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If you are a foreign medical student thinking about applying to residency programs in the United States, one of the questions that you may be considering is the relative amount of time you will spend in inpatient and outpatient care settings. For the three specializations most commonly pursued by foreign medical graduates — internal medicine, family medicine, and pediatrics — the amount of inpatient and outpatient care experience you get can vary greatly between residencies, depending on the program. The right type of program for you depends on your interests and career goals.

Defining Inpatient and Outpatient Care

The term “inpatient care” encompasses all medical treatments that occur directly in hospitals, performed on patients that have been formally admitted to a facility. As an inpatient provider, you would most commonly be working with patients who have serious conditions that require overnight hospital stays. However, it is important to note that there are a wide variety of treatments that fall under the umbrella of inpatient care, ranging from common diagnostic procedures, like CT scans, to emergency surgery following a traumatic injury. If you envision yourself working in a hospital setting, you will probably want to look for a residency program that dedicates more rotations to inpatient care.

In contrast, “outpatient care,” also known as ambulatory care, occurs in non-hospital settings, like the office of a family physician, an outpatient surgery center, or a specialty services clinic. As an outpatient care provider, you would generally work with patients on a longer-term basis. For instance, as an outpatient family doctor, you would provide regular checkups, rather than just treating patients in the hospital when they are seriously ill or injured. If you are an internist specializing in endocrinology, you might prescribe a pharmacological treatment for patients with hormone-related diseases and monitor their care over the period of months or years, altering the treatment as necessary to improve long-range health outcomes and quality of life.

Choosing Between Inpatient and Outpatient Care

You don’t have to choose between a career focusing on inpatient or outpatient care before you apply for your residency, since rotations in both settings are commonly included within residency programs, especially those within internal medicine, family medicine, and pediatrics. But it can help to have an idea of which you are more interested in, so that you can choose a program that emphasizes one over the other.

One way for foreign medical students to gain experience in both inpatient and outpatient care is to complete a student elective program. In a three-month elective program, you have the opportunity to perform three rotations within the same specialty area, and you may be able to work under physicians in both hospital and non-hospital settings. There are also three-month plans allowing you to complete rotations under the supervision of attending physicians in three separate specialty areas, which can also give you the chance to gain experience in both inpatient and outpatient settings.
If you are a foreign medical student looking for an elective program, FMG Portal offers programs with both inpatient and outpatient availabilities. Contact us today for more information about the resources we provide.

It’s almost May, which could mean one of two things: If you live in the Northern Hemisphere, summer is right around the corner, and you can start looking forward to longer days and warmer temperatures. If you live in the Southern Hemisphere, you’re probably getting ready for the longer nights and cold weather of winter.

Foreign medical students may not have the chance to take time off for travel during the summer months, but if you’re looking for a change of scenery within the next few months — or if you want to skip winter in the Southern Hemisphere — you might want to think about enrolling in a three-month clinical experience in the United States.

Clinical Electives for Foreign Medical Students

If you are currently a full-time medical student at a foreign medical school, a three-month elective experience is a great way to gain valuable experience in a U.S. clinical environment, particularly if you plan to apply for a medical residency program in the United States in the future. The most common option is to choose a program in the medical subfield in which you eventually plan to pursue a residency. Within the program, you will spend one month each with three different attending physicians within that specialty area. At the end, you will have gained hands-on medical experience, a better understanding of the U.S. medical system, and the potential for three letters of recommendation when you apply for your residency.

If you have not yet chosen a specialty area of interest, that’s okay too! A clinical elective experience can actually be a great way for foreign medical students to explore their specialization options. Some three-month clinical elective experiences allow foreign medical students to spend one month each with three different attending physicians in three different subfields. That can help you decide whether you determine which one you want to dedicate your career to, and it can also give you a better idea of how each one works in the United States. That way, when you apply for a residency in the United States, you will know that you are making the best specialization decision for you.

Applying for a Clinical Elective Program

It is important to note that many clinical elective programs require you to apply at least four weeks in advance, so if you want to spend summer in the United States, there’s no time to lose! FMG Portal offers clinical electives for foreign medical students at locations throughout the United States in a wide range of specialty areas, whether you want to focus on just one or divide your time between three. Contact us today for more information!

According to the most recent data from the National Resident Matching Program (NRMP), the most common residency specialty for foreign medical graduates is internal medicine. In 2015, 2,763 foreign medical graduates were matched to an internal medicine residency program. That’s 43.9 percent of the total number of foreign medical graduates who were matched.

What’s more, the proportion of foreign medical graduates who choose internal medicine has only been growing over the past few years. In 2011, only 37.5 percent of matched foreign medical graduates were in internal medicine residency programs, so the proportion jumped 6.4 percent in only four years. If you are thinking about applying for medical residencies in the United States, internal medicine is an excellent specialty option to consider.

About Internal Medicine Residency Programs

Internal medicine residency programs last for three years, and they provide broad training in diagnosing and treating diseases and disorders of all organ systems. These programs typically consist of a combination of clinical practice, classroom-based seminars, and research opportunities. In addition to getting hands-on training working with patients with a wide range of internal conditions, residents are also educated in relevant topics like preventive medicine, medical ethics, cost controls, and even providing medical education. If you engage in research during your residency, you will likely be encouraged to publish your work and/or present at conferences, where you can network with others who have similar interests in the field.

Upon completion of an internal medicine program, you would be eligible to take the certification exam offered by the American Board of Internal Medicine. At this point, you could go on to become a general internist, or you could choose to pursue a fellowship in a particular subfield of interest.

Preparing for an Internal Medicine Residency Program

As a graduate of a foreign medical school, one way to increase the likelihood that you will matched to an internal medical residency program is to complete a clinical externship in internal medicine or a subspecialty area within the field. Not only does this demonstrate your interest in internal medicine, but it also indicates that you have what it takes to be successful in the U.S. medical system.

If you choose a clinical externship in a particular subspecialty area, it can serve as a signal of your commitment when it comes time to apply for fellowships.Some of the specialties in which you may find a clinical externship include:

• Allergy and Immunology
• Cardiology (General, Interventional or Metabolic)
• Gastroenterology
• Hematology
• Infectious Diseases
• Nephrology
• Oncology
• Otolaryngology
• Rheumatology

Overall, internal medicine can be a great residency option for foreign medical graduates. For help finding and getting matched to an internal medicine residency program, contact us today!

It’s the start of spring, which means it’s right around the time that fourth-year medical students and and trained doctors start to think about whether or not it makes sense to apply for a residency program for next year. If you’re a foreign medical student or graduate, and you are contemplating applying for a residency in the United States in 2018, your first order of business is to make sure that you are eligible and that you have a competitive application profile. That way, if there are any requirements that you still need to meet, you have ample time to fulfill them before the match process really gets underway in the fall.

Basic Requirements for ECFMG Certification

In order to apply for a residency program in the United States, you need to be certified by the Educational Commission for Foreign Medical Graduates (ECFMG), which is the organization that evaluates whether foreign medical graduates are sufficiently prepared for a U.S. medical residency program. The ECFMG sets forth some basic requirements that you need to meet before you can even consider applying for a residency

• Educational Requirements. As a foreign medical graduate, you need to have completed your degree at one of the medical schools that has been approved by the ECFMG. You can find information about your school in the World Directory of Medical Schools. In addition, you will need to provide documentation of your degree and transcripts before you can complete the ECFMG certification process.
• Examination Requirements. To get ECFMG certification, you will need to pass the first and second steps of the United States Medical Licensing Examination (USMLE). The first step tests your knowledge of medical science, while the second assesses your clinical skills.

• ECFMG Application. Of course, in order to be certified, you need to actually submit the application form to the ECFMG. You can begin the process as a fourth-year medical student by applying for a USMLE/ECFMG identification number, and you can take the examinations as soon as you meet the training requirements, but it is important to note that you won’t officially receive your ECFMG certification until you have actually finished your degree.

Visa Requirements

If you are not already a citizen or legal resident of the United States, you will need to get a visa. The two visa options for foreign medical graduates in residency programs are the H1-B (Temporary Worker) and J-1 (Exchange Visitor) visas. After being accepted to a residency program, your visa may be sponsored by your institution or by the ECFMG, but the United States has specific visa regulations for certain countries, so you may want to consult the U.S. embassy in your country in order to find out about possible visa restrictions.

Residency Program Requirements

Many residency programs also have specific requirements for foreign medical graduates. Depending on the school, they can include:

• Medical school graduation year
• Type of visa
• Number of attempts on the USMLE
• Previous clinical experience in the United States
• Letters of recommendation from U.S.-based providers

If you have concerns about any of these factors — for example, if graduated more than a few years ago — you may want to skim through the websites of some of the schools you are considering to make sure that your degree will still be considered valid.

If you don’t have previous clinical experience in the United States, now is a great time to set up a clinical externship or enroll in an elective program for foreign medical students, which can provide valuable hands-on training in the American medical system and allow you to build relationships with recommenders who can write letters of support for your application in the fall. Even if U.S. experience is not explicitly required for your top-choice residency program, these experiences can boost the competitiveness of your application and increase the likelihood that you will get matched.

Need more help with residency placement? Contact us today!