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Observership, Research and Externship in the United States

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by Dr. Aitzaz Bin Sultan Rai.

 Summary:

Observerships, research and externships give you an exposure of healthcare system of
United States and give you an idea of what to expect during residency; (the nature of work,
healthcare facilities, code of conduct for healthcare professionals, the cutting edge
technology, electronic healthcare records, diseases prevalent in a certain geographical area
and the social and cultural values of people of United States). In this issue of the section of
the Road to Residency, Aitzaz and Saima discuss their views about the importance and the
various ways to do an observership, research and externship in the United States.
Why do an observership, research or an externship in the United
States?

Before we give our views on how to find an observership, research or an externship in the
US, let’s first give you a few reasons as to why to opt for these options.

(1) Observerships, research and externships give you an exposure of healthcare system of
United States and give you an idea of what to expect during residency; (the nature of work,
healthcare facilities, code of conduct for healthcare professionals, the cutting edge technology,
electronic healthcare records, diseases prevalent in a certain geographical area and the social
and cultural values of people of United States).

(2) By working with US physicians and researchers, you make “connections” in the System
which pays you a lot later on when you are applying for a residency spot in the US after doing
your USMLE (Unites States Medical Licensing Examination). The name of an imminent
scientist or clinician in the references section of your CV can open many doors for you in your
professional life. The Letters of recommendations (LORs) from the faculty of a renowned
hospital in US are always looked favorably by program directors of residencies and
fellowships.

(3) If you opt for an externship, it will count as your US clinical experience (USCE). Due to
growing number of highly qualified candidates from the world, the competition is fierce to get
a residency spot. Many residency programs want to see USCE as a prerequisite to apply into
their residency program. If you don’t have USCE you are simply screened out from the list of
eligible candidates for interviews for those programs who require USCE.

(4) If you choose to join a research team, you may get some quality publications which do
carry some weight age when screening candidates for interview and more importantly at the
time of ranking candidates for the residency spots. Even if you are not able to publish a few
research papers, your experience in a research team will reflect your genuine interest and
aptitude for research which is seen highly favorable by many university residency programs.

What to Choose?

Among observership, research and externship, if you have to choose one; go for externship
because it carries the highest weight age of all three. Externship is called a “mini residency”. 
During externship you get “hands on” clinical experience as you are actively involved in
patient care; you can take history, examine the patients and get involved in patient
management along with residents. But the problem is that most of the hospitals do not allow
externships due to tough laws of patient privacy and HIPAA (Health Insurance Portability
and Accountability Act) rules.

The bottom-line, however is, that get whatever you can; may it be research, observership or
externship, but prefer externship over research and observership.

How to find a research position, observership or an externship?

Regarding research, first of all to be very honest emailing professors or other research
scientists does not help much. Most of the directors of research don't open any mail that
would be related to a research opening or volunteering; that's what my Principal Investigator
told me, but exceptions are always there. So you should try and mail the researchers but the
chances of ending up in a spot are not much as most of the researchers get hundreds of such
mails daily from all over the world and they are screened by their spam filters unless they
have an open position. And if you are away from US and the only thing you can do is to email
the researchers then my advice would be not to send a generic mail to all the scientist and
wait to hit the jackpot. Do your homework well, send an individualized email to every
scientist, know his research well, find his publications on pubmed and make an appropriate
cover letter which should show your genuine interest in the research that person is doing.

If you are lucky enough to be in US then the best bet would be to meet the researchers in
person. Take a well written CV and a cover letter with you. But before going to any person
you should spend some time and find his areas of interest, his current and previous research
projects so that you can have common grounds during discussion with that person.
If you don’t have previous research experience , my advice would be that not to ask for a
“Paid” position as nobody is going to pay you from day 1 without enough research skills and
experience. Try to volunteer in some lab for 2-3 months, learn some basic research
techniques and you can later get paid in the same or some other lab if the investigator is
satisfied with your research work.

Another important factor when deciding to work in a research lab is to choose to work with a
researcher who is a big shot in his field as his reference would count when you would be
applying anywhere for any type of work. One way of finding out if the person is a big name is
to search his name on pubmed.gov and find out the impact factor of few of his publications.
But that may not be true in every case.

Regarding observerships, the same would apply. However, the difference in this case would
be that you should contact renowned clinicians through email, phone calls or better still meet
them in person. Another good option is to find an M.D., PHD who is involved in both research
and direct patient care and start volunteering in some of his lab work and then later begin
attending clinics with him, if he is still doing them.

Externship as I previously mentioned are difficult to get but if a certain program offers
externships, then they will have a certain office dedicated to it and you can email or call
them. But for externships these hospitals usually charge you a handsome amount for a
limited period of time and you also have to buy malpractice insurance; but all that spending
is worth it.

Types of Research:

Now coming to what kind of research you should join. There are two basic types of research:
(1) basic science or bench research and (2) clinical research. There are advantages and
disadvantages of both.

For most types of clinical research, the plus point is that there often there is patient contact,
for those who are not interested in typical lab work. However at the same time if you talk
about bench research, the plus point is that often you get hands on experience on latest lab
techniques such as RT PCR, luciferase assay, western blots etc but to get a publication in
basic science research is relatively more laborious and difficult. But if you are interested in
lab work and are considering in pursuing a PhD as well, then the latter may be a better
choice.

Few things to do during your student life:

During student life do not miss any opportunity to get involved in any sort of research
project going on in departments you are rotating no matter how simple it is. Do electives in
US during your clinical years and above all never miss your clinical wards.
At the same time, try to learn a couple of softwares, which will help you a lot in research such
as SPSS (Statistical Package for Social Sciences) and other research related softwares.

Important Lessons to Learn

(1) Externships, observer ships and research should be done to get overview of healthcare
system of US, make some connections in US or to publish few papers.

(2) Externship should be preferred over observership and research.

(3) It’s always better to meet the relevant person in person rather than emailing them and
if email is to be done it should be individualized.

(4) You can choose clinical or bench research depending upon your aptitude, the length of
time available and your future career goals.

(5) One should not miss any opportunity to get involved in any research or clinical project
during student life and to learn few statistical softwares.

(6) Discourage the practice of ‘mass e-mailing’. Day by day, this wrong practice is increasing. Often, you would find students wasting hours in emailing the same request to
almost every other professor to whose email address they can get their hands on. This is a bad practice. Emailing if required should be very individualized and personalized. Along with this, you should first decide if the person’s research area is of any interest to you. In some cases, people end up working in a project in which they have no interest, which in turn
leads to months of precious time wasted.

Even worse is the practice of getting accepted for a research position, using it to get a US VISA and then not going to them. This unfortunate practice too is on the rise. This not
only brings a bad name to your institution, but to your country as
well. These practices should be avoided and discouraged.

At the same time, as the authors mentioned, do not miss upon any opportunity in your home country and college.

These days the undergraduate research especially in Pakistan & India is gaining a lot of momentum. Few of my colleagues have gone onto publish their group work in one of the world’s biggest journals. The lesson is not to underestimate the importance and the good research work that you can do at your own home institution. It is certainly more fruitful than wasting hours everyday mass mailing and getting no response.

 

Reference: Rai AS, Mughal, Mughal SA. Observer Ship, Research and Externship in the United States. 10/90
Student J 2007. 1 (1): e5. 

residency 2014

hello
i need alot of guidance. I am an old graduate 1998. I passed my steps with 210/step 1 and 213/ step 2 in first attempt. I also passed step 2 ck. I am a permanent resident. I have a 4 months usce .Last year, i had applied in more 150 programs but didn't get a single call. I need some guidance, what to do now. Do i need to update my LOR or should I sork in a research institute. Please help me out.
thanks

Externship after internship

First of all I would like to congratulate you on the amazing work you are doin helping so many people out..and I find "Helping professionals become better professionals" a very eye opening line..I am totally new to this field and ur page has been a life saver..Three cheers for the tremendous effort.
I am an IMG who graduated in 2012 and was preparing for Indian entrance last year. Now as I read more I am really interested in doing my residency in the states preferably in IM. As I am a graduate wht I infer is that I am eligible only for externships and observerships. But even though I went through the matter a number of times, I am not very clear of when I should apply, where I should apply and how I should apply.. I would really appreciate if you could help me in this regard... Sorry for the trouble and thanks alot again for takin time out frm ur hectic schedule to help out so many clueless souls to realise their dreams..

hi.. I completed my

hi.. I completed my internship too from India this year March. and even though I have started preparing for Indian entrance I'm more interested in doing my residency in us. your post is something I very much relate with. so if you have any information please do let me know. would really appreciate it. thank you..

externship after getting degree ...

 hello tariqbhai

i am a graduate, completed internship

can i get externship? 

if yes .. where should i look and how to apply

if no

what is the way to get hand on experience now?

ur answer will help many of us sir..thanks

externship after getting degree ...

 honorable sir

thanx for ur site being the most authantic guiding site ever, i would like to know

 

i got my degree fm kazakhstan, internship completed, want to apply for externship?

is it possible?

where to apply ?

how to apply?

what about externshipusa.com etc

 

please do answer .... it will help many

Observerships

Dear Dr Tariq

I have been following your site quite religiously and I believe it is nice forum to help people aspiring for residency. I have something that I would like to share with you.

I am done with my MBBS and will be applying for match next year. So, for the past 4 month I have been working in Telemedicine Department at Teleradiology Solutions, Bangalore.(Telradsol.com). Teleradiology Solutions reports images for more than 150 hospitals in the US and more than 20 countries around the globe. Images from hospitals are reported by radiologists here in Bangalore. They have more than 20 radiologists who are certified by American Board Of Radiology.

They also have a well functioning clinic which has physicians who have done their residencies in the US. As they are expanding their their Telemedicine wing they are looking for doctors who could work in the Telemedicine department. If they find the docotors, these people can help them in getting observerships or research positions in various American Universities including some the Ivy League Institutions.

They do pay a stipend for doctors working here and the minimum time commitment that a person needs to work here is around 4 months. While working here, I got to know a lot about telemedicine. Got to work on 3 research papers. Observed and worked with Physicians from US. Got to see imaging in the Radiology wing which was out of this world. They even report images places like Harvard and yale. Also got an LOR from Dr Sunita MAheshwari, A very renowned pediatric Cardiologist from Yale university and will get to do Observerships in the US.

So, If any one, who has a little bit of time, may come here work for telemedcine and can get a lot of benefits other than the joy of working in a state of the art Telemedicne center.

I thought your blog might be a good platform to spread the word for USMLE aspirants who might be benifitted by this.

Regards,

Anup

 

intrested in telerad in bangalore.

Dear sir,
i am currently an indian MBBS & very much interested in working in Telemedicine Department at Teleradiology Solutions, Bangalore. i have passion for radiology & willing to do residency in USA . Kindly email me shrinivas2020@yahoo.com

het thanks a lot for that

het thanks a lot for that input !! 

apply for telrad

 hi.. its really an informative post. could u please tell me how to apply for telrad???? 

Help for externship urgently

Respected Sir 

I want to know about Fmg portal how reliable source they are for externship ?

They are offering my inpt n outpt place in maryland 

I am an India and have little doubts about this ?

I just cleared step 1 should I go ahead with observership 

regarding reseach cover letter

hi 

i am  img  a  female from i india  ahve gradutated already will be giving  ck in dec.,,t  don  have  any relatves ,.i was  willig to apply  for researh  at a medical university...got 2q)  1..iam really lost int application procedure....like how  do i write a prpper  covering letter...my filed  interest is neuro psyciatry   follwed by  pediatrics,,,,2)since i kept my option open  in these 2 fields ...which r differ  will it effect  in resid  match  later on..wat i mean is  wat if i don getr reserch  int o the field i wanted.....please  help me..plz

Obseverships in another speciality

Hi,

 I am going to apply for IM residency. Im unable to get any observerships in IM right now. But I am currently involved in pediatric research. I also have an opportunity to do an observership at the same place.

Should I go for it?
One of my friends told me I shouldnt do an observership in pediatrics because it creates a doubt in the program directors mind, that I am not sure of the speciality.

Please advise.

regarding externship during or after internship

hi,i have completed my mbbs in december 2011 and currently doing  my internship in india,i wanted to know about the basic reqirements of fellowships in usa,does it require externship during or after my internship,if yes then give me information how and when to apply for externship in US so that ican apply for it,i have not given usmle steps,


plz do reply

clerkship

hello

i have currently doing my internship n preparing for step1 usmle...m planning to take it by sept-oct....

bt m also concerned about clerkships....and i dnt have the slightest clue about how to get along with it

also i would highly appreciate if you could guide me how should i proceed...should i focus on step1 itself or should i search for univ which offer clerkships without step1???

hiii

i hv done my d.ortho frm india....ll tht help me in my cv fr usmle as clinical experience...n fr takin tht branch surgery...pls do replyy... soon pls pls

USCE

Hello,

 Good Morning,

I am old IMG have done step 1 with 236 and planning to do some USCE, I did lot of searches and I did find any university Hospital offering any Externship but only few of them replied that is paid Observership from Drexel
University College of Medicine
and George Washington University Medical Center. I have also come across paid externship from agencies like IMG Prep, Americlearkship, FMG portal, I am Little confused regarding making decision to choose University paid observership over Private agencies's pain externship   as IMG Prep and Americlearkship claiming they will arrange Residency program Hospital.

Kindly Clarify.

hey i have jst completed my

hey i have jst completed my intern yet to take completion. so i wanted to ask tht as i wnt be eligible for externship any more so hw could i get to same par as of those who did externship. if i get gud scores nd do observership wat else can help to improve my cv nd get equivalent to those who did externship plz reply

observerships


 


hey i have jst completed my intern yet to take completion. so i wanted to ask tht as i wnt be eligible for externship any more so hw could i get to same par as of those who did externship. if i get gud scores nd do observership wat else can help to improve my cv nd get equivalent to those who did externship plz reply it is nt possible for me to delay my completion so i have to rely on observership or research only

externship or clerkship?n how to apply?

hey hi..i will completn my final mbbs n jst wantd to know wht to aplly for clerkship or externship?n how to apply?where to find universities who offr such programs?pllzzzz

USMLE steps or research


hi.I am done with my internship this march.I haven't gone for tofel or usmle steps...can i apply for the research n then go for the steps.is it okay if we go for USMLE 1 yr or 1 n 1/2 yr after graduation.won't there be any problem as to why i didn't go for USMLE for so long n all that...and i'm interested in paeds what field do u recommend will be helpful for me in future?


thanks a lot in advance...

externship

Sir,
Is it true that u can only apply for a hands on patient elective while u are studying in a med skul? I was planning to apply for an externship after graduating.

observership


Dr. Aitzaz Bin Sultan Rai

hello Dr,my name is omar i graduated from jordan university of science and technology last year iam a us citezen living in charlotte now,iam interested in pediatric and iam looking for observership so plz help me to find any place,i did the step 1 exam but still pending

thank you so much

which is better??? clerkship or externship??

thnks in advance

clerkship/electives...

umar's picture

clerkship/electives...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

Electives in USA

Hello Sir i am a third year med student in pakistan and i have my exams coming up in november. i was planning on going to US for electives/observership after my exams but i dont know whether it is possible or not? means can i go after my third year exams in december and which universities/hospitals offer observership in US? Kindly please help me out. I shall be truly grateful.

Thanks a lot

Yes you can do observerships

umar's picture

Yes you can do observerships or research electives...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

hai, i wrote to one of the

hai,

i wrote to one of the professors requesting for an observership. He asked me how did i get his email id?.. what is the best response when asked how did the email id?

Thanks

Tell him exactly how you got

ayaz's picture

Tell him exactly how you got his email ID!

ok thanks

ok thanks

Pediatric externships

Hello,

I'm a med student from India(house surgeon currently) The article above was extremely helpful. I want to try for pediatric residency next year but haven't given my steps yet. I've done a couple of clerkships, not entirely pediatric based though. Not sure if these LoRs will help, but getting even electives we want has become extremely tough. So, I checked out online for pediatric externships. Only one place offers them for sure and a few others doubtful.

 I wanted to know if USCE needs to be in that particular dept I'm applying for.. or say, for example.. will an externship in IM help me for pediatrics as it'll still get me USCE certified or sth? Or will it simply be a waste of money and seem fickle to the people interviewing? 

If an externship is futile for paeds, as it'll only be in IM going by the availability.. how many LoRs in general do we need before applying...? That's a lot of questions I'm afraid. I'm absolutely confused.

Something is better than

umar's picture

Something is better than nothing... so the more you have on your CV the better it is... having said all that... keep in mind... anything in ur specialty is better than any other specialty...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

externships or electives after mbbs

sir, 

i have passed mbbs from india nd have also completed internship. i got 99 percentile in step one. i wanted to know that is it possible for a graduate like me to get a research elective or externship in states? i have heard that only current medical students are eligible for that. please do reply..

alok

yes it is... if you are not a

umar's picture

yes it is... if you are not a graduate... if u r a graduate you can apply for a post-doc research position...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

i am an img, female, living

i am an img, female, living in india. i ve very less contacts in US. i have been trying to mail and call many doctors in us asking for a usce but no one has helped me till now. so i was planning to take fmg portal. can you please advice me wat to do. i just have one month for my cs exam and for getting a usce. is it a good organisation? how will i verify?pls help me....right now they asked me only 1600 including all charges but some whr i read finally they cost 3000$.wat shud i do?

fques about mg portal

Can u please share with me your experince with fmg portal I am about to sign contract with them .

I will admire your help

may god bless you

If you are still a student, I

umar's picture

If you are still a student, I would recommend you to try yourself before going for any paid company!

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

Externship in US to get USMLE.

I will be completing final year of MBBS by December 2011, and thereafter to get MBBS degree I have to do one year internship. 

I want to know if I can do externship in US after December 2011, i.e. before starting internship here in India.

to get an elective in internship...

once the final year is passed immidiately go for a toefl exam give it by april so thot one gets a score by next month.
Meanwhile, use this website and info available here to kno how to and where to apply for electives.Get all procedures and requirements fulfilled by the timew your toefl score arrives.
Send application.
wait.
if you do get a call...great fortune...cash in!!
Apply such that u get a rotation immidiately in april march or in the month following which your internship is goin to end.
imp Advice-"dont complete your entire internship-let alone be a particular rotation for one or two weeks(take a repeat)"
finish your rotation in us.come back ...finish your rotation back here.graduate and prepare for Usmle....enjoy

You can do electives before

umar's picture

You can do electives before graduation and externships after graduation!

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

hello........its d greatest

hello........its d greatest informative site ever.....i have completed my internship from india.....m interested ininternal medicine...can u pls tell me what shud i opt 4?observership or externship?thanks in advance.

Thanks a lot for your kind

umar's picture

Thanks a lot for your kind words. Externships are better!

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

Need advice


hi,


I am an IMG outside USA. I already took the step1 exam and preparing for the second. I would like to know how can i get an externship or a research position in the states to have some US experience to put in my CV. I heard that some universities take IMG's for externship if they pay. Is it true. Thank you in advance

Yes places like Harvard do

umar's picture

Yes places like Harvard do offer externships but there is a huge fees. Kindly search for it online.

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

externships

hi

what is the procedure for application?  and how reliable is fmg portal? do they provide hands-on training as promised? also how much earlier do i have to apply to these programs to get a spot in march2011?

thankyou

Every place has its own

umar's picture

Every place has its own procedure. I dont know much about fmg portal, so I cannot comment on it.

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

externship

hello'

i'm a madical graduate from india n hav already completed my internship..i 've learnt from various sources dat even if u do get an extern-ship prog. u do't get ne hands-on clinical practice since u generally go on tourist visa.

is all this true??.should i prefer observership den?

pl reply..

thankyou.

I am not sure about it. I

umar's picture

I am not sure about it. I dont think there is anything like that. If there is, then certainly it is not externship. Visa requirements for externships vary from place to place!

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

electives

hey i m a third yr medical student i want to do research electives in usa help me how can i apply??

Visit various posts in

umar's picture

Visit various posts in electives section of the website!

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

i found a site

i found a site www.americlerkships.org which places me in a teaching hospital for hands on clinical practice under a doctor for upto 36 weeks

can i rely on that ? or would u prefer to apply direclty to universities for clerkship?

is clerkship better than that hands on clinical work in view of fetching for residency?

I prefer applying directly to

umar's picture

I prefer applying directly to universities... hands on experience is the best... whether it is electives or clerkships...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

electives

Can anyone please tell me whether i can apply for electives after i hv completed my mbbs?

No you cannot...

umar's picture

No you cannot...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

regarding applying for observership

hey!

wanted to know whr i can get info regarding the universities tht offer observership n research... preferably both. i just started preparing and i intend to apply by oct 2011. please help as am really short of time.

thanks!

check out usmletomd.com

umar's picture

check out usmletomd.com

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

externship

hello, tariqbhai.

i just want to know that, how to apply for externship program ?

what is ideai time to get it?

what r fee struture?

waiting for reply....

thank in advance..

varies from place to place...

umar's picture

varies from place to place... some have a formal application procedure... at some places, you can get one via email...

Ideal time and fees also varies from place to place...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

thanks....the text was hugely

thanks....the text was hugely helpful.

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