US Clinical Rotations

What are Clinical Rotations

Clinical rotations are a practical opportunity to apply your knowledge of clinical subjects to real-world patient care and to develop the skills to diagnose and treat patients. 

Clinical Rotations for International Medical Graduates

As an International Medical Graduate (IMG), clinical rotations (clerkships) are essential to your success in matching into a residency program in the United States. Clinical Clerkships for IMG allow me to gain hands-on experience in the U.S. healthcare system, work with American physicians, and obtain letters of recommendation.

Here are some of the advantages of clinical rotations for IMGs:

US Clinical Notations
  • Hands-on experience: IMG clinical rotations give you the chance to use your knowledge and skills in a real-world medical setting. You will learn from experienced physicians and be able to practice your clinical skills on actual patients.
  • Letters of recommendation: A recommendation from American physicians is essential for matching into a residency program. Clinical rotations allow you to build relationships with physicians who can provide strong letters of recommendation.
  • Performance evaluations: IMG Clinical rotations provide you with feedback on your performance from experienced physicians. This feedback can help identify your strengths and weaknesses and develop an improvement plan.
  • Pathway to residency: Clinical rotations are a pathway to residency for IMGs. Many residency programs require IMGs to have U.S. clinical experience. By completing clinical rotations, you can demonstrate to residency programs that you have the skills and knowledge necessary to be a successful resident.
  • The outlook for IMGs in the United States is positive. There is a shortage of physicians in the U.S., and many residency programs are looking to IMGs to fill this shortage. By completing International clinical rotations, you can increase your chances of matching into a residency program and becoming a successful physician in the United States.

Types of Clinical Rotations  in the US

Clinical rotations are supervised training experiences that medical students and residents complete in different medical specialities. Clinical rotations occur after the basic science or medical curriculum and can be grouped into two broad categories: core and elective.

Core Clinical rotations are mandatory rotations that students are required to complete to graduate. Typical core clinical rotations include:

  • Family medicine
  • Internal medicine
  • Neurology
  • Obstetrics and gynecology
  • Paediatrics
  • Psychiatry
  • General surgery

Elective rotations are optional rotations that students can choose based on their interests. Typical IMG-friendly elective rotations include:

US Clinical Notations
  • Cardiology
  • Dermatology
  • Emergency medicine
  • Endocrinology
  • Gastroenterology
  • Hematology and oncology
  • Infectious disease
  • Nephrology
  • Ophthalmology
  • Orthopedics
  • Pathology
  • Physical medicine and rehabilitation (PM&R)
  • Plastic surgery
  • Pulmonology
  • Radiology

Hands-on rotations are the most common type of clinical rotation. In a hands-on rotation, students work directly with patients, performing physical exams, ordering and interpreting tests, and developing and implementing treatment plans.

Observerships are clinical rotations where students observe experienced physicians and other healthcare professionals. Observerships are an excellent way for students to learn about different specialities and develop clinical skills in a low-pressure environment.

Virtual rotations are online clinical rotations students complete remotely, by video conferencing and other online tools. Virtual Clinical rotations have become more prevalent in recent years as they allow students to gain clinical experience from anywhere in the world.

Telerotations are a type of virtual rotation in which students work with patients remotely, using video conferencing and other online tools. Telemedicine rotations are a good way for students to gain clinical experience with patients who live in rural or underserved areas.

Which type of clinical rotation is right for you depends on your needs and goals. If you are still deciding which rotation type to choose, talk to your academic advisor or a trusted mentor.

Duration of clinical rotations

The length of clinical rotations varies depending on the medical school and the hospital. Some rotations may be as short as two weeks, while others may last up to eight weeks. The average duration of some standard clinical rotations is as follows:

Medical Program Duration
Anesthesiology 4 weeks
Emergency Medicine 8 weeks
Family Medicine 8 weeks
General Surgery 8 weeks
Internal Medicine 8 weeks
Neurology 8 weeks
Obstetrics and Gynecology 6 weeks
Pathology 6 weeks
Paediatrics 6 weeks
Physical Medicine and Rehabilitation (PM&R) 4 weeks
Psychiatry 6 weeks
Radiology 6 weeks

The duration of a clinical rotation for medical students may also depend on the hospital's speciality and strength. For example, a clinical rotation in emergency medicine at a large metropolitan hospital may be longer than a rotation at a smaller rural hospital.

Here are some factors that may affect the duration of a clinical rotation:

  • Medical school curriculum: Some medical schools have stricter curriculum requirements than others, which may affect the duration of clinical rotations.
  • Hospital size and location: Larger hospitals in metropolitan areas may offer a broader range of clinical rotations and more patients, leading to longer rotations.
  • Speciality: Some specialities, such as surgery and internal medicine, typically have longer rotations than others, such as family medicine and paediatrics.
  • Student experience and learning goals: Students with more experience or pursuing a career in a particular speciality may be able to complete shorter rotations.

Students should talk to their academic advisor or program director to learn more about the duration of clinical rotations at their medical school and the hospitals where they will be rotating.

Cost of US  Clinical Rotations

On average, a US hospital can charge $500/week for a clinical rotation program, and a minimum of 80 weeks of clinical rotations in the United States will cost around $40,000. A standard four-week clinical rotation can fall between $1,000 and $4,199.

How to Apply for a Clinical Rotation

To apply for a USMLE clinical rotation, you must typically submit an application form and any required supporting documents. You may also need to interview with the program director or other members of the rotation team. 

Criteria  for Choosing Clinical Rotation 

You must be a third-year medical student to apply for a  USMLE clinical rotation. The application requirements for each program are different, but some common conditions include:

  • USMLE Step 1 score report
  • Resume
  • Personal statement
  • Letter of good standing from your medical school (if you are applying to a program outside of your school)
  • Letter of intent
  • Transcripts
  • Dean's letter
  • Immunization records
  • Malpractice insurance
  • Criminal background check
  • HIPAA awareness training certificate
  • Urine drug screening report

Some programs may also require additional documents, such as letters of recommendation or a portfolio of work. Be sure to check the specific requirements of the programs you are interested in.

What is the difference between Clinical Rotations, Observer ships, and Externships/Clerkships?

Clinical rotations are hands-on clinical experiences that medical students complete as part of their required curriculum. These rotations typically occur at hospitals and clinics affiliated with the student's medical school.

Externships /Clerkships are also hands-on clinical experiences, but the student's medical school does not directly provide them. Medical students and graduates can complete externships/ Clerkship rotations, and they are often the only option available to international medical graduates (IMGs) to meet the hands-on clinical experience requirements for many residency programs. Externships/clerkship rotations can be arranged directly with hospitals or services that offer these experiences or through rotation agencies.

Observerships are shadowing-only rotations, so observers do not participate in direct patient care. Medical students can complete observerships at all levels of education and by medical graduates. Graduates often use observership rotation to fill in gaps in their clinical education or to demonstrate that they are still up-to-date on medical practices if they have been out of school for a while. Observership rotations are also popular among IMGs, as they can help them become more familiar with the US healthcare system and increase their chances of getting into a residency program.

Here is a table that summarizes the key differences between USMLE clinical rotations, observerships, and externships:

Medical Program Duration
Anesthesiology 4 weeks
Emergency Medicine 8 weeks
Family Medicine 8 weeks
General Surgery 8 weeks
Internal Medicine 8 weeks
Neurology 8 weeks
Obstetrics and Gynecology 6 weeks
Pathology 6 weeks
Paediatrics 6 weeks
Physical Medicine and Rehabilitation (PM&R) 4 weeks
Psychiatry 6 weeks
Radiology 6 weeks

Preparing for clinical rotations

  • Start early: The application process can be competitive, so don't procrastinate.
  • Research thoroughly: Choose programs that align with your interests and career goals.
  • Tailor your applications: Show genuine interest in each program you apply to.
  • Practice interviewing: Be prepared to answer questions about your motivations and qualifications.
  • Consider externships/clerkships as alternatives to USMLE rotations.
  • Network with US physicians to build relationships and secure strong letters of recommendation.
  • Highlight your international medical experiences and unique perspective.

Conclusion: Preparation is key! The more organized and proactive you are, the higher your chances of success. Showcase your passion and potential. Let your application materials and interviews reflect your commitment to becoming a skilled and dedicated  Physician. Embrace the journey! Applying for rotations can be challenging, but the rewards of clinical experience are invaluable

Benefits of Clinical Rotations:

Here are some of the specific benefits of clinical rotations:

  • Exposure to a variety of patients and conditions. Clinical rotations allow medical students to see patients with different diseases and conditions. This exposure helps students to develop a broad knowledge of medicine and to learn how to manage a variety of patient presentations.
  • Development of clinical skills. Clinical rotations are supervised hands-on training opportunities to practice and develop clinical skills. It includes history taking, physical examination, diagnosis, and treatment.
  • They improved communication and teamwork skills. Clinical rotations require medical students to work in close association with other healthcare professionals, such as physicians, nurses, & pharmacists. This experience helps students develop their communication and teamwork skills, essential for success in healthcare.
  • Understanding of the healthcare system. Clinical rotations give medical students a first-hand look at how the healthcare system works. It includes understanding the different roles of healthcare professionals and the challenges and opportunities facing the healthcare system.
  • Preparation for residency. Clinical rotations are an essential part of preparing for residency. Residency programs place a high value on clinical experience, and students with strong clinical skills are more likely to be accepted into their preferred residency programs.
  • Moksh Advantage: We at Moksh are partners with quite a few ACGME-accredited hospitals. We would be glad to guide you through the entire process. What we provide is a complete Medical PG in the US package. We can start with an Elective Clinical Rotation and continue through world-class USMLE training right up to your getting a Medical License.


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