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So far Pedram Mizani, MD has created 9 blog entries.
12 10, 2017

14 markers of a problematic residency application

2017-11-16T14:04:53+00:00

by Pedram Mizani, MD, MHSA, family physician and chief clinical officer of the AmeriClerkships Medical Society

Published in Residency Program Alert* on September 2017.

September 15 marks the start of the main residency Match season. For the most part, each residency program’s highly tailored—and often subjective—residency application screening process yields a high enough number of interviewees to provide an adequate statistical probability for the National Resident Matching Program’s (NRMP) Match algorithm to consistently fill about 95% of residency slots. However, the process and outcome for the unfilled 5% of slots that are reintroduced to residency candidates during the annual Match week’s Supplemental Offer and Acceptance Program are the subject of incredible debate and anxiety.

Download the full article below, for free.

Download the article

Published with permission from HCPro/Residency Program Alert. Also published on HCPro.

* About Residency Program Alert: Residency program managers in all specialties are challenged to effectively manage their programs as accrediting agencies focus on outcome measures, the core competencies, proper documentation, resident supervision, and program, faculty, and resident evaluation. Add to those responsibilities the challenge to prepare for site visits, develop budgets for your program, and mitigate legal risks. Residency Program Alert is the source you need to confidently meet these challenges. This monthly resource provides residency managers with essential tips, tools, and best practices from the most well-respected, in-the-trenches experts. Dr. Pedram Mizani, the AmeriClerkships’ Chief Clinical Officer, is a writer and contributors to Residency Program Alert.
14 markers of a problematic residency application 2017-11-16T14:04:53+00:00
22 08, 2017

10 Considerations when handling re-entering residents

2017-11-16T14:04:53+00:00

by Pedram Mizani, MD, MHSA, family physician and chief clinical officer of the AmeriClerkships Medical Society

Published in Residency Program Alert* on July 2017.

Nearly every medical student I speak with says they have never heard of a medical resident losing his or her residency position, yet over 10,000 medical residents have been subject to dismissal or withdrawal from U.S. medical residency programs between 2005 and 2015. Those who attempt to make their way back into medical residency after an extended leave or departure are generally referred to as re-entering residents, and all parties involved are faced with the daunting task of deciphering what really happened—and if something similar will happen again.

Download the full article below, for free.

Download the article

Published with permission from HCPro/Residency Program Alert. Also published on HCPro.

* About Residency Program Alert: Residency program managers in all specialties are challenged to effectively manage their programs as accrediting agencies focus on outcome measures, the core competencies, proper documentation, resident supervision, and program, faculty, and resident evaluation. Add to those responsibilities the challenge to prepare for site visits, develop budgets for your program, and mitigate legal risks. Residency Program Alert is the source you need to confidently meet these challenges. This monthly resource provides residency managers with essential tips, tools, and best practices from the most well-respected, in-the-trenches experts. Dr. Pedram Mizani, the AmeriClerkships’ Chief Clinical Officer, is a writer and contributors to Residency Program Alert.
10 Considerations when handling re-entering residents 2017-11-16T14:04:53+00:00
26 01, 2017

5 Categories of Student Clerkships

2017-08-04T10:06:28+00:00

For U.S. medical licensure issues affecting International Medical Students: Click here

International Medical Students (IMS) are often challenged with the daunting task of having their clerkships verified by teaching hospitals for state licensure purposes. Inability to verify such rotations or lack of proper affiliation agreements will most likely result in that IMS’ loss of the residency position s/he Matched into. To avoid such a catastrophe, below we have listed 5 categories of “for-credit” clinical rotations for IMS, and their availabilities to AmeriClerkships Medical Society (AMS) members:

  1. Category #1: Community Healthcare Experience (CHE)

  2. Category #2: Teaching Hospital Guarantee (THG)

  3. Category #3: THG VERIFIED

  4. Category #4: THG DO-GME VERIFIED

  5. Category #5: THG MD-GME VERIFIED

Important notes and disclaimers:

  • To minimize future scrutiny, it is recommended that you not cross to a lower clerkship category after you begin your rotations (upgrading to a higher category before you begin, and sometimes after you begin may be acceptable and recommended).
  • Both cores & elective rotations should be conducted within the same category, and in the highest number category possible (i.e. #3 is more desirable than #2, where available).
  • Securing an initial medical licensure in the first state is typically much more difficult than subsequent medical licensure(s) in other states; also with the greater need for practicing physicians, state medical boards want to recruit physicians (especially in Medically Underserved Areas), therefore licensure regulations may be less stringent after completion of residency, or becoming board certified, or having secured an unrestricted medical license in at least one state.
  • Click here to learn more about how clinical rotations are verified by various state medical boards, be sure to read our DISCLAIMER* on the bottom of this page
  • Click here for the our Commitments to Clarify + definition of AMS Clinical Features
  • Medical students enrolled in U.S. accredited medical schools (i.e. LCME or DO accredited medical schools) are legally permitted to engage in the limited practice of medicine (i.e. “hands-on”), whereas medical students not attending one of these medical schools may not. The definition of “hands-on” varies, depending on who you speak with (i.e. state medical boards may define it as partial or full practice of medicine, whereas medical residencies may define it as the ability to engage with patients to take student-type histories and physicals).
  • Taking student-type histories and assisting with physical exams alone may not be enough to label an activity in violation of the practice of medicine laws; however if combined with giving opinions or the patients being under the impression that you are their care provider, could put a foreign medical student at jeopardy of practicing medicine without a license. To be safe, AmeriClerkships recommends that non-U.S. medical students to never be unsupervised, and to never give the impression to anyone that they are doctors or have the ability to practice medicine (that includes using the words “Dr” before their names or even their email addresses).
  • Please note that individual medical boards may define “teaching hospital” differently, so at AmeriClerkships we have expanded our definition of a “teaching hospital” to any facility that meets any of the following criteria:
    1. Is listed in ACGME.org, OR
    2. Is listed as an AOA approved Institution or a Program, OR
    3. Hosts the medical students of U.S. accredited medical schools (i.e. LCME or DO accredited medical schools) for their clinical rotations (start with AMA Freida database, but not all clerkship teaching sites are mentioned there).
  • Remember that this page is for informational purposes only, and in NO WAY is it meant to offer any legal advice OR to circumvent your personal responsibilities of ensuring that you meet the licensure qualifications for the states you are planning to apply to for residency and ultimate medical licensure by contacting each state yourself.
  • AmeriClerkships reserves the right to change any of its published information without notice.

Clerkship Category #1

  • AMS Clinical Feature: CHE (Community Healthcare Experience)
  • Start of availability at AMS: Since March 2007 to present
  • Take me to AMS Clinical Site Search for Category #1 clerkships near me: Click here
  • Can AMS members transfer from a lower category into a higher category clerkship prior to start: Yes, upon availability; additional fees apply
  • Acceptable by ALL U.S. medical boards for initial medical licensure: Acceptable by most states, except possibly by OK, TX, MA, OR, IL, NY, CA, VA (and a growing number of states who are adopting the CA list of approved medical schools; subsequent licensures may not be as stringent)
  • Cost: $$$$$
  • Passing USMLE Step 1 required: No
  • Steps to enrollment: Click here
  • Suitable for crossing the U.S. border and securing a medical student B1 visa: No
  • Affiliation agreements: AMS + teaching attending physicians (+ possibly with your medical school, but not with a teaching hospital), therefore rotations ARE NOT “placed at an affiliated hospital”, but rather with the AMS affiliated supervising attending who may be affiliated with hospitals, and may elect to take you to those hospitals
  • Hands-on or shadowing: Experience will be insured for hands-on in outpatient settings (as permitted by patient and attending); opportunities to visit a hospital are NOT guaranteed
  • Registration with Graduate Medical Education (GME) or Medical Staff Office (MSO): There are NO affiliations between AMS and hospitals for this category of clerkships, therefore none of the above are guaranteed nor should they be expected by IMS of AMS
  • Same specialty ACGME (MD) or AOA (DO) accreditation, being issued a hospital ID badge, or any future verification of clinicals: There are NO affiliations between AMS and hospitals for this category of clerkships, therefore none of the above are guaranteed nor should they be expected by IMS of AMS. Some hospitals are considered a teaching facility due to hosting U.S. medical students for their clinical clerkships, without the presence of any residency program.
  • Recommendations to International Medical Student (IMS) thinking about arranging this category clerkships on their own to save money: This category of clerkships is only being offered by AMS to IMS who are under extreme budgetary constraints, and will limit applying to residencies in states that do not currently have any clinical rotation regulations (which can obviously change at any time). Otherwise AMS DOES NOT recommend this category of clerkships to any IMS.

Clerkship Category #2

  • AMS Clinical Feature: THG (Teaching Hospital Guarantee)
  • Start of availability at AMS: Since May 2007 to present
  • Take me to AMS Clinical Site Search for Category #1 clerkships near meClick here
  • Can AMS members transfer from a lower category into a higher category clerkship prior to start: Yes, upon availability; additional fees apply
  • Acceptable by ALL U.S. medical boards for initial medical licensure: Acceptable by most states, except possibly by OK, TX, MA, OR, IL, NY, CA, VA (and a growing number of states who are adopting the CA list of approved medical schools; subsequent licensures may not be as stringent)
  • Cost: $$$$$
  • Passing USMLE Step 1 required: No, with the exception of a few sites
  • Steps to enrollment: Click here
  • Suitable for crossing the U.S. border and securing a medical student B1 visa: No
  • Affiliation agreements: AMS + teaching attending physicians (+ possibly with your medical school, but not with a teaching hospital), therefore rotations ARE NOT “placed at an affiliated hospital”, but rather with the AMS affiliated supervising attending who may elect to take you to a teaching hospital that he/she is affiliated with
  • Hands-on or shadowing: Experience will be insured for hands-on in outpatient settings (as permitted by patient and attending), and in inpatient settings (if permitted by the hospital(s); most non-affiliated hospitals will only allow shadowing). Supervising attending physicians will provide the IMS with the opportunity to enter a hospital 24 hours a day; the IMS is responsible for taking advantage of those opportunities regardless of transportation or time issues. Opportunity for teaching hospital entry with supervising attending are as follows:
    • THG: <50% of the clinical block (CB)
    • Inpatient (IP) THG: >50% of the CB
    • Hospitalist (HOSP) THG: ~99% of the CB
  • Registration with Graduate Medical Education (GME) or Medical Staff Office (MSO): There are NO affiliations between AMS and hospitals for this category of clerkships, therefore none of the above are guaranteed nor should they be expected by IMS of AMS
  • Same specialty ACGME (MD) or AOA (DO) accreditation, being issued a hospital ID badge, or any future verification of clinicals: There are NO affiliations between AMS and hospitals for this category of clerkships, therefore none of the above are guaranteed nor should they be expected by IMS of AMS. Some hospitals are considered a teaching facility due to hosting U.S. medical students for their clinical clerkships, without the presence of any residency program.
  • Should International Medical Student (IMS) set up this category clerkships on their own to save money and time: Not recommended for IMS under any circumstance, since clinical clerkships should carry the appropriate medical student professional liability insurance, and only be completed with attending physicians who have entered into an affiliation agreement with your coordinating agency (i.e. AMS or your medical school) so that you are protected (i.e. physician accountability for outcomes, clinical evaluations and amount of teaching hospital exposure). Also nearly 50% of supervising attending physicians change their minds to host an IMS at their clinical site, causing unexpected delays in you graduating from medical school on time.  Enrolling with AmeriClerkships will help you avoid unnecessary time delays and continuous rejections.

Clerkship Category #3

  • AMS Clinical Feature: THG VERIFIED
  • Start of availability at AMS: June 2008 to present
  • Take me to AMS Clinical Site Search for Category #3 clerkships near meClick here
  • Can AMS members transfer from a lower category into a higher category clerkship prior to start: Yes, upon availability; additional fees apply
  • Acceptable by ALL U.S. medical boards for initial medical licensure: Acceptable by most states, except possibly by TX, MA, CA (CA may accept verified rotations that also host U.S. medical student clerkships, but unclear at this point; also may be changing soon due to Single AOA/ACGME Accreditation), OR, IL, VA (may change; subsequent licensures may not be as stringent)
  • Cost: $$$$$
  • Passing USMLE Step 1 required: No, but highly recommended
  • Steps to enrollment: Click here
  • Suitable for crossing the U.S. border and securing a medical student B1 visa: Yes; student must request AMS for a Letter of Enrollment on teaching hospital letterhead at least 2 months prior to visa interview
  • Affiliation agreements: AMS + teaching hospital + teaching hospital’s staff physicians (+ possibly with your medical school), therefore rotations ARE “placed at the affiliated hospital”, but can also take place in various inpatient and outpatient settings that the teaching attending physician is affiliated with and takes you to visit
  • Hands-on or shadowing: Inpatient and outpatient will be insured for hands-on at the facilities affiliated with AMS (as permitted by patient and attending; not shadowing); no guarantees when visiting non-affiliated facilities
  • Registered with the affiliated hospital’s Graduate Medical Education (GME) or Medical Staff Office (MSO): Yes, however the student is equally responsible for ensuring that his/her hospital processing has been completed, and that all hospital protocols are being followed by the student (pick up or drop off ID badges, not accessing the EHR, being professional to all employees, not violating patient confidentiality, etc.) Hospitals are not obligated to confirm that a student registration for clinical clerkships actually took place, despite there being evidence of such registration. 
  • Same specialty ACGME (MD) or AOA (DO) accreditation: Not guaranteed; some hospitals are considered a teaching facility due to hosting U.S. medical students for their clinical clerkships, without the presence of any residency program.
  • Must be willing to travel anywhere in the U.S. for same specialty ACGME (MD) or AOA (DO) accreditation as your specialty of clerkship for all 72 weeks of rotations (cores & electives): Yes, where available
  • Issued a hospital ID badge: Yes
  • Future verification of clinicals: Teaching hospital (or AMS as sanctioned by the affiliated teaching hospital; fees apply) may verify that your rotations were conducted with their permission, but are not obligated to do so and may defer you back to the supervising attending physician for actual attestation that such clinicals took place. Additionally the opportunity for verification does not guarantee state licensure outcomes (meaning that states may have more clinical rotation requirements than just verification when an IMS is applying for training/full medical licensure [i.e. specialty specific, existence of agreement with your medical school, etc]; click here for additional medical board requirements for IMS).
  • Should International Medical Student (IMS) set up this category clerkships on their own to save money and time: Thousands of IMS apply to a handful of teaching hospitals offering mainly elective specialties upon vacancy, and most are shadowing. Waiting too long to secure U.S. clerkships will cause a gap in your medical education, which is highly scrutinized by residency program directors when granting interviews. Securing hands-on for all cores & electives by IMS on their own is nearly impossible due to intense competition by U.S. medical schools, shortage of rotation slots, a teaching hospital staff physician’s unwillingness to sponsor someone they’re unfamiliar with due to HIPAA and hospital policies, and a student having to deal with all licensure matters on their own. Enrolling with AmeriClerkships will help you avoid unnecessary time delays and continuous rejections.

Clerkship Category #4

  • AMS Clinical Feature: THG DO-GME VERIFIED
  • Start of availability at AMS: July 2018
  • Show me Category #4 clerkships near me online: Available July November 2017
  • Can AMS members transfer from a lower category into a higher category clerkship prior to start: Yes, upon availability; additional fees apply
  • Acceptable by ALL U.S. medical boards for initial medical licensure: Most likely, except possibly CA (most likely changing soon due to Single AOA/ACGME Accreditation; subsequent licensures may not be as stringent)
  • Cost: $$$$$
  • Passing USMLE Step 1 required: Yes
  • Steps to enrollment: Click here
  • Suitable for crossing the U.S. border and securing a medical student B1 visa: Yes; student must request AMS for a Letter of Enrollment on teaching hospital letterhead at least 2 months prior to visa interview
  • Affiliation agreements: AMS + teaching hospital + teaching hospital’s staff physicians (+ possibly with your medical school), therefore rotations ARE “placed at the affiliated hospital”, but can also take place in various inpatient and outpatient settings that the teaching attending physician is affiliated with and takes you to visit
  • Hands-on or shadowing: Inpatient and outpatient will be insured for hands-on at the facilities affiliated with AMS (as permitted by patient and attending; not shadowing); no guarantees when visiting non-affiliated facilities
  • Registered with the affiliated hospital’s Graduate Medical Education (GME) or Medical Staff Office (MSO): Yes (most likely GME)
  • Same specialty AOA (DO) accreditation: Likely yes; if so, you will be placed with GME offices sanctioned by teaching hospitals that are AOA (DO) accredited for every one of your desired core & elective clerkship specialties (i.e. FM core at a hospital with an FM residency; Cardiology elective at a hospital with a Cardiology Fellowship, etc…)
  • Must be willing to travel anywhere in the U.S. for same specialty AOA (DO) accreditation as your specialty of clerkship for all 72 weeks of rotations (cores & electives): Yes, where available
  • Issued a hospital ID badge: Yes
  • Future verification of clinicals: Teaching hospital (or AMS as sanctioned by the affiliated teaching hospital; fees apply) may verify that your rotations were conducted with their permission, but are not obligated to do so and may defer you back to the supervising attending physician for actual attestation that such clinicals took place. Additionally the opportunity for verification does not guarantee state licensure outcomes (meaning that states may have more clinical rotation requirements than just verification when an IMS is applying for training/full medical licensure [i.e. specialty specific, existence of agreement with your medical school, etc]; click here for additional medical board requirements for IMS).
  • Should International Medical Student (IMS) set up this category clerkships on their own to save money and time: Thousands of IMS apply to a handful of teaching hospitals offering mainly elective specialties upon vacancy, and most are shadowing and don’t have same specialty GME. Waiting too long to secure U.S. clerkships will cause a gap in your medical education, which is highly scrutinized by residency program directors when granting interviews. Securing hands-on for all cores & electives by IMS on their own is nearly impossible due to intense competition by U.S. medical schools, shortage of rotation slots, a teaching hospital staff physician’s unwillingness to sponsor someone they’re unfamiliar with due to HIPAA and hospital policies, and a student having to deal with all licensure matters on their own. Enrolling with AmeriClerkships will help you avoid unnecessary time delays and continuous rejections.

Clerkship Category #5

  • AMS Clinical Feature: THG MD-GME VERIFIED (Teaching Hospital Guarantee MD-Graduate Medical Education Verified)
  • Planned availability at AMS: June 2018
  • Show me Category #5 clerkships near me online: Available June 2018
  • Can AMS members transfer from a lower category into a higher category clerkship prior to start: Yes, upon availability; additional fees apply
  • Acceptable by ALL U.S. medical boards for initial medical licensure: Most likely (Also subsequent licensures may not be as stringent)
  • Cost: $$$$$
  • Passing USMLE Step 1 required: Yes
  • Steps to enrollment: Click here
  • Suitable for crossing the U.S. border and securing a medical student B1 visa:  Yes; student must request AMS for a Letter of Enrollment on teaching hospital letterhead at least 2 months prior to visa interview
  • Affiliation agreements: AMS + teaching hospital + teaching hospital’s staff physicians (+ possibly with your medical school), therefore rotations ARE “placed at the affiliated hospital”, but can also take place in various inpatient and outpatient settings that the teaching attending physician is affiliated with and takes you to visit
  • Hands-on or shadowing: Inpatient and outpatient will be insured for hands-on at the facilities affiliated with AMS (as permitted by patient and attending; not shadowing); no guarantees when visiting non-affiliated facilities
  • Registered with the affiliated hospital’s Graduate Medical Education (GME) or Medical Staff Office (MSO),
  • Same specialty ACGME (MD) accreditation: Likely yes; if so, you will be placed with GME offices sanctioned by teaching hospitals that are ACGME (MD) accredited for every one of your desired core & elective clerkship specialties (i.e. FM core at a hospital with an FM residency; Cardiology elective at a hospital with a Cardiology Fellowship, etc…)
  • Must be willing to travel anywhere in the U.S. for same specialty ACGME (MD) or AOA (DO) accreditation as your specialty of clerkship for all 72 weeks of rotations (cores & electives): Yes, where available
  • Issued a hospital ID badge: Yes
  • Future verification of clinicals: Teaching hospital (or AMS as sanctioned by the affiliated teaching hospital; fees apply) may verify that your rotations were conducted with their permission, but are not obligated to do so and may defer you back to the supervising attending physician for actual attestation that such clinicals took place. Additionally the opportunity for verification does not guarantee state licensure outcomes (meaning that states may have more clinical rotation requirements than just verification when an IMS is applying for training/full medical licensure [i.e. specialty specific, existence of agreement with your medical school, etc]; click here for additional medical board requirements for IMS).
  • Should International Medical Student (IMS) set up this category clerkships on their own to save money and time: Thousands of IMS apply to a handful of teaching hospitals offering mainly elective specialties upon vacancy, and most are shadowing and don’t have same specialty GME. Waiting too long to secure U.S. clerkships will cause a gap in your medical education, which is highly scrutinized by residency program directors when granting interviews. Securing hands-on for all cores & electives by IMS on their own is nearly impossible due to intense competition by U.S. medical schools, shortage of rotation slots, a teaching hospital staff physician’s unwillingness to sponsor someone they’re unfamiliar with due to HIPAA and hospital policies, and a student having to deal with all licensure matters on their own. Enrolling with AmeriClerkships will help you avoid unnecessary time delays and continuous rejections.

 


* DISCLAIMER: State medical board policies change all of the time. We may not have the most up to date information, therefore we strongly encourage you to learn about your desired state’s licensing policies on your own, and to continuously stay up to date with that medical board. Furthermore information collected from medical boards of CO, GU, HI, LA, MN, MO, NY, PR, RI, VI and WY are extremely limited, so please contact those jurisdictions if you’re interested to apply to residencies in their states/territories. Although we have taken great care to remain accurate, AMS assumes no liability for any inconsistencies or inaccuracies.

 

5 Categories of Student Clerkships 2017-08-04T10:06:28+00:00
25 01, 2017

Thought I Knew the Answers

2017-11-16T14:04:53+00:00

I vividly remember the excitement of passing USMLE Step 1 and conducting actual H&Ps, with real patients in a real U.S. hospital, as remarkably humbling and strangely euphoric. After I finished two years of basic sciences in Belize (Central America), I returned to the United States to start my 3rd year clinical clerkships at an Illinois hospital where my medical school had placed me. (This makes me an International Medical Graduate – IMG!)

I thought I knew every answer, until a friend of mine attending a more established medical school asked if I was completing my clerkships at a teaching hospital. Like an amateur, I replied: “Of course I am…I’m learning every day!”

But, I soon found out I was NOT placed at a teaching hospital; something I later learned was happening to thousands of international medical students like myself! My medical school, however, admitted to their colossal mistake and moved me to Atlanta, Georgia where I completed the remainder of my clerkships at an ACGME recognized teaching hospital with an onsite Family Medicine residency program. Later on, I returned to that Atlanta hospital’s residency program and proudly graduated as Chief of the Morehouse Family Medicine Residency Program.

Because of my own struggles, I’ve dedicated my life to helping IMGs succeed in U.S. healthcare. Every few weeks, I will share inspiring clinical experiences of my own past, and ofthree IMGs who decided to shape their own futures in the annual Match by joining AmeriClerkships Medical Society.

I invite you to click the links below, get inspired, become an AmeriClerkships Member, and start capturing the attention of residency admission committees with clinical experiences ranging from 100% inpatients, with residency program directors and residency teams, to outpatients with primary care providers.

I’ll be rooting for you,

Pedram Mizani, MD, Founder

###

A Postgraduate Subinternship Experience:
On May 5, 2015, Angela’s life was changed…

A Teaching Hospital Guarantee Experience:
On April 25, 2015, Divya wrote me saying…

An Outpatient Experience:
On April 15, 2015, Nadia inspired me with the following…

###

Thought I Knew the Answers 2017-11-16T14:04:53+00:00
11 01, 2017

ACGME Core Competencies & Examples of Resident Difficulties (as they pertain to LORs)

2017-11-16T14:04:53+00:00

In order for a Medical Doctor (MD) to become a U.S. licensed practitioner and sit for the American Board of Medical Specialties, s/he must have graduated from one of 9600+ residency program that is accredited by Accreditation Council for Graduate Medical Education (ACGME). In 2002, the ACGME launched a competency initiative called the Outcomes Project, resulting in the identification of six ACGME Core Competencies to be used by residency programs to evaluate the performance of their medical residents.

According to the ACGME 2014-2015 Data Source Book (page 65), 246 residents were dismissed, 18 unsuccessfully completed program, 883 withdrew and 1072 transferred to another residency program, causing significant disruptions year over year. Additionally many of the 1000+ annually dismissed & withdrawn residents may never get the opportunity to re-enter our residency workforce, worsening our prospects of addressing the U.S. physician shortage crisis. Many program directors suggest that these numbers could be significantly reduced with better ACGME Core Competency training and addressing signs of future resident troubles in the pre-residency years, i.e. during clinical rotations. As a result, AmeriClerkships supervising attending physicians are encouraged to prepare and evaluate the student physician utilizing the six ACGME Core Competencies, and remain vigilant in addressing any signs of ‘Examples of Resident Difficulties’ during any clinical encounters with such residency candidates. Furthermore, AmeriClerkships encourages that letter of recommendation (LOR) writers discuss how a residency candidate has met each of the 6 ACGME core competency utilizing objective evidence and unique patient interactions. Click here to read “A Physician Guideline for Writing Effective LORs”.

Click Image Below to Download

 

ACGME Core Competencies & Examples of Resident Difficulties (as they pertain to LORs) 2017-11-16T14:04:53+00:00
29 12, 2016

Protecting International Medical Students

2017-08-04T10:15:56+00:00

For 5 Categories of For-Credit Student Clerkships: Click here

This section only applies to current medical students attending English-based, non-governmental/private medical schools that lack accreditation by the AAMC. Most American-based international medical schools are located in the Caribbean, Central America (primarily Mexico), India, Poland, Czech Republic or Russia (just to name a few), and offer a unique avenue to medical students who plan to complete any portion of their clinical rotations in the United States prior to obtaining a medical degree from those institutions. We at AmeriClerkships Medical Society try not to refer to student clinicals as “Green Book” or “Blue Book,” since summarizing the complete scope of clinicals and their effects on future licensure using colors is misleading. Let us explain (once again, the response is very lengthy but definitely worth reading).

Green Book vs. Blue Book Clerkships

U.S. students do not typically use the term “Green Book” or “Blue Book” rotations; these terms were coined by International Medical Students (IMSs) and International Medical Graduates (IMGs) who typically attend Caribbean medical schools and want to complete their clinicals in a similar manner as U.S. medical students, in an attempt to compete for U.S. medical residency slots. Generally speaking, Green Book refers to a rotation where the IMS is able to set foot in a hospital that is listed in ACGME or AOA (with or without permission from that hospital); Blue Book generally refers to the same, but that hospital has a “family medicine residency” associated with it (again, student’s entry into the hospital may or may not have been authorized). As one can easily ascertain, this fails to capture what would truly resemble clinicals conducted by U.S. medical students, since conducting student type clerkships is much more than being able to set foot on hospital grounds; furthermore, international medical schools typically do not own nor manage their own teaching hospitals or sponsor their own residency programs, which minimizes their footprint in the medical education arena. For these reasons, AmeriClerkships strongly discourages the usage of the terms Green or Blue Book, since they often mislead an IMS into believing that the rotations are somehow sanctioned by that hospital, and also by ignoring the many clerkship verification policies that have long been implemented by all U.S. medical boards and jurisdictions.

What AmeriClerkships Is Doing to Address These Issues

Issue #1

Each state licensing body has individual rules, policies, regulations and requirements of licensure applicants who graduate from non-LCME accredited schools (click here to see some). Although not the most important, one such requirement has to do with clinical rotations conducted by students before they graduate (clinicals after graduation is a whole other subject). Other regulations that are specific to IMSs who intend to complete any portion of their clinical clerkships in the United States at the time of licensure include:

  • The quality of clinical clerkships is monitored (20 states)
  • Clinical clerkships are regulated (13 states)
  • IMS clinical clerkships are forbidden in the state (3 states)
  • Clinical clerkships are accepted in hospital departments with ACGME-accredited residency programs (22 states)
  • Additional regulations exist regarding regulation of clerkships provided to students of foreign medical schools (9 states)

Securing a residency does not ensure completion of residency. Certain state medical licensure rules may inhibit a Matched IMG/IMS from starting in that residency. Other very important rules/policies/regulations/requirements (according to importance) that can affect your ultimate medical career outcomes are:

  • Graduating from a state-approved medical school – typically a rigid policy: many states are using the California List of Recognized Medical Schools
  • Problems with an applicant’s history
  • Practice of Medicine Without a License issues
  • Any arrests, DUIs, previous issues in medical school, criminal histories
  • Appropriate number of residency years, in accredited programs – typically 2 years minimum (1 year in 3 regions)
  • Number of years and attempts that it took an applicant to complete USMLE Steps 1, 2 CK and 2 CS (typically from first attempt at any USMLE)
  • Passing/failing of USMLE Step 3
  • National Physician Databank resources for past failed licensure attempts or any other negative history
  • Previous rejected applications to state licensing bodies
  • Irregular behavior during USMLE, NRMP, ERAS, etc.
  • ECFMG reports on an individual applicant
  • Ability to provide the appropriate documents requested, such as medical school diploma to ECFMG when the medical school no longer exists
  • Unexplained spans of time spent away from patient care (typically more than 30 days)
  • Performance during the licensure interviews
  • Licensure requirement before/during/immediately after residency
  • Resident may not qualify to obtain a license in that state (we see this a lot in California, Georgia and Illinois)

Therefore, there is a lot more to worry about than simply completing clinicals in teaching hospitals.

Issue #2

Just because an IMG secures a residency, that does not mean that the state medical board will issue him/her a license. Therefore, the best pre-licensure and pre-residency practices by IMGs are as follows:

  • Prepare early, maintain your cool, and be prepared to deal with hundreds of different policies that change from one state to another
  • Be cognizant of both residency as well as state licensure rules
  • Licensure typically takes place during or after residency, but some states require training licensure prior to residency (i.e., Illinois and California)
  • Choose the state to practice medicine very carefully, as you may lose your residency position if unable to secure training/temporary licensure as required by that state
  • Be reasonable; saying “I want to practice in all 50 states” is unreasonable
  • Focus on all state regulations that have to do with IMG licensure (see Issue #1), not just clinicals
  • Remember that you may be required to get licensed before or during residency, so familiarize yourself with state licensure before applying to residency programs
  • Choose the states in which it is easier to get licensed if you have doubts – typically Florida, Wisconsin, Puerto Rico or the U.S. Virgin Islands

Issue #3

Not all states have the same clinical clerkship requirements. AmeriClerkships recommends that IMSs keep the following in mind:

  • Not all clinicals conducted in/associated with “Green Book” hospitals address the problems faced by IMG applicants and the states alike when time comes for medical licensure
  • Many teaching hospitals fail to maintain records of IMS/IMG clinicals
  • The first response of most teaching hospitals is to refuse to verify IMS/IMG clinicals, regardless of the presence of a Clinical Affiliation Agreement with the student’s sponsor or medical school, forcing all parties to pursue legal action (seldom successful) or take the path of least resistance – which is verification by supervising attending physician
  • A majority rely on the supervising physician to verify the clinicals, which can satisfy the state licensure need and requirements if done correctly
  • Some physicians or hospitals may reject to verify, due to advice from their legal department
  • Most verifications will confirm the date, time, and name of the supervising physician, but will most likely not address the main issue, which is the quality of clinicals conducted
  • The term “Green Book Clinicals” lacks a specific definition since this never applies to U.S. medical graduates

NEXT STEPS TO BECOMING A DOCTOR…

Step 1: Where do you want to practice?

Step 2:  Know your rights!

  • There are several ways in which you can complete your clinicals and still receive credit for them when applying to residency and medical licensure. They can be conducted in:

Government teaching hospitals in the country where your medical school is located, or

Familiarize yourself with the 5 categories of U.S. clinicals, and select the most appropriate one for your situation

Step 3: Avoid costly mistakes!

  • Watch the webinar below:

  • Begin to steer away from potentially devastating mistakes by becoming a member of AmeriClerkships Medical Society! You will be assigned to your own personal Residency Enrollment Strategist, Dr. Mizani, as your Healthcare Advisor, and an in-house Healthcare Writer & Editor to help you perfect your residency application.
  • Focus on competing with U.S. medical students, learning about the U.S. healthcare and job market cultures, and becoming a great doctor; let AmeriClerkships Medical Society and its team of professionals help you tackle the barriers.
  • Protect yourself: have your medical school agree and authorize your away rotations by completing your  “Clinical Authorization Letter”.

 

Protecting International Medical Students 2017-08-04T10:15:56+00:00
18 12, 2016

Four Epic Traps to Avoid

2017-01-12T06:58:21+00:00

While you’re reviewing the innovative services offered by AmeriClerkships, here are four career traps you may just be finding yourself in (without realizing it!):

1. Your E-mail address.

If you’re using Earthlink, AOL, Hotmail, your local cable provider, or a company email domain with a long name, you could be inadvertently shooting yourself in the foot.

We rarely see AOL, Earthlink or Hotmail email addresses these days. If you’re still using yesterday’s email providers to represent yourself professionally, it could be sending a message that you’re not comfortable with new technology or you’re too set in your ways. Using your local cable provider or your 20 character company name’s default e-mail increases the chances of a typo leading to a bounced emails and missed connections.

Every student at Advanced Colleges of America uses, or has a secondary gmail.‍com. Because gmail is well-known for its ease of use, utility, and power, using gmail as your address is a smart move that also sends the message that “I’m up to date with the times!”

What comes before the ‘@’ sign deserves attention as well.

‘Family’ or ‘household’ or ‘joint’ emails such as ‘thejonesfamily@’, ‘johnandjamie@’, or ‘ourfamilyloveshouston@’ are not good e-mail addresses to use on your resume, or professionally for that matter. Professionals want to write directly to other professionals; requesting that they e-mail your spouse & kids when contacting you is just plain weird.

The best email address is “first name[dot]last name”, at gmail.‍com: john.jones@gmail.com.

If that’s taken, then: john.jones.2015@gmail.com.

You’re probably going to be using this e-mail address into 2015 anyway and starting now makes you seem ahead of the times. And who doesn’t want to work with a healthcare professional from the future?

2. You’re misusing your overqualifications.

Almost all of the students in Advanced Colleges of America are international physicians who are receiving training on how healthcare is practiced in the United States as Advanced Medical Assistants. Why would they succumb to a lesser title?

The answer is simple: no employer will consciously hire a “neurosurgeon” or a self-proclaimed “medical assistant” who hasn’t proven that they’re willing to swallow their ego and learn what a U.S. employer requires of them.

This is what I call the “Overqualified Syndrome”, whereby a perfectly intelligent and capable candidate sabotages their future by sitting idle and not retraining for a less intense transitional career in order to get ahead. Now some employers offer “on the job training”, so you may not need to go back to school, but those are exceptions. Even residency programs will require that you perform as of day one, just like any other employer would. So if your time is valuable to you, then you should think about getting re-educated in a related field (like our International Medical Graduates do by using Advanced Medical Assisting to get a foothold in U.S. healthcare).

Which brings me to the next term I’ve coined during my spare time: the “Underqualified Overqualified Syndrome”. This is an overqualified applicant who applies to less intense healthcare jobs in the U.S., based on having held more advanced jobs abroad.

A good example is a foreign physician applying for a medical assisting position in the U.S., not even knowing what different color-top vacutainers are used for.

Let me ask you this: “Will the President of General Motors make a great car salesman?”  Why not? they’re both selling cars, aren’t they?

3. Your curriculum vitae misses the point, and you knowingly use it anyways.

Print out your curriculum vitae. Tear it in half and hand either piece to someone who is not in healthcare. Can they tell you with ease, what you want to do next in life?

For too many, the answer is no. The reason is that in your curriculum vitae, you’re telling the reader about things that that they can’t possibly prove, such as being a team player, trustworthy, positive, or a multitasker, and you may even have your marital status mentioned too!

You know what I look for in a curriculum vitae? Does this person “have the experience to do a good job?”, “provide an asset or a liability to our clinic?”, “show commitment, or bounced from job to job?”, and “have a bunch of grammatical and spelling errors?”  That last one is my biggest pet peeve.

Obviously, given that you spend all the time with yourself, its completely obvious to you what you’re looking for, but a stranger does not. And, chances are, your curriculum vitae will be read by a stranger, so make it easy for them to like you.

Show everyone, at the top of your curriculum vitae what job you’re looking for (first sentence), and why you’re the best fit for it (second sentence). No need to name all of your subjective attributes or marital status, just plain professional facts. A “to-the-point” approach shows that you’ve worked out all the kinks in your mind, and can form a solution to a problem quickly (maybe in 2 sentences).

4. You’re not speaking with one employer a day.

The internet is awesome: it delivers us news, movies, Yelp, reviews, and of course, acmedical.org!

Therefore “bravo!” for the internet.

But here’s the truth — the internet is not going to read your curriculum vitae; it will be read by humans who hire other humans. An employer.

So ask yourself: did you try to speak with an employer today? Have you called your former classmates? Returned the call from the clinic that perhaps you’re only mildly interested in? Have you taken a former colleague to lunch? Did you call back the Advanced Colleges of America representative you’ve spoken to six months ago?

It’s absolutely vital, while you’re seeking, qualifying, and selecting the healthcare program at Advanced Colleges of America that best fits you, that you realize that a part of becoming successful is to learn how an employer thinks, so you can fulfill what’s on their minds, and ultimately get hired and continue to build your curriculum vitae.

When it comes to competing for that perfect healthcare job, you need to exercise by “speaking with an employer” every day.

Put these tips to work, and you’ll get 4 steps closer to capturing success right at your fingertips.

Four Epic Traps to Avoid 2017-01-12T06:58:21+00:00
3 11, 2014

IMG Friendly

2017-01-09T08:45:17+00:00

Join Dr. Pedram Mizani, MD (former Chief of Morehouse Family Medicine Residency) & Mrs. Nerissa Pawluk (AmeriClerkships Senior Residency Enrollment Strategist) in this FREE live & online event to learn about what “IMG friendly” really means as it relates to you, and hear answers to 20 of the toughest residency entry questions asked by the audience.

IMG Friendly 2017-01-09T08:45:17+00:00