4. RESOURCES

A. FINANCES:

You will need a lot of them, really! All applications and registrations cost money in $$$$$, sometimes payable in your currency, sometimes not. Be prepeared to fish out $$$$$ as follows:

  1. No Fees needed at the time of registration with the ECFMG.
  2. TOEFL costs about $120-130 if taken in the US.
  3. ECFMG charges a TOEFL Score Acceptance Fee. Currently $40. You must also fill a form for it.
  4. USMLE Steps 1 and 2 registration Fees with the application form for each attempt. Currently $ 695 each.
  5. Application Fee for USMLE Step 3. Currently $590.
  6. USMLE Test Center Fees every time you go to take a test. Currently $100 to 200 for each test each administration. This fee is not charged if you take the tests in the US.
  7. CSA administration Fee. Currently $1200 for FMGs! Proposed to be $950 for AMGs for CSE.
  8. ERAS Token Fee when you open your ERAS account online. Currently $75.
  9. NRMP Registration Fee. Currently $90.
  10. ERAS USMLE Transcript Authorization Fee: $50 currently.
  11. Application Fee at ERAS for each residency application you send through it. When you open your ERAS account, check ERAS online for details.
  12. For books, guides, and examination material needed.
  13. For tuitions etc. if you subscribe to them.
  14. For travel inside your country for taking tests, getting visa, etc.
  15. For travel to the US for CSA, interviews and USMLE Step 3. Paid stay in the US is very expensive.
  16. For postage and remittances of money.
  17. Visa Fees. H1B processing fees in the US may be $2000-5000 depending on how quickly you need it. May be free or lower, too.
  18. Visa application and issuance fees at the US embassy in your country.
  19. Notary Fees etc. if applicable.
  20. For use of phones, computers, and internet.
  21. IMPORTANT: For all practical purposes, most fees are nonrefundable.
B. BOOKS AND STUDY MATERIAL:

If you take the tests as you move along your medical course, you should not need a lot of other books and study material except some guide books. A well-stocked medical reference library is invaluable in your efforts and should form an ideal place for all your preparations. If you wish to take available tutorials for the tests, you may need to get study material as guided by your tutors. Go to a bookstore website (see Online Resources on the next page), type 'USMLE Step #', and go through the searched list of books. User ratings are usually provided. The 'First Aid to USMLE Step' books also provide a comprehensive and analytical list of books at the end.

A good list of books can be found here

C. ACCESS TO A COMPUTER AND THE INTERNET

This is of paramount importance for your smooth working and peace of mind. I know some of us hate it, but there is NO escape from the computer and internet in this process. Just consider these facts:

  1. The TOEFL, USMLE Steps 1, 2, and 3 are all computer based tests (CBT). A CBT is fast and more convenient, prevents you from making silly numbering or omission mistakes, helps you in locating and reviewing a marked question, can also incorporate voice based tests (as in a section of the TOEFL), is better for time management, and has the same content as the corresponding written test.
  2. Some ECFMG applications and more than 99% of your residency applications MUST be sent through ERAS through internet. This procedure initially looks complex, but is greatly convenient later on.
  3. Most communication with the residency institutions will be through email only, whether it is about your query about their residency application requirements, your interview calls, or your gentle application reminders.
  4. Some great and most updated help on each step of the process is available online ONLY. After all, you are reading all this online, aren't you? See the point? There are websites and online forums on tests, strategies, visa guidance, visa applications, test and appointment scheduling, books and study material, travel, stay, places, maps, and answers to the whole lot of your questions that you have difficulty in finding elsewhere. Your computer is your post office, your information bureau on any thing, and your most reliable reference library. The bottom line is: Be computer and internet savvy and, if needed, invest some time and money in learning to manage these independently yourself!!
  5. The ECFMG, USMLE, and the FSMB will send you sample examination material and bulletins on a compact disk (CD) which will run on a computer.
D. TIME:

Well! This is the most important of the commodities you are going to spend in the whole process. Try to conserve as much as you can. That can be done by forearming yourself with all relevant information, and having a good sense of logic and time orientation. This should help you in proper planning and understanding of the process. Some of the greatest and wisest persons I know have no sense of these and pay dearly at times. Your aim should be to pass through the whole process as quickly as possible. Much of the time you may just have to sit and wait or study for the tests. Things will not be in your hand. Just look at the following facts, processes, and time-consuming steps:

  1. ECFMG Registration: may take 6 weeks or more. No next steps possible without this one.
  2. Application for USMLE Step 1: About 6 weeks. This gives you a 3-month eligibility period during which you can take the test after seeking an appointment at the Test Delivery Center.
  3. Application for USMLE Step 2: About the same time. Applications for Step 1 and 2 can be sent together in the initial ECFMG registration form. If sent separately, it may take 6 weeks each. The eligibility periods for both may be the same, overlap or be different as per your plan.
  4. Wait for the results of USMLE 1 and 2: 4-6 weeks. Shorter, if you have a US address.
  5. Application for CSA: 6 weeks. Can be sent only after passing TOEFL and Step 1. Remember, TOEFL score has to be 'Accepted' by the ECFMG before your CSA application can be reviewed.
  6. Wait for CSA results: 4-6 weeks.
  7. ERAS opens to candidates after first week of July every year for residencies beginning next July.
  8. ERAS accepts candidates' documents: About second week of July
  9. NRMP opens: 15th September.
  10. Time to scanning of documents by ERAS: (accepted by post only) 2-3 weeks if mailed from outside US.
  11. Time taken by you in sending an application on ERAS: a few minutes if all requirements are met.
  12. Time for your application to show on ADTS: a few hours irrespective of the number of applications.
  13. Time taken by the institutions to download your application: Variable; usually, less than 2 weeks.
  14. Time taken by the institutions to reply: Highly variable, even for saying 'No'! Keep guessing!
  15. Interview period: October to January. Some interviews continue till February, 3rd week. Rarely, till the beginning of residency (I know of one such program, but this one may change in 2003!).
  16. Match results: Declared before 20th March of each year.
  17. Post Match Scramble: For 2 days before Match result day.
  18. Step 3 registration: 2-4 weeks. Scheduling this 2-day test on 2 successive days is not easy.
  19. Wait for Step 3 results: 4-6 weeks from test date.
  20. Obtaining H1B visa authorization from the US: Fast process: 2-3 weeks (for $1000 extra). Regular process: 2-3 months or more.
  21. Residency begins 1st July of each year, usually. Well! You are there! That's it!! However, you may be needed to report to your hospital in the 3rd or 4th week of June. Try to see that you are not delayed in starting your residency to avoid problems in the future.
E. PLUS:

You will need a lot of patience, ingenuity, good luck, and blessings from your elders at home and the medical school!


ONLINE RESOURCES

ELIGIBILITY