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

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Presentation on theme: "Clinical Electives Akbar Herekar Sub-internship – Neurosurgery –UNM Sub-internship – Neurology – UNM Research Elective – Neurogenetics – Northwestern University."— 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: 4 th year American medical student = Our final year SOM: School of Medicine

3 Medical Electives Research ClinicalLaboratory Clinical Observer ship Elective Sub- Internship

4 Observer- ship Clinical Elective Sub- internship Undergraduate

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: 3 rd 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: 4 th 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 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 SpecialtyHospital

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 MedicinePsychiatry NeuroradiologyNeurosurgery Neurology

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 Ive 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: Dont 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 Upwards of $3500 Alpert SOM, Brown Upwards of $3600

20 Procedure Different requirements for different hospitals Contacts vs. no contacts No harm in using contacts but dont 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 22 nd July 2011 to 21 st August Attached along is NOC, ID card, Marksheet and Enrollment card. Thanking you in anticipation, Bashir Chabutra Final Year Dow Medical College Roll no: 123

24 Things you may need: Deans 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 youre 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 Dows 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 Dont 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 youre wearing scrubs. Carry required instruments Dont 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

36 Present cases – Everyday! Start 1 patient, increase daily End of week 1, present 5 patients Mostly floor Dont get careless or overconfident Make atleast one proper presentation Topic from Pakistan Topic seen in rotation (keep your eyes and ears open) Topic youre good or very interested in. Make your presence felt, they should feel your absence when youre 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 /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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