Hi guys. People have been asking for advice about rotations to get USCE.

I thought it is worthwhile giving

some time to this group, since it is a valuable resource for many.
First of all, some form of USCE ( in the form of electives or observerships or externships) is very
important as it exposes you to what medicine is about in the US. If one has not done any USCE and
matches, I think that person would find it hard during first 2 months to adapt in residency. And you want
to be able to make the most of your residency and work on every aspect that can possibly make you
more comfortable during residency. So to conclude, you NEED USCE. It is a MUST.
I know money is an issue for many, but guys, you have to somehow make it happen. Remember that
unlike the AMG's you don't have huge student loans. ( That's not too comforting, but still ..... )
So regarding USCE's. Externships are great as you get hands on, so are electives. But the most easy USCE
to obtain is observership, and contrary to what many say, they ARE useful. Especially if you try to make
the most of them. Show your attending that you know your stuff, participate in discussions, tell your
opinion, learn to speak well with patients, and your attendings might even let you enter patient notes
and conduct physical (with the resident or under resident supervision). Being on good terms with the
residents is also important. Be simple and friendly. Don't be overly apologetic about everything. Make
sure you observe things and learn. The residents will include you in didactic activities and may even let
you examine patients.
It is VERY important to present yourselves well during your USCE rotations. Dress well. Be well groomed.
At first you will not be confident but a week into the rotation you will be. Very often patients will ask
questions about who you are if you are not well dressed, well groomed. Have table manners. Look them
up on google. Am not being condescending but its just that the culture in the US is different and it is
important to learn about a people's culture if you are to work with them. During your rotations you
might have noon conferences where you gotta eat lunch etc. Or more formal dinners on some
occasions. So if you are not familiar with them, do learn a little about table manners.
Make a good impression early in the rotation. Inform the attending that you will be asking for a LOR one
week into the rotation. Talk to the attending. Inform him of your intention of getting into residency, talk
to him about what you have done and intend on doing later. They like to hear about our experiences. Be
polite and nice to everyone. Not in a rigid way, but really try to integrate a little.
When you do ask for a LOR, ask verbally as well as submit a copy of your cv in an envelope to the
attending. Make a good CV. Good format. Give a card to the attending ( and other people you feel you
worked with / had a good interaction with ) when you leave. Tiny chocolates might also be a good idea.
Basically let them remember you well. People of course like observers who are good academically but
this isn't the only thing and it isn't enough. Hence this post. I know most people are aware of all this but
I hope it helps some people. I will write another one about how ( and possibly where ) to get USCE later
....
Hope this helps someone.

WHAT NOT TO DO WHEN LOOKING FOR USCE.

When looking for USCE, do avoid private practice doctors. Go to recognized university or community
hospitals. Things which will matter in an LOR: Name of institute, which rotation you did, and how well
the attending wrote about you, and of course the name of the attending.
If you go to some private practice no matter how well they write about you nobody cares. So go to
university or community hospital ( recognized one). Go to a few different places. Some might not give
LOR , but try to go only to those places that do. You can also rotate for some time in some place that
doesnt give LOR if that means more experience and less gap on CV. but of course don't remain there for
too long.
Whether it is obsie, externship or elective, bottom line is go to good institute not private practice. Some
of the private practice guys will tell you work for me for 2 yrs then i will get you into residency and you
will basically be providing free medical assistant labor to them and many of them are crooked and will
not hold their word. So do not try to create short cuts like this one for yourself. You will get trapped.
Next post will be about HOW to look for USCE.

HOW TO LOOK FOR USCE:

Google / search engines.
Contact residents / seniors / people you know
Ask people about their experience in such and such rotation at such and such places.
Basically get your information down. It takes time. There is no magic list, no magic formula.
For eg I rotated in cardiology at CCF as an observer and they are little reluctant to give LOR at CCF in
general but in another department in the hospital ( gastro) there is a nice attending who is ready to give
good LOR. So do your homework ( which is a lot of detective work in this case, sorry guys) .
Find info about all the possible USCE and apply on time. ( mostly 6 months prior to when you wanna
start )
When applying make sure your paperwork is in line, your CV and cover letter are good.
Look up how to write CV and cover letter. Dont make cover letter the length of a novel.
If you know a resident who can have your application looked at first, then good for you. Have people
pull strings for you. Get into good USCE.
Time-line wise:
Do clinical rotations first. ( Whether obsie or externship or clerkship ) then go and get into research if
you have time. Because mostly to get a letter or outcome in terms of publication or anything out of
research will take time. am talking a lot of time. atleast 9 months. Do be wise.
Do your clinical rotations first then get into research. Even if you just entered research when the
interview season is there its okay. You learn your research protocol and talk about what is being done
on your IV. people will be happy.
You don't need to publish report of clinical trial for people to be happy with you in the IV.
Next post will be about where to apply for obsie ( maybe) but you guys can find that info online too so i
dont know squint emoticon

SOME SPECIFICS ( people should really add on to this )

So I will list some places where obsie / other USCE are available. Please contribute, add on, discuss etc.
1) University of Miami, FL
Paid obsie/ contact Olivia Cata/ Attendings good/ Obsie well structured/ Good LOR if you work
well / good didactics / IMG friendly but mostly latin American/ but I got IV from there. If you
make good impression you might get.
Obsie available in many specialties. Very good for IM, peds, psych. Others must be good also.
1000 USD a month but COMPLETELY worth it.
2) Wayne State University, Detroit , MI
IM one month obsie/ good attendings/ good LOR if you work well/ good residents, will let you
see patients with them/ good didactics/ expensive at 1600 a month. But look at it this way. If
you stay without residency for one year then you are spending more.
Dont listen to people who say Detroit not safe or what not. Stick to what you go to Detroit for.
Dont go clubbing in Detroit then say it is not safe.
3) Cleveland clinic florida
900 a month or so / good attendings / not much chance to actually see patients / good didactics
/ PD will consider your application if you have good profile and can get LOR from the attendings
although it is difficult to get LOR
Best sub specialty to get LOR from attending is ICU/CCU rotation or GI
People will say you need a car to get around but I did without. Walked one hour to get home
daily. On the way to the hospital the landlord was dropping me. wonderful lady. If anyone going
to CCF inbox me for her contact details if you wish for a place to stay.
4) I had obtained obsie for 2 months at Dana Farber childrens hospital cancer center. It was an
elaborately planned 2 months with some component of research too but I could not go as I was
not free. Do apply . there is a skype interview involved. Totally worth applying.
5) I also got obsie at Albert Einstein Philly but couldnt go. I heard its alright. Not totally great. But I
dont have experience there myself.
6) Harlem hospital internal medicine- Simone gittens was the contact person. Heard its good.
7) Canton medical education foundation, Canton , Ohio. Cathy wolford was contact person. Heard
its good.
8) OSMA ( Oklahoma state something ) I heard its good. Although I didnt do it myself.
9) Rutgers, NJ does give obsie, at attendings discretion. So if you remotely know an attending or
fellow there, try.
10) I had got neuro obsie at Nebraska U. forgot contact person. Its a good place though.

11) Externship at Mercy hospital St louis Missouri. Free externship. Apply on time. Michelle kempf is
very nice if you are diplomatic and reasonable. I didnt do the rotation as I couldnt apply on
time. But I interviewed there. Good hospital. Good program.

12) Externship at HVI ( heart and vascular institute) in cardiology, at DMC ( Detroit medical center )
wayne state university
Contact person used to be Rana Srour. Good luck trying to get her on phone or email. But apply.
I had applied. Suddenly out of the blue she called saying you can come next month. Again I
wasnt free to go.
.. to be continued -_- tired