بعض ما قاله طبيب يختص في أمريكا:

I graduated from the school of medicine at Univ of Damascus. at that time, I was stupid enough to think that few year of speciality will give me good training.

now after being in the US for a while. I think my years in Syria were wast of time.. I have learned for sure. but nothing to justify wasting years of my life.

__________

Continuing your medical education in the US, Personal experience

When I was in medical school in early 1990s, I always dreamed of going to complete my ‎study in the US. Unlike all the others in my class, I came from working low-income ‎family. My father and mother were teachers. It was too expensive to think about the ‎USMLEs then. I was confused and always tried to comfort myself by saying that it is as ‎good to do subspecialty in Syria. I had good grades then that let me go to any specialty I ‎wanted. I thought about internal medicine in the University. I spent some nights in ‎Almouassat’s ER when I was a student. I got to know the residents and had good ‎relationship with most of them.‎

By the end of my 5th year, it was very clear to me that I got most of what the internal ‎medicine resident have got in Moussat and Assad Hospital. I could see myself how the ‎professors treated them and that training is very limited. Namely speaking about ‎Neurology, Cardiology and GI.

In my sixth year, I managed to study for USMLE step-2. I had good friend in the same ‎class who lent me some money and I took the exam in Turkey (we did not have center in ‎Syria at that time) and passed with relatively good scores at that time. By the time the ‎result was back I found myself as an internal medicine resident in Alassad hospital. I ‎thought I would do one year and go to the US. The first year was so hard that I could not ‎take USMLE Step-1 in March as I planned at that time. I had to take it next October at ‎the beginning of my second year of residency. This time I had to go to Egypt and I passed ‎with good scores too. By that time I started sending my application (was paper ‎applications then). I was too late then and did not get any interview.

Next year I got my ECFMG certificate already (this is before the CSA era) and I was then ‎in my third year residency. Luckily, the third year was so easy that I could work in some ‎outside clinics and do some paid calls to collect some money for my trip to the US. I took ‎the third year (specialty) exam on November 15. I flew to NY on November 17 and did ‎my first interview on November 21.

In New York, I lived with a friend who came only one year a head of me. He was very ‎nice to host me. I spent all the money I had ($2100) to do my first 10 interviews. I had to ‎work to get some money to finish my other 2 interviews. I think I could at that time ‎borrow some money from my friend. But I was so sensitive and unsure what to do. I ‎ended up working (illegally) in flower delivery in New York City and then moved to ‎labor work.

I managed to match in a good place and I came back to Syria. I got engaged to a long-‎time medical school friend. Now we have been here for 5 years and we have one ‎daughter and expecting another!‎

Being very social in Syria and the US, I know now that at least 100 of our classmate are ‎now in the US! I don’t know any other class that sent that many to the US. Being here I ‎learned about most of my friends experience, from the most successful ones to the ones ‎who went back to Syria. I always wanted to give good advice to people who are coming ‎or to come in the future. I do encourage any one of you to think about coming to the US ‎and I am sure that 99% will not feel sorry for this decision.‎

I will be writing to you periodically to give you detailed advice about what to do and how ‎to prepare yourself to come to the US.‎

Thank you

USYMD

________

Why the US?

If you will leave your hometown, why don’t you leave it to somewhere that worth all the moment of homesickness you will have.

Here are some reasons why I think the US is the best destination for any medical student or resident. Remember that this is my personal opinion and you are welcome to express your opinion(s).

1) There is not doubt that the best medical centers in the world are in the US. I know that it will be extremely difficult to get trained at Mass General Hospital or Mayo Clinic but your will be surprised how close is the level of training is between different program in the US. The ACGME makes sure that every training program should have requirement set by the federal government.

2) If you want to go back to Syria (which I hope most of you will) you will have an American Board. If you decide to go to Saudi, Emirates or any Arab country you will have the same reputation. I personally think that you can go to France and work there!

3) Unlike any other European country, you don’t have to waste one year to study the language. Of course you will have to work hard on your language but that is different burden.

4) I think it is cheaper to live in the US (cheaper than the UK, Germany or France) and you get decent salary that you can save some of it and send some to your family if you need to. And average resident gets $2200 a month. Most of us can live with $1500 or less.

5) If you want to work harder, you can. During your residency you can get extra night calls. You usually get $500-to $700 a night. That much money can improve your family economy for one month.

6) Needless to say that United States is a continent. You can choose the city and the weather you like. From cold snowy weather in the north to a very hot weather in Florida/ Texas to mild weather. Etc…

7) US is a mixture of all cultures. You will find people from all over the world. You may be surprised that the Americans are friendlier with Arabs than the Europeans even after 9/11.

8) You will find here an Arabic community in every major city in the US. I am in a 300,000 city. Syrian residents are more that 50 in this city! There are 5 mosques in this city and 1 Syrian church! More than 9 Syrian-Lebanese restaurants. And this is true in almost all major cities in the US.

9) If you plan to continue in academic medicine (research or teaching) the United States is the place to go for sure! They are teaching me now how to teach. I get feed back from experienced professors after each lecture I give to the medical students here. It is not enough to be the top of your class to be a good teacher. Teaching is different skill and art itself.

10) When you are a student your primary goal is to learn, you will take care of some patients to learn. But when you are a resident, your main job is to take care of your patients. Learning comes as a result of clinical duty. In the US there is daily “protected teaching time” between 1-2 hours everyday. Meaning that someone will cover your patients during that time even if they are dying! We did not have that in Syria when I was a resident. If you have a research idea, you can submit a research protocol and get funded up to hundred of thousands of dollars.

11) Medical informatics: the technology is not only better CT scan or MRI machine. An average resident in the US will have access to computers all over the hospital were he/she can pull medical records, laboratory tests as soon as they come up. View X-ray on the screens (including CT, MRI, ultrasound) and the medication list your patient is on. In many places (like were I am now) you can order new medicine, stop a medicine, order lab for tomorrow and even transfer the patient to different floor. When you try to inter full dose of Gentamicin for example for patient with renal failure a window pops up and say “ do you know that this patient creatinine is 2.3?” And when you add Amiodarone another window pops up to say “please note that your patient is getting Digoxin and you may need to adjust the dose” as you can see here, this is not luxury; it is now medical necessity to minimize errors in the 21st century. I would love to hear that we have similar system in Syria but I really doubt it.

Apparently these are not the only reasons. I don’t want to make this too long. I hope I made it easy to read and understand. Please feel free to post any question. I will learn what you need to know from your questions.

Sincerely yours

USYMD

___________

Dear Maher (and all):

It is never too early to start perparing.

the grades are very improtant. actually it is not a percentage. it is a percentile. the defference is that you may answer about 72% of the questions correctly and get about 90 percentile. the "percentile comapares you to all first time USMLE takers.

the 2 digit score is deffferent from both. to make easy for you, you have to answer about 65-75% of the questions correctly to get good scores.

USMLE scores may not be improtant for American graduates. But it is definetly important for us. remember that the competition is high and 1 out of 3 forign graduate matches from the first time (gets accepted from the first time).

Now I was always asked this question: Is it better to take the exam now and get good score or later and get better score..

my answer is: It is better to take it now and get 86 than after a year and get 96. However it is better to take it after 2 years if you will get 77 now!

It all depend on the screening process. The first step screening is done usually be a secretery. Most of the programs in the US now are screening out the applicant who have any score less than 80 and some of them 85. the step after that does not really depend on the scores. it depends on the reviewer who will look at your application, recommendation letters, clinical experience and the medical school reputation.

So a score of 90 does not garantee you a position but it grantees that you are not rejected from the first step.

for the books to study for the USMLEs: I honestly don't know what are the best abailable in the market now. In my days NMS was the only available sereis my friends who came shortly after me found "board Review" series more helpful. everybody recently used "first aid" in addition to what they have studied. I think it all depends on your motivation and who much information you still need. "Board Review" is usually helpful for those who did well in the medical school and they only need to review what they already know. I will write more about the study books after I get back to some friends who took the exam recently here.

for the TOEFL question. I think it is too early to take the exam (but not to study for it). remember that it expires in 2 years.

About the visa, it is very unpredictable. But believe me, even after Sep 11, it is still much easier to Syrian student to get the visa that to Indian student. if you have good scores that may make your visa easier. I don't know what the situation is currently, it is usually up and down.

I hope I answered your questions.

please don't hesitate to ask more

yours.

USYMD

______________

Dear friend:

i would like to ask u abt studying approaches for people who are studying in our so-called medicine faculty, i am a 3rd year student now, and since i was a sophomore i had this terrible nightmare, that i may not be able to compete with other * american * students who spent there times Studying (the real deal) if u know what i mean ...

as far as it concerns reading english/american/french resources, i am really doing this but, tell u the truth, i cant really concentrate on this valuable info i read since lousy profs are burdening us with a lot of bullsh** and heck, at least i want to pass my darn years here .....

whats the best method to handle it, in ur opinion

Thanx for ur time

_____________

OK, let's make it very clear. you will never compete with Harvard graduates!

you will compete with those who came from lousy American Universities and those who came from outside.

Never underestemate your potentials. I know how hard it is to get to Medical school in Syria. So the fact that you got in tells me that you have very high IQ.

I know that they are lecturing you to death with unnecessary stuff. but that is everywhere.

Practically speaking:

if you are now in your third year I highly suggest you to study Lippencotte Pharmacology and Lange Microbiology and Immunology.

If you are really motivated you can add Lippencotte's biochemestry.

if you finish these three books (reading several times) you can cosider yourself finished half-way to step 1. It is that simple.

Please note that I recommended these three books from few years old experience and I don't know if there are better books out there now.

yours

USYMD

_____________

OK I like the people who do it the hard way!

أو كما قال المتنبي:

ونحن أناس لا توسط بيننا لنا الصدر دون العالمين أو القبر

first: you have to know that there is more than having 99% scores.

to be really an outstanding candidate who can compete anywhere and "crush Harvard graduates" as you said you have to be:

1) extremely fuent in English. remember that you can't speak English like Americans. But you can reduce your "accent". There are courses for "Accent reduction".

2) you have to devote some of your time for active research work. you have to have your name on some research publication to compete in big university programs.

3) I think you also have to work here in the US (Clinical training or observership) you have to work with someone who is well known and wil give you a very strog recommendation letter (onthing like the ones you get from Damascus University)

4) I personally don't believe in luck. But you have to have a lot of patience. you have to be willing to spend few years of your life in research to get what you are aiming for.

I hope I did not make it sound too difficult. but remember, you asked for the hard way.

thank you very much .... its really very useful