USMLE: Guide to Electives

By Dr. Humaira Sarfaraz

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Electives

These are generally the most advantageous of USCE- US clinical experiences and are done while you are still a student. The most appropriate time to apply for these are 3rd year or 4th year- that is almost 6 months to a year in advance. It would be beneficial if you plan your Step 2 CS exam with these rotations. So clinical electives are generally better than research electives because they get you hands on experience and you can definitely work on research simultaneously while doing a clinical rotation. However, if what you do is a research elective, a publication is ultimate goal you should be after.

Here again, a uni program elective is definitely worth much more than a rotation at a private clinic. The main aim of this rotation is to get a strong LOR- to ensure that you need to demonstrate interest and actively participate- volunteer to do more, go early, look up articles and literature on uptodate, medscape etc, volunteer to give presentations, go to the clinic, the pluses of our system are the physical examination- try using that to your advantage, read up, care for your patients, show up on the weekends, ask if there is a research project you can get onboard on, type in patient notes, seek feedback, make friends, explore the city, stay safe. Also,doing a rotation will give you insight into the american clinical system- teach basic courtesy and norms of American system which is really helpful for Step 2 CS.

The elective should be in the area in which you want to do your residency. While something is definitely better than nothing, discrepancies in your application with an elective say in surgery and then applying for residency for IM will definitely be something questionable on your CV. So decide early on at least broadly what you want- neurology, IM, surgery, psychiatry, radiology or pediatrics and try applying in that area. Now as for further sub-specialties of IM are concerned, you can apply into anything which interests you-cardiology, ID whatever but try ensuring that you are at least certain about the broader category.

And research/USCE is all icing on the cake and by no means an alternative to Usmle scores which are the primary in the residency pursuit process.

Documents required for electives include-

-medical transcripts from Uni
-LORs from university usually-for IM, try sending LORs from Internal medicine
-Dean’s letter
-Immunization records-contact pediatrics department
-Immunity titres and PPD test- Quality lab on jail road and Chughtai lab do it as well
-Personal statement-usually really under-rated but a very important document in getting you an elective
-TOEFL-some places require a certain score on each of the sections- writing, listening, reading and speaking- No matter how good you think your english is, please do prepare from Barrons book and CD ideally. For the speaking section, there are videos on youtube, record yourself and practice. Some places may exempt this if a letter showing that the medium of instruction is English is attached with application
-Health insurance-Jubilee and others offer it
-application fee-you may use western union
-malpractice insurance-mostly required after acceptance, you can ask the coordinator about it
Again while sending an email, attach your CV. Things that will stand out on CV: position/ distinction/ research/ attending basic life support courses, volunteerships, humanitarian works/ workshops or seminars attended or organized.

Again this list is by no means all encompassing. Feel free to add up on the list:

Clinical electives:

-Mt Sinai New York- $1000/- application fee, 2000$ elective fee
-Harvard-elective costs around 4500$/ month
-Yale- no application fees. 3000$/month application fee payable after acceptance. Require a very strong letter of why interested in Yale and document showing patients seen in wards-please get stamped from wards.
-University of Alabama-$5000/month as per what I heard-check website, get faculty sponsor by email
-University of Illinois Chicago
-Univ of North Carolina- earlier gave a Step 1 waiver for those who have not given Step 1 if you contact them via email. Not sure if they give it anymore. $2000/month elective fee. Application fee is there too.
-Florida International Uni-fill in and submit application
-Uni of Massachussets-Umass- require TOEFL. Excellent place for a rotation.
-GHLO elective opportunities- contact Rashid sahb in KEMCAANA and search portal for options
-Oschner medical Centre
-Baylor college of medicine-email faculty
-case western reserve
-Louisiana State University
-uni of Tennessee
-cook county

Clinical electives with Step 1-

-mayo clinic
-Cleveland Clinic

Research electives:

-NIH-requires a set score on TOEFL, letter showing interest in field of application
-John Hopkins-email to get faculty sponsor

Where to stay?
-stay safe:
-student accomodation
-ask the elective coordinator
-air bnb-a mobile app-you basically stay in another person’s house
-ask seniors


Are electives or for that matter any form of USCE a necessity?

So here are the facts, mostly when people go for their Step 2 CS exam, they do rotations alongside them. So most people who apply for the match have usually some sort of US clinical experience and that is a definite plus. Given the competition now, one definitely needs to brush up the CV. But for those who consider this as the ultimate US experience- this is NOT. This is only a part of it so if for whatever reason, because of your timeline, financial or personal constraints, you are unable to have this, do not let it be the reason that stops you from pursuing USMLE or even for that matter do not even let it be the only reason why you pursue USMLE. Trust me there is much more to the picture both in the making and in the taking which matters and will define you or your future here.

And research/USCE is all icing on the cake and by no means an alternative to Usmle scores which are the primary in the residency pursuit process.

Many of us know only what we see posted on the social media about the American dream- a picture in front of some tall building, the night skyline, posing: the perfect click- O and it has many of us wishing- but ask yourself these questions- the reason why you stepped into medicine? the reason why your parents sent you across borders and oceans into a foreign land? That click may be a part of why you want to do it but is all that drives you?

Please know that when on a rotation, each of us represents the institutions we come from and our upbringing- It is a privilege and honor to have this...may Allah grant us all the with the ability to do justice to the many bounties that we have. All the best. And hope this helps...

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