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Clinical Electives Akbar Herekar Sub-internship – Neurosurgery –UNM

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Presentation on theme: "Clinical Electives Akbar Herekar Sub-internship – Neurosurgery –UNM"— Presentation transcript:

1 Clinical Electives Akbar Herekar Sub-internship – Neurosurgery –UNM
Sub-internship – Neurology – UNM Research Elective – Neurogenetics – Northwestern University

2 Glossary - Terms Elective – Placement by choice
Attending – equivalent to a consultant in Pakistan Clinical clerkship – clinical rotation/elective Sub- I: 4th year American medical student = Our final year SOM: School of Medicine

3 Medical Electives Research Clinical Laboratory Observer ship Elective

4 Undergraduate Observer-ship Clinical Elective Sub-internship

5 Observership Virtually anywhere in America
“OBSERVER”-ship – Limited or no patient contact Shadow resident/attending Learning experience (comparatively limited)+ LOR + networking Easily possible through contacts Good as last option for undergraduates Can be converted into an elective Dr. Luni will talk about observership after graduation

6 Clinical Elective Rotation of ‘choice’, in a university/hospital at home or abroad. Usually 4 weeks but variable Position: 3rd year American medical student Most places in the US Ample patient contact – usually limited patient management Foreign exposure/experience + LOR + networking

7 Sub-internship Only real difference from Elective – Position: 4th year medical student Offered by limited places in the US especially to foreigners (UNM, University of Texas schools and few others) USMLE step 1 invariably required More patient contact, patient management Suggested time: Final year If you do very well you can secure your residency

8 Impact Last, but definitely not the least – LOR(s)
Foreign learning experience Increases residency chances overall Increases placement chances within the same program Networking/Contacts Last, but definitely not the least – LOR(s)

9 When During clinical years (Core clerkships required)
Suggested time: Fourth and final year vacations (Most require final year status) Start planning 6-8 months in advance Application should be submitted 6-2 months before electives Earlier you apply the better your chances

10 Applying for the elective
Selection of elective Specialty Hospital

11 Choosing a specialty Reason for elective specialty choice:
For experience in the field of interest to aid residency chances Eg. Neurology To explore an area of interest in medicine Whatever you can get Neurology Medicine Psychiatry Neuroradiology Neurosurgery

12 Choosing a hospital Offerings Pre-requisite completion State/city
Climate Finances/relatives Visa status (UK, Singapore good backups) Starting point: On-line Extramural Elective Compendium:

13 Pre-requisites that effect your choices
USMLE step 1 Money TOEFL Note: Requirements are mostly requirements by the elective coordinator or Elective office. It is possible to waive off any requirement by superseding the office itself i.e.. Through contacts, sweet talking or using your brain.

14 Institutions: No step 1, No TOEFL, No fees
NYU SOM $100 application fee to be paid on first day of elective Approval from dean NYUSOM Henry ford hospital, Detroit Easiest application process that I’ve seen University of Connecticut school of medicine Tend to be unresponsive Easy application

15 Institutions: No Step 1, No fees BUT TOEFL required
National Institute of Health (NIH) NIH Clinical center, no med school but have programs with reputable institutes such as JHU TOEFL or Step 2 CS Mainly clinical trial patients University of Louisville SOM Only Dow Medical College and AKU students are eligible

16 Institutions (Good): Minimal fees, require Step 1, BUT MAY ACCEPT A STEP 1 WAIVER
Mount Sinai SOM F1 short-term visa requirement Application fee non-refund around $500 UT-Southwestern Internal Med, Emergency Surg, Surg at Baylor require step 1

17 Institutes: Don’t require step 1, but have fees
Emory University Faculty sponsor required. $180 per month University of Texas, at Galveston F1 required $750 - $1000 per month University of Rochester SOM $100 app, $350 per week elective fee Tulane University SOM Application fee $300, no refund, TEMPORARILY CLOSED Northwestern university $1200 fee

18 Institutes: Require step 1, have minimal or no fees
Cleveland Clinic Mayo Clinic University of New Mexico University of Cincinnati Suny Downstate Medical College, New york Duke University Louisiana state university Virginia Commonwealth University SOM Wayne State University And so on…..

19 Institutes: Money mongers!
Yale University Upwards of $3500 Weil Cornell Medical College Upwards of $ $200 Harvard University SOM Alpert SOM, Brown Upwards of $3600

20 Procedure Different requirements for different hospitals
Contacts vs. no contacts No harm in using contacts but don’t prefer contacts over choice If you want to do nephrology and you have a contacts in pediatrics, apply for nephrology, you will get in No contacts? Not a problem.

21 What you need Make a folder (Dow style!) 10 photocopies of marksheets
10 photocopies of enrollment card 10 photocopies of Dow ID card Atleast 1 photocopy of grade book 10 photocopies of your NIC 4 pictures Printout of colleges where you wish to apply Blank A4 pages and pen for hands on application writing

22 Getting an NOC NOC – No objection certificate is necessary for 2 reasons Required by principal to stamp your application Can you used to forego attendance for allotted time Write an application to Dr. Masroor (or whoever will replace him) for NOC. Write an application + enrollment card copy + nic copy + latest marksheet copy After NOC is signed by the dean (2 to 3 days), take this noc to the finance department and get a voucher made for an NOC. Go to UBL and pay this voucher. Then submit both the voucher and the NOC with attached documents to AFTAB After NOC is ready (1-5 days), get a 2 photocopies

23 To, Dean of Clinical Sciences Dow Medical College Subject: NOC for electives Dear Sir, I, Bashir Chabutra, student of final year, Dow medical college, final year roll no: 123, enrollment no. DUHS/D/2222/2007, would kindly request an NOC for electives. My stated elective is for a period of 4 weeks at Massachusetts General Hospital from 22nd July 2011 to 21st August Attached along is NOC, ID card, Marksheet and Enrollment card. Thanking you in anticipation, Bashir Chabutra Final Year Roll no: 123

24 Things you may need: Dean’s letter of good standing/LOR: Application to principle (ATP)+ ID + EC + Marksheets (M) + Voucher (V) + Aftab IMED letter – ATP + ID + Marksheet + Shahab Letter of proficiency in English: ATP + Consolidated Marksheet: Application + Photocopy of log book + M + V + ID etc USMLE Waiver = ATP + Consolidated marksheet + M + ID etc

25 Immunizations All vaccines AKU
Atleast 1 month before titers All titers Rahila Lab (Mohd. Ali Society) Show proof of vaccination Montoux AKU or Sindh Lab AKU for MMR and Hep B

26 Malpractice insurance
Usually worth $1 million required EFU insurance – Rs premium for Rs. 1 Million Online website (For UK, Singapore, Australia)

27 Application Fill application with all requirements.
Write application to principal stating you have obtained or are applying for electives at this particular place. Attach NOC plus relevant documents to application and give to AFTAB (0-7 days, depending on his mood) Send off your application (Always use TCS or Fedex)

28 (Dow) Tips One NOC is valid for as many applications as you want in that time period If you’re applying to many places at the same time give in your forms together and ‘bargain’ with AFTAB, get 2 applications signed on 1 voucher. Some places require applications from Dow directly Buy white large envelopes from photocopy shop Get them stamped and sealed by shahab/aftab Send them from Dow’s address

29 Visa Dr. Ali khan will be talking about visa

30 Travel Fare Your choice ISIC – International Student Identity Card
Up to 30% discount Limited seats No miles

31 Accomodation University accommodation Family/Friends
Craigslist, beds4meds, Close to hospital

32 Transport Month pass for bus or train
Usually discount with student card Don’t use Taxis Walk Google maps is a life saver


34 Setting a good impression
Study before going SOAP notes Examinations

35 Setting a great impression
Always dress well unless you’re wearing scrubs. Carry required instruments Don’t be late Can I leave? Is there anything else I can do? Do weekend and evening calls Be friendly and courteous at all times PRESENT PRESENT PRESENT

Present cases – Everyday! Start 1 patient, increase daily End of week 1, present 5 patients Mostly floor Don’t get careless or overconfident Make atleast one proper presentation Topic from Pakistan Topic seen in rotation (keep your eyes and ears open) Topic you’re good or very interested in. Make your presence felt, they should feel your absence when you’re gone

37 Usual elective day (Surgery)
reporting time put in SOAP notes 0630 – morning rounds 0730 – OT or ICU rounds 1600 – OT ends go to ward 1600 – 1830 Scut work 1830 – Evening rounds 1900 – Is there anything else I can help with?

38 LORs Most important In-hand or by direct email/letter
Direct , more value, but impact required LOR FROM ATTENDING, NOT RESIDENTS Impress the attending Speak up in rounds Use your charm Create a relationship

39 LORs For in-hand, tell attending about a week before your elective ends For direct , make your attending write the letter the day you are leaving Give updated CV

40 Acknowledgements I would like to thank Dr. Muhammad Ali Khan and Dr. Faraz Khan Luni was their support and guidance and Dr. Junaid Ashraf for his cooperation without which this seminar could not have taken place.

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