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in
Quick Guide
USMLE Process for Indian
MBBS Students
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The Goal
Residency Fellowship Attending
Length 3 to 7 years, depending Further subspecialty Practise as a Superspecialist
on the specialty you choose training, between 1-3 years in USA or come back and
work in India
Tuition Fee : 0 Tuition Fee : 0 US JOB MARKET
Salary Stipend: $60k-$65k Salary Stipend: $70k-$75k Salary: $256k-$558k
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An Overview of the USMLE Pathway
CV/ Profile
USMLE Step 1 USMLE Step 3
Building
During Medical School Anytime after ECFMG Certification
3rd Yr MBBS Onwards
Recommended After ECFMG
Internship Onwards
Certification + Strong CV
Residency
USMLE Step 2 CK
Application
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United States Medical Licensing Exams (USMLE)
Why IMGs Need to Pass USMLE Step 1 on the
IMG PASS First Attempt?
EXAMS
RGISTRATIONS PERCENTAGE As an International Medical Graduate (IMG),
acing the USMLE Step 1 on your first try isn't just
about getting a good score—it's about standing
2022 - 24,956 2022 - 71%
USMLE STEP1 out in a competitive field. Watch the full video to
2023 - 26,141 2023 - 68%
understand the impact of USMLE Step 1 on your
2022 - 14,077 2022 - 86% medical journey in the U.S. and how to prepare
USMLE STEP 2 CK
2023 - 15,806 2023 - 86% for success!
2022 - 12,287 2022 - 89%
USMLE STEP 3
2023 - 12,764 2023 - 89%
https://www.usmle.org/performance-data
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Disclaimer:
The exact process and documentation changes frequently!
All the information in this booklet is published in good faith and for general information purposes only.
USMLE® is a joint program. The Federation of State Medical Boards (FSMB) and the National Board of Medical
Examiners (NBME) are co-sponsors. None of the trademark holders has any affiliation with ConsultCK.The
ECFMG® is a registered trademark of the Educational Commission for Foreign Medical Graduates. The Match®
is a registered service mark of the National Resident Matching Program® (NRMP®). The NRMP has no affiliation
with ConsultCK. Electronic Residency Application Service (ERAS®) is a program of the Association of American
Medical Colleges. It has no affiliation with ConsutCK. This booklet serves as a general idea and timeline of
requirements.
CHOICE
is the most powerful tool we have.
Everything boils down to choice.
We exist in a field of infinite
possibilities. Every choice we make
shuts an infinite number of doors
and opens an infinite number of
opportunities. At any point we can
change the direction of our life by a
simple choice. Its all in our hands,
our hearts and our minds.
- Anonymous
ckshares
The Inthealth ECFMG Platform: your one stop shop for exam applications and score reports and ECFMG certification
https://www.ecfmg.org/
You can find this page
by going to On-line
services > IWA -
Interactive Web
Applications. This is
the main hub for all
exam applications. If
you haven’t yet, go
ahead and create a
USMLE/ECFMG
Identification number
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Creating an account on the ECFMG website
● Click “I want to apply for ECFMG certification”
● You will request a USMLE/ECFMG identification number
● You will then be taken to another window, fill in the
information
● You will need to wait a couple weeks and ECFMG will send
an email with your USMLE/ECFMG ID and password
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USMLE Step I
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What is the USMLE Step 1 exam?
● Predominantly basic sciences: your first three years of medical schooling
during one 8-hour exam
○ Anatomy, physiology, pathomorphology, biochemistry, pharmacology,
epidemiology, biostatistics, embryology, histology
● 196 is a pass; USMLE Step 1 is now a pass/fail examination. 3 digit score is
no longer reported.
● Number of Questions: Up to 280 multiple-choice questions (MCQs).
● Although now Pass/Fail, a strong Step 1 performance can still impact residency
applications, especially for competitive specialties.
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Once you receive your USMLE/ECFMG ID
Sign in using your USMLE ID and password on the ECFMG website
● You will click “ begin application”
● You will need to fill out the entire form
● You will be asked to select an “eligibility period” in which you can
choose to schedule your exam
● At the end of the form you will asked to make the payment for
the exam
Form 183 status
verification
● Before you can be registered for USMLE,
Please find the link to the official application
ECFMG must receive a verification of your
overview here: https://iwa2.ecfmg.org/overview.asp
application status as a currently enrolled
student or graduate from his/her medical
school.
ECFMG will request status verification from
●
your medical school’s preferred method, either
electronically or via paper form (certification
statement for 183)
●
If your medical school completes status
verification requests electronically, you will be
notified at the end of the online application
process.
Form 186 for IMGs
● Download the ECFMG Form 186. This
● form is used to verify your identity.
Upload your documents on the
NotaryCam website. This website is an
online notary service. Go to the ECFMG
portal of NotaryCam
● Book an interview appointment.
● The online session included: confirmation
of personal details, showing your passport
on the screen, placing a digital signature
on already uploaded Form 186.
● ECFMG will notify you when Form 186 is
accepted.
https://www.ecfmg.org/resources/forms.html
https://www.notarycam.com/
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Await Your Scheduling Permit & Schedule Your Exam!
● It takes ~ 3-4 weeks after sending
forms 183/186
● You will receive an email from
ECFMG. This email will contain
your scheduling permit
● You will then be able to schedule
your exam through Prometric
● Do so well in advance as test
dates fill up quickly especially if in
specific locations
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USMLE Step 1 Resources
Top 5 USMLE Resources You Need to Succeed!
Preparing for the USMLE can feel overwhelming, but
with the right resources, you can ace it!
In this video, CK, India’s pioneer coach for US
residency and fellowship assistance, shares his top 5
must-have resources that every USMLE aspirant
should use. From study tools to practice platforms,
these resources will set you on the path to success.
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USMLE Step 1 Free Resources
Free USMLE Preparation Resources!
We know the USMLE journey can be costly,
especially for IMGs, but you don’t have to break the
bank to prepare!
In this video, CK, India’s leading coach for US
residency and fellowship assistance, shares some
top FREE resources to help you ace the USMLE
without the financial burden.
NBME: Prepare for the USMLE exams by doing mock exams that give you an approximation of the score you will
receive on the actual exam. NBME offers practice exams that look very similar to the real USMLE exam.
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USMLE Step 2 CK
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What is Step 2 CK?
Tests your clinical judgement and diagnoses in internal medicine, OB/Gyn,
●
surgery, pediatrics, psychiatry, emergency medicine, ethics, infectious disease
etc. in a 9 hour exam
● Strong component of Step I material and basic science questions as well, so don’t
forget all that Step I material too quickly
● Suggested to take in internship year after you have completed started most of
your core clinical rotations (IM, OBGyn, Surgery, etc)
● Number of Questions: Up to 318 multiple-choice questions (MCQs)
● The passing score (as of 2024) is 214, but competitive applicants score 240+
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Signing up for Step 2 CK
● Signing up for Step 2 CK is much more simple since you already have access to the
ECFMG website along with your USMLE/ECFMG ID
● Just apply for the exam, confirm your contact information, and pay for the exam
● It can take almost 4-5 weeks to receive your scheduling permit for Step 2 CK
● You will then be able to schedule your exam through Prometric
Step 2 CK Resources
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CV BUILDING TIPS
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What are meaningful experiences for CV?
Dreaming of a stellar US residency? Dive into our
latest reel for the top 10 essentials experiences
every medical student MUST have in their ERAS
profile! From research projects to clinical
experiences, nail down those key elements to stand
out in the competitive residency landscape.
Don't miss out on these game-changing tips!
Have you created your list of 10?
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Free certificate courses for CV?
Strengthen your CV & Linkedin Profile with FREE
certificate courses!
Dive deep into essential topics and boost your medical
knowledge.
Expand your horizons and excel in your USMLE journey.
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TOEFL VS OET?
TOEFL or OET: Which Exam Should MBBS
Students Take for USMLE?
If you’re an MBBS student aiming to pursue
USMLE and a residency in the US, you might
be wondering whether to take TOEFL or
OET.
Here’s what we cover:
✅ TOEFL: Who needs it and when it’s
required
✅ OET: Is it relevant for USMLE applicants?
✅ How to decide based on your career
goals and destination country
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OET exam: ECFMG’s Communication Skills Requirement and
English Language Proficiency
● To meet ECFMG’s requirement, applicants must attain a minimum score of 350 (Grade
B) on each of the four measured components of OET Medicine: Listening, Reading,
Writing, and Speaking.
● You can take the exam in India. The exams take place twice a month.
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General USMLE Exam Tips
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Be SYSTEMATIC!
● Review UWorld questions regularly, they are a fantastic resource
and should be the backbone of your studying. You will quickly get
familiar with USMLE-style questions.
● As soon as you commit to the USMLE exams, create a schedule and
stick to it. You will need A LOT of motivation and preparation!
● The USMLE exams may have a different focus than NeetPG exams,
but there will still be considerable overlap. If you study hard, you
will be prepared for both!
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Study SMART!
Consider USMLE Q’s as your virtual rotations
● During your rotations (i.e. Cardiology), incorporate USMLE
resources and techniques into your every day routine
○Review UWorld Cardiology questions
○ Review the Cardiology chapter piece by piece in your First Aid
textbook
○Check out some USMLE-specific videos about the topic (for
example, B&B) if you have access to them
● This will not only help you prepare for the exam, but will help you
keep a routine during your studies!
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ECFMG Certification
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ECFMG Certification
● Verification of medical studies for international medical graduates is mandatory step in
order to obtain specific state licensure and to begin residency
● Required: Step I, Step 2 CK and OET test (Occupational English test) + Medical School
Degree + accreditation via one of the ECFMG pathways
You DO NOT need ECFMG certification to apply for residency, BUT you must
have it before you start residency - long processing time, start ASAP!
https://www.ecfmg.org/certification/index.html
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USMLE Step 3
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When should I complete Step 3?
● Most people complete Step 3 before starting their first year of residency
○ Many clinical scenarios, focused on diagnosis and management, so it’s helpful to get some clinical
experience before jumping in to this exam
● You may consider applying for it sooner if you are an IMG considering an H1B visa, in which case
you must have your score in hand before match day
Step 3 Resources
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US Electives/Observerships
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US Electives/Observerships
Ready to ace your US Clinical
Strongly encouraged during pursuit of a US residency Rotation? Check out our latest reel
Many programs require at least 12 weeks of US-based electives Availability ever- for the ultimate guide tailored just
changing, but start to research electives or observerships early. for you, medical students!
Some electives may require a “tuition” Some require that you have completed your Don't miss out on this insider
USMLE Steps and/or core clinical rotations, but requirements vary between
insight to make the most of your
programs and opportunities
Be persistent, reach out to programs directly to see if they offer electives for IMGs clinical experience in the US!
Research about 12 Week NY Rule for IMGS
3 Must-Ask Questions for Your US Clinical Rotation Service Provider
1️⃣ Is the hospital or clinic accredited, and are the physicians board-certified?
2️⃣ Will I get hands-on experience, or is it strictly observational?
3️⃣ What kind of documentation or LORs will I receive after the rotation?
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Residency Application
FREIDA Online: Helpful database of all residency programs, including a general overview of whether they
take international medical graduates (IMG) and/or offer J1/H1B visas. Student accounts are free of charge.
https://freida.ama-assn.org/
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Residency Application Timeline
https://students-residents.aamc.org/applying-residency/article/eras-timeline-img-residency/
MyERAS: The platform
through which you will
apply for residency, and
perhaps fellowship in the
future. When your
application season comes,
you need to create a
“token” for yourself.
https://apps.aamc.org/myeras-web/
https://aamc-orange.global.ssl.fastly.net/production/media/filer_public/3f/bf/3fbf8f53-48e0-41ed-
89fb -37eab539eefa/aamc-eras-residency-applicant-checklist.pdf
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Total Expense in the USMLE Process
Expense Category Estimated Cost (USD) Are you an International
Medical Graduate (IMG)
📌 USMLE Exam Fees (Step 1, Step 2 CK, Step 3) $3,000 dreaming of a residency in
the USA?
📚 Study Materials (UWorld, First Aid, Pathoma, NBME, etc.) $2,000–$4,000
Wondering about the costs
🛂 Visa & Documentation (B1/B2 Visa, SEVIS, Insurance) $500–$1,000
involved in this journey?
✈️ Travel & Accommodation for Exams (Step 3 in the U.S.) $1,500–$2,500
In our latest video, we break
down all the expenses you need
🏥 US Clinical Rotations (3 Months) (Electives, Observerships, $10,000–$12,000
Externships) to consider :
📑 Residency Application Fees (ERAS, NRMP, ECFMG Certification) $2,500–$5,000
✈️ Travel & Stay for Residency Interviews (If in-person) $3,000–$5,000
🏡 Living Expenses in the U.S. (6 Months) $8,000–$15,000
Health & Malpractice Insurance (For Rotations & Stay) $500–$1,500
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Personal Statement
Your personal statement is your chance to shine
beyond your scores and CV!
● Approximately 1 page essay about your story:
why did you study in India? Why are you choosing
this residency? Do you have any deficiencies in
your application that you have to explain? What
are your academic goals? What are you looking
for in a residency?
● Read this over and over and over again. Proofread a
thousand times. Have your friends and family read
this. I have seen good candidates be thrown away
from the pile because of a horribly written personal
statement. This is important and the first glance at
your personality and your “fit” for the program.
Take your time.
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Letters of Recommendation (LOR)
● Most programs require at least three (3) LORs, maximum four (4)
Ask for these from trusted mentors well in advance, you do NOT want any surprises on your LORs
● You should have at least one letter from someone within the specialty to which you are applying
LORs from US physicians are highly regarded; be sure to ask physicians throughout your
electives/internships.
● These need to be uploaded into ERAS by the LOR writer themselves - you should not upload these!
● Letters are valued more if you’ve “waived your right to see the letter”
Therefore, the LOR writer needs to create an ERAS account for themselves. You will provide them with a
LOR Upload code. Ideally, this needs to be done before September 1st - the day you are expected to send
your full and complete application
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MSPE or “Dean’s Letter”
● This is a letter that is approved and uploaded by the Dean’s office
It includes evaluations from pre-clinical rotations and core rotations
○ Core rotations: Pediatrics, Surgery, Internal Medicine, Obstetrics & Gynecology,
Family Medicine, Psychiatry
● It’s a summary of your performance, expected graduation date, any
deficiencies or interruptions in training, and extracurricular contributions
● There is a standard AAMC MSPE format, however you can also reach out to
your admin office or your seniors for format which college currently uses.
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Medical School Transcripts
● The Dean’s office will have to upload these directly into ERAS
● Each document takes time to process, so again, leave yourself enough time
● Every medical college have their own trancript format, avoid copying from
friends of other medical colleges however you can also reach out to your
admin office or your seniors for format which college currently uses.
● Make sure your Internship Completion Certificate (ICC) is also part of your
final medical school transcript.
NRMP is a separate platform
through which “the Match”
happens. You have to sign
up for this separately in
order to participate in the
Match, and this usually
opens up in the middle of
the interview season.
https://www.nrmp.org/
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State Licensure
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After You MATCH!
● Each and every State has specific requirements
regarding licensure, You need to be licensed to
practice medicine in the state in which you are
doing your residency
● Be sure to communicate with your residency
program right after Match Day (March) in order to
get the licensure application process going ASAP
● Depending on the state, this can take many months
to complete and you cannot start residency
without a license in your hand
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Just when you think it’s over …
● Fellowship applications will require many of the same documents from
the Dean’s office (medical school transcripts, MSPE/Dean’s letter) …
● and, any and every new state licensure will as well! If you think your
● academic career will be a lengthy one, it’s worth considering investing
in a one-stop-shop credential verification platform:
https://www.fsmb.org/fcvs/credentials-verification-process/
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Helpful Resources
● https://www.ecfmg.org
● https://www.ama-assn.org/education/international-medical-
education/practicing-m edicine-us-international-medical-graduate
● https://students-residents.aamc.org/applying-residency/applying-
residencies-eras/
● https://www.nrmp.org/match-data/
https://www.usmle.org/exam-resources/step-1-materials
Resilience is not about being
invulnerable to hardship. It’s
about accepting adversity as part
of life. Some struggles are
challenges to conquer. Others are
weights to carry. Strength doesn’t
come from avoiding setbacks. It
comes from refusing to be defined
by suffering. -Adam Grant
ckshares
