Hi i'm a 3rd year med student and what with the MMC debacle in this country and very tempted to jump ship and will be sitting the USMLEs.
They specialise much earlier there so you need to know whether you want to be a medic, a surgeon, a psychiatrist etc when you apply for training schemes. The residency programmes vary in length depending on specialty and you may do a fellowship in subspecialty after that.
In my case I want to be a psychiatrist so would apply to do a psychiatry residency which is 4 years long.
In order to apply, if you are from the UK you need to have done step 1 and step 2 exams. Step 1 is supposedly basic sciences but many of the questions are pseudoclinical - i.e. based of vignettes but ask you "what is the genetic defect" or "what is the bug" or what is the "mechanism of action of the drug etc". It's fairly straigtforward but only if you know the answers. Now, we never learnt much of this stuff (e.g. about glucocerebrosidase deficiencies and the like) at my medical school.
The exams are bloody expensive too - over $700 for Step 1 which you'd do in london. Step 2 is made up of clinical knowledge (which is computer based and done in london) and clinical skills (like long case examination) which you have to do in america! and it#s exven more expensive/
I suggest you have a look at the usmle website (
www.usmle.org) - can download questions so know what its like. the syllabus is rubbish though they can ask anything! also look at us medical school websites in their programmes. you would have to do better than US students in the USMLE (even though they have the upper hand) and have to have a good CV (e.g. BSc/MSc/PhD, publications, teaching experience, wide extracurricular base, prizes, and perform well in your med school exams) to secure a good residency as home students come first. Also bear in mind that the average age of a first year med student in the US is 24 so they will have lots more experience etc that average british student.
but yes you can enter a training programme if you are good enough and they can't find anyone else better! Also, after your residency is over you could be kicked out of the country! it is reassuring that people from the UK do go there all the time though so if you are a good student and you really want to work over there you will.
