Do not underestimate the value of research and clinical experience. With residency programs being more competitive than ever before today, every little thing helps on a resume. Some find it optional, while others consider it an absolute necessity. It truly depends on how competitive of a program you are looking for, and how much of the competitive edge you want over other candidates.

Why do I need research?

While every other applicant may have double or triple 99s on their USMLEs, what distinguishes them from the rest? Research is the first factor. Any research experience you may have, be it from your home country, or in the U.S., can help. If your research was published in a national journal, you will have the chance to list that on your ERAS application. If it was not published, you may still be able to write about it under research experience. The more publications, the merrier! Being a first or second author holds its weight, and will definitely open doors for you later in pursuing more research opportunities for a fellowship. Now for a candidate with no research on his application / resume, the section on the ERAS application for research and publications will be left blank. It never looks good to leave a portion of your application blank, but if you have no research then please do not try to make something up. It will most likely hurt you more than help. Interviewers will ask in detail about your research, and if there’s even a little discrepancy or doubt, you may be in a lot of trouble from ERAS. Try to gain some research experience during medical school, and pursue research opportunities with doctors in your institution. You have to start from somewhere, and you will not find higher research positions without any experience.

Where do I find research?

This is not an easy task at all. Obtaining a research elective in the U.S., while helpful, is still not as good as a clinical elective, in terms of helping you find residency. If you have the chance to do both, great! Research starts with how much initiative you have to pursue it. If you try hard enough, you will find the position you are looking for, but you’ll have to be extremely patient. If you have connections or know someone currently working on some research projects, offer to volunteer and help. If you show your dedication and hard work, they will offer you a better position in time. Now if you have no connections at all, start looking up institutions known to conduct research in the specialty you are interested in. Dig through the institution’s website and find the email addresses of the professors and researchers. They may be titled as: Clinical research coordinator, post-grad research fellow, research associate, etc. Now begin the mass emailing. Introduce yourself, write about where you are from and currently studying, your research interests (particularly in their study if you looked up what they are currently investigating), what you want to accomplish, and how you will take care of your accommodation and expenses if it is a volunteer position. It may take 200 or more emails, to different professors at different institutes around the country, but you only need one to say yes, and your set. If they want you to interview for a position, decide if its worth traveling for it. If the position is truly what you are looking for and you have the time and expenses covered, take it, as another opportunity may not arise again. If it is in a specialty you are less interested in and don’t have the time or money for it, then let them know.

Clinical Experience

This is an absolute necessity today for IMGs. Most residency programs have a filter where if you do not have a certain amount of months of clinical experience in the U.S., they will toss your application. Some programs require 1 month of clinical experience, while others require 6 months to a year! While this sounds insane, it is true (Florida programs are known for this). How is an IMG supposed to have one year of clinical experience before residency and after graduation from medical school? It’s almost impossible. This is where you have to plan ahead. Starting in your third year of medical school, begin finding places you would like to do an elective at. This will most likely be a university offering a one month clinical elective for a price (anywhere between $300 – $3000). The more reputable the institution, the more expensive. If you want to pursue residency at a specific hospital or institute, it would be best to find an elective there. It really helps getting to know some of the faculty and receiving nice LORs from them, but remember its near impossible for an IMG to match to Harvard, John Hopkins, etc., so doing electives there are only for the experience and LORs. Some electives have strict requirements as to only final year medical students can do electives, while other places just require one year of rotations. Thus, if you can take advantage of every month during the last 2 -3 years of medical school, you can build up a very impressive amount of clinical experience in the U.S.

The beauty of a clinical elective is that you are basically a visiting medical student. You have the responsibility of taking histories, performing examinations, preparing SOAP notes, and presenting the case to an attending or resident. You are required to attending rounds, conferences, and maybe even prepare a presentation or discussion. After a good elective, you’ll realize why its so great to practice in the U.S. The experience is truly educational and rewarding. I strongly recommend to do at least 2 electives, preferably in specialties you would like to pursue for residency. Do not do a radiology and anesthesiology elective if you are applying for Internal Medicine. You will be asked why you did those electives and they may also assume you are applying for those advanced specialties. Apply early (6 months at least) to get the elective you want. Applying late will only leave those specialty electives no one wants to take.

Observerships are also a great way to add some experience. Though not as impressive as a clinical elective (hands-on training vs. observing), it is still a way to familiarize yourself with the U.S. health care system. You’ll notice how different it is in the U.S. from your home country and how you will have to learn and adapt to things here. As to where to find observerships, once again connections help a lot. Any physician can let you shadow them as long as they are willing to take responsibility of you. As long as you do not touch a patient, you’ll be fine. You can ask as many questions as you like, observe various procedures and how a day in the clinic is, and even take histories if you’re allowed; just not hands-on because of the liability issue.

In the end, get yourself out there. You have to be persistent and determined to get the experience you need to get into residency. The difference between one month U.S. clinical experience and three months clinical experience is HUGE. Every residency program looks at this as how much easier it will be for this applicant to adjust to the U.S. health care system. IMGs from the Caribbean complete 2 years of clinical rotations in the U.S. That is considered 2 years of clinical experience in the U.S., which is basically as good as an AMG. IMGs from other countries do not have that opportunity, so you must pursue it on your own. Ask seniors to advise you on where they completed electives. It helps if an institution already had students doing electives from your school. Hopefully they left a good impression and raised your medical school’s reputation.

Sample email to send to researcher for volunteer research position:

Dear Dr. X,

Hello. I am currently a medical student at Y College in Z city. I am writing to you in regards to a research opportunity and would like to know if you had a position available for an extremely eager to learn, determined, and passionate student in any type of research setting. I have completed my course training in Pharmacology and Community Medicine, which focused on clinical trials and research study protocols, respectively. In one of the research studies, I undertook tasks such as subject recruitment, data collection, and preparation of the case report. I am confident that I can apply and utilize these skills acquired from my training for a position in your department.

I am highly motivated and eager to research in Gastroenterology, particularly in IBD and colorectal cancer. I have already familiarized myself with some of the research being conducted at your institution. I seek the opportunity to show my strengths and help assist the research team to complete the tasks at hand. I am willing to work as an unpaid position to gain experience and knowledge, working beside the finest doctors and researchers in the field. I work well as a team member, am very reliable and organized, and continuously willing to learn. Dr. X, if you could give me the opportunity to prove my dedication, loyalty, and determination as a research aid, I would be truly thankful.

Also, I am a US citizen / greencard holder / student visa, thus I have no visa-related issues. I have passed the USMLE Step 2 CS exam and am currently preparing for the USMLE Step 2 CK.

Thank you for your time. I hope to hear from you soon.

Regards,

xyz

Step 5: ERAS Application