Guide for Residency and Fellowship in the USA as an International Medical Graduate

By Uzung Yoon

This book is a guide for residency and fellowship application in the United States as an International Medical Graduate (IMG). It contains invaluable insider information an applicant has to go through in order to apply for a residency or fellowship position. This book includes information about USMLE, application timeline, Interview and applicat

• Language: English
• Publisher: Dragon Publishing
• Release date: Feb 19, 2017
• ISBN: 9781640079212

Uzung Yoon

Dr. Yoon (MD, MPH) graduated from Hannover Medical School in Germany. During that time he conducted 5 years of laboratory and clinical research and graduated with a MD/PHD equivalent degree. Additionally, he finished a 1 year public health master at Berlin School of Public Health. He wrote a book in German” Von der wissenschaftlichen Fragestellung zur Publikation“ published with Elsevier Germany in 2014. Currently he is a faculty member for Anesthesiology at Thomas Jefferson University Hospital in Philadelphia and continues to conduct and lead clinical research.

Book preview

Guide for Residency and Fellowship in the USA as an International Medical Graduate

Second Edition

Author

Uzung Yoon, MD, MPH

Department of Anesthesiology

Thomas Jefferson University Hospital

Philadelphia, PA, USA

Medical School: Hannover Medical School, Hannover, Germany

Graduate School: Berlin School of Public Health at Charité, Berlin, Germany

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ALL RIGHTS RESERVED

Copyright © 2016 Uzung Yoon

This publication is protected by copyright. No part of this publication may be reproduced, transmitted or distributed in any form or by any means, including photocopying, or stored in a database or retrieval system, without the prior written permission of the publisher.

Care has taken to confirm the accuracy of the information presented and to describe generally accepted practice. However, the authors, editors, and publishers are not responsible for errors or omissions or for any consequences from application of the information in this publication and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information remains the responsibility of the reader.

The author has exerted every effort to ensure that the information is accurate at the time of publication. However, in view of ongoing changes the reader is recommended to check on the website of each organization for updated information.

Any corrections or suggestions please email to [e-mail]

May not be copied, scanned, or duplicated, in whole or in part

Acknowledgments

Special thanks to Jennifer Wilson at the Writing Center at the Center for Teaching and Learning, Thomas Jefferson University, Philadelphia, for feedback and proofreading of this work.

Also thanks to Lily Kwok, Lincoln Memorial University-DeBusk College of Osteopathic Medicine for feedback and editing.

Contents

1 International Medical Graduate (IMG)

2 Educational Commission for Foreign Medical Graduates (ECFMG®)

2.1 Requirements for Certification

2.2 ECFMG Verification service

2.3 Other Services by ECFMG

3 World Directory of Medical Schools

4 United States Medical Schools outside the U.S.

5 United States Medical Licensing Exam (USMLE)

5.1 USMLE Step 1

5.2 USMLE Step 2 Clinical Knowledge

5.3 USMLE Step 2 Clinical Skills

5.4 Test Centers for USMLE Step 2 CS

5.5 USMLE Step 3

6 Important information to succeed in Step 2 CS

7 Fees and payment for USMLE Steps

8 USMLE score, passing and failing the exam

8.1 USMLE Step 1 passing rate

8.2 USMLE Step 1 Scores of Matched Applicants by Specialty

8.3 USMLE Step 2 Scores of Matched Applicants by Specialty

9 How to study for USMLE

9.1 USMLE

9.2 Study material

9.3 Test taking strategies

10 Schedule USMLE exam - Prometric test center

11 Visa

11.1 H-1B visa

11.2 J-1 Exchange Visitor Program

11.3 J Visa – Two-Year Home Residence Requirement

11.4 Waiver of the Exchange Visitor Two-Year Home-Country Physical Presence Requirement

11.5 Green Card

11.6 Travel outside the United States while on Visa

11.6.1 Driver's license

12 Medical license

13 California letter

13.1 Postgraduate Training Authorization Letter (PTAL) or California Letter

13.2 Obtaining a PTAL (California Letter)

13.3 Minimum requirements for clinical rotations for PTAL

13.4 Transcript and diploma translation

13.5 Fingerprint

14 Residency application process

14.1 Personal statement

14.2 Letter of Recommendation

14.3 Curriculum Vitae

14.4 Medical Diploma

14.5 USMLE score report

14.6 ECFMG certificate

14.7 Medical Student Performance Evaluation (MSPE)

14.8 Fee for application

14.9 To how many programs should I apply?

14.10 Residency program search

14.11 Couple match

14.11.1 Online search

14.11.2 Offline

15 Interview

15.1 Applicant selection from programs

15.1.1 Percentage of programs citing each factor and mean importance rating in selecting applicants to interview

15.2 Interview

15.3 Interview questions

15.4 Questions you might want to ask the program

15.5 Electronic Medical Record Adoption Model

15.6 After the interview

15.6.1 Sample thank you letters

15.6.2 Different ways to express interests about the residency program

16 Ranking

16.1 Percentage of programs citing each factor and mean importance rating in ranking applicants

16.2 How programs rank applicants

16.3 How an applicant may rank programs

16.4 Success to match based on specialty

16.5 Categorical, transitional and preliminary year

17 MATCH and SOAP

17.1 SOAP

18 Match results

19 Low scores, failed exam, old age, no interview

Case reports

19.1 How to increase the chance of matching

20 Life as a resident

20.1 Entering the United States

20.2 Housing

20.3 Orientation and E-Learning modules

20.4 Salary

20.4.1 Physician Hierarchy in Hospital

20.5 Call Schedule

20.6 Duty hours

20.6.1 Duty Hour Exceptions

20.6.2 Mandatory Time Free of Duty:

20.6.3 Maximum Duty Period Length

20.6.4 Minimum Time Off Between Scheduled Duty Periods

20.6.5 Maximum In-House on Call Frequency

20.6.6 External moonlighting:

20.6.7 Duty hours in reality

20.6.8 Call rooms/transportation service

20.6.9 Duty hour log website

20.7 Residency education

20.7.1 Probation or withdrawal of accreditation

20.7.2 ACGME Resident annual survey

20.8 In Training exam (ITE)

20.9 Vacation

20.10 Evaluation

20.11 ACGME Case log

20.12 ACGME Core Competencies

20.13 Pregnancy and Parental leave for Resident

20.14 Joint Commission

21 Resident work in the hospital

21.1 Rounds

21.2 Daily work activity in general surgery – Exammple

21.3 Medical service and Team’s for patient care

21.4 Clinical documentation and medical coding

21.5 Manditory Reserarch

21.6 Sleep, Alertness, and Fatigue Education in Residency (SAFER) Program

22 Resident Salary and Dept Report 2016

23 Fellowship application

 Using National Resident Matching Program (NRMP) (http://www.nrmp.org/)

 San Francisco Matching Program (https://www.sfmatch.org/)

23.1 National Resident Matching Program (NRMP)

23.2 San Francisco Matching Program

23.3 Fellowship without residency in the United States

24 Residency switch & finding open positions

24.1 Find a Resident

Use Find A Resident If:

24.2 Association of Program Directors in Surgery Open Positions list

25 Clerkship vs Observership

25.1 Clerkship

25.2 Observerships

25.3 Steps to apply for clerkship or observership

26 Life as an attending physician

26.1 Board certification

26.2 Board recertification exam

26.3 Average attending physician salary

27 Finding a job after residency

27.1 Career guide

27.2 Prepare for medical meetings

27.3 Physician cover letter

27.4 Contract negotiation

27.5 Be careful

27.6 Malpractice

28 Credit for medical training outside the U.S.

28.1 Surgery - Credit for foreign graduate medical education

28.2 Radiology

28.3 Family Medicine

28.4 The American Board address and contact information

28.5 Links to State Medical Boards

29 American health system

29.1.1 2016-17 Best Hospitals Honor Roll

29.2 Hospital Facility in the U.S

29.3 Adjust to American medical practice and culture

29.4 Health care association lobby

29.5 Malpractice claim

29.6 HIPPA (Health Insurance Portability and Accountability Act)

29.7 Language access rights

29.8 IMG’s getting a poor deal

29.9 Critism about the U.S. system and being a physician in the U.S.

29.10 Student loan and debt limiting freedom and quality of life

29.11 Physican based patient care and non physician based patient care

29.11.1 Nurse Anesthetists (CRNA)

29.12 Student loan and medical school debt

30 Physician finance guide

31 Tax deduction and reimbursement

31.1 General deductions and related to a physician practice

31.2 Vehicles

31.3 Business Travel

31.4 Medical expense deduction

32 Miscellaneous

32.1 Car insurance

32.2 Involved in a car accident

33 Reference

34 Appendix

34.1 Meaning and abbreviation in health care professionals

Licensed physician who has finished residency and/or fellowship training

34.2 Medical Student Performance Evaluation Template

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Philadelphia Museum of Art

The Gross Clinic -1875 painting by American artist Thomas Eakins.

Dr. Samuel D. Gross, dressed in a black, lectures a group of Jefferson Medical College students.

Background

This is a guide for International Medical Graduates (IMGs) who wants to apply for a residency of fellowship position in the Unites States. This publication explains the U.S. application process for residency and fellowship, gives a step-by-step guide, and includes information for each important organization. The U.S. medical education system is different than in other countries and it is very important to understand the application process.

In order to obtain a full license to practice medicine in the United States, an IMG typically must:

Complete all requirements for, and obtain, a medical degree

Pass a licensing examination, United States Medical Licensing Examination (USMLE)

Document medical education credentials

Be certified by Educational Commission for Foreign Medical Graduates (ECFMG)

Obtain a position in a U.S. residency program (GME: Graduate Medical Education program)

Complete the residency program training

Fulfill any additional licensure requirements of the jurisdiction

Fundamental questions to ask before thinking about U.S. residency

Why do you want to go to the United States for residency or fellowship training?

Is it worth spending the time, effort, and money to qualify and to apply for U.S. residency/fellowship?

Is the U.S. residency/fellowship training better than in my home country?

What if I cannot get a residency position? Is there a plan B?

Am I financially secured to go through the USMLE and application process?

Do I have visa restrictions?

Can I stay in the United States after residency/fellowship and find a job?

Do I want to return to my home country after residency fellowship?

What are the work hours as a U.S. physician?

Is the salary/work hour ratio better than in other countries?

Is it safe for me and my family to live in the United States?

Steps to Residency in the United States

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International Medical Graduates (IMGs) are physicians who received their basic medical degree or qualification from a medical school located outside of the United States and Canada. The location of the medical school, not the citizenship of the physician, determines whether the graduate is an IMG. This means that U.S. citizens who graduated from medical schools outside the United States and Canada are considered IMGs. Conversely, non-U.S. citizens who graduated from medical schools in the United States and Canada are not considered IMGs.

IMGs play a significant role in the U.S. health care system. In 2009, according to the American Medical Association, IMGs in the United States accounted for 25.9% of the total physician population, 29.2% of the physicians in graduate medical education (GME), and 29.3% of all full-time, hospital-based physicians.

Website:        http://www.ecfmg.org

Phone:               [phone]

Opening hours:       Monday - Friday, 9 am - 5 pm (Eastern Time in the United States)

Address: