Posts Tagged 'residency programs'

Questions Potential Residents Should Ask in the Residency Interview

AmeriClerkships helps international medical graduates (IMGs) compete for residency programs in the United States. Founded in 2007, AmeriClerkships is a member of the American Medical Association (AMA) IMG Section.

For medical students, applying for a residency program is a complicated process involving both presenting themselves in the best light and gathering information about the program to determine whether it is a good fit. The AMA IMG Section has published a series of questions to ask during residency interviews. The questions are designed to reveal details that help potential residents determine whether a specific program is appropriate for them.

The series of questions is grouped into specific areas. They include:

– Education. Does the program include orientation for new residents? Does the program have a formal didactic structure? Are there any informal learning possibilities such as bedside rounds? What unique resident programs exist? Is there a feedback mechanism for evaluating the program?

– Clinical duties. What is the residency schedule generally like? What is the volume of clinical responsibilities? What supervision structures are in place? What forms of ancillary support are present? Is there a balance between supervision and independence? Is there a balance between education and service?

– Program performance. Is the program accredited? What is the status of previous citations? How many residents successfully complete the program? How many graduates pass the specialty boards on the first sitting and where do they proceed afterward?

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Factors to Consider When Choosing a Residency Program

Americlerkships

Located in Irvine, California, AmeriClerkships Medical Society was founded by Dr. Pedram Mizani, a family physician, in 2007. AmeriClerkships Medical Society helps international medical students and graduates gain placement into residency programs in the United States.

Narrow down the number of residency programs you want to apply for by researching them. First, research a residency program’s chairman and faculty members. Assess where they attended school, completed their training, and former places of employment. Determine if their clinical backgrounds can support your academic and career goals.

IDepending on the program you choose, residents may be required to rotate through numerous hospitals to finish their training. Health care facilities may be private or cater to veterans. Some programs host training at university or county hospitals. Apply for a residency that helps figure out the type of practice you would like to manage in the future.

Lastly, consider culture, as it has a large impact on students’ overall happiness. Make time to evaluate the characteristics of residents in a program and how they are treated throughout their training. Look for positive aspects of a residency as well as the negatives and weigh each factor to decide on fit. Additionally, ask about opportunities for growth. Opportunities include fellowship and research programs.

Challenges in the First Year of Residency

Dedicated to the success of international medical graduates (IMGs) and international medical students, AmeriClerkships Medical Society helps these individuals become competitive candidates for residency programs. AmeriClerkships has placed more than 700 candidates to date, 200 of which have gone into first-year programs.

While medical school is extremely rigorous, students often find that their first postgraduate year, or the intern year, presents a host of new and even greater challenges. Medical graduates become experienced physicians only by meeting these practical and theoretical challenges, which include handling a broader patient caseload and having greater responsibility for their patients’ care. Meeting these challenges requires knowing enough about each patient to advise staff in an emergency while also understanding when and how to seek support.

Residents should know how to use clinical decision support tools available in the hospital and should be aware of all chains of command that are in place. Hospitals have a distinct hierarchy and are staffed with professionals who have many years of experience, and residents can learn much by relying on the expertise of the care team. However, residents will also need to know when to research a particular condition and strengthen their own knowledge, as well as how to balance this self-education with the many administrative, clinical, and data analysis duties that come along with finally being a practicing physician.

The Ins and Outs of Residency Matching

AmeriClerkships Medical Society offers assistance to overseas-trained medical students and graduates so they can more effectively compete with American-trained graduates for residency placements. Iranian medical professional Dr. Pedram Mizani founded AmeriClerkships after experiencing firsthand the difficulties associated with finding U.S.-based residency programs for foreign-trained doctors.

Matching residency candidates with placements can be a competitive and stressful process. If conducted through the National Residency Matching Program, candidates create a list of preferred residency programs and then submit an electronic application through ERAS, and the NRMP system uses an algorithm to match available residencies with willing candidates. Those applicants who are not matched to a residency through this system then experience what is known as “the scramble,” a period of time following Match Day where the unsuccessfully matched applicants “scramble” to locate and apply for whatever positions remain unfilled.

Some programs offer pre-matching agreements, where the candidates sign work contracts prior to match day. Others use programs to get the list of unfilled positions and spend their time working through the list in the hope of obtaining a contract. The list is typically revealed at noon on a day during match week, and candidates may contact residency programs immediately. In 2008, it was shown that more than half of the unfilled residencies had been filled within four hours of the list being released.

AmeriClerkships: International Medical Graduates in American Residency Programs

In general, international medical graduates prove an invaluable asset to residency programs, strengthening them through diversity. These individuals offer a unique perspective, insight into a different system of values and beliefs, and an understanding of different forms of medicine. Unfortunately, Americans often associate “different” with “inferior.” As a result, many American medical graduates gravitate toward programs that do not accept many international graduates, believing them to be superior in some way. In reality, American medicine will remain forever indebted to the contributions of international medical graduates. In addition, these individuals often perform better than graduates of American institutions.

Unfortunately, international medical graduates still struggle to gain acceptance into American residency programs, largely due to prejudice, difficulties with visas, and a dearth of residency spaces. Once in a program, they often face discrimination from other residents, staff members, practicing physicians, and patients. Language often proves a significant barrier, especially when communicating with patients. While international medical graduates certainly possess excellent English writing and speaking skills, things such as regional differences, slang, and idioms prove difficult to understand. In addition, body language varies dramatically between cultures, requiring that the international students continue to learn American English expressions in addition to practicing their medical skills.

International medical graduates also struggle with differences in the medical education system, and Americans may mistake their deference for shyness or ignorance. Foreign graduates require time and guidance to grow accustomed to questioning their teachers and interacting with other students in a team-based learning environment, an educational system that remains largely American. For this reason, international medical graduates may want to research programs with instructors who have dealt with students from foreign countries extensively. These teachers generally understand how to encourage active participation from international students, and they have furthermore conquered their own biases against foreign education. International students may also want to make their intentions about education clear. While some come to the United States in order to stay and practice medicine, many plan to return to their respective countries and improve the medical systems there. Others may wish to do both.

About AmeriClerkships

International medical graduates can gain invaluable experience with the American medical system prior to enrolling in a residency program through AmeriClerkships. Clinical trainees work closely with attending physicians and other medical professionals, and later they receive an assessment and feedback about their performance. With AmeriClerkships, international medical graduates gain a strong competitive edge in the residency application process.

AmeriClerkships: Challenges for International Medical Graduates in the United States

Numerous physicians who graduate from foreign universities wish to practice medicine in the United States. Many countries do not have the resources necessary for the efficacious practice of medicine, mostly due to economic constraints. By choosing to complete residencies in the United States, medical graduates learn about the most cutting-edge medicines and techniques. Americans spend more money on medical development and research than any other country, making the United States an ideal place for physicians to further their careers. Unfortunately, these medical professionals often face a number of challenges, beginning with gaining acceptance into a residency program. Places in American residency programs are limited, and competition has become exceedingly fierce in recent years. Before applying, international medical graduates must obtain a travel visa to complete an exam and then secure an additional visa after finding a suitable program.

Once an international medical graduate arrives at his or her place of residency, the student faces a number of other hardships. In addition to dealing with possible prejudice, the individual must struggle with different customs, new cultural concerns, a foreign language, and an altered value system. In the end, however, the student must remember that diversity means strength and that these initial struggles will prove invaluable assets in the future. An average of one in four residents participating in a given program in the U.S. studied internationally, and facilities have grown accustomed to easing transitions. Still, the student must remain proactive, seeking help and guidance whenever necessary. Often, international medical graduates feel completely overwhelmed by the transition to the United States, but they must retain the confidence that got them through medical school. They experienced success in their respective countries and can do so again. Eventually, the feeling of foreignness fades as an individual becomes accustomed to a new culture and embraces new conventions.

The most important piece of advice that anyone can offer is to never fear asking for help and seeking out those organizations created to ease the transition, offer guidance, and address concerns before they become real problems. International medical graduates are not alone in facing the challenges of finding a residency, emigrating, and adapting to life in the United States.

About AmeriClerkships

In order to give international medical graduates an advantage in the residency application process, AmeriClerkships pairs qualified individuals with attending physicians for pre-residency clinical training. After each clinical block, supervisors evaluate program participants according to the 11 medical competencies that they use to assess residents. Many residency programs now expect international medical graduates to pursue such training, making AmeriClerkships an invaluable asset for these students.

AmeriClerkships: The Looming Physician Shortage and Foreign Medical Graduates

President Barack Obama’s recent health care reforms aim to increase overall access to health care while reducing the associated cost. Unfortunately, the United States already suffers from a shortage of primary care physicians, and the demand for more will grow sharply in the coming years as the government implements the reforms. The Association of American Medical Colleges expects a shortage of more than 91,000 doctors by 2020, a figure that has more than doubled from previous estimates due to expanded coverage. Part of the problem lies in the fact that graduates from American medical schools generally choose to pursue specialties, which earn more money than general practitioner positions. Many even feel forced to do this, anxious about the student loans that await them in the future.

Many people have suggested turning to foreign medical graduates in order to minimize the shortage of family doctors. Unfortunately, restrictive licensing rules and limited slots in American residency programs keep many foreign medical graduates from practicing in the United States. Those who wish to practice in American facilities must complete at least three years of residency here, but many applicants get turned away. In the European Union, partnerships exist between countries to import medical professionals to areas most in need. While the United States has a similar arrangement with Canada, graduates of institutions in other nations often face great difficulties in finding a residency program. Before these medical graduates can apply for the residency, they must travel to the United States and pass an exam. Many, especially those from the Middle East and South Asia, have trouble securing a travel visa in order to take the exam. If accepted into a program, students must then obtain another visa. The J-1 visa for education, however, requires that applicants leave the United States after training, defeating the purpose of completing a residency here.

The federal government’s Medicare program subsidizes hospital training programs, effectively giving Congress the power to control the number of available residency positions. Many foreign medical graduates are unable to gain entrance to residency programs due to a 1997 cap on Medicare-supported positions. Congress declared it would pay for only 98,000 residency slots. Since that time, the number of available residency slots has not grown at the same rate as the American population. Most of that expansion, furthermore, represents opportunities in advanced fields, not family medicine. Foreign medical graduates now fill about one in four residency positions, but that figure will decrease as more Americans choose to attend medical school. Many have proposed that Congress fund more residency slots, but that will detract from the funding that goes to health care subsidies. As the need for general practitioners increases, however, the United States will need to reach beyond its borders for new physicians.

About AmeriClerkships

AmeriClerkships matches pre-qualified foreign medical graduates with attending physicians and other medical professionals, allowing them to gain pre-residency clinical experience in a variety of specialties. This experience gives clinical trainees a serious competitive advantage when looking for a residency; in addition, several programs actually require foreign medical graduates to complete such training. After finishing clinical training through AmeriClerkships, international medical graduates receive an evaluation of their performance from their supervisor, who uses the same criteria applied to residents.


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