Although residency seems to be the end-all, be-all to International Medical Graduates (IMG), there are many obstacles to overcome once residency is secured. 
United States of America (Press Release) May 7, 2008 --
Despite the pre-match positions, there is still a large number of IMG’s each year, who fail to complete their first year of residency due to the significant lack of acculturation to U.S. healthcare system and pre-residency clinical experience. Therefore, if you are an IMG who received a pre-match offer, you must not stop now. Our objective at AmeriClerkships is to identify potential issues before they become problems, by offering evidence based solutions.
A typical IMG might think once a residency spot is secured, the most difficult part is over, when in fact, the most difficult task is to get off to a smooth start and COMPLETE the first year of residency (better known as Post Graduate Year (PGY) 1, or formerly Internship year). According to the Accreditation Council of Graduate Medical Education’s Data Resources, 3169 residents failed to complete the residency that they Matched into in 2006 academic year alone. For that reason, AmeriClerkships strongly suggests to enter residency completely prepared by gaining as much patient exposure as possible before the first day of residency.
Lack of U.S. clinical experience before the start of residency is a major contributor to many avoidable issues faced by IMGs during the first few months of residency. A collaborative joint project of Program Directors from New York Hospital Medical Center and Mayo Clinic College of Medicine, an article called “The Top Five Ways to Help IMG’s Succeed: Spanning the Cultural Divide” is commonly referred to by residency programs and is directed toward Chief Residents, and makes recommendations on the most effective ways to deal with International Medical Graduates and the problems they face when they enter residency. This documents states:
“Intellectually, the IMG is every bit the equal of a U.S. Medical Graduate, but educational standards differ widely around the globe… Adjustment problems are generally caused by adaptation, not intellect.”
For this reason, AmeriClerkships provides the insured PRE-RESIDENCY “hands-on” clinical experience necessary to facilitate the adaptation required to succeed as a Medical Professional in the U.S.
As the article points out, IMG’s face problems with systemic acclimatization, depression, social Isolation, immigration issues, social adaptation and attitudes towards patient rights and professionalism. Some additional insightful quotes in this article clearly explain the trials IMG’s may face in residency:
“The first months of internship then become a dual battle of acquiring the skills of an intern (such as data gathering, acquiring medical knowledge, developing diagnostic skills, and recognizing the ill patient) and becoming familiar with the US system of medicine (such as documentation, abbreviation and slang, differences in pharmacy procedures and medications, style with rounds, and day to day functioning of a US hospital). While orientation programs may assist in the acclimatization process, each intern will have his or her own learning curve.
The overwhelming schedule of an intern can be a welcome distraction at first. Ultimately, fatigue and mental stress may overwhelm an intern without close social support. New house-staff may struggle with a new language, have difficulty adjusting to local food or customs, and be off from reliable support systems. As the academic year progresses, interns become depressed.
Unlike U.S. graduates, many IMG’s have completed residencies overseas or worked independently prior to starting residency in the United States. They may view the work of an intern as demeaning or below their level of accomplishment…No matter what his previous experience; Dr. Y may not be an effective team leader at this point in his US training. Teamwork is a vital part of professionalism.
Attitudes about patients’ rights differ greatly from culture to culture and country to country. While most US medical schools have incorporated ethics and patients’ rights into their curricula, many different attitudes exist worldwide. An IMG who has not worked in a US hospital may have no experience with living wills, informed consent, and resuscitation orders. In addition, patient autonomy (patients’ rights, treatment refusal, and confidentiality) is viewed very differently in different cultures. Physicians-in-training from many other countries may be unfamiliar with US ethical standards concerning patient rights”
In summary, AmeriClerkships’ Residency Strategists and Consultants recommend that IMGs dually utilize the pre-residency insured hands-on clinical experiences offered through AmeriClerkships as:
1) A preparatory medium by which to secure residency interviews, and
2) The greatest means by which to become acculturated to the U.S. healthcare system prior to the start of residency.
The hands-on patient contact opportunities offered through clinicals with AmeriClerkships will significantly strengthen each IMG prior to actual patient responsibilities during residency, which ultimately improves quality of patient care, decreases the chance of residency dismissal due to an avoidable reason (such as HIPAA and attitudes towards patient rights) and increases resident satisfaction with his/her new career. Most importantly, clinicals will without a doubt provide a smooth transition into the first day of residency, the preliminary tools necessary to complete the residency, and the means by which to become a renowned, respectable members of the global Medical Community. As a matter of fact, this surviving the first year of residency is so important that AmeriClerkships has a 4 week clinical product especially prepared for pre-matched IMG’s named the TOTALResidency ResidencyPREP Package. Please contact us at 877.MD.Clerkships (877.632.5375) or US+949.417.8980 in order to discuss further.”
A typical IMG might think once a residency spot is secured, the most difficult part is over, when in fact, the most difficult task is to get off to a smooth start and COMPLETE the first year of residency (better known as Post Graduate Year (PGY) 1, or formerly Internship year). According to the Accreditation Council of Graduate Medical Education’s Data Resources, 3169 residents failed to complete the residency that they Matched into in 2006 academic year alone. For that reason, AmeriClerkships strongly suggests to enter residency completely prepared by gaining as much patient exposure as possible before the first day of residency.
Lack of U.S. clinical experience before the start of residency is a major contributor to many avoidable issues faced by IMGs during the first few months of residency. A collaborative joint project of Program Directors from New York Hospital Medical Center and Mayo Clinic College of Medicine, an article called “The Top Five Ways to Help IMG’s Succeed: Spanning the Cultural Divide” is commonly referred to by residency programs and is directed toward Chief Residents, and makes recommendations on the most effective ways to deal with International Medical Graduates and the problems they face when they enter residency. This documents states:
“Intellectually, the IMG is every bit the equal of a U.S. Medical Graduate, but educational standards differ widely around the globe… Adjustment problems are generally caused by adaptation, not intellect.”
For this reason, AmeriClerkships provides the insured PRE-RESIDENCY “hands-on” clinical experience necessary to facilitate the adaptation required to succeed as a Medical Professional in the U.S.
As the article points out, IMG’s face problems with systemic acclimatization, depression, social Isolation, immigration issues, social adaptation and attitudes towards patient rights and professionalism. Some additional insightful quotes in this article clearly explain the trials IMG’s may face in residency:
“The first months of internship then become a dual battle of acquiring the skills of an intern (such as data gathering, acquiring medical knowledge, developing diagnostic skills, and recognizing the ill patient) and becoming familiar with the US system of medicine (such as documentation, abbreviation and slang, differences in pharmacy procedures and medications, style with rounds, and day to day functioning of a US hospital). While orientation programs may assist in the acclimatization process, each intern will have his or her own learning curve.
The overwhelming schedule of an intern can be a welcome distraction at first. Ultimately, fatigue and mental stress may overwhelm an intern without close social support. New house-staff may struggle with a new language, have difficulty adjusting to local food or customs, and be off from reliable support systems. As the academic year progresses, interns become depressed.
Unlike U.S. graduates, many IMG’s have completed residencies overseas or worked independently prior to starting residency in the United States. They may view the work of an intern as demeaning or below their level of accomplishment…No matter what his previous experience; Dr. Y may not be an effective team leader at this point in his US training. Teamwork is a vital part of professionalism.
Attitudes about patients’ rights differ greatly from culture to culture and country to country. While most US medical schools have incorporated ethics and patients’ rights into their curricula, many different attitudes exist worldwide. An IMG who has not worked in a US hospital may have no experience with living wills, informed consent, and resuscitation orders. In addition, patient autonomy (patients’ rights, treatment refusal, and confidentiality) is viewed very differently in different cultures. Physicians-in-training from many other countries may be unfamiliar with US ethical standards concerning patient rights”
In summary, AmeriClerkships’ Residency Strategists and Consultants recommend that IMGs dually utilize the pre-residency insured hands-on clinical experiences offered through AmeriClerkships as:
1) A preparatory medium by which to secure residency interviews, and
2) The greatest means by which to become acculturated to the U.S. healthcare system prior to the start of residency.
The hands-on patient contact opportunities offered through clinicals with AmeriClerkships will significantly strengthen each IMG prior to actual patient responsibilities during residency, which ultimately improves quality of patient care, decreases the chance of residency dismissal due to an avoidable reason (such as HIPAA and attitudes towards patient rights) and increases resident satisfaction with his/her new career. Most importantly, clinicals will without a doubt provide a smooth transition into the first day of residency, the preliminary tools necessary to complete the residency, and the means by which to become a renowned, respectable members of the global Medical Community. As a matter of fact, this surviving the first year of residency is so important that AmeriClerkships has a 4 week clinical product especially prepared for pre-matched IMG’s named the TOTALResidency ResidencyPREP Package. Please contact us at 877.MD.Clerkships (877.632.5375) or US+949.417.8980 in order to discuss further.”
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