All Questions Welcome!

Hi Readers,

I opened up this section of the site to answer any questions medical students/pre-meds may have about school, studying, best methods, exams, the residency process, etc. Feel free to ask me anything and I’ll do my best to answer. *Non-medical questions only please.


If you provide an Email you will receive a message, once your Question is Answered.

Hello Osman. I`ve just received my step 1 scores: 250. I wanted to know if it is enough, as an international student, to get an IM spot. 6. September 2017

USMLE is a pretty vital component to the match, both now and with fellowship down the line. A 250 is a fantastic score but remember that there are other parts to your application like letters of recommendation, extracurriculars and most importantly the interview. Continue to use the efforts you put into getting that great score into other parts of your application and I’m sure you’ll find a great match when it comes time!


I will be applying to IM (90) and FM (150); YOG 2013 , Step 192, Step 2 CK 211, CS – Pass Step 3-202.I have a Green-card. After Medical school i moved to the U.S and completed an MPH and during this time I took my exams and have about 9 months of FM USCE and 3 Months of IM USCE. Am heavily involved in volunteer work and currently volunteer as a health educator yearly during december with a non profit that sponsors our trip to Africa. I currently work as an assistant clinical case manager for a home health company. I was wondering what i should do to get noticed. with my scores i probably would be filtered out but this don’t define me. I do go for I.M grand rounds at a local hospital in Atlanta and am considering approaching the PD. from Chris 29. August 2017

Hey there thanks for writing; it sounds like you’re already doing so many things to get noticed! Unfortunately what you say is true, some programs do filter out based on Step scores and it’s a reality we all have to face due to the number of applicants for each field. This is not the case for all programs though so I recommend applying broadly and to community programs that may be more lenient. Just remember that when you go for interview it’ll be your time to talk about the really amazing things you have done that can set you apart from others. My final piece of advice would be to contact programs later in the season during a time where some of their interviewees may be cancelling their interviews for a variety of reasons. Just make sure you are respectful and genuine [which by the sound of it you are!]

I wish you the best of luck!


Hi there! Thank you so much for taking out time and writing this blog, its really helpful! In one of you posts you mentioned narrative medicine. Could you elaborate a bit more about it? How exactly you approached things? How did you get your stuff published? I love writing too and I want to incorporate it in my journey, to improve my profile overall. Hoping to hear back from you. 19. April 2017

Hey there! Thanks for reaching (sorry for the delay in my response, the last months before fellowship applications have been hectic!) Narrative medicine is a genre of writing that focuses on the subjective experience of the people involved in healthcare — it’s main objective is to capture how a nurse, doctor, patient, tech or social worker feels through a personal narrative. I always found it so fascinating because it contrasted so heavily with how we were taught to speak through medical school, objective with a standardized vocabulary. There was no room for how a resident felt watching a patient pass away or the humility experienced when everything went right — I felt strongly that this needed to be captured for others to see.

At any rate — the hardest part is starting. I would recommend you practice a lot as to create a style and voice of your own. My practice was the posts you read on my blog and every now and then I would submit these pieces to narrative medicine journals. The Intima is a great example of a journal that publishes pieces within narrative medicine. I also recommend you follow people/journals on twitter that practice narrative medicine so you can learn about ideas and opportunities.

Hope this helps!

PS You’re always welcome to submit something to my blog for starters! Best of luck! If you do end up joining twitter send me a request @osmanbhattyMD I would love to follow and read your work!


Hi, I’m a US citizen, caribbean student. I got a 209 on step 1. kinda bummed about it. I’ll be starting rotations in January 2017, still have Step 2 to take. I’m interested in IM residency. Is it still possible with my low step 1 score? 29. December 2016

Hey there — sorry you didn’t get the score you were aiming for (that’s always a tough pill to swallow) but congratulations on passing a very difficult exam and getting through two challenging years that only the strong and determined survive. You have plenty to be proud of!

You’ve taken just one of several exams that you will throughout you’re medical career — it is now a part of your past and you must focus on parts of your application that you can actually affect. Do well in clinical rotations, improve your STEP 2 score (USMLE World + Step up to Medicine + First Aid all multiple times), work on publishing posters at the multitude of poster competitions with interesting cases ( ACP, SGIM, SHM), get involved in volunteer work (Work the World) and get letters of recommendations from physicians you believe have gotten to see the best side of you.

Medicine is a long and challenging road full of ups and downs — you’re way more than a single score and you can show that to the residency committee by working on flourishing in other ways. Having said the reality is that STEP scores will be used by most residencies as a barrier to entry. While internal medicine is more forgiving than say ER, radiology, surgery, anesthesiology you can see using NRMP Residency Match Data that it becomes easier once you reach the average Step score of that year.

screen-shot-2016-12-29-at-9-24-30-pm

Internal Medicine residencies range from smaller community based programs to sprawling quaternary academic centers and thus a range of step scores are “acceptable”. Reach for the sky and apply where you like, but have a back up plan and a good one at that. This means applying to smaller community programs that are more forgiving when considering step scores and even specialties with less competitive scores such as family medicine and psychiatry. All of the average STEP scores can be found by googling the NRMP Residency Match data — I advise checking that out.

Overall:
1) Apply to your dream programs but have realistic options as well — with lower than average step scores that means smaller community based internal medicine programs and family medicine programs.
2) Keep working! There are other parts of your application that can benefit your cause.

I wish you the best of luck!


Dear Osman. Your blog is really helpful, why didn’t I stumble upon it earlier! Well, I’m an IMG with an orthopaedic residency outside the USA. I want to do Orthopaedic Fellowships in the US. Will my long duration since graduating basic medical school (2010) affect my chances of matching into a fellowship? I have not yet attempted even Step 1, so the earliest Match I’m eligible for is 2018. Also, I read a 2014 article online about new legislation barring IMGs from getting orthopaedic fellowships. Do IMG-friendly orthopaedic fellowships still exist? Can you please let me know if it’s worth investing time and lot of scarce money to begin my USMLE journey? I’m ready to work harder than required, but I just don’t want to invest so much and later discover a nasty ending. Please help! 19. July 2016

Hey there! Thanks for writing.

So I’ll warn you — what I’m about to say won’t the most encouraging information, so if you don’t want to hear it I’d stop now

Orthopedic residencies are probably the the most competitive specialties to match into in the US and that is saying a lot because in general it is stiff competition! Beyond needing fantastic board scores, research, volunteer work there is a definite disadvantage to being an IMG when applying to this field. Check out the stats below:

Charting-Outcomes-2014-Final

As someone who matched into internal medicine, I’m not someone to dash another’s hopes of matching into a specialty — it obviously has been done. I would ultimately recommend thinking really hard about it. Statistically it is very challenging. If there is one piece of advise I’d provide its that if you are willing to try have a good plan before committing including where you would do research and who you would talk to. You’re one advantage is that you are already an orthopedic surgeon — I would try and get into touch with specific residency programs to see if that would afford you any kind of advantage. Hope this helps!


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