Core rotations in the UK

[agranulocytosis]

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Hey guys

I've been searching through the forums and I couldn't find the right thread to answer my questions that was recent enough to still be valid, but I had a question about doing core rotations in a different country.

I'm going to school in the caribbean, currently M2. My school currently has problems setting up clinical rotations. There basically aren't enough ACGME-approved slots for each of the students doing clinicals in the US, but in the UK, each clinical site's core rotations are "Green".

Now, clinicals at those hospitals are for the full 46 weeks of core rotations, so I will spend the entire 3rd year at that particular hospital. No setting up additional rotations, just apply once for all my cores.

But the questions remains, how valid is doing my cores in the UK? Will residency programs look down up my time there? Will I have difficulty applying for electives because I don't have US clinical experience? Will I have trouble obtaining state licensure (for the most part, ACGME-approval is the biggest qualifier for state licensure as far as I know).

I didn't know where else to put this thread given all my questions, but one place was enough and I didn't want to double-post.

Thanks for your help everyone!

 

[Blade28]

Whoa...weird. So you're going to a Caribbean school but doing all of your MS-III rotations in the UK? I've never heard of that...will that be OK for when you want to apply for the Match?

 

[McGillGrad]

If you are going to a teaching hospital, then your rotations will be ACGME equivalent.

In fact, US med schools usually reserve a couple UK/Ireland rotations for the top of the class as a way of exploring the system across the pond.

Your application is more likely going to be helped by the UK cores, as long as you have US electives to shore up your US experience.

Going to a Carib school will be much more of an issue than doing UK rotations with UK medical students.

 

[agranulocytosis]

If you are going to a teaching hospital, then your rotations will be ACGME equivalent.

In fact, US med schools usually reserve a couple UK/Ireland rotations for the top of the class as a way of exploring the system across the pond.

Your application is more likely going to be helped by the UK cores, as long as you have US electives to shore up your US experience.

Going to a Carib school will be much more of an issue than doing UK rotations with UK medical students.

Right, that makes sense on the surface of it all. But what if the places I want to do my electives don't like my qualifications, i.e. my not knowing the in's and out's of the US medical system?

One good thing I can point out is that of the people who went through core clinicals from my school, the ones who did them at our UK hospitals came back with more clinical experience stemming from the fact that UK docs are less likely to be sued due in part to the socialized health care system in place.

I'm just not quite sure, other than the cost of living close to London (holy $***!) it all seems too good be true. Can it be?

 

[agranulocytosis]

Whoa...weird. So you're going to a Caribbean school but doing all of your MS-III rotations in the UK? I've never heard of that...will that be OK for when you want to apply for the Match?

Yea, weird huh? Thing is, each hospital has anywhere from 3-6 slots for our students per intake, and there's 3 intakes per year (January, May and September). Seems like I should really rock Step 1 and maintain the GPA before such thoughts.

 

[McGillGrad]

From what I have heard, those who did their cores in the UK or Ireland had interviewers who were smitten by the European experience and wanted to know more.

Your cores rotations are not usually important (in terms of LOR) because we know absolutely nothing and are not impressing anyone...lol. The 4th year electives in the US are a place to shine and impress people. Especially in our prospective fields. In some cases, those who completed their cores in the UK had more hands-on experience and that gave them an edge in their electives. It helped them stand out from the rest of the students.

There are drawbacks, though. They include the lack of knowledge about the logistical aspects of US hospitals and the experience in handling multiple cases more independently than in the UK system.

The cost of living in London's satellite cities is high, but the hospitals are usually good with subsidized housing, or at least lists of affordable housing nearby.

Finally, you have to highly self-motivated in the UK system because their version of attendings couldn't care less if you are there or not. If you show them that you are actively ready to learn then they will happily oblige, but you will need to put forth constant effort to push to be granted more responsibility.

Right, that makes sense on the surface of it all. But what if the places I want to do my electives don't like my qualifications, i.e. my not knowing the in's and out's of the US medical system?

One good thing I can point out is that of the people who went through core clinicals from my school, the ones who did them at our UK hospitals came back with more clinical experience stemming from the fact that UK docs are less likely to be sued due in part to the socialized health care system in place.

I'm just not quite sure, other than the cost of living close to London (holy $***!) it all seems too good be true. Can it be?

 

[TMZ2007]

Right, that makes sense on the surface of it all. But what if the places I want to do my electives don't like my qualifications, i.e. my not knowing the in's and out's of the US medical system?

One good thing I can point out is that of the people who went through core clinicals from my school, the ones who did them at our UK hospitals came back with more clinical experience stemming from the fact that UK docs are less likely to be sued due in part to the socialized health care system in place.

I'm just not quite sure, other than the cost of living close to London (holy $***!) it all seems too good be true. Can it be?

I know at one of the Carib schools they changed the rules where students can do part of the 3rd year in the UK and not the whole 3rd year. For Ireland students must comment to the whole 3rd year still. Would you consider doing most of the 3rd year over there and saving the IM rotation for a US site?

I've chatted with a student that did the whole 3rd year in the UK. The student stated that most everything is the same over in the UK as in the US except two rotations- Peds and OBGYN. The student's viewpoint was that pediatricians in the US are normally in the 'general practitioner' category. In the UK pediatricians are in a socialized system where they are considered a specialist. In the UK most children do not ever see a pediatrician, only the sickest of the sick children are seen by a pediatrician in the hospital. Apparently this is also the case for OB docs. In the US nearly every woman uses an OBGYN for hospital births. In the UK an OBGYN is only seen for high risk pts. Apparently home births and certified nurse mid wives are widely used over an OBGYN. Thus there are more procedures/surgeries/high risk pts. Not so many normal births seen except with a nurse mid wife.

This is all info from one student and not my opinion. I have no way to know if it's true or not.... just some info that you might find helpful. 😀

 

[Winged Scapula]

I can only speak from personal experience but all students who study in Ireland, the UK, Australia etc. do their Cores abroad in the country where they are studying. I had pretty much no problem getting electives without USCE...as a matter of fact, I do not recall any of them listing a pre-req as having had done your Cores in the US.

Same thing with licensing. If you are applying through ECFMG, you are not required to have any USCE and therefore, it is assumed that your rotations are NOT ACGME approved but rather meet some simple requirements set forth by ECFMG. You do have to do a certain number of hours, etc. but there is no state that requires your Core rotations be in the US.

 

[agranulocytosis]

From what I have heard, those who did their cores in the UK or Ireland had interviewers who were smitten by the European experience and wanted to know more.

Your cores rotations are not usually important (in terms of LOR) because we know absolutely nothing and are not impressing anyone...lol. The 4th year electives in the US are a place to shine and impress people. Especially in our prospective fields. In some cases, those who completed their cores in the UK had more hands-on experience and that gave them an edge in their electives. It helped them stand out from the rest of the students.

There are drawbacks, though. They include the lack of knowledge about the logistical aspects of US hospitals and the experience in handling multiple cases more independently than in the UK system.

The cost of living in London’s satellite cities is high, but the hospitals are usually good with subsidized housing, or at least lists of affordable housing nearby.

Finally, you have to highly self-motivated in the UK system because their version of attendings couldn’t care less if you are there or not. If you show them that you are actively ready to learn then they will happily oblige, but you will need to put forth constant effort to push to be granted more responsibility.

The consensus seems to be that 4th-year electives are the most important in terms of schmoozing and LOR's, you're right about that. Coming from a carib school, I just need all the help I can get, even if that means living in the most expensive city in the world for a year.

As far as logistics are concerned, I guess it's not so bad if one keeps current and up-do-date in the medical field through forums like this and the state of the economy from the Wall Street Journal, it's just good sense even if one were to do rotations in the US.

I think any carib student is at an inherent disadvantage in opportunities. We have to constantly prove ourselves to others when we say where we're going to med school, and come rotations I'm sure the US students will see the logo our White Coats and give a little snicker. It's all part of the game we have to play.

Hmm decisions, decisions, although I think my mind is already set.

 

[agranulocytosis]

I can only speak from personal experience but all students who study in Ireland, the UK, Australia etc. do their Cores abroad in the country where they are studying. I had pretty much no problem getting electives without USCE...as a matter of fact, I do not recall any of them listing a pre-req as having had done your Cores in the US.

Same thing with licensing. If you are applying through ECFMG, you are not required to have any USCE and therefore, it is assumed that your rotations are NOT ACGME approved but rather meet some simple requirements set forth by ECFMG. You do have to do a certain number of hours, etc. but there is no state that requires your Core rotations be in the US.

Is there another way to apply for licensure without ECFMG?

 

[McGillGrad]

Is there another way to apply for licensure without ECFMG?

The ECFMG just allows us to participate in the match as non-LCME participants. It is just a gate-keeper to make sure we qualify to apply for US residencies. They pretty much just do the paperwork. It is the only way.

 

[Winged Scapula]

Is there another way to apply for licensure without ECFMG?

ECFMG has nothing to do with licensure.

As McGillGrad notes, ECFMG is a credential verification service which is required to enter any US residency. There is no way around it; you must be ECFMG certified to start an ACGME approved residency.

Me thinks you are worrying too much about doing your Cores in the UK. As you yourself noted above, the key to USCE is during 4th year and there should be no reason why you cannot rotate in US hospitals during an elective month or two as a final year student. And while there may be some US students who "snicker" when they see "Ross" (or whatever school you are at) on your lab coat, the vast majority will just ask about what life is like on the island, etc. There is much less negativity about this than it appears you believe there to be...especially once you get into residency.