NEWS LETTER

Dear DOCTORS:
Through your esteemed MAGAZINE I would like to draw the attention of the Doctors who are willing to do anything to come to the USA. This letter should not discourage anybody because these are facts, which I am trying to explain on the basis of my experience. Some of my colleagues might think that I am enjoying life here in the USA and do not want anybody else to come here and enjoy with me but it is my sincere suggestion to them that life here is not as charming as it might seem to them back in Pakistan. Residency is not tough but getting into a residency program is really a big deal. The main culprit I would say is the ECFMG and NRMP, who basically misguide and mislead the Foreign Medical Graduates here in the USA. As an example I would like to quote that according to ECFMG 75% in both the USMLE Steps 1&2 are passing criterion but my dear colleagues it is the minimal eligibility requirement to get ECFMG certificate not the residency and according to an estimate there are about 15,000-20,000 Int'l Med. Graduates, who have scores below 80% and they never get matched for the residency. The recent changes in the ECFMG certification requires a CSA (which is basically a test of clinical skills), and since I have worked here, I am sure unless a Foreign Graduate works in this system for 3-6 months he can not pass that test. Agha Khan University is an exception because they usually follow American system of training. Similarly, the 1999 test would be computer based and the ECFMG is planning to open the centers in Karachi, Lahore and Islamabad, which is a very appreciable idea but only and only if the outlook for residency is good in the USA, which is obviously not the case. I can tell you fellows this is another way of collecting money (because the fees would be increased for the examinees). To be honest the data, which is shown by the NRMP after the match, is totally wrong because the unmatched positions are not unmatched in the true sense. As far as the ECFMG is concerned it is one of the richest organization in USA but still they are highly irresponsible and mismanaging the ECFMG affairs. Recently the ECFMG lost the English test papers of many examinees that sat for the exam in Bangkok, and they did not even bother to apologize or compensate for the loss except for US$ 40.00. Honestly speaking in the future the foreign graduates with at least 80% score would be able to get residency, so my suggestion is that if you sit for the exam try to score as good as you can (at least 80%). My dear colleagues please try to understand and it is a sincere advice, because we foreign graduates do everything to come to USA and then we even do honorary jobs just to get some working experience. It is my suggestion to all foreign graduates that please do your house-jobs after graduation although it is not requires but when you go for a residency interview the first question is "what have you been doing since graduation?" Well this is what I really wanted to tell you but still if you plan to come to the USA please try to get some experience in Psychiatry, Anesthesiology and Emergency Medicine because for the next 2-3 years these specialties would be relatively easier to get into. If you plan to take the USMLE in near future please take it seriously and try to score as much as you can and do not just sit at home because you are supposed to be involved in your field after your graduation.
Anyway as an Int'l Medical Graduate it was my responsibility to inform my colleagues and dear fellows if you have any questions or comments please E-mail me at IMGS2000@hotmail.com
Thanks and think about that.
Int'l Medical Graduates Help-line USA.

TOPICS ON JUNE 1998 STEP-1 EXAM:
1. SECOND MESSANGER SYSTEMS. (ALL HORMONES), EXACT MECH. AT MOLECULAR LEVEL. STUDY IN DETAILS.
2. DRUGS RECEPTORS MECHANISM OF ACTION. EXACT MECH., RECEPTOR CHANGES, IONIC CHANGES AND ULTIMATE OUTCOME.
3. ARACHIDONIC ACID METABOLISM. (ALL PG'S SYNTHESIS, THEIR BLOCKERS AT SPECIFIC LEVELS. ASPIRIN VERY IMPORTANT.
4. MOST PHARMACOLOGY QUESTIONS IN CHART FORMAT. LIKE COMPARISON OF TWO DRUGS, WITH THEIR INHIBITOR, ARROWS UP AND DOWN CHARTS AND DIAGRAMS. MOST QUESTIONS FROM CVS (ANTI ARRYTHMIC very important) AND AUTONOMIC SYSTEMS.
5. MANY QUESTIONS ON DIABETES, HYPERTENSION, PRIMARY HEALTHCARE, MEDICAL ETHICS, MICROBIAL GENETICS, CELL BIOLOGY AND NEUROANATOMY.
6. DIAGRAMS ON BOOK-B (1st DAY, 2nd BOOKLET) WERE MOSTLY GROSS PICTURES OF BRAIN AND CT SCANS AND SPECIFIC LOCATION, SPECIFIC BRAIN LOBES (FUNCTIONS) OF THE LESION WAS ASKED AFTER GIVING THE SYMPTOMS AND SIGNS (MOSTLY BLACK AND WHITE DIGRAMS).
7. DIGRAMS ON BOOK-D (2nd DAY, 2nd BOOKLET) WERE MOSTLY HISTOPATHOLOGY, DERMATOLOGY AND HEMATOLOGY (ALL COLORED DIGRAMS).
8. MOST OF THE QUESTIONS WERE ASKED ABOUT THE MECHANISM OR PATHOPHYSIOLOGY OF THE DISEASES AT THE MOLECULAR LEVEL.
9. COUPLE OF QUESTIONS ON PSYCHIATRY MOSTLY DEPRESSION AND PERSONALITY DISORDERS. BUT DO STUDY BEHAVIORAL SCIENCES IN DETAIL.
10. IMMUNOLOGY WAS ASKED IN GREATER DETAILS, INTERLEUKINS, LEUKOTRIENES AND IMMUNODEFICENCIES.
11. QUESTIONS WERE LENGTHY BUT MOST OF THE TIMES THE THING WHICH WAS ASKED WAS IRRELEVANT TO THE QUESTION. SO READ THE LAST LINE OF QUESTION FIRST TO APPROACH IN THE RIGHT DIRECTION. MOST QUESTIONS IN CLINICAL VIGNETTE.
12. HEREDITARY MODES OF TRANSMISSION. (X-LINKED, AUTOSOMAL, LEARN THEM BY PEDIGREE CHARTS)... VERY IMPORTANT.
13. MANY QUESTIONS ON GENETICS, VERY DIFFICULT, MOSTLY GENE STRUCTURE RELATED (LAC OPERON), IF YOU WANNA DO GENETICS DO IT IN GREATER DETAILS.
14. READ THESE TOPICS IN DETAIL AND TRY TO LEARN THE MECHANISM AT MOLECULAR LEVEL. QUESTIONS ON CYSTIC FIBROSIS, ARTHRITIS, POST-STREP GN, GONORRHEA, SYPHILIS, SKIN TEMP. REGULATION, THYROID, MYESTHENIA GRAVIS, CANCER CHEMOTHERAPY, RHEUMATIC FEVER, SLE, BIOSTATISTICS, INFLAMMATORY CELL TYPES IN DIFFERENT BODY REACTIONS (GENERAL PATHOLOGY), SUBSTANCE ABUSE, TOXICOLOGY, ALCOHOLISM, DOCTOR-PATIENT RELATION, URINARY TRACT INFECTIONS, HEPATITIS, COPD, H.O.C.MYOPATHY, LEUKEMIAS, CHOLESTEROL METABOLISM, GENERAL PHARMACOLOGY (DRUG METABOLISM, DISTRIBUTION AND ELIMINATION).
15. THE EXAM WAS MOSTLY OF MOLECULAR /RECEPTOR LEVEL QUESTIONS. IT IS NO MORE AN EXAM OF TRIGGER WORDS.
16. BEST THING WOULD BE TO DO ALL DISEASES/DRUGS/MICROBIAL MECHANISM AT BIOCHEMICAL LEVEL.
17. AUTOIMMUNE DISEASES ARE VERY IMPORTANT. (RA, SLE)

EXPECTED TOPICS FOR OCTOBER STEP-1 EXAM:
DO ALL THE TOPICS OF JUNE 1998 EXAM PLUS THE MEDICAL ETHICS TOPICS, NORMAL CHILD DEVELOPMENT, OLD AGE NORMAL CHANGES, PHARMACOLOGY CHARTS, SPECIFIC MICRO-ORGANISMS (BACTERIA, VIRUS AND FUNGI) INVOLVED IN INFECTIONS AND THEIR MECHANISMS AT MOLECULAR LEVEL, MECHANISM OF DRUGS IN DETAILS, MECHANISM OF DISEASES IN DETAILS, IMMUNOLOGY, BIOCHEM. CYCLES WITH THE RATE LIMITING ENZYMES INVOLVED, BIOSTATS, CARDIOVASCULAR (EVERY ASPECT), NEUROANATOMY AND IF YOU LEARN THINGS WITH THE HELP OF BUZZ (TRIGGER) WORDS, THEN PLZ. DO KNOW THE MEANINGS OF TRIGGER WORDS.

HELPFUL INTERNET SITES FOR STEP-1 MATERIALS:
1. KANSAS UNIVERSITY MED. CTR. (http://www.kumc.edu), GO TO BOARD REVIEW PAGE. EXCELLENT SITE, DO VISIT THIS SITE.
2. UNIVERSITY OF UTAH, WEBPATH. (best site for pathology and hematology diagrams).
3. UNIVERSITY OF IOWA, (best site for dermatology).
4. VERY GOOD SITE FOR DERMATOLOGY PICS. (http://www.derma.med.uni-erlangen.de).
5. FOR CT-SCANS (www.embbs.com). VERY GOOD SITE FOR X-RAYS, CT-SCANS, MRI.
6. UNIVERSITY OF PENNSYLVANIA, VERY GOOD SITE FOR USMLE.

GOOD LUCK TO ALL OF YOU. IF YOU HAVE ANY PROBLEM OR WOULD LIKE TO ADD ANY USEFUL INFORMATION IN THIS DATA, PLZ. CONTACT ME ON MY E-MAIL (jkamal@hotmail.com).
Junaid Kamal
Jkamal@hotmail.com

Back