Types of US Clinical Experience

This 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/Subinternship (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 thatyou 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 Electives

This 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 requirementbut 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 $11001500- 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, Extracurricular 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 +1 301-4967989

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 freerequires 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-16
Albany, 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 UTSWwebsite), 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
(718) 283-7629

Address: NA- as online application

+1

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 +1 212 263-5291
Address: OFFICE OF REGISTRATION/STUDENT RECORDS NYU 550 FIRST AVENUENEW 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 98
Brooklyn, 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 emailing 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 emailing 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 920930729

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
980565
Richmond, 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 Hill
Jr. 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 537052221.
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: visitingstudents@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 10029
Tel: (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 trainingOther 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) 2754172
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
66160
FAX: 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 213
Boston, 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
Avenue
Boston, 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. - Noon
University Office of the Registrar
Curtis Building, G-22
1015 Walnut Street
Philadelphia, PA 19107
Phone: (215) 503-8734
Fax: (215) 923-6974
E-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 Application
By 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

PREP

Spring, Winter, Fall, Summer

exams

USCE Hospital Rotations

MEDICAL
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

MATCH

Summer and Spring, 2014

Winter 2013

USCE Externship
Rotations

USMLE exam prep and

exams

PREP

Spring 2014, Winter

2014/2013

Fall, Summer 2013

USCE Hospital Rotations

MEDICAL
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 Ive 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 hospitalbased 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 ones 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 doesnt 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, thats 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 dont want you! The
university teaching hospitals really dont 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. Dont 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 statementcontent 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 Hospitals
Medical 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 Programs

1. The University of Washington in Seattle
The 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 Hill

The 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, MD

Johns 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 University

Harvard Medical School has 15 researchers who received the

Nobel Prize

Cambridge, MA

JHU hospital ranked first among all hospitals by U.S. News &
Johns Hopkins University World Report 21 years in a row

Baltimore, MD

Stanford University

Stanford School of Medicine includes five medical institutes

Stanford, CA

University of Cincinnati

College of Medicine offers over 50 residencies and fellowship

Cincinnati, OH

programs

University of Michigan

U.S. News and World Reportranked internal medicine

department sixth in 2012

Ann Arbor, MI

University of Minnesota

Department 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

Report

Seattle, WA

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:

Ran
k

Hospital

Point
s

Specialties

Johns Hopkins Hospital, Baltimore

30

15

Massachusetts General Hospital, Boston

29

16

Mayo Clinic, Rochester, Minn.

29

15

Cleveland Clinic

27

14

UCLA Medical Center, Los Angeles

19

13

Northwestern Memorial Hospital, Chicago

17

12

New York-Presbyterian University Hospital of

Columbia and Cornell, N.Y.

17

10

UCSF Medical Center, San Francisco

17

10

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

13

Cedars-Sinai Medical Center, Los Angeles

12

14

NYU Langone Medical Center, New York

11

15

Barnes-Jewish Hospital/Washington University, St.

Louis

10

16

IU Health Academic Health Center, Indianapolis

17

Thomas Jefferson University Hospital, Philadelphia

18

University Hospitals Case Medical Center, Cleveland

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-internationallyrecognised 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 juniorsenior 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,Lbeck,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.Pnktlichkeit 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 Dner (Turkish-German hamburger) for 3-4 euros (3,5-4,5 dollars)
and for Asian like me, the portion of one Dner is for two portion meals. During my night shift in hospital, I
usually eat half Dner 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 Mnster). 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 experience

Discussion in 'Australasia and Oceania' started by Pollux, Jan 27, 2009.

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1. Pollux
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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=38
NBME 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 crossreference 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) = 10700
I 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
2.

markdc Senior Member

Joined:
Feb 17, 2003
Messages:
153
Location:
Canada

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
#2
3. Pollux
Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

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
#3
4.

amakhosidlo Accepted
Joined:
Feb 13, 2008
Messages:
943
Status:
Medical Student

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
#4
5.

Theillestill
Joined:
Oct 21, 2008
Messages:
124
Location:
Melbourne
Status:
Dental Student

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

Theillestill, Jan 28, 2009

#5
6. Pollux
Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

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

#6
7.

amakhosidlo Accepted
Joined:
Feb 13, 2008
Messages:
943
Status:
Medical Student

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
#7
8.

markdc Senior Member

Joined:

Feb 17, 2003

Messages:
153
Location:
Canada

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
#8
9.

shan564 Below the fray

Joined:
May 30, 2007

Messages:
2,260
Location:
St. Louis via Sydney via St. Louis
Status:
Resident [Any Field]

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
#9
10.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

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
#10
11.

fruitloops
Joined:
Nov 6, 2007
Messages:
44
Status:
Post Doc

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
#11
12.

islandoc2B
Joined:
Apr 28, 2008
Messages:
13
Status:
Pre-Medical

Congratulations on your excellent marks!

Thanks for your thorough posts-very helpful.
islandoc2B, Feb 3, 2009
#12

13.

redshifteffect Senior Member

Joined:
Jan 25, 2003
Messages:
1,165

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
#13
14.

redshifteffect Senior Member

Joined:
Jan 25, 2003
Messages:

1,165

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
#14
15.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

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.

I've had my mind set on Pathology for a while now)

Pollux, Feb 4, 2009
#15
16.

md2011 Member
Joined:

(j/k,

Dec 21, 2005

Messages:
76
Status:
Medical Student

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
#16
17.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

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

#17
18.

md2011 Member
Joined:
Dec 21, 2005
Messages:
76
Status:
Medical Student

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

md2011, Feb 5, 2009
#18
19.

fruitloops
Joined:
Nov 6, 2007

Messages:
44
Status:
Post Doc

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
#19
20.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

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
#20
21.

markdc Senior Member

Joined:
Feb 17, 2003
Messages:

153
Location:
Canada

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
22.

redshifteffect Senior Member

Joined:
Jan 25, 2003
Messages:
1,165

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
#22
23.

Pollux

Joined:
Sep 14, 2005
Messages:

123
Status:
Resident [Any Field]

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
#23

24.

JDMD243.0
Joined:
Jul 5, 2006
Messages:
105
Status:
Resident [Any Field]

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
#24
25.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:

Resident [Any Field]

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
#25
26.

fruitloops
Joined:

Nov 6, 2007
Messages:
44
Status:
Post Doc

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
#26
27.

majesticmar
Joined:
Feb 8, 2009
Messages:

1
Status:
Medical Student

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

Last edited: Feb 10, 2009
majesticmar, Feb 8, 2009
#27
28.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

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
#28
29.

md2011 Member
Joined:
Dec 21, 2005
Messages:
76
Status:
Medical Student

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
#29
30.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:
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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
#30

31.

fruitloops
Joined:
Nov 6, 2007
Messages:
44
Status:
Post Doc

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

#31
32.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

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
#32

33.

md2011 Member
Joined:
Dec 21, 2005
Messages:
76
Status:
Medical Student

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

#33
34.

fruitloops
Joined:
Nov 6, 2007
Messages:
44
Status:
Post Doc

Attached Files:
o

Steroid Hormone Receptors.pdf

File size:

124.5 KB
Views:
794
fruitloops, Mar 2, 2009
#34

35.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

Thanks, fruitloops!

Pollux, Mar 2, 2009

#35
36.

OnlyLiveOnce Pursuer of Happiness

Joined:
Mar 15, 2008
Messages:
110
Status:

Medical Student

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
#36
37.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

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
#37
38.

leilad
Joined:
Jul 30, 2007
Messages:
26
Status:
Medical Student

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

#38
39.

Pollux

Joined:
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Messages:
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Resident [Any Field]

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

#39

40.

Raygun77
Joined:
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Messages:
136
Location:
Melbourne, Aus
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Resident [Any Field]

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
#40
41.

Pollux

Joined:
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Messages:
123
Status:
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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

done.
...
Click to expand...

!), and it certainly paid off for you- well

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
#41
42.

bsga
Joined:
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Messages:
1
Status:
Medical Student
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
#42

43.

SFs Own Tone

Joined:
Jul 12, 2009
Messages:
82
Status:
Pre-Medical

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
#43
44.

shan564 Below the fray

Joined:
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Messages:
2,260
Location:
St. Louis via Sydney via St. Louis
Status:
Resident [Any Field]

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
#44
45.

SFs Own Tone

Joined:

Jul 12, 2009

Messages:
82
Status:
Pre-Medical

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
#45
46.

shan564 Below the fray

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St. Louis via Sydney via St. Louis
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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
#46
47.

Pollux

Joined:
Sep 14, 2005
Messages:
123
Status:
Resident [Any Field]

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
#47
48.

shan564 Below the fray

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I see, I guess I misspelled it.

shan564, Jul 19, 2009

#48
49.

shan564 Below the fray

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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
#49

50.

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