Clinical education in the U.S.A

As an international medical student who wishes to pursue a residency in the United States, obtaining a United States Clinical Experience (USCE) or clinical rotation in the specialty and location you wish to practice is one of the most important decisions for your medical career. In the United States, clinical rotations are available in teaching hospitals, community clinics, and urban or rural sites and there are many different ways to apply for an opportunity. During a rotation, you are exposed to a snapshot of residency life. You interview patients, perform physical exams, present cases, and oversee follow-ups.  You will be supervised by a resident or an attending, making clinical rotations a golden opportunity for you to audition and prepare for residency.

Clinical rotations can give you practical and procedural experience that you may not receive in your current medical program.

Why is a Clinical Experience so important?

  1. Strengthens your residency application

One of the goals of completing a clinical rotation or experience is to obtain a strong letter of recommendation (LOR) for your residency application. Many residency programs see value in the the letter of recommendation as it showcases how you work with others as well as in a team-based environment.  You should ask for a letter of recommendation after you have given a chance to your supervising attending physician to accurately observe and assess your conduct, medical knowledge and skills. You can ask first on feedback verbally on your performance after the second week of your rotation to allow for time to improve on areas of concern. Then by the beginning of the fourth and final week, you may ask for your letter of recommendation.

Having a letter written by a faculty member or mentor in that program shows that you are dedicated in choosing that residency program when you apply.

  1. Audition for residency

This is your chance to treat a clinical experience as if you already were in the residency program and that you are adaptable and work well in a new environment. Preceptors will also be considering you as a possible candidate for residency and will see if you are a right fit for their program. Connect with faculty members and residents in a positive way, and that could influence your chances in matching to the program. First impressions are everything.

  1. Gain hands-on experience

You can also use a clinical experience to improve your skills in interacting with patients, fine-tune presentation skills, and adapt to different clinical settings. As you are gaining hands-on experience, ask for feedback when performing new tasks. When you act on that feedback, it will show that you are dedicated to improving your skills.

  1. Improve your clinical documentation skills

The most important yet underrated aspect is properly documenting the medical history of the patient and their chief complaint. With proper history taking skills, you will find it easier to document the patient’s complaint, as well as documenting their physical examination and possibly filing their admission notes. This is a common task that residents perform when in residency.

  1. Understand the U.S healthcare system better

Performing a clinical experience allows you to obtain real practice and exposure to the U.S healthcare system. You will be able to understand how layered the U.S healthcare system is, from insurance, treatments, to supporting staff, and how all of these integrated pieces work together.

  1. Ability to Network with Faculty members

Leaving an impression with faculty members increases your chances of being accepted into a residency program. You can connect with faculty members to show that you are serious about applying to this residency program.

Remember different residency program directors place varying degrees of emphasis on the importance of visiting students in their interview list. Some programs consider international visiting students heavily in their choice for residency candidates, vs. other programs use different criteria when deciding whom to interview, like a lack of geographic regional ties, board score cut-offs, DO/IMG status, or other factors.

Despite that, conducting a clinical experience has more benefit to shaping your medical career and choosing your desired specialty.

Take time out.

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  • Value your time – omnis iste natus error sit voluptatem

  • Take time off – totam rem aperiam, eaque ipsa

  • Never stop learning – quasi architecto beatae vitae dicta

  • Experience is overvalued – aspernatur aut odit aut fugit

  • Be courageous – iste natus error sit voluptatem

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