Clinical rotations, future post-graduate studies, and the new USMLE Prep Course

For students wishing to practice in the United States, OUM and most American/Canadian medical schools require their students to pass the United States Medical Licensing Examination Step 1 (USMLE) before they begin clinical rotations, especially if they want to rotate at US teaching hospitals. Completing rotations at approved teaching hospitals is also a requirement for most US residency programs, as well as state licensing boards.

“It is absolutely essential for medical students to understand the nature of the three USMLE licensing exams and value the positive opportunities that can result from good exam scores,” says Hugh Bartholomeusz, OAM, RFD, MBBS, FRACS, OUM Vice Chancellor. “Passing USMLE Step 1 is absolutely critical to a student’s progress through our programme and for the overall validation of their pre-clinical fund of knowledge.”

Strong USMLE performance opens doors

Passing USMLE Step 1 with good scores opens doors both for rotations at better teaching hospitals and for a good residency match in the future. Students who do not pass USMLE Step 1 will find themselves scrambling to find rotations at a community hospital or in a private practice, neither of which is looked upon favorably by residency directors or licensing boards. It is therefore not an option in our new programme, says Professor Batholomeusz.

“I can’t say it enough: Not only is passing Step 1 on the first attempt essential but getting as good a score as possible (>220) will help students compete for the rotations and residency of their choice,” he says. “Those passing on the second attempt or those just getting by with scores around 200 are going to have a tough time matching.”

Many teaching hospitals even require a specific score on Step 1 in order to be considered for rotations at their facilities, and no matter where students do their clinical rotations, they must pass all USMLEs before they may apply for post-graduate residency match in the United States.

New USMLE Prep Course has launched

Because so much rides upon good USMLE performance, OUM has typically offered USMLE Step 1 preparation, the newest program having started this month. OUM has obtained a Lecturio institutional license to provide a solid structure and plan for students preparing to sit Step 1.

“After students have completed their system-based modules and the Clinical Skills Course, they may contact me to enroll in the USMLE Prep Course,” says Daria Camera, PhD, Director of Pre-Clinical Education (, who adds that cost for the course is included in tuition.

The first step upon course enrollment is a required 100-question pre-test. “This provides valuable information on each student’s current knowledge base,” says Dr. Camera. “It also helps the University make necessary adjustments to the course structure and ensures that knowledge gaps are addressed,” she adds.

OUM’s USMLE Prep Course is structured to provide 100 days of intense independent study, with each student receiving a daily schedule of material and quiz questions that must be completed.

“While there are shorter programs, this 100-day timeframe was specifically selected to ensure that students have adequate time to prepare for USMLE Step 1,” explains Dr. Camera.

Lectures, quizzes, final exam — and remediation, if needed

Course content includes:

  • Daily required recorded lectures and videos, supplemented by textbook reading, with students required to prepare notes from the materials provided.
  • Daily content quizzes are provided for self-assessment, as are weekly quizzes of USMLE-style questions administered in Lecturio.
  • Live review sessions are held weekly (Sunday and Monday evening US ET) to provide students with feedback and strategies in applying their basic science knowledge to the USMLE-style assessment.

“While not compulsory, the live sessions are strongly encouraged and integral for optimizing USMLE Step 1 preparation,” says Dr. Camera.

At completion of the 100-day prep course, students will be required to take a comprehensive 200-question final exam over two, 2.5-hour time blocks within 24 hours. The final exam will be proctored under the standard OUM exam policy.

Per guidelines set by the National Board of Medical Examiners (NBME), students must score 75 percent or higher on the prep course exam, a figure that determines readiness to apply for the USMLE Step 1. Remediation will be provided for students who do not achieve the required pass rate.

“Since all students need different levels, content, and time for preparation, we established a four-week remediation extension of the USMLE Prep Course, individualized to each student’s personal knowledge deficit,” says Dr. Camera.

At the conclusion of the four-week extension, students may elect to continue with additional preparation or retake the final exam to determine whether the pass rate was achieved. Students who pass USMLE Step 1 after completing remediation must retake the five-day, face-to-face Clinical Skills Practical Workshop prior to beginning rotations, to ensure that their clinical knowledge is current.

Is the USMLE Prep Course only for North American students?

While North American students must pass USMLE Step 1 before they are permitted to start their clinical clerkships and eventually for residency applications, students from Australia, New Zealand, Samoa, and beyond also are encouraged to consider applying for Step 1.

“There are several reasons that it could be beneficial even if you aren’t an American or Canadian,” says Professor Bartholomeusz. “We have no way of knowing exactly what our futures may bring, so passing Step 1 now increases your opportunity to practice in the United States one day. In addition, USMLE is an internationally regarded milestone exam. Passing it makes you more competitive in your local communities for better rotations and internship positions,” he says.

For additional information about the new USMLE Prep Course, contact Dr. Camera.

(December 2021)