Types of US Clinical ExperienceThis page will help you clearing concepts about various basic terms that you probably already have or will come across in your 'learning' expedition on US Clinical Experience (USCE).

US Clinical Experience (USCE): It is a US hospital based working experience in a clinical specialty like Surgery/Medicine. When you claim that you have USCE, you are expected to be well oriented and skilled with routine functioning of a US hospital. It includes general skills like interacting with patients (history/physical), inputing their records into the electronic system, coordination with nurses and staff, and a general sense of hospital working.

For practical purposes, you can obtain 2 types of USCE.

1- Hands on Clinical Experience

2- Non-hands on Clinical Experience

Hands on Clinical Experience : This is the 'Real' or 'full bloom' type of clinical experience. It has all the traits of USCE described in the definition above. The key to' hands on' is 'Patient contact'. Depending on whether you are a student or a graduate you can obtain it in shape of either a Clinical Elective/Clerkship/Sub-internship (see the individual definitions given below to know about minor differences) or an Externship respectively.

- Clinical Elective : A clinical elective is an optional away rotation that a final year medical studentcan do outside the hospital of his/her parent institute to gain Clinical Experience. It can be at your home country and it can be at any other country in the world, but if your ultimate aim is to apply for a residency in USA, then your elective in a US based hospital will be most valuable in your Resume.

For example if you are a final year medical student at Harvard Medical School and you are doing your rotation in General Surgery at Massachusetts General Hospital (which is a hospital affiliated with the Harvard University), then this is not a clinical elective, BUT if you try to do an away rotation in a specialty of your choice, say Vascular Surgery at the Cleveland Clinic (a hospital not affiliated with Harvard), then that clinical experience will be a clinical elective. Remember this example I will use it again below.

Electives are most frequently 4 weeks in duration- can be shorter or longer. Note

that Research elective (see below) is a different form of elective in which there is no patient contact and is not considered USCE. Some instiutes like Johns Hopkins does not accept International students for clinical electives (unless your institute has a direct affiliation with Johns Hopkins) but do accept them for Research electives (Click here for more details).

From my personal experience, any elective experience is only a window of opportunity for a student to build contacts with famous US doctors and obtain Letter of recomendations (LOR) to support your residency application. It is your chance to prove your potential, caliber and passion to your attending. There are only a BASIC set of skills that are expected from a medical student, and you are evaluated based on your ability to adapt quickly, Iq, common sense, interpersonal skills, overall general knowledge, Confidence, ability to define your roll in a fast paced environment, multitasking, and your functionality to adjust as part of a team interms of how much others can rely on you to get their job done. The easier you will make work for them the more they will like you. No one evaluates you on how much knowledge you have, but on how much you are able to retain/reproduce on what they teach you and how much you refine it from your self study.

- Clerkship: It is a compulsory medical student clinical rotation that is part of your curriculum (for this reason sometimes also referred to as core clerkships) at the affiliate hospital of your parent institute. US medical students do clerkships as part of their 3rd year requirement, but for most international medical students Clerkships are part of their third ear as well as 4th year ward rotation.

In the Harvard example above, if you are a medical student at Harvard medical school, and you do your rotation at Massachusetts General Hospital (Harvard's affilate) then that rotation is an example of a clerkship.

practically there is no difference between electives and clerkships in terms of clinical experience and because of this reason some institutes even use the word 'Clerkship' interchangably or essentially for the same meaning as 'elective'. Example Mayo Clinic uses both terms clerkship and elective to describe their general surgery rotation.

- Sub-internship: It is the most superior form of USCE that an applicant can have (in my opinion). The learning opportunity is immense at the level of a medical student. Its the same as an elective except that the level of responsibility is more and one added distinctive feature is an on-call participation with your team. This means that you spend the whole/most part of night with your team in addition to your day rotation. I like Sub-Internships the most because they give you the Maximum possible opportunity to spend more and more time with your team/attending, and you have all the time in the world to learn and they have a

greater flexibility of time to teach you stuff compared to busy day time. Plus, traditionally the US doctors like it alot if you spend extra time, they take it as a proof of your commitment. Sub-internships are very useful if you desire a future residency in a Surgical specialty. You should always prefer electives that have in their discription 'student functions as an intern' or is titled sub-internship per se. Some good examples of Sub-I offering places that I can think of right now are Mayo Clinic, Yale University, Case Western Reserve University, University of California San Diego, University of North Carolina. As you dig down deep into the list you will still find quiet more of them.

All of elective-Clerkship-Sub-I are undertaken for accademic credit (which means it will contibute towards your degree and you will be evaluated at the end of your rotation), another important fact that makes them more valuable.

- Externship: It is a relatively rare specie of USCE with a lot of application requirements that if available to a Graduate is considerd hands on and better than an Observership (see below). As a general rule, any postgraduate training that involves patient contact will require you to be ECFMG Certified (for more details read through getting started). This form of USCE is inferior to elective/clerkship/Sub-I because there is no gaurantee that the training is supervised- in other words you are on your own.

Most institutes/hospitals do not offer externships. Some that used to, do not any more, and very few do offer still, but conditionally depending on your contacts. Another diference is that sometimes they are paid. Some hospitals use externships as 'cheap' labour to manage their overwhelming workload. They are not done for accademic credit which makes them less valuable than former types of USCE described above.

Non-hands on USCE and other terms: The most popular example is an "Observership". The difference from hands on is that this type of clinical experience is limited due to "no or minimal patient contact." Not in my opinion, but Clinical Research may be considered an example of non-hands on USCE by some.

- Observership: The reality is: It's least respected, better than nothing type of USCE that a graduate can undertake to fill in for the blanks of USCE in his/her resume. Thats what most program director's think. However, in my opinion, Observerships can be considerably resourceful depending upon your ability to make use of them and who you work with (especially if you were able to secure one via contacts). At the end of the day all that matters is what someone is willing to write about you in the letter of recomendation and that intern depends on how much your efforts made them like you.

The biggest drawback that an Observership has is 'minimal or no patient contact.' The good thing is that they are relatively easier to find, have greater chances of acceptability, and have less vigorous application requirements. Regradless, there are sill a lot of things that you can do while being an 'observer'. For example: You can project an intelligent image, help as a team member, make things easier for your attending, discuss cases to full detail, voluntier for more work, do powerpoint or case presentations. You can still do everything that a student can do except for a physical exam, that too if your attending likes you so much that he lets you do that-you can ! All that is more possible if there already is not a student on that rotation. So you see practically "its not just better than nothing type of a thing" But rather still a door of opportunity that can be very benificial. I have never done an observership, but I have seen observers when I was on rotations, and I could easily make things what I personaly thaught others could have done to highlight their presence. Your attitute is what makes the difference, because most of the times you decide what more you can do and what you want to do. In USA people are just so nice that they are never a hurdle in your way as long as they find that you are helpful. If you participate in your observership with a preset mind that 'you are just an Observer and you can barely do anything under that status'. Then its applicable for you how 'rumorously' people define Observerships. You have to find work for yourself thinkin of ways how you can help your attending, and trust me if you can do that then it can reward you better than an elective can. Be resourceful of whatever opportunity you have. Earn their trust and they will let you do what you want !

Research Elective: It is a research experience at a reputed University that medical students can undertake for accademic credit. They have no comparison to a Clinical Elective because its not USCE. So I cannot comment if its better or worse, but your application will cary more weightage if you have done a research elective in addition to some USCE, compared to someone who has only a research elective experience.

In my opinion, a Research elective experience, adds a very unique flavor to your residency application. 1) It helps proving that your an indivisual with a multitute and diversity of experiences and that you 'bring more to the table'. 2) It helps proving your dedication towards your specialty, especially if you had the opportunity to work in a clinical research setting. 3) It proves that you also have a research experience in addition to just USCE. 4) You have a big institute name in your resume. 5) if you were fortunate, a publication. 6) It can be a doorway to help you get an observership in future via the contacts you develope with people whome you help in their research.

Remember that Research alone cannot compensate for USCE deficit, unless it is done for an extended period and is rewardingly fruitful with publications and you are able to build strong contacts during the process.

Johns Hopkins University is very famous for offering research elective positions, but over time the application load is increasing with an inverse relation to availability of spots at a given moment. You might wanna take a look at their website incase you are interested or try your luck e-mailing individual attendings and calling labs separately.

Internship: In USA Internship is the first year of postgraduate training (PGY1) in the specialty of your choice. In other simpler words the 1st year of your residency training is an internship year and the person undertaking internship is an Intern. This definition is not strictly true, and not universaly applicable as in some countries e-g in India internship is completed before graduation and essentially constitutes as final year of undergraduate training.

Some specialties like Neurosurgery, Urology, Vascular surgery, opthalmology have an internship year where where residents rotate through 1st year of general surgery to learn and develope some basic surgical skills. After completing that first year of general surgery training, they then carry on with their respective specialty training. This type of an internship is also called Transitional year orDesignated PGY1. Prelimnary PGY1in any specialty is also an example of internship. Quiet a few surgical programs require you to have atleast 1 year of USCE in shape of an internship or collectively othervise, before they will consider your residency application. Internships in USA are always paid.

Application for Clinical ElectivesThis page is intended to explain various components of Elective application procedures with an overview of the entire process in practice. Minor procedural variations are always there and vary from institute to institute. Regardless I will try to cover all 'variety' of such variations.

The huge list of requirements my seem scary to start with, however NOT every institute will require you to satisfy all the requirements described on this page. BUT if your are an extraordinarily fortunate person or you work hard enough that you are able to manage all possible application requirements described on this page, then most probably you can apply to almost any US medical institute that has a policy of accepting students (including international students) for Elective/Clerkship positions.

I assume that you have already read or are adequately familiar with the content discussed in sections : Getting stated and Types of USCE, of this website. If not, then it is advised that you do so now. This page can wait until you have matured your baseline knowledge required to understand what will be discussed here.

Additional Documents 

This page will provide specific instructions on documents that must be submitted along with your application in addition to the application form. A complete list of all possible documents is provided below. Note however that not every institue will require submission of all the documents.

I asume that you have already familiarized youself with the content discussed in 'Elective application' page. I you have not I strongly advise that you do so now. Here I will not go through the extensive description on what every application document 'means' as this has already be elaborated and discussed under Elective Application. This page is however a step further from what has been discussed before already. I will try to provide samples on almost every document that requires to be submitted so that you know exactly what every document is about.

A list of documents that may be required is as below:

- Accademic requirements:

1) Transcript: A complete transcript should show details about your clerkship duration in terms of hrs or weeks. Heres what an ideal US medical school transcript looks like, the one that is very easy to interpret by the elective coordinator. Since most international medical schools do not have a GPA system or even grades, a similar transcript can do the work. If your transcript does not show duration of your clerkships then you can attach along with it a supplemental Clerkship Letter validating your clerkship length as well as the site (hospital) of your clinical rotation.

2) TOEFL (Test Of English as a Foreign Language) exam result: Generally if you have a score of 100+, you are good. It is not so much difficult to score around 100. The maximum possible score is 120 and each of reading, writing, listening, speaking are scored out of 30. Some institutes however have High specific requirements. Example: National Institute of Health (NIH) requires you to score 26

or above on the speaking section. You will still do fine if your individual score is lower than 26 on other components (but is in 20s) except speaking. If you are fond of watching TV series and English movies, you will do really well on the listening section. An American accent does not increase your score, more important is the fluency and the clarity of words. The passages are abit tough and time consuming on the reading section usually based on topics outside medicine like Archiology, Austronomy, Civilization, History etc. If you have a nice expression in writing then you will easily do well on writing section. Most international medical students score low on the speaking section. Barrons iBT TOEFL book   can be used for prepration. It has a CD that contains simulated TOEFL exam. It may have started to sound a bit difficult, but trust me you really do not need to loose sweat over its prepration. 1-2 weeks of prepration is enough, I had my final year Surgery Exam a day after I took my TOEFL and did reasonably well: you will too!

Score reporting is 'weird' in the sense that it takes ABNORMALY long for the official transcript to reach you via mail. I know people whose score reports were recieved up to 3 months after the online declaration (which is usually 20 days after the exam is taken). Your online score report is equally valid and it is my advise that you do not waste your time waiting for the official score report to reach you in mail. Just print the online score report from your profile and post it with your application to where ever you wanna send it.

Some institutes however require that your original TOEFL score report be mailed to them DIRECTLY from ets ( the organization responsible for score reports and for conducting your exam). Example : Northwestern University does not accept score reports mailed to them by students (even if they are official score reports in mail).

Also remember that when you are applying for TOEFL you have the option to send official score reports FREE of cost from ets to atleast 4 Universities. You must fill in at that time and make a selection for the University where you wanna apply, because you wont be given this 'free' option again after you have taken your exam. Its like an avail it or loose it type of a thing. I am stressing upon this fact at this point because the application system/instructions DO NOT warn you against this. And you will have to pay some extra bucks if you wanna send your official score report directly from ets to a University (say: Northwestern) if you did not avail this free option at the time of application.

Click the links to see how your official score report and online score report will look like.

3) USMLE Step1 result: If you have already taken it at the time of application, you have done a great job. You have more options to apply to than other student and

much greater chances of acceptability. Click the link to see how the Official USMLE score report looks like.

4)HIPAA & OSHA: These have already been discussed in the section 'elective application. A sample HIPAA certificate that you will get after completing the course on the Johns Hopkins University website can be viewed by clicking the respective link.

So lets Start it !

The MOST basic requirement for Clinical Electives program at almost every Medical School or Hospital in USA is that you must be a final year medical student in good standing who has completed his/her Core Clinical Clerkships at his/her parent/home medical school and must have your institute's dean's/principal's approval to undertake the desired elective course. If you cannot satisfy this basic requirement, you cannot apply ANYWHERE for a CLINICAL ELECTIVE rotation. Example: if you are not a final year medical student but rather a 1st/2nd/3rd yr student or so-you will not have completed your Core Clinical Clerkships, Or conversely if you are a Graduate-you are no longer a medical student and electives are only for students. In either case you would not be able to apply for electives.

If you are a 1st/2nd/3rd year medical student who is reading this, don't be disheartened, the only thing you have to do at this point in time is to wait till you grow up to acquire final year status. This does not mean that you should stop reading. Its impressive that you have discovered this website so early and tells me that you are smart and focused right from the beginning. Keep visiting this website in order to keep yourself updated, and when YOUR time will come you will know EXACTLY what you need to do and this will save you a lot of time and effort compared to your peers. So Good Job!

If you are a graduate, then options are abit limited, but focussed struggle can be fruitful in securing Observerships/Externships. I advise you to continue to read as the application procedures are very similar for Elective/Observership etc.

APPLICATION COMPONENTS

For purpose of simple understanding , I have grouped the application requirements into specific categories. I will discuss each of these individual 'groups' in detail separately.

Application Forms Academic Requirements Nonacademic Requirements Additional Supportive documents

1. Application forms : The purpose of an application form, from the point of view of an elective coordinator is to verify in order of importance: a) that you are a final year medical student. b) if you have completed your core-clerkships or atleast satisfied their minimum requirements c) You are not faking and you have your dean's approval (in shape of your institute's seal on forms) d) The rotations and dates you are interested in e) your personal information.

the answers to a)-e) MUST be yes or favorably conclusive. Or your application processing will be delayed or rejected.

Other information like: if your institute provides insurance coverage,or you have had OSHA training is secondary, and does not adversely effect your application if the answer is no on the application form ! ( will explain 'Why' and 'What those things are' later-see filling forms and/or below for details).

Example : Take a look at the application form of Baylor College of Medicine, a very well reputed institute to apply for electives.

Dont worry about terms that you dont know YET, you will know them soon, just read on.

For more details and guidance on filling forms click here

 

2. Accademic Requirements : This group of application materials deals with documents that demonstrate your academic competency. The list below enumerates in aggregate, the most commonly requested proof of accademic related documents. Dont freak out, Not every institute will ask for all of these. But as I am trying to create a 'general awareness' on requirements, I have to consider all that requirements requested by various institutes inorder to creat a super max 'complete list.'

a) Transcript. Most commonly and almost every institute will ask for your transcript. A transcript is a document that is supplied to you by your institute when requested. It is a record of evaluations of all the professional exams that you have taken so far since the start of your medical training. It also enumerates what courses you have taken and your performance in the form of marks or grades or

GPA, depending on your institute. It should mention the duration of your clerkships, proving that you have completed your core-clinical clerkships in (medicine Surgery etc) and preferably should mention your overall class rank or percentile. This document is a basic requirement and almost every student has it. Every institute has its own pattern of transcripts, you can better check that out with your University registrar.

b) Toefl (Test Of English as a Foreign Language) Exam result. Documentory evidence of English speaking proficiency. Most institutes will ask you for it. Some institutes like harvard Medical School and Yale University will prefer your application over others if you have taken it. This exam evaluates your reading, listening, speaking and writing capabilities and provides you with a score. If you have a score of 26 or above in all individual sections, then you are safe to apply almost anywhere. The greatest emphasis is on the speaking section, try to score as high on it as you can.

Only a few places will waive TOEFL requirement if the medium of instruction is English, in that case your University/College Dean may need to supply you with a verification letter. Example: Mayo Clinic, University of North Carolina.

More information about the TOEFL exam can be explored by visiting their official website.

c) USMLE Step 1 result. Most Universities ( about 80%-just my estimate) now require you to have taken USMLE Step 1 as a requirement for elective application. A lot of places like State University New York (SUNY) and Memorial Solan Kattering Cancer center, where Step1 was not an application requirement before, now ask for it. My hunch is that over time, the rest 20% of Universities will eventually update their list of requirements to incorporate Step 1. The point is to realise the importance of taking Step 1 and to start planing accordingly ahead of time. For institutes that ask for it, there is no way around, and myths of 'Step1 waiver' are old, and no longer practical because of increasing competition. For obvious reasons, your application cannot be preferred over someone who has taken step 1 if you havent (as now quiet alot of people do take it before graduation) and the truth is that your's will simply be ignored or rejected if you ask for a waiver, because the elective coordinator will already have a better pool of candidates to choose from for the limited spots he/she has available. More details about USMLE Step1 can be reviewed on the page Getting Started of this website.

For those who believe that it is too late for them to take step 1 now: not having been able to take step 1 before graduation does not still close all doors of elective opportunities. You can try your luck for institutes that do not have this requirement- but my general analysis is that they will charge you alot. Two good examples of

places that do not require USMLE Step 1 as a requirement, but are reasonably affordable are Baylor College of Medicine and Northwestern University, with an overall expenditure (excluding living and traveling) sums up to be around $1100-1500- thats the cheapest you will get without step 1 for most Universities. For comparison, Cleveland Clinic provides absolutely free electives with free residence but it requires you to have taken USMLE Step1.

d) HIPAA (Health Insurance Portabiliy and Accountability Act): It is a compulsory short course that all visiting medical students are expected to complete (depending on the institute) either before or after acceptance into an elective program.

This course is usually an online short course (2-3hrs) dealing with professional mannerisms towards protecting patient's confidential information in a hospital environment e-g minor things like how to discard patient information on paper, and what is 'their' institute's policy on sharing specific type of patient information with outside authorities (like some other hospital etc).

You dont have to worry about it so much, because the practical use of this knowledge is minimal at the level of student, and no matter how many of such courses you take, the practical side is very different and you will develope that sense only when you are 'in the system'- (My opinion). And dont panic, never on earth will your attending ask you questions about HIPAA to test your knowledge on that. Even elective coordinators think of HIPAA as a mere formal requirement. Courses are separate if you intend to do a 'clinical' or a 'research' elective.

If your home institute does not provide such training/course, you will be prompted to take the course, and the elective coordinator of the institute will help you in acquiring it. Most institutes will have availability of such courses on their website, where upon after completion you will take a quiz and you will be expected to pass with 80-90% correct answers as a minimum and you will then recieve an online certificate which you can print and submit with your application as proof. Others will have you do it when you start your rotation or may be on the orientation day.

To get a sense of things, take a look at the instructions file on acquiring HIPAA on Johns Hopkins University website

 

e) OSHA (Occupational Safety and Health Administration): Like HIPAA, OSHA is not a pre-elective aproval compulsory requirement. Another name for the similar course is 'Universal Precautions against Blood/Air born pathogens or infection control course.' This course is about general precautionary measures that should be

taken in dealing with potential contaminants in blood and air. Example: info on how to dispose a syringe needle after drawing Blood, or what precautions can you take to avoid getting a needle stick injury. The quiz at the end of the course will also test your knowledge about the spread of air/blood born diseases like AIDS, TB, Hepatitis etc. In my opinion, this course is less tourtuous than HIPAA to complete.

Most institutes will require you to provide proof of such training only after you have been accepted into their program (example: Memorial Solan Kettring Cancer Center elective program). If you havent done such training at your home institute, then most programs will have you do it at the start of your elective rotation by showing you slides or videos relating to it (example: Mayo Clinic).

If you are applying to an institute in New York State, then there is another application requirement that you need to obtain. This requirement is the New York Eligibility Letter(see below non-accademic requirements) and one of the requirements to obtain this letter is to supply them with OSHA training certificate from a New York state approved infection control course providers. These providers do not provide these courses for free but rather charge a reasonable fee for it around $25-50. As of now I am not aware of any website that offers such course for free.

f) CPR training: CPR Card (BLS (basic life support) for Healthcare Provider level from the American Heart Association). This is one 'out of the box' requirement, requested by University of Wisconsin and a few other places. Most US medical students take BLS during their undergraduate training (usualy before their 4th year). There is no other institute that asks for the same requirement to my knowledge. If you have never been to USA before, then I dont think that you will be able to acquire that kind of training, If some how you can, or your home institute hosts such courses in accredation to American heart Association, then this institute is a good option, because its a top notch University with minimal application fee and no requirement of USMLE step1.

g) Prior US Clinical experience: If you have survived the previous panic of CPR training requirement by University of Wisconsin, here's another one: They also require you to have acquired prior US clinical experience in form of an elective at some other US institute before they will consider your application at U Wisconsin. Again this uneasy requirment is also pretty much only requested by the University of Wisconsin and no other institute as such.

Other institutes like Northwestern University, prefer your application over others if you have had prior USCE before your rotation will start at their institute, but its not a mandatory requirement. From my personal experience, I think it is very true not about just Northwestern but almost every other place no matter they specifically

ask for it or not. So if you have prior USCE, it will be a BIG plus to your application even more so if you are interested in Surgery.

3. Non-Accademic requirements:

These requirements eat your time like a hungry linon who eats a loaf of meat after 10 days of starvation. Enlisted and discussed below are a list of non-accademic requirements, and like I said before, not every institute will ask for all of them.

a) Immunization and health form/certificate: Every institute will require you to submit a verification 'document' validating your Immunization status. Most institutes will ask you to have their immunization form filled and signed by a physition providing his or her contact information. Some will also ask for an institutional/physician stamp (example: Northwestern University) on the form.

Generally you are expected to supply them with evidence of immunity (either vaccination dates/ serologic antibody titers or disease Hx) against the following diseases:

1) Tuberculosis, if positive an X-ray is required,

2) Tetanus/Diptheria/Petrusis,

3) Mummps, Measels, Rubella,

4) Varicella (Chicken pox)

5) Hepatitis B :vaccincations and/or evidence of serologic immunity.

6) Menningococcal meningitis : Vaccination. (this one is usually optional but Yale University mandates it if you are intending to secure housing on their campus)

For better understanding you can view the immunization form of Northwestern Universityas an example.

Some institutes have specific peculiar requirements, e-g Northwestern University does not accept Montox (TB) test results from your home country, but will require you to acquire one from US or at their institute before you start your rotation. In another example Case Western Reserve University, requires to also provide immunization dates for your Polio vaccination-not a very strict requirement though.

b) Dean's Letter: Out of all the non-accademic requirements, Dean's letter is the most important. Almost every institute where you intend to apply will ask for its

submition as a part of their application requirements. This dean's letter is not the same as the one required for residency application.

If you are a Registrar or Dean of a medical institute reading this information then it is strongly advised that you take into account all the factors discussed below in order to formulate a COMPLETE standardized dean's letter, so that it can satisfy the application requirements of majority of the US based medical Universities to which your institute's medical stutents will be applying. Faliure to comply with these basic requirements can result is rejection of elective application.

Deans letter is the letter that your Institute's Dean/Principal writes about you, validating that you are a student at their institute in good standing who is allowed to undertake an elective course outside his/her parent institute. This is ofcourse just the main summary, however there's more to Dean's letter than just that.

A COMPLETE dean's letter should clearly convey that you are a final year medical studentenrolled for X years of undergraduate medical trainning course (or your degree name e-g MBBS) at their institute with your session starting dates. It should state your expected date of graduation. General comments about your personality or conduct are also mandatory and it should convey that you are a student in good standing. There should be a clear statement stating that you are approved to undertake the elective course for accademic credit.

Other 'variable/non-compulsory' components of deans letter can be comments on yourenglish speaking skills or a statement that the medium of instructions at their institute is English, criminal background check (see below) or a statement verifying that you have never been involved in mis-conduct or crimminal activity ever since your enrollment at their institute. (examples: Cleveland Clinic and Case Western Reserver University asks for this requirement in dean's letter) If your medical school provides coverage for your Health Insurance and/or Malpractice Insurance, then it should be mentioned in the letter as well (example: National Institute of Health (NIH) requests that your dean's letter should specifically mention about health/malpractice insurance coverage). If you are applying in New York State, then you probably will also be applying for New York Eligibility letter(see below) whose requirement is that your dean's letter should also specify the duration of your elective period and the institute's name in NY where you will be doing your elective.

For non-immigrant visa application at the US Embassy in your home country, if you intend to also use your Dean's letter as proof that you will be coming back to your home country after completing your electives, then it can be useful if there is a mention in the Dean's letter that you are expected to return after completion of

your elective course and that you will have to take your Final year exam inorder to graduate. It may also state that all your pre-medical original diploma/certificates and related documents are submitted with the registrar's office which will be released only upon graduation.

 

c) Malpractice Insurance or Professional Liability Insurance: This requirement is the most problematic out of all non-accademic requirements in my opinion- one reason being that there are ony 2-3 reliable insurance companies that provide such coverage. It adds an unecessary bulk to your overall application expenditure, has the potential to delay your application considerably, and depending on whether or not you are able to obtain it, it can even shorten your list of institutes to where you are interested in applying and I hate it!

This insurance is supposed to protect/cover your expenditure against law suits that a patient potentially can protest against you, if he/she thinks that you have done harm to him/her. Practically, when I asked related questions to senior residents on my rotations, majory of them replied by saying that ' firstly there is HARDLY anything that a medical student can do wrong because of controlled supervison, and secondly the patients are not stupid ! They will Sue the attending instead of a medical student, so that they can make more money that way.'

The malpractice insurance policy that you purchase should atleast provide coverage of $1million/$3million. One exception is SUNY Downstate which requires a malpractice insurance coverage of $3million/$3million. Dont think of it interms of the amount that you will have to pay to purchase this insurance. You will be able to purchase it for around $200-300 for 4 weeks of electives. The Company you purchase it from should provide such coverage in USA. This also indirectly means that the company should be US based.

I personally believe malpractice insurance is a BIG monoply on part of Insurance companies to make easy money. They are fully aware of the fact (from their experience) that students hardly will ever need their help, but they know that its like a compulsory requirement to acquire one on part of the student- and that there is no other way round. They exploit the fact that most international medical schools do not cover malpractice insurance for their students and so charge huge money which is BAD.

The tragedy is that except for a few, no institute wants to bother about the fact that paying for malpractice insurance substantially hurts the pocket of international students for no good reason, which is sad and disappointing. If places like Mayo Clinic, Northwestern University, University of Texas x 3: Houston,San Antonio and

Southwestern, Johns Hopkins and University of Wisconsin, provides malpractice insurance for no additional cost or as low as $20-50, then EVERY UNIVERSITY SHOULD and NONE is poor enough that it cant, because its practically never going to cost them any buck as students wont do harm to patients.

d) Health Insurance: It is a relatively easier and cheaper requirement compared to Malpractice insurance (in my opinion), because there are alot of companies that offer such type of insurancce. Unlike malpractice insurance which is required by some, almost every Institute requires you to provide proof of Health Insurance coverage at the time you submit your application. Travel health insurance = Health insurance and you can purchase it from your home country. Cost varies with increasing age. Most institutes ask you to provide evidence of coverage of about $50,000 to 100,000. To acquire such coverage you may need to pay an amount of around $40-90 for 4 weeks. It may cost you cheaper if you purchase it from a local company at your home country.

e) Crimminal Background Check/Police Clearence: Complicated as it may sound, its not so much difficult to complete this requirement. It is requested only by a few institutes (example: Case Western Reserve University and Cleveland Clinic). There are two ways to satisfy this requirement. 1) Either you can consult your district Police officer to issue you a character certificate or 2) Your college/University Dean/adminstrative official/registrar can issue you a letter statining that ever since you enrollment you have been an individual with sound moral character who has not been involved in any illegal activity. The former method has more weightage, but the latter option is an acceptable alternative.

f) New York Eligibility letter: Every institute in the New York State requires you to submmit New York Eligibility Letter in the time frame: after acceptance into an elective program and before the start of your rotation. It is a state requirement that you should obtain permission from the New York State education department in shape of obtaining NY Eligibility letter if you wanna do an elective at any institute in NY state. You cannot apply for the New York eligibility letter if you do not already have an acceptance from the institute that you are interested in applying. This is because you need to submit the "institute's approval letter" along with the New York eligibility letter request form for the issuance of New York Eligibility letter.

The usual sequence is that you apply for to an institute in NY, that institute approves your application, then you apply for NY eligibility letter telling the NY State education department that you have been approved for an elective/clerkship by an XYZ institute in NY state, and that you want to pursue your elective but require state's approval. The NY state education department then verifys that whatever you are saying is accurate, verify's your medical school and then issues you an NY eligibility letter which you then submit to the institute that accepted you making

your elective participation legal. No institute in NY will allow you to undertake an elective course (even if they previously accepted your applicaiton) if you do not submit them a NY eligibility letter.

Your midical school must be enlisted in the WHO directory and/or IMED/FAIMER

It may sound like a big hassel but, it is relatively easily attainable and the fact that you already have an acceptance from your prospective institute makes the process easier and the wait less painful. The following are the requirements that need to be fullfilled inorder to apply for an NY eligibility letter.

1) NY Eligibility letter form

2) Evidence on Infection control course completion(same as OSHA).

3) Approval letter from the hospital/Institute in which you will perforn your elective (s).

4) A letter from your dean verifying that you are approved to undertake that particular elective/clerkship for credit.

5) A cheque/draft of $30 payable to New York State Education Department

Regarding electives/Clerkships in New York State, Please note that you should not do electives for more than 12 weeks, or you will be renderd ineligible to apply for residency in New York in future. However this rule does not apply if you have completed your electives collectively for 12 + weeks in some other states (may or may not include NY), provided that the elective period in NY is still less than 3 months.

If you want to do clerkships in US for more than 12 weeks, then you need to have taken USMLE step 1 or equvilant (like Complex 1), the rest of the process is similar.

Other forms of USCE like observerships are not subjected to this rule.

g) Faculty Sponsor for an Elective: For international students some reputable places like Emory University, University of Washington, University of Wisconsonin, Johns Hopkins University will only consider or prefer your application if you know or have contacted a faculty member who is willing to sponsor your elective rotation. This requirement is usually difficult to satisfy if you already do not know any of that institute's staff member in the department of your desired rotation. But if you are one of those fortunate people who is lucky enough to have recieved a faculty member's supportive response, then you should definitely connsider pursuing your elective application at that institute. I advocate in favor of this because if you are

able to fullfil other requirements for that place, then its a Definite acceptance, compared to other places where you have applied with lesser probability of acceptance.

One way of searching for a faculty member sponsor is by strolling through the website of these institutes and then searching for the faculty names in individual departments. Every institute has a specific method of employee/staff e-mail 'structure'. you will have to figure that out on your own because its variable from institute to institute. You can start from analysing the e-mail address of the elective coordinator and then 'calculate' the formula for making an e-mail out of a given name for that particular institute. After that you search for the faculty names, 'make' their e-mail from their name using that formula and then send them e-mails. No pains no gains!

Always remember, US doctors highly respect hardworking, honest and enthusiastic people who are passionate to learn in the specialty of interest. Who knows, when your star shines, and someone is able to see the light in you and is able to recognize your abilities, where all it costs you is some additional effort and a nicely written e-mail. My advise: Always avail your opportunities and never run away from hardwork, and its your commitment to your work that will make you stand distinctively out of a pool of thousand others. It might sound like a sentimental speech to you at this point, but sooner or later you will realize for yourself that this really is the reality and the right force that drives you through your way to success ! Your potential faculty who will be sponsoring your elective, might have been in your shoes at some point in his carrier, so do not underestimate your chances of acceptance and their sense of judgement !

h) Faculty letter (s) of recommendation: Most Institutes, if not all, will require you to submit atleast 1 or 2 or maximally 3 letter(s) of recommendation in addition to the Dean's letter. These do not necessarily have to be from US based faculty, and letters from professors or faculty at your home institute can suffice the requirement. Preferrably the letter should come from a faculty member who has accomplishments in your desired speciality of elective. For example: a letter from a clinical professor of medicine will be considered more credible if you intend to apply for an Internal Medicine elective. The letter should sufficiently comment on your clinical skills. Some institutes like SUNY Downstate will supply you with their own letter of recommendation 'form' that you need to have your faculty complete and enclose it into a sealed confidential envelope, which you can then submit along with your application.

4. Additional Supportive documents: This category of application requirements include documents that are not an absolute requirement but they 'polish' your overall application. You are not dependent on someone's approval or skills to add

these to your application and these DIRECTLY express your own self, personality and accomplishments and makes you application presentable at a glance to who so ever reviews your application. If you know how to make use of these documents as tools correctly, they will emensely help you stand out. Refer to the list below for specific details.

a) Personal Statement: This is the single document which is the most unique in every application. Via this statement you convey your passion/interest in the specialty of your choice and their institute. You discuss about your accomplishments, and your future plans and then explain how this elective will help you to accomplish those goals. You also discuss what makes you different from others and what you like about their institute ! Remember that its your speech, where you must reveal your entire self to the audiance in a manner that they are forced to pay attention to and like what you want to tell them. In my opinion there are no rules to writing a personal statement other than the fact that it should be interesting and specific to your case, so never bother about what others tell you whats 'right or wrong', Do it just the way you feel like how its supposed be done !'. Also train yourself to listen to your instincts

b) Resume/Curriculum vitae (CV): Firstly, there is no as such difference between the two terms, but however the term Resume is used more frequently in USA. A resume is a structured, to the point, representation of your professional accomplishments since the start of your accademics. It is difficult to explain the organization of a resume without an example, take a look of this sample resume and then follow the text below for explaination.

Your resume should accurately convey all your achievements. It should prominantlyhighlight your distinctive accomplishments. (yes ! just like this line.) Be brief ! do not use lengthy sentenses, say more while using few words. The quality of language that you use in your resume and personal statement are strongly indicative of your maturity and professionalism. From my experience: Minor as these things may sound-but they are really important. Your accomplishments may loose their credibility if your resume and personal statement do not complement the level of skill you claim. Most attendings hightly value their own personal judgement and would draw conclusions from the impression they get from your overall application rather than basing their decision on what you tell them specifically. Your application should strike in his head that its comming from an intelligent young man who knows how to do stuff !!!

To summarize, your resume should have dedicated portions for the following areas: Professional goals and objectives, Education, Accademic accomplishments, Clinical Experience, Research Experience, awards/achievements/memberships, Extra-curricular activities.

c) Cover Letter/Letter of intent: It is essentially the same as personal statement in context. National Institute of Health and the University of North Carolina use the term Cover letter which means the same as personal statement. Letter of intent is somewhat different in that its brief and you dont need to describe your future goals and your current accomplishments extensively, but you rather focus on why you wanna do that elective at their institute and you briefly summarize your documents that you have enclosed in your application packet. After reading this letter the elective coordinator should know where he/she needs to send your application, and whats included in the envelope.

 

Man ! ....this one took a lot of time to complete.....

Hope you got benifit from all what I wrote. Have a nice day and good luck with your application !

University list for International Medical Students

This webpage will provide you a comprehensive list of all US based universities/medical schools where international medical students are eligible to apply for electives, if they meet the application requirements

I have Categorized the University list into two groups:

1) Group A: Universities that offer electives to ALL international medical students regardless of affiliation.

2) Group B: Universities that offer electives to only those international medical students whose medical school have a formal affiliation with their institute

The list has NOT been arranged inorder of Rank. Before you start to dig down into the list, you might want to take a look at the official list of Best US Hospitals and the University rank list based on Research by visiting the US news website.

For every institute enlisted below: clicking the institute name will open up a new window to the official elective application webpage for that institute. Before you start, there are some basic Principles that have general applicability, and must be taken into consideration before interpretating the information on institutes given below:

1- For all institutes enlisted below, if the visa type is not specified in requrements then it means that you can do an elective at that institute on B1 Visa or business visa.

2- For all institutes in New York State, you will be required to obtain New York State Eligibility letter as part of the application requirements ( usually after acceptance), even if its not specified.

3- Most elective periods are of 4 weeks duration, tuition fee is usually per 4 week elective, e-g if you want to do x 2 four week electives where the tuition is $100 then you will have to pay $200 for two electives. Application fee on the other hand is constant and is a 'once only' fee regardless of the number of electives you do at the same institute. However many places still use 'application/tuition fee' interchangably, specific information will be provided of their website in every case.

4-Unless specified otherwise, the minimum requirements for malpractice insurance are $1million/$3million for most institutes that require it.

GROUP A Universities and Hospitals

1-Cleveland Clinic (Ohio)

Download/visit: Application form, Immunization form (you need to supply your own), elective catelogue

Application fee:NA, Tuition fee: NA, Accomodation: Free, Health Insurance : Req, Malpractice Insurance: Req, Immunization: TB,MMR,VZ,HBV,DPT, USMLE Step1: Req, TOEFL:Req

other req: Criminal background check

Comments: No 1 in Heart in US and the world, overall 4th Best US hospital.

Elective coordinator: Pat Gasser gasserp@ccf.org   +1 (216) 444-9977

2-National Institute of Health (NIH) (Maryland)

Download/visit: Application form, Immunization form (you need to supply your own), elective catelogue (enlisted in the application form). Read FAQs for more detail.

Application fee: NA, Tuition fee: NA, Accomodation: NA , Health Insurance : Req, Malpractice Insurance: Req (can be purchased after acceptance), Immunization: TB,MMR,VZ,HBV,DPT, USMLEStep1: NA, TOEFL:Req (must have 26 or+ in speaking)

Other req: Electronic deans Letter and a faculty LOR

Comments: NIH is a Huge Research Institute, it funds other institutes to conduct research.

Elective coordinator: Vicki L. Malick malickv@cc.nih.gov +1 301-496-7989      

3-University of Alabama (UAB) School Of Medicine (Alabama)

Download/visit: Requires online application , Immunization form , Course catelogue (enlisted in the application form).

Application fee: $100, Tuition fee: NA, Accomodation: NA , Health Insurance : Req, Malpractice Insurance: Req (can be purchased after acceptance), Immunization: TB,MMR,VZ,HBV,DPT, USMLEStep1: NA, TOEFL:Req (must have 22 or+ in speaking)-but can be waived if medium of instruction at home institute is english

Other req: Electronic deans Letter and a faculty sponsor is required- refer to course catelogue for course contact personnel. Additional $20 for processing health forms, background check, CV.

Comments: Accepts, B1, J1. Their website says that procedures and fee will be revised for the year 2013-2014.

Elective coordinator: visiting@uab.edu  for additional information. (No phone calls accepted)

4-University of Connecticut (UConn)(Connecticut)

Download/visit: Application form, Immunization form , elective catelogue

Application fee: NA, Tuition fee: NA, Accomodation: NA ,USMLE Step1: NA, TOEFL: Req ,Malpractice

Insurance: Req, Immunization: TB,MMR,VZ,HBV,DPT,Polio Health Insurance : Req

Other req: Criminal background check (is part of application form), Requires submission of a sample History and Physical exam documetation performed by the medical student independently.

Comments: Requires core clerkship in Community Medicine. Is not available to international students throughout the year. Visit website for more details.

Elective coordinator: Marianne Olson olson@nso1.uchc.edu +1 860-679-2246

5-Henry Ford Health system (Michighan)

Download/visit: Application form (must be copied and printed/faxed), Immunization form ,(need your own) elective dates and list

Application fee: NA, Tuition fee: NA, Accomodation: Yes(but not free-requires separate online application) ,USMLE Step1: NA, TOEFL:NA, Malpractice Insurance: NA, Immunization:TB,MMR,VZ,HBV,DPT Health Insurance : Req

Other req: Deans letter,cover letter, CV

Comments: Recent concerns that they are not considering foreign medical students, you can try your luck or call the elective coordinator to verify.But people have gone there in the past & have done electives there

Elective coordinator: Dianne Weiland DWEILAN1@hfhs.org.  +1 313 916-1465

Address: The Office of Undergraduate Medical Education,Medical Education Department,Henry Ford Hospital,Clara Ford Pavilion – B046,2799 W. Grand Blvd.,Detroit, Michigan 48202

6-Albany Medical College (NewYork)

Download/visit: Application form, Immunization form ,(need your own) elective dates and list

Application fee: $100, Tuition fee: NA, Accomodation: NA ,USMLE Step1: NA, TOEFL: Req,Malpractice

Insurance: Req, Immunization: TB,MMR,VZ,HBV,DPT, physical exam Health Insurance : Req

Other req: Deans letter, Transcript

Comments: Availability is restricted at certain periods of the year. Recent Updates that they have stopped taking International medical students, but their website is not still up to date, email elective coordinator for more details. revised 12/2011

Elective coordinator: Tiffany Smith ISSS@mail.amc.edu .  

Address: Albany Medical College,Graduate services program, division of international student and scholar services, New Scotland Avenue MC-16Albany, NY 12208

7- University of Texas Southwestern(UTSW) (dallas, texas)

Download/visit: Application form, Immunization form , elective catalog

Application fee: $25, Tuition fee: NA, Accomodation: NA ,USMLE Step1: (req by some departments-see supplemental requirements webpage UTSW-website), TOEFL: NA, Malpractice Insurance: Req (available for purchase $25 per rotation at the institute), Immunization:TB,MMR,VZ,HBV,DPT Health Insurance : Req

Other req: Deans letter, Transcript

Comments: Availability is restricted in certain departments, e-mail or call the DEPARTMENTelective coordinator before you choose a specialty to make sure if you are eligible. 150$ International visiting student application processing (in addition to $25) fee. HIPAA training can be completed at their website. F1 visa is required.

Elective coordinator: UTSW is different in that every department has its own elective coordinator ! Refer to the Department elective page

Address: Varies with the department.

8-Case Western Reserve University (CWRU)(Ohio)

Download/visit: Application form, Immunization form (need your own) elective catalog

Application fee: $120, Tuition fee: NA, Accomodation: NA ,USMLE Step1:Req, TOEFL: Req,Malpractice Insurance: Req, Immunization: TB,MMR,VZ,HBV,DPT, Health Insurance : Req

Other req: Crimminal Background check, Dean verification form, Clerkship form

Comments: Cleveland Clinic ohio is an affiliate hospital with CWRU. You cannot apply for Cleveland clinic electives through CWRU as those rotations are only for CWRU students. You will be eligible for University hospital electives. Department of GENERAL Surgery does not accept International students. But you are eligibile for specialty electives like Ortho/Urology.

Elective coordinator: Inca Dorsey inca.dorsey@case.edu.   +1 216.368.3723

Address: Inca Dorsey CASE School of Medicine 10900 Euclid Ave.Office of the Registrar, Room T-408. Cleveland, OH 44106-4968

9- Wayne State University School of Medicine (Michighan)

Download/visit: Application form, Immunization form, elective catalog

Application fee: $75, Tuition fee: NA, Accomodation: NA ,USMLE Step1:Req, TOEFL: NA,Malpractice Insurance: Req, Immunization: TB,MMR,VZ,HBV,DPT, Health Insurance : Req

Other req: CIS Access form, Malpractice Insurance form, Confidentiality statement

Comments: Has Specific B1 visa reqiurements. click here for more details.

A recent update that they have stopped accepting international medical stdents, but this info is not yet reflected on their official website. Please contact the elective coordinator for details

revised1/29/2013

Elective coordinator: Office of Records and Registration, Mrs. Kaaym Gudger +1 313 577-1470kgudger@med.wayne.edu.+1 313 577-140

Address: Office of Records and Registration Wayne State University School of Medicine,Suite 318Mazurek Education Commons, 320 East Canfield, Detroit, MI 48201

10-Memorial Solan Kettering Cancer center (New York)

Download/visit: Application form, Immunization form, elective catalog

Application fee: $100, Tuition fee: NA, Accomodation: NA ,USMLE Step1:Req, TOEFL: Req (will accept equilant) Malpractice Insurance: Req (after acceptance), Immunization:TB,MMR,VZ,HBV,DPT, Health Insurance : Req

Other req: Dean's letter, Transcript

Comments: It is the 2nd Best Cancer treating hospital in US and is an affiliate of weil Cornell university.

Elective coordinator: medstudent@mskcc.org 212-639-3359

Address: Medical Student Coordinator, Memorial Sloan-Kettering Cancer Center, Graduate Medical,Education, Box 187, 1275 York Avenue, New York, New York 10065

11-Maimonides Medical Center (New York)

Download/visit: Online application, elective catalog

Application fee: NA, Tuition fee: NA, Accomodation: NA ,USMLE Step1:NA, TOEFL: NAMalpractice Insurance: NA, Immunization: TB,MMR,VZ,HBV,DPT, Health Insurance : Req

Other req: NA

Comments: Recent concerns that they are not considering foreign medical students, you can try your luck or call the elective coordinator to verify.But people have gone there in the past & have done electives there

Elective coordinator:Tina Marshall tmarshall@maimonidesmed.org   +1 (718) 283-7629  

Address: NA- as online application

12-University of Texas Health Science Center San Antonio (UTHSCSA) (Texas)

Download/visit: Application form, Immunization form, elective catalog

Application fee: $25, Tuition fee: NA, Accomodation: NA ,USMLE Step1:Req, TOEFL: ReqMalpractice Insurance: Req , Immunization: TB,MMR,VZ,HBV,DPT, Health Insurance : Req

Other req: Dean's letter, Transcript

Comments: They have a big University Hospital and a Vetrans (VA) (means millitary hospital). F1 Visa.

Elective coordinator: variable for every department, see elective catalog for more details.

Address: UTHSCSA,School of Medicine, Student Affairs,ATTN: Norma E. Fox, AA Sr,7703 Floyd Curl Drive – MSC 7790,San Antonio, TX 78229-3900.Confirm with the respective department of elective application before mailing !

13-East Carolina University Brody School of medicine (North Carolina)

Download/visit: Application & Immunization form

Application fee: NA, Tuition fee: NA, Accomodation: NA ,USMLE Step1:Req, TOEFL: NAMalpractice Insurance: Req , Immunization: TB,MMR,VZ,HBV,DPT, Health Insurance : Req

Other req: Dean's letter, Transcript, Faculty LOR, Basic Life Support certification, Crimminal Background check,CV, Photo, Confidentiality statement, Statement of English fluency, proof of Visa status.

Comments: Electives are available during specific part of the year only, please check their official website for more details, It appears that they start accepting further applications when the seats are full.

Elective coordinator: +1(252) 744-2278

Address: Visiting Student Elective Coordinator,Office of Student Affairs,The Brody School of Medicine,600 Moye Blvd, Brody 2S-20,Greenville, NC 27834

14-New York University (NYU) (New York)

Download/visit: Application Request form, Elective Catalog,

Application fee:$100, Tuition fee: NA, Accomodation: NA ,USMLE Step1: NA, TOEFL: NAMalpractice Insurance: Req , Immunization: TB,MMR,VZ,HBV,DPT, Health Insurance : Req

Other req: NA

Comments: They require you to submit application request form prior to submission of a formalApplication Form inorder to determine eligibility. IMS are only considered after the NYU students have been scheduled and there is still availability for elective positions. Availability is restricted during certain parts of the year only (typically April-May). You can try your luck during this time. Rarely accepts IMS.

Elective coordinator: MAUREEN DORAN +1 212 263-5291Address: OFFICE OF REGISTRATION/STUDENT RECORDS NYU 550 FIRST AVENUE- NEW YORK, NY 10016 – USA

 

15- State University New York (SUNY) Downstate (New York)

Download/visit: Application form, Immunization form, elective catalog, Dean's letter, Faculty LOR,Check list

Application fee: $175 for 1st elective $100 for the second, Tuition fee: NA, Accomodation: NAUSMLE Step1:Req, TOEFL: Req Malpractice Insurance: Req , Immunization: TB,MMR,VZ,HBV,DPTHealth Insurance : Req

Other req:NA

Comments: Availability is restricted to certain times of the year only (mostly spring). Not all departments are elligible, make sure you review the website before you apply. Their malpractice insurance requirement is higher $3million/$3million instead of the 'regular' $1 million/$3million by most institutes.

Elective coordinator: visitstudent@downstate.edu

Address: Office of the Registrar,SUNY Downstate Medical Center,450 Clarkson Avenue, Box 98Brooklyn, New York 11203,Facsimile: 718-270-7592

16-University of Texas Medical school at Houston (UT-HSC)(texas)

Download/visit: Application & Immunization forms may be requested by e-mailing the elective coordinator, elective catalog

Application fee: $250/4week payable to UT-HSC, Tuition fee: NA, Accomodation: NA ,USMLE Step1:Req, TOEFL: Req if native langusge is not english(may accept alternatives)Malpractice Insurance: Req (available through UT-HSC), Immunization: TB,MMR,VZ,HBV,DPT, Health Insurance : Req

Other req: Medical evacuation and repatriation coverage, its a type of insurance that can be purchased through UT-HSC. Dean's letter, 2 Faculty LOR.

Comments: F1 Visa.

Elective coordinator: Jamie Munsinger +1713-500-5167 Jamie.d.munsinger@uth.tmc.edu.

Address: University of Texas, Health Science Center at Houston, Student Affairs Office, 6431 Fannin Suite G400, Houston TX 77030

17-University of California San Diego School of Medicine (UCSD)(California)

Download/visit: Application & Immunization forms may be requested by e-mailing the elective coordinator AFTER submitting via fax the documentation enlisted below, elective catalog

Application fee: $250/4week (paid AFTER acceptance), Tuition fee: NA, Accomodation: NA ,USMLE Step1: NA, TOEFL:NA Malpractice Insurance: Req Immunization: TB,MMR,VZ,HBV,DPT, Health Insurance : Req

Other req: Dean's Letter, Evaluation of clinical skills for Surgery electives

Comments: Top Notch-affordable with relatively 'easy' requirements. Availability is restricted to certain parts of the year only, review website for more details.

Elective coordinator: Adrianne Edwards a1edwards@ucsd.edu, 858-534-1396

Address: UCSD School of Medicine,9500 Gilman Drive, 0729,La Jolla, CA 92093-0729

18- Mayo Clinic School of Graduate Medical Education(Minnesota/Florida/Arizona)

Download/visit: Online Application by creating an account, elective catalog

Application fee: $350/4week , Tuition fee: NA, Accomodation: NA ,USMLE Step1: Req, TOEFL:Required if medium of instruction at home institute is not english Malpractice Insurance: Provided by Mayo Clinic for free Immunization: TB,MMR,VZ,HBV,DPT, Health Insurance : Req

Other req: Transcript, Electronic submisstion of 2 LORs and 1 Official medical school Verification Form. There are 3 Mayo Clinics (Minnesota, Florida, Arizona). The one in Minnesota is the MAIN Mayo Clinic. If you want to do an elective at the Branch in Florida you will also be required to passUSMLE Step 2, which is a State requirement unless your medical school has an official affiliation.

Comments: Mayo Clinic is the 3rd best US hospital according to 2012-2013 ranking by US news. Extraordinary dedication towards teaching. Very well reputed all over US. Attendings are very famous !

Elective coordinator: Minnesota: Linda McConhay clerkship@mayo.edu, Arizona: Silvana dalessandro dalessandro.silvana@mayo.edu, Florida: David Ausejo FLACOMVISIT@mayo.edu

revised 7/30/2012

Address: Every thing is electronic, they do not accept paper work, however address details can be found on their website.

19-Virginia Commonwealth University School of Medicine (Virginia)

Download/visit: Application Form, Immunization form, elective catalog

Application fee: $100, Tuition fee: NA, Accomodation: NA ,USMLE Step1: Req, TOEFL: Req (other proof of english fluency may be acceptabe) Malpractice Insurance: Requires $2million/$2million

coverage Immunization: TB (within 3 months),MMR,VZ,HBV,DPT,mennigococci Health Insurance :Req

Other req: Dean's Letter, Transcript, Photo, 2 LORs, HIPAA at the time of application. Evaluation form your home medical school.

Comments: Applications are accepted only during certain part of the year. Make sure you are on time, confirm with the elective coordinator before hand. No offerings during June July August.

Elective coordinator: Nancy Jackson, nbjackso@vcu.edu

Address: VCU School of Medicine,1101 E. Marshall Street ,VCU/MCV Campus Box 980565Richmond, VA 23298-0565

20-Johns Hopkins University School of Medicine (JHU) (Maryland)

Download/visit: Application Form, Immunization form, elective catalog

Application fee: $300/9week (after acceptance), Tuition fee: NA, Accomodation: Provided at cost of $500/month,USMLE Step1:NA, TOEFL: Req (other proof of english fluency may be acceptabe)Malpractice Insurance: NA Immunization: TB (within 3 months),MMR,VZ,HBV,DPT, Health Insurance : Req- Accepts ONLY US based insurance or can be purchased from JHU.

Other req: Dean's Letter, Transcript, HIPAA from their website, Click here for guideline on completing HIPAA on their website. Confidentiality agreement.  HIPAA Security Awareness Agreement

Comments: International students are accepted for RESEARCH ELECTIVES ONLY. Clinical Electives are offered if your medical school has a formal affiliation with JHU (See below: Group B electives) Apply atleast 5-6 months in advance, takes time for processing.

Elective coordinator: Emma sulens,vismed@jhmi.edu, +1 410-614-4320

Address: Johns Hopkins University School Medicine, Registrar's Office 733 N, Broadway Research Building, Suite 147, Baltimore, Maryland 21205

21-University of Cincinnati College of Medicine UCCOM (Ohio)

Download/visit: Application Form, Immunization form, elective catalog

Application fee: $250 (After acceptance-must be submitted atleast 4 weeks before start of elective), Tuition fee: NA, Accomodation: NA ,USMLE Step1: Req, TOEFL: Req Malpractice Insurance: NA Immunization: TB,MMR,VZ,HBV,DPT,mennigococci Health Insurance : Req

Other req: Dean's Letter, Transcript, evidence of clerkship completion, Need to enroll for blood born pathogen insurance $37 in addition to application fee.

Comments: Limited availability ( 4 international students per year per department). Applications are submitted to each separtment separately !.

Elective coordinator: Department specific -variable, see application form for more details.

Address:Department specific, must confirm before mailing. General address layout: Department Name PO Box Number University of Cincinnati College of Medicine Cincinnati, OH 45267

22-Emory University School of medicine (Georgea)

Download/visit: Application form, Immunization form, elective catalog, Instructions

Application fee: $500 , Tuition fee: $3000/4 week, Accomodation: NA ,USMLE Step1: Req,TOEFL: Req Malpractice Insurance: req Immunization: TB,MMR,VZ,HBV,DPT Health Insurance :req

Other req: International Criminal background check, Proof of B1 visa (or atleast Passport details), Phone interview for students who are non-native english speakers.

Comments: They have recently revised their application requirements, which are now quite strict. They might possibly waive tuition fee if your medical school can confirm that you are on a full scholarship program. Students from foreign Universities who have a formal affiliation with Emory: University College Dublin, La Salle University-Mexico, Yonsei University, Tiblisi State Medical University are also exempted form the tuition fee. revised: 8/18/2012

Elective coordinator: : Ms. Nicole Buchenholz nicole.buchenholz@emory.edu, Tel: 404-778-1372, Fax: 404-778-1370.

Address: Office of Clinical Education, Emory University School of Medicine, 49 Jesse HillJr. Drive, SE, Atlanta, GA 30303

23-University of Wisconsin School of Medicine(Wisconsin)

Download/visit: Online Application, elective catalog

Application fee: $125 (online payment), Tuition fee: NA, Accomodation: NA ,USMLE Step1:NA,TOEFL: Req Malpractice Insurance: req Immunization: TB,MMR,VZ,HBV,DPT Health Insurance :Req

Other req: Requires prior USCE with an evaluation from a US based attending, Requires Faculty Sponsor (verify from their website on latest info). Requires American based CPR/BLS training. They have an online application system that will automatically formulate a pdf file for your application which you can print and post. Personal statement, transcript. Specific departments have specific requirements, verify from the website.

Comments: Top notch,one of the very few places that do not req step 1 and is economical. Availibility for medicine is restricted to certain parts of the year only verify from the website before you apply.

Recent Update that they have stopped taking International medical students for electives - I know SAD ! According to their website seems like they got fed up of numerous phone calls etc.

Elective coordinator: verify from website for update, Jane McGann jmcgann@wisc.edu+16082637676

Address: Visiting Student Coordinator,UW School of Medicine and Public Health,2130 Health,Sciences Learning Center,750 Highland Ave,Madison, WI 53705-2221.

last updated 5/22/2013

24- Mont Sinai School of Medicine (MSSM) (New York)

Download/visit: Application Form, Immunization form, elective catalog,

Application fee: $1000 , Tuition fee:$2000/4week, Accomodation: NA ,USMLE Step1: Req ,TOEFL:Req Malpractice Insurance: Req Immunization: TB,MMR,VZ,HBV,DPT Health Insurance :Req

Other req: CV, deans letter,Transcript. Student health fee $40 (separate from health insurance)Online infection control pdf (print the last page and submit)

Comments: Requires F1 or J1, has a history of waiving off Step1 and Toefl, you can try your luck. Begin application process 8-9 months in advance.

Elective coordinator: Jeanneth Persaud,Tel: (212) 241-6691 Tuesdays and Thursdays only, between the hours of 10:00 A.M. and 3:00 P.M,E-mail: visiting-students@mssm.edu

Address: Courier Service:The Mount Sinai School of Medicine,Student Affairs Office,Attn: Jeanneth Persaud,Annenberg 13-30, 13th Floor,New York, NY 10029Tel: (212) 241-6691 Postal Service:The Mount Sinai School of Medicine,Student Affairs Office,Attn: Jeanneth Persaud,One Gustave L. Levy Place, Box 1257,New York, NY 10029

last updated 4/29/2013

25-Northwestern University Feinberg School of Medicine (Illinois)

Download/visit: Application Form, Immunization form, elective catalog, Application Payment form Tuition and health insurance payment fee

Application fee: $100 , Tuition fee:$1000/4week, Accomodation: NA ,USMLE Step1: NA ,TOEFL:Req Malpractice Insurance: NA(provided free of cost)Immunization: TB,MMR,VZ,HBV,DPT, require TB test to have been performed within US or at their institute Health Insurance :Req (can be purchased at the university on arrival).

Other req: CV, Faculty LOR,Transcript, Personal statement, HIPAA, Universal precautions training Other forms

Comments: Requires TOEFL score report to be sent to their institute directly by ETS. Preferrs prior USCE and Step 1 but not required. Recent update that they have stoped taking foreign medical students since June 2013. unless your medical school is part of Global partner institutions-see website for details. In which case the fee may be different as well

Elective coordinator:

Address: Northwestern University Feinberg School of Medicine,Jennifer Banys, Visiting Student Program Coordinator, Augusta Webster Office of Medical Education, Ward 1-003,303 E. Chicago Avenue,Chicago, IL 60611

last updated 4/29/2013

26-University of Rochester (New York)

Download/visit: Application Form, Immunization form, elective catalog,

Application fee: $100 , Tuition fee:$375/week=1500/4weeks (must be paid atleast 4 weeks in advance), Accomodation: NA ,USMLE Step1: NA , TOEFL:Req (min 100) Malpractice Insurance:Req (after acceptance)Immunization: TB,MMR,VZ,HBV,DPT (req after acceptance), Health Insurance :Req

Other req: 2 LORS, Dean's letter, institutional seal, Transcript, CV, letter of intent, Technical Standards policy (just needs a signature), F1 Visa, repatriation insurance ( req after acceptance)

Comments: Only 2 IMS per quater are accepted and they stop accepting applications as soon as the spots are filled.

Elective coordinator: cristina_morganti@urmc.rochester.edu +1 (585) 275-4172

Address: University of Rochester School of Medicine and Dentistry,Student Enrichment Programs, Box 601,601 Elmwood Avenue,Rochester, NY 14642

27- University of North Carolina (UNC) (North Carolina)

Download/visit: Online Application, Immunization form, elective catalog,

Application fee: $100 , Tuition fee: $2000/4week, Accomodation: NA ,USMLE Step1: Req (will accept Step 2 CK or German Physikum as substitute), TOEFL:Req (will accept alternatives)Malpractice Insurance: NA Immunization: TB,MMR,VZ,HBV,DPT , Health Insurance :Req

Other req: 2 LORS, Dean's Office certification form, Transcript, CV, Cover letter

Comments: Top Notch but less affordable. Have a great diversity of electives and sub-internships. They reply to e-mails promptly.

Elective coordinator: international@med.unc.edu 919-962-6195

Address:UNC School of Medicine,CB # 9535,1066 Bondurant Hall,Chapel Hill, NC 27599-9535

28-University of Kansas School of medicine.

Download/visit: Online Application request, elective catalog, Immunization

Application fee: $400 , Tuition fee: NA, Accomodation: Provided @$600/month at international house,USMLE Step1: NA TOEFL:Req(but not for nationals of UK/ireland/canade & english speaking countries) Malpractice Insurance: NA Immunization: TB,MMR,VZ,HBV,DPT , Health Insurance :Req

Other req: Also require Evacuation/Repatriation insurance-all insurances reqafter acceptance. Dean's letter. F1 visa-encourages to apply 9 mo in advance. no more than 2 electives.

Comments: One of the few affordable places that does not req USMLE step 1 from international students. affordable accomodation

Elective coordinator: Internationalprograms@kumc.edu

Address:KUMC Office of the Registrar MS4029,3901 Rainbow Blvd,Kansas City, KS 66160FAX: 913-588-4697

29-Yale school of Medicine (CT)(Connecticut)

Download/visit: Application form, elective catalog, Immunization

Application fee: NA , Tuition fee: increased from $2800 to $3100/4week, Accomodation: no longer available,USMLE Step1: NA TOEFL:Req(for non-native english speakers) Malpractice Insurance:NA Immunization: TB,MMR,VZ,HBV,DPT , Health Insurance :Req

Other req: Payment on arrival not at the time of application. encourrges to apply 6mo in advance, personal statement, CV, 1 LOR. US residents/citizens from foreign medical schools cannot apply.

Comments: Encourrages international students to apply, if they can afford their fee.

Elective coordinator: internal.health@yale.edu

Address: Office of International Medical Student Education Yale School of Medicine ,ES Harkness Hall, 367 Cedar St. Room 221 New Haven, CT 06510

last updated 5/25/2014

30-Harvard School of Medicine (MA)(massachusets)

Download/visit: Application form, elective catalog, Immunization forms are given if you scroll down.

Application fee: $100/4week , Tuition fee: $3500-3700/4week(depending on month),Accomodation: Provided vanderbilt hall(not covered in tution fee),USMLE Step1: NATOEFL:preferred Malpractice Insurance: NA Immunization: TB,MMR,VZ,HBV,DPT , Health Insurance :Req

Other req: Application requirements, Requires Phone Interview, for assessment of English fluency, even if you have submitted tofel result. For Dorm rooms: vanderbilt_hall@hms.harvard.edu, Ph:(617) 432-1630

Comments: Tuition waiver my be given if you are from an underrepresented country & can prove financial hardship. Email:exclerks@hms.harvard.edu to confirm. 90% tution fee is refundable if informed 2 weeks before the start of clerkship. No.1 University. People who have done electives there have great remarks.

Elective coordinator: Exclerks@hms.harvard.edu

Address:Office of the Registrar Harvard Medical School 25 Shattuck Street, Gordon Hall, Room 213Boston, MA 02115-6092 Ph: 617 432-1515

 

31-Tufts University(Massachusets)

Download/visit: Application form, Immunization forms, elective catalog

Application fee: $75 , Tuition fee: $2500/4week(payable after acceptance), Accomodation: NA (not covered in tution fee),USMLE

Step1: NA TOEFL:req(for non-native speakers)Malpractice Insurance: NA Immunization: TB,MMR,VZ,HBV,DPT , Health Insurance :Req

Other req: Transcript, LOR,Dean's letter,(sponsors B1/F1/J1),CV,Passport photocopy. US citizens in foreign medical schools cannot apply.

Comments: Acceptance is relatively easy, if you can afford.

Elective coordinator:boston-intl-affairs@tufts.edu 617-636-0355

Address: Clerkship Coordinator,Tufts University School of Medicine,145 Harrison AvenueBoston, MA 02111

32-Thomas Jeffersson University   (Pennsylvania)(PA)

Download/visit: Application form, Immunization forms( you will have to e-mail the registrar to obtain this)-they usually respond in 1-2 weeks, elective catalog

Application fee: $75 , Tuition fee: $750/4week(payable after acceptance), Accomodation: NA ,USMLE Step1: yes(but accepts alternative local home country exam)TOEFL:req(?)Malpractice Insurance: Req Immunization: TB,MMR,VZ,HBV,DPT , Health Insurance :Req

Other req: Transcript, ,Dean's letter,CV. Evidence of health and malpracice insurance, english proficiency in form of TOEFL or local state exam, Evidence of financial support( may be from parents/bank statement may help)

Comments: Good University, relatively affordable

Elective coordinator: Sheryl High sheryl.high@jefferson.edu, University.Registrar@jefferson.edu

Address:Our office hours are: Monday, Tuesday, Thursday & Friday: 8:30 a.m. - 5:00 p.m.Wednesday: 8:30 a.m. - NoonUniversity Office of the RegistrarCurtis Building, G-221015 Walnut Street Philadelphia, PA 19107

Phone: (215) 503-8734Fax: (215) 923-6974E-mail: University.Registrar@jefferson.edu

33-North Shore-Long Island Jewish Health System (New York)

Download/visit: Application form, elective catalog

Application fee: NA , Tuition fee: NA, Accomodation: NA ,USMLE Step1: NA TOEFL:NAMalpractice Insurance: Req Immunization: TB,MMR,VZ,HBV,DPT , Health Insurance :Req

Other req: Initially you will have to submit the paper application form + CV, after acceptance you will be required to submit a letter from your medical school and also apply for NY eligibility letter

Comments: Affordable. Recent update that they have stoped taking international medical students except for students from institutions who have a formal affiliation with them

Elective coordinator: oaa@nshs.edu.

Address: Office of Academic Affairs via email oaa@nshs.edu.

last updated 5/25/2014

 

GROUP B Universities & Hospitals

These Universities are open to only those medical students for clinical electives who's medical school have a formal affiliation with them, or they will consider your application if someone working at their institute is willing to sponsor your elective.

1- Duke University, School of Medicine

To find out if your medical school is enlisted click here

Duke University requires that your home medical institute have a formal affiliation aggreement with them before medical students are eligible to apply for electives. If the medical school is interested to establish a formal affiliation agreement with Duke University, NOT YOU, but your official home school representative should contact Steven Wilson : steven.wilson@duke.edu and provide specific info

regarding: institute name, location, type and length of program, educational reason for agreement and contact info.

Briefly, despite affiliation, an application fee of $50 and a registeration fee of $6000 per elective are still applicable as well as the requirement for a passing score on USMLE step 1 for international students. Please contact Steven Wilson for details

Updated 1/29/2013

2- University of Pensylvania

To find out if your medical school is enlisted click here

3- University of Pitsburgh

To find out if your medical school is enlisted click here

4- Johns Hopkins University: For Clinical elective only

Specific info about affiliated international medical institutes is not enlisted on the official website, we will update as soon as the info is available.

5- Brown University Alpert Medical school

Specific info about affiliated international medical institutes is not enlisted on the official website, we will update as soon as the info is available.

6- University of Washington

Requires a faculty sponsor

7- University of Texas Medical Branch, Galveston

Specific info about affiliated international medical institutes is not enlisted on the official website, we will update as soon as the info is available. E-mail elective coordinator for details

8- East Tennesse University

If you have a sponsor it will help, if you were born there or are married to a resident in Tennesse, then you are eligible provided you satisfy their requirements click here

9- Tulane University School of Medicine

Specific info about affiliated international medical institutes is not mentioned on the official website, we will update as soon as the info is available.

10- University of Illinois

To find out if your medical school is enlisted click here

11- University of Louisville

To find out if your medical school is enlisted click here

12- University of Minnesota

To find out if your medical school is enlisted click here

13- University of New Mexico

Requires a faculty sponsor

14- University of Massachusetts (Umass)

Specific info about affiliated international medical institutes is not enlisted on the official website, we will update as soon as the info is available. E-mail elective coordinator for details Sherrie.Carey@umassmed.edu

15- Baylor University School of Medicine

They have recently updated their policies & they have stoped taking International student at this time. However their official website states that they will update their website & will open electives to only those international istitutes that have a reciprocral relation with them.

Planning for U.S. Residency Match and Building a Competitive ApplicationBy chicagoclerkships ¶ ¶ Leave a comment

There is a tremendous amount of mythology and legend bouncing around the

internet “echo chambers” about how to prepare for the U.S. residency match,

mostly because the vocabulary involved, the cultural nuances, and the complexities

at every stage of the process. It can be confusing and overwhelming. In this article

we will lead you through a no-nonsense, jargon-free introduction to planning for the

U.S. residency match and building a competitive application. We will cover

preparation components and key issues, how to prepare a timeline flow chart for

yourself, and some information on each component. Subsequent articles will exam

each component in more detail.

As you begin thinking about seeking a position in a US residency program, first and

foremost you must remember that this process is essentially a job search. It is

critical to incorporate key job search strategies with the strategies you will use for

applying to a training program. You should also understand that there is

considerable risk involved in this process. These risks include large expenditures of

money, time and energy, and there is no guarantee that you will be successful. Also

the differences in the US economy vs. developing countries can make it even more

expensive.

Planning is key to reducing your expenditures and increasing the probability of

getting an interview.  The earlier you begin the planning process, the better you are

able to fit in all the components in an efficient manner.  Also, you will be more in

control of the timing of each component.  Timing is crucial because many programs

will not look at you if you have been out of medical school more than 5 years, and

your letters of recommendation should be dated within a year of submitting your

application.  Finally, in order to avoid banging your head against a rock searching

for the elusive “perfect” clinical experience scenario, you should attempt to gain at

least a basic understanding of how the US medical system works and how

opportunities for clinical experience vary for students vs. graduates as well as the

terminology involved.

The best way to inform yourself by going directly to the source. You should read

the www.ecfmg.org andwww.nrmp.org websites from start to finish, and then you

should be checking it periodically for updates. Also, you will see references to two

studies cited in this article. These studies will help inform you as you plan, and will

answer many of the speculative questions about your chances in different

specialties given your USMLE Step scores and accumulated experience.

There are three main components of the application package that you will submit

Step Exams and ECFMG Certification

US Clinical Experience    Clinical Electives/Externship and Observership as

demonstrated by your CV and Letters of Recommendation

Application upload

In this article, we will not address the USMLE Step Exams or the ECFMG certification

in detail, except in terms of planning your timeline.

“Ideal’ Timeline Flow Chart

As you begin your planning process, or even if you are already in the thick of

preparing your application, we suggest you make a flow chart.  To do this, you will

start with the MATCH date and work backward in time. We will call the year before

the MATCH date your “MATCH Year.”  We will call the year before the “MATCH Year”

your “PREP Year.”  Before that is MEDICAL SCHOOL.  

Starting from the MATCH date (on top), work down and backward in time:

Activity Year Season

MATCH date MATCH Spring

SOAP MATCH Spring

Interviews MATCH Winter and Fall

Networking Observerships MATCH Fall

Application Upload MATCH Fall

Program Research MATCH Summer

USCE Externship Rotations MATCH Summer, Spring, Winter

USMLE exam prep and exams PREP Spring, Winter, Fall, Summer

USCE Hospital RotationsMEDICAL SCHOOL

Final/penultimate years of med school

 

For example, if you are preparing for the 2015 match, your flowchart might look like

this (remember we are working backwards in time and there may be some seasonal

overlap):

Activity Year Season

MATCH date MATCH Spring 2015

SOAP MATCH Spring 2015

Interviews MATCH Winter and Fall 2015/2014

Networking Observerships MATCH Fall 2014

Application Upload MATCH Fall 2014

Program Research MATCH Summer 2014

USCE Externship Rotations MATCH

Summer and Spring, 2014 Winter 2013

USMLE exam prep and exams

PREP Spring 2014, Winter 2014/2013

Fall, Summer 2013

USCE Hospital RotationsMEDICAL SCHOOL

MEDICAL SCHOOL before 2013

 

Application upload is historically in September. By this time you ideally should have

ALL of your components (LORs, fully developed CV and personal statement, Step 1,

Step 2cs and Step2ck, and ECFMG certification, and if possible Step 3).

No matter where you are in your process, but especially if you have already finished

medical school, you will need to adjust this flowchart to fit your own reality. The

point is that in order to make your application as competitive as possible, it is

helpful to start planning early.

Now that I’ve shown you how to design a flow chart based on your own reality and

with the important components, we are going to unpack each one of these steps. 

Here is a little bit of the rationale behind the design of the flow chart.  At this point

we are starting from the beginning of your planning and preparation and moving

forward.

Medical School Period

If you start planning in your last or penultimate year of medical school, you will save

time, money and reduce your anxiety.

While you are still in medical school it is possible to apply for clinical rotations at

some of the U.S. hospitals that offer this opportunity to foreign students. If you have

the time and the money, this is an excellent way to build your CV with hospital-

based US clinical experience. The letters of recommendation you would get at this

time will most likely be too old when you submit your application, but you are doing

it to build your CV at this point, to show hospital experience, and if you are lucky

you will do some networking and get to know people who run the residency

program. At this point in your process there is no need to use a 3 rd party placement

service because you can and should apply directly to the hospitals if you are still

enrolled in medical school

PREP Year

Have a look at this article on page

3. http://www.nrmp.org/data/programresultsbyspecialty2012.pdf

There is a lot of speculation about one’s chances for getting an interview, but as

you can see from this survey of residency program directors, 82% cited the Step 1

score as a factor in deciding to interview.  The Step 1 is the single most important

thing you do to make your application competitive.  Seventy percent of program

directors cited the Step 2 as a factor. This is why I recommend that you dedicate an

entire year to preparing for and taking the Step exams, without distraction.

The exams are SO CRITICAL that we recommend you dedicate an entire year to this.

However, when you make your own flow chart, you will need to consider your own

reality, when the exams are given and where, and other competing factors.

MATCH Year

Choosing your focus

During the MATCH Year, you are going to choose your specialty and do some

research into programs.  It is important to begin to focus at this time.  Consider this

report on the NMRP Results and Data document, specifically the table on page

3.  http://www.nrmp.org/data/resultsanddata2012.pdf

You can get a sense of the number of slots won by international medical graduates

by looking at the “No. of Matches” column and subtracting the number of US

seniors from the total.  For contrast, look internal medicine:

                Total matches:  5226     US seniors took 2941 of those slots. 

                This means that 2285 went to non-US graduates, a full 44%. 

Now for a stark contrast, look at dermatology in PGY1. 

Total matches:  23     US seniors took 22 of those slots.  

Only 95% were filled, so likely that last slot was not filled by a non-US graduates. 

The picture doesn’t get much better for dermatology PGY2.

So when you are deciding which specialty to choose, do the math, consider the

odds, and then try to match that with your passion. It is important to follow your

passion, but it is also important to be realistic as this is a job search, and it is

important to go where the jobs are.

After you make your decision, start to research the programs and you will get a

better idea of the odds and which programs are IMG friendly. Choose one specialty

and stick with it.

US Clinical Experience

At this point you have aced your Step exams and have decided on your specialty. 

While you are researching programs, you need to get US clinical experience. If you

started the planning process early, you may have already done some hospital-based

US clinical rotations while you were in med school. If that is the case, that’s great!

Those were CV-builders.

Now you are continuing to build your CV and on top of that, you are collecting your

letters of recommendation.  As an international medical graduate, you will need to

participate in an externship in order to secure a letter of recommendation.  Your

letters should:

Be written and signed by a physician who is board certified in the specialty area.

Reflect varied and content-rich experience.

State the activities you were involved in during your clinical rotation.  For this

reason it is critical that your letter be based on a hands-on externship, NOT an

observership.

Express an opinion regarding your clinical skills and professionalism.

Reflect a variety of inpatient and outpatient work if possible

Here is where there is a lot of confusion around the mythical “teaching hospital

LOR” that everyone seeks and only a very few find. Assuming that at this point that

you have graduated from medical school and are now what we call an “IMG”

(international medical graduate), getting a clinical rotation in a teaching hospital is

going to be nearly impossible.  The teaching hospitals don’t want you!  The

university teaching hospitals really don’t want you!  Unless your brother-in-law is a

resident or your aunt is a faculty member (and probably not even then), there is no

place for IMGs in teaching hospitals. Don’t waste your money or your energy

banging your head against the wall trying to find something that nearly impossible

to secure as an IMG.  

The best you can do is to work with a physician who is affiliated with a teaching

hospital, and even then, your rounding experience will likely be minimal as the U.S.

health system move more and more towards ambulatory care.

This is one of the reasons why we encourage you to start planning early and do the

hospital-based clinical rotation while you are still in medical school. Even though

your LORs will not be usable (because they are likely to be too old), it looks good on

your CV.

Program Research

While you are doing your externships and collecting your LORs, you can begin your

research in to the programs. We suggest that you make an Excel database, and try

to prioritize them by the likelihood of matching there and other geographical or

personal criteria. If you are five or more years post medical school graduation, you

will have to use that criterion as well and filter out the programs that have this

limitation.

Again, look at this article on page

3. http://www.nrmp.org/data/programresultsbyspecialty2012.pdf.  You will see that

after the Step 1 scores, most program directors are looking at your letters of

recommendation in the specialty (note that it does not mention “teaching hospital”

or inpatient!) and your personal statement in order to decide whether to interview

you or not.  This tells you that they want to see that you are focused and passionate

about the specialty to which you are applying.

Application Upload

Now we are in the summer before the application upload. You should have

thoroughly researched everything you need to know about the application process. 

Here are some tips about preparing your CV and personal statement:

CV:  Download a hard copy of the application and model your CV on it. Many

companies offer CV review services. Absolutely take advantage of this. Remember

these two key points:  your CV should be content-rich and minimally formatted. Go

to the internet and get a list of active verbs and use them (performed, conducted,

supervised, coordinated, etc.). 

Personal Statement:  Your personal statement should be professionally oriented.  In

subsequent articles we will discuss ways to prepare this, but the same advice

applies to the personal statement—content rich, no fluff, focused, and readable.  We

suggest using the standard essay format, and again, use a reviewing service.

The first paragraph should introduce the reader to you and state clearly why you

are the best person for the position.

The body paragraphs develop supporting evidence that ties back to your main

argument. Introduce each idea with a transitional sentence, and stick to each point.

Start by describing how your academic preparation makes you the most qualified

candidate for the residency position, and let the reader know how your academic

preparation helped you arrive at your choice of the specialty.   Dedicate a

paragraph to explaining why you think this choice is right for you, and how you

have prepared yourself experientially. This should include your clinical experience,

as well as research, extracurricular or work experiences that are pertinent. 

Essentially you discuss how your experiences (internship year, US clinical

experience, etc.) make you the most qualified candidate for the residency position. 

Your final body paragraph should inform the reader what you see as your long-term

goals, or how you see yourself in this specialty. And how do your career goals make

you the most qualified candidate for the residency position?

Finally, end with a concluding paragraph.  Here is where you restate why you are

the best candidate for the residency position, add personal comments or anecdotes,

and then close by thanking the committee.

Networking Observerships

After you have uploaded your application, it is time to go back to your list of

programs. Pick the top 5 or 10 and start calling to request an observership. As we

have stated before, it is unlikely that you will get clinical experience at a teaching

hospital, but they may be amenable to having you observe.  You are not doing this

to get LORs, you are not doing this for your CV. You are doing it to know people and

to be known.  With your presence and the people you meet, you will put a face to

your application. It is like a month-long interview.  The timing of this is critical. Any

earlier than August/September/October and they may not remember you. Any later

and they may have already filled the spots.  Start your calling in August.

With all confidence and a little humility, call the program and tell them that you are

applying and very interested in observing for a short time. Call each program every

two weeks. Try to get the name of the person (secretary or administrator) each time

so that when you call back you can address them properly. Be polite, but keep at it.

If any program allows you to do this, drop everything and go. 

The next piece are all the interviews you will get. This is an entire workshop in itself

that discusses the topics to the right of the box. Next fall keep a look out for our

workshop on this.

Interviews

If you are lucky to get invited to an interview, make sure you prepare for it.  Do your

research, know what questions to expect, and practice in front of a mirror or with a

friend.

SOAP

Finally, we come to the end of the process, and that is the SOAP.  The SOAP is a

messy, high-anxiety way of filling the final unfilled spots and it generally takes place

by phone and internet over the course of one week in the spring.  If you did not get

invited to an interview, there is always the SOAP!

 

Remember, planning is key to getting started and staying on track. Before you start,

make sure you have enough time and resources to take you through to the end.

Best of luck to all of you!

Best Medical Residency Programs: List of Top Schools and HospitalsMedical residency programs provide doctors with training in a specialized field of medicine. A

university's medical school may offer residencies in areas such as pediatrics, family medicine,

oncology or urology.

View 5 Popular Schools

Top Medical Residency Programs1. The University of Washington in SeattleThe University of Washington (UW) is a public university that has satellite campuses in Bothell and

Tacoma, in addition to its main campus in Seattle. U.S. News and World Report ranked UW's School of

Medicine eighth on its 2011 list of top pediatrics medical schools. UW offers 92 accredited clinical

fellowship and residency programs in areas such as anesthesiology, psychiatry and pediatrics. In the

3-year pediatric residency, based at Seattle Children's Hospital, students work in the neonatal ICU

(intensive care unit) and the normal newborn nursery, among other areas. In the final year, students

may work as associate chief residents for a 2-month period.

2. The University of North Carolina at Chapel HillThe University of North Carolina at Chapel Hill (UNC) was chartered in 1789 and offers 69 doctorate

degree programs through the College of Arts and Sciences. UNC's medical school offers 54 graduate

medical education programs. U.S. News and World Report ranked UNC's School of Medicine second

on its 2011 list of top institutions for training in family medicine. A 3-year residency training program

is available through the school's Department of Family Medicine. Students provide inpatient care at

UNC's Family Medical Center and outpatient care at the William B. Aycock Family Medicine Building.

Students perform 1-month rotations in emergency medicine, pediatrics and urology, among other

areas. As part of the final year of the residency program, students work in rural practice at the

Chatham County Emergency Department.

3. Johns Hopkins University in Baltimore, MDJohns Hopkins University (JHU) is a research institution that opened its doors in 1876. The Princeton

Review included Johns Hopkins University on its 2012 list of 'The Best 376 Colleges' in the nation.

JHU's School of Medicine offers an internal medicine residency training program through the Johns

Hopkins Bayview Medical Center. The program offers two study programs: a traditional track and a

general internal medicine track. Students in both programs provide care in areas such as cardiology,

rheumatology and endocrinology.

List of Ten Good Medical Residency Programs in the U.S.

School Name Distinction Location

Harvard UniversityHarvard Medical School has 15 researchers who received the Nobel Prize Cambridge, MA

Johns Hopkins UniversityJHU hospital ranked first among all hospitals by U.S. News & World Report 21 years in a row Baltimore, MD

Stanford University Stanford School of Medicine includes five medical institutes Stanford, CA

University of CincinnatiCollege of Medicine offers over 50 residencies and fellowship programs Cincinnati, OH

University of MichiganU.S. News and World Reportranked internal medicine department sixth in 2012 Ann Arbor, MI

University of MinnesotaDepartment of Medicine offers a residency program in internal medicine in dermatology Minneapolis, MN

University of North Carolina at Chapel Hill Medical school has Nobel Laureate professor Chapel Hill, NC

University of Pennsylvania

Among academic medical centers, Penn researchers receive $500M annually from National Institutes of Health - second in the U.S. Philadelphia, PA

University of Washington Teaching programs ranked in top ten by U.S. News and World Seattle, WA

Report

University of Wisconsin, Madison

Department of Medicine offers residency training at three hospitals Madison, WI

Which programs are the most highly regarded

The survey revealed that several postgraduate training programs have well reputed by many physicians. U.S. News identified the 24 programs with the most nominations, ranked by the number of nominations. The top 10 programs listed were:

1. Massachusetts General Hospital in Boston (732 nominations)2. Johns Hopkins Hospital in Baltimore (696)3. Brigham and Women's Hospital in Boston (600)4. University of California in San Francisco (579)5. Mayo Clinic in Rochester, Minn. (297)6. Duke University Hospital in Durham, N.C. (283)7. Washington University/Barnes-Jewish Hospital in St. Louis, Mo. (249)8. University of Pennsylvania in Philadelphia (248)9. New York Presbyterian Hospital (Columbia Campus) in New York (215)10. McGaw Medical Center of Northwestern University in Chicago (201)

Baltimore's Johns Hopkins Hospital reclaimed the No. 1 spot after last year losing a 21-year reign to Boston's Massachusetts General Hospital. In order of rank, the Honor Roll hospitals are:

Rank Hospital Points Specialties

1 Johns Hopkins Hospital, Baltimore 30 15

2 Massachusetts General Hospital, Boston 29 16

3 Mayo Clinic, Rochester, Minn. 29 15

4 Cleveland Clinic 27 14

5 UCLA Medical Center, Los Angeles 19 13

6 Northwestern Memorial Hospital, Chicago 17 12

7New York-Presbyterian University Hospital of Columbia and Cornell, N.Y.

17 10

7 UCSF Medical Center, San Francisco 17 10

9 Brigham and Women's Hospital, Boston 16 10

10 UPMC-University of Pittsburgh Medical Center 15 10

11 Hospital of the University of Pennsylvania, Philadelphia 12 11

12 Duke University Medical Center, Durham, N.C. 12 9

13 Cedars-Sinai Medical Center, Los Angeles 12 8

14 NYU Langone Medical Center, New York 11 8

15Barnes-Jewish Hospital/Washington University, St. Louis

10 9

16 IU Health Academic Health Center, Indianapolis 7 7

17 Thomas Jefferson University Hospital, Philadelphia 7 6

18 University Hospitals Case Medical Center, Cleveland 6 6

I

Being an Oxford Elective Student part I

17.49  medis  No comments

I've just arrived in Indonesia after I finished my Elective program in Oxford, England.

Well, first of all, without a doubt, University of Oxford Medical School is a good-internationally- recognised medical school.

Medicine has been taught in Oxford since 13th century so we can imagine, How good they are to provide teaching in this area. and We rarely heard Indonesian studies in Oxford Medical School, albeit when I "declared" that I took my Elective in Oxford, Many people got impressed, amazed, even jealous about this special "infrequent" privilige to study medicine in Oxford like I got.

It actually started when my good friend, Dr. Oliver Quick invited me to come to his teaching hospital in Keele, Stoke on trent, UK. And because his invitation,I became wondered, whether there is an opportunity to be trained in highly-ranked international medical school like Harvard or Oxford. Then I started searching.

Harvard automatically were not my choices anymore when I read that you have to pay tuition fee USD 3500/month. But I become interested with Oxford because Oxford promised : not only their training is completely free, but they also stated that we have similar privilege with Oxford student. the program itself is highly competitive since Oxford only takes 50 persons worlwide per year to got accepted in this program ( compare with Harvard which accept 1000persons/year). So instead of applying to Keele ( or Harvard), I decided to apply to Oxford for Elective program.

I began to prepare all the requirements. TOEFL, Letters of recommendation ( I got from 2 proffesors in my medical school and also I attached letter from my boss in World Health Organization(WHO) when I worked with them),CV, transcript of academic, and writing an essay. My friend, Oliver were "insanely" really nice. not only he corrected my essay ( so it sounds more "British") but he also kindly offered to bring along all the documents to England so he could posted them from Keele to Oxford. it easier and cheaper. Huge gratitude for him.

Then, I got an email from Mrs. Carolyn Cook, Elective Coordinator in University of Oxford Medical school.She happily informed me that Oxford University already secured one place for me to able to be trained and study as an Oxford Elective student. but there is one issue.

Though Oxford didn't charged me for tuition fee, but Oxford can not provide financial assistance for airfare,living cost and UK Tier-4 visa ( which ridiculously very expensive). The invitation letter from Oxford University came, right before I would like to leave for Germany for IFMSA Professional exchange, my school program. These package from Oxford University remained untouched until I came back from Germany.

Then I started to think for searching scholarship. My medical school, Faculty of Medicine, Andalas University, indeed provides international travel grants for students. But since I just took international clinical rotation in Germany ( which I fully financially supported by my med school and Germany). I must be very greedy, if I took this grant for second time. So I started looking for scholarship from outside. I applied a proposal to Higher Education directorate (DIKTI) for scholarship. Then I got phone call from them for interview particularly about this program and how I got accepted in Oxford. Lucky me, and I am so grateful that Oxford has a good reputation, I got full scholarship from DIKTI based on HPEQ scheme!

Actually, HPEQ doesnt have a particular scheme for this program, but because this is Oxford university, they have willing to change the scheme, so it will fit to HPEQ program, only because

it is Oxford. Despite they entailed more time to procceed, but eventually they commited to cover all the expenses .Very many thanks HPEQ and DIKTI!

Before departure, I was very busy with my final obligations in my medical school. Finishing my clinical rotations, preparing for national exam (UKDI). After I finished all obligations, I flew to United Kingdom for the first time to come to Oxford as a student, financially supported by DIKTI.

Anyway, I forgot to mention about how difficult I was before to get UK Tier 4 visa. I have to fly to Bali only to give my visa application because I hardly got an appointment in visa application centre in Jakarta. Moreover, my documents must be sent to UK embassy in Bangkok,ect. The proccess itself in my opinion is really tiring,time and money-consuming,and completely "bureaucrazy". Well, if you are non EEU or UK citizen, and have plan to apply for elective in Oxford, you MUST always thoroughly ponder visa application as your priority because in my academic year in Oxford, there is an elective student who must cancelled his coming to UK due to his visa is declined by United Kingdom Border Agency (UKBA)

But, because this visa hurdles, I felt how professional Oxford is for managing and maintaining its students. I got extremely a quick-rapid-fast response from Oxford medical school and also University. They contacted all authorities (UK embassy in Jakarta,UKBA manager in London,ect) they have to speed up my application proccess. They always assist their student and dont let their student to cope their problem alone. No wonder they got a prestigious reputation as a world class university.

then, finally I got UK visa.I distinctly remember ; I flew on Thursday from Jakarta in the early morning by Emirates. Stopped by in Dubai. I took my times there to have lunch in Restaurant and enjoying Dubai International airport : One of the luxurious airport in the world, they claimed. Funny, I met many Indonesian workers there, and Indonesian languange are easily heard there. Then I took second flight directly to Heathrow Airport, London.

Arriving in London for the first time was such a holly-gracely-cultural experience for me. I guess it is because I raised with many British Cultures ; famous five and all Enid Blyton Novels, Sherlock Holmes, The Beatles, Adele, One Direction. I remember I always said that one of cities that I want to visit before I die is London. And now dream comes true.

When I arrived in Heathrow,London,I think Heathrow airport is pretty similar like Schiphol airport in Amsterdam (I visited Amsterdam last spring). Huge, busy, but well-organized. When I wanted to pass UK border in Heathrow, due to having bad experience with UKBA and their bureaucracy, I prepared all the stuff I need. CAS, passport,insurance, even I brought all my hard documents in my bacpack, in case UKBA ask for that. I dont want to be a "double-checked-person". But no, my fear is not coming. Even the officer lady commended me for arranging all stuff very organized so it made the checking easier.

I took my luggage, took cash money from ATM (I only brought few pounds from Indonesia), and directly went to bus station in Heathrow. Many Indonesians and foreigners always think that Oxford University is only a university which located London. no, it is wrong. University of

Oxford located in Oxford city, the old ancient city, one hour from London by bus. I drove to Oxford which X90 bus and I arrived safely in Oxford, stopped by in Headington Shop, a shopping centre in Headington hill, a place where John Radcliffe Hospital ( JR Hospital) and Oxford Clinical Medical School located. All shops were closed since it was already 9 pm, but because it is summer in England, The Sun still there. I called a taxi to JR Hospital ( only 6 pounds), took my flat key in main receptions, and pulled my massively huge luggage to my flat. I am extremely exhausted with long flight, so even outside still was eventide, and without changing clothes, I quickly hit the hay. Tomorrow I have to meet Carolyn for my orientation.

To be continued...

Being an Oxford Elective Student part II

00.22  medis  No comments

"What is an Elective Program?"

Many, Many friends and colleguaes of me asked about that. They heard about me studying in Oxford, and many people would like to follow my step. I can say I am the first pioneer of person from my university ( or Indonesia?) to

study medicine in Oxford and join this program. Some people ( who did not understand ) considered me going to UK only for traveling ( since I really like to explore foreign country). But I took this program for some reasons.

I understand "Elective" is not part of Indonesian medical education system. But it is a compulsary program for developed country (like United States,United Kingdom,ect) doctors before taking residency/housemanship. It is part of curriculum. So if I someday, want to be enrolled as a resident doctor in those countries, I should -at least- have had an Elective Program in my medical education history.

Taking residency abroad always be one of my choices. Residency in Indonesia is a bloody hell

crazy system. You work in hospital more than 100 hours/week, 2-4 night shifts in a row, 32hours straight working hours, but you dont get paid by hospital. in fact you have to PAY to hospital. It is a forced-labor-system made by government. Moreover, we should talk about a daft junior-senior relationships. You literally dont have life outside hospital.Ridiculously, it is 180degree different in another country. Resident doctor is paid job, and the working hours is more friendly.

Well, eventhough I dont really like those Indonesian system, but actually I havent decided yet whether taking residency in Indonesia or not,because living outside Indonesia forever is not also my intention. I always want to go back to my home country. But well let it be one of my choices. And knowing that I have another option is really soothing.

Having an Elective programme is very necessary for someone who intend to take residency outside Indonesia. I have friend who now struggling to get residency in US, but he havent taken Electives. Now he desperately need them because he already graduated as a doctor long time ago. He now tried to get an "observeship" program instead of elective program in rural hospital in US. He has to pay alot of money for getting into the program eventhough actually observeship is way less appreciate than elective in terms of residency. It is because only few indonesian medical student know how important elective program is, but it was extremely late for them when they finally realize about that. The programme is also important to get LoR (Letter of Recommendation) from professor or supervisor. A good LoR from supervisor in good institution will definitely boost you Curriculum Vitae (CV).

It is also important for Indonesian medical students to take Elective at the end of his/her final year or before he/she join internship program. It is because ,there are alot of bursaries and travel grants offered by ministry of education for us, and it can only be accessed when you apply as a medical student. I applied DIKTI scholarship when I was a student, though I went to Oxford after finishing all rotations in Indonesia and passing national exam (UKDI). Most medical schools also only offer you an Elective placement when you applied as a medical student, hence, it is likely very important for Indonesian medical student to aware more about elective and searching which med school is best for their elective and apply as soon as possible, if they have a plan to take residency abroad.

University of Oxford Elective program itself, I admit, is undoubtedly very excellent. I will tell why I choose Oxford as my elective placement in the next chapter...

To be continued...

Being an Oxford Elective Student part III

18.32  medis  No comments

So, Why I decide Oxford ?

Well, first of All. it is Oxford. Without telling any word,everyone already know about Oxford.

but, to put it very bluntly, at the first time, my reason why I chose Oxford over its rivals ( Harvard or Cambridge) is simply because it

is completely free. Like I posted before, Harvard charged you approximately USD 3500/month (totally ridiculuos), Cambridge charged 250+900 pounds for administration+accomodation fee. You could compare among them.

But free of charge is not enough for Oxford. They offer ; not only you will get opportunities to be trained in one of the best and greatest NHS teaching hospital in United Kingdom, but you will also get similar privilege as local Oxford students.

As an elective student, you will get your own College ( Green Templeton College), which is a good way to feel "Oxford vibrant". You will also can attend so many journal readings, lectures from many internationally-recognized proffesors from the best institution around the world, and get involved with a new-sophisticated treatment for patient. after finishing your Elective in Oxford, you could also be enrolled as a member in Oxford Medical Alumni (OMA) ( but you have to pay small amount of pounds for member's fee).

You will get a University Card which is very useful to visit many Colleges, Chapel, botanical garden, library, and museum which belongs to Oxford University , FREE of charge ( people usually have to pay each, if they want to visit them).

And those reason ensured me to apply for elective in University of Oxford. I knew this program is highly competitive. Oxford only accepts few students per year, but this program is irresistable.

But I must admit : University of Oxford Elective Program is very outstanding and excellent program. I did Proffesional Exchange in Germany last year, so I have comparison to work in developed country hospital, but Oxford is beyond. Beyond my expectation ,beyond all the things.

The program is very well-organized, and they managed this program very seriously.

On my first day, Mrs.Carolyn Cook, The Oxford Medical School Elective Coordinator brought me to JR hospital, the place where I have to work and study during my Elective. she explained every single details. Furthermore, she gave me all stuffs that I probably need, hospital map, university card, security card ( so I can open the doors in my department in JR Hospital) ect. And she was almost available every time I need during my Elective.

I also met my supervisor, Dr. Paul Greig, an anaesthetist consultant. He was the one who open his door for me and made a cup of coffe on my first meeting. He discussed with me about my learning objectives ( I should give my objectives to Oxford Medical School before , what I want to learn,what I want to see) during my Electives. It is very rare because in Indonesia, No consultant would like to discuss " what student want to learn" to students. It is about compulsory lesson.

After he discussed my objectives, he arranged my timetable so I can get as many opprtunity as I can so I could fulfill my objectives. He then gave me the timetable, and once again, he brought me to see JR hospital, the OR,the ER, the scrub room,the changing room. Then we discussed again about anaesthetics. He also give me timetable for lecture and tutorial during my Elective.

What I really like about Elective in Oxford, their program is really well-organized. they never really let Elective student alone without nothing to do. There is always learning opportunity for elective student to enhance their knowledge and skills. And it is not just observeship program. they do let Elective students to have clinical exposure with many patients as much as They can. I did many intubations, IV cannula, putting LMA, all clinical skills. They emphasized also on basic sciences. every little thing we do in medicine has science reason on basis.

Oxford is also has an International environment. It seems like many people from every parts of the world study in Oxford. I remember, when I had formal dinner in my college, in my table, there are many various nations ; Indonesia,Malta, Australia, United States,Greece,China, Taiwan,Korea,Japan, India, Germany ect and we came from different background and different field of study. I know this is because my college is for Graduate Student and,most graduate student are non- UK citizen, but I like the international vibrant in Oxford.

Oxford city itself is simply beautiful. Many ancient buildings with long history along with UK beautiful scenery make Oxford as the city of dreaming spires. Some people considered Oxford people are typically-British-elite. They speak British English Received Pronunciation (RP), they talk in advanced vocabulary. Sometimes it is true, but beyond of that, Oxford is one of the best cities in United Kingdom, and it is a good place to learn English Culture and History.

Being an Oxford Elective Student, indoubtedly is an honour.

It is recommended program and every people should always consider to apply into this program...

Germany : the best country in the Western Europe? ; A perspective from an Indonesian

23.06  Opini  No comments

First of all, this is obviously only one opinion from an Indonesia guy. It wont affect any rank or any statistic

regarding which country is the greatest,the most powerful,the richest or the best in The Western Europe.

It was only my personal opinion toward this country : Germany. 

I stayed in Germany in the late Winter and Spring 2012. I worked as a Famulant ( German: junior doctor/clinical student) in Universitaetsklinikum Essen, North-Rhine Westfalen. I shared Wohnung ( German : flat/apartment) with a German doctor and a German student. I've visited not only the big cities like Berlin,Munchen,or Frankfurt, bu also suburban area and small cities like Aachen,Lübeck,ect. I was also very fortunate to be able to be invited by Native conservative German family to celebrate Easter ( their big holiday) during that time. Hence, I consider that I've already had some experiences and perspectives about the real Germany and how the people actually lives. I've already also traveled to and stayed in several countries in Europe ( France, Belgium, Netherland, United Kingdom and Austria) to be a comparison.

Dont get me wrong. I wrote this without any intention to make other countries less than Germany. I was raised with British pop cultures influences, Paris will always be my favourite city (till now), and I always ordain Salzburg,Austria as the most romantic city in Europe. And Clearly, it is only my opinion without referred to reliable sources. I do not know in statistics whether Germany's performance is better than any others country in Europe or not, but for me, Germany is my favourite country. Well,I guess, because their NAZI history ( Deutschland uber Alles!), they are inclined to not mentioning their achievements and proclaiming their country to be the best ( though I believe they noticed that their country is one of the most powerful in the world). But,there are several point that makes me pondering that Germany is one of ( If we can not say the most) the best countries in Europe (or particularly in Western region).

1. Public Transportation

Are you familiar with DB (Deutsche Bahn)? ICE or RE? U bahn or S bahn? Yes.and I was always amazed with Germany's national public transportation system.

So what is the differences? England already has National Express and Nationalrail or Britrail and they're quite good. France has TGV ( fastest train) and it is obviously excellent. Netherland has its Nederlandse Spoorwegen (NS). All of them are great. But What I was amazed from Germany in comparison to other countries is, the system is really and extremely integrated into one national system with same high standard with (almost) similar terms and conditions. There is only very slight distinction among 16 states (Germany is federal country), but overall it is similar whether you are in Kiel,Aachen,Frankfurt,Stuttgart,or Dresden. The choice is always ICE or RE ( city to city)? S bahn, U bahn,or bus (inter city) ? With same sign,same rules,same prices. Their train system unites Germany and connects every cities there. This integrated national system is notably very helpful for foreigner like me because it is easy to understand. You dont have to hire a guide, purchase a travel agent packages, if you want to travel in Germany. You dont have to confuse about choosing which modality or which kind of bus you take because it is similar in every part of Germany. You dont have to read many terms and conditions. The great thing about germany, is the goverment are clearly invested massively for public transportation and take lead. private sector were not really involved in this bussiness so there is no unnecessary competition and the price for public transportation is very affordable. Another great thing, The timetable for every public transportation in Germany are precisely very punctual and can be accessed on the internet. You can save alot of time.

I also love the concept of one-stop-services of "hauptbahnhof" (main central station) where every modalities transportation ( bus,train,taxi,subway) station are located into one spot (usually in city centre/touristic site and with so many shops/mall/hotel/parkinglot there).the hauptbahnhof are usually located in downtown, so it is quite easy to hang around. 

If you want to reduce your costs for transportation during traveling in Germany, you can always share ticket with Gruppen ticket, or traveling during weekend, or have experience of "Mitfahrengelenheit" (you rode in with stranger car but only pay for the shared cost of petrol)

2. People, Languange and Living Cost

"Was ist der typisch Deutsch? 1.Ordnung 2.Pünktlichkeit 3.Diszipliniert 4.Kalt 5.Unnahbar"

What's typical German? 1.Everything in order 2.punctuality 3.Discipline 4.Cold 5.unapproachable

Those are some stereotypes for German people. But like every other stereotypes, sometimes it's right, sometimes it's wrong. But from my experiences, German people are (more or less) is nice people.I particularly amazed with their attention with details. Just try to ask something (even just casual question like a direction to a street that you dont know) and they will give you every detail. They will draw you sketch and everything, and it is exquisite how crazy they are for detail.About the Language. Ok, German is hard. Even when you already studied German in high school (like me), but when you speak with native German, you hardly understand what they actually talk. But the good news is most of them can speak English, and WILLING to speak English. They tend to accept that English is our lingua franca in this world ( because the history of British Empire) and wont force foreigner to speak German (though preferably if you could speak in German, it is a great plus). It is not like when I was in Paris, and there is a man who forced me to speak French "this is Paris, this is not London.Please speak French". But,still I Love Paris :D

Living cost.This is what I like from Germany, the living costs are ridiculously cheap in comparison with others developed country. You can buy Döner (Turkish-German hamburger) for 3-4 euros (3,5-4,5 dollars) and for Asian like me, the portion of one Döner is for two portion meals. During my night shift in hospital, I usually eat half Döner for dinner and eat another half for breakfast. For students, there is semester ticket which you can purchased for 200euros/terms and it is valid for almost every transportation in whole area of the state (you can imagine, like in Northrhine westfalen, you could travel from Aachen to Dusseldorf,from Essen to Münster). To be a comparison. DAAD (Deutsche Akademischer Austauch Dienst/ German Academic Exchange services) gives annual scholarship for scholars with 750euros/month. It is sufficiently enough for living cost in whole parts of Germany, But UKBA (United Kingdom Border Agency) will only issued UK Tier 4 visa (student visa) if the applicant showed there is a financial ability to support them 1.000 poundsterling/month (outside london) and 1200pounds/month for London. 750 euros compare with 1000poundsfor living cost, you see the difference,right?

One of my friends from Jakarta who studied Engineering in Essen Germany told me that his living cost in Essen were lower than his cost in Jakarta,Indonesia. gobsmacked? Yeah, I am.

3.Education

 Education is one of great points for Germany. They offer very high standard of education for FREE. There are several states in germany who charge a little tuition fee but still it is quite cheap. No matter you are native,local, foreigner, white,black,asian,atheist,muslim,christian, but as long as you want to learn and pass the exam, then you got education as high as you want and you can. This affordability would not reduce their standard, in fact their universities were still in highest rank in the best world university.

The affordability of German Education attracts so many students around the world including Indonesians. In Germany, it easy to find Indonesian students (another great point). Germany is different with some fellas in western europe who charged foreign student very greedy like " Ok, you are from third world country and want to study abroad,you must be INSANELY rich. Let's suck your money and bank deposit"

5. Cultures

France are very well known for French Food (and also...french kiss). British? Ok, Dont ask me about British cultures,because I am so infatuated with Brits! And when Britons speak with their accent as well. Germany Cultures are less popular than Germany BMW or German team soccer but they do have great culture!"pommes und currywurst" would not beat the popularity of "Boeuf bourguignon" and they will not ever beat English for their accent but Germany has another thing to explore.

I recalled when I visited Bayern (Bavaria) I see alot of native german cultures there. I was invited to Easter tradition celebration in Munchen with my friend (Native German) and it was very exciting! and then I realized, Germany is very rich for their cultures. And we should remember in the early days, English and Dutch are actually German inherited. With the Prussian Empire and Old Romanic Empire history in Germany, we could see, this nation has already went through hardship and another hardship before they achieved like these days.

And there are so many points why I love this country. From Germany, I could learn some lessons how to develop your country (remember, Germany starts from a scratch after World War II) and with their perseverance, they become one of the remarkable developed countries in the world. Such a great Job!And now, after I leave this country, there is always a piece of my heart that I already left in Germany. Ich hab mein Herz in Deutschland verlosen! And (if I could), I defenitely will come back someday to this country to make such a sweet-walk-to-remember!

Ich immer vermisse Deutschland!

Preparing for USMLE in Australia: my experienceDiscussion in 'Australasia and Oceania' started by Pollux, Jan 27, 2009.

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Hi,

I'm currently a 4th year student at UQ. I took the step 1 in December, and got my score last Wednesday. I am extremely happy about my hard-earned score of 276/99, and would like to share my experience with other medical students studying for this exam in Australia.

Compared my classmates, I had to spend a significant amount of time on the side to study for this exam, as the Australian medical curriculum does not place a lot of emphasis on basic sciences education. The course covers very little biochemistry, pharmacology, and microbiology, so I spent extra effort studying for these subjects. I generally don't find lectures useful in med school, and the greatest piece of advice I've received regarding lectures is to attend them selectively. I spent a lot of time in second year studying at home as opposed to going to lectures, and I was able to get through resources fairly efficiently at my own pace. I also joined a USMLE study group at the beginning of second year, where a group of my friends would spend an afternoon every Saturday to go over materials that are frequently tested on the USMLE, especially the subjects mentioned above. Each person would be assigned a topic, prepare for it during the week, and give a brief talk on the topic on the following Saturday. I found the study group very helpful in getting me motivated to study for this exam.

I initially intended to sit the exam at the beginning of third year, so I spent a month studying after second year was over. At the end of the month, I didn't feel quite ready and decided to postpone my exam till the end of third year, thinking that I would have plenty of time to study during the clinical rotations. Wrong. I only had some time during my rural rotation and psychiatry rotation to study for USMLE, but could only manage to do 1-2hr/day on weekdays and up to 8hr/day on weekends. At the end of third year, I spent a month studying hardcore again, and finally took the exam on the 26th of December.

I've posted my experience in exam preparation below; feel free to PM me if you have any questions regarding my preparation. However, I'd be grateful if you could read the Q&A section

first before you PM me, just in case I have already answered it.

=====================

Initial goal: 250+Total prep time: 1000 hours.

IMG at an Australian medical school (UQ); MCAT=38NBME 1: 258 (9 months out)NBME 2: 261 (2 months out)NBME 6: 262 (25 days out)UW 1: 265+ (15 days out)NBME 3: 265+ (8 days out)NBME 4: 265+ (6 days out)UW 2: 265+ (4 days out)NBME 5: 265+ (2 days out)USMLE CD: 96% (1 day out)

I did over 10000 USMLE-style practice exam questions in the following order:USMLERx: 94%Kaplan Qbank: 91%First Aid Q&A step 1: 93%UW: 88% (Random, unused, first time through)Plus NBME + UW exams + USMLE CD + RR Goljan...

Prep material:FA of course!! I read it cover-to-cover 3 times. However, I tend to cross-reference it when I read other books and I frequently consulted it during second year during PBL. I also annotated notes in FA when I did UW, so I was very familar with the content of this book. For every diagram/table/metabolic pathway in FA, I made sure that they were familiar to the point that I was able to to reproduce them from memory.Anatomy: Kaplan notes & Kaplan webprep, USMLE Road Map Anatomy, HY Neuroanatomy. Behavioural science: Kaplan notes & Kaplan webprep. Biochemistry: Kaplan notes & Kaplan webprep.Cell biology: HY Cell and molecular biology.Microbiology: Kaplan notes & Kaplan webprep, Micro Made Ridiculously Simple, MicroCards.Immunology: Kaplan notes & FA.Pharmacology: Kaplan notes & Kaplan webprep, HY Pharm, Pharmacology Flash Cards (Brenner).Physiology: Kaplan notes, BRS Physiology.Pathology: BRS Pathology, Goljan audio, Goljan notes.

Preparation timeline:

During second year - Read BRS Pathology and pretty much memorized the book. I love pathology so it wasn't really a daunting task for me. I also started listening to Goljan audios in

first year and I was really glad that I started early. I finished Goljan audios at least three times, but I always felt that I learned something new each time.

December 2007 - Finished reading Kaplan notes (all subjects except Path) and Goljan notes for Path. 8-10hr/day. (300hr)

Jan - Nov 2008 - On and off. I did NBME1 in March and got 258(720) and was pretty happy that reading Kaplan notes paid off. However, I had only about 4 months during this time (rural and psych) where I could fit USMLE studying into my schedule, but could only manage to study about 25 hours a week. During this time, I read the supplementary material (HY, Road Map, flash cards), listened to Kaplan webprep while commuting, and did the majority of the practice questions. (400hr)

December 2008 - Did most of the NBMEs and UW assessment exams in this month. Completed UW question bank for the second time. Spent the last week just memorizing FA and doing practice questions. 8-10hr/day. (300hr)

Exam experience on 2008/12/26:

I started the exam at 8:30 and finished at 4:00 with 20 minutes of break time to spare. On average, I spent 45 minutes in each block and took a 20-minute break after each block (except the first block). During each break, I would drink 300mL of oolong tea or green tea to keep me awake, eat half a sandwich, go to the washroom, and wash my face so I felt refreshed and ready to tackle the next block. I thought the strategy worked quite well for me.

I thought the exam was quite a bit harder than NBME but easier than UW. It was probably comparable to UW self-assessment exams in terms of difficulty. I marked 6-7 questions each block. I thought 85% of the questions was straight-forward, 10% was tricky, and 5% was difficult.

Pathology: Not surprisingly the bulk of the exam. Around 70% of the questions were patholgy questions or required pathology integration. I thought UW covered these sorts of questions really well, so there weren't really any surprises for me. I only had around 5 questions that came with pictures of gross pathology specimens.

Anatomy/neuroanatomy: 15 questions. Most of them involved intepretation of X-rays/CT/MRIs, nothing too obscure. I even had brain CT and angiograms for structure identification. Make sure you know the brain stem and cranial nerves well.

Behavioral science: 20 questions. Half were biostatistics, and the other half were the typical "what would be the best action/response in this scenario" type of questions. I thought just reading FA or Kaplan notes was not really sufficient to answer these sorts of questions. I had almost no questions that came out of the psychiatry section in FA, except a few psychotropic

medications and a question on defense mechanisms.

Biochemistry/Cell bio/Molecular bio: Geez, I noticed the trend of increasing proportions of cell biology questions in the NBME, but I never expected this many on my exam. I probably had 50 questions that fell into this category (Biochem/Cell bio). I was glad that I flipped through HY Cell and Molecular biology just a few days before the exam, because it probably helped me answer 5 questions correctly. The different kinds of receptors and intracellular signalling pathways are extremely high-yield. For metabolism, know the key regulatory enzymes and global control of metabolic processes (i.e. insulin vs glucagon's effects).

Pharmacology: Around 25 questions. Piece of cake compared to UW. I thought FA covers pharmacology in sufficient details. As usual, emphasis was placed on autonomic pharmacology and cardiovascular medications. I had quite a few questions on pharmacodynamics too.

Microbiology: 30 questions. Make sure you know the various bacterial exotoxins and their mechanisms of action. Quite a few questions involved TB and HIV. Even West Nile virus appeared on my exam.

Physiology: 30 questions. Most involved the up/down arrows and graph interpretation. Endocrine questions are high-yield too.

I walked out of the testing centre feeling quite confident I did pretty well. I was certain I broke 260, but wasn't too sure if I was able to get 270+. Got the score last Wednesday, 276/99! I didn't

even know it was possible! Needless to say, I was ecstatic!!

=====================

I've also compiled a Q&A from the emails and PMs I've received since last Wednesday. I'd like to thank those who emailed or PMed me and also their permission to post these questions up. I hope this answers more questions regarding my exam preparation.

Learning Resources:

Q: What edition of Kaplan notes did you use, and did you use the accompanying videos?A: I used Kaplan notes 2004 edition. I was running out of time toward the end of my preparation so I didn't use the videos.

Q: Did the Kaplan webprep audios make a big difference where the lecture notes are concerned?A: I wouldn't say the webprep audios were essential, but they certainly helped solidify many

important concepts, especially for biochem and pharm. If time is a factor for your preparation, I would suggest doing the webprep audios only after you finish reading the lecture notes.

Q: First Aid – how much does it cover?A: FA covered about 80% of the material on my exam, so I would definitely recommend using it as the primary resource the week before the exam. I went over the rapid review section at the end of FA the night before the exam date, and I found it quite helpful as a last-minute review.

Q: Do you think the lecture notes for biochem are okay to use without the videos?A: I think the lecture notes for biochem are adequate to be used on its own; I didn't use Kaplan videos so couldn't comment on them. However, I would highly recommend listening to webprep for biochem. Dr. Raymon is just simply amazing; he does an excellent job integrating pathology, pharm, and biochem. However, it is still of utmost importance to memorize all the tables/diagrams/metabolic pathways in the biochem section of FA. I think it really ties the information together nicely toward the end of the preparation.

Q: For Pharmacology, do you think studying FA is enough?A: I think FA is enough for Pharm, provided that you know the mechanisms of the drugs well. I found it quite difficult to memorize the list of clinical uses and side effects without having a solid understanding of the mechanisms, so I chose to do Kaplan notes before tackling FA, and it certainly made those things easier to memorize.

Q: Did you like the Pharmacology flash cards you used or were they too detailed?A: I liked the flash cards, they are handy to carry around if you want to study them on the bus or during a boring lecture. It can also be conveniently used to quiz yourself, with the drug's generic name and trade name on one side, and the list of drug class, mechanism, clinical uses, side effects, route of metabolism on the other side. I don't think they are overly detailed.

Q: Despite reading Microbiology Made Ridiculously Simple over again, I am still missing tons of micro questions. I dont feel like there is anyway to "master" these questions cause they often test trivia that while I know I read, I just cant recall on the spot. Although, I do think my main problem here is focusing too much on MRS and not on FA.A: I agree with you that using FA to supplement MRS would be very helpful. It's a good idea to start with MRS in the beginning of your preparation, but toward the end, the tables in MRS and the charts in FA are the way to go. A heavy amount of rote memorization is required to master Microbiology, that's for sure. I would encourage you to focus on the classifications and lab algorithms first before you start memorizing the rest of the minutiae. (Remember: Big pictures first!) The gram positive and negative lab algorithms in FA are gold. Pay close attention to the bacterial exotoxins as well, because they frequently appear on the exam. Make sure you know these like the back of your hand. For virology, use the mnemoics in Kaplan notes to remember the DNA, +RNA, and -RNA viruses.

Q: You mentioned that kaplan and FA were not enough for behavioural and biostat questions. Any suggestion what shall I go for to cover that?A: A lot of my friends liked HY behavioural and biostats a lot, but I have only read the first few chapters of HY BS so I can't really comment on them. I didn't like Kaplan and FA because they focused too much on the psychiatric disorders, and not so much on the "best response/action" scenario type of questions. The practice questions from UW and NBME are very good though, and I would recommend doing as many questions like those as you can, so you're familiar with the concepts. Sorry to confuse you, but for biostats, I think FA is quite sufficient, but make sure you are comfortable doing those calculations and drawing those 2x2 tables. Doing lots of biostats questions will definitely help solidify the concepts.

Q: How much do you get through a day and how do you retain that information? One of my problems is that I get through maybe 30 pages of Kaplan Biochem notes a day, and at the end of the day, while I retain the information, I find that I really didnt learn that much. Furthermore more, I tend to forget things as I go. When I do questions later on on the same subject, I forgot much of what I learned maybe 2 weeks ago.A: Don't worry too much about having to retain everything in Kaplan notes, it's impossible and often unnecessary to try to remember some of the details. I think the primary purpose of reading Kaplan notes is to help you understand FA later on so you can memorize the facts in FA with better ease. What types of questions are you getting wrong, are they questions that require straight fact-recall or ones that require you to apply a concept? If it's the former, I wouldn't worry too much about Kaplan notes and would probably spend more time studying FA instead; for the latter, you do have to make sure you comprehend the info in Kaplan notes before moving on to FA.Another thing I found helpful was to read the corresponding section in FA after finishing a subject in Kaplan notes. It helps solidify information right away.

Q: How many pages of FA and kaplan notes can you get through in a day?A: I set goals to get through 100 to 120 pages of Kaplan notes every day, at the speed of 12-15 pages per hour. It depends on the subject too; anatomy and biochem were slower, whereas physiology and pharm were faster because I had done BRS physiology and Pharmacology flash cards already. I could read around 60 - 80 pages of FA in a day toward the end of the preparation, but when I first started, it was painfully slow. I could remember spending an entire day just studying the embryology section, which was only a few pages long but very memory-intensive. But once you start remembering the mnemonics and are familiar with the content, the speed goes up quite quickly.

Question banks:

Q: Did you do questions after each subject during your initial read, or did you skip questions altogether until after you completed your first read?

A: Thanks for raising this point as I probably didn't make it very clear in my post. I started doing questions after reading all of Kaplan notes, BRS path and phys, Goljan notes, and most HY books that I mentioned. The only book that I was still reading after I started doing questions was FA.

Q: When you say you did 10000 questions, do you include the book questions or any other questions?A: I only counted the questions in USMLE format. UW (2000) + Kaplan practice tests (2000) + Kaplan Q-bank (2000) + FA Q&A (1000) + USMLERx (did ~2000) + NBME 1-6 (1200) + UW self-assessment 1&2 (400) + Goljan RR Path questions (100) = 10700I didn't count BRS questions or questions in Kaplan notes because they were not always in board format.

Q: Did you do robbins review of path? Was USMLERX useful?A: I didn't do Robbins, and I wouldn't recommend it either. USMLERx was okay in terms of helping me memorize some details that I wouldn't have paid attention to in FA, because this Q-bank is basically based on the material in FA.

Q: Would you say that a particular question bank or all the 3 question banks that you did do cover all the usmle questions (=subject matter) that you were asked?A: I would say UW was the most high-yield of them all. USMLERx and Kaplan Q-bank have been known to test minutiae that are not necessarily high-yield info. These 3 question banks combined definitely covered more than any one of them alone. As I mentioned in my post, only 5% of questions on my exam were things I had never encountered before, so doing tons of questions was certainly helpful for me.

Q: I am dedicating a solid 8 hours everyday to question banks (I time myself), but my scores are not improving. What can I do?A: I would recommend going over the explanations in more detail, making sure you really understand what the question is asking. Don't skip the explanation for questions you answered correctly; you can learn a lot by reading about why the other choices are wrong. It can take a very long time when you first start doing it this way, but after a while, if you learn from your mistakes, you will not get the same type of question wrong again. When I first started doing questions, it often took me 40 minutes to do 50 questions, but an hour to read the explanations and annotate notes into FA. However, I learned a lot from the explanations in UW, probably just as much as the questions themselves. It's easy to feel frustrated when you first start, but with time, I'm sure your accuracy rate will improve. Good luck.

Q: I am quite frustrated with questions that test minutia details, e.g. "Which of the following can be found in bacterial endospores?" (Answer is dipicolinic acid) I had never seen anything like that and I had to flip through pubmed to get the answer. Are these questions worth remembering?

A: I'm not trying to discourage you here; although dipicolinic acid is probably a trivia type question, it was actually mentioned twice in FA, so I'd actually still remember it. Sometimes the strategy is to eliminate the other answer choices if you couldn't recognize the right answer. For example, if other choices are peptidoglycan and mycolic acid, you know they just can't be right.

Q: What did you annotate into first aid? Only qbank questions? I find some of the Micro Qbank questions extremely tedious and testing pHD like material. How can I tell if its important? Or is it all completely important?A: I only annotate information that I consider "high-yield". As you do more questions, you'll soon know what types of questions tend to show up over and over again; these are the ones that are high-yield. Take Micro for example, they often give you a clinical presentation of an infectious disease, then ask you for the most appropriate antibiotics. These require a two-step process (Presentation - Bug - Antibiotics), and are guaranteed to be on exam. If they want to be mean, they can ask you about the side effect of the most common antibiotics used. These questions require a three-step process (Presentation - Bug - Antibiotics - Side effects), and are less common than the type of questions above. Things that aid in the laboratory diagnosis or things that have to do with treatment (for example, HIV gene products and antiviral drugs that target these products) are also extremely high-yield. Ignore the weird trivia type of questions that have no clinical correlation. I agree that Micro Qbank questions can sometimes be a bit annoying, but that doesn't mean the real exam is like that. I found that FA covers > 90% of the Micro questions on my exam, so make sure you know FA well and don't get too discouraged by the low-yield questions.

Q: About doing usmleworld 2X: did you find that helpful even though you already did the same questions once?A: I did UW again one month apart. I don't think there's much benefit doing it again right after you finish it first time through, but a month gives you enough time to test if you really understand the materials tested, and not because you memorized the questions and answers. For me, the second time helped me increase my speed as I was more comfortable dealing with long question stems (but that could be an effect of having seen the questions before as well).

Q: When should I do UW again?A: I would recommend doing UW again as close to the exam date as possible, while still giving yourself enough time to go over FA again and do the rest of the NBME forms. I went through UW the second time 3 weeks before my exam; I did 350 questions every day to simulate the exam length and build up my stamina. When I finished, I still had 2 weeks left to review the material that I mentioned above.

Q: When did you really start feeling comfortable with the material?A: I probably started feeling comfortable with the material after I finished Kaplan notes and had done 2000+ questions. By that time, I knew my strengths and weaknesses and knew what to

focus on in order to get the most out of the review process. For example, after doing some questions, I realized I had a lot of trouble with neuroanatomy, and so did HY neuroanatomy for 2 weeks, which seemed to effectively remedy the problem. Besides, as you do more questions, you soon realize the amount of information that FA actually covers. The questions also help you remember the material in FA more easily.

Q: Any advice on test-taking strategies?A: One thing I found really useful from doing tons of questions is that on the real exam, I could often read the question stem and predict what type of question they were going to throw at me. I would also recommend coming up with your own answer in your head before you look at the answer choices; reading the other answer choices (distractors) before committing to a response can be confusing, especially when you're not very certain of your answer to start with. Of course, if you really have no idea what the question is getting at, reading the options first while using the process of elimination is often helpful.

Pollux, Jan 27, 2009

#1

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markdc Senior Member Joined:

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Congrats on your accomplishment Pollux. Are you 100% aiming for the US?

I am already out and working and thinking about the daunting task of completing the USMLE at this late point.

markdc, Jan 27, 2009

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3. Pollux

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markdc said: ↑

Congrats on your accomplishment Pollux. Are you 100% aiming for the US?

I am already out and working and thinking about the daunting task of completing the USMLE at this late point.

Click to expand...

Thanks markdc. I plan to stay in Australia for my intern year and apply for US residency in the mean time. I am aiming for the 2011 match. This gives me at least a backup plan so I can return to Australia for

college training in case the financial crisis in US continues to get worse.

Can I ask why you're interested in going to US now that you're working?

Best of luck in your preparation. Feel free to email me if you have any questions regarding the exam and exam preparation.

Pollux, Jan 28, 2009

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amakhosidlo Accepted Joined:

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276???That is....amazing, and thoroughly reassuring.I've been hesitant to apply to Oz schools due to worries about being able to prepare for the Step (If I chose to return to the states).....Not so worried anymore.

Any advice for IMG's(US) applying to Oz schools?

amakhosidlo, Jan 28, 2009

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Theillestill Joined:

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now to see if i can do the same for NBDE part 1. ugh.

Theillestill, Jan 28, 2009

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6. Pollux

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amakhosidlo said: ↑

276???That is....amazing, and thoroughly reassuring.I've been hesitant to apply to Oz schools due to worries about being able to prepare for the Step (If I chose to return to the states).....Not so worried anymore.

Any advice for IMG's(US) applying to Oz schools?

Click to expand...

Please take my experience with a grain of salt. I never intended to use my score to prove that IMGs studying in Australia all succeed on the USMLE. I just wanted to show that it's definitely possible. You just have to put in a lot of work on your own.

I'd still encourage you to try US schools first before you apply to Oz schools, especially if you intend to go back to US eventually.

I believe the application process has changed quite a bit since I applied to Oz schools, so you probably have to look up these things yourself. However, I'd definitely suggest applying early, and to as many schools as possible. (You can list 2 schools on your ACER application, but many schools take independent applications; please look them up yourself because the list constantly changes)

Theillestill said: ↑

now to see if i can do the same for NBDE part 1. ugh.

Click to expand...

I don't know about the NBDE so can't help you there, but all the best.

Pollux, Jan 29, 2009

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amakhosidlo Accepted Joined:

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Pollux said: ↑

Please take my experience with a grain of salt. I never intended to use my score to prove that IMGs studying in Australia all succeed on the USMLE. I just wanted to show that it's definitely possible. You just have to put in a lot of work on your own.

Click to expand...

Haha, well obviously. I meant that it was reassuring in the sense that, like you point out, your story proves it can be done.

Pollux said: ↑

I'd still encourage you to try US schools first before you apply to Oz schools, especially if you intend to go back to US eventually.

Click to expand...

Well, part of the reason I'm applying to Oz schools is that with the way things are going, I'm not sure I want anything to do with the American healthcare system, hence my interest in Australian

schools. (That and a lifelong infatuation with Australia in general .)

I've just heard of the shortage of internships predicted for Oz grads in the next couple of years, and was taking into consideration the fact that I might be forced to return to the states to find employment opportunities after graduating...

amakhosidlo, Jan 29, 2009

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markdc Senior Member Joined:

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I would say that Pollux is not representative of anything here. He did what he did on his own and it likely had nothing to do with the education he received here. There is very little focus on biochem, microbio etc to the level of minute detail needed for the Step 1. That being said, it is mostly useless stuff to memorize for the real world. Pharmacology and Physiology sure, but knowing what nematode causes perianal pruritis is hardly useful in the long run. If you want to prepare for the USMLE you have to do it on your own.

Pollux, I don't know if I will apply to the US but it had always been part of the master plan to have the option to go. In order to do that I have to the USMLE at some point. However the longer I wait, the less likely it is that I will do it. My new plan is to study for the Step II and MCCQE1 together and then worry about step 1 later if for some reason I don't match here or in Canada soon.

markdc, Jan 30, 2009

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shan564 Below the fray Joined:

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Great suggestions. I'm fairly certain that I'll be referring back to this thread in the future as I prepare for the USMLE.

shan564, Jan 30, 2009

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amakhosidlo said: ↑

Well, part of the reason I'm applying to Oz schools is that with the way things are going, I'm not sure I want anything to do with the American healthcare system, hence my interest in Australian

schools. (That and a lifelong infatuation with Australia in general .)

I've just heard of the shortage of internships predicted for Oz grads in the next couple of years,

and was taking into consideration the fact that I might be forced to return to the states to find employment opportunities after graduating...

Click to expand...

I agree that the Australian healthcare system is quite unique in that there are both private and public systems. It works quite well now, but there are concerns that the healthcare cost will skyrocket in a few years time due to aging populations. I'm not working yet, but I'm sure the interns and residents here will tell you that the Australian healthcare system has its own share of problems too.

The shortage of doctors might end in a few years time due to the projected "medical student tsunami." Australia has opened around 5 new medical schools in the last 4 years, and there are a few more to come. There are concerns now that they might be overproducing medical students relative to the number of training positions available. The international students at UQ in the year above me had no problems getting intern positions after graduation for those who chose to stay, but some people are not so optimistic that the situation will be the same in 1 or 2 years time.

markdc said: ↑

I would say that Pollux is not representative of anything here. He did what he did on his own and it likely had nothing to do with the education he received here. There is very little focus on biochem, microbio etc to the level of minute detail needed for the Step 1. That being said, it is mostly useless stuff to memorize for the real world. Pharmacology and Physiology sure, but knowing what nematode causes perianal pruritis is hardly useful in the long run. If you want to prepare for the USMLE you have to do it on your own.

Click to expand...

If I want to thank UQ for one thing, it's gotta be the assessment format and the exam content in the basic sciences years; only 4 exams each year, and the questions were so random that going to lectures didn't really help. It gave me the option to skip irrelevant and uninteresting lectures

so I could spend my time and energy studying for the USMLE.

I agree that a lot of information on the step 1 seems to have little clinical importance, especially in areas like biochem. However, I don't like the fact that the Australian medical curriculum de-emphasizes the value of basic sciences to the point that the amount of pathology and pharmacology education that one receives in 2nd year is quite minimal. In my opinion, these two subjects probably have the most clinical importance, and progressing to clinical years without a solid foundation in them will only make life harder.

markdc said: ↑

Pollux, I don't know if I will apply to the US but it had always been part of the master plan to have the option to go. In order to do that I have to the USMLE at some point. However the longer I wait, the less likely it is that I will do it. My new plan is to study for the Step II and MCCQE1 together and then worry about step 1 later if for some reason I don't match here or in Canada soon.

Click to expand...

I see. I will be sitting step 2 CS some time this year and CK next year. If you ever want to study together, let me know. (Are you based at GCH if I remembered correctly?) I probably won't be taking the MCCEE or QE any time soon because I'm not Canadian and therefore not eligible for CARMS matching, so my plan is to complete my specialist training in Aus or US before moving to

Canada. (I went to uni at UBC, I really miss Vancouver )

shan564 said: ↑

Great suggestions. I'm fairly certain that I'll be referring back to this thread in the future as I prepare for the USMLE.

Click to expand...

Thanks. I remember that you applied to UQ and USyd last year and got accepted to both. Are you in Australia now? If you ever have questions regarding USMLE preparation, don't hesitate to

contact me.

Last edited: Jan 30, 2009

Pollux, Jan 30, 2009

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fruitloops Joined:

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Pollux, Congratulations on doing so well and thanks very much for your helpfulness. I'm curious about how you went through your exams. Did you mark them at all and then go back to check ones you were unsure of? I ask because I tend to mark all the ones I'm not sure of. From those marked questions, there's some I miss and some I get right; so, I don't know if it's a good strategy for me to mark them anyway. Of course, at the end of practice exams, I always go over the marked ones and missed ones. Seems I sorta knew marked ones I got right, but wasn't sure of them. Any thoughts about this?

Thanks in advance.

fruitloops, Feb 3, 2009

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islandoc2B Joined:

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Congratulations on your excellent marks!

Thanks for your thorough posts-very helpful.

islandoc2B, Feb 3, 2009

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redshifteffect Senior Member Joined:

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Sadly the only two interns who failed internship last year were both from UQ. Both excellent guys but they had a lacking of the fundamentals. From what I've heard around the place UQ seems to be well known for skipping out on a lot of the basics.

redshifteffect, Feb 4, 2009

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redshifteffect Senior Member Joined:

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In terms of the "medical student tsunami" I've heard it both ways. It's really impossible to accurately predict what will happen, but keep in mind that not only is the Australian population aging (thus requiring more healthcare services/and therefore doctors) but so are the doctors themselves. Many doctors will be retiring in the next 5-10 years putting a lot of pressure to find people to fill these jobs, and there simply will not be enough graduates even with the increase in numbers to fill all the jobs that will be vacant in the next few years.

Then there's also the trend towards increasing numbers of (mainly) female doctors (as well as non-traditional male) doctors who work only part time or take on mainly locum work. Thus it's now taking two or three doctors to do what used to be the domain of a single doctor, again increasing the number of doctors that will be needed.

Even in pathology both of my consultants work only 4 days a week, and it's nearly impossible for them to find anyone willing to work the full 5 days as they've been trying for the last 5 years.

redshifteffect, Feb 4, 2009

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fruitloops said: ↑

Pollux, Congratulations on doing so well and thanks very much for your helpfulness. I'm curious about how you went through your exams. Did you mark them at all and then go back to check ones you were unsure of? I ask because I tend to mark all the ones I'm not sure of. From those marked questions, there's some I miss and some I get right; so, I don't know if it's a good strategy for me to mark them anyway. Of course, at the end of practice exams, I always go over the marked ones and missed ones. Seems I sorta knew marked ones I got right, but wasn't sure of them. Any thoughts about this?

Thanks in advance.

Click to expand...

Hi fruitloops,

I marked all the questions that I was not sure of (even the questions for which I could narrow down to 2 choices). Then after doing all the questions in the block, I would go back to the marked questions only. I found that going over all the questions again took too much time for me, and I usually don't change my answers for unmarked questions anyway. I'm not sure whether there's an ideal approach to marking questions, but this is just what worked for me. I

tended to mark questions rather generously though, and from experience (the stats in UW), 80% of questions I answered incorrectly were also questions that I marked.

islandoc2B said: ↑

Congratulations on your excellent marks!

Thanks for your thorough posts-very helpful.

Click to expand...

Thank you for taking the time to read my posts.

redshifteffect said: ↑

Sadly the only two interns who failed internship last year were both from UQ. Both excellent guys but they had a lacking of the fundamentals. From what I've heard around the place UQ seems to be well known for skipping out on a lot of the basics.

Click to expand...

Hi redshifteffect,

Thank you for your input. For some reason, I'm not terribly surprised. I do believe that the UQ curriculum places too much emphasis on clinical medicine rather early on in the course at the expense of a solid foundation of basic sciences. Granted, detailed knowledge in subjects like biochem and anatomy is probably not relevant to everyday clinical practice; however, I wish they had spent more teaching hours and effort on the more clinically relevant subjects, like pharmacology and pathology. It would have made clinical years a lot easier with a solid foundation in the basics.

Working 4 days a week? I'm definitely going into Pathology then. (j/k, I've had my mind set on Pathology for a while now)

Pollux, Feb 4, 2009

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md2011 Member Joined:

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Hi, Pollux, For microbiology, do you think memorizing virus structure (DS/SS RNA/DNA linear/circular, # of segment), capsid shape (helical/icosahedral), and envelop/naked are important for step 1?

Thanks for the great advice you have posted.

md2011, Feb 4, 2009

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md2011 said: ↑

Hi, Pollux, For microbiology, do you think memorizing virus structure (DS/SS RNA/DNA linear/circular, # of segment), capsid shape (helical/icosahedral), and envelop/naked are important for step 1?

Thanks for the great advice you have posted.

Click to expand...

Hi md2011,

You don't necessarily have to know viral structures to get the virology questions right, but knowing them definitely helps. For example, they will often give you a clinical scenario (1-year old infant presents with severe watery diarrhea for 24 hours) and mention that naked virus with dsRNA genome were identified. You could come to the conclusion that it's most likely to be Rotavirus based on the clinical presentation and patient's age alone, but knowing that Rotavirus is a naked virus with dsRNA could further confirm your suspicion.

I relied a lot on mnemonics for micro.

For example,

Naked viruses - naked PAPP smear and CPR. PAPP = Naked DNA viruses = Parvovirus, Adenovirus, Polyomavirus, Papillomavirus.CPR = Naked RNA viruses = Calicivirus, Picornavirus, Reovirus

Alternatively, you could link the viral structures back to the diseases themselves. Because naked viruses don't have an envelope, they are less susceptible to denaturation by stomach acids, so their route of transmission is often fecal-oral. For example, Hep A (picornaviridae), Norovirus (caliciviridae), Rotavirus (reoviridae).

I would recommend learning the viruses with DNA, +ve RNA, and -ve RNA genomes as well.

There's a pretty nice mnemonic for that in Kaplan notes. On the other hand, capsid shapes are not as high-yield, so I would not really worry about learning them.

Pollux, Feb 5, 2009

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That's so helpful. Thank you very much, Pollux

md2011, Feb 5, 2009

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Hi Pollux,

Thanks again for all of your help and thoughtful tips! So, I've read through Kaplan biochem notes, specifically the chapters focussed on metabolism, two different times and understood everything quite well. Both times, my objective was primarily to understand. Now, with me test looming at the end of the month, I need to read through it again but it's important that the information stick this time. I've seen your recommendation to know all of the illustrations in First Aid. Are there any tips to remembering which enzymes go in which direction and memorizing control points of different cycles? I do have Goljan's HY Biochem list which seems to require just brute force memorization -- have you seen or used it? Any helpful hints are greatly appreciated.

fruitloops, Feb 5, 2009

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md2011 said: ↑

That's so helpful. Thank you very much, Pollux

Click to expand...

You're very welcome.

fruitloops said: ↑

Hi Pollux,

Thanks again for all of your help and thoughtful tips! So, I've read through Kaplan biochem notes, specifically the chapters focussed on metabolism, two different times and understood everything quite well. Both times, my objective was primarily to understand. Now, with me test looming at the end of the month, I need to read through it again but it's important that the information stick this time. I've seen your recommendation to know all of the illustrations in First Aid. Are there any tips to remembering which enzymes go in which direction and memorizing control points of different cycles? I do have Goljan's HY Biochem list which seems to require just brute force memorization -- have you seen or used it? Any helpful hints are greatly appreciated.

Click to expand...

Do you mean you're going to read Kaplan biochem again with less than a month remaining? I would not actually recommend it. Instead, just try to focus on the biochem section in FA, and you should be fine.

Don't bother learning EVERY single enzyme in the metabolic pathways. Take glycolysis for example, the enzymes you need to know are hexokinase (glucokinase in liver), PFK, and pyruvate kinase, because these enzymes catalyze irreversible reactions and are subject to regulation. Similarly, know the 4 enzymes in gluconeogenesis that catalyze the reactions in the reverse direction.

If you know the substrates that these enzymes catalyze, you should have no problem remembering the direction of reaction they catalyze. Remember: Kinase = Adding a phophate group, Phosphatase = Removing a phosphate group. You can easily see that this applies to hexokinase and PFK because you're adding a (P) to the substrates. However, pyruvate kinase gets its name not because it adds a (P) to pyruvate. It adds the (P) to ADP, making ATP, via substrate-level phosphorylation.

Pay special attention to the enzymes where deficiency leads to clinically important diseases, such as Von Gierke, fructose intolerance, and galactosemia. I would also recommend learning the list in FA which summarizes the enzyme catalyzing the rate-limiting step in each of the major metabolic pathways, which can be found in FA 2008 edition or newer. Sorry, but this does

require certain amount of rote memorization. No pain, no gain.

I didn't use Rapid Review Biochem because I found it to contain a few unnecessary details like the whole shebang on Purine and Pyrimidine denovo synthesis, which I consider to be overkill for board purposes. If you really wants to spend more time on biochem, I would recommend Kaplan webprep Biochem audios by Dr Lionel Raymon. I think it's around 8 hours total time, which you can finish in one day.

Pollux, Feb 6, 2009

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redshifteffect said: ↑

Sadly the only two interns who failed internship last year were both from UQ. Both excellent guys but they had a lacking of the fundamentals. From what I've heard around the place UQ seems to be well known for skipping out on a lot of the basics.

Click to expand...

How does one fail internship? Isn't it a rotation based assessment? I can see how someone would have to repeat one rotation because of a bad assessment but the whole internship? Did they make these guys re do the whole year?

markdc, Feb 6, 2009

#21

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markdc said: ↑

How does one fail internship? Isn't it a rotation based assessment? I can see how someone would have to repeat one rotation because of a bad assessment but the whole internship? Did they make these guys re do the whole year?

Click to expand...

The way that internships were assessed in Hobart was we had two assessments - a midterm and an end of rotation appraisal from our supervisors. There were basically three categories, below average, average or above average and a pass/fail over riding all of that. There were also other things like clinical skills etc that were assessed in the above three categories, and a section at the back for putting a plan into place if the intern was struggling at midterm.

I dont want to give too much away in case the people in question read the forum, but lets just say they failed more then one rotation (if it was only one they could have simply repeated that rotation) and they were given very "easy" consultants when it was noted that they were struggling. They still failed to pass. They also failed all their core rotations, so were unable to get general registration at the end of the year.

But to put this into context, they were seeing about 1/3 of the number of patients in DEM that other interns were seeing, even by the end of the term, and were unable to make even simple clinical decisions.

redshifteffect, Feb 6, 2009

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redshifteffect said: ↑

The way that internships were assessed in Hobart was we had two assessments - a midterm and an end of rotation appraisal from our supervisors. There were basically three categories, below average, average or above average and a pass/fail over riding all of that. There were also other things like clinical skills etc that were assessed in the above three categories, and a section at the back for putting a plan into place if the intern was struggling at midterm.

Click to expand...

I imagine there weren't too many UQ graduates who went interstate to Tazzie, yet two of them

failed the intern year. Wow, that should be some sobering statistics for UQ SOM.

I haven't heard of anyone failing their intern year in Queensland yet. But again, maybe I just don't know enough interns and residents.

Last edited: Feb 6, 2009

Pollux, Feb 6, 2009

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Hey Pollux, I'm curious if you thought that taking the test after clinical rotations helped you on Step 1. Curious both from a prep point of view and also wondering how useful cramming all this stuff into your head will turn out to be on rotations.

JDMD243.0, Feb 6, 2009

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JDMD243.0 said: ↑

Hey Pollux, I'm curious if you thought that taking the test after clinical rotations helped you on Step 1. Curious both from a prep point of view and also wondering how useful cramming all this stuff into your head will turn out to be on rotations.

Click to expand...

Hi JDMD243,

I would actually recommend taking step 1 after the basic science years if you can. Because I took my exam at the end of 3rd year, I had some time to study for clinical rotations using material like Step-Up to Medicine and Goljan step 2 audios. I'd say that these helped minimally in terms of Step 1 preparation. It's really not worth the effort trying to tackle this exam and dealing with clinical rotations at the same time.

However, it's definitely useful to know the basics well when you're in clinical years. So use that as extra motivation to learn your basic sciences well, not just for the exam, but for rotations too.

Pollux, Feb 6, 2009

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Hi Pollux, Thanks again for all of your help. The biochem actually seems easy when you explain some of the high points as you did in your last post to me--that is, it's easy until I realize there's

a lot of it. Anyway, having almost 3 weeks left to study, I'm considering the self-assessment situation. I've taken UW 1, UW 2, and NBME 5--tests were taken in November and last test taken was first week of December. I'm thinking of taking one at the end of this week and then another at the end of the following week. My question is which two of the remaining nbme exams would you recommend that I take? I wasn't thinking of taking all the nbmes because I "waste" a whole day each time I take one in the sense that I don't have answers for the nbmes and am usually pretty tired after I take them, so, post-test study effort seriously wanes.

fruitloops, Feb 8, 2009

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Thanks for posting this...very helpful... CONGRATS

Last edited: Feb 10, 2009

majesticmar, Feb 8, 2009

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fruitloops - I would recommend NBME 6 because the questions are most similar to the real exam. The last one doesn't matter; most people consider NBME 3 to be the hardest because it contains tons of questions on molecular biology. I would say give it a go; I had a lot of cell bio and molecular bio questions on my real exam, so I'd say better be prepared for them.

majesticmar - Thanks. I've replied your PM. If you have more questions feel free to PM me again.

Pollux, Feb 10, 2009

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Pollux said: ↑

fruitloops - I would recommend NBME 6 because the questions are most similar to the real exam. The last one doesn't matter; most people consider NBME 3 to be the hardest because it contains tons of questions on molecular biology. I would say give it a go; I had a lot of cell bio and molecular bio questions on my real exam, so I'd say better be prepared for them.

Click to expand...

Hi, Pollux,

Do you think HY Cell Biology book will be sufficient for the step 1 given the increasing number of cell and molecular bio questions on real exam?

md2011, Feb 12, 2009

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md2011 said: ↑

Hi, Pollux,

Do you think HY Cell Biology book will be sufficient for the step 1 given the increasing number of cell and molecular bio questions on real exam?

Click to expand...

Hi md2011,

If you read FA and HY Cell Bio and understand everything in these two books, you should be able to answer >90% of cell and molecular bio questions on the exam.

Pollux, Feb 13, 2009

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Pollux said: ↑

Hi md2011,

If you read FA and HY Cell Bio and understand everything in these two books, you should be able to answer >90% of cell and molecular bio questions on the exam.

Click to expand...

Hi Pollux,

Since we're on this topic of cell and molecular bio questions, do you think the 1999 HY Cell Bio is adequate or did you use the much denser newer version of HY Cell Bio? And, are the UWorld questions covering this topic not enough? Thanks in advance.

fruitloops, Feb 13, 2009

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fruitloops said: ↑

Hi Pollux,

Since we're on this topic of cell and molecular bio questions, do you think the 1999 HY Cell Bio is adequate or did you use the much denser newer version of HY Cell Bio? And, are the UWorld questions covering this topic not enough? Thanks in advance.

Click to expand...

Hi fruitloops,

I would actually recommend the 1999 edition, because the new edition contains way too much detail for board purposes. The UW questions are helpful, but by no means cover the entire spectrum of questions in this subject. I would highly recommend knowing the different types of receptors and the intracellular signalling pathways for each. There's a recent post on the usmle step 1 subforum where a guy shared his summary diagram for this topic. Highly recommended.

Pollux, Feb 15, 2009

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Pollux said: ↑

I would actually recommend the 1999 edition, because the new edition contains way too much detail for board purposes. The UW questions are helpful, but by no means cover the entire spectrum of questions in this subject. I would highly recommend knowing the different types of receptors and the intracellular signalling pathways for each. There's a recent post on the usmle step 1 subforum where a guy shared his summary diagram for this topic. Highly recommended.

Click to expand...

Hi, Pollux,

Do you have the link for the summary diagram you mentioned by any chance?

md2011, Mar 1, 2009

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Attached Files:

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fruitloops, Mar 2, 2009

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Thanks, fruitloops!

Pollux, Mar 2, 2009

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Hey Pollux,

Would you recommend a certain edition of FA over the others? I noticed that the 2009 FA doesn't contain the "high yield clinical vignettes" at the beginning of each section the way the 2008 FA does.

OnlyLiveOnce, Mar 3, 2009

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OnlyLiveOnce said: ↑

Hey Pollux,

Would you recommend a certain edition of FA over the others? I noticed that the 2009 FA doesn't contain the "high yield clinical vignettes" at the beginning of each section the way the 2008 FA does.

Click to expand...

Hi OnlyLiveOnce,

I don't think the edition of FA makes much of a difference. I used 2008 FA and I quite liked the clinical vignettes, so it would be a shame if they remove those from the latest edition. However, you can always just buy the 2009 edition and borrow your friend's 2008 if you wanna read the vignettes.

Pollux, Mar 4, 2009

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Hi Pollux,

Congrats on the amazing test score! I had a couple of questions for you, since you're thinking of going to practice in the States. I was wondering where you went for your elective in first year and whether this will affect your chances at getting a residency position in the States. What about doing clinical rotations in North America; would that increase your chances of getting into a residency position in the US/Canada? Also, where do you think you will be doing your fourth year elective? I am confused about the whole process of doing electives in N.A. for the sake of having a better shot at residency positions in USA/Canada. I'm sure it helps, but I wanted to know if it is absolutely imperative that you do them in N.A. if you "think" you may end up wanting to practice there (just in case AUS doesn't pan out for me). Thanks for the help and great job once again!

p.s. I am also a fellow UQ'er!

leilad, Mar 10, 2009

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leilad said: ↑

Hi Pollux,

Congrats on the amazing test score! I had a couple of questions for you, since you're thinking of going to practice in the States. I was wondering where you went for your elective in first year and whether this will affect your chances at getting a residency position in the States. What about doing clinical rotations in North America; would that increase your chances of getting into a residency position in the US/Canada? Also, where do you think you will be doing your fourth year elective? I am confused about the whole process of doing electives in N.A. for the sake of having a better shot at residency positions in USA/Canada. I'm sure it helps, but I wanted to know if it is absolutely imperative that you do them in N.A. if you "think" you may end up wanting to practice there (just in case AUS doesn't pan out for me). Thanks for the help and great job once again!

p.s. I am also a fellow UQ'er!

Click to expand...

Hi leilad,

Glad to see a fellow UQer here!

I would say where you do your first year elective is not very important. I went back home (Taiwan) and basically just took it as a long holiday. We're only required to go in for 20-25 hours a week, which is not a lot of time at all. And I was so clueless back in first year so it didn't really

matter what I did for elective in retrospect. I'd just suggest doing something that you find interesting.

However, doing your 3rd or 4th year clinical rotations in North America is highly recommended, if not necessary, if you plan to apply for US or Canadian residency programs. You will need up to 4 letters of recommendation when you apply for NRMP matching, so I would recommend getting at least 3 from US clinicians. I will be going to New Orleans in 2 weeks time and spending

at least 4 months at Ochsner Clinic. I'll let you know how things go.

Pollux, Mar 10, 2009

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Pollux said: ↑

Hi leilad,

Glad to see a fellow UQer here!

I would say where you do your first year elective is not very important. I went back home (Taiwan) and basically just took it as a long holiday. We're only required to go in for 20-25 hours a week, which is not a lot of time at all. And I was so clueless back in first year so it didn't really matter what I did for elective in retrospect. I'd just suggest doing something that you find interesting.

However, doing your 3rd or 4th year clinical rotations in North America is highly recommended, if not necessary, if you plan to apply for US or Canadian residency programs. You will need up to 4 letters of recommendation when you apply for NRMP matching, so I would recommend getting at least 3 from US clinicians. I will be going to New Orleans in 2 weeks time and spending

at least 4 months at Ochsner Clinic. I'll let you know how things go.

Click to expand...

Firstly, massive props for the fantastic score pollux! You definitely worked hard (1000 hours on

the basic science is more contact hours than I had for my first two years at uni, lol !), and it certainly paid off for you- well done.

A little about me- I'm a Ugrad at Melbourne Uni. In 3rd year so doing my last pre-clin semester.

If I could, I'd just like to ask you a question about doing your elective in the states.

A) If you wouldn't mind, could I ask how much you're budgeting for the entire trip? I imagine the hospital would have an admin fee attached to it, and then there's travel/accom/living expenses...I've toyed with the idea of doing my final year elective in the states/UK, but since I'm trying to be as financially independent as possible this could be a deal-breaker...I'd like to start saving now though, so if you could throw me a rough figure, I can probably get myself organised

.

B) Are there any barriers in Ugrad med students doing their electives in the states, a far as you know? My understanding is that the concept of a 'ugrad med student' is a bit of an oxymoron to a lot of american hospitals, and my friends have found it difficult to get research placements (for their B. Med Sci years) there.

C) Finally, how'd you go about getting this elective sorted? Are a lot of institutions keen on having foreign med students over? Ideally, I'd love to do a rotation at a place like the Mayo Clinic since I'm interested in neuro, but I have no idea how keen they'd be on an australian joining them for 6-8 weeks.

Cheers for any thoughts/insights. And hope your placement over in New Orleans goes fantastic- sounds to me you'll get all the recs that you deserve!

Raygun77, Mar 14, 2009

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Raygun77 said: ↑

Firstly, massive props for the fantastic score pollux! You definitely worked hard (1000 hours on

the basic science is more contact hours than I had for my first two years at uni, lol !), and it certainly paid off for you- well done.

...

Click to expand...

Hi Raygun77,

Sorry about the late reply. I just arrived in New Orleans a week ago, and things have been quite hectic. I have sent you a PM, so please check your inbox.

-Pollux

Pollux, Mar 30, 2009

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Hi Pollux I am just reading your USMLE experience for the 1st time. Good job. In your thread, you indicated that it only took you a month to finish Kaplan notes for all subject save for pathology. How concise are these notes? I am planning to use my school notes in lieu of Kaplan notes. Each subject's is over 1000 pages. Finishing about 5000 page of notes seems like a daunting task. Is reading school notes a good idea?For exam purpose and review of concept would suggest Kaplan's notes instead? I still have about a year before the Exam. Thanks and congrats

bsga, Jul 16, 2009

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Pollux,Thanks for all your information. It is very much appreciated. I would love to hear more about your time at Oschner and how you plan on matching in the US. I'm applying now to UQ (awfully awfully late) but I'm also planning on being ready for the 2011 year (USyd and UQ being my targets because of what I've heard.) Hope your time in NO is great!

SFs Own Tone, Jul 16, 2009

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SFs Own Tone said:

I would love to hear more about your time at Oschner...

Click to expand...

FYI, Oschner is a new program that they just started this year. Pollux wouldn't have gone to Oschner. Also, even now, most of the international students at UQ will do their clinical years in Brisbane; only a few go to Oschner.

shan564, Jul 17, 2009

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shan564 said: ↑

FYI, Oschner is a new program that they just started this year. Pollux wouldn't have gone to Oschner. Also, even now, most of the international students at UQ will do their clinical years in Brisbane; only a few go to Oschner.

Click to expand...

Pollux wrote that he's in New Orleans now and plans on spending 4 months at Oschner. It sounds like its not part of the 2 years UQ/2 years Oschner, but his experience would still be a good indicator of Oschner's clinical education.

Edit: Just read that he posted arriving in NO back in March. I guess he would be finishing up about now.

SFs Own Tone, Jul 17, 2009

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Oh, I see... I searched the thread for "Oschner", but I didn't find his post because he misspelled it.

shan564, Jul 17, 2009

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bsga said: ↑

Hi Pollux I am just reading your USMLE experience for the 1st time. Good job. In your thread, you indicated that it only took you a month to finish Kaplan notes for all subject save for pathology. How concise are these notes? I am planning to use my school notes in lieu of Kaplan notes. Each subject's is over 1000 pages. Finishing about 5000 page of notes seems like a daunting task. Is reading school notes a good idea?For exam purpose and review of concept would suggest Kaplan's notes instead? I still have about a year before the Exam. Thanks and congrats

Click to expand...

I wouldn't recommend using your school notes for USMLE review purposes; Kaplan notes are very long-winded already. If you have a good foundation in the basic science subjects, you can probably go straight to HY series or FA.

shan564 said: ↑

Oh, I see... I searched the thread for "Oschner", but I didn't find his post because he misspelled it.

Click to expand...

No. It is spelled "OCHSNER".http://www.ochsner.org

SFs Own Tone said: ↑

Pollux wrote that he's in New Orleans now and plans on spending 4 months at Oschner. It sounds like its not part of the 2 years UQ/2 years Oschner, but his experience would still be a good indicator of Oschner's clinical education.

Edit: Just read that he posted arriving in NO back in March. I guess he would be finishing up about now.

Click to expand...

Yep, just finished my last day of rotation yesterday. It's been a pretty crazy 4 months for me, because I decided to take the Step 2 CK AND CS while I was in the US. I just finished CK 3 days ago, actually.

Now that I finally have time to write about my experience at Ochsner, I would say it's been absolutely fantastic: very modern facility, busy yet efficient hospital service, diverse patient population, and attendings who are dedicated to teaching. As a medical students, I was given a lot more responsibilities in the US than in Australia, in terms following up my assigned patients and learning about their progresses, discussing the cases with the attendings, and coming up with a management plan. They expected me to function at the level of an intern, which is the best way to learn how things are done. I've thoroughly enjoyed my experience at Ochsner and would recommend it to anyone. In fact, I'm only going to be in Australia for 2 more months now for my O&G rotation, and I'm going back to New Orleans at the end of September for my last rotation in med school.

Pollux, Jul 19, 2009

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shan564 Below the fray Joined:

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I see, I guess I misspelled it.

shan564, Jul 19, 2009

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shan564 Below the fray Joined:

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Pollux - did you do anything during first year aside from listening to Goljan and reviewing your normal course material?

shan564, Jul 23, 2009

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FlamingGalah Joined:

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Hey,Im an intern in Melbourne about to take the step 2 CS in a few weeks. Completed step 1 and CK with high scores but havent done much study for the CS exam as yet. Just wanted to get an australian trained perspective of what it was like. Is it very similar to our OSCEs? and did you study much for it? Any deficiencies you noticed by training in australia that I should concentrate on?

Ive got the FA and usmleworld subscription for it and I feel like i should pass without problems.

Cheers