Thursday 24 December 2015

USMLE AND ITS BENEFITS

USMLE  AND ITS BENEFITS
If you are a medical student and looking for a way out, I will guide you through your options. the best way for a doctor who passed the exam recently is to give USMLE step1 & 2 here  is why

Benefits:
1.you can apply for a residency seat in HAMAD medical corporation which is in QATAR.(requirements is step1 &2)

2.if you have studied for Step 2 CK. Then you can apply for the license exam in Saudi Arab.
  If u get a good mark you can apply FOR A RESIDENCY IN KING FAHAD MEDICAL COLLEGE.
*you will get paid in these residencies. Don’t worry

3.you can give any license exams of the middle east like Qatar,Bahrain,UAE,Kuwait ,oman
As all of them requires you to pass their license exam which follows the exact pattern of USMLE step 2 ck.
*this will allow you to work as a GP in their country provided that you have 2yrs experience post internship. only EXCEPTION is Saudi Arab. you don’t need experience to give their license exam.

4.passing the two usmle steps will facilitate to get your USA visa ,and you can get a job ther and finish your step 3(i.e usmle step 2 CS) .then  apply for residency.

5.if  you pass all the STEPS in USMLE and still don’t get a seat in residency in USA .then you can easily apply for practicing licenses in the middle east and you can get that without any exam.(mainly I know about UAE.. hoping it wil be same for other countries if they follows the exam exemption protocol).  

When to give USMLE
1.       You can  give the Usmle step 1& 2 during your internship.
2.       You can also give step 2 CK first as it is more clinical oriented and then give step 1.
3.       You will remember everything you studied as you passed recently thus making the exam prep easier.
4.       You can also give step 1 in your 5th year.
Study materials:
1)MASTER THE BOARDS
2)USMLE WORLD
#kaplan series… mainly solve as many questions as you can to get oriented with the system.

HOPE THIS HELPS
Dr Alimul haq. 


Saturday 12 December 2015

Pseudopapilledema vs. True Papilledema

Ophthalmoscopic  Features of    Pseudopapilledema

• Elevated disc; margins obscured
• Absence of physiologic   cup
• Vascular anomalies with increased branching
• Normal nerve fiber layer; disc transilluminates
• May have spontaneous venous pulse
• May see disc drusen  (“hyaline bodies”)
• Hemorrhages rare
• No exudates
• No nerve fiber layer  infarcts



Pseudopapilledema vs. True Papilledema
J.L. Smith “The Optic Nerve” ~ 1975
Finding                 Pseudo        True
SVP                       Yes            No   
Hemorrhages         No             Yes
Retinal Striae        No              Yes
Enlarged BS                   No              Yes
TVO                     No              Yes
FluoroLeakage      No              Yes
Other Neuro                   No             Yes
High Hypermet      Yes              No


Opthlamoscopic finding of papilloedema        

Frisen Grades of
“Swelling of the Optic Nerve Head”
Grade 1: C-shaped blurring of nasal,
superior and inferior margins of disc;
temporal margin normal.
Grade 2: 360-degree elevation of the disc
margin
Grade 3: Elevation of entire disc with
partial obstruction of one or more of the
retinal vessels at the disc margin

Grade 4: Complete obliteration of cup and
complete obscuration of at least some of the
vessels on the surface of the disc
Grade 5: Dome-shaped appearance with all
vessels being obscured (“champagne cork”
papilledema)
Other Signs Consistent With Papilledema
Flame shaped hemorrhages
Paton’s lines
Intraretinal exudates
Intraretinal hemorrhages
Unilateral or Asymmetric Papilledema
In IIH about 10% of cases have asymmetric
Swelling.


Ref: Papilledema vs.Pseudopapilledema
Robert L. Tomsak, MD, PhD Professor of Ophthalmology and Neurology
Wayne State University School of Medicine

Specialist in Neuro-ophthalmology . Kresge Eye Institute .Detroit, MI