basics about usce-united states clinical experience...
this is not my work....hv collected from different forums....
Clinical background is commonly a highlighted point in your credentials.
Several hospitals look for applicants who possess experience handling patients and feel comfortable with the bureaucratic paperwork part of a patient file. Another important reason for clinical experience is that during your time at a hospital, you may obtain a LOR from attending physicians.
The more experience you have, the better for your application. If your experience is at a renowned hospital, it will booster your application even more.
to know the importance of clinical experience... click here
Usually, this is no problem for AMG's, since clinical clerkships give enough experience, and their medical education is oriented toward clinical practice in the US. Although, apply for externships before graduation is highly recommended since it offers a great educational experience and the opportunity for an audition at that program. It may be of concern for PD's while considering IMG's, since they are aware that medical education, as well as clinical practice, is considerably different in other countries.
Requisites in terms of USCE vary between different hospitals. Some programs consider it of extreme importance and request that their IMG applicants have no less that 1 year of USCE. Other centers find it irrelevant when considering an IMG application and accept your background at your home country as a valid part of your application. This means that if you are an IMG with no USCE, you still can obtain a residency position but it will decrease considerably the number of hospitals to which you can apply, and of course your credentials will not outstand.
There are different types of USCE.
Electives/clerkship are rotation of last year of med.school or what we call in india is during internship [in usa internship in first year of residency]..most important of all usce.after you graduate the chances of getting USCE (esp hands on) is markedly less to none... so getting it while in med school is your best bet...read experience here
Externships offer a time at a hospital during which you can attend conferences, rounds, and if the patient agrees you can be present or even participate during clinical encounters, therefore it is considered as "hand-on-patient" experience.
Observerships are quite similar to externships with the difference that you are not allowed to have contact with patients, you can just observe and because of that it is also known as "shadowing". obsevership may not be counted as usce by some hospitals...bt it doesnt matter...as its a clinical rotation it wl help you a lot.moreover externship is very tough to get. any type of usce looks good in cv..so better to do observership than lament later.
During research you can assist in the development of investigation studies, and sometimes even publish a paper.read whether research helps in getting a residency here
advantages of doing clinical research--click here
Obviously, hand-on-patient USCE is the most useful for IMG's and is the one you should aim to obtain.
in short electives>>externships>>research with publication>>observership>>rotation under private practitioner>>research without publication
Ideally, all your USCE rotations should be completed before you enter the match. Therefore, to obtain enough USCE you must plan in advance. If you are still a medical student, you should apply for externship positions since several universities have educational programs for international students and those are a lot easier to obtain than externships for graduates.
Each rotation commonly last one month, but duration can vary according to your possibilities and hospital policies.
Basically, there are three ways to get rotations at American hospitals; you can search in the internet for programs that offer elective positions and send a formal application, you can contact friends who already did their rotations and ask them how to get yours, or you can present at a hospital and personally ask to participate in an elective rotation (it sounds extremely bold, but it results pretty often). An elective rotation is usually a very expensive thing to do; not only housing, transportation, and food have to be considered, but at some hospitals a fee will be charged as part of your application. All expenses should be considered while planning your trip, and see if such investment is affordable to you.
best is to apply to hospital via email or meet them personally when u land in usa...
other services that offer paid services r
www.fmgamerica.com
www.fmgportal.com
www.americlerkships.com
many more....but not reliable to spend about 4000$ for 3 month externship...most of the reviews of this services is nt good...
Do your homework first :
Obtain a list of programs on FREIDA on the aamc website. Click on individual programs for the email ids if the program coordinators/ directors and the websites of the universities or hospitals.
Check the websites for information about observership/ externships/ short term research projects.
note down the email ids and contact numbers of the coordinators.
prepare your resume/ cv in the american style.
->* for basics about cv and sample cv -click here
now write to the PC/PD to enquire about the observership/ externships.
->*sample email to write to program director...click here
What are the things to ask:
Formally introduce yourself. Mention any exams taken or pending results. Express a desire to match in their program and why you prefer that program over others...a nd that you wish to get some experience before applying for a residency spot.
Also ask if one is required to pay a fee for the same.
What are the requirements to apply for the position? Steps cleared? malpractice insurance? Favourable visa? Fresh / old graduate?
Do they offer / suggest accomodation?
Is their institution IMG friendly?
If you are interested in externship, ask about the visa requirement...whether they sponsor any?
When to apply :
The best period is April- June. Most programs are accomodating of observers and externs before the applications for the residency pile in. As the number of applications are increasing every year, the possiblity of getting US clinical experience during the interview season ( October to February) will be meagre.. unless pre- arranged.
The wait :
You have taken the first step.. now its their turn to respond. Wait for 2 weeks. Resend the email..Wait another week for the reply. If there is still no reply.. now is the time to call. Do not leave voicemails.. your call will not be returned.
Which places to consider :
IMG friendly program with IMG Residents in the hospital is the safest bet. But do search on net whether hospitals you are applying gets u a letter of recommendation..
Some hospitals like Medical University of South Carolina (MUSC) offer observerships to candidates in IM/ PEds/ Ob Gyn.. but they hesitate to offer interviews / residency spots/ good recommendations to the observers.
There are two kinds of observerships, ones that have established observership programs like Cleveland Clinic, Mount Sinai Medical Center etc. These are very few in number and competition is a way too high. Another type is when you request any individual prof to observe with him and he allows you.
Now established programs are few and tougher to get unless you apply 6-10 months in advance. But individual profs or depts allowing you is relatively easier and more feasible route. There is rarely a fixed funda regarding such observerships. First lets see what a prof would look into while assessing you application:
- Visa status
- Scores, if any
- Your CV ie. any research background specially for a research post
- Does he know you or if somebody he knows has recommended you
- Overall feasibility of you as a prospective residency candidate at their program.. this is the most important thing and all the above factors are assessed in this light.
- Of course, the timing of your application. The sooner the better.
If you apply to profs randomly without even a single step score, in general they won't even consider you once. Out of the certain established programs some might accept your application without scores.
Emailing is the easier option but its always better if you can personally meet a prof. The chances of acceptance are much higher in such cases. Specially the people who are already in US and are looking for USCE in their own city, should try and meet the profs in the nearby programs personally. A prof tends to say yes more to a person who he can talk to in person rather than a faceless email.
other ways:
1) to search in webmd the list of doctors in your locality and request them to help you for the same...as they hv already passed through this painful process some may help you out...
2) search local va(veteran affairs)hospital
3)search local ahec center.
4)contact local members of aapi for indians..for other countries contact their respective association.
Visa is a very important issue. No prof is going to sponsor a visa for a observership post and only rare established observership programs give you a letter for the visa. Hence the best bet is the period when you get to US for CS.even visitors visa are allowed by hospitals..u have to search for the same..f1 visa have no worries same as a greencard holder or citizen.for visa issues click below
1]fmgvisas
2]immihelp
When you email programs, try to convince them as to your suitability as a future resident. That would be the most important factor in your acceptance.
Since this list of hospitals offering observership is everywhere on the net these are the most difficult to get cos everyone tends to apply to these..
some of these are...
1)usmletomd
2)usmlerockers
3)imgfriendlylist
4)medgraduate
many more...just search externship/observership hospital list in google..
for electives click here
for research click here
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faq
*does observing private physician help?--click here
*How to behave during usce? click here
*rules to observed...click here
*making most of observership... click here
*books for electives...click here
*malpractice insurance..click here
*vaccinations
Some of the vaccinations commonly asked for are:
1. PPD
2. Hepatitis B
3. Mumps
4. Measles
5. Rubella
6. Chicken pox
Do LORs from MDs in USA who are FMG count?
Its not as worth as an LOR from an American MD.
But something is better than nothing.
Lor from fmg from usa counts more than from md from home country
For other queries do read usmletomdblogs
