Working in Miami, Florida

[mtranter]

Hi

I am planning on doing a medical degree, and then move to the USA to Miami.

Can anyone give me some advice on the tests, visas etc that need to be done in order to be able to practice in the States.

Also, do you need to do a PRHO year?

Thanks
Matt

[NEEPO]

hiya there

thats a good plan actually.... i was thinking of going to the US myself.... it is really hard to decide what exact state u want to get into...

well u have already chosen youyr choice of destination....

the tests required are the USMLE's ( step 1- after year 3, step 2- after year 4 and finally step 3 (CSA) after medical school)

it is one hell of a long process... but i suppose it may be worth the hassle esp. when quality of life in the states is generally much better than the UK

Hi

I am planning on doing a medical degree, and then move to the USA to Miami.

Can anyone give me some advice on the tests, visas etc that need to be done in order to be able to practice in the States.

Also, do you need to do a PRHO year?

Thanks
Matt

[AndreucciodaPerugia]

You can do most of USMLE steps 1 + 2 here in the UK but most states will require you do at least a year of residency in the US before you take step 3.

Here's an outline of how it works in the US if you're interested. It's generalized but as far as I know most schools work this way. I'm just saying what I know - I don't know much more than wot's listed here.

So the procedure for most med students in the US is:

1. Apply and get into med school.
2. Pass USMLE step 1 in order to proceed to year 3.
3. Pass USMLE Step 2 in order to graduate. You're now an MD but you're not free to practice until you complete USMLE step 3, usually during first 2 years of a residency.
4. Apply to residency. Many are attached to US medical schools. Your score on USMLE is extremely important here, and your grades in med school count too, though not as much as USMLE since some US med schools (eg Harvard) don't have grades. You also need very strong reccomendation letters. Your residency is like PRHO but it's combined with your field of specialty. If you want to be a family doctor, you apply to family doctor residencies, and most are about 2 years long. If you want to be a cardiothoracic surgeon, or an anesthetist, etc you apply to the appropriate residencies which range in length from 3-8 years. Your residency is VERY important as it pretty much determines where you can work and what sort of jobs you can get. If you get one in the backwaters of Montana, you will likely practice in places like that for the rest of your career. Residencies are not to be messed about with, and should be chosen carefully. You apply for the vast majority through a national program called Match, with exceptions beings residencies for the armed forces (and for some specialities, I think). Being a FMG (foreign medical school graduate, or IMG in some places) it's extremely difficult to get residencies unless your USMLE scores are stellar - and I mean 99th percentile stellar - so definitely take the USMLE seriously. Also bear in mind you'll be competing with experts, many of them with years of experience, from all over the world since everyone who practices medicine in the US needs to complete the USMLE and therefore needs a residency. But don't worry - unlike PLAB and other uncool exams, the US has a blanket policy - even US citizens have to take and pass the USMLE*. But it's still much much harder to get in as a FMG even if you score well - you have to convince the residency program that you're worth the hassle of getting you the right paperwork done.
5. After "being matched" you usually take USMLE Step 3 during your first 2 years of residency. Your first year of residency is what is commonly referred to as "internship" year just to confuse you further, so interns are usually 1st year residents, with most not yet having taken USMLE Part 3. After passing Step 3 you are now a registered physician and allowed to practice medicine unsupervised. You then complete your residency, get board certified in your specialty (more exams, whoo-hoo) and apply for jobs.

Notes:
a) Almost every US med student has completed Steps 1+2 coming out of med school, and certainly before applying to residency. But they are NOT guaranteed PRHO jobs like we are (F1+F2), they have to apply - and while most are matched, a very small # are not as they are not competitive enough that cycle. We're lucky in that we know that 2 years out of med school we're guaranteed to be registered physicians, barring major calamity/malpractice.
b) All three steps of the USMLE must be taken within a 7 year period. With the new F1 and F2 taking 2 years now (drat) instead of one - and bearing in mind you may not get a residency the first time around - you should keep that in mind.
c) Some residency programs don't even look at FMGs, you should check with the individual program before wasting a valuable spot on it.
d) Requirements vary slightly from state to state - definitely check out the state(s) you want to go to's licensure requirements.
e) As far as I know USMLE Part 2 CS has to be taken in the US.
f) Residencies in certain fields (e.g. surgical specialties, diagnostic radiology, emergency medicine, ophthalmology, dermatology, according to Kaplan) are insanely more competitive than, say, psychiatry. Also keep that in mind when you apply. You're also a stronger candidate if you have recs from doctors in the US e.g. from an elective or other medical experience in the US.

Ok that's wot I know. feel free to ask me more but no guarantees that I'll have an answer Good Luck!

*(It's a little more complicated in that our USMLE is a little different, because of the way the ECFMG (Educational Commission for Foreign Medical Graduates) checks FMGs credentials but it's not too diff. Basically we take computer-based USMLE Steps 1 and 2 CK, and then a hands-on clinical skills exam (USMLE Step 2 CS)).