Observership / Externship at TIPS SW for IMGs

Thanks to a gracious reader who left me a comment to share with you all... TIPS SW stands for Texas Indo American Physician Society South West, which is one of the five chapters of the Texas Indo-American Physicians Society (TIPS), which is turn is affiliated to the American Association of Physicians of Indian Origin (AAPI), about which I already covered on a previous post about IMG Physician organizations in USA.

Though this program is titled as an 'externship' it really is an observership in the way it works - implying no patient contact or hands-on experience....but if they officially allow you to call it an extership, that's what you can write up on your CAF ;-)

Lets go over the Details:

Duration:
- Total 6 weeks, two rotations of 3 weeks each

Location:
Non-Residency hospitals in San Antonio, TX

Specialty:
- IM, Cardiology, Gastroenterology, Family medicine

Criteria:
Minimum 2-digit score of 78 on both USMLE Step 1 and Step 2 CK

Application:
- Click here to Apply online
- Click here to download paper-format application

Fees:
None mentioned, probably no fees, but you gotta take care of your own accomodation, travel, food, etc. etc. 

Hmmm..2 IMGs per 6 weeks, which is about 17-18 IMGs per year....hurry ! 

Read more at TIPS SW website

"Clinical Externship Committee" of the AAPI

Though this post is specifically for IMGs from India - it can be a good lead for IMGs from other countries to get in touch with physician associations in USA representing their respective countries.

AAPI, which stands for American Association for Physicians of Indian Origin is a powerful national organization representing 40,000-plus physicians, and 12, 000-plus medical students, residents and fellows of Indian Origin in the US and were responsible for the creation of an IMG section on the AMA. A 2005 Newsletter of the AAPI said:

"Clinical Externship Programs are being established in Texas and Washington, D.C./Baltimore area, modeled after the Oklahoma program started by Dr. Mehta to help newly arrived Indian physicians to get into residency."

Thus, it might be a helpful lead to contact the Clinical externship committee of the AAPI. to check out the members of this committee along with their contact information.

Membership fees may be needed, but then if you think of it, it may still be cheaper and better (since its a legitimate organization) than paying 3000-4000$ to a private externship organization of unsure legitimacy.

Hmm..something surely for ya'll to dig into. People who get more information and/or interact with the committee are requested to drop me a comment below this post to help others :-)

I shall soon put up a list of similar IMG - physician associations of for various countries on this blog or on the Tips4Match blog

OKLAHOMA (OK)

EXTERNSHIPS


Oklahoma State Medical Association (OSMA)

Specialties: Various - Family medicine, Internal Medicine, Anesthesiology etc.
Application: To Apply, You must procure an Application Form from OSMA - call 405-843-9571 OR 800-522-9452 and inquire about the application forms. Usually, they will email the forms to you. I secured the forms from a pal - Download sample OSMA externship form Here. Use this downloaded form only as reference, You should communicated with them directly for the form - also try emailing Linda at mcdonald@osmaonline.org, for the forms, as long as she is working for the OSMA ;-) Click here for OSMA Externship Program Website Link
Duration: "The Extern will be allowed to have four (3 week) rotations with a sponsor in different specialties. Upon completion of the Externship rotations (twelve weeks), the IMG Council of the OSMA (upon receipt of letters from sponsor physicians) will give a letter and certificate of completion to the Extern indicating the number of weeks as well as physicians and their medical specialties"
Cost: This Externship Is Free, but IMGs must take care of their own living expenses


Notes:

1. The OSMA Externship program closes from time to time, depending on the applicant volume, but reopens again - so keep a look out on their website Here for the notices.
2. They call it an 'externship', but works like an observership, since IMGs are not allowed any patient contact. Well, if the certificate from the OSMA says 'externship', I would not be wrong to call it an 'externship' when I fill in the ERAS application form for residency applications, would I ? ;-)
3. This one is from a State Medical Association, which means, its prestigious !


OBSERVERSHIPS


United Regional Health Care Center, Wichita Falls
Specialty: Family Practice
Cost: 300$ per Month
(This information awaits being verified)
Contacts Page

INDIANA (IN)

EXTERNSHIPS


Indiana University School of Medicine
Specialties: Ob-Gyn + Family Practice
Click here to Download Criteria and Appointment Letter format (pdf)
Requirements: ECFMG Certification, At least one US LOR
Allow Visitors, Student (F1) and even J1 visas

Note: The letter is to be completed by the faculty after you land an externship, which implies you will need to write to individual program directors / faculty of desired specialty to get an externship"


OBSERVERSHIPS



Indiana University School of Medicine
Specialty: Internal Medicine
Click here for Observership Information - Check out the last paragraph on that page, which says:

"Two of the partner hospitals, Wishard Memorial Hospital and Clarian Methodist Hospital will consider applicants for observership. At Clarian, prospective observers should contact Marcia Bothwell, Residency Program Coordinator - B342, Clarian Methodist Hospital, 1701 N. Senate Blvd, Indianapolis, IN 46202 or phone 317-962-5096. At Wishard, please contact Dr. Kaisner-Duncan, 1001 West 10th Street, OPW M200, Indianapolis, IN 46202 or phone 317-630-7044." ...Sweeeet ?

BASICS: Electives, Clerkships, Externships, Observerships, etc

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.




Search keywords to this article:

- "how is elective different from externship"

KANSAS (KS)

CLERKSHIPS / ELECTIVES
( For 3rd / 4th Year International Medical Students)


Kansas University Medical Center, Kansas City
Specialties: Multiple
Application Information
Application Brochure Request Form




EXTERNSHIPS

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:

• Universal Application (Download PDF from NRMP)
• ECFMG Certificate
• Dean's Letter
• USMLE scores: Step 1 & Step 2 CK
• Medical School Transcript

Mail / Courier all the above material to:

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.




Also Read:

- ECFMG Certificate Details
- Dean's Letter Details and Sample
- J1-waiver Sponsors, Specialties and Locations

COLORADO (CO)

EXTERNSHIP


University of Colorado Health Science Center
Specialty: Anesthesia / Anesthesiology
Contact Information


Health South Rehab Hospital, Colorado Springs, CO
Phone: (719) 630-8000
This is "circumstantial evidence" - An IMG resident profile listed on Eastern Virginia Medicine School FP resident program says she did a 2-year Internal Medicine hands-on externship at this facility - besides a Family Medicine Observership at Colorado Springs Osteopathic Foundation - I leave it to you to call up the place and find out :-)

TENNESSEE (TN)

EXTERNSHIPS



East Tennessee State University (ETSU), Johnson City
Specialty: Internal Medicine
Apparently a friend heard that someone managed to get an externship there in 2006 - something for you fellas to dig in more about !




OBSERVERSHIPS



Vanderbilt University, Nashville
Specialty: Neurology
Application Information

OHIO (OH)

CLERKSHIPS / ELECTIVES
(3rd / 4th Year Medical Students)


University of Cincinnati College of Medicine
Specialties: Multiple
Click Here for Application Info and Application Form
Duration: Maximum of two 4-week electives (total of eight weeks)

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
Specialties: Various
Click Here for Application Information
Duration: 4 Weeks or More
[Needs ECFMG Certification]


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

NEW YORK (NY)

CLERKSHIPS / ELECTIVES
( For 3rd / 4th Year International Medical Students)


University of Rochester Medical Center, Rochester
Application + Requirements


Albany Medical College
Application + Requirements


Mount Sinai School of Medicine
Electives for Foreign Medical students
They also sponsor your J1 visa for the electives

New York University (NYU)
Specialties: Multiple
Application Forms


Columbia University College of Physicians + Surgeons
Only for students of these 23 Medical Schools around the world.


SUNY Downstate, Brooklyn
Fee: $175 1st Elective : $100 per additional Elective
Visas: Students are responsible for their own B1 visitors visa
Duration: 12 Weeks Maximum
Application Form & Instructions


Weill Cornell Medical College
Specialty: Multiple
Fees: 2000$ per month
Application Information




EXTERNSHIPS



Jamaica Hospital Medical Center, Jamaica, NY
(Don't confuse this with the country Jamaica..LOL)
Specialty: Psychiatry
Duration: 5 Months
Call: 718-291-0764 or See more Contacts
Requirements: Must be ECFMG Certified, and have your own Visa / Green Card

Mount Sinai School of Medicine (Cabrini) Program
Specialty: Psychiatry
As their Residency Program Website Says: "We have in the past offered externships, but they are offered at the discretion of the Program Director.You may fax your resume and cover letter regarding externships to (212) 995-7031."
Thus - its worth a try :-)

New York Medical College (Westchester Medical Center), Valhalla, NY
Specialty: Psychiatry
Duration: 8 Months !
Click Here for IMG externship selection & policies
Click Here for IMG externship application form
Email inquiries: wmcexternship@hotmail.com



North Short LIJ, Long Island
Specialty: Psychiatry Externship for a Year
Contact: Externship Coordinator at : 718-470-7992




OBSERVERSHIPS



Beth Israel Medical Center
Specialty: Pain Medicine & Palliative Care
Application Information


Hospital for Special Surgery
Specialty: Radiology (For Current Radiologists)
Fees :

• $500 per 1/2 day
• $1000 per day
• $4500 for one week (10% discount applied)

Expensive Affair ! Read more here


Mount Sinai School of Medicine, NY
Specialty: General Surgery
Click Here for Eligibility Requirements
Click Here for Application Information



New York Eye Center
Specialty: Ophthalmology
Application Information


New York University (NYU)
Specialty: Dermatology
Click Here for Description
Duration: 1 Month, 6 Months or 1 Year
Fees: This is a very comprehensive Observership Program and carries a hefty Tution:
1 Month: $3000
6 Months: $15,000
12 Months: $30,000
"Participants in the Program will receive a certificate from the Department of Dermatology, New York University School of Medicine verifying their observership as an International Dermatology observer."


New York University Medical Center
Specialty: Orthopedic Surgery
Visa: If you need a visa, the University does do a J-1 Visa for the Observership, though it may not be compulsorily be a J1 - in that event, I would recommend going with a Visitors or F1 visa instead.
Application Form and Links




Unity Health System and it's ring of hospitals e.g.: Park Ridge Hospital
Specialty : Primary Care / Internal Medicine
Residency Contact Information : Individual Hospital Contacts



Wyckoff Heights Medical Center, Brooklyn
Specialties: Internal Medicine (I know IMGs have done it in Internal Medicine - other specialties may be possible)

MARYLAND (MD)

CLERKSHIPS / ELECTIVES
( For 4th Year International Medical Students)


National Institute of Health (This one is prestigious !!)
Specialties: Multiple : See List Here
Application FAQs
Online Application Form


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




OBSERVERSHIPS


Johns Hopkins University, Baltimore
Specialties: Multiple
Application Information


Johns Hopkins : Institute of Genetic Medicine
Specialty: Clinical Genetics
Click Here for Application Information


Union Memorial Hospital, Baltimore
Specialties: Medicine + Surgery
Application Information

ILLINOIS (IL)

ELECTIVES / CLERKSHIPS
(3rd / 4th Year Medical Students)


Northwestern University: Feinberg School of Medicine, Chicago
Application Forms and Information
Visa: Students need to come on their own Visitor's visas
Fees: $1000 per rotation
(Prestigious Medical School !)


University of Illinois at Chicago
Specialties: Multiple
Application Information


Southern Illinois University, Springfield, IL
Specialty: Psychiatry
Application information




OBSERVERSHIPS



Good Samaritan Hospital
Dr. Rao K Batchu
Charges 1000$ to 4000$ depending on length of Observership and Externship
Call: 630 963 4990


Southern Illinois University
Specialties: Multiple - Internal Medicine, Pediatrics Etc.
Application: Though there is no formal program as such, individual faculty could arrange them as per this policy manual which says:

"It is assumed that the availability of an observership is at the discretion of individual clinical departments based on that department’s availability of resources, and the existence of these guidelines is no obligation on the part of any clinical department to provide such an experience. Foreign medical schools must be recognized by the educational commission for foreign medical graduates.Any candidate accepted by a clinical department must be approved by that department’s chair, and notification of that acceptance must be given to St. John’s Hospital and Memorial Medical Center"

Link to the Medicine-Surgery Departments at SIU


University of Illinois at Chicago
Specialty: Neurosurgery
Application Information


University of Illinois Urbana-Champaign
Specialties: Multiple
Applications Information

DISTRICT OF COLUMBIA (DC)

EXTERNSHIPS


St. Elizabeth Hospital
Specialty: Psychiatry
Duration: 4 Months + More if extern is good
Application + Contact Information


Providence Hospital, DC
Specialty: Internal Medicine
Cost: Don't have to pay anything - just work for them, they need people due to lack of enough staff (Understaffed hospitals normally offer Externships to get free-labor in high-patient load cities)
Contact: Program Coordinator at : (202) 269-7747
Duration: 3 Months busy Externship for hands-on experience : Needs minimum 3 months for
Requirements: ECFMG Certification | 'High' USMLE scores | 3 LORs | Copies of Medical Diploma + ECFMG Certificate | Resume
Send materials by post to : Program Director (Internal Medicine Residency Program)
Providence Hospital, 1150 Varnum Street, N.E., Washington, DC 20017 - 2180




OBSERVERSHIPS


George Washington University Medical Center
Specialties: Dermatology, Emergency Medicine, Medicine and specialties, Obstetrics and Gynecology, Pathology, Pediatrics, Psychiatry, Radiology, and Surgery
Cost: $800 per week
Application Info


Washington Hospital Center
Specialties: Multiple
As the website says:
"Upon approval of the Hospital Center’s clinical department director, international physicians may participate in observerships to observe clinical activities and participate in academic discussions with Hospital Center physician colleagues." - Thus a start would to be contact faculty in various departments listed on their website

CALIFORNIA (CA)

CLERKSHIPS / ELECTIVES



David Geffen School of Medicine at UCLA
Specialties: Multiple
Application Request Form


University California Los Angeles (UCLA)
Specialties: Multiple
Application Information

University California San Francisco
Specialties: Anesthesiology + Radiology
Fees: $500.oo per 4-week elective + 300$ Homeland Security Fee
Application Information




EXTERNSHIPS

Cedars-Sinai Medical Center
Specialty: Psychiatry
Click Here for Contact Information





MINI-RESIDENCY



Vision International Eye Missions, Santa Rosa
Specialty: Ophthalmology
Application Information



OBSERVERSHIPS



David Geffen School of Medicine at UCLA
Specialty: Family Practice Observership program for Latino IMGs
Read About This in the News !



Stanford University
Specialty: Emergency Medicine (Visiting IMG Observational Fellowship Program)
Program + 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 'circumstantial evidence'. At the time of this writing, on one of the resident profiles posted on their family medicine website, it was mentioned that the person did an observership at their program before.
Program Contact


UCLA IMG Program for English-Spanish speaking Hispanics and other minority IMGs
Specialty: Family Medicine
Application Information