What states allow graduate IMG to touch the patient in Observership/Externship? - USMLE Forums
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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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Old 01-22-2011
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Question What states allow graduate IMG to touch the patient in Observership/Externship?

I really wanna know what states in the US allow graduate IMG to touch their patient during observership, consequently this observership will turn into hand-on experience? or the states that they allow us to do externship (which I understand it as a hand-on experience for graduate IMG)?

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thx in advance
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Old 01-24-2011
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Hello and good evening. You are able to work hands on with patients prior to residency in almost all states (excluding California and Pennsylvania). Now, the individual state regulations can be pretty specific (for example, a maximum number of weeks of training in the state for licensure eligibility) and are subject to constant change so I would also suggest checking with the medical board of each state before attempting any type of clinical training. Here is a registry of contact information that may be useful:


REMEMBER: your training *if hands on* MUST be insured with medical liability insurance. You can have no interaction of any kind (even discussions) with patients without the proper insurance coverage

There are areas that will be more flexible with their regulations on IMGs participating in post grad and pre residency clinical training. Generally the Eastern and Mid western (NOT western) states would be more IMG "friendly". It is important to pay attention to state licensure regulations as well, for example there are certain states that will not allow for the step 3 to be take prior to 6 months to 1 year of GME (graduate medical education). Please follow this link to purchase the AMA Medical Licensure booklet to review and become familiar with:


I hope that this was helpful to you.
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