Munavvar Izhar has significant experience with residency programs, residents, fellows, Medical Students and is currently engaged in graduate medical education activities and AMG/IMG placements at various educational sites and hospitals in the US.

clinical rotations for the Medical Students are typically in the third year or fourth year of medical school curriculum. These rotations are training periods to gain hands-on and direct patient care experience under a supervising practicing physician.  A lot of IMGs apply from international areas like India, Pakistan Bangladesh, Middle East, Africa, Europe, South America Caribbean islands. There is an apprehension in Students about choosing clinical Rotations. 

There are Six or seven characterstic features you should look for:-

1. “Hands on” there is a myth amongst the mind of Medical Students that hands-on means doing procedures like thoracentesis or paracentesis, etc. etc. You will personally be not allowed to do these procedures because of liability issues however you can see them under the guidance of a resident, physicians or attending physicians . Hands-on for an IMG typically means that You’ll be able to interact with the patient. You’ll be able to talk to the patient and their families, and take a history. Do a physical exam, do an Assessment and plan, discuss the  same with the Attending Physician and then arrive at a treatment plan and facilitate that treatment plan by conveying the orders to the nurse, making sure they are being done. Get all investigations done and follow up on those, follow up the patient daily till the time of discharge. This is what a hands-on clinical rotation typically means.

2. They should be predominantly hospital rotations, at least 6 to 8 or 10 hours per week of hospital work. A lot of times it depends on the physician’s schedule They can have you come two times a week for five hours every day or they may spread it out over three days. But hospital exposure is very important because you would be spending 90% of your time on the  floors in the  hospital when you start a residency program. 

3. Hospital should be either university hospital or university hospital affiliated place, should be a teaching place or an academic Medical Center.

4. ⁠LOR – For the  letter of recommendation, the Hospital letterhead is not as important as who you are rotating with, what their faculty designation is, are the chairman, head of the department or chief of section?  Or teaching faculty people. when the selection committee or the Program director reads your LOR they see who has written the LOR, what their position is.

5. ⁠ Also consider what is the cost of Rotation – to make sure that the cost of the application fee processing fee, credentialing fee physician fee, hospital fee and most importantly Malpractice should be included. without Malpractice Insurance please do not do the Rotation as it is liability risk. Make sure that all the costs are included, a lot of agencies slap them on later and is a surprise to the student! 

6. It has become a business of independent practitioners, private practitioners. Ask hard Qs before enrolling, am I going to the hospital? How often? What am I going to be doing there? Am I going to be doing the history and physical? assessment etc.. Question if The fee includes everything I have mentioned before. 

7. Most agencies arranging clinical rotations have office secretaries or medical assistants with some minimal medical background and a lot of times they’re not able to satisfy the student’s queries. Sometimes it takes them 5- 7 days to communicate effectively. Response to students should be quick within a couple of hours rather than over days. 

8. Try to find Rotations through agencies where Accomodation is close by you will end a lot of time and it will be convenient to you. It being in close proximity will save you $200-$300 in transportation. I know students who commute one and a half hours each way for clinical rotation. Save yourself the  grief. 

IMG MYTHS NEEDING CLARIFICATION:

A. Rotation from a smaller academic center or university affiliate or hospital with chairman of the department is more meaningful than an ordinary Attenfing physician from a bigger hospital or institute. 

B. Another Myth is that IMGs want to do a rotation in New York, another one from Chicago, one in Houston. Different cities in USA. Geography Doesn’t matter. what matters is who you are doing the rotation with, are they teaching faculty, Professors or chairman’s?those are important things.

C. “I need to get a letter of recommendation on the  hospital letterhead”, It is important but a lot of times the programs and the program director see who has written the LOR, is it Ordinary Attending Physician? On Hospital letterhead is much less valuable than the chairman or the  head of the department, director or section chief writing that letter on their own letterhead. The latter has more weight. These are some of important points. I hope this helps you and you can make good selections. Follow my videos on YouTube @wellnesswithDrizhar, connect with me on LinkedIn or Instagram. I will be happy to help you. 

Munavvar Izhar.

Medical Student Rotation 

Chicago.