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USCE & Clinical Rotations IMG discussions of United States Clinical Experience (USCE), clinical rotations, clerkships, externships, observerships, electives, and internships.


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  #1  
Old 09-24-2016
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Default What are companies that help with clerkships really doing?

Hey all,

So apart from high USMLE-scores it's essential to have good letters of recommendation. You can get these by doing electives in hospitals.

Now, companies like Chicago clerkships etc. what are they really doing? Are they the owners of private hospitals or are they just a third party that helps you get into a big hospital easier?

I've heard that it's important to get letters of recommendation by ceritified doctors and a hospital where it's possibly to do residency in. These kind of hospitals, can companies like chicago clerkship help me get into them? Or is it only "unknown" and small hospitals that these companies can help you get into? Someone explain this to me!

So asking a hospital A myself for a elective would be difficult. But with these kind of companies, it would get easier to get an elective in that specific hospital? Is it this the companies do?
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Old 09-24-2016
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It seems like they send you to a physician who works in any hospital. Is that correct? So the companies have no connections whatsoever with the hospital itself, only the physicians?
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Old 09-24-2016
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Also, do I pay these companies and that's it? I get my elective? Or do I have to pay the company AND the hospital itself too separately!?
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4 weeks seem to be the average time for a elective. It's possible to get a letter of recommendation during this time right?

So many questions! I hope someone can explain all well
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Old 09-24-2016
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Quote:
Originally Posted by Naramsin View Post
4 weeks seem to be the average time for a elective. It's possible to get a letter of recommendation during this time right?

So many questions! I hope someone can explain all well
You may get 1 LOR for one rotation which typically refers to a 4week duration.

These companies only have connections with doctors and no you don't need to pay the hospital separately and neither can you participate in direct patient care at the hospital as you are not officially enrolled with it. You just have to pay the company which will facilitate your placement with a physician who may or may not be(mostly) associated with a residency hospital. And most of your rotation will take place at the doctors private clinic. Although some companies nowadays are giving a guaranteed teaching hospital elective but I'm not sure how true that is.

Most of the doctors associated with them are ACGME accredited.

If you are still a student your best option is to apply to universities for electives/clerkships.

If you are a graduate then you may apply for observerships directly to the university(observership is not hands on experience though). And if you still want to have some hands on experience as a graduate then you don't have any other option but to take help of these companies. Also be careful and check the regulations of various states as some don't allow foreign graduates to get hands on experience or participate directly in patient care(I think California is one such state) even though the company might say that you'll get a hands on experience.

I hope I was able to answer most of your questions.

And lastly please check the reviews of these companies before selecting the best one for you.
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Old 09-24-2016
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Quote:
Originally Posted by Naramsin View Post
Hey all,

So apart from high USMLE-scores it's essential to have good letters of recommendation. You can get these by doing electives in hospitals.

Now, companies like Chicago clerkships etc. what are they really doing? Are they the owners of private hospitals or are they just a third party that helps you get into a big hospital easier?

I've heard that it's important to get letters of recommendation by ceritified doctors and a hospital where it's possibly to do residency in. These kind of hospitals, can companies like chicago clerkship help me get into them? Or is it only "unknown" and small hospitals that these companies can help you get into? Someone explain this to me!

So asking a hospital A myself for a elective would be difficult. But with these kind of companies, it would get easier to get an elective in that specific hospital? Is it this the companies do?
Chicago clerkship, Medclerkship, FMG poratl - these agencies help you get 4,6,8,12 weeks of clinical rotations with some physician. Basically, they assign you to a physician and then you get to shadow that dotor through out his daily practice. Most of these doctors have an out-patient clinic and then they have affiliation with other hospitals where they have their patients admission- so you get clinical experience in both in-patient and out-patient scenario.
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Old 09-25-2016
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I'm still a student (honestly, I just began medical school) on semster 1. Our clinical semesters don't begin until semester 6 and last until semester 11. Semester 6-9 would correspond the third year of American medical school, where we do our core rotations. Semester 10-11 would be the final 12 months where electives would be possible to do.

It seems like these companies do offer even clerkships, meaning I don't have to wait until the last 12 months to be able to get some USCE and letters of recommendation. So that's good, although Chicago Clerkship recommended me to at least pass semester 6 before applying just to get some clinical experience in Sweden. I think I'll do that, especially since I'll be doing Step 1 directly after semester 6 too.

Of course, I will prioritate contacting the universities themselves and ask directly for clerkships and electives. These companies are my plan B. The thing that sucks is that my university in Sweden has the best medical education among all 7 being offered here with best lectures, teachers and the school itself, which is a university hospital, is the best hospital in all of Sweden. But there are three other medical schools that have official affiliation with John Hopkins, Columbia, Albert Einstein College of Medicine Bronx, Northwestern University, Feinberg School of Medicine Chicago, University of California at Los Angeles, University of Iowa Iowa city, University of Minnesota, Minneapolis and University of California. But their education sucks and their students get the lowest scores on our corresponding USMLE-test. Since I know USMLE is the most important I chose the university I'm going in right now. And changing now is just something I don't feel like doing, especially since changing schools here in Sweden usually mean redoing certain semesters and it won't look pretty on the CV. And of course, the schools themselves suck (they're known for their research and not medical education really).

So basically what that means is that the students in those schools can ONLY during semester 11, i.a. the last semester, have a SLIGHT chance of being nominated and HOPE that Americans want to come to Sweden during that specific semester and time of elective-startdate. So it's not even a guarantee.

Now however, these medical schools that 3 of the universities here have affiliation with don't require TOEFL. Sending them our High School-grades in English have proven to be just enough, and in those cases which it hasn't a telephone interview would work just fine. Does that mean that even I don't have to do TOEFL or is this some sort of exception for just these students in the affiliated schools?

But yeah, as I said earlier, worst case scenario is the companies. However, I got the impression that MOST of the time it's hand on experience in real, teaching hospitals. If it was otherwise it wouldn't be called clerkship or elective; it would be an observership. So how is it really? Now of course I'm aware of that I should avoid private clinics and unknown physicians at all costs, but will the companies tell me before hand which physician it is and where my rotation will take place? If so, that's great because I can then just tell them that I don't like the physician alternatively the place where I'll do the rotation and perhaps they could find me something else. I think I've read somewhere that someone did this and got something more satisfactory. But at the end of the day, even if it's a private clinic and some unknown physician, a letter is better than no letter and this kind of letter is definitely better than an observership.
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Old 09-25-2016
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Well I read your post completely and would like to ask you something out of curiousity, if you don't mind ofcourse.
Why do you think people do clerkships/electives/observerships ?
Like okay they help you gain USCE but no apart from that. Do you think there might be any other reason??
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Of course, apart from USCE I get letters of recommendation that will greatly boost my chances of getting into a specific residency. I also get to make friends /contacts with other people and contacts will open even more doors for you, even doors that might be closed for immigrants but open for solely Americans. Those are the main reasons I can think of.

Is there something else I'm missing except for the obvious (experience a new country, new culture, see how the healtcare is in the US compared to Sweden etc.)?
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Quote:
Originally Posted by Naramsin View Post
Of course, apart from USCE I get letters of recommendation that will greatly boost my chances of getting into a specific residency. I also get to make friends /contacts with other people and contacts will open even more doors for you, even doors that might be closed for immigrants but open for solely Americans. Those are the main reasons I can think of.

Is there something else I'm missing except for the obvious (experience a new country, new culture, see how the healtcare is in the US compared to Sweden etc.)?
You got that absolutely right. And believe me, you need absolutely no tie up between your school and the US universities to be able to participate in their clerkships/electives. All you need to do is apply well in time.

And yeah a Clerkship is managed by the Deans office or the Students affairs office of the University so no private company or a doctor(even if he/she works in that hospital) can offer you that.

Focus on applying to the universities who accept Foreign Students in the final year of their college, for clerkships/electives and keep the private companies only as a backup.
(The approach would have been different if you would have been a graduate, but that's not the case so...)

If you will still not be done with step 1 before going for clerkships even then there are quite a few universities that will accept you for clerkship/elective spots. Focus on those, skip worrying about the companies and hope for the best. I'm sure you will bag yourself a handful of clerkships.

Wish you luck
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Old 09-25-2016
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Thanks for the motivation man!

Now do universities really even offer clerkships? Now I'm assuming clerkships is what the Americans are doing during their 3rd year, right? It's the core rotations. The impression I've gotten though by just looking at a handful of universities is that they only seem to offer electives (which is the final 12 months, final year for American students) and not clerkships. But I'm persistent, so lets hope that pays off when I contact each university when time's right. I've heard that Swedes have a slight advantage over other immigrants for some unknown reason so that's good for me at least, hehe.

Now, another thing I'm just curious about is the fees. The private companies take around 2000 dollars for 1 rotation of 4 weeks. People say that this is expensive, but isn't that the case even with a direct contact with the universities themselves? Either way, in Sweden we have CSN that gives loans to every student. We have loans for tuition fees, train/bus tickets, children and even driver's license lol so needless to say, the money won't be an issue.

The ideal would be to find a hospital that requires step 1 but not TOEFL while accepting other verifications, e.g. telephone interview or my High School grades (we have the same grading system as Americans). I mean, USMLE stopped requiring TOEFL so lets just hope that it becomes even less relevant in the future even for applications...

which brings me to my other though; it seems that there's a fee for applying. But if I'm going to apply for each of the hundreds of hospitals I'll go bankrupt! It probably doesn't work like that but I'm assuming that as long as you meet the requirements you should get in and not get rejected.

Either way, my first clinical semester begins in January 2019. I don't think it's possible to do my first clinical semester in the US as I'm not experienced at all, but I will still try. I will contact the universities in September 2017, i.a. more than 1 year beforehand, and see if it's possible.
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  #12  
Old 09-25-2016
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Lol, no man you wont go bankrupt. Here's a list of universities that accept foreign students for clerkship/elective:
Electives list for international medical students
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Old 09-25-2016
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Thanks for that link!

Now, our semester 8 is all devoted to just research. I want to take advantage of this and do my research project in the USA. The question is though how I should take advantage of this opportunity so that my chances of getting into a residency increases a little bit extra, e.g. do I do research with a group that's focusing on a certain unknown mechanism in the body or do I join a group that's doing research about something connected to the residency I'm interested in? We get 6 months in total. Think I can publish something during this time? I will also do research in the summer break in 2021 which is almost 3 months and during the time between my graduation and the match, which should be another 4-6 months.
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Old 09-25-2016
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Quote:
Originally Posted by Naramsin View Post
Thanks for that link!

Now, our semester 8 is all devoted to just research. I want to take advantage of this and do my research project in the USA. The question is though how I should take advantage of this opportunity so that my chances of getting into a residency increases a little bit extra, e.g. do I do research with a group that's focusing on a certain unknown mechanism in the body or do I join a group that's doing research about something connected to the residency I'm interested in? We get 6 months in total. Think I can publish something during this time? I will also do research in the summer break in 2021 which is almost 3 months and during the time between my graduation and the match, which should be another 4-6 months.
Connected to your field of interest would be the best. Check John Hopkins. They give research electives to foreign medical students. You may get a publication for 6 months is a pretty long time.
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Old 09-25-2016
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Very cool man. This is going to be a long journey. Lets hope it has a happy ending.
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Quote:
Originally Posted by Naramsin View Post
Very cool man. This is going to be a long journey. Lets hope it has a happy ending.
It definitely will. Good luck 😄👍🏼
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  #17  
Old 09-25-2016
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Yeah, even the private companies recommended me to apply to the hospitals first before seeking help with them.

Now if I apply and pay the fee, what exactly am I getting? Do I get a precursor or do I have to pay extra for it? Really dumb question, but just want to make sure haha. Apparently there's an application fee but is that really it? Will the precursor also lecture a bit for me? Usually when you do rotations you also have lectures, at least in Sweden, to go on and study beyond the clinical rotations. But the lectures are probably only if you end up in a teaching hospital? Or am I mistaken? I just don't want my school to be like: "Since you didn't have this lecture you can't get the full credit for this specific rotation". But the latter shouldn't happen as lectures are optional anyway, at least in my school...

A rotation for 4 weeks with the private companies which includes a precursor goes for 2000 dollars. How much would the price be if I apply directly to a hospital?

One thing that the private companies mentioned as well was that they would give me all the information I needed so I can take the credits for my medical education in Sweden as well, otherwise I can't get the surgery rotation e.g. considered done. But I'm assuming that the hospitals will help me in this regard as well, no? And I really hope that they're also around 4-8 weeks long and not like months as that would make it alot more difficult to fit with my school's curriculum.
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Old 09-26-2016
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Also, the physicians in the private companies will write letters of recommendation and sign on some papers that my school requires in order to give me the credits for the rotation, right? Or are they for some reason going to be anonymous in both these cases?
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Old 09-26-2016
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Same goes if I apply to a hospital directly (without the help of private companies), right (i.a., the physicians there will also write letters and sign papers from my school not-anonymous)?
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Old 09-26-2016
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Just a clarification (lol I wish there was an edit option): By anonymous I mean like not tell what the name of the physician and/or hospital is.
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Old 09-26-2016
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Quote:
Originally Posted by Naramsin View Post
Same goes if I apply to a hospital directly (without the help of private companies), right (i.a., the physicians there will also write letters and sign papers from my school not-anonymous)?
As i told you before that the clerkship/electives are handled by the department of student affairs of the university. Why? Because they carry academic credit. So yeah you will get academic credit for your University clerkship/electives.
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Old 09-26-2016
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Do the university/hospital the private companies send you to have that student department as well? I would assume so as it's almost students only who seek help with these companies.

So as long as I can do a rotation somewhere I can always guarantee myself to get credit, with the help of private companies or not. I shouldn't worry regardless as my precursors here have to control and make sure that I'm doing the right thing anyway in order to get credits, otherwise they'll reject my desire to do a rotation abroad as it's not part of my education.
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Old 09-26-2016
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Quote:
Originally Posted by Naramsin View Post
Do the university/hospital the private companies send you to have that student department as well? I would assume so as it's almost students only who seek help with these companies.

So as long as I can do a rotation somewhere I can always guarantee myself to get credit, with the help of private companies or not. I shouldn't worry regardless as my precursors here have to control and make sure that I'm doing the right thing anyway in order to get credits, otherwise they'll reject my desire to do a rotation abroad as it's not part of my education.
Your university may not accept the academic credit for the rotations you do via a private company because it is not affiliated to any university.

But if you do it in a university(you can not get into a university elective via private company), then ofcourse you will definitely get credit if your medical achool approves your participation
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Old 09-26-2016
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I see.

I contacted Chicago Clerkships and they said the hospitals they send you to are certified, legal (lol), big and "AND WE DO NOT CONTRACT WITH HOSPITALS. WE CONTRACT WITH INDIVIDUAL PRECEPTORS WHO HAVE THEIR OWN AFFILIATIONS WITH THE HOSPITALS."

Does it really have to be a teaching hospital in order for me to get academic credits or will just a hospital be enough? What do you call them, community hospitals? Chicago clerkships tend to send you there way often than clinics (judging by the answer I got from them), or at least let you do it if you so desire (by asking if you can do the rotation somewhere else). Regardless, my university says that it's possible to do your medical studies in a university abroad, hospital, clinic, etc. They mention clinics too, so even if the worst scenario would happen I should be fine and get the academic credits.

of course all this is the plan B. It's just good if everything gets planned.
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Old 09-26-2016
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Well if your school's dean says that they will accept academic credit from the private clinics as well then it's definitely good for you. 😊
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Old 09-26-2016
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Thanks man, and just to rehearse: Electives list for international medical students

That list of hospitals are the ones I should contact only? There are a tons more (obviously), but it's like you say that some (well in this case, the most) don't accept clerkships/electives at all for immigrants.

Also, say that I can't get into any of those. Should I contact private clinics on my own then first or seek help with the private companies? What should I prioritate in this situation? I'm thinking the private companies as there's still a chance to end up at hospitals instead of clinics, while if I contact clinics it's obviously going to be a guaranteed clinic.

Thank you for answering btw man.
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Old 09-26-2016
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Also, what's this talk about malpractice insurance that some of the schools require? 1 million dollar/year? I'm assuming it's not something I should worry about, or...? Thomas Jefferson University elecitves e.g. has it in their requirement.
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Old 10-05-2016
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bump.

I'm still not sure what this malpractice liability insurance is all about. 3 million dollars annual aggregate, 1 million dollar per medical incident and like all schools that offer clerkship/electives requires the international student to be covered by this insurance.

What does that imply? Because the third parties like ChicagoClerkships etc. are paying for this malpractice insurance. But if you apply directly that doesn't seem to be the case, the university hospitals do not provide malpractice insurance... And it's a requirement to apply!

Unless my school here in Sweden can provide me that? Or is it something we have to pay from our own pocket? I mean, this could be the reason why third parties cost so much (2000 dollars for a elective of 4 weeks).

But of course, if my school in Sweden can provide me that then applying directly to university hospitals in the US is still what everyone should do first before seeking help at the third party companies...
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