LoR: observership through networking or elective through registrar's?

[CamBrady]

International Medical Student from Europe here. I am in my final year and plan to do away rotations in the US. Some years ago I went to high school as an exchange student. Since then I have been having very positive feelings about moving to the US and starting a new life there. So I get that the thing to do is to obtain LORs while doing clinical electives in order to strengthen your application including good USMLE scores, research, yadda yadda… I also get that elective > observership.

Unfortunately, it is very hard to secure an elective position for foreign students. In addition to that we are not allowed to participate in VSAS which leaves out a lot of potential schools that we would normally apply to.

Now my question: Is it necessary to obtain these letters while officially doing a clinical elective, thus being temporary enrolled (maybe that’s not the correct legal term?) at this particular medical school? Or would it suffice to obtain a LoR through observership? Do LoRs from physicians in private practice carry any weight? Through networking in my home country I have contacts to some doctors in the US. Still, I am afraid that this will rather land me an observership and not the desired clinical elective at an US institution.

I do know the difference between observership and elective. But a fellow student of mine went to participate in before mentioned observership and actually was allowed to touch, examine and manage patients to some extent. If that's the case, what is the difference in the description of one's clinical skills in an LoR after an observership vs. after an elective?

Thanks for any helpful comment in advance.

Yes, I’ve already used the search function of this forum. Some useful information showed up. Yet, I wouldn’t mind reading your 2 cents about my situation.

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[MHC7]

Every IMG case is different i know people that have matched and they only did observerships in the US. .. BUT they got a around a 97 - 98 score in the usmle step 1, one of them graduated as summa cum laude, the others just had great grades, they collected their LORs during the observership, and 2 out of 10 had research. Of all of the IMG students (from mexico) that i've know two did not matched , one because failed 2 times the step1.
Idk i think it depends on the programs you apply and how well you write your personal statement and "things" that programs directors find "attractive" in your CV. besides scoring a good grade in step1 and 2

 

[MHC7]

now about the rotation......................
If you have the chance to do an elective rotation instead of an observership, just do it ... the BIG difference from a observership an elective i am guessing is the fact that you pay for the mal practice insurance ...........
Im not sure it would be a good idea to state in your application for the residency that you get to touch and managed patients as an observer.

Im just guessing here ... I'm an IMG just like you making my way into IM residency....... work hard and focus on being outstanding

 

[Medstart108]

International Medical Student from Europe here. I am in my final year and plan to do away rotations in the US. Some years ago I went to high school as an exchange student. Since then I have been having very positive feelings about moving to the US and starting a new life there. So I get that the thing to do is to obtain LORs while doing clinical electives in order to strengthen your application including good USMLE scores, research, yadda yadda… I also get that elective > observership.

Unfortunately, it is very hard to secure an elective position for foreign students. In addition to that we are not allowed to participate in VSAS which leaves out a lot of potential schools that we would normally apply to.

Now my question: Is it necessary to obtain these letters while officially doing a clinical elective, thus being temporary enrolled (maybe that’s not the correct legal term?) at this particular medical school? Or would it suffice to obtain a LoR through observership? Do LoRs from physicians in private practice carry any weight? Through networking in my home country I have contacts to some doctors in the US. Still, I am afraid that this will rather land me an observership and not the desired clinical elective at an US institution.

I do know the difference between observership and elective. But a fellow student of mine went to participate in before mentioned observership and actually was allowed to touch, examine and manage patients to some extent. If that's the case, what is the difference in the description of one's clinical skills in an LoR after an observership vs. after an elective?

Thanks for any helpful comment in advance.

Yes, I’ve already used the search function of this forum. Some useful information showed up. Yet, I wouldn’t mind reading your 2 cents about my situation. .

LoR from an observership isn't as strong as an LoR from an elective. LoRs from physicians in private practice don't carry much weight because there isn't any accountability. If you did an official elective at a university hospital they know that letter writer teaches medical students and residents often so they can make an accurate judgement of your skills especially in a "residency type setting". If you do an observership in a private clinic first off the doctor probably doesn't get many students so they won't be able to compare but second off they don't know what you actually did in that clinic and whether or not they are just writing a good letter because you know them well.

A LoR from a private physician on an observership won't carry any weight. Again technically observership don't allow you to touch patients but in reality most people do, however they don't usually get to do invasive procedures and manage patients like an elective student would be able to do. That is the key difference between an observership and an elective. During an observership you are probably going to be able to take histories, do an exam or two, follow a patient or two. During an elective you are treated like a first year resident so you will be taking call, managing patients from beginning to end, doing invasive procedures, ordering tests, writing notes. Its a big difference.

An elective is an audition for the job. An observership is just to learn about the job. People do match with only observerships, but the good programs will say outright they want US elective experience and someone with good LoRs from an elective rotation will always be given priority over someone with good LoRs from an observership.

I'm sure its not too hard to secure an elective position. There are some schools that will make partnership agreements. Check to see if you are on that list. I know Harvard gives electives although it will charge you a fortune for them, its worth it if you are actually good and you think you can get a good reference out of it. There is going to be a lot of hassle, immunization, malpractice etc, so you will need to start prep early.

 

[tshionhoto]

yes,There is going to be a lot of hassle, immunization, malpractice etc, so you will need to start prep early.thanks

 

[CamBrady]

Thank you guys for your comments! this helps a lot!!!