USMLE Requires more than Optimal English Proficiency

Foreign and even US medical graduates wanting to do their residency in the United States are required to undergo a Clinical Skills Assessment (CSA) as part of licensing requirements.

Candidates conduct a day-long examination of actors playing patients by conducting a timed clinical encounter : 1) talking to the ''patient'' about his or her chief complaint - Data Gathering (DG), 2) performing a physical exam, and 3) writing a Patient Note (PN).

Excellent English Required
Besides the DG and PN, candidates are assessed on their Communication and Interpersonal Skills (CIS) and Spoken English Proficiency (SEP).

The SEP is broken down into listening effort, pronunciation, and word choice.

While statistics indicate foreign medical graduates mostly fail because of their CIS than English proficiency, the two are interwoven.

Acting patients are instructed to ask questions, request more than a superficial explanation of unfamiliar terms, and to simulate angry, moody or otherwise difficult patients.

USMLE Preparation
While a TOEFL score of 35 is usually considered adequate to possess the English proficiency needed to pass the US Medical Licensing Exam (USMLE) Step 2, the candidate needs to be understood by exercising good grammar and pronunciation in a professional context.

Therefore, it is important prospective candidates practice with a English native if possible to test rapport with a patient, role play medical scenarios, and build confidence speaking in layman's terms.

An exam prep text is a start. However, in preparation of students, instilling confidence and getting the candidate to speak naturally about ailments on a patient's level appear to be the foremost challenges.

While role playing, challenge the candidate to a calm and thorough explanation of an illness presented and offer advice on how better to speak up and address the patient directly.

From experience, medical vocabulary does not appear to be an issue, but pronunciation often is.

In sum, an English professor can coach students to interact naturally using optimal English and to develop a patient routine to be followed not only at test time, but in their residency and beyond upon a successful score.

*** If you are in São Paulo and need English lessons, or Elite English Services including translations (Spanish/French/Portuguese to English), please contact Professor Winn by sending an email to mrenglish101@gmail.com for a prompt evaluation. Buy your English-language texts today!

English Test Study Tips

English Test Study Tips

1. Avoid persistent loud noise.

2. Avoid environments that are too hot or too cold.

3. Don’t try to do two or more things at once.

4. Arrange your work space so that your eyes aren’t drawn to other jobs that need to be done.

5. Don’t put unreasonable demands on your attention span.

6. Be aware that emotional distress reduces your ability to concentrate.

7. Understand that drugs (alcohol, caffeine, nicotine, sleeping or diet pills) alter your ability to concentrate.

8. Be aware that lack of sleep is a major reason for poor concentration.


If you are in Buenos Aires and want English lessons personally designed to fit your needs, please call Professor Winn at 1160 461 342 or send an email to mrenglish101@gmail.com.

Anyone interested in English-language services or translations (Sp/Fr/Pt>En) may send an email to mrenglish101@gmail.com for a prompt evaluation.

Buy your English-language texts today!

Sipping English Exam Soup II

In our previous post, we covered the primary exams for entry into a US university.

An entire testing industry is also devoted to British English and entry into university in the United Kingdom, Australia, New Zealand, or Canada.

The University of Cambridge administers the testing alphabet soup via its ESOL (English Speakers of Other Languages) department.

The British are more organized in spreading their brand of English with a British Council office is almost every country. American English on the other hand is diffused on a wide basis through popular culture - music and film without a strategic plan to advance the use of American English.

British English Exams

There are principal British English tests served up in our alphabet soup of exams today each leading to a higher level of English language proficiency.

1. KET (Key English Test) - The KET tests on a basic English language level. It's a starter exam to prove competencies in four main disciplines of reading, writing, listening, and speaking. According to its official handbook, "a language user at this level needs to be able to read simple
texts, many of which are of the kind needed for survival in day-to-day life or while travelling in a foreign country."

On the Common European Framework of Reference for Languages (CEFR), a scale of language abilities, the KET encompasses levels A1 and A2. The target age group is 12 to 16 year olds (mostly female), but some adults take the exam as well. The KET prepares one for the PET.

2. PET (Preliminary English Test) - The PET tests on an intermediary English language. "PET reflects the use of language in real life, such as understanding signs and announcements, and is accepted by many employers as proof of ability to use English in clerical, secretarial or managerial jobs."

3. FCE (First Certificate Exam) - The FCE tests on an upper-intermediary English language level. Mastery of the FCE demonstrates core competencies to function in work or study.

4. IELTS (International English Language Testing Sytem) is the granddaddy of the British English exams. Its official website boasts about a half of million candidates take the test every year, far less than the TOEFL. The nearly 3 hour exam is scored from 0-9 - a 9 indicates an "expert user." Many universities require a 7-8 for entry. The IELTS is required by universities using the British brand of English.

If you are in Buenos Aires and want English lessons personally designed to fit your needs, please call Professor Winn at 1160 461 342 or send an email to mrenglish101@gmail.com.

Anyone interested in translations may send an email to mrenglish101@gmail.com for a prompt evaluation.

Buy your English-language texts today!

Sipping English Exam Soup I

An alphabet soup of exams to test your English proficiency exists. We explain the acronyms and the gist of each test to dispel any confusion.

In this post, we will discuss those exams geared more for attending a US university in particular or US English in general. In our second post we will cover the exams with a focus on British English.

TOEFL: (Test Of English as a Foreign Language) - The TOEFL exam is the granddaddy of all the US-based English exams. The Educational Testing Service (ETS) declares boldy on its website that the TOEFL is "most widely accepted English-language test in the world."

There are two TOEFLs: paper-based (PBT) and Internet-based (iBT). The TOEFL PBT tests reading, listening and writing skills in English, but you will need the TSE® (Test of Spoken English™) for your speaking ability. The iBT has the two advantages: 1) it covers all four disciplines incuding speaking English in one sitting and 2) given it is taken on the Internet, wherever in the world you are with a Net connection you can take the exam. By visiting their site, you can download an e-book with test tips and even take a practice exam.

TOEIC -(Test of English for International Communication^TM) - The sister of TOEFL, may be less known, but 4.5 million annually take the exam measuring your business skills in English. We have previously discussed the importance of Business English in the global economy (1,2). Speaking, writing, reading and listening to English are tested.

MELAB - (Michigan English Language Assessment Battery) - The renown University of Michigan stirs the bowl of English exam alphabet soup by offering its MELAB to evaluate "advanced-level English language competence of adult nonnative speakers of English." The MELAB also tests the four main components of mastery of the English language in three parts: a composition, a listening test, and a written test containing grammar, cloze, vocabulary, and reading comprehension problems and an optional speaking test. As of November 2008, according to their website, the test has been designed with more questions.

TOEFLGear MELABGear TOEICGear IELTSGear FCEGear KETGear

If you are in Buenos Aires and want English lessons personally designed to fit your needs including test prepartion or other English Language Services, please call Professor Winn at 1160 461 342 or send an email to mrenglish101@gmail.com.

Anyone interested in translations (Spanish, French, and Portuguese > English) may send an email to mrenglish101@gmail.com for a prompt evaluation.

Buy your English-language texts today!