Practicing Medicine in the United States
Nubi Achebo
question about medicos from Nigeria and the USMLE (test American and
foreign trained doctors have to pass to handle patients in the USA
health care system). I was under the impression that passing the
USMLE was a piece of cake for Nigerian doctors. I have a town's man
who has been at it now for 5 years without success; I thought the guy
was not applying himself to the process resulting in his dismal
perfomance. After talking to a couple of people, I now know that
there are several Nigerians medicos in the same category who are in
the perpetual exam taking stance. I want Nigerian trained medicos on
the Village Square to shed more light on this problem - is it a
function of the Nigerian system or otherwise?
Nubi Achebo
===
If at first you don't succeed, then try again. Then quit.
There's no use being a damned fool about it.
-- W.C. Fields
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Babalola Olalekan
USMLE is not a too-difficult nut to crack, but must be approached
sensibly. Moreover, the USMLE is not only for foreign doctors, but for
everyone (including US trained docs) who wants to practice in the
States.
A typical naija trained doctor passed thru the British system, which
encouraged learning by rote, with their true-false pattern of exams;
however, the American system prefers an in-depth understanding of facts,
and a demonstration of ability to apply them. So unless a naija guy
knows about this difference, he might fall prey to the USMLE exams.
Notwithstanding, the exams demand adequate preparation. Indeed, it is
virtually impossible to pass without studying hard. The syllabus is
wide, so that mastery requires hard work.
Of equal importance is the books that are used for the preparation. I
have come across a lot of them (most are useless, however). The NMS
Series, and other big books, I have found, to be time wasters. Basic
books like USMLE Board Review for Steps I/II, plus Prescription For The
Boards (written by fellow students) are almost entirely adequate. These
could be supplemented occassionally with other reference books. I don't
think anyone needs more than these to pass.
My suggestion to the guys concerned is that they take the exams serious
and use the right materials. I didn't pass until I did this. Adequate
and systematic preparation cannot be over-emphasised. One more thing: it
is not enough to pass the USMLE; one must pass well. So, an aim for the
sky is justified. I hope this helps.
Babs
--
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Lawal Garba
As Babalola said to you, there are more Nigerian trained doctors who passed
the test than those who did not. It is usually dependant on the individual
and his preparations as well as how long ago they left medical school. Most
Nigerians that have problem with USMLE complain of the first part which is
basic science and which was taught in the first two years in Medical school.
People tend to forget most of those basic sciences once they have been in
practice for too long. The approach in the US is different from the British
approach we were used to in Nigeria hence even the part two, which is
clinical could be difficult as people not familiar with legalities and
disease patterns in the west particularly in the US, could have a problem.
Lawal
Abraham Ariyo
The medical examinations for physicians in the United States has been
changing constantly. These rapid changes are not in the interest of
the foreign medical graduates, in fact, they seem to be against them.
I remember as a student in a Nigerian Medical School in the late 1980s
(Great Medicos!). The few guys in my class that ventured to take the exam
without much preparation, did not only pass, they passed very well in the
upper 10%. At the time, these guys were those you generally classify as
the "lay-about" guys in the class. They took the exam not in the "promised
land"(USA), but on the Nigeria soil. Ironically, with the changing times,
of the three such examination centers in Nigeria (Ibadan, Lagos, Kaduna),
none of them exist today!
At the time, the examination for the foreign graduates was separate from
that for the American graduates. The ECFMG was for the foreigners, and the
NBME for the American graduates. Of course, the American graduates pride
themselves in taking a separate exam from the foreigners. Interestingly,
although the ECFMG appeared to be tougher, the pass mark was also higher,
it was 75, while the pass mark for the Americans on the NBME was 50.
In the mid 80s, there were protests that foreign doctors should be allowed
to take the NBME too. Finally, in 1989, the doors of the NBME were open to
foreign graduates, and subsequently, the two exams became a single
examination for all, the USMLE (the U.S. Medical Licensing Examination).
Personally, I took the American exam at the start of the merger, and it
was not a big deal, at least, not comparable in any magnitude to what we
had previously gone through back home or in Britain.
Anyway, there might have been a mild decline in the standard back home
with all the consultants fleeing to Saudi Arabia. But on a more serious
note, the difficulties that the foreign graduates are facing has been made
worse by the propaganda that there are surplus of physicians in the
U.S.(Of course, that is not the case). Thus, foreign graduates are not
welcomed anymore and quite frankly, on occasions, they face hostile
conditions. Thus, the pattern of the examination has changed tremendously
in line of this propaganda. Just like the SAT scores, and other
standardized examinations, which are geared towards testing certain
specified skills which may not necessarily indicate medical knowledge
superiority per se, the USMLE now test skills that may not be available to
foreign physicians. Recently, those who took the exam complained of too
many rat and rabbit models, basic laboratory and highly technical
questions that may not necessarily have direct impact on medical
management but may be a common knowledge to those in the U.S Medical
School.
Things are changing very fast, the earlier one can come on board, the
better. The Kaplan preparation school is also another potentially helping
tool, although, it is expensive. In general, one may not be surprised soon
if you don't find new foreign graduates entering the system in a few years
to come.
My advice for those preparing for the examination, if they are in the U.S.
is to go to medical library close to them. There are many questions and
answer booklets that are written primarily for the exam. There are many of
them, especially the new and latest editions. Also, try and make
meaningful friends with the students, especially those preparing for the
same exam. Quite often, they may be helpful, and sometimes, some of them
have practice questions that may help you familiarize yourself with the
exam. A better prepared candidates usually have the best shot at it.
Good luck.
Abraham
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segu...@gmail.com
> I have always wanted to ask a practicing physician in the USA this
> question about medicos from Nigeria and the USMLE (test American and
> foreign trained doctors have to pass to handle patients in the USA
> health care system). I was under the impression that passing the
> USMLE was a piece of cake for Nigerian doctors. I have a town's man
> who has been at it now for 5 years without success; I thought the guy
> was not applying himself to the process resulting in his dismal
> perfomance. After talking to a couple of people, I now know that
> there are several Nigerians medicos in the same category who are in
> the perpetual exam taking stance. I want Nigerian trained medicos on
> the Village Square to shed more light on this problem - is it a
> function of the Nigerian system or otherwise?
>
>
> Nubi Achebo
> ===
>
>
>
>
> If at first you don't succeed, then try again. Then quit.
> There's no use being a damned fool about it.
> -- W.C. Fields
>
>
> _________________________________________________________
> DO YOU YAHOO!?
> Get your free @yahoo.com address at http://mail.yahoo.com
To register go to ecfmg.org.
Just start preparing on time, at least from 200L.
you can send me an email though, segu...@gmail.com.