Clinical Clerkship Verification Issues

[Xbocker]

I am an IMG doing my rotations in the States. What would happen if after you get matched into residency the Medical Board rejects one of your clinical rotations because not greenbook, no affiliation etc etc. Can you repeat the course? Will you lose youre residency spot?

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[Winged Scapula]

I am an IMG doing my rotations in the States. What would happen if after you get matched into residency the Medical Board rejects one of your clinical rotations because not greenbook, no affiliation etc etc. Can you repeat the course? Will you lose youre residency spot?

1) you avoid this by only doing Green Book rotations;

2) there would technically be time to do another rotation between Match Day and the start of residency provided you could get it arranged;

3) if you aren't eligible to start residency on time a program could rescind the offer of a position through the match; some programs will work with you if the delay is a few days/weeks

 

[Houmd]

WS is spot on, the only thing I would add is that as an IMG you need to be very conscious of the laws applying to each state in which you apply for residency. The laws pertaining to IMGs is different from LCME and you don't want to get into a situation in which you are giving up your residency position over something dumb.

Greenbook mostly pertains to permanent licensure as opposted to temporary resident licensure but there are states like Virginia that require all cores to be greenbook for temporary permit, and IL requires there to be either a verbal or written affiliation agreement with your medical school and the rotation site in order to acquire a temporary license.

If you have gone the IMG route then it is in your best interest to stay as informed as possible so that you can prevent or manage any bumps that come your way.

 

[Xbocker]

Thank you both for your replies. Another question. My school is a 4 year program with a mandatory 5th year internship pathway. So in case for example they did not accept my Family medicine and Neurology rotation in 4th year because it wasn't greenbook but They accepted the rotation when I did in the 5th year at a greenbook hospital (5th year is basically a repeat of the cores) Would that count?

What would happen if you graduated and you find out your rotations are null. Are you pretty much done?

 

[Houmd]

No, mandatory internship is not considered as core clerkships and to my knowledge it wont be treated as such by any state boards. However, you'd be better off asking any state boards to which you intend to apply.

No, there are many states that don't care about your rotations as vigorously as you may think. Also, remember that any rotations outside of the USA are considered greenbook since the ACGME has no jurisdiction outside of the US

 

[dhavalp]

No, mandatory internship is not considered as core clerkships and to my knowledge it wont be treated as such by any state boards. However, you'd be better off asking any state boards to which you intend to apply.

No, there are many states that don't care about your rotations as vigorously as you may think. Also, remember that any rotations outside of the USA are considered greenbook since the ACGME has no jurisdiction outside of the US

Something interesting: https://www.acgme-i.org/web/index.html. But, I agree with what you are saying.

 

[Xbocker]

No, mandatory internship is not considered as core clerkships and to my knowledge it wont be treated as such by any state boards. However, you'd be better off asking any state boards to which you intend to apply.

No, there are many states that don't care about your rotations as vigorously as you may think. Also, remember that any rotations outside of the USA are considered greenbook since the ACGME has no jurisdiction outside of the US

Even if my school is a 5 year program in which we wont recieve our full diploma until after finishing the 5th year? The 5th year is everything we did in 3rd year cores. except its done in the U.S. Why would it be different from core clerkship

 

[gutonc]

Even if my school is a 5 year program in which we wont recieve our full diploma until after finishing the 5th year? The 5th year is everything we did in 3rd year cores. except its done in the U.S. Why would it be different from core clerkship

You can't be the first person from your school to try to match in the US. Have you tried asking somebody at your school?

 

[Houmd]

Agree with Gutonc, the best place to ask those questions would be your seniors and your administration.

If your 5th year is a rotating internship then it wont count as core clerkships. If your core clerkships were done outside the US it really doesn't matter anyway because those are greenbook.

Also I've never heard of 5th yr being conducted in the US.

 

[Houmd]

Yes I've seen that before about the ACGME-I, but it's extremely small (only a few programs in the world) and it's entirely voluntary. While the ACGME doesn't technically have a jurisdiction in the sense that those programs don't NEED ACGME the way ours do, I will note that a select few have opted to try and maintain ecgme standard

 

[Winged Scapula]

Agree with Gutonc, the best place to ask those questions would be your seniors and your administration.

If your 5th year is a rotating internship then it wont count as core clerkships.

They call it an internship, but he will not have graduated so its an extended curriculum. Those rotations can be used toward licensing just like the other 3rd and 4th year ones. Most FMGs do no cores in the US, so as noted above, it depends on the state licensing board.

If your core clerkships were done outside the US it really doesn't matter anyway because those are green book.

Technically, "Greenbook" rotations refer to rotations at a hospital that has an ACGME residency program in that specialty. It refers to the days before ERAS when all residency programs were listed in a Green leatherette bound book kept in the medical library; you perused that book for programs to apply to.

Also I've never heard of 5th yr being conducted in the US.

He's probably at a school in Mexico.

 

[Houmd]

I'm unfamiliar with rotating internship rotations being used towards clerkship credit for licensure but WS would definitely know more than I would.

I am however fully aware of the actual green book but in our current terminology we tend to refer to it as what it is, and for those outside the country we (though semantics would argue we shouldn't) also often refer to them as greenbook, although truthfully they are just exempt from the greenbook requirement by licensing authorities

 

[Winged Scapula]

I'm unfamiliar with rotating internship rotations being used towards clerkship credit for licensure but WS would definitely know more than I would.

I am not aware of every state's requirements. My point is that most FMGs have no core clerkships at ACMGE approved hospitals yet somehow are eligible for a license. The cores (IM, Surg, etc.) don't necessarily have to be completed during 3rd year. The states I'm familiar with accept any rotations completed before graduation; YMMV.

I am however fully aware of the actual green book but in our current terminology we tend to refer to it as what it is, and for those outside the country we (though semantics would argue we shouldn't) also often refer to them as greenbook, although truthfully they are just exempt from the greenbook requirement by licensing authorities

Perhaps its late but I'm not sure what you're saying here. Are you referring to rotations completed outside of the US as "greenbook" rotations?

 

[Houmd]

I'll clarify. Reading through the laws of the state boards and having extensive contact with them, IMGs that do any rotations in the states are expected to have those rotations as greenbook (or in most states, just cores), but those core clerkships or any other rotations done outside of the states are exempt of this requirement. Eg. A Russian graduate completes all medical school in Russia, and Texas wasnts core rotations to be greenbook for permanent licensure, that graduate will not be deneid licensure due to the fact that all rotations were conducted outside the US and thus those rotations were exempt of any greenbook requirement by the board.

 

[Winged Scapula]

I'll clarify. Reading through the laws of the state boards and having extensive contact with them, IMGs that do any rotations in the states are expected to have those rotations as greenbook (or in most states, just cores), but those core clerkships or any other rotations done outside of the states are exempt of this requirement. Eg. A Russian graduate completes all medical school in Russia, and Texas wasnts core rotations to be greenbook for permanent licensure, that graduate will not be deneid licensure due to the fact that all rotations were conducted outside the US and thus those rotations were exempt of any greenbook requirement by the board.

I think that very obvious but your earlier explanation was convoluted. It is much simpler to state:

Rotations done in the US need to be done at hospitals which have ACGME residencies in the specialty ("Greenbook rotations")

Rotations done outside the US are done according to the requirements of the medical school the student is training at; there is no need to refer to these as meeting or not meeting Greenbook requirements as it is not relevant as they cannot meet the requirements. Whether this changes in the future with ACGME-I remains to be seen.

 

[Xbocker]

I did all my cores outside the U.S besides 1 (internal medicine) which was done in the U.S. It was done at a bluebook hospital I believe. Now even though we get our medical degree after 4th year, we don't get the TITULO until after the 5th year internship which is required before we can be ECFMG certified. During the 5th year we repeat our cores. Can I use the internal medicine rotation during the 5th year to satisfy my requirements?

 

[Doctor Bob]

I think I counted "greenbook" being used as 3 different parts of speech throughout this thread.

You can wordify anything if you just verb it.

 

[deleted604824]

Piggybacking on this thread but with a question similar to the OP:

I will have all of my third-year cores (Surg, Peds, Medicine, Psych, etc) completed outside of the US. My program give students the option of doing the entire fourth year Stateside (at affiliated US hospitals if Step 1 is completed at that time) for which I can do my electives then. I'm leaning towards applying to FM or Psych, if I choose to do one of my electives in FM again (Stateside) must it be at a 'Greenbook' location (i.e. where there is an existing FM residency program at this particular facility)?