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  1. #1
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    Preparing for the USMLE 1

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    Hello,

    I'm in year 2 of a 6 year program and I've been getting a bit stressed out abou the USMLE...my future doesn't really depend on it but I would like it as a back up.

    I know this is supposed to be in the USMLE forum, but I would like some advice from Canadians who have gone through the process...

    When did you start studying/what books did you use and what happens if you fail?

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    on it

    Hi. My man is in year 3 and I'm in year 2. I'm starting now in that I'm using board review books along with my regular texts for all courses. Also, doing analyses of schools, programs, match histories, electives offered at prospective schools, letters of reference, research articles published over the next few years and lots of review questions. Most people say pick one book and stick with it. The first aid book is a must - basic, but it guides you through the process. Apparently there is one for IMG's but I've not seen it. Kaplan always seems popular. But we've not written it. Good info is also on the studentdoctor.net forums. Check out what those guys say too. Good luck. If you fail... don't really know. Work in Germany or Switzerland? You won't fail. S-

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    thanks

    Thx 4 ur response peacefuljourney!

    How are you enjoying Eastern Europe....must be getting cold there huh? Do you come back home during your breaks, or just stick around there?

    Anyway best of luck.

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    neilc is offline Permanently Banned
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    my ideas...

    i took it at the end of summer after year 3 in a 6 year program...my advice:
    1. the best possible prep is to go to your classes, and do well during the first 3 years. well, maybe not go to class always, but be sure to learn the material. even if it is from a school that does not teach to the USMLE, the material is the same. it surprised me, too, but i can't emphasize this enough. DO WELL IN YOUR BASIC SCIENCES!!!
    2. take the USMLE as close to your basic science as possible. don't wait. in fact, i took it before i finished pharm, simply because i didn't thinkit wise to wait a year and be that much further from path and phys for the benefit of 1 semester of pharm. plan it smart, and take it early.
    3. keep it simple. i bought way to many books, made a complicated schedule and all that crap. do not do this. give yourself about 6 weeks, maybe a touch more if you are really weak in a subject. during the first weeks, read BRS style books, and focus on high yeild stuff that you are weak on. then, for the last 4 weeks do kaplan q-bank, and do it hard. exam style, 50 question blocks. go over every question when you are done, and if you don't completely understand it, then hit the books for a few minutes on that topic specifically. do this for 4-6 hours minimum each day. with down time, read first-aid over and over, know and understand (i didn't say memorize!!) everything in there. another great down time book is pathophys for the boards and wards. a must have. read it over and over and over....

    that should get you a good score. i am still waiting for mine (gggrrrrrrr! i hate the ecfmg), but if i had to do it over again,this is exactly what i would do. i honestly think my score will suffer from the time i wasted re-reading subjects that i already learned. remember, there are a lot of easy questions, and relatively few difficult ones. make sure you get all the easy ones right, and you should be fine. if your focus is the difficult stuff, you had better not screw up on the easy ones! know the basics cold, first and foremost....

    i know i am not a canuck, but i thought this might help...
    good luck!

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    Books?

    Thanks neilc...

    that's good advice, so which books exactly do you think are the essentials? (Other than first aid, and pathophys)

    Thanx

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    life in eastern europe

    How is life in Eastern Europe? I’ve delayed in responding because it is a tough question to answer. Mat’s response would be edited and replaced by some ridiculous phrase so I’ll try to proceed with mine.

    Note: this is not considered to be the east by those who live here. The east is reserved for Russia, Ukraine, Bulgaria, Romania etc.

    Slovakia, Poland, Hungary, Czech Republic are joining the EU next year in May. I make this distinction because I note here that the forum is 'eastern europe and russia' and there are BIG differences between the two. As graduates of an EU school we can move freely in Europe, practise in any EU member state etc. The standards of education etc. are now harmonized with western europe. The situation is Russia is very different.

    First I think I have to tell you a few things about myself so you understand where my comments come from. (cv attached if you are interested). I lived in Prague mid-1990’s doing a portion of my MBA in international business so I can comment a bit on the changes that have taken place. I also visited Bratislava at that time. Then we did a 6 month stint here in the year 2000 to ‘drop out’ from North America for a while and check out the school. Finally we relocated here in 2002 to start medicine. Mat started 1 year before me as I was working during his first year. I worked for Deloitte & Touche – consulting firm – for the first year and was also involved with some aid projects dealing with Roma (the gypsy population) and the delivery of health care. I live in a village outside of Bratislava (25 km) and my 2 kids are enrolled in the local school system. I only mention the latter because those who live in Kramare and Koliba with drivers, maids, cooks and their kids in the international schools (or in Vienna/Salzburg) have quite different experiences than I do.

    Communism & Politics
    Communism was a terrible system that has decimated these countries. The transition into a market economy has been anything but smooth – especially for Slovakia. The Czechs had a much more progressive ‘western – leaning’ Havel while Slovakia had Meciar who clung to relationships with Russia. The ministers and people in power take those positions because it places them in a better position to steal. Contracts must be paid for. Slovakia is entering the EU in the Spring, I don’t think the rest of Europe knows what it is getting into. Frankly, they are going in because of geography. If you look at a map, Slovakia is like a finger that sticks into the middle of Europe – Bratislava is about 45 – 50 min from Vienna while the other end of the finger borders with the Ukraine. The front is militarily indefensible – 2 nato bases are quietly being located here. This will be the hard-line from west to east.

    American foreign policy does not help how we are viewed and treated either. The US embassy is in the heart of the old town with fences and barriers and construction which creates a lot of resentment – it does look like pooh pooh in the main area because of this.

    Corruption
    This is the worst aspect of society here. The communists who killed people and put them in jail for their dissenting opinions (like my husband’s father) are still here. They did not disappear with the coming of democracy – only their hats. Many ‘successful businessman’ were the top communists of yesteryear or the secret service folk. You must try to understand this country is 5 million people. The elite group are very small – it is more like a village here and everyone knows everyone. So, even if one disagrees with corruption, the status quo (or not telling on anyone) works well because everyone is so interconnected: “if you tell on me I know that your cousin extorted money from xxx” and so it is in no-one’s best interest to reveal or change anything.

    There are basically 5 (last time I talked to someone who knew) mafia families here – Russian, Ukrainina, Albanian, 2 slovak families and I don’t know who else and they run drung, prostitutes, police force, and you must pay protection to have a shop or restaurant in the old city etc. etc.

    You cannot believe how many Mercedes and Porsche SUV’s and Mercedes SUV’s are here – many more per capita than Toronto to be sure. These are $200,000 cars. Hmmm, where the ‘average’ wage is $400 USD per month.

    My consulting unit at Deloitte & Touche was closed for corruption – ie bribing to get contracts – very common practise here. If you don’t want to pay to get the contracts, you will not have ANY business – all sectors, all businesses. I was working on large, multi-country projects. There is a ‘fixer’ that you pay and they then go around and pay who needs to be paid and surprise – you win the tender. This situation is sure to continue upon EU entry as Slovakia will now have access to EU structural funds (the pre-accession funds were peanuts compared to the new funds they have access to). And if you don’t want to pay to play, that’s fine because someone else will. Then they take a huge chunk of cash for themselves and use the rest of the cash to complete – sometimes – the project in a half-assed way. Then, of course, their friends or relatives – ‘audit’ the project and (no surprise) all funds are accounted for.

    Racism & Human Rights
    It is a very racist country. Many documents and reports available on these topics. Check out the UNDP (united nations development program) or European Association for Roma Rights – in Brussels I think for interesting reports.

    Here is the roma rights organization link. Just look for the Slovakia information.

    http://errc.org/

    Roma rights org.

    http://errc.org/jobs.shtml

    Here is the UNDP stuff. The first and second reports (human development and avoiding the dependency trap are the most relevant.

    http://www.undp.org/rbec/publications/

    There is a black guy from Nigeria studying here. Many racists incidents in broad daylight – old town. Knives pulled on him in shopping centers. Spanish or Mexican girls I know have had their hands slapped by shop people for picking up shoe boxes to try on shoes.

    I was working on a CIDA (Canadian International Development Agency) project in a settlement of Roma in East Slovakia. I have never seen such poverty – distended stomachs, parasites, aids – it was very very shocking. Aid people who have worked in Africa called the situation here much worse. And the common Slovak will say “What do you know about it? They are lazy blah blah blah and burn their houses blah blah blah but I am not racist” Also very anti-Semitic. There is a jewish community here (our Dean is Jewish) but it was decimated. And most people think there is a huge jewish plot to overthrow the world or something. (They can’t really tell you why or what will happen next) but stupid things like the Russian Kursk submarine sank because there was a defect in a part supplied by the jews. We still argue every time we hear such comments, but I know that I cannot change their opinions.

    People
    As in any country there are nice people and Richardheads, but here there are definitely a higher percentage of people who just don’t think. Many of the people in our village are very kind however, our car was tarred – tar poured all over our car because we are from ‘the West’ and we represent everything that these people hate – or don’t have.

    I must make a distinction between the younger and older generations, the teenagers and up to 24 are eager to learn and to live and see the world and think and use their intellect, but their parents are often rude, lazy and would and do steal anything that isn’t tied down. The phrase under communism was if you don’t steal from the state you are stealing from your family.

    Mostly, I get frustrated by the rudeness, lack of customer service – really – nothing. If you buy a $100 pair of boots and they collapse the next day, too bad for you. The movie you went to see no sound, distorted images – too bad. Etc.

    Paperwork, legalization, superlegalization, bills going to dead people and when presented with death certificate, name still can’t be changed. Etc. etc.

    It is a very frustrating place to be.

    Education
    The education is Russian-style. Much much memorizing and an attitude of listen, shut-up and do what you are told. This is ok for me because I know the difference but for my kids it is a problem. I want my kids to be able to think for themselves and question and problem solve. Those things I must work at at home. Generally, the kids are about 2 years ahead of their western counterparts in Canada. Great emphasis on math and science. Kids are streamed from an early age – highschool for doctors, for engineers etc. The teachers are kind with the students but if they step out of line, they will be punished. People say oh the Slovak kids are so well behaved compared to the wild western kids. But there is a reason for that – they really beat their kids. The first time it happened in front of me I couldn’t believe it, but it is the norm here. Yes, the kids are very obedient and generally more passive. The teachers make no money and have very few resources. I’m constantly impressed with their dedication and creativity to do many things with what they have.

    University.
    Our experience is only with medical faculty. Our professors are very accomplished. Some have problems with English, but their credentials are very high. Many have studied abroad & work in Western Europe and teach here because this is their home & family are here. Only party members and their kids could attend or teach at Comenius so many of them were die-hard believers in that system. I can think of 2 out of about 20 professors I’ve had who still yearn for Mother Russia. The one guy just makes stupid comments like: “mother Russia – now there’s a country that knows math and science – you Americans couldn’t get a satellite up in the air if you tried.” Or “you Americans with your high-school textbooks.” I mean what can you say to that. This guy doesn’t really have contact with the students anymore. Some professors were never allowed to publish under communism and only now being awarded their PhD’s & publishing their own work. The faculty seems split along political lines. We have the same training as Slovaks and they complain because we have the department heads and chiefs while they have the assistants. We have good basic facilities – lots of bodies in anatomy, path anatomy, maybe 50 new computers, 60 or so new microscopes, but of course the buildings need major restoration and paint etc. The school is in Maria Theresa’s old palace and some rooms are awesome with fresco’s & gold leaf etc. I hope they can get the buildings back to their former beauty.

    Travel
    I think if we had more money to get away for weekends or home more often, it would be easier here for us. We are coming back to Canada for Christmas so we are psyched about that. If you are in Toronto we could see you.

    Anyhow, I’m sure many will disagree with me. Many expats here live very insular lives and their biggest complaint is not being able to buy homemade spinach pasta. The country has evolved incredibley – even in 2 years. In Prague in 1995 you were happy to find good carrots in winter time – no stores, no meat, no anything. But now there are stores with a wide variety of good fruits & vegetables. Celery made its debut this year!!

    Ciao. S-

  7. #7
    neilc is offline Permanently Banned
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    Books?

    Quote Originally Posted by redshifteffectz
    Thanks neilc...

    that's good advice, so which books exactly do you think are the essentials? (Other than first aid, and pathophys)

    Thanx
    i don't think any other specific books are essential. well, maybe brs path. loved that book too. just have your textbooks handy for when you don't understand something in q-bank or first aid. i would seriously only learn those two sources, but i would know EVERYTHING in them PERFECTLY.

    i tried to do a schedule, work on topics mixed with questions, blah, blah, blah. wasted time, in my opinion. i passed, but i got a crappy score. i knew a lot, and i feel i deserved a better score, but it is my fault. lots of the stuff i knew simply was not tested, and i did not effeciently use the high yeild resources. i wish i had a rewind button....

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    heads up

    You know what Neil. I'm really sorry that your score is disappointing for you but you passed and its finished - you've completed that hurdle. So, I must say Congratulations on passing the USMLE!!! (even if you are not ready to hear that yet).

    Regardless of your score you will be able to return home and practice medicine.

    So it's not radiology or dermatology, you have lots of options. Once the shock and disappointment passes re: your score, you will move on and keep going down the path you've chosen AND your perseverance, intelligence and factors such as research projects, clinical rotations, electives taken elsewhere other experience etc. will become your 'selling points.' and will serve to distinguish you from your peers.

    Keep going and start thinking about next steps for your residency placement. It will happen.

    S-

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