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How To Get An Externship or Observership
Participants of this type of program can go for ward rounds, clinics, operating rooms, ground rounds, seminars etc, but they can only observe what is going on and not touch the patient. The reason they can only observe is because the participant has no malpractice insurance.

The advantages of undertaking such a program are huge, you get a chance to see the different activities in a US hospital and get used to the different terms and procedures. You connect with residents, attendings and other hospital staff, and if you make a good impression could get letters of recommendation from the attendings or even a shot at interview at the program.

An Externship
This is similar to an observership but with a major difference, the participant can touch the patient and actually participate in patient care. Externships can run from one month to two or more, and the participant gains some useful hands on experience. Your participation in an externship warrants that you get a letter of recommendation and again here, if you make a good impression it could translate into an interview and a residency offer if you are lucky.

Because getting an observership or externship is highly competitive mainly due to a large number of people looking for limited opportunity, it is very important that every candidate put his best foot forward to get a spot.

What are the requirements?
For an observership the requirements are minimal, as long as you do not touch the patient and are not compensated in any way, you can do that with a visiting visa. There are no formal requirements for that. On the contrary for an externship you are required to be ECFMG certified and also have medical insurance and malpractice coverage.

As an IMG looking for an observership/externship you should bear in mind that there are hundreds, maybe thousands competing for the same jobs as you.

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Most residency programs will like to see some form of US clinical experience in your application, especially if you are an international medical graduate. It’s not because they hate you, but just the fact that excellent medical practice have different innuendo all over the world.

The two common ways to obtain US clinical experience are:-
  • An observership
  • An externship

An observership
It is a form of training where you learn by looking and asking questions but not doing, that is no hands on experience.

Your strategy to get in should include:-

  • Sending out requests by email, snail mail and phone calls to hospitals and clinics
  • Talk to your family and friends. Have them introduce you to their primary care physician to open up a communication channel.
  • Approach a private clinic, explain who you are and ask for a volunteer position in exchange to shadow the attending and learn. Again this opens up a communication channel; they might take you or point you in the right direction

You will get a lot of rejections, but do not take it to heart. Be persistent. Continue to send out emails and think of other specialties you might want to get into and contact them too. If you have enough funds for your upkeep outside the state you live in, expand your search to other states and mention in your letter that you can take care of your upkeep for those 4 weeks.

Remember, the harder you work, the luckier you get.
Strategy meets opportunity
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