how necessary are US rotations?

[treesap]

I am not much of a thread starter, more of a lurker...but here goes...

I have read that doing US rotations in your 4th year is ABSOLUTELY essential for getting a residency in the US (coming in just after good Step 1 scores). I am curious what anyone might think about this topic.

I am very interested in spending my electives internationally and think that 4th year would be a great opportunity. Of course, if you absolutely need those LORs then I guess I'll have to pass on it.

To those that have been there...what do you think?

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[leorl]

I know that as a foreign med student (Ireland), the Americans and Canadians know the importance of having American rotations and LORs to getting a US residency. However, not all our rotations are done in US schools obviously. The US system is pretty different from ours, so I don't know which rotations you'd be doing in 4th year, so am not sure how crucial it would be for you to stay in the US for those electives. You should ask your program director the feasibility of doing some electives abroad.

Here, we could start doing electives after 4th year (of a 6 yr. program), and are encouraged to do some abroad - one in a third world country. So, I'll get to do abroad electives as well as US ones.

 

[Winged Scapula]

I'm not sure if they're ABSOLUTELY necessary but I'm also not convinced that it would be wise to pass on doing US electives.

Obviously there are people who match every year without having done US electives - especially foreign trained physicians who decide to come to the US for further training or to live here.

The importance in doing US electives not only lies in learning the system and what's expected of you but getting the all important LOR. Its fine to get letters from Flinders consultants but IMHO a LOR from a US faculty who is familiar with generations of medical students and what it takes to be a resident in the US is much more valuable.

I'm not sure how many rotations you're allowed to do abroad now but if it were me, I wouldn't risk NOT coming to the US in my final year.

 

[ApacheIndian]

IMHO where you do your 4th year rotations/electives doesn't matter all that much. It's where you do those 3rd year Cores (esp. IM, Surg, and OB) that is important.

 

[Winged Scapula]

Dr. Cuts...

While I agree that the importance of Core rotations is paramount for most IMGs, the OP is currently studying at Flinders and is not allowed to go abroad for Core rotations, only for 4th year electives.

Therefore, the importance of where he does his Core rotations is a moot point as he has little option but to stay in Australia but does have the chance to do US rotations in his 4th year (which I still consider relatively important and too much of a risk to take - I don't know anyone who has matched into a US residency who has NOT done a 4th year elective here).

 

[pitman]

Kimberly -

I think I remember reading that at Flinders, up to two rotations (something like 12 weeks, + vacation time if desired) can be done outside of Australia...

I plan to attend an Australian school, and would *like* to do a rotation in a third country, e.g. in Brunei if I go to UQ, but it sounds like I should do as much time as possible in US, if I care ultimately to be US-licensed? How many rotations did you do in US, and did you get any feedback from programs on a "comfort level" for # of US rotations desired/expected?

-Pitman

 

[Winged Scapula]

Pitman,

I was able to do 24 weeks (which included my 6 weeks of vacation time) in the US as 4th year electives. I did not receive any feedback from US programs as to a "comfort level" but perhaps that was because I never asked nor did it become an issue at places where I rotated.

I note that in the link above to program requirements may state that they require 1 year of US clinical experience - not sure how hard and fast that rule is.

I don't discount the value of doing a rotation in a 3rd world country - it will make you an intruiging candidate. I'm not sure there is a "magic" number to weeks you should do in the US. I don't think anyone can give you that answer. I do however think that it is important, as I've said earlier, to do US rotations if only to get a US LOR from someone who has seen you in a clinical context. If you go to Brunei for 6 weeks, that still leaves you time to do US clinicals.

 

[pitman]

Thanks, Kimberly.

I'll find and look more closely at the link you're referring to.

-Pitman

 

[treesap]

Thanks for all your help! I didn't realize that there were more to the US rotations than just LOR. I guess it is necessary to do at least some.

I am at Flinders and as far as I know, there are 8 blocks to 4th year. There are 5 selectives, 1 vacation, and 2 elective blocks to play with. 4 of your selectives must be done in the "Flinders Axis", meaning you're stuck here, which leaves 3 blocks and a vacation term to do abroad. Most of the US students do go back and do all of their eligible blocks in the states.

I am not looking at any super-competitive residencies, not because I am an underacheiver, but it is just coincidence. I don't want to get stuck in a city I don't want to be in, but I think there is less pressure on me than there would be on the applicant who wants to do Ortho or ENT at Johns Hopkins.

If I try to do one elective abroad and the rest in the US, that shouldn't hinder me too much, should it?

BTW Kimberli, what was that link you mentioned?

 

[silenthunder]

Hello all,

just wondering about how people go about getting clinicals in the states if they go to an Ireland/Australian school?

Does the school admin help you with this, or are you completely on your own?

Is there added cost?(this isn't a big factor for me; more a good to know kinda thing)

Are there any Canadians out there? Are you opting for as many US electives as you can possibly get, or are you doing some in Canada also? I would appreciate hearing pro/cons on this if anyone knows....

hope everyone's doing well especially those studying for the MCAT (blecchh

Cheers,

Silenthunder

 

[Winged Scapula]

Originally posted by silenthunder
Hello all,

just wondering about how people go about getting clinicals in the states if they go to an Ireland/Australian school?

Does the school admin help you with this, or are you completely on your own?

Is there added cost?(this isn't a big factor for me; more a good to know kinda thing)
...

Cheers,

Silenthunder

You either do rotations available through your school (ie, some schools have formal affiliations or relationships with US schools for rotations) or you apply directly to the US program for the elective. The latter is what I did because I had specific programs that I was interested in that my school didn't have affiliations with.

My administration helped me little beyond providing statements that I was in good academic standing, had malpractice and health insurance and send out letters. Obviously different programs will vary in how much they assist you.

Some programs do charge an application fee or tuition for an elective. However, unless you are extremely wedded to such a program I would avoid them as there are heaps which charge you nothing at all to visit. You are responsible for your living costs while at these programs and that can be substantial as you may have to rent a room somewhere rather then stay on campus.

Hope this helps...

 

[pitman]

So does Flinders have a number of affiliations/agreements with programs in the US? Anyone know about USyd or UQ?

-Pitman

 

[Winged Scapula]

Originally posted by pitman
So does Flinders have a number of affiliations/agreements with programs in the US? Anyone know about USyd or UQ?

-Pitman

I'm not sure what the current status is (perhaps some current students could assist with that) but when I was there we had agreements with Columbia-Presbyterian, University of California, Harvard, University of New Mexico, Cleveland Clinic, and Hopkins amongst others for elective clinical rotations, as I recall.

 

[pitman]

Not the same as residency, I know, but you should rub those nice affiliations in MacGyver's face

-Pitman

 

[trkd]

USYD doesn't have any such affiliations. We have spoken to the administration and new dean about it. They are now hiring an international (primarily US and Canadian) student liason. This person is supposed to set up affiliations with schools and things like that. I suppose that we'll see how this works out. Hopefully, we will get something going soon but nothing at the moment.

 

[Winged Scapula]

Originally posted by pitman
Not the same as residency, I know, but you should rub those nice affiliations in MacGyver's face

-Pitman

Perhaps.

I did rotations at UCSF, UCSF-Fresno, UVA, Baylor, Univ of Louisville and Hopkins as a 4th year (I deferred graduation so I could do some extra rotations - not sure if they'll allow that anymore).

 

[treesap]

How did you fit in the USMLE I/II, TOEFL and the CSA with all those rotations? Did you have them all completely finished before you started 4th year, or do some of them during?

Did you defer for a whole year or just a few months? I am seriously considering that in order to get some of the exams out of the way...shouldn't matter too much as long as I graduate before June, I hope.

 

[Winged Scapula]

Originally posted by treesap
How did you fit in the USMLE I/II, TOEFL and the CSA with all those rotations? Did you have them all completely finished before you started 4th year, or do some of them during?

Did you defer for a whole year or just a few months? I am seriously considering that in order to get some of the exams out of the way...shouldn't matter too much as long as I graduate before June, I hope.

I did USMLE Steps I and II during two of my rotations - simply asked for the time off and it wasn't a problem for Step 1 and had a week off between rotations and took Step 2 then.

I took TOEFL during 3rd year when I was in the states for vacation and I completed the CSA at the end of 4th year.

I took off a total of about 4 months so I graduated in April instead of December - all my stuff was done was NRMP/ERAS and the match so I spent the months from December - February (I think) doing rotations, interviewing, etc. and then relaxing while waiting for the match.

It was a real pain to delay because they only have graduation certain times of the year although you can graduate "by committee" which I what I did, but it requires paperwork, etc. I felt I had no choice and was worried about not having my ECFMG certificate before starting residency (since my diploma wouldn't be awarded until April, it had to be mailed frm Oz, processed by ECFMG, etc.) but I made it.

Hope this helps.

 

[Winged Scapula]

I cannot agree with Crepitus Fremitus more and would like to "ditto" his words - especially those in his last paragraph. I found several programs at which IMGs were essentially prohibited or allowed only to do certain rotations where I was welcomed (for example, UCSF, Hopkins). An office clerk has no authority to advise you any different than what her handbook states, ie, we don't accept IMGs for rotations.

Email the department chair or faculty member with whom you'd like to work; you may be suprised that you will be greeted with open arms. And it may depend on the department - for example, I was turned down by the General Surgery department at UVA but welcomed by the Plastics department there for an elective.

Best of luck to you...

 

[stephew]

one of the benefits of rotating in the us is that you can do an "audition rotation" and perhaps even sign outside the match if that's what you want to do. The NRMP was to stop that as of 2004 but enough hospitals howeled loudly to delay that indefinitely
steph

 

[sporter1992a]

hi stephew,

did I read your last post correctly -> are you saying that pre-matching is still possible? I was under the impression that the last match cycle was the last year this would be possible.

Thanks,
SP

 

[Winged Scapula]

Originally posted by sporter1992a
hi stephew,

did I read your last post correctly -> are you saying that pre-matching is still possible? I was under the impression that the last match cycle was the last year this would be possible.

Thanks,
SP

Yep...still is. If you look at the NRMP's web site you will see that for now, pre-matching is still allowed.

 

[stephew]

yep