and thus
  asks why.

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Example

• A 24-year-old woman presents with a 3-day history
  of fever, chills, chest pain, and cough
  productive of rust-colored sputum. Past medical
  history includes a splenectomy 1 year ago. A
  chest x-ray film indicates consolidation of the
  right lower lobe. Blood cultures are positive
  for alpha-hemolytic gram-positive diplococci.
  Immunity to the causative organism is based on
• A. alternative complement pathway activation
• B. antibody to an alpha-helical coiled fimbria
• C. IgA antibodies to C carbohydrate
• D. IgG antibodies to C carbohydrate
• E. IgG antibodies to a surface acidic
  polysaccharide

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Answer

• The correct answer is E.
• The patient in this question has pneumococcal
  pneumonia (Streptococcus pneumoniae), which must
  be considered in any patient with chills, fever,
  chest pain, and cough productive of purulent,
  rust-colored sputum.
• The only recognized virulence factor of S.
  pneumoniae is its carbohydrate capsule (which
  contains acidic polysaccharides).

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USMLE Step 1 - Scoring

• About 3-4 weeks after you sit the exam youll
  get your score report.
• The minimum passing score is 182.
• There is a 3 digit score and a 2 digit score
• The two-digit score is derived from the
  three-digit score. It is used because some
  medical licensing authorities have requirements
  that include a passing score of 75. Thus, a
  passing score,182 75.
• The 2 digit score IS NOT YOUR PERCENTILE
• Thus, exam scores are reported as 182/75

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When Should I take Step 1?

• Step 1 and Step 2 CK/CS can be taken any time
  after 2nd year
• In the US, 2nd year medical students take USMLE
  step 1 during the summer between 2nd and 3rd
  year.
• GMP international students are allowed to take 1
  4th year rotation off to study for USMLE (any
  step)

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When should I take Step 1?

• Option 1
• Summer between 2nd and 3rd year
• Option 2
• After mid-year break in 3rd year
• Option 3
• First rotation in 4th year
• May be taken off or done during 4th year rotation
• Option 4
• Doing Step 1 and Step 2 at same time

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When should I take Step 1?
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Logistics

• USMLE step 1 can be taken any time after youve
  completed 2nd year
• Go to ECFMG website and register to take Step 1
• You nominate a 3 month window period
• Must be at least 2 months away.
• You nominate a region which you CANNOT CHANGE
• You must therefore decide where you want to take
  it
• Must pay upon registration

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How should I study for it?

• Discipline Approach
• Study the 7 core disciplines separately
• PROS
• The vast majority of books are organized by
  discipline
• The vast majority of question banks are organized
  by discipline
• CONS
• Difficult to integrate
• Systems Approach
• Study the 7 core disciplines as a system
• PROS
• Good integration
• Useful to approach with GMP
• CONS
• Many items are difficult to place into a system
  (e.g., basic pathology, genetics, strange
  microbiology questions)

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3 step method for the disciplines

• Basic Terms and Definitions
• Core vocabulary
• Use of associational memory
• Study Plan brute force memorization
• Central Concepts
• Meaning of concepts
• Use of reconstructive memory
• Study Plan diagrams, tables, pictures,
  discussions
• Apply the Concepts
• Questions, questions and more questions

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Resources

• ?GMP
• Review books
• Review courses
• Question books/websites

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GMP Coverage
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GMP and USMLE

• Pathology can be interpreted several ways
• GMP offers good overall structure
• Poor on rare (but frequently tested) syndromes
  and associations
• Bugs and Drugs
• Pharmacology is used to integrate many basic
  science concepts
• Learn pharmacology early
• Microbiology and immunology are high yield and
  neglected by the course
• Biochemistry
• 1.01, 1.02, 7.05 and 7.06 are it.
• All the metabolic and genetic diseases need to be
  learned (theres more to biochemistry than PKU!)

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Books

• Buy early and use often
• First Aid for USMLE Step 1
• Key!
• Cannot be your only source
• Use the library books before purchasing
• An extensive number of current USMLE texts are
  available
• Dont just go with one series
• Board Review Series (BRS)
• Rapid Review
• High Yield Series
• Underground Clinical Vignettes
• Platinum Vignettes

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Review Courses

• Kaplan
• WebPrep
• Approx. 70 hours of lectures on the internet
• 800 US
• Access is for 3 months
• Centre Prep/Deluxe Prep, etc
• Approx 120 hours of lectures either on video at
  the Kaplan centre or in person
• 70 hours is already on the webprep
• 3500-6000
• Princeton Review

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Questions

• Kaplan
• Most like the USMLE
• QBank (2200 questions)
• Integrated Vignettes QBank (1100 questions)
• Various options for subscription over the web
• QBook (800 questions available in September)
• Rapid Review
• Each text comes with a CD of 300-500 questions
• One text devoted to questions (1000 questions)
• Available in the library
• NMS
• Robbins

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Where do we go?

• How to study for each section
• Study techniques for USMLE step 1
• Memory techniques
• Question answering techniques
• Case Studies
• USMLE Step 2
• MCCEE/MCCQE

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Questions?