Friday, September 3, 2010

The road less taken.. and how much it'll cost

I’m going to make a list of the moolah spent by an IMG (Indian in this case) if they want to do a Residency in the US of A.
The journey from USMLE to MD ( Yeah! Borrowing term from Digital Doc :D) is a long, and, of course, expensive one. A lot of juniors at college have asked me this question time and again - "How much will it cost me if I decide to work for a Residency in the USA?"
Having been through almost 3/4th of the process, I’m just listing the basic $s that I have spent on the process till now. By the end of this post you should have a gross idea of how much it’ll cost, and thus you can make a realistic decision of what you want to do next – AIPGEE or USMLE.
(I assume that you have basic idea of what the USMLE and the whole process is like on the whole, and are familiar with the terminology.)
-A lot of costs vary by individual choices. So I’m going to list what I spent as an example where this difference arises.

There are a lot of exams that you need to take to be fully ECFMG certified.
TOEFL: An optional exam that is steadily converting into almost a mandatory one if you want to have a competitive CV for electives- Fee $130  Its $165 now.
USMLE Step 1, 2 (CK & CS): A little over $1400 ($700*2) for USMLE Step 1 and 2CK, and $1200 for CS. EDIT: Exam now costs much more than that. USMLE Step1 $880, Step 2CK $895, CS $1295. Check official website for regular increments!
USMLE World: QBank plus the Self Assessments- They’re worth every penny. For Step 1, a two month UW subscription plus UWSA will cost you $195 ($135 + $30*2). And Step 2, will be $165 ($135+$30)
NBME Self Assessment: To assess your prep, you’ll end up taking online NBME practice tests. Since each test costs $45 to take (and $60 for one “special test’ for each exam), the number of tests you take depends on your preparation. There are some who take none while others end up taking all tests. I spent a total of $375 for NBME SAs for both exams.

Application: Most Universities have an application fee of $100 or so. Although there are some that are free too. Umar Tariq’s website has a comprehensive list of all information for electives. (I spent about $500 on applications)
Tuition Fee: This totally varies by University where you end up doing electives. Some like Harvard and Tufts have a fee of $2000-3700, while others like Cleveland Clinic and NIH are free. (I paid about  $1400 as tuition)
Malpractice Insurance: This is another thing that is new for us and since there seems to be just one company that provides MI to students on a monthly basis, they have been increasing the premium with every passing year! I ended up spending about $600 for MI.
Travel and Housing: Of course travel to the US will cost another $1000-1500.
Housing will vary from $300 to $500 per month depending on the location. This cost multiplies depending on how long you stay in the US. (I’ll take my expenditure as $500 since I was in luck wrt housing.)
Misc: Add to it other costs like travel insurance, visa fees, immunization titers before going to the US.
Then there’s the whole other set of expenditure on FOOD (major spending if you don’t know how to cook daily meals!), travel within the country and, of course, SHOPPING in the United States. ;-)

Fed Ex:
Giving this a special slot since there is a LOT of paperwork to be sent! There are numerous applications, college documents and Godknowswhat!! Each packet costs about $50, and I’m sure I’ve sent over ten such packets. (= well over $500)

Applying for Residency:
After all this preparation, we come to the main application! It costs a bundle, especially for an IMG!
Registrations: $50 for NRMP and $90 for ERAS token
Application: Come September 1, and a major hole in your pocket is just one click away.
In ERAS, applying to 30 programs in each specialty adds up to $305, and then for each additional program its $25 per program. So, if you are a regular IMG who needs a visa, and is not a big hot shot already in the medical world, you’ll apply to over a hundred programs.
You do the math.
(I ended up spending over $2500, plus another $70 for a USMLE transcript release)

Then there’s more:
Although till now this is the stage I’ve reached in the process, there’s a lot more to come.
Travelling again to the US, expenditure of travel within the US for interviews, USMLE Step 3, living there for about six months… and it goes on.

Going by this list, USMLEtoMD -till now- has cost about a total of *drumroll* $11,350 *faints*
For those who are planning to start on this journey, this was just a preview for you to have an idea of what the costs are going to be like. Just a thought to keep it realistic.
(And now I won’t have to explain the details individually to anyone who inquires- I can just direct them here! :D)

Note: I’ve tried to keep all figures correct and comprehensive according to my memory. If there is something that you’d like to add or remove, let me know. Hope this post was useful! 

Image credit: Google Images


  1. Oh honey, toefl is now $165. heheee :)
    still reading the rest..

  2. You know what..i am actually shocked! i imagined the total cost to be half but..
    i hope the juniors don't deter by this humongous amount, coz once in the residency, it will all pay back.

  3. One more thing, if anyone plans for going for MPH, you are surely dead..just kidding.
    Just adding the information:
    It has a whole round of application process to SOPHAS, ie like ERAS, but students generally apply for 10-15 universities, so it is not that expensive.
    Plus you have to take GRE($190) and get your documents evaluated by WES ($245).

  4. Gulp !! 11 K bucks !! he he..
    btw whats electives ?? (forgive my ignorance :P)

  5. this is an excellent post...iu'm putting this up on fb.. others need to read this.

  6. @ Avi: Thanks for adding info on MPH. But then that is a whole different ball game altogether. You still have to pay the tuition, besides all the other costs. (And since when did you start addressing people as "honey" :P)

    @Arun: Yep. And that's not even the end of it. To think I could have gotten a nice big car with all that money :o) Kidding.

    @Roshan: Thanks :)

  7. An eye-opener post! (I rather keep my eyes shut on the USMLE-roller coaster when it comes to the expenses!)
    BTW exam now costs $880 Step1, $895 Step 2CK & $1295 Step 2CS...
    u sure saved big time on housing expenses!

  8. Very very useful article. Thank you :-)

  9. @Priyanka: Thanks for the updates.
    I've been an ostrich through it all too! It was only after I finished writing this post, that I realised that I've already spent money that could've bought me a decent car ;-)

    @MGeek: Glad you liked :)

  10. Hey Di,
    Don' worry. Your decent car would convert into a luxury Merc/BMW, when you return an year after joining residency!! ;)
    But, definitely a must and imp. outline for 'pocket-check' for the aspirants. :)

  11. Can you put up an article stating reasons on WHY one would want to study in the US/give the MLE ? also include what prospects such a person later has in India . Thanks



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