Why IMGs Should Consider US Clinical Experience? - Insider Strategies
​Dr. Alina Joseph Roy
USMLE Sarthi Ambassdor
Clinical Experience in the United States (USCE)
USCE or US Clinical experience stands for the clinical hands-on experience you get from dealing with patients in a hospital setup or clinical facility in The US. Most clinical rotations follow a four-week timeline with certain exceptions. Overall it serves as a means for the person to get acquainted with the healthcare system in America. 
​Why should you do a USCE (Clinical Experience in the United States)?
USCE is a way for you to get a first-hand experience of what it would be like to work in an American hospital setting and even within the specialty of your choice. It would help you assess your own clinical skills and learn firsthand before residency which areas you need to better in as a medical professional. Another plus point is you get to work in close contact with senior doctors of the specialty you choose. This will help in building a good rapport and can eventually help you match into your specialty of choice at the residency program of your choice. As a matter of fact, a lot of residency programs use USCE experience as a way of filtering applicants. Hence Letter Of Recommendation (LOR) that one is awarded at the end of a rotation is crucial at the end. Also, A good word as well goes a long way to help boost your ERAS CV at the time of the Match. 
Types of USCE and their differences
  • ELECTIVES: These are for medical students who are usually in their final year of medical school and have hands-on hospital experiences. History taking, Case presentations, physical examinations, and such all under supervision from an attending setting.
  • EXTERNSHIPS: The same as electives, with hands-on experience in a hospital setting under supervision. There is only one difference: it is only for medical graduates.
  • CLINICAL CLERKSHIPS: Rotations done in a specific clinical subject such as pediatrics, ob-gyn, or surgery. This is also hands-on experience for the most part.
  • OBSERVERSHIPS: This is when you shadow an attending or senior doctor around the hospital and learn about the various clinical aspects in a passive way. As this lacks more one-on-one patient interaction a lot of residency programs don't consider observerships as proper USCE experience. 
  • TELEROTATION: This came into prominence during the Covid era and even post-COVID is being offered at certain hospitals. Though many programs may not consider this as full-on clinical rotation you can opt for this if you are pressed for time or have visa issues to be physically present, it's still the experience of sorts.
How many month of usce do IMGs need? 
At least two or three full-term (four-week) rotations are considered good. The more the better, as it is a direct testament to the amount of exposure you have to The US healthcare system. Another thing to keep in mind would be to apply to different states in THE US and not concentrate on one region to do all your USCEs.
How to apply for USCE?
There are two routes to go about this. Firstly, you can actively try to find rotations by yourself by scouring program sites. Occasionally, hospitals and residency programs do offer such services with limited seats up for grabs. The second and easier way would be to use a paid service. We provide rotations to a lot of acclaimed programs that have been helping IMGs to have their fair share of USCE experiences. Keep an eye out for the free on-site and tele-rotation giveaways we frequently do through our social media platforms. ​
What is required to apply for USCE?
It would depend on what type of USCE you are applying for. When applying for electives most programs mandate STEP 1 pass. However, observerships and externships are less strict regarding this. You will have to apply for a visa, which is usually a B1/B2 travel visa Other mandatory documents will be your vaccination certificates as stated on the US embassy website, and Medical malpractice insurance documents as for most USCEs there is hands-on patient care and of course a language test score to prove your English proficiency such as TOEFL, OET, IELTS etc.

A piece of advice would be to start preparing all these documents way in advance, as these do tend to take a bit of time to arrange and can be a hassle at the last minute.

USMLESarthi offers IMGs a unique and valuable experience for their USMLE journey. With extensive hands-on rotations in various medical specialties, connections to preferred residency programs, and affordable options without additional fees ute. 

All graduates and medical students can do the Sarthi rotations. Check here USMLESarthi rotations.

Useful videos for IMGs on US Clinical Experience