Presentation on theme: "Clinical Electives Akbar Herekar Sub-internship – Neurosurgery –UNM"— Presentation transcript:
1Clinical Electives Akbar Herekar Sub-internship – Neurosurgery –UNM Sub-internship – Neurology – UNMResearch Elective – Neurogenetics – Northwestern University
2Glossary - Terms Elective – Placement by choice Attending – equivalent to a consultant in PakistanClinical clerkship – clinical rotation/electiveSub- I: 4th year American medical student = Our final yearSOM: School of Medicine
3Medical Electives Research Clinical Laboratory Observer ship Elective Sub-Internship
5Observership Virtually anywhere in America “OBSERVER”-ship – Limited or no patient contactShadow resident/attendingLearning experience (comparatively limited)+ LOR + networkingEasily possible through contactsGood as last option for undergraduatesCan be converted into an electiveDr. Luni will talk about observership after graduation
6Clinical ElectiveRotation of ‘choice’, in a university/hospital at home or abroad.Usually 4 weeks but variablePosition: 3rd year American medical studentMost places in the USAmple patient contact – usually limited patient managementForeign exposure/experience + LOR + networking
7Sub-internshipOnly real difference from Elective – Position: 4th year medical studentOffered by limited places in the US especially to foreigners (UNM, University of Texas schools and few others)USMLE step 1 invariably requiredMore patient contact, patient managementSuggested time: Final yearIf you do very well you can secure your residency
8Impact Last, but definitely not the least – LOR(s) Foreign learning experienceIncreases residency chances overallIncreases placement chances within the same programNetworking/ContactsLast, but definitely not the least – LOR(s)
9When During clinical years (Core clerkships required) Suggested time: Fourth and final year vacations(Most require final year status)Start planning 6-8 months in advanceApplication should be submitted 6-2 months before electivesEarlier you apply the better your chances
10Applying for the elective Selection of electiveSpecialtyHospital
11Choosing a specialty Reason for elective specialty choice: For experience in the field of interest to aid residency chancesEg. NeurologyTo explore an area of interest in medicineWhatever you can getNeurologyMedicinePsychiatryNeuroradiologyNeurosurgery
12Choosing a hospital Offerings Pre-requisite completion State/city ClimateFinances/relativesVisa status (UK, Singapore good backups)Starting point: On-line Extramural Elective Compendium:
13Pre-requisites that effect your choices USMLE step 1MoneyTOEFLNote: 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.
14Institutions: No step 1, No TOEFL, No fees NYU SOM$100 application fee to be paid on first day of electiveApproval from dean NYUSOMHenry ford hospital, DetroitEasiest application process that I’ve seenUniversity of Connecticut school of medicineTend to be unresponsiveEasy application
15Institutions: 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 JHUTOEFL or Step 2 CSMainly clinical trial patientshttps://www2.cc.nih.gov/apps/publicForms/cep/forms/cepApp.aspxUniversity of Louisville SOMOnly Dow Medical College and AKU students are eligible
16Institutions (Good): Minimal fees, require Step 1, BUT MAY ACCEPT A STEP 1 WAIVER Mount Sinai SOMF1 short-term visa requirementApplication fee non-refund around $500UT-SouthwesternInternal Med, Emergency Surg, Surg at Baylor require step 1
17Institutes: Don’t require step 1, but have fees Emory UniversityFaculty sponsor required. $180 per monthhttps://emorymed.emory.edu/Public/CurriculumPublicPages/CourseInformation.aspxUniversity of Texas, at GalvestonF1 required$750 - $1000 per monthUniversity of Rochester SOM$100 app, $350 per week elective feeTulane University SOMApplication fee $300, no refund, TEMPORARILY CLOSEDNorthwestern university$1200 fee
18Institutes: Require step 1, have minimal or no fees Cleveland ClinicMayo ClinicUniversity of New MexicoUniversity of CincinnatiSuny Downstate Medical College, New yorkDuke UniversityLouisiana state universityVirginia Commonwealth University SOMWayne State UniversityAnd so on…..
19Institutes: Money mongers! Yale UniversityUpwards of $3500Weil Cornell Medical CollegeUpwards of $ $200Harvard University SOMAlpert SOM, BrownUpwards of $3600
20Procedure Different requirements for different hospitals Contacts vs. no contactsNo harm in using contacts but don’t prefer contacts over choiceIf you want to do nephrology and you have a contacts in pediatrics, apply for nephrology, you will get inNo contacts? Not a problem.
21What you need Make a folder (Dow style!) 10 photocopies of marksheets 10 photocopies of enrollment card10 photocopies of Dow ID cardAtleast 1 photocopy of grade book10 photocopies of your NIC4 picturesPrintout of colleges where you wish to applyBlank A4 pages and pen for hands on application writing
22Getting an NOCNOC – No objection certificate is necessary for 2 reasonsRequired by principal to stamp your applicationCan you used to forego attendance for allotted timeWrite an application to Dr. Masroor (or whoever will replace him) for NOC. Write an application + enrollment card copy + nic copy + latest marksheet copyAfter 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 AFTABAfter NOC is ready (1-5 days), get a 2 photocopies
23To, 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
24Things you may need:Dean’s letter of good standing/LOR: Application to principle (ATP)+ ID + EC + Marksheets (M) + Voucher (V) + AftabIMED letter – ATP + ID + Marksheet + ShahabLetter of proficiency in English: ATP +Consolidated Marksheet: Application + Photocopy of log book + M + V + ID etcUSMLE Waiver = ATP + Consolidated marksheet + M + ID etc
25Immunizations All vaccines AKU Atleast 1 month before titersAll titers Rahila Lab (Mohd. Ali Society)Show proof of vaccinationMontoux AKU or Sindh LabAKU for MMR and Hep B
26Malpractice insurance Usually worth $1 million requiredEFU insurance – Rs premium for Rs. 1 MillionOnline website(For UK, Singapore, Australia)
27Application 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) TipsOne NOC is valid for as many applications as you want in that time periodIf 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 directlyBuy white large envelopes from photocopy shopGet them stamped and sealed by shahab/aftabSend them from Dow’s address
34Setting a good impression Study before goingSOAP notesExaminations
35Setting a great impression Always dress well unless you’re wearing scrubs.Carry required instrumentsDon’t be lateCan I leave? Is there anything else I can do?Do weekend and evening callsBe friendly and courteous at all timesPRESENT PRESENT PRESENT
36PRESENT PRESENT PRESENT Present cases – Everyday!Start 1 patient, increase dailyEnd of week 1, present 5 patientsMostly floorDon’t get careless or overconfidentMake atleast one proper presentationTopic from PakistanTopic 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
37Usual elective day (Surgery) reporting timeput in SOAP notes0630 – morning rounds0730 – OT or ICU rounds1600 – OT ends go to ward1600 – 1830 Scut work1830 – Evening rounds1900 – Is there anything else I can help with?
38LORs Most important In-hand or by direct email/letter Direct , more value, but impact requiredLOR FROM ATTENDING, NOT RESIDENTSImpress the attendingSpeak up in roundsUse your charmCreate a relationship
39LORsFor in-hand, tell attending about a week before your elective endsFor direct , make your attending write the letter the day you are leavingGive updated CV
40AcknowledgementsI 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.