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Guide to 4 th Year Electives. Hosted by ASG 21 February 2007. Why “Away” Electives?. Witness medicine, U.S-style. PRACTICE medicine as it is in the U.S Understand WHAT will be expected of you during residency. Understand WHERE you want to complete your residency training.

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guide to 4 th year electives

Guide to 4th Year Electives

Hosted by ASG

21 February 2007

why away electives
Why “Away” Electives?
  • Witness medicine, U.S-style.
  • PRACTICE medicine as it is in the U.S
  • Understand WHAT will be expected of you during residency.
  • Understand WHERE you want to complete your residency training.
  • Solidify your choice of specialty.
  • Get LOR’s from U.S. physicians
getting started
Getting started
  • Setting up electives can be an easy 3 step process.
  • If…you put in the effort early:
    • 1 – Research
    • 2 – Doing the paperwork
    • 3 – Sending out the material
why are you doing this or how to choose where what electives
Why are you doing this??Or how to choose where/what electives.
  • By the summer between 3rd and 4th years you should be decided upon your choice of specialty.
  • Further, you should have a geographic area chosen for your residency.

This will inform your choice of electives.

step 1 research
STEP 1 – Research
  • Visit a medical school near your home
  • Visit FREIDA at www.ama-assn.org.
    • This is probably the best way of choosing.
  • Consult the ASG provided list of past electives
step 1
STEP 1

Things to consider:

1. DO THEY TAKE FOREIGN STUDENTS?

2. Location

  • where you are going to live?
    • Cost of housing. Can be substantial.
  • how will you get there?

3. Cost

  • how much does the elective cost
  • Expenses : transportation, housing, food, gas, utilities, etc.

4. Time/Schedule

  • What is the limit of time spent at institution
  • will you have enough time to get from one rotation to the next (if schedule available)
step 17
STEP 1
  • Don’t do ALL your electives at Big Name Schools
  • Look for programs that have taken IMG’s in the past and that you are planning to apply to that particular program
    • Make a good impression, will most likely get an interview offer
step 18
STEP 1
  • Narrow down your possibilities to 4 or 5 different institutions
  • Last part …EMAIL and ASK for the material
    • You might have to have it sent to your house…US/Canadian address.
    • Some schools offer all the applications online
step 2 paperwork
STEP 2 - Paperwork
  • It will involve:
    • getting material from Dean’s office
    • getting your medical records
    • getting medical tests
    • asking for a number of letters
  • Watch out for application deadlines!

(Some places have them, others do not)

step 2
STEP 2

What you will need:

  • Transcript from Dean’s Office
  • Letter of “Good Standing” from Dean or Vice Dean
  • Vaccination proof and/or Titers
  • Malpractice Proof
  • Proof of Personal Health Insurance in the US
  • USMLE Step 1
  • Letter of Recommendation (s)
step 2 transcripts
STEP 2 - Transcripts
  • Official transcripts with all completed Basic Sciences and Core Clinical Rotations.
    • PROBLEM ! You are in the middle of your rotations
    • Solution – make sure Dean’s office puts down “pending” for clinics which you are in or still have to do.
      • Internal Medicine
      • Surgery
      • Psychiatry
      • Family Medicine

Might have resubmit to the Elective institution a full completed transcript before starting

  • Make sure that you have all grades and credits from Basic Sciences!
step 2 letter
STEP 2 – Letter
  • Obtain letter of “Good Standing”
    • What is it?
      • Nothing more than a letter that you have not killed anyone here, that you are up to date with all your work, and you are mentally stable
    • Who writes it?
      • Dean or Vice Dean should write it
    • What if they don’t have it?
      • You write one, have them read it, and they will sign it.
    • How many?
      • Get enough copies with original signatures as you have applications
step 2 medical proof
STEP 2 – Medical Proof
  • You will be asked to provide proof of the following vaccination or exposures to:
    • Polio
    • MMR
    • DPT and last Tetanus booster
    • Hepatitis B
    • Hepatitis C
    • Varicella
    • TB
    • Pneumococcal Vaccination
  • You might have to provide Titers for some
step 2 medical records
STEP 2 – Medical Records
  • Do I need titers:
    • YES…it is a definitive way of showing proof that you have been immunized and that you are not infectious now
  • Where to get it?
    • ASG website has the map posted with directions how to get there
  • How much is it?
    • It will cost you about 300 zloty to get the following:
      • Rubella Ig, Varicella Ig, HBV Ig, HBV Ag, HCV Ig
step 2 medical records15
STEP 2 – Medical Records

TB – you will have to be tested

  • Where?
    • You can do it at Pulmonology and the cost is 25 zloty
  • When?
  • What about BCG?
    • They do not care…you still need to be tested.
    • You will also need to have CXR and if you are lucky they will even write the results in English
step 2 malpractice
STEP 2 - Malpractice
  • Available at the Dean’s office at your request.
  • If not there, email the New York Office and have them Fax over a copy with your name on it either to
    • Dean’s office
    • ASG office
step 2 other material
STEP 2 – other material
  • Other things they can request:
    • STEP 1 results – if you haven’t taken it, but you are planning on it, then hold off with application until you can deliver the scores, but REMEMBER ABOUT DATES
    • Letters of Recommendation
      • You should be also collecting them for your ERAS/MATCH
      • Consider getting them from Department Heads – some Residency programs also require them
step 3 sending application
STEP 3 – Sending application
  • Check and recheck your application
  • Attach application fee
    • US currency (check/money order) or Canadian currency depending where you are doing your elective
    • Money orders can be obtained on Fredry near the Okronglak (round building) at Western Union
    • Send applications home and have your parents attach checks
step 3 sending application19
STEP 3 – Sending application
  • Before sending application
    • Inquire if rotation is still open
    • Get in touch with institution and ask if they can reserve the particular rotation that you are interested in
    • Check deadlines to see when you can send it in.
  • If everything is OK…SEND IT!
  • FedEx an expensive but reliable option – tracking option
after sending application
After sending Application
  • Remember it takes a good week for mail to arrive to the US/Canada
  • Ideally, you should get a written response within a month… if you don’t, email or call!
  • If they did not receive your application, ask if you can fax it to them and deliver official version at a later date.
arrival of letter
Arrival of Letter
  • IF you are approved…You are done. You now only have to worry about getting there.
  • IF you are NOT approved…Call them
    • Ask why
    • If rotation booked…your alternatives are:
      • Change date (if possible)
      • Change to a different rotation
      • Try to pick up a rotation at the other institution that you have applied to
time line
January

February

March

April

May

June

July

August

September

STEP 1

STEP 2

STEP 3

You should be in electives !

Time Line
what electives should you do
What electives should you do?
  • Start out with an “easier” rotation:
    • Outpatient clinic
    • Consult Service
  • If you are feeling ambitious:
  • Sub-Internship
    • All MS4’s are required to do one
    • Extremely demanding, huge responsibility
    • Sub-I’s in Internal Med difficult to get, as MS4’s are all required to do one by their medical schools, spots usually full
    • Save it for the end:
      • Familiar with the hospital
      • Comfort with writing notes/physical examination
  • Get specialty-specific letter of rec.
conclusion
Conclusion
  • Start early and you should have no problems!
  • If you are planning on doing electives in the Spring the same deadlines may apply to you (check with the medical school)
  • If you are the ‘last minute’ type, you too can get an elective.
essentials26
Essentials:
  • Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine – by Marc S. Sabatine
prep for your electives
Prep for your Electives
  • Practice presenting patients like you would during rounds and writing SOAP notes
  • Pre-read!!!!
  • Learn Lab Values shorthand:
  • Familiarize yourself with medical shorthand terminology:
    • rrr, mmm, ntnd, ttp, no m/r/g…..

Hb

Na

Cl

BUN

Gluc

WBC

Plt

Htc

K

HCO3

Cr

most importantly
Most Importantly:
  • Practice presenting patients like you would during rounds and writing SOAP notes
  • Familiarize yourself with medical shorthand terminology:
    • rrr, mmm, ntnd, ttp, no m/r/g…..
  • Know EVERYTHING about your pts
  • Follow up on all lab results, imaging studies, line placements, etc
  • Communicate with the nurses – don’t assume that they check their orders regularly
  • If something’s changed, let the nurse know
slide29
Tips
  • Geriatric pt?

- GDS/MSSE

-Make sure that they’re seen by PT

    • Inquire about pt’s activity level, who do they live with, etc
  • Lines? PICC, central line - note placement and date

- ie PICC line in left arm (9/06/06 -)

  • Pt on antibiotics? – Note start of tx
    • ie Zosyn (11/17/06 -)