The IMG Roadmap Series #11: Dr. Dike (IM)


It may look like Nigeria has been leading the series lately, but today’s guest was my USMLE Step 1 partner.  We met over a decade ago in Maryland, while we were both preparing for Step 1.

Despite the fact that I was a Caribbean medical student taking a dedicated study period to prepare for the test, Dr. Dike and I grew our friendship on the basis of study accountability. She had just recently graduated medical school when we met and began studying together at the Prince George’s county library in Maryland.

Let us jump right into her Q&A!

Dr. Lum: Please tell the audience more about your awesome self Doctor.
Dr. Dike: I am an Internal Medicine attending physician from Nigeria & I practice solely hospital medicine. I relocated to the United States after I got married and I am now a mother of three children.  I had all 3 of them during this “hustle” process. For hobbies, I love to shop, travel and sometimes cook.

Dr. Lum: Please tell us about your medical school education prior to coming to the US.
Dr. Dike: I attended medical school at Ebonyi State University, Nigeria where I Graduated in 2009. During my medical education, I had no plan of coming to the US to study and/or live, hence I was not preparing for any of the test-taking or transitioning that happened after I moved to Maryland from Nigeria. I met my husband during my last year of medical school and it was obvious then that I’ll have to relocate for us to build our life together.

Dr. Lum: Walk us through what that Step 1 preparation process was like for you.
Dr. Dike: You know all about this Dr. Lum. We started this together. I took Step 1 around September 2011. I scored a 229. During my preparation, I had to keep an open mind to learn what was different.  I embraced the fact that the scope of what I needed to learn during this process was new. I realized that the medical knowledge I had from Nigeria was great but the expectation of the USMLE is a separate ball game and requires studying from the prep books. Kaplan videos made a huge difference for me. I sat down, listened to Kaplan videos, especially in areas I struggled with such as neurosciences.  First Aid and USMLE world Q bank were it for me. I also did some of the NBME forms for preparation. After reading through this material, I did the USMLE question bank with each section. I noticed that a student can study the books but still can’t answer questions correctly, so I stress the importance of incorporating questions with your studying. I went over USMLE World twice in total prior to sitting for the test.

Dr. Lum: Very elaborate. Thank you. Any pearls for us on step 2 & 3?
Dr. Dike: I took  Step 2  around September 2012 and scored a 221. For step 2 I used Master the boards & UWorld Q bank.  Same mindset. I took Step 3 in 06/2016. This was during my first year of residency and I scored a 207, I clearly did not need that to get into residency. For step 3 I used the UWorld qbank.

Dr. Lum: I know Step 2 CS was a touchy one there for a while. Can you share your experience?
Dr. Dike: Unfortunately, I repeated the CS exam and I passed it on the second attempt. I clearly learned some valuable lessons there. CS is all about repeated practice and communication. You have to time yourself & know what to put down on your assessment form. It was my first time using the EMR to type during a clinical encounter, so that slowed me down and I did not finish during my first attempt. I had to change my entire approach to pass it.  I went online and I found 3 partners via an online forum, we met in person and practiced at the University of Maryland twice a week. I used a practice partner once before on skype the first time around, I can tell you that was not enough. I learn via repetition and timing myself helped me stick with completing my patient encounter. With reading it was all about memorization, what we call “cram work”, but with repetitive in-person practice, I understood all the relevant questions to ask and the mannerisms to adopt. Besides learning and adjusting on time management, my body language needed work and my partners helped me with that.

Dr. Lum: You have shared some valuable pieces with me today, I am sure the readers will glean some wisdom from you today. Did you obtain USCE (US clinical experience)? If so, was that helpful?
Dr. Dike: Yes, I got an externship in a VA hospital. I believed it helped my CV. I was asked about it a lot during my interviews. Tells me they were looking for some type of USCE. I also participated in 2 kinds of research and 1 observership. USCE helped me a lot more for the USMLE CS exam. It helped me build confidence when I was in those clinical scenarios. Rotating in US hospitals helped me build clinical confidence. For most IMG’s, though we are “book smart” there is a cultural adaptation that needs to happen to express what we know in a convincing manner. Witnessing others do this helped me become more expressive.

Dr. Lum: You are right. Can you tell us what you will tell someone else going through this phase?
Dr. Dike: The process was draining with many unsure variables. It was particularly hard for me because I had kids in between my steps I guess. BUT, do not be discouraged, especially after a failed attempt. I did not listen to the naysayers. Stay focused and remain determined. Be selfish for your good. What I mean is to create a plan and stick to it. Create a schedule, do the same –stick with it. For women with children during this process, you will need a support system. Have someone else to watch them during your dedicated studying time, then pick them up after a long day of studying or work. Above all: stay focused, create some structure and protect your time. Once I got home I knew I could never study and so it was important to protect my study time. Don’t listen to negative people, stories are being told about people who had a failed attempt on boards. Yes, failure can make it difficult but there are people who match regardless. Try to make contacts with attendings and residents to create relationships that can lead to positive LOR’s. There is a success story on the other side of resilience.

Here is my mantra, never lose hope. Have a plan, create a schedule and stick to it. Go out, look for observerships, externship, and research opportunities. Pursue them, whether paid or unpaid. Just go the extra kilometer! Best wishes to all preparing for the next match.

IMG’s I want to help guide you as you prepare for the match. If you have been seeking to be coached or mentored by myself (Dr. Lum),  here is an opportunity. On June 22nd I will be launching my online course and coaching program that focuses on teaching IMGs what they need to increase their chances of success. You can learn more, click here and sign up.

Can’t wait to see you there!


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