Overview: Boards & Training in N.A. - North-American …nimsa.ca/wp-content/uploads/Boards-Electives-2013.pdfOverview: Boards & Training in N.A. ... USMLE STEP 1 USMLE STEP 2 CK

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Overview: Boards & Training in N.A.

Victoria Swan [email protected]

Kyle Halligan [email protected]

Bradley De Souza [email protected]

Resilience

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Obstetrics & Gynaecology Paediatrics

Surgery part A Forensic & Legal

Medicine

Medicine 1 Psychiatry Medicine &the Community

Professional Completion Module: Medical elective, Subinternship, Clinical

emergencies, Independent study, Intensive revision.

Public Health

Medicine

Surgery part B Medicine 2

Cell-cell Communication and Signalling

Molecular Basis of Life and Disease

Patient-Centred PracticeStudent -selected option

Structure of the Thorax

Cardiovascular and Respiratory PhysiologyCardiorespiratory Disease

Principles of InfectionCardiorespiratory Therapeutics

Gastrointestinal and Genitourinary StructureGastrointestinal and Renal Disease

Gastrointestinal and Renal PhysiologyGastrointestinal and Renal Pharmacology

Endocrine System in Health and Disease

Opthalmology and OtolaryngologyProfessional Clinical Practice

Oncology and ImmunopathologyDisability

Neurology in Health and Disease

65 Programme credits5 Option credits


65 Programme Credits


10YEAR

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Semester 1 Holiday Semester 2 Summer

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2010 1010

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Surgery part A Medicine 1 Surgery part B Medicine 2 Obstetrics & Gynaecology Paediatrics

PsychiatryMedicine &

the Community

MedicalElective

STAGE 1

STAGE 2

STAGE 3

STAGE 4

Personal and Population Health 5

Haematology and Immunosuppression 5

Reproduction, Psychology and Child Health 5Advanced Clinical Skills

10

Student-selected option 5

Graduate Entry Medicine Programme Detail

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RESEARCH vs. VACATION

USMLE STEP 1

USMLE STEP 2 CK + CS + MCCEE +

ELECTIVES

GRADUATION!! INTERVIEWS APPLICATIONS DUE MARCH – MATCH!

ELE

CTIVE

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USMLE Step 1 Scores (2011)

228 220 228 210

200 230 228 218

75% IMG Match



Medicine




Public Health

Medicine


















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the Community

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USMLE STEP 1


ELECTIVES


ELE

CTIVE

Res Year (GEM3/UG5 Year) •  History and Physical exams!!

•  Learn how to manage patients •  Learn surgical techniques (scrub in!)

•  GRADES MATTER GRADES MATTER GRADES MATTER GRADES MATTER

•  Don’t for one second think your Step 1 will be your saving grace for Med 1 MCQ!!

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GEM3/UG5 - After January •  Get through your courses •  Arrange to have Obs/Gyn & Peds first

•  Why? – Because you need to have these core

modules completed to gain electives during the summer months

– Because after the summer you have the Step 2 CS, CK, MCCEE



Medicine




Public Health

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the Community

MedicalElective

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USMLE STEP 1


ELECTIVES


ELE

CTIVE

Summer of GEM 3/UG 5

•  Clinical Electives •  USMLE Steps 2 CK/CS •  MCCEE

•  Focusing on Electives first…

Applying for Electives

•  Get on them early (Canada due in Aug/Fall vs. US due in March/Spring) –  Immunizations: try and do them when at home

•  How many to apply to? Scheduling?

•  Must fulfil UCD’s requirements (min. 1 x 6wk OR 2 x 3wk…anything but 2wks)

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Applying for Electives •  Paperwork to the office

•  Be nice but persistent with UCD programme office

•  Personal statements (if needed) •  Write early, make appropriate to elective

•  UCD has a number of affiliations •  List will only grow

Applying for Electives

•  Checklist –  Immunisations – Malpractice Insurance (MPS or site specific) – Personal Health Insurance – Background Check (Garda or Home police) – Personal Statements – Letters of Recommendation - Irish letters (?)

How to choose electives? •  Look at CaRMS/ERAS websites

– Each description is written by program director

•  Related to specialty or program of interest •  Try to know what you want to become before applying

to electives in order to tailor your application early

•  Personal Anecdotes

Be a Superstar on Electives!

•  Modesty & hard work •  Ask for letters early •  Get electives according to your goals

•  DO ELECTIVES WHERE YOU WISH TO MATCH!

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Letters of Recommendation

•  Think about getting your letters early •  Approach your supervisor in the 1st week

– Do NOT ask to see your letters - They will be submitting this blinded letter via LoR Portals

•  For America residencies – up to 4 letters •  For Canadian residencies – varies, up to 5

letters •  Letters from Ireland – may be of use for elective

applications and to support Dean’s Letter

An approach to asking for letters

•  Ask early! Day 1-2: Tell your preceptor you’ll be applying to “CaRMS/ERAS” for “X-specialty” in the fall and this elective is a meaningful opportunity for … and hopefully, to obtain strong letters of support for your residency application.

•  Ask re: expectations & feedback early & throughout

•  Research what areas your preceptors should be commenting on about you

•  Offer an outline of your positive learning achievements during the elective

Similarities & Differences of NA system

•  North American Students: – Newer curricula adding clinical experiences in

years 1-2 – Clinical medical students are an integral part

of the team, expected to have a comprehensive grasp of the facts and plan concerning the patients they follow


•  Electronic Medical Records –  e-Prescribing / Order Sets –  Note/entry to be co-signed by a resident

•  Admission Notes –  As you would see here

•  SOAP Notes –  Subjective - Patients feelings –  Objective - Lab values/Clinical Signs –  Assessment – Problem List/What’s going on? –  Plan – What are you going to do about it?

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•  Discharge Summaries –  Admit date –  Admission diagnosis –  Procedures done (major ones) –  Hospital course –  Consultants involved and specialties and recommendations –  Medications at discharge –  Diet or activity instructions –  Follow up appointments and tests –  Disposition at discharge: discharged to where/whom: eg

assisted living center, rehab, NH etc

Abbreviations

•  Medilexicon.com –  BMP: basic metabolic panel –  NED: no evidence of disease –  WD/WN: well developed, well nourished –  HEENT: head eyes ENT –  NC/AT: normocephalic/atraumatic –  NBM: nil by mouth –  NC: non-contributory –  CTA: clear to auscultation



Medicine




Public Health

Medicine


















10YEAR

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Apr

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Human Form


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2010 1010

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the Community

MedicalElective

STAGE 1

STAGE 2

STAGE 3

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USMLE STEP 1


ELECTIVES


ELE

CTIVE


•  Medical/Surgical Clinical Electives •  USMLE Steps 2 CK/CS •  MCCEE

•  Focusing on America next…

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USMLE Step 2 - Clinical Knowledge (CK)

•  352 MCQs over (9) hour blocks •  Start studying during electives (maybe

even during 3rd year Med/Surg)! •  All about management & clinical acumen – stuff you

learn during Res year and internship here

•  Resources – USMLE World Q-bank / NBME mocks – Books: First Aid CK & Crush the Step 2 • Designate ~6-8 weeks to intense

studying

USMLE Step 2 - Clinical Skills (CS)

•  12 OSCE Stations –  Simulated patient encounters

•  Actors + patient notes - DDx, management – Some telephone patient encounters

» (Grand-dad inquiring about infants’ yellow diarrhea)

•  25 minutes/case - 8 hours total •  Apply for the CS early/NOW

–  Only a few cities in the US where it’s offered, so choose early and according to where you will be

•  Get it done early! (review website for score reporting dates to ensure your score is available ASAP for ERAS)

Step 2 CS Reporting Schedule USMLE Step 2 - Clinical Skills (CS) Scoring

•  Integrated Clinical Encounter –  Data gathering and data interpretation skills –  Scoring via:

•  Checklist completed by patients for physical exam •  Scoring of the patient note by trained physicians

•  Communication & Interpersonal Skills •  Fostering the relationship / Gathering & Providing Info /

Helping patient make decisions / Supporting emotions

•  Spoken English Proficiency

REVIEW THE WEBSITE FOR CHANGES TO FORMAT AND SCORING

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•  Medical/Surgical Clinical Electives •  USMLE Steps 2 CK/CS •  MCCEE

•  Focusing on Canada next…

Canadian Match Process •  Do electives in Canada!

– Must have good experience and show off your clinical skills

– Last year: 70% of Matched CSA’s did at least 1 elective in the same province as where they matched

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Canadian Match Process

•  Our IRISH medical school status has a HUGE impact on matching

– Clinical Knowledge – same or better – Clinical Skills – better, hands down – Management plans (SOAP) – weaker, quick

learning curve

Medical Council of Canada Evaluating Examination

(MCCEE) •  Apply early (look into it January of res year) •  Application seems complicated but go

online for Application Wizard •  http://www.mcc.ca/en/exams/ee/apply.shtml •  Answer YES to: Are you an IMG? Is this

your 1st time applying to MCCEE? Are you in your final year?

Medical Council of Canada Evaluating Examination

(MCCEE) http://www.mcc.ca/en/exams/ee/EeExamWizard/

FirstTimeStudentApplicationSteps.shtml

•  Read all the steps before you do anything •  PCRC and MCC are the 2 websites you

work with and information is shared across •  Try to do as much of the offline hassle

before completing online steps because there are time restraints

MCCEE

•  180 MCQs – 4 hours •  More straightforward than the CK

– BUT – each of the major specialties is equally represented

•  Write it IN SEPTEMBER of 4th year to join the 1st iteration of CaRMS – Register early to secure Dublin spots

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MCCEE •  Write both the EE and CK around same

time – all the information overlaps

•  To study: Use CK resources •  In addition - look at Population Health & Ethics portion

of EE separately

•  EE grade matters!!! – Programs interview top percentile (>90th) – Don’t be fooled that this is an easier exam

than USMLE Step 2 CK

Best of Luck! Please note that the informations contained within this document

are accurate as of the date of publication – this information however, changes annualy.

Please be sure to verify all information before acting on it

Documents

Overview: Boards & Training in N.A. - North-American …nimsa.ca/wp-content/uploads/Boards-Electives-2013.pdfOverview: Boards & Training in N.A. ... USMLE STEP 1 USMLE STEP 2 CK