USMLE: Should I or Should I Not?

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Email from Vishwas Vanar, MD (Jan 2008)

I don’t know where I should start. You’ve got too many plans and too little time. Lets start with something basic:

I’m all for the GRE/MPH route too because (as I’ve repeated umpteen number of times in online forums):

1). Gives you an extra US degree
2). Depending upon your abilities and “luck” – opportunity to do research and publish papers
3). Time to get acclimatized to the US education system and lifestyle in general
4). The much needed communication skills
5). Gives you something to fall back upon if residency doesn’t work out
6). Bonus – You never know if you fall in love with a US citizen and decide to marry her (bye bye visa issues) 😀

Speaking for myself, I study MPH at Temple University, Philadelphia and the course is exhaustive and yet interesting. I have found a good Mentor in one of my professors who is a clinician and a MPH instructor and we will be publishing 2 papers in June this year. I also work at the Center for Obesity Research and Education at Temple which is currently researching USA’s largest obesity prevention trial under the supervision of Dr. Gary Foster. I got a RA this semester and things are going well

Before you actually say antyhing, let me add that I attribute most of these “achievements” to communication skills, right timing, hard work and then finally “Luck”. You cannot expect everything to happen by fate alone – Work hard and expect results. Fight on, Fly on.. Till the last drop of blood and gasoline.

Some cons of MPH:

1). You get less time to dedicate to USMLE studies if you haven’t finished off with your steps
2). Depending upon your university and the state – you may have to shell out a lot of moolah ($$$, Ka-ching!)
3). You may actually end up liking MPH and leave clinical practice all together 😀
4). “Waste” of 2 years of your life

Now that you have my unbiased view about the MPH route let me try and answer your other questions (if you are still considering the GRE/MPH route):

MPH or other courses?

MPH is a good way to enter USA but there are other courses you can consider too. Esp MHA, MS in Epidemiology, etc. Look for a course that has least credit hours – so that you end up having more time for USMLE and have to spend less on the tuition fees

Which university?

Again depends upon your academic and long terms goals. If you’re going to MPH just for visa – go for a cheap uni in a remote place. If you’re looking for good research experience, good recommendation letters and possibly good funding – go for accredited universities. A full list can be found at . Believe me – being an alumni of a reputed institution helps in all walks of life

1 yr or 2 yr course?

That again depends upon your exam commitments. If you plan to come here after giving your step1 and CK then I think even a 1 year course should suffice but it will be hectic (you can confirm this with your senior at JHU, who, I believe, has a 11 month course). Go for a 2 year course if you really want to enjoy all the USA lifestyle or did not manage to give CK in India or if you want to give step 3 before match. Keep in mind that there are certain universities that have a 1.5 year course and most universities have a flexible course i.e. an avg student takes about 2 yrs to complete but that does not mean that you have to complete the course in 2 yrs – you can finish it in 1 yr, 2 yrs or 2.5 yrs.

Does MPH give sufficient time ?

Again depends upon your university, your course, how many credit hours you’re taking, if you’re working (on-campus or off-campus), how many exams you’ve got left. On an avg I could say that MPH is an easy course but the system is so diff over here that it takes time to get adjusted and will take a toll on your preps. You may not get sufficient time for all your exams. I gave my step 1 last march and am giving CK this march – so as you can see, I clearly did not have enough time

Research exp?

You mentioned that you do not have any publications. I cannot comment anything on that but can only say this:

Based on what I’ve been hearing from my friends, these days everyone gets 99. So it is not a big deal to score 99 but the competition is so fierce that you should not expect interview calls from places. What will possibly put you on top of others is:

1). Research experience – i.e. publications
2). Reco letters from US doctors
3). US clinical experience

Keep these things in mind when you’re considering your options.


Definitely go for them if you pass all the hurdles of getting one, NOC, visa, etc. The hierarchy of USCE in descending order (from best to atleast something) is: clerkships > externship > observership

It is not easy getting a clerkship and even if you get one, visa is an issue. If you think you can manage both – please go for it. Period. As far as suggesting one goes, I had no one to guide me in that area and so am drawing a complete blank on that issue. I wish you luck with searching on your own.


This varies upon your reading habits, which year you are planning to apply to and many other factors. I’ll assume that you are going via the MPH route and will apply for the 2011 match and give you a schedule accordingly:

Jan 2008 – April 2008 – GRE/TOEFL
May 2008 – June 2008 – get results of GRE/TOEFL and start preparing for step 1
Nov 2008 – Dec 2008 – Apply for MPH in universities
Jan 2009 – Feb 2009 – Give USMLE step 1
Mar 2009 – Apr 2009 – Prepare for CK
Jun 2009 – Jul 2009 – Appear for student visa / apply for CS
Jul 2009 – Aug 2009 – Give CK
Aug 2009 – Sep 2009 – Come to USA
Jan 2010 – Mar 2010 – Give CS
Apr 2010 – May 2010 – prepare for step 3
July 2010 – Aug 2010 – give step 3
Sep 2010 – Apply for match
July 2011 – Start residency

Use this as a rough guide and don’t religiously follow this schedule. You will face many difficulties esp
1). In the post step 1 period (where you just wouldn’t want to study)
2). In the visa period where you’ll have to decide which uni you want to go to, manage funds, shopping, tickets, arranging accommodation in usa, etc
3). After coming to USA – adjusting to atmosphere, MPH studies, etc

Always keep a leeway in your schedule for unforeseen circumstances and keep a plan B. There always has to be a plan B

Phew, now that is a LOOOOOONG email. And while I’m at this here’s my 2 cents of advice –

1). Do not expect anyone to spoon feed you in USA. You’re pretty much on your own
2). Don’t rely on family ties in USA. No one likes guests more than 1 week (actually only 3 days)
3). NEVER stay with Indian roommates.If you want a good social network, good communication skills and acculturate their lifestyle
4). Carve your own identity – you can rely on family contacts to get things done initially but this is a good opportunity to emerge as a strong individual who is self made.

Hope it helps you find a way