by Akshay Sharma

I am an Intern and like you all here I too am planning to pursue a residency in the US. Coming to the main story, how I got my electives. I have no family in the US and not many seniors or friends to guide me with the process either. Internet has practically been my source of all the info and let me assure you, it is good enough. Through people who have secured electives on these communities, their descriptions, various websites etc I too was able to chart out my plan and thus got electives. But before I begin, let me tell you one more thing. There is no one single source that will give you all the info and neither am I trying to do so. Things change and the so do the policies of the colleges. And no one person can collect all the info at one place. You have to do your own research. You have to search for the best place that suits you and that accepts you. I am describing below my story.

1. When to start: The process of finding electives should start as soon as you decide to pursue the USMLE path. There is no denying the fact that after your MLE scores the single most important factor that seals your fate is USCE and electives are undoubtedly the best of them all. If you are just into your internship, well and good. If not, it is worthwhile to take some break during your internship and prolong it (read extension) till you secure electives. Remember that you still need to be a final year student when you are doing your electives. In India this means that you should still be enrolled in your internship while for students in Pakistan I guess it means that they should be in the Penultimate year (Since the medical diploma is granted before the beginning of internship there.). There is no fixed deadline so as to how early you should begin doing your research but the earlier you start, the better it is. Though different universities have different guidelines on how early you may apply and please follow them religiously. Do not be over zealous to apply before the application process has even begun, your application will not even be looked into. I began my research work when I entered internship. Was not so keen on electives in the beginning so didn’t think about it so seriously but as my internship drew towards the half way mark, I got more serious. Advice from some seniors and online resources such as this one made me think about electives seriously. Finally just 3 months left for my internship to get, I filled up my applications. Within a month everything got done and now I have taken an extension of the last two months which I will finish when I get back after my electives.

2. Where to start: USMLEtoMD is a good website to start and get some nice info about electives, clerkships, observerships etc and get some fair idea about the terminology. See where you fit in and what is that you can afford. I believe some universities in India do not allow you to break internship in between so in those cases it is worthwhile to try to clerkships. UmarTariq.com is another awesome resource. The guy has done an extensive work and is one of the best maintained and updated websites I have seen. But at the same time, please do not rely on these websites for all the info. As I said before, policies of the colleges change and even the most well maintained website cannot cope up to keep themselves updated, hence do your own research. Make a list of all the universities that you think you can go to and check their websites individually. If you know of any other university that is not mentioned in the list on these websites, do check that up as well. Do verify the requirements on each univ website. Many a times we just do not apply coz a particular univ asks for TOEFL or Step 1 or some other mandatory requirement. Mail them and ask. They may be ready to waive it off for you. What’s the harm in asking?? Email is free and they reply promptly.

3. Make your priority chart: Applying to univs in the US is expensive, especially if they ask for an application fee. Even if they don’t ask for a fee, sending the documents to US by the DHL Univ Express coupons costs you minimum 900 bucks. So make your choices well and apply accordingly. A well thought out application plan and thus applying to a few univs is good enough. You need not have to apply to a dozen universities. I applied to just two places and got selected at both. But I applied to those places where I was confident to get accepted. So make a priority chart first of the univs you plan to apply. Location of the univ, Application fee, Tuition fee, whether they are IMG friendly or not, previous selections of Indian students etc can be deciding factors.

4. Mail them: It is a good idea to mail the university coordinator or the email ID of the concerned official mentioned on the elective website and ask for the eligibility and other requirements before you actually apply. Sometimes the univ may have a policy where in you must be sponsored by a faculty. In that case do not be scared to approach the faculty. Most of the times they are pretty forthcoming and accept you (I got accepted this way). But you need to be polite and intelligent while mailing them. Some tips are as below:

a. First of all, search for their email IDs(of the mentors/faculty) by thoroughly scanning the university or hospital website. Most of the times they are mentioned there. If not, you may call up the hospital (phone numbers are invariably given or the website or you can google them up) and ask them to connect to the concerned doctor’s assistant from whom you can procure the number. While making calls please make sure you understand the time zones well, they follow EST and PST on the eastern and western coasts.

b. Write a proper subject to the email. Do not leave it blank. It may be “Request to Sponsor for Elective”.

c. Address them by their second name. Like “Dear Dr House” if the name is Gregory House, MD.

d. Tell them about yourself. Tell who you are and where you study. Tell them why you are interested in a particular elective.

e. Attach your recent CV to the mail and mention it that you have attached it in the text of the mail. Trust me; they go through it very carefully.

f. Close the mail by saying that you are hoping to hear from them soon.

g. If you know their administrative assistants email ID, CC the mail to him/her as well. They are the ones who will get your work done. So be genuinely nice to them. By this I mean, be actually nice to them, thank them if they reply back. Remember, they are doing a favor on you by even replying to your mail. They don’t gain anything by replying and moreover they don’t lose anything if they don’t.

h. If they reply, good enough. If they say you are accepted and they will sponsor you, thank them and follow up, but don’t overdo it. If they say that they cannot accept it due to some reason, still thank them. It’s not a bad idea to make people feel important and laud them for the effort that they have made. Who knows the person may remember you just coz you said thanks even when you were rejected and remember you again when there is a position available.

i. If there is no reply, you might as well send another mail or call up and follow your application after a week. But don’t keep pestering.

5. What next: Once you have decided where all you are going to apply, get the preliminaries ready. Get your titres done for various diseases. If you have not taken vaccinations (like Hep B and Varicella) take it as soon as possible. It needs at least 4 weeks for the titres to come up and since these tests are not done at all the places, it might take a couple of weeks for you to get the results. Religare (Ranbaxy) is a good lab which does these tests. There may be other labs too but I am not sure about them. Most of the Univs will ask for these titres: Hep B, Measles, Mumps, Rubella, Varicella and Mantoux/Chest X ray. It will cost you around Rs 5K to get all the tests done. Get the various forms and letters required from your dean, college etc ready. Various univs have different requirements and it might take you some time to extract all the forms from the college officials.

6. Fill up the forms: It is better to type all the info into the forms than writing with hand. Especially if you have handwriting as bad as mine, typing is definitely a better option. Most of the forms are available online in PDF format. You will need a PDF to Word converter before you can enter text in them. There are some free tools that do this as well. Google them!! Fill up all the info correctly and without ambiguity. All the forms should tell the same dates etc.

7. Application Fee: If you need to send an application fee too, please make sure what form will they accept it in. Ask them specifically if they accept international cheques. A cheque is a draft (also called a dollar draft)made in a bank in India. You may get it made from SBI or any other bank at your place that deals in foreign currency.

8. Send the forms: You may send the forms by speed post or by a courier agency. Speed post is fast only till it is in India. Once out in the US, the mail is carried by standard US Postal Service and they may delay the mail by a week or two. DHL delivers within 3-4 days in major US cities and that can be tracked easily. Buy DHL University Express Coupons. Normally DHL charges Rs 2K for parcels to the US but with these coupons the cost is only around 900 bucks. That’s a pretty good bargain. Speed Post will cost you around 500 bucks.

9. Now wait and keep your fingers crossed.. If you have planned your application well in advance and sent to univs after a considerable pre thought, you need not apply to more than 4 places/univs. All the best!!



Lastly a few more points to ponder upon. Do not keep sending them emails unnecessarily. It sometimes is irritating and might create a bad impression not just for you but others who are applying as well.

Be polite and courteous in your communication. Saying thank you and please doesn’t hurt a bit but can definitely win you a lot.

Share your knowledge!! You are not going to lose anything by sharing what you know. You are your own competition. There is no one else who is competing with you in the USMLE race. I got my electives coz someone else shared his info and I learnt from it. I have a responsibility to share and you by reading this share that responsibility as well. I hope all those who read this, gain from it do well. I wish you all succeed in your aim and then share what you know so that others may gain too.
And now How I got my Visa

Hi.. Here are my two cents on the Visa Interview. I am first going to describe my Visa interview and then going to discuss a few points about it that I feel made me secure it easily.

My Visa interview was at the Chennai Consulate, reporting time 9 am. I reached the city a day before and reached the consulate at 8:15 am. There was a huge line with about a hundred people already standing in front of me on the road and the footpath. There is no rain shelter there and weather can play havoc. I had my interview in January which is an unlikely time for it to rain in Chennai. Sky was a bit cloudy when I reached and when I was in the interview it did rain outside as well. Moral of the story is, carry some weather protection like umbrella (preferably a cheap one) when going to the interview. They won’t definitely allow you to carry it inside though but you obviously don’t want to go inside all wet. Carry a cheap umbrella and leave it outside if they say so. Do carry a bottle of water as well as it may be sunny and really hot and leave that out as well if they insist. Be prepared to wait for long durations!! I stood in the queue for about 45 min and then was let in.

I was wearing formals (with a tie) but I did see people over there in all sorts of attires from full three piece suit to jeans and T shirt. My viewpoint; wear what you want, but just be yourself. Don’t try to act. Don’t wear a suit just because you think it looks professional. Wear a formal shirt and pant, that’s enough. Women were wearing full American attires (like shirt, pant and a jacket, long skirt etc) to sarees. Don’t bother much about it. You are hardly going to get 2 min max with the VO and he shall be sitting across a window and you will be talking via a microphone. So obviously he would be more interested in listening to what you say than to see what you are wearing. Any king of religious symbols like tilak, head scarf etc should also be fine. I saw several women in head scarves and a few gentlemen with their fore heads smeared with 3-4 rows of tilak (some white powder, sorry I don’t know what it’s called) also getting Visa easily. At the max they might as you what it is or what it is called.

In the building after the initial frisking they make you sit in a number of places constantly shifting you from one place to another according to the appointment time. Keep your eyes and ears open so as to move quickly when they tell you to. There will be a pre screening area where they shall take your fingerprints and verify your appointment. Keep your Visa IV letter, Form 156, the HDFC blue slip and the passport ready here. Get it checked and go ahead.

Now there will be another set of queues, each for a different type of Visa. There will be someone to guide you where to sit. Do that as they say and then just wait for some more time. There will tell you when to go to the VO.

My VO was a middle aged White American. Really friendly fellow.

Me: Hello, Good morning Sir!

VO: Hi. Can I have your papers please?

Me: Yes, right here. (Gave him the Visa IV appointment letter, form 156 and 157 and the passport)

VO: (Reading my application) So you want to go to the US for electives. What does that mean? What is an elective?

Me: It is a short period of clinical training in the US.

VO: Can you please show me your degree certificate?

Me: I am still a student, haven’t completed my degree yet. I shall be finishing my college in Aug 2010.

VO: But you have mentioned that you attended your institution from Aug 2004 till Dec 2009.

Me: Yes, that’s right. While filling the application, the website didn’t allow me to enter any date after Dec 2009 in the drop down menu. That’s why. I have my mark sheets though, would you like to see them?

VO: No, its OK. Who would be paying for your trip?

Me: My parents.

VO: What does your father do?

Me: Both my parents are doctors.

VO: Hmmm.. Okay, enjoy your trip in the US. Your Passport will be couriered in a week’s time.

Me: Can I please collect it before that myself?

VO: Sure, you can. Call the VFS on Monday after 3 PM and find out from them.

Me: Thank you.

And so I walk out a happy man.

I am not an expert on Visa issues and standing there in the line I did see several people carrying hundreds of documents with them getting rejected. Here is what I carried with me:

1. Invitation letter from the hospital and emails that I exchanged with the electives coordinator and the mentoring doctor.

2. Last 6 months bank statements from both my parents and their last three years Income ax receipts. Also a letter signed by them saying that they were ready to sponsor me for my trip and stay in the US.

3. Letter from the college saying that I was a final year student, I have been granted leave for the said period and that college has no objection in me taking a break and visiting the US.

4. A printout of the medical school electives website for the information about the elective programe.

5. My college ID card and mark sheets.

My strong points (as per my experience) in the Visa IV:

1. Wish them good morning/good afternoon early on. Don’t wait for them to initiate a convo or ask a question. Helps build a good rapport. Also helps you be confident (or at least show that you are confident)

2. Be confident. You are not a thief. You are going there so that it helps you as well as them. If they don’t give you a Visa, at the max you won’t be able to go. Nothing worse is going to happen. You still have your degree in hand. Who knows, you might be the next Nobel Prize winner in which case it’s their loss. So be bold and don’t get too nervous. VO is not a monster.

3. Tell them that you are a student as early as possible. Helps clear any doubt about your potential migrant status.

4. Be brief. Short and sweet is good. Do not elaborate unless asked.

5. Carry all the documents you think might be important. You never know when you may need one.



All the best to all!!

Electives : An Exhilarating Roller Coaster Ride!!



Hi Friends!!!

This is Purav from GMC, Surat, India. I am presently doing my internship right now. The process of application to electives has been a fascinating journey for me which I would like to share with you. I first heard about electives from a classmate of mine when she went for her electives to Emory in our final semester. Initially I was a bit sceptical about it, but when I heard her experience I made up my mind to apply for electives and that’s where my journey began! At first when I started looking for colleges and about programs I didn’t even know what is visiting student or electives or clerkships or how to go about the application process. But slowly and steadily I mailed as many colleges as I could for information. It was a long tedious and sometimes a frustrating process being rejected for some reason or the other. Back then I did not know about Umar bhai’s wonderful website and when I finally found it on the net my first reaction was of immense surprise. All the information I was gathering about electives was right there and everything was arranged in such a lucid manner! Umar bhai’s website is as how I like to call it is an Encyclopaedia on Electives! That really impressed me and since then I am a regular! Coming back to the original story, the process of finalising colleges was very tough because I had not given my step 1, no TOEFL scores, did not know anyone on the faculty, had an average CV and came from a very ordinary but good government college so the list kept narrowing down. Also my college clerks did not make my task any easy. Getting my application forms signed, getting multiple copies of transcripts all was really tough and anyone who has dealt with Indian bureaucracy has an idea about what I am talking about. In the midst of my application I decided to give my TOEFL mainly because I saw on Umar bhai’s website how important it was! Finally with everything ready, apprehensively I sent in my applications having no idea what the future had in store for me. I was hoping that I would at least get a single elective and I would be more than happy. Slowly the replies poured in and to my great joy I got accepted in my top 3 choice of colleges (Tufts, Yale, Jefferson) in my lines of interest Gastroenterology, Cardiology and Pulmonary Medicine respectively. Additionally I have also been accepted for Cardiology at Mt Sinai! Never in my wildest dream had I imagined such a scenario! I am truly thankful to everyone who helped me in this journey and Umar in particular! I have no idea what the experiences are going to be like but I am tremendously excited and want to make the most of it. I would like to share some points regarding my application process which are by no means complete. They are strictly personal and I strongly recommend everyone to go through the website for additional information!

Positive Points

1. Early Application:- I applied relatively early and I strongly advice everyone to do the same e.g. I started gathering information in April and sent Jefferson app by July however my classmates who sent it in august were denied electives because till March all medicine electives are full. Just matter of 20 days made all the difference! Also in colleges like NYU you have to send in a request for electives and it has to be done before May 15th and a friend of mine did it and he has been accepted for pulmonary medicine and cardiology! Even I missed the cut!



2. Documentation:- Documentation should be perfect. E-mail the coordinator if you have any doubts. All my applications were complete and processed on time. Because of incomplete documentation few friends had to send additional documents and delayed their process unnecessarily!



3. Post mailing scenario: - I guess there is a fine line everyone treads after mailing your application. Constant e-mailing and phone calling can annoy the coordinators and at the same time a subtle reminder can go a long way! For example after sending my application to Tufts I called up the coordinator after a month. On speaking to her she told me my documentation was complete but I was ineligible for 2 out of 3 choices that I had written (I had written Sub Internships!)However she told me if I wanted alternate choices I could mail them to her. I wrote in Gastroenterology because I had not mentioned it previously and I got accepted for it!



4. Personal Statement: - I think this one document carries a lot of importance. It is the one chance to really impress upon the coordinator with your thoughts and views. I recommend to keep it short (mine was about 450 – 500 words, single page) and keep it honest. Good personal statement can really help to push your case for an elective ahead of others.



5. TOEFL: - I highly recommend giving it if you have time and personally I sent my scores to even those schools who didn’t ask for it. It was a great way to further my application especially with the number of applications increasing every year! Also the trends that I have been observing are that more and more colleges are making it mandatory. Case in point is SUNY DOWNSTATE and Mt Sinai who initially or say 4 months back did not require TOEFL, but now require it!



6. Malpractice Insurance: - This is particularly a sticky point. Lot of colleges ask for it and the problem is how do you buy it and for how much time, when you have no idea regarding your acceptance in that college. I would suggest e-mailing the coordinator and assure her that once accepted you will buy the necessary coverage and mail it to her. I did this for Jefferson and they obliged!



7. Immunization form: - All colleges usually have the minimum requirement of titres or history of vaccination for MMR, Varicella (history of past disease is also acknowledged by some colleges) and Hep B . I got my titres done at Metropolis and was lucky to have all of them positive. This made filling of health forms really easy. In case you get negative titres go get vaccinated again and get document of vaccination and send it with your application. It might just work (a friend of mine did it and she did not encounter any problems)


Negative Points



1.) My colleges are all expensive with high tuition fees but they are all really well known colleges and hopefully the experience will be worth it!

2.) I have a TOEFL score of 112 which is really good but the problem was that I scored a little low on speaking 24. It did not make a major difference to most of the colleges but I could not apply to NIH where requirement was 26, so I strongly recommend that before giving TOEFL make sure that speaking is good because the rest sections are relatively easy and the minimum score requirement is not very high

To wrap things up it has been an incredible journey so far and is by no means complete. I would be able to tell you a lot more when I actually attend these rotations. And finally the best advice I can give you is that always be POSITIVE and HOPE for the best! I didn’t come from the best of colleges, did not have a super CV, did not give my step1, my college is not affiliated to any college in the US! But I still managed to get 4 acceptances from really good schools. So go for it my friends and I wish you all the best and May God be with you. As Umar bhai has said it the best

“Hope is a good thing, probably the best of all the things one could ever come across!!”

If you have any queries regarding the above write-up/application process/electives you can post it on the site or mail me at purav.mody@yahoo.com. I would be more than happy to help you to the best of my knowledge. Best of luck!








ELECTIVE EVALUATION FORM
Elective Name:____________________________________
Elective Number:__________________________________
Student’s Name Elective Period & Dates: ___________________________
Supervisor:_______________________________________
Address and contact info:___________________________
__________________________________________________
__________________________________________________

For home office use only: Elective Credit ________

Insert the numbers 0 – 4 from the scale below or NA to characterize this student’s performance in each area
0: Unacceptable 3: Superior Performance (Top 20%)
1: Marginal Performance (needs improvement) 4: Honors (Top 5%)
2: Typical Performance (average) N/A: Not Applicable
___Depth & integration of pertinent clinical and basic science knowledge ___Maintains complete and orderly records ___Punctual, attended all conferences
___Outlines rational plan for investigation ___Demonstrates enthusiasm ___Contributing member of team
___Demonstrates reasonable depth of knowledge ___Demonstrates realistic appreciation of his/her own competence and limitations ___Works well with and shows respect for members of the health care team
___Obtains confidence and cooperation of patients ___Demonstrates honesty in admitting errors ___Well organized, analytic
___Establishes priorities and institutes an appropriate plan of treatment ___Accepts direction or criticism comfortably ___Reliable and responsible
___Recognizes an emergency situation and manages it appropriately ___Takes initiative/works independently ___Completes tasks

Supporting comments:







Circle one: Attending Fellow Chief Resident

_____________________________________
Evaluator’s Name (Please Print)
_____________________________________
Evaluator’s Signature

_____________________________________
Date Signed or date of Exit Interview
_____________________________________
Student’s Signature - if exit interview is completed



PLEASE RETURN TO:
Office of Registrar,
Address of Your Home Medical College/University