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SUNY UpState Internal Medicine Observership: Tips for success

Clinton Square in Syracuse Where SUNY Upstate Medical University is Located

The State University of New York Upstate Medical University, also known as SUNY Upstate, is one of our nation's oldest medical schools. Throughout its long history, the medical school has been known for making important contributions to patient care, teaching, and research.

As one of the few medical schools that offers an internal medicine observership for international medical graduates (IMGs), I often encourage IMGs to learn more about the program.

If you are approved for an observership at SUNY Upstate, you may be wondering how to make the most of your opportunity. Below are tips for success before, during, and after the observership.

Before the Observership

As is often the case, there are advantages to applying early. Applicants who apply well in advance of their preferred start date have an excellent chance to observe in their specialty or subspecialty of interest. Options include general internal medicine, critical care, endocrinology, gastroenterology, hematology/oncology, infectious disease, nephrology, pulmonology, and rheumatology. While the program recommends that you apply at least 8 weeks before the start date, we would recommend that you apply even earlier to maximize your chances of acceptance and to improve your chances of securing your top specialty choices.

To be eligible for consideration, you must have minimum passing scores of 200 on the USMLE Step 1 and 2 CK exams and a passing score on the Step 2 CS exam (all on first attempt). According to the website, ECFMG certification is also required. As part of the application, you must provide a letter of recommendation from a physician with whom you have worked in a clinical setting.

Will exceptions be made for applicants who do not meet these eligibility criteria? Only the SUNY Upstate Department of Medicine can answer this question but we do recommend that you make these inquiries before submitting your application with its nonrefundable $ 300 application fee.

All applicants should carefully consider their goals for the rotation. If you are seeking to become a more attractive internal medicine residency candidate at SUNY Upstate, please note that the Department of Medicine prefers applicants who have scores greater than 220 on the USMLE Step 1 and 2 CK exams. While applicants with scores between 200 and 220 may be considered for observerships, they may not receive consideration for interviews. This should certainly be factored into your decision-making.

During the Rotation

The goal of the program is to help learners become familiar with the U.S. healthcare system by providing opportunities to observe the day-to-day work of attending physicians, fellows, and residents.

Working with attending physicians in a department where there is an internal medicine residency training program may allow you to form relationships with faculty that can help your residency application attract attention at the program.

Most IMGs also seek to obtain a letter of recommendation from the experience. Since your goal is to secure a strong letter of recommendation, we recommend that you consider the following:

  • Please note that this is a program where you will not be directly involved in patient care. Therefore, a letter obtained from this experience will not describe your abilities in some key areas, including taking the history, performing the physical exam, or writing the progress note. With that being the case, you should give thought to how you will make a favorable impression on the attending physician. Will you demonstrate your knowledge base through your involvement in teaching rounds? Will you show your communication skills by making a topic presentation?

  • Your ability to form strong relationships with attending physicians may also be limited by the duration of your contact. It is common for attendings to rotate off at 1-2 week intervals. This, of course, will limit your time with any one attending and this can impact the strength of the letter of recommendation.

  • The typical observership duration is 2 weeks although there is a possibility that this can be extended pending approval from the program coordinator, attending physician, and Chair of the Department. IMGs should consider extending the rotation duration to 4 weeks as it can take several weeks to become comfortable in a new clinical environment and show your true abilities.

  • The Department of Medicine asks every attending physician with whom you work to complete an evaluation of your performance. The key competencies that are assessed include knowledge base, communication and interpersonal skills, professionalism, practice-based learning, and systems-based practice. Not sure what practice-based learning and systems-based practice are? You're not alone. In one study, 39% of residency applicants were not at all familiar with any of the six core physician competencies. In order to receive the highest marks and comments in these areas, it is essential that you take the time to understand these competencies so that you can demonstrate your abilities in these areas during the observership.

After the Observership

Following the observership, reflect upon your experiences. What went well? What do you need to improve? Look over your evaluations to gain additional insight, and speak with your attending physicians to learn more about your strengths and areas for improvement.

If your attending physician has agreed to write you a letter of recommendation, determine what he or she will need to write the letter. Your goal is to make it as easy as possible for the attending to write the letter that you deserve.

Finally, remember to stay in touch with your attending. Such efforts will deepen your relationship, and you will benefit from the ongoing mentorship.

Dr. Samir Desai is the author of The Successful Match 2017 and co-host of the Success in Medicine Podcast. He is the founder of the MD2B Connect IMG Clinical Rotation Program which provides international medical graduates and students with exceptional hands-on clinical experiences.

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