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Hello, everyone. Um Welcome. We're gonna wait two minutes before we start. So just so that more people can join. Hello guys, welcome. Um I'm just gonna do a quick intro of BSA and then I'm gonna hand over to the doctor. So BSA is stands for the Bulgarian International Medical Students Alliance. Um Our aim is to build more connected community for international students in Bulgaria and to make it more accessible for students to reach out for help and support, we offer support as you navigate through the process of reintegrating into the NHS. Recognizing the unique challenges faced by IM GS who study in and graduate from Bulgaria. We are committed to simplify the transition. It's just not the, but we also do other series like for example, the in G series that we're gonna do today um where we also talk about integrating into the other healthcare systems. Today, we're gonna do about the USA one. If you ever have any questions or suggestions about um initiatives that can help students at your universities in Bulgaria, please feel free to reach out and let us know. Um Finally, please do follow our page um on meal and become a member in order to get email updates. When our next event is gonna be, we also have an Instagram page uh where we do posts about our talks and other stuff. So please do also follow our Instagram for more information. Uh with no further ado I'll hand it over to doctor Fatima who will talk about um tell a little more about herself and the pathway to the US. Thank you Jemima and thank you for having me today. So, first of all, welcome everyone. Uh I'm Fatima and I'm an I MG uh right now in the US undergoing my residency. So a little bit about my background, I have been born and brought up in the, in Kuwait and I completed my medical degree from Georgia uh the country and uh post that I worked in India for a while and then I applied for the US residency and I'm here in the US now in Philadelphia. So um I'm going to talk about my journey. Uh What all I went through, uh anything that can help you out. And I hope that at the end of the session, you all gain an insight about the US journey. And um I hope I can influence some of you guys to pursue this pathway. So I think we should begin now. OK. I'm going to share just a minute. Thank you. OK, Jemina, is it visible? We can see. Yeah, we can see your screen Ok. So let's begin talking about the ultimate your Asem journey. So this is the big picture of the entire journey. So I know looking at it, it's quite overwhelming. There are um yeah, sorry for interrupting. Uh We, I think I can just see your uh screen sharing like it's on me. I can't see your slides here. I'm going to share them. Can you see the presentation though? Yes, we can. Yeah. Yeah. Yeah. OK. And can you see it on full screen? Yes, we can. OK. OK. So let's go ahead. Is it visible? Yes. Yes. OK. OK. Yeah. So let's start over. So the big picture of the entire assembly journey. So as I was saying that looking at all these steps involved, it can seem like it's a lot, it's quite overwhelming. But my biggest advice for someone who is going to start this journey is to just take it step by step, not to look at the entire picture, but to just see what's ahead of you. And every time you complete a step, it's just going to be easier to go on to the next step. So it all begins when you start and you give the USM step one. So starting for these steps is the beginning of this journey and then you will go on and you will do some rotations in the US. You have to give some exams like the O ET uh which is the English exam for uh the US, you will have to do some research and then you basically have to build your entire CV uh do some voluntary work and uh prepare your application with the personal statement, the letter of recommendations and even a part of your med school journey will be uh a part of this uh application. You will apply to uh the er which is the uh which is the portal which uh has the whole application in it. You will give the interviews, you will send out some letters to the programs you really, really want to match and then you will match and you will be here in the US. So first step is to give the U assembly exams and how to apply for it. So um there is this link uh that I use from youtube, uh the A playlist which was very helpful for me when I was applying. Uh I won't be able to go through the whole application process uh Because uh this link right here will explain each and every step with all the visuals. So I have just put the link up here and uh this entire PPT will be shared with you all and you can follow this link and you can um uh go through step by step how to apply for the US family exams. Uh So talking about your assembly step one. So how do you start preparing for it? So the first step is to get the first aid for your assembly, step one. So that book is basically everything you need to study for step one. As you all might know that uh step one has become passed and failed. So there is no more score to it. So it's really become easier for people to pass the step one. Uh Of course, you do not underestimate this exam uh because it's pass or fail, you have to study for it. Uh These are the resources that I have used personally and these are more than enough to pass the step one. So the first aid then of course there is you. So you world is a question bank which has um all the questions which are similar to the ones we get in our step exams. So they cover the same concept, the uh entire picture of the question itself. It's kind of the same, it makes you accustomed to solving and secure type of questions. And one advice that I give uh to everyone who uses Neworld is to, to use the notes feature of new world. So you can just copy and paste anything in the neworld explanations to your notes. And then you can actually save these notes by copying it into a Microsoft Word or a doc um uh program and you can use it for your future as well even after the usual expires. So uh I advise that everybody should use this notes feature uh put on the notes that uh uh of questions that you think or you won't remember or the concepts that you think you are weak at and then eventually over your entire journey, you can always go through the these notes even after you're done with step one another resource is divine intervention podcasts. So these are really good podcasts uh where uh they're like really short 20 minutes, 15 minutes uh where the um where divine uh he discusses some topics which are very, very uh important and high yield in these exams. So, again, I have put in a link over here. It's an Excel Sheet which gives uh what all subjects are covered in which uh podcast episodes. So these podcasts are easily found on Google podcast or Apple podcasts. And um they're really, really helpful. So just going to these podcasts while you're just um maybe taking a walk or in the gym, uh it really helps uh listening to someone uh explain the entire topic to you. Then there are N BM ES. So N BMS are these assessments um which are done on the N BM website. So they help you um assess where you stand, they give you a percentage, uh a score which you can then correlate to your um score that you will get based on those assessments. So, uh doing these towards the uh um last uh third of your preparation of these steps is really helpful because that gives you a background of what are your strong um subjects, what are your weak subjects? And then you can work on those uh subjects and improvise yourself. And then we have Phoma. So Phoma is uh basically a PDF um by uh one really good doctor uh called Hussain. So this is the uh for pathology and it covers all the high yield um things in step one that come from pathology. So, pathology is the main subject which is covered in step one exams. And uh this book really helps and it is very concise and it actually, it also helps uh as a med student, I used to use it when I was a med student. And then there are some supplemental sources which you can use to um uh under uh to learn about topics uh which you are weak at, for example, sketchy, micro and Pharma is really good. Uh If you're weak and micro and Pharma, they give you a whole uh picturesque um explanation that uh it's very catchy and it helps you remember about drugs and uh even microorganisms. Then there's both and beyond which is again, uh which again uh videos which review all the high yield topics. Kaplan. I'm sure everybody must be knowing about Kaplan. Ay. Yunky is like a flash flash card or app and you can, if you like doing flashcards and it helps you remember. Uh this is a really good app and they are all already perform an available uh online, easily downloadable and you can just go through all the high yield um uh topics as flashcards and then there's Ambos. So Ambos has everything but ambos is quite detailed. Uh They have question bags, they have all the topics, all the subjects covered, everything is covered in there, but it's very detailed. So first step one, I don't really recommend doing a because it's really, really detailed and it will take a very long time to go through it. So the first five um first five points, they are the main resources that everybody uses to pass step one and they are more than enough to pass step step one. Then we have step two cm. So step two CK is more of clinical exam. It covers uh all the clinical subjects like internal medicine, psychiatry, pediatrics, uh OBGYN and surgery. So um first step two K again, first a first step one is very helpful. Uh If you step one knowledge, your basic sense knowledge is good, then it's very easy to build up on the clinical knowledge. So again, first aid is a good resource to just go through it and to recall everything all the basics to make them clear. And then of course, there's you will, so you will again, um it covers all the topics, everything high yield uh is covered by you world. Then we have N BM ES again to assess where you stand and to um help you um help you with your weak areas. And uh uh N BMES again should be done towards the end of your preparation. And also the topics which are covered in N BM are very, very similar to the topics in the main exam. And it's actually the N BM, which is the entire board, which is um uh making up all the test papers. So they usually cover all the topics that they cover in the actual exam. So that way it's a really good resource. And then we have something called CMS forms. So these are subject wise forms which are available um uh online to do uh there are again some assessments and mock exams, but they are subject wise. So for example, if you do an N BM and you discover that, that uh you are weak and like pediatrics, so you could then do the CMS forms for pediatrics. And you could um it's, it's basically a test and you could uh then go into more details starting pediatrics and assess where assess if you're improving in pediatrics itself. So that way it's really good. And then there is again Divine Intervention Podcast. They have step two K podcasts uh differently and everything is there in that Excel sheet that I have shared in this. So you can um just select the um uh episodes which cover the step two topics and then just listen to those and of course, there's am. So in step two K, I think am serve as a very good source to study from because step two CK is more detailed exam and um you know, covers the diagnostic tests and the treatments of all diseases really well. So step two CK personally, uh I love, I like doing A B and I think it really helped me get a good score in step two, seek care and then comes step three. So step three is not really uh unnecessary thing to do before you match. So a lot of people take step three when they are already in residency. So the initial first or second year, everybody takes step three, but it definitely helps getting done with step three before you match. First of all, it, it is like a plus point on your CV that you have already finished this exam. And there is no burden of studying for this during uh the residency. And secondly, in during residency, you are going to be so busy that uh everything you will be studying will just be clinical, what you see in the hospital, how you treat a patient in the hospital. That is how you will be starting during residency. So there are, there's not a lot of time to time to go through you or go through some books, notes and all of that and give the step three exam. So it really helps to just get done with step three if you have a chance again for step three. So step three is like a two day exam and it covers both the basic and clinical signs. Um Also they have these um uh cases uh in you in step three. So at the end of the exam, there's a whole block where they give you some cases and it's all interactive. You have to put in the labs, you have put to put in the treatment and then they tell you whether you put in the right kind of diagnostic test. And uh whether you put in the right kind of treatment for that particular patient and whether the patient is you know, healthy recovering or w whether the patient just died. So it's very fun to do step three honestly. Uh But it's one of the hardest um your family steps. So again, your world is a good source. Actually, the only source is you will and CCS cases. Basically, if you do these two things uh thoroughly, you can pass step three. So CCS cases is and the um kind of a mock version of the interactive cases block on step three. And they prepare you for all the topics that could um uh all the cases that you could encounter on during step three. Also having a good grasp on step two topics helps. So basically, so uh definitely your step two notes will be very useful uh for step three. And for all the topics that you think you could be weak on and you've forgotten the Divine Intervention Podcast. And AMBOS is always a good supplement for step three. So my general advice on how to get a good score and how to ace these. The assembly steps is, first of all, have a good um have a good basic knowledge about all these subjects and uh study whatever you can very thoroughly. So it's impossible to cover everything, to cover every topic and to cover all the resources, it's just impossible. The medical knowledge is vast. So whatever you do study, make sure, you know, 100% of that topic, so always keep revising whatever you have studied. Uh nobody can remember something that you have only read once, no matter how much you have read, uh how much, how many resources you have read. But again and again, revising that topic or, you know, revising about that disease will definitely help you remember it. So, uh my advice is even if you study less, make sure whatever you are studying, you know it and you remember it and the only way to memorize it is by revising it again. And again, secondly, you need to assess yourself. You need to assess where you stand and how well you are doing. What are your weak areas? What are your strengths? If you know, this is your strength, you don't have to again and again, go through it. But when you know something is your weakness, you have some chance to improve in it. And if you're really poor in it, you can even improve until you become average in it. Or if you're on average in it, you can improve until you become an expert in it. So make sure that you are not scared of assessments. Assessments are only there to guide you um to show you where you're weak. So don't ever be scared of taking an assessment. Even if it's uh what I can advise is take an assessment right at the beginning of your preparation so that you know, at basic level where you are and then as you keep on studying and uh uh remember new topics, when you take the assessment, you will feel really good that you have improved at least in some part of your um knowledge. So yeah, third thing is to just improve, to keep revising your weak areas. I give you 100%. So your 100% can be different from your friend's 100%. That doesn't matter. You have to do what you can do 100%. So there should be no regrets at the end of your preparation that oh, I wish I did that, you know, so always give you 100% and leave everything else for the universe to work for you. And again, just keep revising. So what are all the basic documents that you need to apply for residency? So of course your um scores those are the top things that you will need. So there is no um score that will give you 100% guarantee of you matching. So it is all an ever-changing process. Uh a score that worked last year, last year might not work this year. So it all depends on your overall application. So just try but always try to get a, a good score in the your ASEM exams. Secondly, there is AF MG certificate. So once you're done with your step one, step two or like just step two, some people opt to um give step two before step one. That is doable. But uh for me, it's not advisable. Um So step two, along with the O ET, which is the occupational English test used for the application. Both of these are requirements to get your CF MG certificate. ECs MG certificate is um an important criteria. So everybody needs to have an E CF MG certificate before the match. Then there are the lo so with the letters of recommendation. So these are given to you by physicians under whom you have worked or, or you have done some rotations. So for the USM applica for the US application, it's preferable that these L OS come from US physicians. So when you come to the US to do the rotation, you try to impress these positions, you try to uh connect with them and uh build A R over with them and then they will uh give you a letter, uh not, they won't give it to you, but they will upload it directly on the uh portal. And uh when it's coming from a fellow US physician, the program director knows how the training in the US is. And if they are recommending you and telling the program director that you will be a good candidate, they know how you will do in the US in this environment. So it's really helpful to get it from a US physician. Then we have the MSP and the MST. So MSP is medical school, performance evaluation and the MST is medical school transcript. So these are given to you by your medical school. I mean, again, they are uploaded directly on the portal. They just give a brief um overview of how you performed in your uh medical school. What basic grades you got, what grade you graduated with? Um In my opinion, they are not that important. Uh Like nobody pays a lot of um nobody gives it a lot of value because different countries have different ways of evaluating their medical students. There is no set, set standard criteria how every country uh uh goes uh through or what it compares with with a US medical student. So uh honestly, it's not um that valuable but it is a requirement for the APP application. Then there comes the personal statement. So personal statement as it is describing itself, it gives an idea about how you are as a person, what experiences shaped you in your life? What made you choose the specialty that you are applying for? What makes you a good eligible candidate for this, for that specialty or for that program itself? So, personal statement is just a one page, um uh one page essay in divided into paragraphs and it should give a brief overview of um what are your values and uh what skills you have, what cha characteristics you have. If you have done some rotations, you could talk about it. If you have some life changing experiences, you've done volunteer work, all of that could be included in your personal statement. Um You could start with something really catchy and you could then progress through the entire personal statement ended by, you know, how you are a very valuable candidate for the program. Basically, you're just selling yourself in the personal statement, then we have the, er CV. So the CV, in the er uh it is something you have to type it in the portal itself. And um again, it will include all the experiences, you have the work experiences, the rotations that you did any research, publications and the experiences. And also there is a section for hobbies. So if you had any interesting hobbies and where you were like, really good at something or you're really successful or even some hobbies like watching movies or like cooking something, baking, you could include all of that if it really inspires you and if it shapes you as a person, if it's important for a program director to know about it, yes, you can definitely mention that. So that's uh basically your URO me. Uh Also, you can mention all the volunteer work you have done. Uh that that is also a good way to showcase your um uh all your experiences. And then you need a list of the programs that you have to apply to. So how the whole timeline for us application is that you need to have everything prepared by the end of August of that particular year. So before August, you need to have your USM scores, you need to have S MG certificate, your L, your MSP personal statement and what all you have to write in your er CV along with the programs you have to apply to. So by the end of August, you should be ready with all of this in September, the application portal opens, you fill everything in, you upload all the documents and at the end of September, you click submit and then it's done. Your application is in and then the interview season starts. So interview season is from October till the end of January in the next year. So you can get in uh interview invites throughout. There is no fixed particular month that you should be getting your interview, that everybody says that you should be getting it in October. But that doesn't matter, you can even get one in January. And then um in February, you submit the rank order list. So that is basically the programs you interviewed at and how you would rank them from one to whatever number of programs you got. So the top choice for you will be your number one. Uh So in February, you submit that rank order list and in March, the result comes out. So freedom and residency explorer, these are two resources that I personally use to select my program list. So you, the selection of program list is uh depending on what um criteria they have for candidates uh for their program and also the criteria you have that you want uh from a program. So may suppose uh for example, somebody wants more of programs, uh somebody wants to work uh or do residency in the in New York. So you will select or you will definitely apply to all the programs in New York. But you have to also make sure that those programs are I MG friendly. Like do they have, do they take IM GS also majority of us as Im GS require visas? So do they do the pro programs give visa? Uh thirdly, uh it, it doesn't matter, it doesn't uh always happen that you have research experiences. So what if that program prefer someone with a research experience or um you might not have a lot of us clinical experience. So there are some programs which require at least six months of us clinical experience. So it all depends on the filters that the programs have for you. And also the filters you have that you want from a program. So these are uh good resources which can, you know, um break down all these uh filters and then you can choose which way you fit in basically. Uh So yeah, so prepare a all of these uh things before August of that year that you want to apply for, for March. Oh Sorry. So how do you get observers or rotations or electives? So, um firstly, uh what I would say is if you have any relative, any contact, any uncle or aunt in the US, reach out to them, everybody has some or the other doctor, friend in the US if they're living in the US. So just reach out to any remote relative also that you know, and tell them that this is like what's going on. I need some rotations in the USI need to uh just do like one month under a doctor, just observe the doctor. So you could do that. You can just email uh just, sorry before emailing, you can just contact all your relatives and ask them if they know some personal friends or doctors and if they can, you know vouch for you and they can set you up with them. So these kind of um observers come for free mo majority of them won't charge you because they know somebody who's a friend and who's asking for just some help. Right? So that is the best way to get some observers. Second is just cold emailing. So go on linkedin, go on the websites of hospitals, just find random doctors and just email them. You will have to email at least 100 or 200 of doctors, but from them, maybe 10 will reply to you and maybe at least five will accept you. So this is a chance you have to take just prepare a good template. Uh introduce yourself. Talk about a little bit of where you are at in this journey. If you have given the stamps, if you have the MG certificate, mention all of that, tell you about your interest in the specialty you want to apply to and just go and email all these doctors, maybe one or two will get to. You just come to the US. Do these observers talk to more doctors in that hospital and then you can ask those doctors to give you observers as well. So that is how I did it. I just had one contact who I knew in the US where I came. I just started doing the observer and in the hospital itself, I found more doctors who are willing to help me. They recommended me to some other hospitals to other doctors where I then went from there onwards. So call emailing randomly to uh to doctors or maybe you have like a community, maybe some uh if you go to a church, maybe there are some people from church who uh who will help you out. Or maybe if you go to some mosque, there are people from a mosque who will help you out. So just try to reach out to your community or any kind of relative or just cold, email, random doctors and somebody, everybody knows the struggle that um we as IM GS face come to the US. So somebody out there will be willing to help you but you will have to do some effort for it. Now if you are already in the US. So for example, as I said, you f you came here, you did one rotation. Now you're already in the US. Then what you can do is just go out on the street, visit some primary care clinics in person, have your CV in your hand, give it to them, just request them that you are here, you want to do residency. And so and so uh specialty and you want to do some rotations or you can just volunteer in their clinic for free or you could just help them out with some administrative work, anything like that, you can go and request them. And sometimes even that way doctors are willing to take you. So you could even try that out. And for me, the last option is to approach an agency. So I do not um personally prefer this option because um there is no guarantee that doing a rotation at an agency will give you a match. Secondly, already, the cost of this journey is too high and financially and agencies cost a lot more than what's worth um for the rotations. Uh When you can do these initial four things by yourself for free, then why would you want to pay for uh pay thousands of dollars for someone for a one month rotation? So, but sometimes um we sometimes all the first four steps don't work. So you can approach an agency. There are many found online and you can um book up a rotation with them but make sure you do a thorough background check for uh about that rotation about the doctor that they are setting you up with and whether you will get a letter of recommendation at the end of the rotation or not because you're basically going to us and doing these rotations to get a letter of recommendation from that us physician. So if the agency is not providing you with that, and it should be a personalized letter of recommendation, not just a copy pasted template. So that is very important. So, always do research about it before you book a rotation with an agency. Now, what are some skills that you could develop while you are in the journey and which will help you ahead to match or to even get a rotation. So first of all conversational skills, so uh I know sometimes it's hard if you're an introvert and you don't really come out of your shell a lot and you don't really know how to talk or how to network with people, but you need to develop these conversational skills. So people who grow up, grow up in the US, they learn all of this from childhood and they know how to communicate well, how to sell yourself, how to talk about yourself. So these are some conversational skills that you need to have, how to interact with doctors, how to, you know, um how to showcase your personality when, as you speak. So I definitely recommend that you uh talk to more people, talk to, if you're working in the hospital, talk to your colleagues, talk to your seniors, talk to your patients and just um have this kind of a conversational skill. So that will really help you then uh job experience and related skills. So, of course, you're in the medical field and uh how will you build your expertise? It's just by experience. So, work experience is really important. Um try to get a job wherever you are while you are um going through this uh journey. So there is a lot of free time in between like when you are starting first steps or when the visa process is going on, there is a, there is free time and you can just take up any kind of job in the medical field. Every kind of job can help you build your experience if it's just even obser obs observation like observers or whether you're doing a medical assistant job or even a transcript job or you, of course a job as a doctor, all of that will really help you uh even knowledge wise and as a doctor then research. So research is something which is really trending now in the US. So they require um applicants to have some basic research skills to know how to like write a case report or to, you know, just be a part of reviewing uh how to review an article or how to gain the conclusion from an article. All of that has um become really important now. So if you don't have any researches on your CV, you could just be a part of some projects. Uh Again, you will have to reach out to doctors in the US for this or even wherever you are, you can reach out to doctor doctors there in your hospital or from your um medical school. If there is anybody doing research and you can be a part of that research. And if you have some publications that is, that is really a good um bonus for your c then volunteering in community. So everybody over here in the US uh likes that you are, you should be a part of the community where you are working, you should be able to help out mm people in your community and uh do some volunteering work uh raise awareness about medicine and uh about diseases. So wing experience will definitely help like medical camps and blood uh donation camps and things like that. All of that uh is a very good um skill to have then sports and fitness. So uh a lot of people uh program directors when uh we interview with them, they might be having some kind of favorite sports. And it really helps that when you also are a fan of something or if you're playing something, if you're an athlete, you talk about it, it shows that you are an allrounder and, uh, you have some skills outside medicine, you have some hobbies. So it really makes it an interactive conversation with doctors. Uh, personally over here people are fond of sports. They like to watch, uh, football, soccer and, you know, all those games and, uh, if you yourself have sports as a hobby, that's a very good skill. And you should show, definitely showcase that when you are interacting with doctors here. Also personal hobbies, something like reading or even watching movies. Uh, supposedly for me in one of my interviews, I just talked about a horror movie and that really got the conversation going for me and it was a very good conversation and I ended up matching at that program just because we connected over a horror movie. So that's something really funny. You just don't know what you did in your life could actually be a good topic to talk about. So just go sit back and think of everything you have done in your life, all the skills that you have everything that makes you unique and just write it down and know how to talk about that in your interview or whenever you are interacting with someone and make it like a plus point about you. So any kind of hobbies, anything you are good at just um think about it, how it makes you special and how it makes you unique. What uh it brings out in you, uh how it makes you, you know, a best version of yourself and be ready to talk about it. And another skill to develop is cooking. So when you come to the US, you will be living all by yourself and eating out is really expensive. Ordering food is really expensive. So cooking is a, is an evergreen skill that everybody should know. So having that skill is really important and uh even some skills like baking and all of that is helpful. Uh like to talk about just shows how much of an allrounder you are. So yeah, these are some skills that I advise people to have. Now, uh these are some important things to know before you are traveling to the US. So a lot of these things I did not personally know about and it was hard for me, uh, doing research about it before I traveled. And a lot of things I came to know after I traveled over here and I experienced it firsthand. So there are something that I noted down that everybody before traveling should do. So, of course, before you're traveling, you need your visa. Uh Also, it's good to have a debit card or a Forex card which has dollars in it so that you are not charged for transaction uh or like uh sorry, currency change fees. So it's good to have a dollar debit card, which you can use over here everywhere. Also SIM card. So nowadays everybody uses Esims over here. So it's very convenient. You can just buy it before you travel and you can come to the airport and activate it. So E SIM S are really good. Um I recommend uh uh some the SIM card called Mint Mobile. So that's a very good. Um So I basically just bought it while I was in Kuwait and I came to the airport and activated it and it was really easy for me. So uh I advise on getting Esims and then a driving license. So if you already drive wherever you are, just get an international driving permit and then once you come to the US, your life just becomes easier if you're coming for a short time, like if you're coming on uh B1 B2 Visa. So now you could drive here for six months without uh the driving license in the US. You could have the international driving license and that will work for you. So you could just get a rental car and then uh commute will be really easy for you and if you do not know how to drive. So I definitely recommend learning how to drive because uh transportation and uh the public transportation here is very bad and a lot of places, a lot of hospitals are in the suburbs, like all the I MG friendly hospitals where they don't have good transport system. So you do need a car when you come to the US. But if you're in New York or you know uh Chicago, for example, those have really good and well like widespread car transportation system. So maybe if you're doing rotation there, you will, you might not need a driving license. Then there are some important uh documents that you need to have like insurance. So you should have a health insurance. We don't know what can happen to us where uh and if God forbid you need to visit a hospital here, it costs a lot and it's really hard to recover that amount of uh money. So having an a health insurance, travel insurance, all of that is helpful. So you can easily get it or wherever you are for way more cheap than when you come here. Also, some rotations require you to have health insurance. So make sure you check about that um before you apply for it, then uh it's always good to have your uh photos with you. When you come over here, copies of all the ids that you have back from home, your passport, all the IDS uh also immunizations. So everyone, every hospital in the US will require you to show that you have done these immunizations and uh especially from pe for people who are from India getting atb uh test and all of that is uh really important. So make sure you know what all immunizations you need and do them back home before you come here, then uh read common bread and butter topics. So whatever specialty rotation you are doing, it's good to know a all the uh bread and butter topics of that specialty so that you can uh leave a good impression of yours on, on the um doctor that you will do the absorption. But um uh because as a medical student or as a just graduated um individual, the only thing you could show them is how much your medical knowledge is. Of course, you don't have any firsthand experience in, in that field. So you don't know the clinical um way to treat a patient, but you should know the textbook way to treat a patient at least. So it's good to read all the bread and butter topics just to revise before you start any kind of rotation. Now, this one advice I'll give everyone uh which I did not personally know. And I got to know once I finished the rotations that note down everything you see in a day. So anything interesting that you see any kind of case, you see uh whatever happens during the day. If you did something, if you were involved in some part, even as an observer, sometimes you are involved as a pa as a part of the patient care. So whatever you did in a, in the day, come home and just note it down, this will help you when you are building your er CV, when you will be writing down about that rotation. So if you yourself know clearly, because you don't know when you will do these rotations and when you will be writing the CV, there will be some month difference and you might have forgotten what you did in that rotation or if you saw something interesting. So or if there is a skill that you develop, like sometimes when we do observers, we develop good bedside skills uh while seeing a patient. So all of that, it's good to note down. And then you can, you yourself have a good picture of how you did in that rotation. And also you can see what you missed out. So that in the next rotation, you can give more importance to that. So note down a reason you see in a day when you're doing rotations. So then what are some essentials that you need to have when you come for irritation? So, scrubs, of course, um, scrubs you are not expensive. So just get scrubs from home, get a set, have at least two or three white coats and a good pair of shoes and then accommodation. So, uh I personally used uh airbnbs for accommodations. I did not have any relatives where I was um doing my rotation. So of course, it's really good to just be uh with some relatives and um save some cost for accommodations. But airbnb S are a good option. There is something called furnished finders, which is also a good option to find um some apartments or like one bedrooms and um homes and of course, there's relatives then transport. So II obviously prefer public transport because it's very cheap. And um uh in places like New York, Chicago, oh, it's uh it's very um accessible. So pub public transport is really good. But um if not, the second best option is to just drive yourself when you come to the US, get a rental car and just drive yourself that way you will even have a good chance to just explore around wherever you go in your free time. AAA after you are done with the hospital, you could just go and explore the city and make some friends. And uh if you can't do both of that, then the other option is taking a cab. So there is also this app called Lyft, which is used here, which is a little bit cheaper than Uber. But uh honestly, um over your cabs are very expensive. So when I did my rotation, I used uh I was at, I was in Texas and there was not good public transport there. So I used to use cabs and trust me when I say this, the entire cost of my, of the Ubers and Lyft were more than what it cost me for my tickets to the US. So yeah, um I'd really recommend that you know how to drive and get yourself in a car or use the public transport. So I get a lot of uh questions about what was the cost of the entire journey? So it's variable um for some in some aspects because um uh for some things, it's not like fixed, for example, rotations. So sometimes rotations can be free of cost, but sometimes it can cost you thousands of dollars. So in that way, it's quite variable but the approximate cost according to me and what I experienced is like 20 to $21,000. So I have like made this stable and I've listed the most recent cost of everything uh that uh was there in, involved in this journey. So the app from the start from the application fee uh to the end like the rotation score. So like for example, applying to programs can cost you 3500 to $4500. But it depends on the number of programs you're applying to. So as an I MG it does ideally, oh, it is ideal that you apply to at least like 1 3200 programs. But it totally depends on you if, if these programs are meeting all your filters and if you are meeting all the requirements for that program, sometimes people just apply to like 100 programs, but they are very, very particular and specific for these programs. So the, so the cost can vary up to a limit, but majority of the times it's going to be like up to two thou $20,000. Now, what are the most common specialties that people match? Uh So, so uh so these are just the common specialties but I'm not discouraging anyone from applying to any of the other specialties as well. Uh It's totally like based on your skills, on your experiences, on your overall application. But uh for this, uh for the last uh match cycle, uh the majority of people matched in internal medicine uh who are non USI M GS. So by non usi M GS means they did not, they are not citizens and they're also IM GS. So um it, so the top one is internal medicine, of course, then internal medicine, there could also be prelim and transitional internal medicine. So all of that is included the main internal medicine is the category of internal medicine. So um then comes family medicine and pediatrics, psychiatry, surgery, prelim. So surgery prelim means that you do one year of prelim uh surgical rotation. And then again, you have to apply for a match to get into a surgery category program. Then is neurology and pathology. So all of these are the most common ones, but that does not mean that it's impossible to match in any other specialties. So I'm not discouraging anyone from applying to any other specialty that they are interested in. Um And then talking about the basic hospital system in the US. So hospitals here they run based on the insurance uh that the uh patients have and everything is insurance based. Um but you uh basically as for me, as an internal medicine resident, we have inpatient, we have outpatient clinics, we do electives ICU rotations. And yeah, so in inpatients, the patient will come to the ED first and then based on how they are triaged, they get admitted either to the general floors or to the ICU and then they are discharged. So we see patients when they are admitted in the floors or the IC. And if you're doing an emergency medicine um or residency, you will see the patients in the ED itself, then there is outpatient clinic. So these are continuity care clinics. So every uh few weeks you will be posted in the clinics. Um and uh you will sometimes see the same patients when they are following up with you. So that helps you build a relationship with that patient. And uh you get to know that patient in more detail, all their pathologies you are managing as an outpatient uh primary care physician, then we do electives. So, electives are the subspecialty rotations. So for example, if I'm taking internal medicine, I can do electives and cardiology, pulmonology, uh gastroenterology. So all those are subspecialty uh um rotations that we get to do. And then of course, there are ICU rotations. So your majority of residencies have um uh the residents have to work six out of seven days a week. So everybody gets at least one day off during the week during outpatient um rotations being get two days off and also any kind of public holidays we get off in outpatient. But when we are doing inpatient rotations, we get like one day off and some uh programs have golden weekends where they get two days off, Sunday and uh Saturday and Sunday. But um most of the time we get like at least one day off and the maximum time we walk during the day is like 12 hours a day. That's the max. So anything more than that, then they need to like um compensate you the next day or so, most of the rotations are such that you work six days a week and you work, work for maximum of 12 hours a day then, uh, there's vacation time. So the, this is the paid vacation, uh, as residents, um, we get like 3 to 4 weeks per year and then plus or minus the six days. Um, majority of program have like four weeks max per year. So this is, and then it depends like program to program if they allow for additional, um, unpaid leaves. Now, lastly, talking about the living conditions in the USA, like what is the cost of living and all of that? So um most of the programs the in hand pay you get per month could range from 3500 to 4600. It could even go a little bit more depending on the location, the city, the state, the taxes and all of that. But this is the income that most of the people get without tax. Uh like after the taxes cut, this is the in hand pay that people get. Uh over here we get biweekly pay. So like we'll get half of that every two weeks. Uh that really hurts and like paying the rent, uh the bills and all of that. Uh Well, uh so according to my experience renting an apartment over here in the US, it could range from, to me living in like uh a little bit of outskirts of Philadelphia, the one B sk uh apartment could cost like from 1100 to 1600. But like now if you go to New York, for example, over there, the cost of living is higher. Of course, the pay will be higher as well. So in that case, it could like range from 2000 to 2500 maybe. But most of the people have like this kind of um um range further uh renting an apartment and then like wifi some card, all of that could cost like 60 $70 per month. Uh also grocery and like shopping. So majority of people like uh spend around 400 to 500 per month. It totally depends on, you know, as someone who would like to order things or like uh eat outside of it will be more than that. But uh yeah, this is just the average and then if you get a car, uh you might have to pay for car insurance. So everybody um has to pay for car insurance over here. It could range from 250 to 4 $50 per month depending on how experienced driver you are and what they think uh about your, you know, driving capabilities. So this is the basic cost of living per month along with the income. So I think uh I tried my best to cover all the most common questions that everybody has about you is to give a picture about how uh the journey is how the life is here. But if you all have any more questions, if you need any kind of help. You can always reach out to me on linkedin. So I've attached my uh linkedin um web link here. So feel free to reach out to me for any questions. But even uh today, we will uh I hope I can answer uh some of your questions. So thank you everyone for listening to me. And I hope uh you all achieve whatever you dream of and uh good luck to everyone get started with your journey and hope I see you at the other side. Thank you so much, Doctor Fatima. Uh That was really good and it was beautiful. Um So we're gonna be doing Q and A session with Doctor Falconer. Now, um before we jump into the Q and A session, uh I will be putting the feedback form in the chart. If everyone could take a minute and uh fill out the form, it would be a great help to our doctors who present. And yeah, it will be a great addition to the series. So we'll give you like 10 minutes for you to fill in the feedback form quickly and then we'll start uh you in the session with Doctor Fatima. I'm sure you can all see the feedback form in the chart. Now, if you all can just quickly go and do that for us, we would be really grateful. OK? Um So we'll do a quick clear session. No. Um I'll read out the question and doctor F you can answer. Um The first question is, are we able to access a recording of this meeting or a copy of this powerpoint presentation after this meeting? Yes, we will be uploading the recording and the powerpoint um onto our BSA meal page. Um You all can access whenever you wanted to. Um The next question is Bergera is not currently recognized by WFM. E. Does this affect my ability to write usm next year? Can I get EC F MG and apply for step one like normal? So your medical school needs to be recognized by WFM E as far as I know. So if it's not, uh if your medical school is not recognized, then yeah, it does affect your ability to register because when you're applying for um the USM ID, they will ask you your medical school and whether it is recognized, they will be checking whether it's recognized in the directory of WFM. So yes, it will affect. Um The next question is, do you know uh about those who are G MCU K registered and employed to convert uh and registry with the States or is the process the same as for all IM GS? Yeah, they process the same for all the IMG S no matter from where you graduate. Uh Of course, it will help you sometimes after you register and uh when you are in the journey, uh when you are in the interviews, uh knowing that you come from um UK or you are registered with UK. Uh you know, Canada, UK, all of these are uh they know that the standard of um the medical studies there is a bit higher according to the US. Um you know, according to the people in us, Canada, UK, Ireland somewhat, they hold a bit higher value. So yeah, uh but the process is the same, you have to do all these steps the same way as any other IMG has to do. But you can of course showcase on your CV that you are registered as a GMC license doctor. Thank you. Uh The next question is where can I check? Which specialties are I MG friendly? So you can search uh on Google for NRM P match data and there is a whole PDF available for every year. It shows all the percentage um uh of people who have matched in uh in the US in that particular specialty. And they have like categorized them into USM DS USD or D or the USI M GS and known USI M GS. And then they have given percentage for all the specialties of um how many people have matched, how many have unmatched, how many applied? So you can just search NRM P uh match data for that particular year that you want to know about and all of that is easily available. Yeah. The next question is how much importance is required in publications. Um If the question means that our publication is important. Yeah, they are. Um, I mean, um, so the, the program directors have this entire list and they have like check boxes. So if you're checking more boxes, it's obviously a plus point for you having research experience in my experience is a good skill. Um And publications also, like, it depends what kind of publications now if you're doing really well. Um, a publication in a very well known uh journal, like, you know, any em, or like uh PUBMED and all of that, it's really a good uh skill to show on your CV. Uh But uh if you're just doing some case reports, like just publishing here and there, it might not be as um favorable, but of course, it still shows that, you know, how to research on a particular topic and how to do a literature review and things like that. So, having any kind of um publication or research experience is always better than having none. The next question is, are the chances of matching higher for someone who has work experience as a doctor after medical school or is it equal for someone who is applying, applying straight out of medical school? So, I think the best thing is to apply straight out of medical school. So at that point, you are a fresh graduate, all your medical knowledge is new and um they don't, uh they don't expect you to have any experience at that point. Uh in your life. Right. So that is obviously an advantage. They want young doctors and people who have fresh, uh, medical knowledge. But if you, uh, are not able to apply when you are a fresh graduate, uh, it's good to have experience then, uh, so better than, like, just sitting and studying at home. Like, uh, because they want to know each and everything you did after you graduated. So, when you tell someone that, oh, I just, I was just studying for exams versus when, when you tell someone, oh, I gained this experience, I was working in a hospital. It's obviously going to be helpful for the experience will be helpful for you as you know, it will build confidence in you itself as well as you can show all the skills that you gained while you were doing that experience and then they know that, ok, you know how to be a part of uh a patient care team, you know, so it's advisable if you can to apply as soon as you graduate. But in case you can't, then it's good to have a working experience. Um How did you do research? And how many papers did you publish in med school? Ok. So I did not have any publications. Unfortunately, I did do research. Uh but I was not able to publish anything on time for me to um, put it on my CV. Uh what I did was uh um whenever there were any conferences in my medical school. I used to um do literature reviews and like submit abstracts and like present or do some posters. So all of that is also counted as as a research, not just publication. If you did some workshops, if you did poster presentations, if you just talked in any of the um um conferences, if it's National International, anything, all of that counts as uh some research. But uh obviously it doesn't hold that great value as a publication does. But yeah, I did not have any publications. So how you can uh how you can get to do researches uh just re try to reach out to your seniors to any professors that, you know, who um are uh you know, working or doing some kind of research and just try and ask them that you can just be a part of anything you can help them out if it can just get your name and the uh publications really good or try to just uh get in touch with doctors from the US. If you can like on linkedin or just on some university website, you can find some doctors, you know, if, if there are programs you are interested in applying to, you can reach out to doctors from there and they can help you uh do some research. So you just have to reach out and try to um get uh find a mentor. Yeah. Uh The next question is how long does it take to obtain a green card? Are there a lot of residency physicians that sponsor H ONE B Visa? Uh I am not sure how long it takes to get a green card because I don't have a green card. I'm here on J One Visa. Um, but uh about H one B there are programs who do sponsor H ONE B but as I MG friendly programs, um there are less compared to J one. So every I MG, every program that takes will definitely at the basic level be providing J One Visa. But I think around like 50% of those programs will only be providing H One B Visa. But it's obviously not impossible to get H One B Visa. But you do need to have um your assembly step three if you want to apply for H one B Visa. So you can only apply for H one B if you are a fully licensed doctor in the US. And that only happens when, once you have step three. Yeah. Um The next question is, could you share a with what you used if it's possible or where can I find good ax? So I personally did not use a um I know a lot of friends of mine who used a and found it really helpful. Uh I am not a flashcard uh user like it all depends on the way you would like you are comfortable with studying. But uh you can easily find on um online, just search for your family, step one deck. Um uh Also on Reddit. So there are um groups on Reddit for IM GS and uh first steps like step one, group, step two group. And they all share all the famous um monkey cards and monkey um uh decks that are downloadable. So you could search there. Um The next question is, what did he do about volunteers in Bulgaria? I think the main, they might mean like if you have done any volunteer work and if so what kind of volunteer work you have done? Um me in my med school or like in general, um What I did is I used to be a part of medical camps. So wherever. Um um so in my community, we used to organize medical camps and just help people uh like uh spread, spread awareness about the camps and then just do basic like BP and like blood glucose level checking and things like that. Uh In medical camps. I used to be a part of that. Um There were some uh religious functions which are organized where um we used to just do basic checkups for people. So something as small as that could count as a warranty of work. If during COVID, we used to go around in Georgia when I was in Georgia and COVID. During COVID, we used to go around spreading awareness about vaccines and um uh you know, raise awareness about COVID, the precautions and all of that, that is me that is volunteer work or you could just uh go to any kind of a clinic and just um help them out there, do basic work, you know, in the clinic. All of that can count as volunteer work. The next question is, is it possible to open up a private practice while you are in H B1 visa or is a green card mandatory is step three mandatory for H B1. Um I am not sure if I'll be able to answer that question. So step three is just a requirement. Which one B but uh if you are able to open. So if you are on AJ one Visa, you need to do AJ one waiver for three years and only then you can um uh get an H one B. Um But uh I am not sure about the whole visa. Um part of this because I'm not on H one B nor do I know anything about green cards yet. So I'm sorry, I cannot help you answer that question. Um The next question is I know you get your diploma in December. But how did you start matching in August? Is it possible to match with our diploma? And when did you officially match with hospitals? And when did you start the residency? So I did not study from Bulgaria. But uh so I got my diploma and July and I did not apply directly after um I got my diploma, I did one year gap. So in that I did step two, I did the rotations. I got some work experience and then I applied for Match. So yes, you do need your diploma. You need your diploma. I went to get the ECF MG certificate and ECF MG certificate you need to submit by January uh of the match cycle. So if you do graduate by, let's say November, December, you need to have your ECF MG certificate by the end of January. And it takes like at least 4 to 6 weeks to get your ECF MG certificate. You need to have OE and step two ready as well. I don't think there's enough time for that, but um, it depends in December. If you get like early December. Yes, you can. Uh if you get like in late December, you still need 4 to 6 weeks. So it's quite risky because for example, you get all these interviews and you like, oh, you know, you're almost set to match, but you don't have your ECF MD certificate, then you will just get disqualified from the match. So, yeah, you need to plan accordingly. So I started residency. So the match results come out in March and then you start residency um in July the first of July. So yeah, so from March to June, you have time to get your visa or the working visa for the US um the next question is for our volunteering, what paper work, work or certification would you recommend to present at the interviews? So no one will ask you for the certification or any kind of approve that you did the volunteer. They just by asking you questions about the volunteering, they will know if you really did it or not and whatever you are speaking about, the volunteering is your own experience or somebody else. You know, the interviewers are really smart. They have been doing this for a lot of years. So they know how to uh judge a person by the way they speak about something and whether they have really done it or not. So if you do a volunteering work, it's good to have a certificate as a proof, but nobody will ask you about it. And also secondly, you should be able to explain what you did during that volunteer work in detail with confidence during the interview. So that is the certificate that they need. Perfect. Um I think Alan's question was answered in the chat by chance. Thank you so much. Um That was the last question for now. We're gonna wait like um a minute or so and if there are no more questions, we can end the talk. No. Yeah. OK. There's another question, how much time is minimum for the placement experience in the US? I'm not sure what you mean by placement experience. Could you elaborate on that? Do you mean that how much time it takes to get into residency in the US? Um Maybe um like how many weeks do you require to do the placement or how many placements? OK. You mean you mean the rotation, the observer? Um maybe but uh OK, like, OK, let's just talk about that. So, um you need to have at least three months of US clinical experience uh on your CV, you need to show that you did at least three months and it's good to have more. It's good to have up to six months, but three months is minimum. OK? I think that was the question. Yeah. The next question is when you talked about living conditions is the salary at that time of the residency. Yes. Yes, that's the residency salary. Ok. Um Another question is linkedin the best way to contact you for future questions. Yeah. Yes, you can contact me on linkedin. I will, I'll definitely answer. It might take a few days for me to answer if I'm in a busy rotation. But yes, I'll, I'll try my best to answer you on linkedin. OK? I think we can end our talk here. Thank you so much, Doctor Fatima for taking your time. We're really grateful for your information, your insightful information about the uh the pathway. Thank you so much and thank you everyone so much for having me. I hope I could help. Yes. Yes. It was really um good information. That we got. It was really helpful. Thank you so much. Um And thank you everyone for who joined this evening on the weekend. Thank you for your time. Thank you uh for your feedback from us. Uh Please do follow our page on Medal and on Instagram for further information on our upcoming uh events on me all. Thank you so much, guys. Have a great evening. Bye.