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

Describing an Observership on Residency Applications

Each time you experience something fantastic in life all by yourselff - to others it is only as good as you can describe it to them ..be it a great movie you saw, or an awesome car you drove or maybe that amazing good-looker that just walked by your seat ;-)

I did answer the question about how to describe an observership on the CAF on the forum and then I thought I might as well put it up here as well ..so, here's a sample of some things to add:


- Followed residents and attending closely on history taking, physical exam and assessment/plan in inpatients and clinics
- Participated in case presentations on morning rounds and contributed to management discussions
- Diligently attended didactics, noon-conferences and weekly grand-rounds
- Assembled and authored a case report with a resident on a patient with Wegener's granulomatosis
- Achieved good diagnostic and management expertise in common cases like COPD, CAD, CHF, ARF, GI bleeding and CVA [dont use acronyms like I did here ;-)]
- Gained practical expertise in the use of Cerner Electronic Medical Record systems, Epocrates drug lookup, etc.
- Developed excellent professional rapport with patients, nurses, residents and attendings


Plus you can add stuff about any poster presentation, help on research work etc. too

No bluffing ....but think back and creatively expand on what you accomplished during the time, you often will find more if you look back ;-) As for those who still doing observerships or about to start theirs, use this post as pointers to what you could be doing during your rotation...

Search keywords to this post:
- "sample description for observerships on CAF"
- "how do i describe my observership experience on residency CAF application"

Possible Observerships at Univ. Florida

If my intent on this blog is to throw light on USCE possibilities and avenues for ya'll to follow-through, then I must back that with a disclaimer that in case it does not work out - "Like I said - This is a good possibility" ;-)

I might have mentioned this already, but you gotta understand that most observerships that IMGs are not formal departmental programs. Additionally, even though a website or a program coordinator emails you saying that we do not do observerships, if you make contact with a physician faculty on whatever pretext and then he /she does agrees on letting you observe , then the 'observership' will occur even if the department does not formally encourage it.

Anyways, when I see a Univ. Florida webpage declaring a formal procedure for visitors interesting in shadowing physicians (observing, that is), I would think it's a pretty good chance that you might.

The webpage itself was last updated in 2005, but its worth digging more into. Here's what it says:

"For any visitor who wishes to shadow a physician/clinical staff member and observe patient care at the University of Florida Health Science Center and/or Shands HealthCare at UF, the following must be done PRIOR TO THE VISIT:"

Read More here

Retinal Observerships @ Doheny Eye Inst., CA

This is a second successive post on Opthalmology observerships and I should be useful to at least some prospective Ophthal-residency seeking IMGs. Maybe these observerships might have some value even to candidates seeking prelim surgery positions too. Here's a another one at the Doheny Eye-Institute in Los Angeles, California, affiliated to the prestigious University of Southern California (USC).

At Doheny Eye Institute, IMGs (i.e. International Medical Graduates or Foreign physicians) are responsible for their own visitors visa during the maximum of 2-weeks of retinal department observership. 2-weeks seems short but look at the bright side - this hospital was ranked 8th in the 2007 US News Ranking for Opthalmology and besides we are talking Los Angeles here = 2 weeks is gonna be blissfully cheaper than 4 weeks or 6 months..hehe

Click here to navigate to the application form

Note: Besides IMGs seeking US residency positions, Observerships at prestigious places in the US can be valuable resume additions even to IMGs aiming for Australia, New Zealand, etc.

J1 Research / Observership @ Univ. California, Irvine

Yet another possible good opportunity for IMGs, not only for a clinical observership but also getting to do pulmonary medicine research alongside.

Of course, logically speaking, this experience would be especially useful for candidates planning on pulmonary medicine / critical care fellowships later on, but since thats a sub-specialty of internal medicine, candidates with interests in Internal Medicine should find it useful too.

Specific Notes:

1. If a visa is needed, Only J1 visas are accepted for the purpose at UCI - Note that a J1 visa for a visiting research associate / fellow / observers is not automatically subject to a 2-year home stay rule [212(e)] - read more on this on my post about types of J1 visas .

2. You can get your own short-term Health Insurance - if not, the brochure gives contact information for help on that issue.

3. Since this is not a post-graduate training position, the California letter (or PTAL) should not be necessary.

4. This is NOT a J1 RESEARCH FELLOWSHIP - rather it is an unpaid and voluntary research - another reason why I strongly believe this J1 will not be subject to the 2-year home residency requirement.


Click here For Observership Information & Application Details [PDF]

Or follow the link to the Brochure from UCI Pulmonology Website

Also Read:

- Types of J1 Visas
- Pulmonary Medicine Salaries and Career Issues

Observerships at Wayne State University, MI

I don't believe I actually missed this one before - but here's information about observerships for IMGs at the IMG-friendly Wayne State University at Detroit, MI



Duration: 2 Observerships of 1-Month Each Allowed Per Person
Specialties: Multiple
Visa: Visitors Visa Allowed - other visa statuses (LIke an F1 during the summer) may qualify too
Application: Click Here for Application Information
Eligibility: MUST BE ECFMG Certified

[ Note: Needing ECFMG Certification for an Observership is not usually the case, that usually applies for IMG externships.]



Also Read:

- ECFMG Certification Basics for IMGs
- Observership Applying Basics for IMGs

E.N.T. Observership @ Med. College of Georgia

Medical College of Georgia is one of the top-100 grant fund receivers from the NIH. This post is to alert IMGs interested in Ear Nose Throat (E.N.T) Surgery to a possible observership at the Thyroid/Parathyroid Center at the Medical College of Georgia.

Like I often mention, having a US Observership is better than having no US Clinical Experience at all - lemme add that having a related US Clinical Experience is better than having no US Clinical Experience at all - and thus, an ENT Observership might be of value even to the General Surgery or other surgical specialty IMG candidate.

As the Observership section on the website says:

"If you are interested in observing one of our physicians in surgery or in the patient office, please email your Curriculum Vitae and your preferred visitation dates to donnab@mcg.edu. MCG Health System requires at least 30 days notice for approval of observerships."

Maximum Duration: 30 Days

Read more Here

I was unable to open the Observerhip Policies PDF posted on the site, but that's something you can make contact and receive

They seem to need malpractice insurance, faculty approval (Faculty Listed Here)


Also read:

- Have Observerships Lost Value for IMGs ?
- E.N.T. Surgeon Salaries in USA

University of Iowa Observerships for IMGs

These are clinical experiences that the University of Iowa refers to as 'traineeships' - both observerships and hands-on externships for physicians with IOWA licenses, but for IMGs, they seem to be limited to observerships.

These are conducted as CME - Continued Medical Education activities and charged as thus.

This is what their instruction document says about Non-US Physicians seeking 'traineeships'

"If you are NOT a U.S. licensed physician who would like to apply for a traineeship, please contact the Carver College of Medicine’s CME Division at 319/335-8597 for assistance. "

Read More Here on the University Iowa Website

So that is what you should do and then get back here to leave a comment your findings ;-)

And this is what the Iowa Medical Board says about US Clinical Experiences in Iowa for unlicensed IMGs:

"State law does not allow a physician who is not licensed in Iowa to provide hands-on care except in certain circumstances. The Board cautions physicians not to provide clinical experience with patients for graduates of international or domestic medical schools when the graduate is not licensed in Iowa as a physician. While the Iowa-licensed physician may offer such a graduate the opportunity to observe, the observer may not provide direct patient care, regardless of the level of supervision."

Have Observerships Lost Value for IMGs ?

The usefulness of Observerships has been often questioned by some IMGs - can't blame them, since so many programs mention on their websites that they need hands-on clinical experience or a PGY1 internship and that an observership or clinical research does not satisfy that requirement.

BUT

while it's true that there are residency program directors that do not consider Observerships as clinical experience, there are also many other residency programs that do look upon observership experience as relevant, important and some, even necessary. Since we are in the era of Evidence-based this and Evidence-based that, here is some :

1. University of Buffalo Internal Medicine Residency Program ( SUNY)

"We prefer applicants who have had observerships in the U.S. or who have not been away from clinical medicine for more than 3 years (or who have graduated from Medical School within the last 3 years)"

2. St. Luke's Hospital Family Medicine Residency Program, Maumee, Ohio:

"U.S. experience in an observership role is more desirable than no U.S. experience at all."

And more which I swear I recollect seeing, but not have the patience and time to fish that out from the World Wide Web.






So, here's some things I gotta say:

1. If you had the luxury of deciding between a hands-on clinical experience opportunity and an observership, certainly select the former - hands-on experience is any day better than a mere observership, but if you have nothing else worked out, then do look for observerships - they are always better than no US experience of any kind.

2. Policies change as program directors change, which usually change every 3-4 years. Hence observerships may become important for some programs for a given year and might lose importance at others.

3. If you missed the US clinical electives boat during medical school, An Observership is at times an easier way to get a big university name on your resume than an externship, since externships are e usually available at high patient load low-budget community hospitals. ( Again, select an externship above an observership, if you had a choice)

4. An Observership still give you a US LOR !

5. Even if a program did not consider Observerships as US clinical experience - it would still look at an IMG with an Observership as more competitive than one with no U.S. Experience of any kind.

6. If the place of the Observership also has a residency program, that gives you a very good chance at getting invited for an interview at that program - you can always request the sponsoring physician to personally recommend you to the program director over email / phone.

ACR's Radiology Observerships for Iraqi Radiologists

Thanks to the efforts of Dr. Abdul Hadi Al Khalili, the former chair of the department of neurosurgery at the University of Baghdad, who had to escape the unfortunate & merciless killings in Iraq- the American College of Radiologists will host at least 6 Iraqi Radiologists each year for up to 4 weeks of Observerships at various participating Radiology Programs across the US.

The Radiology Programs Initially participating are:

- University of Michigan Medical School, MI
- Henry Ford Hospital, MI
- University of Pennsylvania School of Medicine, PA
- Thomas Jefferson University, PA
- Massachusetts General Hospital, MA
- University of California at San Diego, CA

Read Report Here

Eligible Candidates should inquire with the American College of Radiologists

Headquarters:
1891 Preston White Dr.
Reston, VA 20191,
(703) 648-8900

Plastic Surgery Observership: Children's Hosp. Boston

So how many of ya'll are aiming for Plastic Surgery residency/fellowships in the United States ? Even if you were not planning the US and were interested in pursuing plastic surgery in other countries, an observership in the United States would certainly hold a lot of juice - and that too in a place like the ultra-prestigious Childrens Hospital of Boston which was Ranked 2nd In the United States by 2007 US News report for pediatrics.

Details for the plastic surgery observership:

Visa: IMGs need to do their own visas - so a visitors visa would work - in fact any visa would work as long as you don't violate the visa status. IMGs on F1/OPT visas elsewhere could do this during their summer break - hence apply during the Winter (spring) semester

Duration: More than a Month Permitted (Limited to observing three physcians total)

Application Procedure: There are two parts - Online part and the Paper part - BOTH need to be completed. Click here to goto Application Instructions

Fees: Not Mentioned, possibly no fees, but the scary living costs in Boston sound like high-fees themselves :-D

The website also says:

"In addition to shadowing day to day practices, observers may also be invited to watch surgical procedures. Observers may also have the opportunity to attend different conferences; as well as utilize all of the resources found in Harvard Medical School and Children's Hospital Libraries."

I don't like the flavor of the 'may also be' part in the statement above - after all isn't WATCHING SURGICAL PROCEDURES the highlight of a surgery Observership ? ;-) Of course, you should clarify this with them before hand...after all, you don't wanna only observe how the surgeons walk, talk and wend coffees off the machines ...hehe

Paid Observership Experience at Drexel University

As Drexel Medicine's Physician Refresher Course website says:

"An innovative program for physicians wishing to return to active clinical practice, change their sub specialty, or prepare for admission to US graduate medical education training programs.This program may help meet the current physician shortage needs."

The Program is offered in three formats :

1. On-site Preceptorship (Preceptorship = Observership)
2. Online Distance-learning didactic curriculum
3. Online Clinical Skills Assessment

Hmm...Option 1 is what Most IMGs would be interested in. Drexel University is a prestigious place to be and have on your resume - except that the fees are pretty steep.

Fees:

1. Observership : $7500 (What !!)
2. Didactic Teaching: $ 7500
3. Clinical Skills: $ 8500

Combined Package: $20,000

Whoa ! It's absurd that only one letter 'r' separates the words "Fee" and "Free" - They need to be totally different-looking words that bear NO resemblance to one another ..he he..and besides someone who can afford to pay those is already very well off and doesn't need to be a physician income-wise ......I meant income-wise ;-)

- Click Here for Application Information & Application Form



Anyways, This information is now neatly filed under Observership opportunities in Pennsylvania State

WASHINGTON (WA)

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 :-)

Innovative IMG or Yet Another USCE Firm :-)

Recently, this post on Craigslist, caught my eye:






Hmmm..either an innovative IMG trying to grab attention of physicians - or more likely an old / new clinical experience organization trying to recruit physicians - $2000 to be paid to the physician for one observing IMG - steep price, eh ! If that's what the USCE firm pays the physician, the IMG will obviously need to pay much more to the firm ....hmmm...middle men ALWAYS shoot up prices...

If the above method worked worked successfully for IMGs (for externships rather than cheaper to find observerships)...there will be no middlemen - Like Denzel Washington going directly to Vietnam to get drugs cheap in "American Gangster" ;-)

AMA to develop Observership Programs for IMGs

AMA stands for the American Medical Association

The American Medical Association House of Delegates (AMA-HOD) meets each year around June to discuss new policies and proposals. Year 2007 saw a proposal introduced by the International Medical Graduates sections on the AMA about designing a formal observership program. While the proposal listed as Resolution 308 was surely not rejected, it has been referred for consideration pending resolving legal issues by individual states

- see the proposal request [Doc]
- See the Meeting outcome minutes [PDF]

Currently not many program directors are aware that a thing like 'observership' can even be done, while others are too scared of the legal implications - hence a formal model plan that comes from AMA will be most beneficial opening up many opportunities.


Hmmm...Around 10,836$ had been requested to find out about "collect information on observership programs, develop a model program, and disseminate information about the model program" - They could have just given that to me, you know - and I could have simply allowed them to call this blog an official part of AMA ;-) Lol

Exploring "AHEC" centers for US Clinical Experiences

AHEC stands for Area Health Education Center and as the National AHEC website says , the AHEC program was "developed by Congress in 1971 to recruit, train and retain a health professions workforce committed to underserved populations" with 120 medical schools and 600 nursing and allied health schools working together to provide health care experiences to medical students in every state.

Click here to check out an interactive US Map that gives a listing of AHEC centers offering clinical rotations all over the United States - clicking on an individual state gives you the contact person, email and phone numbers of the AHEC centers.

Note that these are generally meant for US Medical school students since they are funded by tax-payers money. However I know an IMG who called up a center in Missouri and not only got a 4 week rotation, they also also arranged for his stay for a mere 75$ for the month, and that was because they did not have enough of their own medical students to rotate at that period. Anyways it would not hurt to try and talk / email politely saying you are an IMG and are looking for an experience with them since you are keen on practicing there after a residency. Though these are hands-on experiences (externships /clerkships), IMGs would most likely be allowed to only observe.

I would suggest a better idea would be to Google individual state AHECs to get mroe information. So for someone - so since we were on the Missouri page, this would be googling for "Missouri AHEC Clinical" and I get this page.

Having said that I would still prefer an experience at a teaching university rather than a non-teaching hospital - but remember the golden rule - some USCE is better than a none at all :-)

MAINE (ME)

OBSERVERSHIPS

Maine Dartmouth Family Practice Residency: Residency Website
Note: This info is based on circumstantial evidence - an IMG resident profile on the website says the resident did an observership at the program before the residency ! (yeah ain't I cheeky :-p )

Observerships Basics for IMGs

There are three entities that must come together to make an Observership happen:

1. You, of course

2. The Physician that you will be observing: The physician that you end up 'observing' is also referred to as the 'sponsor', preceptor or the mentor. The term 'sponsor' in the context of an observership often finds some IMGs scratching their heads wondering if that 'sponsors' involves some visa or money matters - Well, No, that does not. The term in this context means: "a person who vouches or is responsible for a person or thing" [yeah , I scrubbed that off dictionary.com ;-) ]

3. The administrative office that will take care of the paperwork and other stuff depending on the hospitals / programs / institution policies. Paperwork involves getting your immunization / medical records, visa issues and HIPAA issues (shall deal with HIPAA soon)


Now, looking at the way various IMGs have historically got observerships, I tend to classify observership arrangements in three categories:

Informal, Semi-formal and Formal

[Lol...I am almost making this sound like a science in itself ;-) ]


1. Informal:

In a majority of places trying for observerships is an informal affair, it is upto you to make contact with a potential physician 'sponsor' via email or phone or in person to make a request. If you are lucky to write to the right person at the right time and right place, you will find a doc who is willing and get the stone rolling with the administrative office. Hmmm..so the more efforts and more places you contact, the better your chances will be. And if you got contacts in the form of residents, physician relatives, your 'chances' almost become a 'certainty' ;-)

2. Semi-Formal:

In this scenario, the department will allow observerships but will typically want you to first make contact with their physicians themselves - i.e. you gotta find a willing physician 'sponsor' yourself, and then the administration does the rest of the paperwork for you. Thus, they have an observership program in place, just that there are no formal applications accepted.


3. Formal:

This category, unfortunately the most uncommon, where the office will formally accept potential applications and then forward them to their staff physicians to make the selections on a rolling basis. The observerships mentioned on this blog with a link to application forms belong to this category, some are free while some need you to pay a fee.






Search keywords to this blog post:

- "what is the meaning of observership sponsor"

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)