USMLE TALK 2025 back to the Philippines for 2 years of
Speakers: Dr. Miguel Yu and Dr. Joemar Tan
- USMLEs
o PLE first US for good Sa US tinake lahat
ng exams
o There is an option to take it in the
Philippines = PROMETRIC in Ateneo Law
School
- STEP 1, STEP 2 CK
o Ateneo Building Dela Costa Campus
(Salcedo Village)
- STEP 2 CS
o Must go to the US
- USMLE has 4 exams:
o What are STEPS 1, STEPS 2 CS AND CK, STEP
3?:
Step 1 – Basic sciences and how these
correlate to the practice of medicine
Step 2 CS – Recently cancelled this is
clinical skills OSCE 13 patients and
you must diagnose them and etc.
• Replacement: OEG
Step 2 CK – 2022 onwards, Step 1 will just
be PASS/FAIL; STEP 2 CK will have a
definitive score
• CK – Clinical Knowledge
o Diagnostics, Management
Step 3
• No need to take this for residency
• No need to take this before ECMG-
certified
• Huge advantage for interviews
• H1BC Visa
• Usually taken after the first year of
residency
o J-1 VISA Trainee VISA
You are NOT allowed to work
Only need to take Steps 1 and 2
Step 3 usually taken after first year of
residency
There is a waiver you can just serve in
the US in the rural areas
7-year maximum for training
Requires at the end of the training
• Agreement between PH and US
o US gov’t is bound by law not to
offer you another visa until you go
return of service
o If you want to stay in the US long-
term, you need to do the 2 years
thing before you can be given an H1
Visa
o H1B1 Employment VISA
Need to take Steps 1-3
Green card no need for VISA
Work agreement
You are being employed in a hospital
agreement that a hospital can sponsor
you for long-term stay
Harder to get, but it’s harder to get
Leads easier to a green card, especially if
you are a foreign graduate
You can work during the times that you’re
not on-duty
o Most common approach: J1-VISA
Gives more options on where you can
apply for residency
Somewhat easier for residency programs
to take you under that visa
There are financial incentives from the
government
Main repercussions:
• 7 year maximum
• 2 years Return of Service (R.O.S.)
o Way around it: Waiver Process
More complicated
H1B1: For staying in US beyond 7 years
• Eventually transforms to long-term
stay (e.g., permanent visa)
- Green card
o Naturalization process in the USA
o Easiest is naturalization through family
o Permanent resident can lead to
permanent citizenship
o H1B can lead to the Green card
o O-Visa = If you’re extraordinary
o If J1 Route:
Supposedly you’re in US as an
international trainee
At any point in your 7 year process
(continuous) If it elapses, you can
switch to another visa (O-visa/Einstein
visa)
There is a Waiver Process
 • Your future employer will have to file
an appeal on your behalf with your
employer stating that we need a
physician in his caliber in our system
we want the us govt to remove the
contract US govt is willing to waiver
the 2 years R.O.S.
• You need to apply for a hospital
they will apply to a local health service
appeal to homeland security
• You are willing to take a 3-year waiver
• Entire process: 6-8 months to go
through once you go through, we
recognize that he has value and this
kind of value cannot be fulfilled by
anyone else in the country to fulfill
this, applicant must be willing to serve
in an underserved place for three years
- If you want to apply for good training be
selective with the programs you’re applying for
- If you want to apply to stay apply broadly
o Each program you apply to will come into a
cost becomes worth it once you become
an attending
- After residency you get board certified
you can get into any fellowship program you
want subspecialty big leagues open up for
you
- Just put a foot in the door as long as you get
yourself in a program, and you perform very
well you will get rewarded
- Description of Journey:
o Dr. Joe Tan
Step 1 had a score
Step 2 CK had a score
Step 2 CS was still there
PLE first then 6 months for Step 1, 3
months for Step 2 CS, and 2-3 weeks for
Step 2 CK (Pass/Fail)
• Now that Step 1 is Pass/Fail, Step 2 CK
now has more weight (scored na)
• As IMGs, our scores will be lower than
everyone else
o Score (minus 150-200)
o You need to have a high score to be
at par with someone who has
similar caliber who is a US citizen
Letter of Recommendation (usually from
a US-trained physician) will be helpful
• 1 from Dean
• 1 from Dept. Chair of Specialty you’re
applying into
• 3 from US-practicing physicians
• It’s important that you don’t find a LOR
from a relative
o Dr. Miguel Yu
The scoring now is different 3-digit
score
Depending on specialty, the scores will be
different
A score of 250 or 260 is more
recommended
Most programs still discriminate against
VISA because it takes a lot of work for
them to sponsor you a VISA
Step 1 – PASS/FAIL
• Repercussion for IMGs:
o Our differentiating factor You
have to get very high scores on Step
1 to get noticed
Step 2 CK – Might be the name of the
game for our generation now
Number of times you take it will matter as
well
Letter of Recommendations are
important
• Philippine LORs
• US LORs are quite hard to get
• For LORs, it depends on the program
o Some programs read it
o Some programs don’t read it
Observer-ships are important to find
connections (DTTS) for LOR
• Letter is not just given printed the
doctor has to upload it themselves
• A waived letter will have more weight
than an unwaived letter
DTTS
• Facebook group for those who are
taking the USMLEs
Cost: 500k to 1 million
• Half a million to a million in total to
fund for:
o Flights
o Exams
 o Study materials How good can you memorize?
o Lodging Usually one-step questions
o Food o USMLEs
• Register for the exam May bayad No recall questions
• Pay for the exam May bayad Everything is integrated requires a lot
• Reschedule May bayad of analysis
• Per program May bayad Usually 2 or 3 steps
• Per step, there is a payment o Summary:
• Materials: UFAP PLE helped in the recall part, but on the
o UWorld exam itself, hindi talaga
o First Aid and pathoma Use PATHOMA and SKETCHY MED and
o Sketchy PHYSEO while in medical school
o Online Mended Do not rush the process, but do take it
o Try not to have too much resources when you feel like you are ready
and just stick to one and master it • If you take it post-PLE, you might get
o UWorld – Gold standard for USMLE delayed for another year
500 dollars = 25k Reco letters, Step Scores more important
Subscription-based it expires If you have a residency here, you have a
You need this to prepare you for HUGE advantage
an exam Take the board exams in the US
https://medical.uworld.com/us o How to reach?:
mle/usmle-step-1/ Joemar Tan iMessage (ask Jae)
- Salary: Miguel Yu Messenger
o 3.5 million PH/50,000-60,000 dollars a year
for a US resident
o Fellows get 60-70,000 dollars a year
o Up to 200k dollars a year as a
consultant/attending
o Up to 400k dollars a year for sub-spec
holder
o Though, US gov’t will hold 30-40% for tax
- Study hours:
o Step 1: 6 months (14-16 hours per day with
1-2 hours with breaks)
o Step 2 CK: Studying less because working na
4 months (8 hours per day for studying)
- Work hours:
o Not as intense
o Required that you have a 20-work days off
o You have 100 days of weekends off
o Pre-duty: 7-5
o Duty: 7-7
o Post-duty: Have been In the hospital over
night
- PLE FIRST OR NO?
o PLE
Asks you a lot of recall questions
Breadth of knowledge