Navigating the pathway to practising medicine in a foreign country is a pivotal step for International Medical Graduates (IMGs). Historically, the United States Medical Licensing Examination (USMLE) has been the go-to choice for many, with the Professional and Linguistic Assessments Board (PLAB) exam being its UK counterpart. However, the Australian Medical Council (AMC) exam is increasingly gaining traction, with over 6,000 IMGs beginning their careers in Australia in 2023 alone. This two-part series delves into the costs, processes, and career prospects of AMC and USMLE, highlighting key differences and similarities.
Real Cost of Licensing Exams: AMC vs. USMLE
AMC Pathway
To become work-ready via the AMC route, the initial costs are relatively lower compared to USMLE. Here’s a breakdown:
AMC Portfolio and EPIC Verification: Approximately AUD 872 (£448)
AMC Part 1 (MCQ Exam): AUD 3,124 (£1,605)
AMC Clinical Exam (optional for immediate work): AUD 4,398 (£2,259)
English Proficiency Exam (e.g., OET): AUD 587 (£302)
The total cost for work readiness with AMC Part 1 alone is around AUD 5,733 (£2,945). If you opt for AMC Clinical, the figure rises to AUD 10,131 (£5,204). Despite these costs, 70% of IMGs secure jobs after passing AMC Part 1, often without needing to relocate to Australia initially. Many of these processes, including interviews and exams, can be completed online, significantly reducing travel and accommodation expenses.
USMLE Pathway
In contrast, the USMLE route is notably costlier:
ECFMG Certification and Steps 1 & 2 (including surcharge fees): USD 4,010 (£3,144)
Pathway Certification and Associated Expenses: USD 925 (£726)
Electives (critical for IMGs): USD 4,500 (£3,529)
Living and Travel Expenses for Electives: Approximately USD 11,000 (£8,634)
The total cost to become job-ready in the US reaches an estimated USD 23,465 (£18,411), including mandatory electives and associated living costs.
Key Takeaway:
The AMC pathway emerges as a more economical and flexible option for IMGs, especially for those balancing work in their home countries while progressing through licensing requirements.
Availability and Venue of Exams
Both AMC and USMLE offer flexibility in exam locations and formats, but differences remain:
AMC Part 1: Available through Pearson VUE centres globally, with dates accessible within 4–5 months. The clinical component can be attempted online from anywhere with a stable internet connection.
USMLE Steps 1 & 2: Conducted via Prometric centres worldwide, offering multiple locations and date availability.
While the USMLE boasts broader geographical coverage and greater date flexibility, AMC’s online format for clinical exams is a game-changer for IMGs, eliminating the need for physical relocation.
Exam Content and Preparation
AMC Exams
AMC Part 1 (MCQ): A 3.5-hour test comprising 150 questions across subjects like medicine, surgery, obstetrics, and paediatrics, with an emphasis on clinical applications.
AMC Clinical Exam: Focuses on OSCE stations, testing practical skills like history-taking, diagnosis, and management, with communication playing a central role.
Preparation typically requires 4–5 months, with recommended resources including:
John Murtagh’s General Practice
AMC MCQ Handbook
Online platforms like MedBullets and UpToDate
USMLE Exams
Step 1: Covers basic sciences such as anatomy, pathology, and biochemistry, administered in an 8-hour format.
Step 2 CK: Focuses on clinical knowledge, resembling AMC Part 1, with a 9-hour exam structure.
Key preparation materials include:
First Aid for the USMLE Step 1
Kaplan’s QBank
UWorld
Comparison:
The AMC exams are generally considered more accessible for fresh graduates or those in active clinical practice. In contrast, USMLE exams demand a more extensive time commitment and a deeper dive into basic sciences, making them challenging for candidates with significant practice gaps.
In Part 2, we will explore job prospects, training opportunities, visa and residency pathways, financial outcomes, and work-life balance in Australia versus the US. Stay tuned for a detailed discussion to help you make an informed decision on your journey as an IMG!
All images are from Canva
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