UK Clinical Experience for US Residency Application

[Osala]

My post is relating to the clinical experience component of the US residency application.

I am an IMG based in the UK and will be doing my USMLE steps in the UK. While preparing for my exams over the coming months, I aim to do a 3-month clinical attachment/rotation in Internal Medicine at one or two UK hospitals. To satisfy the application requirement of letters of recommendation (LORs), I will gain these from UK consultants/attendings of whom I will have worked with..

While I appreciate that US clinical experience is more desirable and is stated as a clear prerequisite for IM residency, my time is very limited as I am only starting to prepare for Step 1 as of now.
Having said that, I still hope to do an observership/externship after Step 2 CS when I go to the US and hopefully gain a LOR from a US physician.

Is this a good action plan?
So if I were to obtain 1 US LOR and 3 UK LORs, will this satisfy clinical experience requirements?
Are UK clinical rotations highly regarded by Program Directors for IM residency programs?

I have searched through previous posts regarding how valuable UK clinical experience and LORs are, however, there are no definitive answers. I look forward to hearing about your opinions on the matter.

O

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[gutonc]

While I appreciate that US clinical experience is more desirable and is stated as a clear prerequisite for IM residency, my time is very limited as I am only starting to prepare for Step 1 as of now.
Having said that, I still hope to do an observership/externship after Step 2 CS when I go to the US and hopefully gain a LOR from a US physician.

Is this a good action plan?
So if I were to obtain 1 US LOR and 3 UK LORs, will this satisfy clinical experience requirements?
Are UK clinical rotations highly regarded by Program Directors for IM residency programs?

Not really. But if that's what you've decided on,so be it.

An observership won't count for USCE and the LOR won't be that useful. But if that's all you'll have, then I guess go for it.

 

[Osala]

Thanks for your response. I am open to suggestions.

Unfortunate!y, due to time constraints I might not be able to get 3 US LoRs.
And with observerships being rendered useless by many residency programs, wouldn't it be prudent to get LoRs from UK consultants who have seen me perform in a fellow first world setting? I will have hands-on clinical experience - something perhaps I will not be afforded if I were to apply for US clinical experience.

I am led to believe some Caribbean students carry out their clinical rotations in the UK and also some Australian IMGs apply with clinical experience from their home institutions. Both sets of students have successfully matched to their respective IM programs, so I suppose there is precedent. Any further information or opinions are welcomed...

 

[bashwell]

My post is relating to the clinical experience component of the US residency application.

I am an IMG based in the UK and will be doing my USMLE steps in the UK. While preparing for my exams over the coming months, I aim to do a 3-month clinical attachment/rotation in Internal Medicine at one or two UK hospitals. To satisfy the application requirement of letters of recommendation (LORs), I will gain these from UK consultants/attendings of whom I will have worked with..

While I appreciate that US clinical experience is more desirable and is stated as a clear prerequisite for IM residency, my time is very limited as I am only starting to prepare for Step 1 as of now.
Having said that, I still hope to do an observership/externship after Step 2 CS when I go to the US and hopefully gain a LOR from a US physician.

Is this a good action plan?
So if I were to obtain 1 US LOR and 3 UK LORs, will this satisfy clinical experience requirements?
Are UK clinical rotations highly regarded by Program Directors for IM residency programs?

I have searched through previous posts regarding how valuable UK clinical experience and LORs are, however, there are no definitive answers. I look forward to hearing about your opinions on the matter.

O

Thanks for your response. I am open to suggestions.

Unfortunate!y, due to time constraints I might not be able to get 3 US LoRs.
And with observerships being rendered useless by many residency programs, wouldn't it be prudent to get LoRs from UK consultants who have seen me perform in a fellow first world setting? I will have hands-on clinical experience - something perhaps I will not be afforded if I were to apply for US clinical experience.

I am led to believe some Caribbean students carry out their clinical rotations in the UK and also some Australian IMGs apply with clinical experience from their home institutions. Both sets of students have successfully matched to their respective IM programs, so I suppose there is precedent. Any further information or opinions are welcomed...

Obviously best to apply with USCE and LORs from US attendings. But if for whatever reason you can't do this, then no use worrying over what you can't do. Instead focus on what you can. If that's observerships, then they won't be beneficial or helpful for many places, but if you think you can impress at a particular institution, get to know people, network, make connections, etc, then maybe it might be helpful in that respect at that particular institution. Not clinically beneficial, but beneficial in terms of getting known by PDs, assistant PDs, residents, etc, which maybe could be helpful. It's hit or miss though. No guarantees. Whether that risk/benefit is worth your time and effort and costs only you can decide. Perhaps you can ask a UK consultant who is happy to write you a LOR if he or she in addition knows of or has any connections to US physicians at good residencies and can personally connect you with them? If so, that could be a good place for you to go do an observership if you can't do an away rotation? Otherwise some places explicitly state you need a certain amount of USCE or they won't even look at your application. For example I believe Indiana is one or was when I last heard maybe a year ago. I do know of people who have matched without any USCE but they seem to be at the lower profile residencies which in turn could affect fellowship applications if you want to subspecialize.

 

[Osala]

Thanks for your responses.

Any further input will be highly appreciated.