Step-by-step, checklist: Applying to clinical electives as IMGs

Applying for clinical electives can be a tedious process. Different programs have different requirements. Some of them accept online applications whereas others ask for an offline application form to be sent directly to their office along with other documents. Hence many people find it hard to have all the documents in hand quite early so that they can apply to the programs as soon as the applications start being accepted. Dr. Shahin Isha, USMLESarthi’s campus ambassador, has shared this must-read step- by-step, one-stop checklist for the clinical electives.


1. USMLE Step 1 Score
This can be a game changer. Although there are several programs which don’t require USMLE Step 1 score, with USMLE Step 1 score in hand, the options available for you will be twice the number of programs which don’t require Step 1 score.
Plus for those programs which don’t ask for Step 1 score, you’ll have more chance to get selected if you show the score (needs to be competitive) in your CV.

2. TOEFL score
 Just like Step 1 score, having a TOEFL score opens up a lot of opportunities. There are quite a few colleges which don’t ask for a TOEFL score, few others waive this requirement if you provide a letter from your college mentioning that the medium of education in your college is English. But a good TOEFL score can be another major game-changing factor. It makes your CV more attractive. Different colleges have different requirements but a score of 100-105 out of 120 with 23-26 in the Speaking Section can help you meet most of the program’s requirements.

3. CV
This should be your absolute masterpiece – almost all programs ask for this. The CV/Resume should enlist your academic and non-academic accomplishments, awards, professional memberships, volunteer works, extracurricular activities etc. Normally a CV doesn’t contain a photograph (better to omit adding a photograph unless mentioned to do so).
 
4. Personal Statement
This should mention about yourself and how you developed an interest in medicine, your career goals and the specialty of your interest.
 
5. Letter of Intent
Like Personal Statement but this letter is addressed to the clerkship coordinator. This letter should describe the reason for your interest in their program, your unique abilities (i.e. why they should choose you), your long-term career goals.
Only a few programs require this letter.
 
6. Transcripts
This enlists the clinical experience you had at your medical school ( 2nd,3rd,4th, and Final year wards). Ideal transcript should contain the duration of each rotation and grades obtained in each of those. The transcript should be printed on a Medical School Letter Head paper and properly stamped, signed by the authority.
Few programs ask for original transcripts to be sent via mail. Hence, it’s better to ask for multiple copies from the college.
 
7. Dean’s letter
Things get a bit tricky here. Although a few college administrators are aware of the clinical electives, most of the IMG (non- Caribbean) colleges are not aware of the electives. Hence the student has to convince them to write a permission letter like “Mr. X is a final year student at this institution, He/She is in good standing in his academic year and will have completed the required core clerkships before the elective start date. He is permitted to take part in an elective course at your institution during this period – (mention the months) “.
This Dean’s letter will not only act as a document to meet the program’s requirement, but it can also be used as a No-Objection Letter during the visa interview.
 
8. Immunization
Following immunizations are required along with appropriate proof (like doctor’s letter):

• Measles (2 doses after 1 yr age)
• Mumps
• Rubella
• Influenza vaccine (latest)
• Hepatitis B vaccine 3 doses
• Varicella vaccine or proof of titer if one has suffered from chicken pox in past
• Tdap within past 10yrs
• Polio vaccination
• BCG vaccination along with IGRA (quantiferon gold) or TST done recently
• Meningococcal vaccine (very few colleges require)

 If exact dates of past immunization are unknown, one can get serology done to provide proof of adequate titer.
  
 9. Proof of health insurance
Sometimes a letter addressed to clerkship co-ordination mentioning your intent to purchase health insurance after getting selected is accepted. However, if you have already decided that you are surely going to the USA during a period, it’s better to purchase an insurance. It might shorten the processing time for your application.
 
10. Proof of Malpractice insurance
Just like Health insurance, you can write a letter to the clerkship coordinator. Most of the colleges accept it. Purchase it once your spot is secured at that institution.
 
11. Criminal Background check
A few programs require a criminal background check reports from the local Police station. For Indian students, it can be easily ordered via Passport Seva Portal website here.
However, a few other colleges do require a criminal background check done by the agency they recommend. Their policy regarding this will be mentioned on their website.
 
12.  Basic Life Support (BLS) training
 Only a small number of programs require this.

13. HIPAA and OSHA training
 These courses are available online. You’ll receive certification on course completion and payment. These certificates are accepted by all institutions.

14. Urine Drug Screening report
Negative urine drug screening reports are required for some programs. However, these reports expire in 3 months. Hence you may write a letter addressed to the clinical coordinator that you will send the latest reports as soon as you get accepted at the institution.
 
And Finally,

15. Application fee
The amount varies from $0 to $1000 per college. You can expect total cost of $1000 to $2000 for applying to 10-15 programs.
If you’re going to attend paid electives, additional tuition fee will be required after confirmation ($500/month -$5000/month).
 
Additionally, some programs may require a green card, prior affiliation with your home school, home school’s participation in VSAS etc. There is no reason to worry if someone doesn’t meet these requirements because there are a lot of other programs where you can apply using the 15 requirements mentioned above.
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