作为中国人, 总希望自己的同胞有更好的发展前途.

如果你是中国毕业的医学生, 而且你酷爱科研, 下面的就不要看了. 我们要承认, 对专业的热爱是成功的重要动力, 而且可以使你的生活更有乐趣.

如果你像我一样, 是中国毕业的医学生, 对科研的感觉一般, 那我强烈建议你去考USMLE.
(一些基本内容可以在这找到: www.ecfmg.org)

Before you start to prepare USMLE, buy a book called "First Aid for USMLE Step 1 (or 2, 3)". You will know the very basic and important info. At the end of the book, there is list for all books you need to buy. Get at least one from the different specialties.

1.Step 1 (basic knowledge): For people who have research experience or hold a PhD, this is an relatively easy step.

2. Step 2 (Diagnosis): For people who had been clincians in China, this is a not very difficult exam. This exam includes two parts now: CK and CS. For CS, you should speak relatively fluent English. However, like all exams, you can always crush it by taking some Kaplan courses or practicing at home or with friends. Don't be scared by the CS exam. For most people who have been working or studying in this country, this should not be a problem. Acturally, this may be the most easy part among all the USMLE, although it is also the most expensive one.

If financially permit, take a Kaplan course. It is very helpful, esp. for us the foreign medical graduate. One month before the exam, buy the Q bank from Kaplan. This is a must investment. Once again, use the Q bank from Kaplan.

By now, if you have green card or you would like to take J visa, you are ready for application, interview and match.

If you want to take H1B visa, you need to go one more step further, step 3.

３．Step 3 (Treatment). There are many contents overlapping between step 2 and stept 3. Therefore, it is a good idea to take them consequently.

如果你没有美国医生的推荐信或者美国医院的工作经验，考个好的USMEL成绩是你成为医生的唯一出路．

如果你的USMEL考的不是很好（比如说７０分左右），你依然有机会．试着找个临床医生的实验室做Postdoc，和系里的ＭＤ，program director, or chair 搞好关系，即便不能留在那个Program，也可以拿到很好的推荐信去申请其他的Programs.

如果你没有养家糊口的压力，去你想去的Program里做半年或一年的Externship (Volunteer), 这是很多印度人和东欧人的做法, 但是非常有用．

有绿卡最好，如果没有，依然有很大的机会．H1B, J1 visa 都可以用的．

按照中国的人口基数，我们在美国的医生还是太少了．参看下面的文章
http://content.nejm.org/xxxx/reprint/353/17/1810.pdf

既然大家已经来到这个国家，为什么不能团结起来，生活得更好一些呢？　即便你不是医生，怎么能保证你的亲戚朋友，甚至你将来的配偶不是中国的医学生呢？在美国社会里多一些中国医生总比多一些餐馆老板要好一些吧．BTW，当你做完Residency,申请考专业Board 时候(不是USMLE), 很多Sepcialty board　会问你 How to show your title in your diplomate: 只有两个选择, MD or OD. That's it.

对所谓的ＭＤ或ＭＢ打架可以告一段落了．
(2): Interview and Match

上次谈到了USMLE的一些基本问题. 这次谈谈如何面试和成功找到Program.

先澄清两个误解:

有的Program要求从医学院毕业不能超过10年(或者7, 5年). 确实有这种Program. 很多吗? 我看未必. 别忘了, 美国有几千个Program, 你可以申请别的Program. 如果你离开医学院超过10年了, 但是你已经做了很多年内科医生, 现在要联系内科的住院医生, 这应该是你的长处, 要善加利用. 因为有的专业是可以Waiver掉一年的. 作为有经验的医生, 你做住院医生的主要目的不是training, 而是为了有资格参加specialty board, 以便将来行医.

没有绿卡不能做住院医生? 错!
我有时候挺佩服印度人的干劲, 虽然对有些印度人的人品不是很佩服. 他们才不管什么J visa or waiver 的问题, 先当上医生再说. 曾经有个印度人跟我说过: 当上了医生, 什么样的好律师请不到, 哪有解决不了的身份. 至于H1B 签证怎么办, 如何通过J visa 办绿卡,我将在下一贴里详讲.

现在来谈谈如何申请Program.

1. USMLE score: This is the most important part for general people (I mean most of us have no experience in the US hospital).

2. Personal Statement: The second important part. This is probable the only way to show your written English to the program director. When the Hi-Tech was still hot, there were several pretty good websites run by some MD to present some wonderful sample PS for various specialties. Unfortunately, most of them are closed now. You can search Google to see if something could pop out. I do still have some collections, and would like to post here if anybody shows interests. But keep in mind, just as reference, do not copy them. If you can find them from internet, others can find them as well.

3. Recommendation letters: If you can get a letter from a MD, you may switch this with the 2nd part (PS). Most of us are working in the medical schools. Try to find some collaborators from clinical department. Trust me, most the US doctors are for practice only. They don’t really have any publications. Therefore, if you put his/her name on you paper, or even a conference abstract, they will be really happy.
这时候要封推荐信就是水到渠成的事了. 发挥你的聪明才智, 至少找到一封MD的推荐信．

4. Medical school tranxxxx and dean letter: The least important parts. Regarding the tranxxxx, average is OK. If you can’t get the dean’s letter, don’t even bother. Just tell ERASE you medical school does not provide it.

如果你想联系不同的Program，一定要下点功夫写完全不同的PS．一个专业一般申请20到30个Program应该就够了. 一般的规律是这样, 拿到了一个interview就会拿到很多, 拿不到的往往就一个也拿不到.

一般的申请范围包括: NY, New England area, PA, NJ, MD, TX, FL and CA. In Middle West, you can try IL, MI, WI, and IN. Those states, esp. NY, are called FMG friendly area. Here the “friendly” does not mean they are really nice to FMG. Instead, they need FMG to fill the residency position. Otherwise, they will lose the federal government support (mainly from Medicare financially). Unless you really have some special reasons, don’t bother to apply for the programs in the South.

Call the program before you apply through ERASE. Make a question list before you call, such as:

How many FMG do you have?
What is the minimal USMLE score?
What kind visa do you sponsor (if you have a visa issue)?
Do you have any house allowance (esp in some metropolitan area)?
etc.

现在到了interview的时候了. 一旦有了interview, 你就成功了一大半了. 因为一旦进入了interview, 其他的条件, 包括USMLE scores, PS, Recommendation letters已经变得无所谓了. 这时候 Program director看重的有两条: Communication ability and personality. Communication refers to your spoken English, and personality refers to how easy you can get along with people.

As for the communication ability, don’t be scared about your accent. As in CS exam of step 2, they know you are a foreigner, and they don’t care your accent. As long as they can understand you, you will be OK. For most of us, having working here for several years either as a student or researcher, this is not a big problem. Just practice some common questions before you go for interview.

Regarding the personality, you have to convince the program director that you are a team worker, instead of trouble maker. How? I guess you can write a book about this issue.

Actually, those two issues should have been addressed in your recommendation letters. All you need to do is just emphasizing those and impress the interviewers.

Sometimes, talking some life topics during the interview may be even better that the medical issues. Based on my personal experience (I had been interviewed and interviewed people), you should try to control the interview, but don’t let the interviewer feel any pressure. Having a casual talk, so people will feel you would be a nice one. Having a sport or music topic, people will feel you would be an interesting one. When you interviewer is a talkative one, your job will be very simple: just listening with a little bit of follow up. If your interviewer is a shy person, you should try to control the speed of the talk so that the interview won’t finish in 10 min while it is supposed to be 30 min. Don’t be too aggressive, because nobody like to be pushed forward.
(3): visa issue

这次谈谈身份的问题. 要先声明一点, 大部分内容都是朋友的经验之谈, 无法提供详细解释.

如果没有绿卡的话, 最理想的方式是夫妻中的一方办绿卡, 另一方去做医生. 这样即便没拿到绿卡, 也可以先用EAD去做住院医生.

既没绿卡, 又想做医生, 最简单的办法是用J1 Visa. 我觉得很多人, 包括我自己, 以前都有一个误解: 用了J1, 以后waiver会很麻烦. 当然有点麻烦, 但是用J1简单, 不用求人, 而且连绿卡也解决了.

1. ECFMG提供J1 sponsorship. 因为美国的住院医生不够用, 管理和帮助FMG是ECFMG的主要责任, 因此在J1的问题上, ECFMG只会帮助你, 而不会刁难你. 只要program提供很简单的paperwork就可以了, 基本没有INS的积压问题.

2. 移民配额里, 专门有一类NIW 绿卡是为医生准备的, 不需要你去找推荐信, 也不需要你的publications, 唯一的条件是在Underserved area (“贫困地区”) 服务5年. 这里请注意非常重要的两点:
A. 贫困地区并不一定是在WY 或AL的穷乡僻壤, 相反, 所有的VA medical center和大城市的贫苦地区, 比如说LA或 NYC的downtown 都属于Underserved area.
B. 所有的专业都可以用NIW来办waiver和绿卡, 而不是primary care specialty only (medicine, pediatrics, OB/GYN).
具体怎么办, 恐怕要找专业律师去咨询去了. 但我知道有内科专科, 放射科, 麻醉科, 病理科的医生通过这种途径办了绿卡.

既然说得这么好, 大家为什么还不愿用J1呢? 第一, 你找工作的范围小了. 第二, 你这五年的工资不会很高. 但是任何事情都有利有弊, 就看你怎么权衡了.

第二种VISA, H1B, 大家都知道了, 必须先考过STEP3, 而且program答应sponsor H1B. 因为要办很多paperwork, 所以有一些program甚至是整个医学院都不给办H1B. 这就只能找其他的program了. 因此, 送交申请前, 要先打电话问清楚.

The 3rd is a little bit of tricky. If you are pursuing a PhD in the US, you may try OPT to start your residency, then change to H1B visa after one year. This is a gray zone, because strictly speaking, OPT can only be used in the training which is related to your major. How to interpret is depend on both the lawyer and the court. I know someone used this way to do their 1st year residency, and I also know some medical schools state very specifically that OPT can’t be used for residency unless you are a graduate from a US medical school. You make your decision. It may be risky.

The 4th method might be the best one, but it has lots of criteria to fit.
Do you know that residency is an employment? Then why can’t we apply for green card based on employment? Because the residency contract is usually renewed every year, but the green card application requires a “permanent job”, i.e. at least three-year contract. Let me show you example. You worked for your boss for some time and your boss really likes you, and your boss would like to help you for what ever reason. Plus your boss is the chair of your program, and you know most attendings from your program and impress some of them, i.e. nobody is really against you. Then ask your boss to show a three-year contract to the international office for green card appliation, and start your residency meanwhile.
这最后一条纯粹靠运气, 所以放在最后.

It takes me too much time to type those words. So, I won’t put any long article from now. If you have any questions, please specify in the follow up. I will try my best to answer.

Good luck, my fellow countrymen.