| Securing
Residency in the USA
In order to secure an American post-graduate
residency, it is recommended that
students take the following preliminary
steps during their medical studies
in Ireland. Medical students at
American medical schools take the
same steps.
1. Take the United States Medical
Licensing Examination (USMLE) Step
1
The USMLE Step 1 is a one-day multiple-choice
examination that evaluates a medical
student's understanding of the preclinical
sciences needed to practice medicine.
Students in Ireland usually take the
USMLE Step 1 at the end of the third
year of the five-year medical degree
program. There is a testing center
in Dublin.
2. Take Electives at an American
Medical School or Hospital
During the final years of study in
Ireland, it is recommended that the
medical student choose to do a few
elective rotations at an American
medical school or hospital. This allows
the student to evaluate the school
itself and in turn, the residency
to assess the student's clinical and
interpersonal skills. Electives may
also facilitate letters of reference
from American preceptors who can help
comment on the student's abilities.
Some of the Irish medical schools
have scholarships for electives taken
during the summer months at partnering
medical schools in the United States.
University College Dublin, for example,
has full travel scholarships and pre-arranged
electives with the University of Pennsylvania
and the University of Kansas medical
schools.
3. Take the United States Medical
Licensing Examination Step 2 Clinical
Knowledge (USMLE Step 2 CK)
The USMLE Step 2 CK is a one-day multiple-choice
exam that evaluates the medical student's
applied clinical knowledge in providing
supervised patient care. Students
in Ireland usually take the USMLE
Step 2 CK between the end of the fourth
year and the autumn of the final year
of medical school. There is a testing
center in Dublin.
4. Take the United States Medical
Licensing Examination Step 2 Clinical
Skills (USMLE Step 2 CS)
The USMLE Step 2 CS is a one-day pass/fail
assessment that uses simulated patients
to measure the medical student's history
taking, examination, and investigation
skill with the patient. The test also
evaluates the examinee’s communication
and interpersonal skills, and their
proficiency in spoken English. This
examination replaces the Clinical
Skills Assessment (CSA), which was
administered for the last time in
2004. The USMLE Step 2 CS is taken
at centers located in the USA. Most
students training in Ireland usually
schedule the assessment to coincide
with a vacation in the United States
or a trip home to visit family and
friends.
5. Enter the National Residency
Matching Program (NRMP)
Also during the student's final year
of Irish medical school, the student
enters the NRMP, a matching system
used to fit medical students to appropriate
residency slots. The USA offers approximately
23,000 first-year residency posts
each year and there are only approximately
16,000 graduates of US medical schools,
so many positions are still available
to graduates of medical schools from
outside the USA. All American residencies
are available for review in a large
online database called the Fellowship
and Residency Electronic Interactive
Database (FRIEDA). After browsing
FRIEDA for desirable residencies,
medical students use a single online
application called the Electronic
Residency Application Service (ERAS)
to apply to multiple residencies.
6. Conduct Interviews at Residency
Programs
Around December of the final year
of medical school in Ireland, the
student accepts invitations to be
interviewed at American residencies.
These interviews allow the student
to visit the facilities first hand
and meet with their future staff and
colleagues.
7. Graduate Medical School and
Begin Residency
After the interviews, the student
enters a ranked list of their desired
residencies via the Internet. Residency
directors also enter their ranked
list of candidates via the Internet.
Students are matched to residencies
and the results are announced online.
The student graduates from medical
school in Ireland and starts residency
in the USA a few weeks later.
Completing Residency in the
USA
1. Take the United States Medical
Licensing Examination (USMLE) Step
3
Once the student has graduated from
medical school in Ireland and begun
training at an American residency,
the resident arranges to write the
USMLE Step 3, which assesses a resident's
ability to apply clinical knowledge
to the unsupervised care of patients.
2. Take the Specialty Examination
Near the end of residency, the board
examination for the resident's chosen
specialty is taken. For example, a
family physician would take the American
Board of Family Medicine (ABFM) certification
examination.
Visa for Canadian Citizens
in USA Residency
Canadian citizens who train at residency
programs in the USA generally get
a student visa called the J1 visa
that permits them to train in the
USA for the duration of their residency.
Obtaining a J1 visa is straightforward.
When the results of the match are
announced, the Canadian student prints
off the residency offer from an American
program, then gets a letter from the
Federal Department of Health (Health
Canada) specifying that there is a
need for more physicians in Canada,
and fills out the accompanying form.
The package is sent off, and a J1
visa is made ready for the first day
of residency. While the J1 visa is
by far the most popular visa type,
others such as a H1B visa are possible,
but involve extra requirements and
are more time consuming to obtain.
American Residency Posts 'Outside
The Match'
Some students studying in Ireland have
accepted an American residency post
"outside the match". In
this case, the student has a preference
for a particular residency quite early
on, and the residency director and
the student sign a contract in advance
to start that particular residency
upon graduation. Though there has
been a policy of the residency authority
to try to only use the official NRMP
and ERAS for matches, occasionally
some students sign outside the match
because it saves time on the student's
part, and the residency director is
guaranteed a strong resident from
Ireland.
fellowship and residency interactive database www.ama-assn.org
national residency matching program www.nrmp.org
electronic residency application service www.aamc.org
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