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The terms can vary, but I have usually heard in-hospital experience described as clinicals, and field experience as ride-alongs.In an EMT program, clinical time is done in the emergency room where you will gain experience interacting with patients and performing basic assessment skills such as taking and recording vital signs.Ride-alongs are done with an EMS service. You will ride with an experienced EMS crew. The preceptor on the ambulance will watch you as you assess and treat a patient and keep you from doing anything wrong that would harm a patient.In both cases, the school supplies an evaluation form that must be filled out to document patient contacts and evaluate your skills.

It seems this topic could you a little more information.What Dr. Bolin said is very true. The US residencies will require a certain level of experience in an American-based academic environment to ensure that the potential resideny is accustomed not only to medicine but also to the demographics served, hospital practices, billing practices, etc. to some degree.Data from the 2018 Residency Program Director Survey 86% of Directors surveyed stated that letters of recommendation within their specialty were an important factor in selecting applicants for an interview (pg. 6), and 72% of Directors said it was an important factor in selecting the applicant interviewed (pg. 7).Your clinical rotations also do give you a way to potentially build a stronger “Dean’s Letter” (aka Medical Student Performance Evaluation or MSPE). If you were only given an observership, for instance, the clinical experiences gained would be minimal and that preceptor would be less able to accurately evaluate your clinical knowledge and advancement.If, however, it was rated as a Sub-I (Sub-Internship) this would alert residency directors that you potentially spend several months in a learning environment that may be equivalent to the first year of residency. This means you would be more accustomed to independently handling patients and require less oversight (in the form of hand-holding) than your peers may.For what clinical preceptors and past residency directors are looking for, I recommend our new podcast, the 1-Minute Preceptor Podcast. We interview mostly clinical educators to give students insights into how to maximize their rotations, prepare, and ask for Letters of Recommendation. We also have a few past residency directors that are planned for some later episodes.

Q. Can someone do a sub-internship in the USA, being a medical graduate?A. My standard answer would have been sub-internships are reserved for medical students who have not graduated. Until I saw this listing:Postgraduate Sub-Internship ProgramOtherwise, graduated physicians can apply for observerships which may or may not allow much direct patient care. Below are programs for IMG listed with the AMA.Observership Programs for International Medical GraduatesObserverships are designed to help international medical graduates (IMGs) adapt to the practice of medicine in the United States. Review the list of observerships that have registered with the AMA.American International Integrated Observership Program (MedicalObs)New applications are being accepted for 2018 positions at this time. Scholarships now available for highly competitive candidates.At MedicalObs, our focus is on the applicant’s experience. While there are many programs to choose from to help better prepare for entry into U.S. medical residency programs, what distinguishes us is our customized, integrated and individualized program curriculum designed to formulate an action plan to set applicants apart from the competition. Our values and philosophies are centered around the importance of personal growth, innovation, communication, commitment, teamwork and reliability.Length of Program4-12 weeksPreceptorsMedical Director for Hospitalist Program, Internal Medicine Physicians, Emergency Medicine Physicians, Psychiatry, SubspecialistsProgram OverviewObserving with U.S. licensed physicians in a hospital-based settingPerformance and evaluation review with chairman/program director*Letter of recommendation from chairman/program director*Certificate of completion with honors from AIIOP-MedicalObs*Review and edit of personal statement for residency applicationLive mock interview seminarsComplex clinical case reviews and live didactic sessionsAccent reduction and dialect coaching coursesAttending colloquium guest speaker series run by U.S. physician leaders and coachesExclusive alumni membership network with U.S. physicians via MedicalObsIntegrated cultural experiences with local community groups and social events*Based on a successful performance/evaluationEligibility CriteriaForeign medical graduates (FMG) from medical school and ECFMG certifiedU.S. senior graduatesU.S. FMGsNonmatched residency graduatesRecommend completion of USMLE Step 1 and Step 2Applications for Observers/PreceptorsGo to www.MedicalObs.com, click on the “apply now” section to fill out formsFor questions and enrollment, email us at [email protected] us via phone at 1 (833) 876-3627 or 1 (833) USMDOBSApplication DeadlinesWe screen applications year round.We accept and screen applications from all countries.Tuition and fees to be paid in full prior to start.AmeriClerkships Postgraduate Subinternships With Residency ProgramsLength of ProgramMinimum 4 weeks; maximum 48 weeks. Start in as little as 2 weeks.​PreceptorsProgram Directors (PDs), Associate PDs, Residency Program Faculty, Teaching Attending Physicians and ResidentsProgram OverviewAmeriClerkships Medical Society (AMS), in partnerships with Graduate Medical Education (GME) departments offers a rare opportunity for medical graduate members of AMS to enroll in Postgraduate Subinternships (PGSIs) in over 30 specialties.PGSIs are designated as AMS-PGY1CONNECT sites, meaning that AMS members have secured residency interviews and even “matched” into such hospital(s).A typical “matched” AMS member who has matched into a PGSI residency program has:Completed 12-28 weeks of PGSISecured 2-4 letters of reference directly from PGSI supervising attendingsIs a U.S. citizen or permanent residentPassed USMLE Step 3By enrolling as an AMS PGSI, medical graduates may expect to gain first-hand exposure to the inner workings of U.S. GME and medical residencies (even in 100% inpatient settings), and develop into an effective PGY1 by learning how to:Become an integral member of U.S. medical residency teams who manage acute and chronic medical problemsRotate and collaborate with top residency program faculties, teaching attending physicians, chief residents and even program directorsParticipate in teaching rounds, and possibly present in journal clubs and residency conferencesRefine history taking and physical examination skillsFormulate problem lists, prioritize medical problems, select laboratory and ancillary tests, as well as institute drug and supportive therapiesUtilize subspecialty consultative servicesDevelop definitive plans for ongoing care and follow-up of dismissed patientsUpon satisfactory completion of each PGSI clinical block, AMS PGSI will be evaluated based on the 6 ACGME Core Competencies, and may request a performance-based letter of recommendation on official GME/teaching hospital letterhead.For questions and enrollment, please contact AmeriClerkships Medical Society directly at +1 (949) 417-8980, or visit the website.Bridgeport Family Medicine Externship/Preceptorship ProgramBridgeport Family Medicine offers real hands-on experience in family medicine, internal medicine, pediatrics and urgent care medicine. The program is structured as a "mini residency program" to prepare IMGs for the U.S. medical system by using state of the art EMR/HER systems.Length of the Program:4-12 weeks, extern may start any Monday of the weekProgram OverviewThe extern interviews the patient, performs the physical exam along with attending physician and discusses differential diagnoses, management options, labs, imaging and forms a management plan. In addition, the extern will:See and manage patients with their preceptorLearn on a state-of-the-art Electronic Medical RecordImprove physical examination skillsImprove patient note taking skillsImprove history taking skillsLearn to perform EKG, Phlebotomy, PFTs and UADiscuss family medicine topics and the latest guidelines on a daily basisFor more details, visit www.usmedicalextern.com or email: [email protected] Medicine® Physician Refresher/Re-entry PreceptorshipDrexel University College of Medicine has a tuition-based structured preceptorship/observership for IMGs preparing for a U.S. residency. Preceptorships are offered in internal medicine, pediatrics, OB-GYN, surgery and anesthesia. Rotations are all on the main university campus in Philadelphia.Length of Program6-week rotations; repeatable once. The course starts on the 1st Monday of every month and is first come, first serve. The application process takes 4–6 weeks.Program OverviewAttend inpatient and outpatient rounds, core conferences, lecture and learn about medical care in the United StatesAttend didactics: morning reports, noon reports, grand rounds and clinical case discussionsHomework will be assigned to hone in on medical knowledge, clinical reasoning and communication skillsMeet weekly with preceptor to review the exercises and receive feedbackFind more details on the program or call (215) 762-2580.Griffin Medical Clinical Observership ProgramThe application process for 2017-2018 runs through Sept. 30, 2017. New applications are accepted during this time only.The program is no longer accepting applications for October 2017 - January 2018. All positions for time have been filled. Only applications for the months of February 2018 - June 2018 are being accepted.Length of Program4 weeksProgram OverviewTo familiarize yourself with the U.S. medical systemTo become proficient in presentation of history and physical examinations on daily roundsTo become proficient in ascertaining patients' acute symptoms and making a therapeutic planTo learn to write daily progress notesTo learn how to interpret basic lab tests and radiology data such as blood, urine serum, X-rays, etc.Eligibility CriteriaForeign medical student graduates must be:Graduates of a medical schoolMust be ECFMG certifiedApplicationsThe following are required to be submitted to the Committee for consideration of participation in the program:A completed application or ERAS application (for ERAS, months for which the candidate is applying should be indicated in the email. In the event that ERAS application is not available, a common application form can be substituted)A cover letter detailing desired rotationA curriculum vitaeAt least 1 letter of reference from a clinical supervisor or advisor, or an attending physicianUSMLE score reportsMedical school diplomaECFMG certificateTOEFL score report ( if available)Documentation of up-to-date immunization record (including flu shot during flu season (Oct-March)Proof of health insurance coverageA recent photograph for identificationCopy of passport and valid visaApplication DeadlineA completed application must be received no later than Oct. 1Formal start date is usually the first working day of a calendar monthTiming is at the discretion of the program coordinator and teaching service schedulesVisit Griffin Medical’s website for more details and to apply.International Observership ProgramAllegheny General and West Penn hospitals host observers from around the world. This program was designed for physicians, nurses, pharmacists, medical students, physiotherapists, technologists, technicians and health administrators.Length of Program4 weeksThe observership is a specific exchange program in which the observer accompanies the medical staff through their daily hospital routine, sharing experiences with doctors, residents, staff and students. This program is not for academic credit.Program OverviewObservation of the clinical care of patientsParticipation in lectures, grand round and other related eventsNo privileges are granted to participate in the clinical treatment of patients to assist in any medical procedures, test or surgeriesFor inquiries about international educational opportunities available through Allegheny General, call International Services (412) 359-5269 or email [email protected] Memorial HospitalIt is the policy of the Public Health Trust to accept physicians or resident physicians desiring to participate as an observer/rotator at Jackson Health System facilities. All requests for observer/rotators must be reviewed and approved by Risk Management.Length of ProgramObserverships may last up to 4 weeks (1 month), longer if written approval by the department is obtained.Program OverviewThe individual desiring to participate must provide the Office of Physician Services all required documentation as set forth in this policy in order to be considered for a rotation or observership. Jackson Health System will not provide professional liability coverage for any resident for an outside institution. If the home institution will not provide the coverage, then they will be classified as observer status only. An observer is a health care professional or student who will not provide patient care or have direct patient contact. Observers differ from students in an academic program in that the observership is not an educational requirement of any academic program (see administrative policy 389 for students).Observer may be one of the following:Physicians (foreign or domestic)Registered nurses (foreign or domestic)Other health professionals (e.g. radiology, respiratory therapy, psychology, pharmacy technicians, etc.)Students not covered under an existing affiliation agreementObserverships may be in an inpatient or outpatient setting and must be approved by the Jackson Health System facility’s department(s) director(s) of the area being observed. For physicians, approval is needed from the associate/chief medical officer. For residents, approval is needed from the GME office. For nurses, approval is needed from the director of patient care services and/or the chief nursing officer. For all other students, approval is needed from the associate/chief medical officer.For more information, view the Policy & Procedure Manual.Contact InformationGraduate Medical Education OfficeJackson Memorial HospitalInstitute 118B1611 NW 12th Avenue, Miami, Florida 33136Phone: 305-585-4310Fax: 305-585-4309For more information on visiting medical students, please visit the information page.Somerset Family MedicineHands-on externship/observership in outpatient family medicine in Michigan for FMG, international medical graduates, Caribbean medical students and Caribbean graduates. Outpatient family medicine office in Troy and Sterling Heights, Michigan.Length of ProgramMinimum 4 weeks; maximum 12 weeksPreceptorNeil Jaddou, M.D., M.S. board-certified family medicine, clinical assistant professor of family medicine and community health, Wayne State School of Medicine and Oakland Beaumont Medical School. Staff at 4 hospitals and affiliated with St. John Oakland-Macomb medical students teaching program.Program OverviewBecome efficient in electronic medical or health records.Get familiar with the health system in the United States.Practice on presenting a patient and doing history and physical examinations.Learn how to interpret basic lab tests and radiology data such as blood, urine, X-rays, EKG and PFT.Expand your medical knowledge and build on your differential diagnosis.Improve your scores on CK, CS and USMLE Step 3.Tour the hospitals and attend conferences when available.Online lectures given by Dr. Jaddou on common problems in family medicine, taken from future textbook by professor Jaddou.Opportunity to publish patient education article in the community newspaper.Receive a letter of recommendation at the end of the rotation that has a university and hospital logo.Receive a certificate of completion at the end of externship. There is also a possibility of finishing with honors and student of the month award.Opportunity to be chief extern and teach others.Volunteer in the church clinic once a week.Eligibility CriteriaUSMLE not required.Immediate availability. Start any day that is convenient for you.Must be living in U.S. to apply. We do not sponsor visas.All visas are accepted as long as you are physically present in U.S.ApplicationVisit www.americanexternship.com for details on price and submitting an application. For additional information or questions email us at [email protected].