Residency Programs In The United States

1
Residency Programs In The United States
2
U.S. MedicalEducational System
4 years College/University
6 years Medical School
Residency Programs In The United States
MCAT Exam
4 years Medical School
Residency (3 to 7 years)
3
What is a residency program?
A residency program is a period of education and
training in a chosen specialty that physicians
undergo after they graduate from medical school.
Most residency programs last from three to seven
years, during which residents care for patients
under the supervision of physician faculty.
When physicians graduate from a residency
program, they are eligible to take their board
certification examinations. Residency programs
are sponsored by teaching hospitals, academic
medical centers, health care systems and other
institutions.
4
What is the Accreditation Council for Graduate
Medical Education?
The ACGME is a private, non-profit organization
that accredits 8,300 residency programs in 126
specialties and subspecialties that educate
107,000 residents. Mission, Improve health care
by advancing the quality of resident physicians
education through accreditation.
5
Who is eligible to apply to residency
programs? The U.S. Medical Graduate
IMGsECFMG USMLE
6
The U.S. Medical Graduate,

• A medical student officially enrolled in, or a
  graduate of a US medical school program leading
  to the MD degree that is accredited by the
  Liaison Committee on Medical Education (LCME),

Residency Programs In The United States
7
The International Medical Graduate
(IMG)

• Anyone from an accredited 6 year program from
  outside the U.S. https//imed.faimer.org/
• Includes U.S. citizens with a non-U.S. education
• Must be certified by ECFMG prior to patient
  contact in the U.S.

Residency Programs In The United States
8
ECFMG Certification!

• Assures residency program directors and the US
  public that the international medical graduate
  (IMG) has met minimum standards to enter US
  residency programs
• Prerequisite for all IMGs for
• Entry into ACGME-accredited GME

Residency Programs In The United States
9
ECFMG AND USMLE
ECFMG
USMLE
Residency Programs In The United States
USMLE Step 1
USMLE Step 1
USMLE Step 2
USMLE Step 2 (CK CS)
Step 2 Ck
Step 2 Cs
USMLE Step 3
10
ECFMG Certification Requirements

• Exams
• USMLE STEP 1Medical Sciences
• USMLE Step 2
• Step 2 CK (Clinical Knowledge)
• Step 2 CS (Clinical Skills)

• Credentials
• Completion of all requirements for final medical
  diploma
• Receipt of final transcript
• ECFMG verification of credentials

Residency Programs In The United States
11
ECFMG Medical School Web Portal (EMSWP),
Through EMSWP, international medical schools have
access to a free, web-based program that enables
them to verify the status of their students and
graduates who have applied to ECFMG for the
United States Medical Licensing Examination
(USMLE).
Residency Programs In The United States
12
USMLE Step 1

• Fees 840
• Eight-hour, 45 minutes break, multiple-choice,
  computer- based test
• Covers basic medical sciences
• Anatomy
• Behavioral sciences
• Biochemistry
• Microbiology
• Pathology
• Pharmacology
• Physiology
• Interdisciplinary topics

Residency Programs In The United States
13
Step 2 CK- Clinical Knowledge

• Fees 855
• Nine-hour, 45 minutes break, multiple-choice,
  computer-based test
• Test questions focus on the principles of
  clinical science.
• The first section deals with normal growth and
  development, basic concepts, and general
  principles.
• Other Sections focusing on individual disorders
  are subdivided according to Physician Tasks
• Promoting Preventive Medicine, Understanding
  Mechanisms of Disease, establishing diagnosis,
  applying Principles of Management

Residency Programs In The United States
14
Scheduling USMLE Steps

• Choose an appropriate three month eligibility
  period and testing region.
• Send completed paper application and fee to ECFMG
  or apply online using Interactive Web Application
  (IWA).
• Receive Scheduling Permit from ECFMG electronic
  scheduling permits through (IWA).
• Register and schedule a testing appointment with
  Thomson Promteric.

Residency Programs In The United States
15
STEP 2 Clinical SKills (CS)

• Purpose of Step 2 CS
• Description of Step 2 CS
• Registration and scheduling
• Scoring

Residency Programs In The United States
16
Purpose of Step 2 CS!
To ensure that graduates of medical schools
demonstrate the ability to gather and interpret
clinical patient data and communicate effectively
at a level comparable to standard students
graduating from U.S. medical schools.
Residency Programs In The United States
17
Description of the Step 2 CS

• One day, hands-on exam in limited U.S. sites
• Fifteen-minute examinations of twelve
  standardized patients
• 10 minutes to compose the written record of the
  encounter (Patient Note)
• Covers internal medicine, surgery, obstetrics
  and gynecology, psychiatry, family medicine and
  Pediatrics.
• 30 and 15 minutes break
• Tests
• Data-gathering skills including medical history
  taking and physical examination skills in patient
  note
• Communication / interpersonal skills
• Spoken English language proficiency

Residency Programs In The United States
18
Scheduling Step 2 CS

• Fee 1,200
• On-line and paper application are available via
  the ECFMG website.
• Applicants must take Step 2 CS within 12 months
  of their registration date.
• Applicants can select a testing location, subject
  to availability, at the time of scheduling.
• Receive Permit from ECFMG.
• Exam is administered at five clinical skills
  evaluation centers Atlanta Georgia, Chicago
  Illinois, Houston Texas, Los Angeles
  California Philadelphia Pennsylvania.

Residency Programs In The United States
19
On-line Applicant Status and Information System
(OASIS), https//oasis2.ecfmg.org/
ECFMGs web-based information service for ECFMG
applicants. Applicants for ECFMG
certification can use OASIS to check general
information as well as the status of items
related to ECFMG Certification. You can also use
OASIS to make a payment, update your contact
information and access your exam results.
Residency Programs In The United States
20
Scoring

• Passing performances on all three components in a
  single administration are required to obtain the
  overall designation of passing on Step 2 CS.
• For ECFMG certification, there is no limit on
• the number of attempts to enter Step 2 CS.
• CS test can not be re-taken within 60 days of
  last attempt.
• CS test can not be taken more than 3 times in any
  12-month period.
• Results are finalized within 6 to 8 weeks after
  the examination date.
• Scores are reported in a Pass/Fail designation.

Residency Programs In The United States
21
Timing of Examinations
Residency Programs In The United States

• Must have completed three years of medical school
  before applying to take any part of the USMLE
  Step 1, Step 2 CS, or Step 2 CK.
• Tests may be taken in any order.
• All three tests must be passed within a
  seven-year period.
• If all three are passed, results do not expire.

22
Steps To Residency
USMLE Step 1
Residency Programs In The United States
Step 2 CK
Step 2 CS
ECFMG certification
Applying to Residency Programs
23
Finding A Residency
Residencies The Graduate Medical Education
Directory (Green Book) Accreditation Council for
Graduate Medical Education (ACGME) database
http//www.acgme.org/adspublic/
Residency Programs In The United States
Fellowships International Fellowships in Medical
Education (IFME) http//www.ecfmg.org/faimer/
24
Applying to Residencies
1- ERAS (Electronic Residency Application
Service). 2- NRMP (National Resident Matching
Program).
Residency Programs In The United States
25
Applying to Residencies

• ERAS (Sep. Oct.)
• Apply directly to program directors by using the
  ERAS (Electronic Residency Application Service).
• ERAS transmits residency applications, Original
  Documents for Letters of Recommendation (LoR) and
  Medical Student Performance Evaluations (MSPEs) ,
  and other supporting documents to residency
  program directors via the Internet.
• http//www.ecfmg.org.eras

Residency Programs In The United States
26
ERAS and Residency Programs

• Program coordinators can access the system
  and check applicants requests.
• Programs categorize applicants according to
• ECFMG test scores,
• previous clinical experience,
• recommendation letters,
• community service (volunteer work) etc.

Residency Programs In The United States
27
Residency Programs

• The applicants are then invited for interviews.
• Interview (Nov., Dec., Jan.)
• Applicants need to be qualified to meet the
  selection criteria. The ACGME endorsed general
  competencies for residents in the areas of
• Patient Care
• Medical Knowledge
• Interpersonal and Communication Skills
• Professionalism

Residency Programs In The United States
28
The Match

• National Resident Matching Program (NRMP)
• Applicants rank programs programs rank
  applicants
• NRMP application is separate from ERAS/program
  application http//www.nrmp.org

Residency Programs In The United States
29
The Match

• Applicants have to be aware of the options of
  Inside the Match
  and Outside the Match positions. However, its up
  to the program director to allocate positions in
  and outside the match.
• In February, after the interviews the applicants
  have submitted their program preferences (Rank
  order list) applicants rank their preferences and
  programs rank their preferred applicants.

Residency Programs In The United States
30
Post Match Scramble

• On the Tuesday of the match week
  (third week of March) a list of
  unfilled positions is posted on the website.
• It is very competitive and all positions could
  literally be filled within an hour.

Residency Programs In The United States
31
Programs

• More chances of being accepted in certain
  specialties such as Internal Medicine, Family
  Medicine and Pediatrics than other fields like
  Orthopedics or Ophthalmology.
• Regular programs (3 - 4 years) in areas such as
  Internal Medicine, Family Medicine and Pediatrics
  take only 3 years, Surgery is 5 years, Psychiatry
  is 4 years and Neurosurgery is 7 years. For
  subspecialties like Cardiology, applicants have
  to take a 3 year program of Internal Medicine and
  then Cardiology for another 3 years.

Residency Programs In The United States
32
Criteria for Acceptance in Residency Programs

• Exam scores
• Past academic performance
• Recommendation letters
• Patient Care
• Medical Knowledge
• Interpersonal and Communication Skills
• Professionalism

Residency Programs In The United States
33
Visa Application

• Must contact U.S. Embassy/ Consulate once
  DS-2019 received
• Must guarantee intent to return home
• Must apply for an interview as early as possible

Residency Programs In The United States
34
Steps To Residency
USMLE Step 1
J1-VISA
Residency Programs In The United States
DS-2019
Step 2 CK
Acceptance
Step 2 CS
Matching Programs
ERAS
35
THANK YOU GOOD LUCK Rohayma Rateb