Foregoing an Observership in Favor of a Clinical Externship

As a foreign medical student, an observership in the United States might sound like a great idea. After all, an observational experience in a clinical setting might have been one of the things that initially inspired you to pursue a career in medicine. When you were in secondary school or completing your undergraduate studies, just spending a short period shadowing a physician may have really made a difference when determining your decision to pursue a medical course of study. However, the situation is much different after you’ve completed medical school. As a foreign medical graduate, you have dedicated years of your life to the study of medicine in the classroom and the clinic, so it is far less likely that you will truly gain from standing by and watching other physicians work. Therefore, if you’re looking for a US experience before applying to a US medical residency program, the best approach is to forego an observership in favor of a clinical externship. Read on for more information about why.


The Differences between an Observership and a Clinical Externship


The fundamental problem with observerships is that they are just what they sound like: the chance to observe another physician go about their daily routine. But as a foreign medical graduate, you’ve probably already spent a lot of time doing just that over the course of your education—and a few more months of doing so before you apply for a US medical residency program probably won’t make a big difference. Plus, if you try to write about an observership on your personal statement when you apply, it will be harder for you to argue that the familiar experience was truly meaningful–and the program official who is evaluating your application will be able to tell.


Moreover, the observership itself can be both frustrating and disappointing for a well-trained physician like yourself. Once you’ve been classified as an observer in a clinical setting–not as a true participant–it’s easy to get sidelined by other healthcare professionals. If observership is in a high-pressure specialty area like surgery or cardiology, it’s easy to get pushed aside by an attending physician who is (rightly) more concerned about the patient’s health than about making sure you have a good view of the procedure they are performing. As a result, there’s a high risk that you’ll end up missing out on any truly meaningful learning experience you might have had, since you’ll just feel obliged to get out of the way and let the attending physician and the other healthcare professionals do their jobs.


In contrast, if you enroll in a clinical externship program, you’ll always be in on the action. A clinical externship is a truly hands-on experience, which means that you’ll have real responsibilities from Day 1. Depending on the specialty area in which you are working, some of the tasks your attending physician may assign you include:

  • Presenting patients
  • Analyzing patient histories
  • Performing physical examinations
  • Assisting with complex procedures

Put simply, a clinical externship will truly give you a taste for what you would be doing if you chose to pursue a residency in the specialty area of the attending physician with whom you are working. Later in the medical residency application process, you will be able to draw on the experience when you write your personal statement, talk about your career goals during your interviews, and decide which programs from which specialty areas you want to include on your ROL.


Establishing a Strong Relationship with the Attending Physician


Over the course of your clinical externship, your attending physician will come to rely on you to complete the tasks discussed in the previous section. Not only can this increase your knowledge of the specialty and help you cement your decision to pursue a US medical residency program in the area, but it can also enable you to develop a strong professional relationship with your attending physician. They may be able to act as a mentor as you go through the US medical residency application and matching process, and they may agree to write you a strong letter of recommendation when you decide to apply. Since many US medical residency programs require or prefer foreign medical graduates to submit at least one letter of recommendation from a US physician, this relationship can play a major role in whether or not you get matched to the program of your choice.


When you’re just doing an observership–not a clinical externship–you won’t be working quite as closely with the attending physician, so there will be less of an opportunity for true mentorship. Also, because you were only observing clinical procedures (rather than directly participating in them), the attending physician won’t be able to speak to your technical abilities when they write you a letter of recommendation. That will make for a weaker reference that will be less convincing for the program officials who read it.


A Clinical Externship Through FMG Portal

FMG Portal recognizes the value of hands-on experience for aspiring US medical residents, so we don’t offer observerships–only hands-on clinical externships for foreign medical graduates and student electives for foreign medical students. Contact us today to learn more about our high-quality programs!