Time is the most precious commodity one has, and doing the right thing at the right time is crucial. "Failed to plan = plan to fail." Here, I am going to share my USMLE IMG time frame as a former medical student, just so you can get an idea of how to plan ahead:
2013: Enrolled in medical school.
2013-2014: Started learning bench research in university.
2014-2015: Studied my ass off as a second-year med student.
2015-2016: Undertook clinical research at Brigham Endocrinology.
March-June 2016: Prepared for Step 1.
June 2016: Took Step 1.
2016-2017: Came back to Malaysia, resumed as a third-year med student.
December 2017: Took Step 2 CK.
2017-2018: Crazy busy fourth-year med student, spammed Freida website, emailed coordinators for USCE positions.
April 2018: Rotated in a Michigan community hospital.
May 2018: Took the chance to get Step 2 CS done (saved flight money).
August-September 2018: Volunteered at Kathmandu Children Hospital, Nepal.
2018-2019: Spammed coordinators again for USCE.
July 2019: GRADUATED!
August 2019: NIH Cardiology internship.
September 2019: Audition rotation in the same Michigan Hospital.
October 2019: Interview trail started.
February 2020: Interviews ended, submitted RoL.
End of February 2020: WHO Internship in Geneva.
March 2020: Matched!!!
June 2020: WHO internship ended.
End of June 2020: PGY-1 commences.
Remember, this is just one example of a time frame for USMLE preparation and the matching process for an IMG. It's essential to customize your plan based on your circumstances and goals.
The USMLE pathway is time-sensitive, and you can make your life much easier by taking it during your medical school years when you have extra time after school to prepare for these additional tests. You can also do it during Housemanship, but it won't be any easier, so why not take it now?
When you apply for USCE, it's beneficial to have Step 1 and, even better, Step 2 scores ready. When I applied for the Michigan USCE, the coordinator asked for my Step 2 score if it was available. Although not a requirement, it is a plus factor.
Plan your medical school elective, especially the away rotation, well. If your school does not offer it, use the end of the semester break or year-end break to go to the US for your rotation. During the same trip, take Step 2 CS.
Once you have your Step 2 CS, consider applying for the NIH visiting student elective. NIH requires either TOEFL scores of 29/30 or Step 2 CS. I tried TOEFL, but I did not get a near-perfect score, so I used Step 2 CS instead.
If you have completed all the steps mentioned above, engage in volunteer activities or pursue other internship opportunities. I found out about my WHO intern position in December 2019. Later, during my residency interviews, I mentioned this experience and expressed my interest in Public Health, among other topics.
What you do after medical school is super important. Remember that your CV does not end the moment you click "send" on the ERAS application. New work experiences, internships, publications, and even additional USCEs can provide you with ideal reasons to email programs, update them on your professional achievements, and express your interest.
If you don't have the mentioned experiences above, don't worry. What matters is how you spend your time, whether it was wisely spent, and how it contributes to your personal growth.
Touch wood, but if you don't match for that year, at least you have already started planning ahead for the next even better and stronger Match cycle with your new experiences.
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