Great, thanks for the info. I plan to enter IM and from the website it looked like boards are every August. I am debating the utility of international rotations now where I am not funded much by my med school vs during residency or even the first month after residency, if I plan to start work in August or so. Just wondering how realistic this plan is, I'd really like to do more international work before starting a jobby-job that will likely allow very little flexibility for international work. Thanks.
So as I understand it, you want to so some international work of your own arrangement and you are questioning when you should do it: during medical school, during residency, delayed start of residency, etc.
Obviously any time off during medical school or residency which is not approved needs to be arranged for on a case by case basis. Certainly people DO these rotations during medical school and thereby delay their graduation if the school does not allow the rotation for credit.
Delaying graduation may mean delaying the start of residency, especially since many programs expect you to arrive for orientation mid June or even earlier. It is expected that if you use NRMP for your match, that you start residency on July 1 unless there has been other arrangements made with the specific program. I would not match and then "spring" this idea on them. Every program has different requirements, so it would be impossible to say whether or not you would be allowed to either delay the start of residency or to take time off, or even get credit for an international rotation during residency. This is something you would have to explore with each program.
Another option is to do it after you complete residency. If you are taking the boards in August after the completion of an IM residency, you might consider either doing your work right before boards or after you take them. I would certainly recommend the latter...take the month of July off, study for boards in August, and then when complete, take time off before starting work to do your international foray.
There is no reason you have to start a job after residency on July 1 (barring financial issues). You can negotiate your contract so that you start in say, October. Bear in mind it might take you several months anyway to get licensed out of state, get on insurance plans, get hospital privileges, etc. So you mght want to save some money for this, and to be able to take some time off to do the international stuff.