To help out my fellow IMGs, I’ve put together a list of clinical rotations, along with all the necessary information about requirements and application procedures.

Fact number one: As an IMG, USCEs are crucial to match into Medical residency in the US. 

Fact number two:  Finding a USCE as an IMG can rapidly transform into the hunger games.

As an IMG, when I started searching for US clinical opportunities, I felt like me against a wall. 

Indeed, most university hospitals don’t accept IMGs; if they do, it’s through the VSLO portal, which doesn’t apply to most IMGs. 

There were still some options for observerships, but if you’ve read my article on all you need to know about USCE as an IMG, you probably already know that many programs don’t consider them as USCE. 

Luckily there was still one option, online directories or databases that offer clinical rotation opportunities for IMGs.

The first time I heard of online directories, I was scared to fall into a scam and waste my money.

I also wondered about the actual value of this kind of experience on my resume.  

Because many IMGs share the same questions and concerns about using online services, I want to share my experience with these services.

Who are they? What are the positive and negative aspects? How can you make the best of these experiences?

In this article, we’ll try to answer all these questions, and I’ll share with you a list of these online services. 

Before proceeding, please remember that every IMG profile is unique. Although my experience might not apply to you, it’s always interesting to understand and consider all your options before making the choice that will suit you best. 

Benefits and disadvantages of Using Online Directories or Databases

When considering an online service, you must know the advantages and disadvantages, as those aspects are what will help you make up your mind. 

The benefits

The accessibility

First, you can apply to a USCE through online services either as a medical student or a graduate. 

In addition, most of the time, you don’t need to have passed any of the USMLE exams to apply and get a USCE. 

Therefore, these opportunities are open to almost every IMG, regardless of their profile and how far they are in the journey. 

The choice

Online services allow you to find any type of USCE in almost every specialty. 

You can find opportunities in cardiology, ObGyn, anesthesiology, and so on. 

Online services offer observerships, and telerotation if you cannot travel. 

In addition, spots are available across different states and cities. 

Flexibility

The process of applying to a USCE through online services is flexible. 

In other words, you won’t need to apply three or six months in advance and can submit your application all year long and find a spot.  

In addition to choosing the start date that best fits you, you can select the period length that is most appropriate to your needs and budget. 

The disadvantages

The cost

Prices vary between agencies, but overall you’ll spend a minimum of 1200 dollars for a 4-week experience. 

Considering that you ideally need at least three months USCE on your resume, this is a considerable budget, which can be very frustrating. 

However, note that some agencies offer a “dual” rotation with two physicians and in two different specialties for those with a limited travel period.  

The setting

Most of the time, the experiences you’ll get from online services are in an outpatient setting, meaning you won’t have access to hospitalized patients. 

Of course, exceptions exist but are much less available and generally more expensive, so you’d better consider this information when making your choice. 

If you need more information about the setting of USCE and its importance, you can refer to my article for more details. 

The value

Many consider that USCEs provided by online services aren’t valuable, and the same applies to the LoRs you get from them.  

I won’t tell you that this is not true. 

Indeed USCEs in big institutions and universities programs are more robust.

However, experiences in such places may be out of reach financially. 

Luckily, many IMGs match each year, thanks to experiences acquired through online services. 

Now, are these experiences perfect? No.  

But does it need to be perfect to make you achieve your goal? Not either. 

You do your best with what you have. 

Furthermore, it’s important to keep in mind that your application involves numerous other factors.

The number of participants

Because they are accessible to many IMGs, the USCEs provided by online services may be slightly overcrowded. 

Of course, this isn’t always true, but you may have to work in a team on your cases. 

Personally, I don’t see it as a disadvantage, as I met wonderful people from whom I learned much. 

Exiting your comfort zone and navigating an entirely new healthcare system can also be scary. 

Therefore, working with a team of other IMGs can be beneficial and reassuring for the whole group.

Popular Online Directories or Databases for Clinical Rotations

Okay, now that we’ve detailed all you need to know about online services, here is a list of available services to pick up from. 

AMOpportunities U.S. clinical experiences

AMO opportunities offers one of the broadest range variety of choices among all online services. 

Once you’ve created an application, you can select among 200 rotations on their website, including inpatient, outpatient, and observership experiences. Their eligibility criteria are the following: 

• ONLY a CV/resume to apply (unless a hospital requires more to accept your application)
• After you’re accepted, to complete enrollment, you will need the following:
• Proof of immunizations (MMR, hepatitis B, meningitis, tetanus, varicella, influenza when in season, and a recent PPD)
• Health insurance
• Proof of student or graduate status
• Professional liability insurance (for hands-on experience)
• Proof of English proficiency
• B1 visa or other valid U.S. entry status (or citizenship/permanent resident)
• Other paperwork required by specific clinical sites (background checks, additional references, other immunizations, etc.)

One drawback may be the cost, as AMOpportunities count as one of the most expensive online agencies 

If you desire more information about them, you can visit their website. 

America Clinical Rotation JCMI

Located in Orlando, Florida, JCMI offers the opportunity to do inpatient and outpatient rotations in various specialties and many other options.

Their eligibility criteria are the following: 

• Current Resume/CV
• USMLE Step reports (If any, but not mandatory)
• Medical diploma (If any)
• ECFMG certificate (If any, but not mandatory)
• COVID-19 vaccination proof
• Government-issued photo ID (passport/driver’s license)
• Current visa or valid U.S. entry status

For more information, you can visit their website.

American Medical International Quality Training Observerships

The American Medical International Quality Training Observerhips provides observerships and externships in the metropolitan Washington, D.C. area, and also offers free consultation for the residency process upon request.

 The specialties available are the following:

• Neurology
• Internal medicine
• Family medicine
• Paediatrics
• Obstetrics-gynecology
• Psychiatry
• Ophthalmology
• Nephrology

For more information, I recommend you visit their website

Bridgeport Family Medicine Externship/Preceptorship Program

Bridgeport Family Medicine Externship/Preceptorship Program offers hands-on experience in family medicine, internal medicine, pediatrics, and urgent care medicine, starting any Monday. 

For further details, please consult their website.

Chicago Clerkships

Chicago Clerkships is a well-known agency that offers rotation for IMG in various specialties, including hospital exposure. 

Chicago Clerkships offers other options, including:

• Assistance with finding housing.
• Research internships in immunology at the Northshore Evanston/University of Chicago.
• Rotation boot camps where you can do two rotations simultaneously and get two LORs (for those with time limitations).
• Personal statement and resume editing.

For more information, you can refer to their website.

Griffin Medical Clinical Observership Program

Griffin Hospital is a 160-bed acute care community hospital serving more than 100,000 residents of the Lower Naugatuck Valley Region.

The hospital offers four weeks of observership to IMGs who fit the following eligibility criteria: 

• A completed or ERAS application (For ERAS, the months for which the candidate is applying should be indicated in the email. If an ERAS application is unavailable, a common application form can be substituted.)
• A cover letter detailing desired rotation
• A curriculum vitae
• At least one letter of reference from a clinical supervisor or advisor or an attending physician
• USMLE score reports
• Medical school diploma
• ECFMG certificate
• TOEFL score report (if available)
• Documentation of up-to-date immunization records (including flu shot during flu season (Oct.-March)
• Proof of health insurance coverage
• A recent photograph for identification
• Copy of passport and valid visa

Note that application must be submitted no later than October 1.

For more information, please refer to their website.

International Observership Program

The Allegheny General and West Penn hospitals located in Pennsylvania propose four weeks of observerships to IMG. 

For further information, please visit their website.

Jackson Memorial Hospital

Located in Miami, Florida, Jackson Memorial Hospital offers observership in either an inpatient or outpatient setting for foreign medical graduates and students. 

For more information on their observership program, please visit their website. 

MD2B Connect IMG Rotation Program

MD2B connect offers rotations in inpatient and outpatient settings or observership experiences.

Please refer to their website for ore information about the rotation available and their pricing. 

Somerset Family Medicine

Located in Michigan, Somerset Family Medicine offers outpatient rotations in family medicine for foreign medical graduates and students. 

Among their services, you may get the opportunity to publish patient education articles in their community newspaper and volunteer in their church clinic once a week.

For more information, please refer to their website.

USMLESarthi

USMLESarthi provides hands-on and telerotations opportunities for IMGs in various specialties and different localizations. 

For more information, please refer to their website.  

Tips for Using Online Directories or Databases

Before using online services, you must take the time to understand all the types of USCE and their differences and pick one that best suits your profile. 

In addition, although many legit platforms offer you the possibility of doing a USCE, there are also many scams on the internet.

Therefore, due diligence is necessary before making any engagement. 

Do not rush this process. Take the time to compare each offer, and contact IMGs who rotated with the online services you’re considering to gather their feedback. 

Moreover, although you can apply to these rotations throughout the year, these experiences should be as fresh as possible during the match season. 

The same principle goes for your LoRs. They need to be as recent as possible. 

Thus, make sure to plan for these rotations ahead of time.

Conclusion

For many IMGs, finding a USCE that can strengthen their application for the residency match can be a real struggle. 

Luckily, online services offer IMGs a wide variety of clinical experiences in the US. 

Among their strength, online services are accessible to all IMGs, either graduates or students. 

In addition, they provide hands-on rotation in many different specialties, and the flexibility of their process makes them attractive to many physicians willing to pursue residency training in the US. 

My experiences with online services were an excellent opportunity to make my first steps in the US healthcare system and meet other IMGs with whom I share the same goal. 

However, although they are a good alternative for IMGs,  it’s crucial to understand their benefits and drawback and compare all the available options to make the best choice possible and help you achieve your goals!