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Ok, so welcome everyone to our second session. We have John Hannah who is 1/4 year medical student at Queens University in Belfast and tonight he'll be running through. Um Yes, I step one and step two. He's already written step one and he's prepping for step two and um he's gonna be happy to answer your questions at the end and the guidebook will be sent out to you um later on tonight and our next session is gonna be covering electives and then the following one will be covering step three residency applications if you have any questions related to those and we can probably cover those in the later sessions. Um So I'll let John and take over off. Thank you John. All right. Thank you James. Uh So hi everyone. Yeah, my name is John. I'm looking for your medical student at Queen. Um I saw my step one last year and third year summer in August and thankfully passed and I'm prepping for my step two examination now hoping to take it sometime in fourth year summer with the elective. So sometime in July or August. So uh I'm gonna be just talking briefly about the step one examination. Uh and a bit about step two, how I'm prepping for that one. Just talking about the resources I used and some like tips that II picked up along the way. So uh James, if you could do the next slide, please. Thank you. So, um just a quick overview of what we're gonna be talking about today. Um I know that we had an earlier talk on the E CFM G certification. I just wanna briefly go over it again because it is quite important because it's changing this year. Uh We'll go over the steps to become a US physician. Uh The over overview of the USM OE um how it's scored now. So the scoring recently changed and the emphasis is kind of switched over to step two instead of step one, some key terminology and then the resource I used and then we can do AQ and A afterwards. So, uh this next slide. Thank you James. So um real quick, the F MG. So this is the governing body responsible for the entry of IM GS into the United States for medical practice. So this is how the States basically validates and certifies um medical students from across the world. They want to make sure that you went to a university that is accredited that has a reputation of teaching their students. Well, so this is how they do it. Uh We had an earlier session earlier on with Sandra about the certification process and how to apply for the exams. I won't go too much into detail with this, but basically, um, they're changing the way that they want to certify medical students across the world in the past, your school just had to be on this list and it was perfectly normal. No bother, easy, easy things to go through. Um, they changed it recently and as of my knowledge, currently, the UK medical students will not be able to apply for certification or accreditation to practice in the States after 2024. So you have up until December 2024 to pay this fee. I think it's something like 100 and 50 lbs, maybe 200 lbs. It's not much. Uh, and once you do that, you are guaranteed certification as a medical student under the United States, they will accredit it to you and they'll say that you went to a legit med school. Uh After that, if the GMC hasn't, uh, complied with the United States F MG certification guidelines, um, you won't be able to set the exam so the States will be something out of reach for you for the time being unless the GMC changes what they're doing. Um So I would suggest if you're considering it, it's just even a possibility in the, in the distant future that you sign up for the EC F MG certification, you pay the 200 lb fee and you just get that stressor off your mind. Um Other than that, these are just some of the points that joins over. So you go to the website, it's really not that difficult. You search up P CFM G step one application and you just fill out the application and they should get back to you within like a week or two. You have to pay like a 200 lb fee, but it's not, it's not like the end of the world. Other than that, I won't spend much more time on it. So if we go to the next slide to these dreams, so these are the steps to becoming a US physician. So first off, you have to complete your exam. So you have to complete uh your um step one exam and your step two exam. Uh after COVID, they took away the C SS exam. So there used to be an A that we had to sit and write, uh they took, they took that away and they replace it with an OA which is basically like an English literature examination to make sure you can speak and write English. Well, um I'm not too sure, don't quote me on this. I can get the information and get back to you guys with a handbook in it. But I believe if you went to a Mexico within the UK or Ireland, then you don't necessarily need to take the O ET. But I'll get back to you on the information of that. I think if a dean's LA can prove that you were taught medicine in English, you don't have to take that examination. Uh Typically, if you want to make yourself in a competitive, a applicant into the match process for the States, you would choose to undergo your electives in the United States. More information will be available on that in the next talk. Uh You then send off your applications, you do your interviews, residency, you apply for the match and then match that you find out where you've matched what specialty you've matched into. And it's, it's usually like a really fun day if you match. Um Other than that just next slide please, James. So what is the EEM? So the UEM stands for the United States Medical Licensing Exam and it's a three step exam process. It's used by national medical graduates. So people who go to the States for medical school, write these three exams. It's also used for IMG which are us international medical graduates to kind of accredit and prove that we have the basic knowledge to go and work in the States and we're not going to kill patients. So it's, it's, it's a governing body that everyone has to write. It's um owned by the FSM D, the Federation of State Medical Boards. And more importantly for you guys, the National Board of Medical Examiners. So the N BM ES, they um write the exams and they also write the practice exams. So that'll be very important in terms of resources when we get to that slide later. Um So the U 70 is an all in one exam to grant both locals and img us the ability to practice in the United States. It starts off with the step one examination which is based on basic clinical sciences. It's a much more annoying exam to write. I can tell you that from experience. Uh then step two clinical knowledge examination, that's a much more fun exam to write. It's more practical things, stuff that we've learned in medical school, to be honest, stuff that comes up on our exams in medical schools. And then the step three part, the step three is an exam that you write afterwards. Once you match, it's typically written in the first or second year of residency. So it's not much worry uh for us as of yet, it's not a huge problem. And as I said, the step two CS or the Os examination has been canceled indefinitely because of COVID regulations that they deemed it wasn't necessary and they, they're not planning on bringing it back thankfully. So it's one less exam for us to take in order to get there. So just the next slide please. So this is the step one breakdown. So as I said, the U Assembly step one is the first of the three step examination process to obtain your medical license in the United States and it assesses the students ability to understand and interpret important concepts in basic sciences. I have basic sciences underlined and bolded there because it's a very annoying examination. You have to keep in mind in the North American medical schools, both in Canada and the States. You do a four year undergrad and then you are allowed to apply for medical school. So these, these people, you typically spend four years in a, a degree such as biology or medical sciences or life sciences and they learn all the nitty gritty, really annoying aspects of medicine that we don't really remember that much from our first two years of medical school. Stuff like the biochemical processes, uh cytokines, cellular pathways. It's, it's, it's a very annoying exam to write which I'm gonna get to with the table on the right. So the right has the the the discipline specification or the breakdown of the exam of the exam. Sorry. So it says here that pathology is around 50% of the exam. You might think that that's really easy and like not difficult pathology saying what's wrong with the patient? What what what are they presenting with? What's the condition that they're presenting with? But when they say pathology, they typically mean more of like the cellular adaptations or the pathways or the cytokines that led to that presentation or that disease, it's not as fun as you think it is. It's a lot more tricky than, than, than most people understand. It's, um, it's something that you just didn't learn in medical school. I personally never learned it in my first four years of medical school here at Queens. And I don't think many UK or Irish schools go over it. It's the fundamental sciences, the stuff that you learned in undergrad. So you'll need to, um, you need to learn that through the resources type of thing. It's, it's a very annoying exam. Um 25 to 35% is the physiology behind all of those conditions and just normal physiology that occurs within some of the sys systems within the human body. Uh 15 to 20% is pharmacology. So that's mainly more of the mechanism of action and side effects of medication, not really choosing medication yet, in terms of what's the best medication to give the patient. That's more of a step two questions. Step one will just ask you about the mechanism of action or the side effects that can be as a result of this medication, uh biochemistry and nutrition. So those are the pathways, microbiology, those are specific bugs. Um Once again, something I didn't learn very much in, in, in the UK or Irish system. To be quite honest, I had to pick it up studying for this exam. Um But it's not difficult, there's a very good resource for it called sketchy that we'll get to in a bit that, that taught me a lot. And it's helped me actually with my fourth year medical exams, acts um immunology, gross anatomy, histology, and cell biology. So these are slides, you have to learn a bit about the slides or the histopathology, what's happening with the patients and, and how can you diagnose not off the presentation but based off the histopathology or the histology slide that they're giving you um behavioral sciences and stuff like ethics and genetics is just autosomal dominant, autosomal recessive stuff. It's, it's not, not too difficult, but that's the basic breakdown so far of step one, um just the next slide to these dreams. So on the actual step one day, so step one is a one day examination, it's uh seven blocks. So each block is around 40 questions. They say it could be less than 40 questions, but there will never be more than 40 questions. So there's 71 hour blocks of up to 40 questions per block or up to 280 questions per day. It's all set in one day. Uh It's more I believe not to test your knowledge in that sense, but to test your perseverance, perseverance and determination. During that day, they could have very easily split this exam into two days. But they want, they want to test how focused you are and how ready you are and how determined you are to get through this exam and, and the material that it has to, to be examined on, um, the examination has seven hours of actual content. You get 45 minutes or, um, a lunch break. You can however, divide that 45 minutes in any way you want. So some people will just do three blocks, take 45 minutes to eat their lunch and then do another three or four blocks. I personally did not do that. I don't know many people that did. I would take one block. I would go outside, I'd walk around, wash my face, take a 5 to 10 minute break and then go back into step two, or, or to block two. Once again after block two, I take another 5, 10 minute break, take a breath and relax. Go into block three. You can divide those 45 minutes up in any way. You'd like. The exam also starts with a 15 minute tutorial. Um, but you can skip that 15 minute tutorial and add it on to your, your break time to make it an hour. Uh And the tutorial is something you can read on beforehand. You can even, I think, I believe you can even like read it and take it before the examination on their website. So most people will read that tutorial to, to skip the 1st 15 minutes of the exam to add it to their break time. Any time you finish a block early as well, any extra time on the block will be added to your break. Time. So if you only needed 45 minutes uh in block two per se, then an extra 15 minutes will be added to your break time uh for the day. So it's an eight hour exam. You're gonna be there for eight hours. Basically, you can end early. It's not recommended, but you can end early in any extra time that you have after a block will be added to your break time. Currently, as of January 2022 the exam is scored as pass fail with the website or the U assembly website saying you need to score approximately 60% of questions in order to pass. So, um they say around 60% because there's a huge question bank and there's multiple exam papers floating out there. Some exams, they'll look at the, the, the, the curve and they'll see how everyone performs. Some exams will be easier than others. Some exams, the pass mark might be like a 6263 maybe even a size of 64 depending on how everyone else scored on that paper. While other exams might be a lot more difficult, there might be a lot more biochemistry or immunology or cytokines that you need to know or like pathways that you need to know on that exam. And people might not have scored as well on that exam. That exams um pass mark can be anything like a 56 to a 60. It's around 60%. You need to get around 60% in order to pass that exam. Uh Just next slide please. Thank you, James. So as we said, the scoring recently changed, it used to be the way it worked was um programs would get 100s to maybe even thousands of applicants for a specific specific position at their uh university or at their program. So someone uh something like 1000 people would apply to a university in Florida for their internal Medic medicine uh rotation. They used to say, OK, in order to, to cut down the numbers or to hint uh to thin the herd, they would say anyone that scored under this mark on step one is automatically rejected. It used to be a way for them to set a standard so they can cut the numbers down a lot easier. Now that it's pass fail, that basically means that they pushed that setting of standard to step two. So the exam for step one is not pass fail, which is good because it makes it easier to um to pass. It looks nice on your application. You have to put an exact score and it is a harder exam than step two to write. But that kind of puts the emphasis on step two right now as the thing that will determine whether you get automatically rejected from a program or not and what gets you the interview for these uh these programs to match. Um I believe that's everything the slide has to offer. Go to the next slide. Thank you. So, um basically some quick terminology that I want to get across with you guys, you'll see it on the Reddit forms and anyone that's studying for step one properly should know these terms. So um there's something called pre dedicated studying time and there's dedicated, studying time, pre dedicated, pre dedicated, studying time is something like while you're in university studying, you don't have the time to be studying for this exam. Four or five hours a day. You have placements, you have work, you have to come home and study for your actual med school exams. That's pre dedicated study. Typically, people would start this around maybe the beginning of the year. So January, if they're planning to take it in, in the summer and you just come home, you do maybe an hour's worth of revision, revision. You, you do some newer questions. You try to revise a bit here and there. That's pre dedicated studying. Typically that's something like a few months. So that would be something from like January to, to May or June. That's 56 months of pre dedicated study. When you're getting to the last two months, 7 to 8 weeks of your examination, you'll hear people say something uh about your dedicated studying time. So this is, this is when you're really studying for this exam. It's almost as if it's your job. So you wake up from 9 to 5 for your job, you wake up for 9 to 5 to study for this exam. So the last eight weeks of people's exam period time before they take step one, they typically spend their entire day studying for the exam and then chill up at night to make sure that they're, they're well rested. So you have your pre dedicated studying time and your dedicated studying time in terms of some important resources just right off the bat that we need to get uh get, get, get used to knowing and familiar with is you world. So you provides the gold standard for practice questions and step one and step two K exams. So I personally only really used you world and to, to pass my step one examination. And I know quite a few people that have done similar things to me not using many resources anymore because we don't need that 250 that 260 to, to, to match into the program. So we want, we just need to pass this exam and we can put our focus on the step two CK exam, the actual medical exam. So I personally only use you World. It is the gold standard. It's what everyone needs in order to pass up one, you can't pass up one without this resource. So it, it, it gives you questions that are very similar to the actual exam and actually a bit more difficult in the exam to be honest with you, they will provide you answer options that are all very similar. So you really have to understand the concept to um actually answer the questions right on your world. Uh It really hes in those, those key principles that you need to know and um just a disclaimer, it's very normal to start off with a terrible percentage on your world. I personally probably started around on my first couple of blocks of step one studying for you world. I started around maybe 25 to 30% on my blocks. Uh Maybe a good day would have been like a 40. It's, it's very normal to, to do poorly on your you world blocks in the beginning. And that's ok. That's something that you need, guys need to get used to, to the feeling is feeling ok with a bad mark on your world. It's not an assessment tool for you guys. It's a learning tool. So they have around 3000 questions and they repeat the concepts continuously throughout the the question bank, but they present it in different ways to really make sure you understand the concepts that are going to come up on this exam. So don't be upset if your, your scores are poor on Europe, they will be poor for a very, very long time. It's important that you're, you're keeping up to date with the concepts that you're getting wrong and you're learning through Europe. Europe is a learning tool. There is not an assessment tool in terms of assessments though, something that I mentioned earlier in this talk was the N BM ES. The people that write the exam, they have also written six practice papers for us to take before we actually step, step or take step one in order to see if we're ready for this examination. So M BME has six papers. Um it's a bit outdated here on the slide, I think they took away M BM 20. So it now starts at 25. So you have six papers. 25 26 37 28 29 30 31. And typically what I did and what I know what I know of most people doing was in my dedicated time I would do and my donkey cards and any flash cards or videos I needed to, to watch or any concerts. I just wanted to revise. I would do that from Monday to Friday, Saturday. I'll wake up early in the morning, I'd eat breakfast. I calm myself down before my first N BM E and then I would take my uh practice exam, my N BM E. It's a five or six hour exam. I can't recall. It gives you half of the exam length. So it gives you four blocks each block. You're allowed an hour 15. On the real exam, you'll be only allowed an hour, but they also give a few more questions per block. I think it's something like 50 questions per block. So it averages out, but this is what you used to assess. If you're ready for your examination, not you will, at the end of the exam, they'll give you a percentage score. So you'll be able to see if you got above the 60% ish that you need in order to pass it will also calculate how ready you are for step one. I don't know how accurate these calculations are to be quite honest, based off what I've been reading on Reddit and when I was studying for the exam and based off people, I've seen take the exam um but it will tell you uh what your likelihood of passing step one is within a week's time. So if I took this NBME and I did well, and it said that I got a 99% chance of passing step one within a week, that means if I was to take step one within a week, they believe I would pass with 99% certainty. I don't know how accurate it is though because it's either something super high like 99% or they'll give you something trash like 20%. So take it with a bit of grain of salt. Look at the percentage you got and look at the trend of the marks you're getting on your M BMES. I would personally recommend taking all six. I took all six. but some people just take the last four or the last three. The later M BMS are more relevant to the actual exam than the earlier M BMES if that makes sense. So let me say that again. So II get that across properly. Um M BM 25 is a good exam but it is more likely that M BM E 31 would be more likely exam than the others. So I would work myself up. That's what I did. II took M BM E 25 and then the next week I took 2627 all the way up to 31 and then I took the free 120. Um So moving to the next block on the side over there, it's supposed to say free 120 they've updated, it's not 100 questions anymore. It's 120 questions. They also released a document called the free 120. So these are free 120 questions you can take any time on their website. Um People say that's most likely the exam. So MB 31 and free 120 is what is most likely exam? I would save that for your last week before you actually take the exam, take it in exam like conditions, you can do it at home or you could pay a 50 $60 fee and go to the actual testing center where they'll put you in exam conditions. So you go early in the morning you drive there, they take your fingerprint, they scan you with the metal detector. It's all super weird stuff. They sit you down, they're watching on a camera as you take the exam, it kind of helps you settle in into the nerves of taking this huge exam. You know, I would recommend if, if you're someone who's not a great test taker, you go to the exam center, you pay the 50 $60 fee in order to take it there and you take the free 120 there. But the free 120 should be one of your last resources that you use along with M BME 3031. Um Talking about first aid. Everyone has knows first aid and everyone's spoken about first aid. It's called the U Assembly Bible because it provides a comprehensive guide to all the materials covered in the U Assembly. I personally did never, II personally did not use it. I never bought it. II checked it out for the last week from the library for the last week before my examination. It's a great, great book. It has everything you'll need to know or almost everything you need to know. And it has a great rapid review section at the back. It's just too comprehensive. It's, it's too wide for, for someone to consistently go through and, and to, to learn everything from. If you start really early, maybe you could and incorporate it into your studying. But to be quite honest, I don't believe it's really needed that much, much. Uh I would stick with you World and a and maybe a few sketchy videos or videos here and there to help supplement your learning. But you will, I mean, first it is a great book. In order to help supplement some concepts you're not understanding from you world or from maybe sketch or, or these video lectures. There's also some other question banks available for people to use. So you world is the gold standard. I'm telling you everyone needs this. Everyone uses this capacity board exams. But there are other good ones such as Ambos Kaplan is a bit. Yeah, it's, it's all right. It's not the greatest but it is, it is a resource people use and you assembly Rx. Um I don't think it's used that commonly anymore, but uh people used to go through your world and then go through these other question banks to really try to get those really high scores because they would want to match back into competitive specialties that's not needed anymore with the pa scale system. Um People kind of just stick to your world. You can still do that and help supplement your learning and really like get a comprehensive knowledge, overview of all of the things you need to know. But uh I don't know how useful that would be per se. It's up to you. Um anyhow, the next likely. So just a few more resources I was mentioning in the past. So stuff here like content, review books. So there's first aid and Phoma Phoma is a video lecture series. Um I personally didn't do however, I uh I unsuspected the ony cards associated with the Phoma lectures. I never watched the lectures, but I would unspent the flashcards associated with the lectures in order to learn those lectures. And I think that helped me a lot people say on Reddit that Poma chapters 1 to 4 is, is essential for the step one examination. And during my exam, I can confidently say there was at least 10 questions I got from just knowing the film was chapters 1 to 4. Those are the nitty gritty, really annoying stuff that you need to know. They'll ask you specifically about carrier protein names and cytokines and, and, and sell your adaptations and, and stuff basically taken straight out of the book to be quite honest. So I would recommend if you're taking this exam seriously, you don't have to watch Phoma. I would encourage you watch Phoma lectures, but you at least unspent the ony cards associated with Phoma in order to learn the content. C banks really went over. There's new world and, and, and new world is the gold standard that you will need flash cards. I was talking about AKI now I personally never used AKI once in my life before. Step one, I'm not a flashcard type of studying student. Uh it never worked for me. I would just do question banks and I've learned based off that, I believe you cannot do that for this examination. As someone who has never touched on before this exam, II would say that AKI is very necessary for this exam because there's no way you can remember the names of these, these these carrier proteins and these very specific details. They want you to know for the exam, the basic sciences, especially as someone like myself who came straight from secondary school with no undergraduate degree. I would say that you need to constantly count in the information AKI will give you the card and then three days later, they'll give you the card again. And then four days later, they'll give you the card again. If you've been doing that for months, it just becomes active. Recall on the exam day, you'll instantly see the word or the key word you need to know and you'll know the answer like that. I think AKI is very important for this exam as someone who's never used it before this exam. I highly endorse it, but to each their own, some people don't need flashcards to learn. There's a very good resource for on a free uh download called on King. On King is a download. You can find on Reddit, I believe where it has all the cards associated with you world sketchy and already made. You just have to unsuspected on King and then you would search up the Euro question that you're, you're, you're just taking the concept you've just taken and you can just unspent and release the cards associated with that concept without making the cards instantly. It's, it's, it, it's very well paired together. Everything is very well connected because of this on that. I would recommend for sure Googling on King A NK in G and on and watching maybe some videos of how it works in order to get into this process. Um in terms of video lectures. So I spoke about Phoma is very necessary. It teaches you the pathology which is 50% of the examination. So Phoma chapters 1 to 4 very necessary if you can do more, do more. That's one of the video lectures that are available as a resource. Another really important one that I liked was sketchy. So once again, I didn't watch the sketchy videos because I just didn't have time during my third year of medical school. I would however, unsuspecting flashcards associated with the specific specific sketchy video on on. So I would search of the bug that I was learning that day on sketchy or the type of drug I wanted to learn about that day on sketchy in my ony flash card deck. I would find the cards associated with it. I would unsuspected and then it would just constantly keep coming up and I'd have to answer it if I got it wrong and bring it back again for me to learn. So, um I would really endorse sketchy Ilma and New World as the three resources with Ati supplemented with on of course, but those three are the three resources you need in order to pass this exam from my personal experience, supplemented with ac but you know what sketchy is, is it draws a sketch for you. So you'll be learning about the specific bug bug such as that or per se. They'll make a whole sketch for you and everything in the sketch has a symbol. They'll, they'll, they'll draw the bug in a way for you to remember it and they'll draw mechanisms or they'll draw things that make you understand or make you remember, sorry, the, the specifications with the bug. So how it commonly presents um what type of bug it is. Uh what's the treatment for this book? And it's the same for a sketchy ph as well. Pharmacology. They'll draw a sketch for the drug and they'll, they'll draw certain things for you to understand and to remember and to help visualize um specific things you need to know about that drug. So I would, I would endorse sketchy as well. Sketchy Phoma you supplemented with on those are very good resources for very good resources for you to use in order to pass your step on examination. And what I personally did to pass my step one examination. People also um pay for some subscriptions such as osmosis. I don't know much about it. To be honest, I didn't look too much into it. It is a bit more of a pricey subscription. I think it's 203 $100. Um, but, uh, you, you can have a look into it. Something that most people like about osmosis is, it makes a schedule for you. So if you're someone who just feels overwhelmed with everything and you can't get through all the content and get through all your medical school studying. It will provide you with a schedule each day of um what you need to get done. And if you miss a day or if you miss a week per se, you can readjust the schedule on osmosis and I'll make a new schedule for you and everything. That's what people like about you. I think about it. But I think it's, it's too much for what it, what it gives to be quite honest. Um So next slide, please. So this is a sample study schedule. This is something very similar to what I did on my, my step one prep. So around the end of January, I started my pre dedicated uh studying time. So I got a Euro subscription. I would do a block a day and get absolutely destroyed. Getting like a 30 to 40%. I would review the concepts, review the questions, go on to ki and uh search up those concepts and unspent those cards and, uh, just continue the next day. And I would, I started at the end of January and I wanted to get a full pass or finish the complete a complete a full pass of the question bank by the end of my medical school term. So around like May June time, I wanted to get through the 3500 questions from Jan to June. That was my pre dedicated time. It sounds a lot easier than it. Uh It is to be quite honest, these questions take time. They're very difficult. But um that's what I wanted to do and that's what most people do starting with my dedicated studying time. I reset my question bank. So when you buy the subscription, you're allowed one reset, you can do all the questions and then you can do your incorrect if you'd like and then you can reset the whole bank. So everything is brand new. You can redo the question bank. That's what most people do. That's what I would recommend as well to really get those concepts in. I can tell you that there are certain questions on Europe that popped up on my actual exam, like word for word and I just, I knew the answer like that just because I had done my quest twice. So during your dedicated time. So on here, it says June 14th, August 7th, if you're planning to take it, August 7th, reset your Euro. Uh and do it all over again in, in a month or two. It's gonna be 9 to 5 dedicated like a job studying for this exam. You do your, you work from Monday to Friday, Saturday, take the day off, do your N BME. Once you're done your M BME practice exam, take the rest of the day off and Sunday to next Friday you have until then to review your NBME. I would say so I would do my U blocks Monday to Friday, Saturday. I would take my N BM. Once I'm done with my M BM, I would be completely brain fried after five hours of trying my best on some impossible questions. I would chill that night, Sunday, I would um hang out with friends a bit in the morning, uh go to church and then I would come back and I would do my M BM E review. I would review the questions I got right and wrong. What concepts are reoccurring throughout the M BM E and I would add it to my a something important to know about M BS as well that I forgot to mention is you'll see concepts reoccurring throughout each practice paper. That's not a coincidence. Those are concepts that will come up on the exam for sure. So if you're getting it wrong consistently, you need to learn what's going on there or you need to revise that concept. So, um that's like a practice exam schedule for, for for people that want to take it within the summer per se. You start five or six months earlier, you start, you're prede doing a block a day if you can or whatever you can. And once you're sitting down for your actual prior like eight weeks prior to your actual exam, your, your summer, you do a block a day or two blocks a day. You finish the, the block or you finish a second pass of the question bank and you take your practice exams. Uh next side foods. So this is just an overview of the three steps and this is a schedule for someone would like to take all their exams and apply for the match process in fifth year. So this is the schedule you would take if you're hoping not to do F one, if you just want to dip straight to the States right after your, your medical education in the UK or Ireland. So in step one, you would take your seven hour MCQ exam which covers the basic sciences. As we said, you would take that in the summer of third year. So anyone in the third year now that's hoping to get this exam out of the way I would recommend doing the summer, uh towards the end of year, four year, four summer is a bit more difficult. It's because we have electives and we end later and with the whole new system in the UK, with the UK and Malay, we have our UK board exams that we have to study for at the end of June now, but sometime in the summer of fourth year when you feel ready and confident that set your step two examination and then, uh, you would do your o at uh sometime during fourth year as well. Um I'll get back to you on that if we have to do it as students of a UK or Irish Medical School. And at the beginning of fifth year, you would get your letters of reference, you would put the application together, write your personal statement, send it off in the beginning of fifth year and wait to hear back for interviews or any information from the program. So that's, that's just kind of the overview with or the pathway you would take if you're hoping to do um or to match back to the States right after fifth year. No, no left one years. Uh next slide, please. All right. So in terms of the step two breakdown, uh it's gonna be a lot more brief because there's a lot of overlap. Also, I haven't actually sat step two yet. I'm in the process of studying for the exam to sit, sit it in hopefully July or August. So the step two examination is the second of the three step examinations to get your medical license in the States. This exam is a lot nicer in the sense that it tests medical knowledge and understanding of clinical sciences. So this is the type of stuff that we learned in medical school. This isn't a lot more difficult. This is learning about patient treatments. This is identifying the condition. Um knowing what investigations you need to diagnose the condition, the treatment plan, the guidelines. This is stuff that we know. So it's a lot more easier in that sense, but it's still something you need to like take seriously and understand and, and study. So, um the topics that are covered are internal medicine, of course, surgery, peds, OBGYN, preventative med medicine, psychiatry, and just a bunch of other areas of medicines on the right. I have a table from osmosis actually that provided this table, but they provided a table of um test two specifications. So what each specialty of medicine contributes to the actual exam. It's all relatively the same to be quite honest, but some people might have a a weaker area and some uh in in certain areas that are a higher percentage of the actual exam. So it might help point out where you need to study, but it's generally the same to be quite honest. Uh in terms of the next slide please, in terms of step two breakdown. So this is exactly like step one. It's a step, it's a one day examination, it's um nine hours long. So it's one hour longer than step one just to test your determination for the actual uh exam um or for severance. So you'd write 81 hour blocks administered in 19 hour testing days. Each block once again will have up to 40 questions. A maximum of 40 questions. Uh But there could be less. Once again, you have a 45 minute lunch break. You can divide any way you want. You can add another 15 minutes to that lunch break by skipping your tutorial and any extra time that you have after each block that you end the block or have extra time will be added to your break time. So it's exactly like step one, it's just one hour longer. Um The difference with step one and step two is step two is now a scored exam. It's always been a scored exam, but now it matters a lot more than, than, than it did. In the past, it scored from uh a range of 1 to 300 points. And the current passing score for the step two CK examination is a 214 with a standard error of measurement of six points. So because step one changed the pass fail, step two now really, really matters the score that you get in. Step two will determine what you can and can't apply to for specialty training in the United States. So if we go to the next slide, I have a table once again from osmosis that very kindly provided this for everyone. You can look at the stats. So someone who's matched, that's an MD in anesthesiology. The average score that they got in step two was a 246. Whereas someone who was a USI MG that matched into anesthesiology needed around the 239 in order to match. You'll notice with more competitive specialties, the um score you actually need as an I MG will be lower than the score than you need as an MD because there's not that many spots. They have guaranteed spots for internationals for certain certain programs, but there's not as many whereas many M Ds will be gunning for the anesthesiology specialty. Um This will be provided in the handout that's given to you. So I'm not gonna spend too much time over it, but you can do this research yourself and look at the statistics of what you need as a USI MG. So an I MGA medical graduate outside that graduate outside of the States, but has a US passport or a non USI MG like myself, someone who has no American passport and also stayed outside the states. What scores you need on your step two in order to apply for certain programs. Um Next slide please. So lastly, I want you to go over a few um questions, common questions that are given with uh this talk um or asked with this talk. So do you have to write all the you assembly exam during med school? So most medical licensing authorities require completion of step 12 and three exams. Within seven years of you passing step one, the step three exam must happen after step one and two. But you can write step two before step one. Actually, it's not commonly done and I wouldn't recommend it to be quite honest for step one. When you learn all that nitty gritty stuff, it kind of helps with step two. They won't ask about the cytokine per se, but they might mention it, which will give, will give you like some knowledge as to what's going on. You might be able to identify what disease is going on just based off the histopathology slide that they provided. But some people who have been outside of med school for a while, they know their medicine really well, they want to get step two out of the way and then they can probably focus on step one. We will take step two first before step one. But you have seven years. Once you get your step one, pass results to take all the examinations, you can take step two before step one. It's not typical. But you can step three though, however, can only happen once you match. So it has to be after the first two exams. Um you can write step one up to six times incl including incomplete attempts. So for whatever reason, you had to leave the exam center, you weren't feeling well or you had a medical emergency or a family emergency. You had to leave the exam center. Um, that counts and you have another five chances to write the examination. And how do I study for the exams? I told you how I personally study for this exam but it's, it's a different per person and you have to find a way that fits you. I use II use, um, pass me, I use a lot of question banks uh, during my medical schooling, education to learn and study for my examinations in medical school. I'm a type of person that learns off questions. Uh that might not be the case for you. So you need to find what works for you. But I told you that for myself when I say for this exam, I took, I used you world to question bank. I would unsuspicious being repeated in my mind and I can't forget those really like annoying but important concepts for this exam. One last thing I wanted to add was II truly believe that this exam can be written by any medical student. I don't think you have to be particularly smart to write this examination. I think it just really takes dedication and perseverance. I think they want to see who really wants to come to the States. This is a board exam. This is one of the biggest exams you're gonna be writing in your life. This will determine a lot. So it's not something you can really mess, mess about with and having a failed does look bad. Now that's pass, fail. It doesn't look bad. It's not necessarily the end of the world and there's ways to get around it and to find positions afterwards, but it looks bad and it, it, it's a major step back. So if you don't feel ready for the exam, don't take the exam. But if you're gonna sit this exam, you need to be determined, you need to be committed, you need to sit down and get you the content and make sure you're learning the content. If you do that and you take your MS and they are good scores, then you should have no problems uh taking the exam, you should have no worries taking the exam. Um but yeah, that's that's my talk. So uh we're open to any questions if you guys have any. Great. Thank you John. There is a question in the chart there already. If you're able to see it would be version 11 by any chance. Yeah. Yeah. So on version 11 would work. I use version 11. Um they come up with new versions per se and some of them are paid now. You don't need the paid versions. You don't need any newer versions. The old versions were perfectly fine on K as long as you get on King version 11 or so and you unsuspected cards associated with the your questions or the sketchy videos. Uh you should be fine. Sorry James. I can't quite see the chat because I'm on my phone. Um, there's another one. thanks for the talk. I had a couple of questions when doing the world blocks during your pre dedicated period. Did you similar topics for each book or did you just do random? That's actually a great question. Some people, everyone's different. Some people would, would do specific blocks to make sure they're learning concepts. I however, didn't do that. I wouldn't follow a specific category of questions because I felt I would provide bias in how I would answer the questions. I did random uh untimed blocks every time I did it, I even during my um my dedicated, my pre dedicated and dedicated, I always did random untimed blocks because I wanted to not expect what's coming. If I specifically chose hematology and an answer involve something that wasn't hematology, then I would immediately cancel that answer out. So everyone's different. I personally never did it. But if you feel like it's gonna help hound those concepts in for you to, to, to constantly see the concept of whatever hematology concept you're doing, then sure go for it. But II would recommend especially in dedicated, you do random blocks for sure, because that's how I was gonna present in the exam. You won't be able to have a bias and counsel out options. Yeah, perfect. And then the other question is, how long would you recommend buying the subscriptions for considering the price? Yeah. So you world is a hefty subscription. I didn't talk about the price at all because it is needed in order to pass the exam. I got a one year subscription. So I bought it in December and, um, I wanted a bit of a leeway in order to push the exam if need be because it is a scary exam. And I will tell you from experience and from everyone that I've known that's taken this exam or about the subscription. It's, it's very scary to sit down and start doing the questions because you're not gonna get a good score and it's gonna be very difficult. It's gonna be very long to learn these concepts. It's, it's, it's, it's stuff that I've never seen before the before studying for this exam. So you're gonna be be hesitant in um starting the blocks and there's gonna be days where you just say I don't wanna do it. So I would say if you're able to overestimate, I got a year subscription, I only needed it for like seven months or so, 67 months, I got a year subscription if you're willing and you're able to, I would say overestimate because if you need to push the exam back, which is completely fine, many people push the exam back, you're able to extending the sorry, extending, extending the, the, the question period block instead of buying a longer subscription is significantly more expensive, they charge because they know that you're desperate now, they charge a lot more to extend it by 90 days than if you just bought it for one year at the very beginning? Great. And then did you buy the, the or did you just use an, can you repeat that? Sorry James. Did you buy Ilma or did you just use an? So I just used on. So II just couldn't sit down and listen to the Phoma lectures and the, or the sketchy lectures because it would frustrate me. I never heard of these concepts before. So I would sit down and I'd make notes and it just wasn't working for me. So personally, I didn't buy the subscription. I didn't listen to the videos I would do on cards and the cards over 67 months would force me to understand the concept and, and to, and to know the information and the on key cards also have notes associated with them. That's why it's, it's such a great resource. This person made this entire de for free uh with all the resources and then he wrote notes on each card as well. So if you read the notes, you understand the process. That's why I'm really trying to say, I think on key is necessary for this exam. I don't use it for any of my med school exams just for board exams because these exams really matter great. And then somebody asked if, when you registered for the E TFM G given that you took step one in old. So I registered, I did my E CFM G registration II, it was very delay because I didn't know what I was doing. To be honest, I had no like um talks to attend in the beginning of like how to get this done. So II did my A CFM G certification after my first exam in third year. So sometime in November, I got the certification but I did nothing with it. You need to verify yourself your identity, this whole process and you probably talked about already. I did nothing about it until January when one of my friends texted me and said we need to get on this like we, we just had this certification for, for time, but we haven't registered for the exam or proved that we actually exist. So I would say the earlier, the better you can apply for it tonight. It's it, it's, it's a quick application. They'll send the application to your med school. It's only 100 5200 lbs. And if you're thinking about applying to the States, you need to get it done before the end of 2024 because the GMC is not budging right now on, on this whole thing. So um I would say do that for sure. Sorry. Yeah, perfect. Um And what would you say your pen nasal pass medicine for the assimilation? Um I used it, I used it for the first week of my studying to be quite honest. And I don't think it's a good resource. I love, I love Pasmed. It's carried me completely through all my exams in Queens for the first four years. I've done spectacular because of Pasmed. I II can only give Pasman good credit for that. But you have to keep in mind. Pasmed is a UK resource. It's not a US resource. It's a US board exam. So it's very new. I wouldn't trust it per S ei wouldn't put my, my, my, my, my worth on it. This is a huge exam. I would stick to what everyone's been using for time. You world was sketchy. I would prefer you guys stick to that in order to fast exam, you can try fast me but be aware, you're kind of like lab rats for them. It, it says when I tried, it said um beta. So keep that in mind. Yeah, that's helpful. Um Then would you say um resources um question by would also help you for your medical school exams or how did you balance them both? So I will say that step one has helped very little in all honesty. There's a few questions that come up on my exams where I've been like, I know that because of step one and to be quite honest, that was kind of the basic knowledge of step one. Like those, those, those step one questions don't provide much help for your medical exams, I will however, say I just took my last ever fourth year paper in my medical school in Queens. And I would say I knew a lot of information, not because of studying from passed that much, but because I was doing my step two studying step two and medicine aligned a lot better. I would no information just because I've been staying from my step two and I've been doing my on cards to be like, I know this, I do this card every other day. So I would say step one doesn't really help for your medical school examinations, which is why it's a real pain to study and sit. But step two will help you for sure in your medical school examinations. Yeah. And then would you recommend doing step two first if you were 1/4 year medical student as you've kind of lost the basics of year one and year two. I actually considered it myself in theory, writing step two first because it's a lot less of a scary exam to write. I don't recommend it though for the reason that I stated during the talk sometimes when I'm doing a step two question, I'll kind of know what's going on with the, the presenting complaint. I'll get it. I have a few differentials going in my head of what I think they're asking, but they'll show me like a histopathology slide or they'll just mention a certain gene or a cytokine I'll be like, ok, I know this 100% now because I learned it in step one. Like, what I forgot to mention is what I've learned through medical school is there's a way to write every exam queens has this particular way of writing exams and you need to learn how to write that exam in order to do well. It's the same with these board exams. There's a certain way to write this exam. Step one will teach you how to write this exam. And I would rather you, you do step one and you learn how to write the exam on a pass fail. Then you learn how to write the exam when it's scored and it determines literally your entire future in the States. Perfect. Thank you. And then we'd set in the exam in December 4th year. A good idea. They're also a student with the MLA um the GMC 2024 thing is this is this step one and that's what I'm assuming it would be step one like sure. Yeah, you can, you can write the exam whenever you feel ready. To be honest, the CFM G certification is something you need to get done by 2024. But it doesn't mean you need to get the exam done by 2024. You just need to prove to them that you were a medical student student that was going to a certified or verified university before 2024. Once you're certified, you don't have to write that exam necessarily. In 2024 you can write it like 56 years after they, they don't really care. They just want to make sure that you were certified at, at the time. So if you feel ready to write it in December or fourth year, go ahead and write it, just make sure that you're ready because you need to pass a fail isn't the end of the world once again because it's pass, fail. A fail will get you automatically rejected from many programs in the States. And then they also asked um if you just bought World subscription in terms of resources. Yeah. So the only thing I actually paid for was uh was a Euro subscription and I had a, I just downloaded it for free on my Android uh with on King. I did watch some sketchy videos that you can find some of them on youtube and some random like shared full websites. And I watched the video, I told you guys, I watched the video a few times. It was just frustrating like I didn't understand it and I wasn't getting it. So I needed to do the ony cards. I just, it wasn't, it wasn't a good use of my time watching the videos. That was personally, for me, I only bought uh it was a very expensive but I it was needed. Um But I would 100% recommend if you're a visual learner or if you really want to hound down on the basics, you can buy the film, you can buy sketchy or you could just do the cards but get some type of information from those resources into your brain for the exam. Yeah. And then once you're certified, how long do the test? It's not pick up. I don't know, once you're certified, I think you're, I don't quote me on this for sure. But once you're certified, I think you're certified, you can take the exams whenever um in terms of booking an exam. So this is the whole, like when my friend texted me, we need to do something about this. It was like this is the, this is the reason why exam dates are booking up and especially in the summer, everyone's writing this exam, not only you but the nationals, the, the Canadians and the Americans that want to write for this exam are writing it in the summer as well. So dates book up quick. So once you get your CFM G certification, book a date that you feel comfortable with and work towards that date. Um I would say book as soon as possible because dates will fill up. And there's not that many testing centers, especially in, in I II know at least here in, in, in, in Belfast. The closest one is Dublin. I don't know about the UK. I know there's one in London, but especially here like book as soon as possible because those dates book up and if they have no computer for you to write it on, too bad, you're not writing the exam that day or maybe even that week and then for the CFM G process, somebody was wondering, would it be changing or ending in 2029 rather than 2024 for UK Medical. So, um, I, I'm not too aware of the whole process anymore. To be quite honest, I was told that it's changing in 2020 December of 2024 where they're changing the way it works and the GMC is not complying and I was, I heard a rumor going around that GMC is not complying because they want to keep us to, to fill in the junior doctors spots because the NHS is struggling a bit. That's just a rumor. But anyhow what my knowledge is is it's 2024. You need to be certified as a UK medical student, at least need to be certified before then if you want to be in the clear for sure, they might have extended the timeline or the GMC might have, might have finally given into the requests of EC F MG. I'm not up to date with that. You need, you need to search it up or you could probably message, I think Sanders get in contact to someone who knows more than me on that. Yeah, that's perfect. Um Then how early did you put your step on exam? So I did a CFM E certification in November. Um I did my prometri sign up in January and I actually booked the exam. I was under the impression that you booked the exam much later. I didn't know dates fill up. I thought you had you, once you felt ready, you would book it. But um I actually booked it in March and I panicked, booked it that day because once again, one of my friends texted me and told me that spots are booking up. So I booked the latest possible date I could before I had to fly back for fourth year. So, uh I did my FMD certification in November. I did my promet identity verification in January and I actually booked the exam in March. I would however, definitely not recommend that if you have a date in mind, book that date and if you feel ready before that date that you've booked, you can always push the exam up, people cancel exam dates, it's easier to book up than down if that makes sense. So, put a date further down in mind and if you need to push it back, you can push it back. There's no problem if you need to bring it up, you most likely won't have a problem bringing it up. So bring it up. Excellent. Um That is all the questions. Thank you everyone for Jordan tonight and that was, yeah, really? Good. Thank you for that. And if anyone has any questions, you can get in contact with James to get in contact with me. I don't mind uh talking about this. I understand it's a stressful process so perfectly happy to answer questions through Insta or anything. But thank you for the time I can uh and I can pop in an email. There's a couple more questions for me here and now. So is it too late to start the same E CFM G certification Promes, etcetera. Now, uh, this is the person who's thinking about setting and their exams in December 4th year. No, no, it's, it only takes like a few weeks to a month to be on. Well, actually, yeah, it only takes like a few weeks to a month depending on how fast this person is in. Queen, depending on how fast Queens verifies us. I sent in my step two application a week ago and usually it only takes a day or two, but I haven't heard back from Queens. It should only take around like a couple of weeks to a month to get this whole process done. It doesn't need to take that long, to be honest. So you can definitely get it done before December if you start now or if you can start in a few months but start now be in the clear. Yeah. And then whenever you go on to book your, um, step one and your step two, you get to choose like what month and what date? Yeah, so you choose uh you put an address in, you put whatever address you're living at, wherever you wanna be, you put an address in, they'll show you testing centers near you and then um you can put like AAA month period and they'll show you all the available dates but they do book up especially of July August. They book up quick. So, um yeah, get, get, get the booking. You, you put your address, they'll find the center near you, they'll find dates near you. Just, just find the date. And then can you apply for EC FMD certification in your first year of university? You, you can, yeah, that's why the plan is if you're planning II tell people if you, if you even think it's a possibility that you want to apply or write these exams and you want to get to the States before you go through your complete training pathway as a consultant. Do the E CFM G certification right now. Even if it's a thought, it's, it's uh, it's a bit expensive. It's 100 50 to 200 quid. I don't remember what it is, but it keeps that door open. It keeps that, that gives you that relief of mind. So if you can do it as early as you want in medical school, as long as you're in medical school, you're proving you're a medical student, that's the point. Excellent. Thank you Joe. And is it equally as expensive to push it back and like to December then push forward to the summer? So when you sign up, I'm not sure. II II believe so. I think San have gone over this. When you sign up for the exam, you get a three month uh testing period, you choose three months um of where you want to write this. I chose July, August September so I could write the exam with any of those three months. I take one day from, I would take one day from the those three months. Um If you wanna push it back, I believe it's a, it's a fee. I don't know how much it is. Don't quote me. I think it's like maybe like 200 to $300. I don't know how many pounds that is. And I believe if you wanna push it up from those three month, that three month period, it's also the same, but you're not gonna be pushing your exam, I believe three months up from the period, you're gonna be pushing it up maybe a month at max or a few weeks. So pushing it up is always easier than pushing it back. So plan in advance, be safe is what I would say. Excellent. Yeah, great. So um we will get out the guide book to you guys tonight and then as John said, he's happy to answer any more questions. By email so I can pass it on to him and if you have any more questions by step one set two and, and if you don't get the guidebook or anything, just um, send me an email. Um I'll put my email into the chat there now. Um Thank you everyone for joining. All right, thanks for, thank you. Thank you. Bye.