Free List of Hospitals Offering USCE - Observerships, Clerkships, Electives, Externships, Mini-Residency and direct research / clinical fellowships
USCE (US Clinical Experience) is a great value addition to International Medical Graduates seeking Residency in the United States!
Univ. Puerto Rico Electives for Non-U.S Med. Students
Puerto Rico is a semi-autonomous U.S. Commonwealth territory island located around 1200 Miles off the Florida Coast and the University of Puerto Rico School of Medicine offers electives to Non-US Foreign medical students too, in various specialties.
Here are some details:
Before you read any further, note that besides English, you need to be fluent in spoken Spanish too - merely knowing Hola, Adios and Gracias won't cut it ;-)
Duration: 12 Weeks Maximum Visa: F1 visas only - No Visitors will be accepted during the Elective Fees: $25 Per Specialty ( but verify with the document posted below)
Download Eligibility , Instructions and Application Form Over Here [PDF]
Search keywords to this article:
- Electives, Clerkships for International medical students - MBBS
SUNY Downstate Electives for Non-U.S. Med. Students
The fresher a applicant from medical school while applying for residency, the better - add in a hands-on US Clinical Experience to that freshness - that's like an icing on top ;-) That's why clerkships / electives are cool to do.
Here are the Details of the SUNY Downstate Electives Program - which is of course, now neatly indexed on our New York Listing for USCEs on this blog.
SUNY Downstate for International Medical students Duration: 12 weeks Maximum - Remember the 12-week Clerkship rule of NY State Fees: $175 for first elective application - $100 for additional electives Visa: International Students need to get their own visitors visa (Remember to carry their acceptance letter to the visa officer while getting the visa) HIPAA: Once accepted, the program itself will send you a website link to a tutorial and take an easy HIPAA test online. (Shall write a post about HIPAA tests later) Application Eligibility and Application Form
Notes:
1. The SUNY Downstate Medical center visiting international student program page begins with prohibiting outside students from enrolling in their clerkships - which potentially might have some of you confused. In the US medical school system, all clinical rotations are called 'clerkships'. Clerkships done before the final 4th year are the same for all without a choice and are called core clerkships' - while the clerkships during the fourth year (also called senior year) are called 'Electives' since they students get to choose.
Since I already made a reference, here are the how the years of any post-high school undergraduate degree in the US are labeled:
1st Year = Freshman Year 2nd Year = Sophomore Year 3rd Year = Junior Year 4th Year = Senior Year
2.As I have already covered, clerkships or electives in American medical schools / Universities are only an option to internationals who are still in medical school - Notice that I did not use the term "IMG" in the title, who have already graduated from their medical schools. For IMGs - observerships / externships / mini-residencies are usually are the the only options for rotating through Hospitals or Universities.
ELECTIVES / CLERKSHIPS (3rd / 4th Year Medical Students)
University of Washington School of Medicine, Seattle Duration: Maximum of 12 Consecutive Weeks Visa: Will Sponsor Student Visas Only (F1) - Visitors Visa Not Accepted Fees: Need to pay for two credits per week Application Information
OBSERVERSHIPS
University of Washington Affiliated Hospitals Specialty: Family Medicine This is what their Website says: "We do not offer observerships at the University of Washington Family Medicine Residency program. Our department is, however, affiliated with WWAMI (Washington, Wyoming, Alaska, Montana, Idaho) region residencies and we encourage you to contact our network office for further inquiry (206.685.1856)" ....I say you should make the contact then :-)
So what exactly is the difference between Externships, Observerships, Clerkships, Electives, Mini-Residency, Sub-internships, etc. ?
They are various types of USCE terms that you will come across scattered all over the Internet and USMLE forums. Though I have already clarified the differences on the Tips4Match blog, I guess it's a good idea to put the food where the mouth is ;-) I mean, placing that info on this blog exclusively meant for USCE.
Before we begin, let me clarify that these terms are explained here in the context for International Medical Graduates.
1. CLERKSHIPS or ELECTIVES: In most cases, the terms 'Clerkships' or 'Electives' are clinical rotations granted by US Medical schools to medical students. Note that I said students and Not graduates. This implies that you need to be still enrolled in the 4th year of your home-country medical school while applying and will be doing part (one to three months) of those 4th year rotations in the US. Such rotations, besides being accepted by the US Medical school, also needs a "NOC" - No Objection Certificate, from the Dean of your own medical school or University.
Note: The term '4th year medical school' is often referred to as internship year in some places like India. While in the USA, an Intern is the First year candidate in any Residency program , also called PGY1
Experience-wise, Electives are like doing a medical school internship in another hospital which gives a good hands-on experience, you are allowed to do physical exams, touch the patients besides histories, case presentations and lab-result followups. You are not held liable for errors because of your student status.
Once you graduate out of your Medical school you become an "IMG" for US purposes and you no longer qualify for Electives / Clerkships in the USA, (unless you re-enroll in a US Medical school - Yeah, some rich fellas do so). Instead, IMGs can avail of the following kinds of USCE.
You do the same thing as an externships, except that you are still a 'medical student' - not a medical graduate.
2. EXTERNSHIPS: Externships are clinical rotations for International Medical Graduates that give a solid hands-on experience working as a resident under supervision. You do almost everything that a PGY1 resident does except that your medical notes need to be approved by a resident or attending and you will not have the authority to write orders and prescriptions.
Often an externship spans a single department, while a sub-internship or mini-residency may be longer over several specialties.
3. OBSERVERSHIPS: An Observership or shadowing (Sometimes also called as a preceptorship) means exactly what the english word means - to see and note without touching the patient ! In most cases they consist of attending morning rounds, seminars, student lectures and attending case presentations. You cannot touch the patients and perform physicals.
Some places may also call Externships as or a Sub-internships or a Mini-Residency, but the terms are not always strictly externships. Likewise, at times, when a program says "externship" it may actually mean an Observership - so it's upto you find out beforehand, the nature of the rotation.
Thus, Externships, Sub-internships, Mini-Residencies, Clerkships or Electives are considered true USCE since they give you 'hands-on' clinical experience, whereas Observerships or Shadowing only give you a chance to be a passive observer without being allowed to touch the patient.
Sometimes a program may explicity mention that Observerships do not count as USCE ! For example, the University of Michigan psychiatry residency program at Ann Harbour. An example of a "Mini-residency" is the Mt. Sinai Mini Residency Program at Miami, Florida, in 13 Specialty areas (300$ per area) . For registration, Info and contacting - Click Here
Be advised that in terms of importance for getting considered for a Residency position :
"Hands-on Experience is Better than Observerships"
Q. Doc, I only got an observership - no externship. Am I doomed ?
A. Agreed that an externship is better, but having an observership is still better than having nothing at all! There are thousands of IMGs without any of these..
Q. What Visa Can an IMG do an observership / Externships on ?
A. Any Visa....Yes it can even be a visitors Visa AS LONG AS as the Observership or an Externship DOES NOT pay you. Any USCE that PAYS you (Like a visiting scholar's position or a paid sub-internship ) would need either an J1 (more common) or a H1 visa to be sponsored by the hospital. At times, the specific Program may need a specific visa type like a student visa, visitors visa, etc. and they will provide a supporting visa letter for the same.
Q. Requirements for USCE ? Do you need USMLE Steps for Observerships/Externships ? ECFMG Certified ?
A. There is no formal American policy on this - but hospitals may have their own internal demands. It's best to find that out when you contact the guys. As a sample, Click here to check out the requirements of the Baylor Neonatology Observership program. And have a look at USMLE step 1 requirements for the IMG requirements for clerkship at the Mayo Medical Schools. Usually for an externship, most programs may need you to be ECFMG certified, since you do similar stuff as a resident would, while requirements are usually less stringent for Observerships since there is no patient-touching involved.
To reiterate and irritate ;-) : There are no universal policies on these and you must endeavor to find those out via emails / phone.
Reader Experience & Advice : "How I secured my Elective"
Since the past few months, I am beginning to see a surge in user contributions to USMLEtoMD.com blogs and I'm Feeling Lucky – yeah just like that Google button! ;-) Since the generous gal contributor to this great article preferred anonymity, lets call our lady Madam-X.
Note:An US Elective (also called a Clerkship) is a medical / surgical rotation option ONLY OPEN for current Medical school Students in their final clinical internship year. Students who have already graduated from medical schools cannot avail this option - they must look for Observerships / externships instead
The Following is her personal experience on how she went about applying for electives / clerkships in US Medical Schools and tips to fellow aspirants. Read on... "How I secured my Elective in US Medical School" - an experience of a Foreign Medical Student (MBBS)
Step 1: Gathering Information
I came to know about this electives stuff through a friend, who was applying for the same. He mailed to me a list of medical schools where electives are open for international students. They are mostly already listed on Digitaldoc’s USCE list Blog. I also searched for them via Google by typing various words like visiting students, electives, clerkships for foreign medical students and so on.
Step 2: Collecting Eligibility Criteria
I had to search all these sites and laboriously make a list of their eligibility requirements, the documents required for the application process etc.
- All the websites had a complete and proper description of the exact documents required about their precise selection and eligibility criteria and these differ from program to program. For example, some like mayo Medical School and UT southwestern will require you to pass the USMLE step 1 before the electives begin – while others do not.
- Most of them have similar eligibility requirements like you must have finished your core medical school clerkships – i.e. the ones that we do during our own medical school rotations.
- You must be in your final year i.e. you must be within the last year for graduation, which in India implies that you are an ‘intern’
Step 3: Collecting Information on Documents Required
Again, each individual program website provides a definite list but the common ones are:
- Completed specific application form for each medical school u apply to. This can be downloaded from the Internet in most cases. In that form, you fill your elective choices in descending preferences. They may ask for three or more but you may fill out more to increase your chance of getting an elective
- Resume and its supporting documents
- Medical school transcripts and hour certificate
- Letter from dean of your medical school stating that you are a student in good standing, your graduation date, and that u are allowed to do the elective, along with some other qualities of yours as well as the medical school. In my school, since I was the first one applying for electives so it was hard to convince my Dean that such electives can be done. You may have to obtain No-Objection Certificate (NOC) from your University in such cases, as I did. But if your dean is convinced then no problem will arise.
- Next you need Letters of Recommendation from the Department chair of the field you are applying for electives in
- Full immunization records and proof of immunity by showing antibody titers against Hepatitis B, Measles, Mumps and Rubella. These tests are a bit costly and not available in small towns so be prepared for getting them done early.
- Proof of Health insurance in some cases.
- Some US Medical schools will also require proof of malpractice coverage too which I could not get. If you can get that then a host of schools may be open for you !
Other requirements vary from school to school. Step 4: Application Fee
Some schools have application fees which need to be sent along with the application packet in the form of draft in US Dollars. Now, most schools have a single fee requirement for 2 electives but some will require you to send two application fees for 2 electives.
Step 5: Mailing out the Application Package
Each medical school site will provides an email correspondence contact who you can ask your queries, they are very quick and informative in their replies and reliable too, than most other people. Send the application packets to the addresses mentioned in the specific application form.
Step 6: Communicating
After about a week, it is a good idea to write an email to the person at the registrar's office (it will be mentioned on the form or the website), that u sent the application packet. Request for acknowledgment of the same and also ask about when can u expect a reply on the status of your application. Some schools reply about the status in a month or two. rest do it only one to two months before your scheduled date of arrival.
Step 7: The Hurrays, Cheers and Visas
Once you are placed for the elective in the medical school, they will ask you for further documents according to the visa they sponsor. It may be J1 or F1 and some instances the visitors visa too. J1 visa in these cases may not be free from the 2 - Year Home country residence requirement rule, so do look into that carefully before you accept.
My Two Cents:
The key to get selected is to act fast . I sent my applications 7 months before my elective start date. This way u can assure that seats are not filled out.Then send in all the documents at the very start so your application is not incomplete ans thirdly fill out choices using your brains. As US students are pref. if u fill out choices they like u have less chances, just like match u know. That’s all I had to say about the elective application process. Hope this helps. God Bless"
*****************
Wow ! Did she say, “That’s all” – I thought this WAS ALL ! Very well written and structured. Thank you ...
I am also hoping she provides us with her with experience and tips DURING her electives, but lets not get ahead of ourselves and wait for Ma’am-X to complete the rotations first..right
:-)
Google keywords to this blog post:
- "how to apply for electives" - "how to apply for clinical clerkships in america"
Brown University : Brown Medical School Visiting International Medical Students Program Specialties: Multiple Application Information TOEFL not required but an added plus to demonstrate English Fluency.
University of Kansas School of Medicine-Wichita (KUSM-W) This externship is conducted at the attached Veteran Affairs Hospital (VA hospital) Specialty: Internal Medicine Contact: Internalmed-wichita@kumc.edu Application Requirements:
KUSM-W Internal Medicine Residency Program Attention: Externship 1010 North Kansas Wichita, KS 67214-3319
Note: - Many thanks to Padmaraj, MD of SVNGMC, (India) for this information - Each year, applications will be reviewed in January and July for externship positions in the Spring and Fall, respectively. - This is a prestigious Externship, and since it is in the VA hospital, it could give you the benefit of making contacts for possible J1-waiver jobs later on when you need one.
Bryn Mawr Hospital, PA Externship/observership + research in Cardiothoracic surg Starts: end of March 2009 Duration: 3 months to 6 months Contact: Pat Dorris (dorrispa@mlhs.org ) Attending:Robert S Boova M.D.[ System chief Cardio Thoracic surgery] Strong CT surgery experience in Bryn Mawr hospital, affiliated to Thomas Jefferson University.. Clinical research is strongly encouraged along with externship.
OBSERVERSHIPS
Children's Hospital of Pittsburgh Download Application Form [PDF] Specialty: Multiple (Pediatrics and Pediatric Sub-specialties)
Drexel University College of Medicine, Philadelphia "Drexel Medicine Physician Refresher Course" Specialties: Multiple Click Here for Application Information Steep Fees !
University of Pittsburgh Medical Center Specialty: Critical Care Medicine / ICU Duration: 2 weeks to 2 Month along with additional option $200 Critical Care Medicine course (Which I highly recommend for your resume) Application Info
Temple University Hospital, Philadelphia Specialties: Internal Medicine (other may be possible) Internal Medicine Website (This information is unconfirmed word-of-mouth evidence)
Thomas Jefferson University, Philadelphia Specialties: Multiple Visa: They will determine the visa type you will be granted / eligible for (B1/ B2 / J1) Click here for Application Information
Notes: - Needs Passing USMLE Step 1 Score - Applications must reach at least 4 weeks before start date
EXTERNSHIPS
Columbus Community Hospital, Columbus Specialty: Pediatrics This could be a pot-shot, but I read this information from an IMG's resume posted online who was apparently working full time as an extern in this community hospital. This makes it worth a try - call (614) 445-5000 and ask to be transferred to the deparment of pediatrics
Huron Hospital Specialty: Internal Medicine Policy Statement: "The Internal Medicine Program offers externships, observerships to candidates meeting our minimum criteria, but it is not required to be a resident. We do not schedule externships in the months of June or July. Externships are for one month only and must be approved a minimum of three months prior to starting."
University of Cincinnati Academic Medical Center Specialty: E.N.T. (Otolaryngology) Note: According to their FAQs Link, "Application are considered on an individual basis by contacting Robert Keith, PhD, Director of Medical Education at robert.keith@uc.edu, Department of Otolaryngology-Head and Neck Surgery, PO Box 670528, Cincinnati OH 45267-0528."
OBSERVERSHIPS
Case Western Reserve University Specialty: Family Medicine (Only for candidates selected for Interview) Application Information
Cleveland Clinic Specialty: Clinical Neurophysiology + Epilepsy Observership Course Information Duration: 3 Months Notes: 1. Course if Free - But IMGs and International Medical Students must fund their own stay 2. Good for candidates interested in Neurology Residency !
Ohio State University College of Dentistry Specialty: Periodontology Application Information
This is what the Internal Medicine Department Manual Says about Observerships: "At this time we are no longer offering observerships. Due to the extreme high volume of applicants that have applied in the past, we are no longer able to accommodate any new observership opportunities. We wish you much success in your future endeavors. " = Which means - you gotta periodically check back with the site
University of Michigan, Ann Harbor Specialty: Ophthalmology (for IMGs pursuing PG in home-countries Visa Sponsored: J1 Visa Application Information
University of Massachusetts Medical School Specialties: Multiple : List(only Type B & C are for Foreign Medical Students) Application Criteria
OBSERVERSHIPS
Brigham & Women's Hospital Specialty: Abdominal Imaging and Intervention (Radiology) 5-Day visiting Observership - Click here to learn more
Children's Hospital Boston, Harvard Medical School Specialty: Congenital (pediatric) Heart Surgery observership course Fees: $3000 for two weeks OR $4,500 for 4 Weeks Click Here for Application Requirements Click Here for Application Form
Criteria: "At least 2 years of post-doctoral training in orthopedics." Expected Living Cost in Boston: Cost: "A free room is provided, but no cooking is allowed. You will need to get meals at the hospital cafeteria or buy your own meals elsewhere. You will need money for personal items. Estimated cost is about 200 -300 USD per month. There are no other costs" and yea = "You will be expected to complete a clinical research project for publication at a regional or national meeting, or publication in a peer-reviewed journal." BUT site mentions = "You must be planning to return to your country after the observership is over. We want you to use your new knowledge and skills in your own country where you are needed. This opportunity is not intended to help you immigrate to the USA." (Of course they can't make you sign a bond saying that, but you should be discreet in discussing your plans !)
University of Maryland School of Medicine Specialties: Multiple :List Application Information Note:It is the policy of the University of Maryland School of Medicine to accept only fourth-year students for clinical experiences who are enrolled in accredited allopathic medical schools which are approved by the Liaison Committee on Medical Education (LCME). We do, however, offer an exchange program with the University of Heidelberg and accept two students each year to study with us for six months. The students are selected by the Dean of Studies at Heidelberg
EXTERNSHIPS
Dr. Barry Mehta Specialties: Internal Medicine, Family Medicine, Surgery, Pediatrics, Ob-Gyn Duration: Minimum 7-weeks tp get a Letter Of Recommendation. Schedule Cost: $4,400 for 7 weeks (Training + Staying) Call: 410-730-3961, 443-285-9563 (Mobile) Note: Interestingly, as a reader pointed out on the comments, the same Dr. Barry Mehta was found guilty of fraud and fined $250,000/- for robbing the state Medicaid program. He billed the state for clients that were never present as per this news here. However, the American Medical News also featured the Barry Mehta Externship program, Read the News article here. I was amused that they did not write about the fraud, the article was written by a student of the externship program anyways
Harbor Hospital, Baltimore Specialty: Internal medicine Contact Program Coordinator at:410-350-3565
Medical Surgical Specialists, Naples, Florida Specialties: Multiple Observership Listings and Information (If any available) - but I would anyways suggest you contact them even if they say they have no current positions Application Form [pdf]
Mount Sinai Medical Center : Mini-Residency Program (Observerships) Specialties : ( 4 weeks each - each specialty is treated like a 'course') : "ANESTHESIOLOGY , CARDIOLOGY, CARDIOVASCULAR SURGERY, GASTROENTEROLOGY, GENERAL SURGERY, INFECTIOUS DISEASE, INTERNAL MEDICINE, MEMORY DISORDERS, NEONATOLOGY, ONCOLOGY /HEMATOLOGY, PATHOLOGY/LABORATORY MEDICINE, PULMONARY & SLEEP DISORDERS, RADIOLOGY " Cost: $300 Per Specialty Application Information
University of Miami, Miller School of Medicine, Miami Specialty: Physical Medicine & Rehabilitation (PMR - Physiatry) Application Information
University South Florida, Tampa "Stephen Klasko Observership Program for International Physicians" Specialties: Infectious Disease, Anesthesiology, but more may be introduced Application Information and Application Form
Note:Though This Is mentioned as an "Observership" - the description sounds more like it is ONLY meant for current Medical Students. Remember that while Observerships could be done by both current medical students AND medical graduates - Clerkships are usually restricted only to current medical students
University California San Francisco Specialties: Anesthesiology + Radiology Fees: $500.oo per 4-week elective + 300$ Homeland Security Fee Application Information
UC Davis Network of Affiliated Family Practice Programs Specialties: FP, Internal Medicine, Pediatrics Application information
UCSF - Fresno Specialty: Family Medicine Note: This is what the website says: "UCSF Fresno Family & Community Medicine offers observerships on a very limited basis. Once your residency program application has been submitted via ERAS, and you have been invited for an interview, you will have the opportunity to apply for an observership. Participants are selected by the Program Director."
Well, even if you do not match there, you can still use the experience elsewhere.. Read here
UCLA IMG Program for English-Spanish speaking Hispanics and other minority IMGs Specialty: Family Medicine Application Information
Puerto Rico is a semi-autonomous U.S. Commonwealth territory island located around 1200 Miles off the Florida Coast and the University of Puerto Rico School of Medicine offers electives to Non-US Foreign medical students too, in various specialties.
– yeah just like that Google button! ;-) Since the generous gal contributor to this great article preferred anonymity, lets call our lady Madam-X.
