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Electives in America - Frequently Asked Questions by Jaidev Nath

Written on August 02, 2011 Contact address: jrn772@bham.ac.uk

1) Who are you?

My name is Jaidev and I am a final year medical student here at Birmingham. I grew up in America and am planning to go back after graduation for a pediatric residency. So if I get a job, I promise I'll write up a guide on how to go to America for post-graduate training :)

2) Where did you go for your elective? And what did you do it in?

I did my elective in Pediatrics at INOVA Fairfax Children's Hospital in Fairfax, Virginia, about 20-30 miles away from Washington DC.

3) Is it easy to get an elective in America?

It's not that easy! The main reason for this is the USMLE Step 1. This is an eight hour, standardized preclinical exam that every American medical student is required to take after year 2. Without a passing score on USMLE Step 1, your options are significantly limited. I had to do Step 1 to get a placement in Virginia. That being said, if you know which Unis don't require step 1, you have a high chance of securing an elective and there's no reason to give up on that American dream!

4) So should I take USMLE Step 1 to increase my chances?

Please don't! Not unless you are serious about applying to America for postgraduate training (either residency or fellowship). This is a daunting exam that requires months and months of preparation. It also costs about $800!! If you are serious about taking this exam, feel free to email me and I will be more than happy to help.

5) Which universities don't require Step 1?

Mt. Sinai School of Medicine - New York City, New York

Washington Hospital Center - Washington DC (You need to email individual departments. Tuition is free and there is no application fee)

University of California Los Angeles (UCLA)

University of Rochester - Rochester, New York

National Institute of Health - Clinical Elective - Bethesda, Maryland

Harvard - Boston, MA

Yale - New Haven, CT

Emory - Atlanta, GA (Their application says step 1 is required, but I know someone in my year who secured an elective without Step 1)

Cornell - New York

Northwestern University - Chicago

Brown University- Rhode Island

University of Louisville - Louisville, Kentucky

Baylor College of Medicine - Houston, Texas

Tufts University - Boston, MA

Thomas Jefferson University, Philadelphia - You need to email the registrar for more info.

University of Missouri - Kanasas City

University of of Kansas- Wichita (Step 1 is required but can be exempted, but please email to confirm)

University of Washington - Seattle

Cook County Hospital/John Stroger Hospital - Chicago

Unfortunately they don't have a website. You have to google search individual departments and email them.

The general trick to finding these websites are to google search "University Name" and "Visiting Medical Students".

6) Is that it? Just 19 universities?

This list is almost comprehensive. I might have missed out a few community hospitals that don't require step 1. The only way you can spot them is by mass emailing random hospital department faculty members. I have also left out a few places such as UMass and NYU, because I know the deadline has passed. But the 19 places mentioned above are the major players that don't require USMLE Step 1.

7) Any other helpful websites?

The VSAS website is really helpful. Make sure you checkmark "Accepts International Students" when you are performing your searches.

8) How do I choose from that list?

Go through the list above and study each and every website. Tuition can be a big limiting factor, with some places such as Harvard charging up to 3-4000 dollars for four weeks! So narrow down that list to about 6-7 schools depending on what you are looking for; prestige, budget, location, specialties available for international students etc.

9) Ok, I have a few schools in mind. What do I do next?

After you narrow it down, email all of them (email addresses are often hidden in these websites,

but they're almost always there). Don't ask questions that are answered in the websites. They

really dislike that, as it shows that you didn't put in the time and effort to study the website

carefully. Therefore please read every single page/form carefully before shooting off any emails.

But good questions to ask would be, how early should I apply? When will I find out if I have

been accepted? What's the competition ratio like? What are the accommodation options nearby? Visa queries? etc.

10) How early should I apply?

I have a friend who applied and secured a spot while he was still in 3rd year (April). So apply

ASAP if possible! Once you have received your replies and you're happy to apply, narrow it down to a single program. Download all their application forms and requirements and get started

on them immediately. US universities are notorious for requiring tedious immunization forms,

CV etc. For most applications, time is money. So try not to waste any.

11) I have applied. What next?

Congratulations. The hard part is over! Now just sit back and relax. Sip on a hot cup of tea and keep clicking the refresh button on your email. Hopefully you will be receiving that acceptance email soon. And be very wary of applying to programs that won't confirm your acceptance until

a few weeks/couple of months before the beginning of elective. Make sure you have a decent backup plan if you have your mind set on one of these schools.

12) How are electives like in America?

There is no general answer to this question. It can vary depending on which university and which specialty. But as a rule of thumb, be prepared to work at least 35-40 hours a week, and up to 80

hours if you are applying for sub-internship electives. American electives are very hands on and consultants will give you a great deal of autonomy on patient management. This means that you will get to learn a lot by doing. No matter where you end up going, I can almost guarantee that it

will be a fantastic learning experience.

13) Thanks a lot for this guide. But I have so many more questions dude! What should I do?

You're welcome :) If you have any more questions feel free to email me at JRN772@bham.ac.uk

and I will try and help you out as much as I can. Otherwise I will definitely point you in the right

direction. Best of luck with your application process and enjoy your time in America. It won't

disappoint!!