Module 2: How to Network, Find Observer-ships and the Value of USCE (United States Clinical Experience)

This is Module 2: How to network, Find Observerships and Create Value with US Clinical Experience. How has the course been going so far for I'm proud of you for clicking and watching this video to the very end, because that is absolutely important. In this section, you learn how to network as an international medical student or an international medical graduate. You will gain understanding of the value of US clinical experience as an IMG and which ones of these to prioritize. Did you know that networking is just as important in medicine as it is in the business We often feel like networking is meant for business people, for sales Yet as physicians, we neglect it altogether. We're human, and our work is based on the concept of building relationships. Patients and families over a period of So if that works in medicine, then it works everywhere else, right? When it comes to your journey in medicine, or in this case, your journey to creating a career in the United States through residency training who you know is just as important as what you I'll teach you the tenets of networking, how to do so effectively and efficiently, and I'll show you how to network at medical conferences and even how you can leverage your clinical rotations. I'll tell you specifically how to utilize your clinical rotations, your observerships, your externships. And for those of you who've already graduated from medical school, you may no longer have the opportunity to participate in electives per se, because those are usually reserved for medical students. But you have observerships. You have. Internships, you have research projects that you're involved or you may even be a part of a clinical fellowship program. Either way, all these clinical experiences are indeed an opportunity to network. Now, let's define some of the terminology that you hear throughout this The first one is the concept of observerships. An Observership is basically a clinical experience where you're learning about the specialty without hands on work. An Externship is similar to an Observership, but the difference being that you have hands on experience. A clinical rotation is reserved for current medical students, typically part of the medical curriculum. Clinical rotations can be core rotations or elective rotations. Core rotations are mandatory primary rotations that all students are expected to complete. Electives on the other hand, are chosen by the student, based on their desire to match into a certain specialty or to learn about a specific An acting internship, also known as a sub internship, is where a final year medical student participates in an elective rotation at a hospital that has a residency program that they are potentially interested The goal with the Sub-i's, or AI's, are to network your way into getting an interview at that program. So regardless of which one of these you may be working with, the goal is simple. You can network to advance your career through any of these clinical experiences. Yes, any one of I'll show you exactly how you can incorporate these tenets into your lifestyle during your season so that you can make yourself stand You can grasp opportunity for letters of recommendation. You can gain a mentor or find an advisor through the process. US local experience is an opportunity for an experience that becomes your opening statement in your personal statement, right? It's also an opportunity to get known and to be particularly to show your work ethic, to show your preceptors, how competitive you can USD e is important because beyond showing you how the US. System functions, for those of you who moving in from outside of the United States, it's an experience for you to learn how the system here differs from what you're familiar It's an opportunity for you to get your foot in the It's an opportunity for people to see your character, for your supervisors to see your character Believe it or not, a lot of programs are drawn to applicants based on personal experience with them, especially when these applicants have certain red flags in their application. Networking is one thing we're not taught in medical They don't teach us how to put ourselves out there. They don't teach us how to look for a job. But this entire process is a job and I want you to look at it from that perspective. Keep watching. There's a lot to uncover in regards to networking, and I'm here to show you exactly how.

Networking. So what is networking? Let's start Networking is basically the exchange of information or services amongst individuals, groups, or institutions. It's specifically for cultivating productive relationships for employment. That's a definition you find when you put that in Google. The reason I brought this definition is because I want you to remember that networking is about cultivating relationships So you're not going to network by sending an attending physician a direct message on Instagram or other social media and say, hey, can you be my mentor? Right. That's not The chances are, they are likely to say 'Yes', because there has been no preexisting relationship between both of Over the course of three or four months. If you have been communicating via Med, Twitter or some of these other social media platforms with an. Attending physician. What happens is maybe you're building some type of Internet relationship with that person so they know about you. And at the time you come forward to ask for opportunity to shadow or observe with them, then there's been at least some preexisting communication or preexisting networking relationship between you So the goal at this point with your networking is always about building a productive relationship that can lead to employment. Or at least it would lead you and provide you with things that are beneficial for your future employment. In our setting as IMGs, that may mean obtaining a letter of recommendation after we've worked with them in a shadowing observership or clinical opportunity. It may lead to an observership opportunity. It could be remembering that the number one reason is always really to benefit your future attainment of employment, which is residency. So networking in the marketplace for business people remains the number one cause for job attainment. If you look at every company across the world, but this is really how people that have one or two interviews end up matching. So I am just one or two interviews end up matching because they're able to I'll tell you right now, I got my opportunity into residency by networking as So that's why I firmly believe that the type of relationships that you're building are so vital in this So some of your communication could evolve around questions, right? Like, what are requirements for residency? What do I need to do to be competitive enough to be a part of your program? And so on and so forth. Whether that's by email, by phone calls, or when you meet them at conferences, if you know a resident at a program, reaching out to them and establishing relationship with them gives you a little bit of insight. How about an attending physician that you may know about or may have a distant relationship Seeking out opportunity with such people would allow you to at least initiate a networking So networking is absolutely vital, even in a medical Everything you do on a rotation, for example, is a part of networking. If you're participating in a clinical rotation right now, that is an opportunity to network. That means the way you show up to work each You show up early, you leave late, you volunteer your time, you're actively participating in clinical work, you're showing interest in your patients, you're asking your attending questions about your and you're building a trusting relationship between yourself and the team members. The way to build likability with people is to connect with them on. Personal level as well as a professional you need to create a connection. As we continue on the networking talk today, I would tell you a little bit about the different types of clinical experiences and how you can still leverage those for networking. Because a very common area that I get questions about is how to make a difference between your clinical experiences or people thinking, if I don't have a sabi, I can't make a good impression, or If I don't have a sabi, that means I don't get the opportunity to get an interview there. But that's a You can get these opportunities even after clinical rotations. Electives, observerships, externships, whatever the case may So rotations are primarily for those enrolled in medical school, but in your fourth year of medical school, you have the opportunity to do electives. If you're a Caribbean medical student, that fourth year is just as important for you. A lot of times, students who are enrolled in European, African, middle Eastern, south American, or Central American schools, they don't have a four year curriculum. Maybe it's a six, seven year curriculum. And so because that's a little bit different, your electives could fall anywhere in the course of that So depending on your academic structure, you can do electives as long as you're enrolled in medical school. So that would mean you have the opportunity to visit the United States for one month and to participate in a rotation at any course of time over your six or seven-year program. For Caribbean medical students, we have our third and fourth year as that window of opportunity. Now, I usually strongly recommend that if you are enrolled in medical school, you attempt to do your clinical work so it counts as an elective, just because that is equally comparative to your American medical student population. When you wait and you graduate, then that puts you in that pocket for observerships and I want you to look up the AMC's website and look at the Visiting Student Learning Opportunity program. Prior to the pandemic, this was a great way for exchanging opportunities for medical students to come into the United States to learn about the US Medical system and take it back to their home country. Participating programs can be found on VSLO, so just look that up. VSLO Visiting Student Learning Opportunities via the so it's an important thing to remember that the rationale for creating these rotations via the VSLO had nothing to do with matching into residency in the United States. It was all about creating exchange learning opportunities between other countries and the United States medical system. So when you do get an opportunity via the VSLO, your intention is never really to migrate into the United States, but it's to gain a learning opportunity. Now, for so many of us watching this, or so many of you, and for you who's particularly sitting at home right now taking this program, your intention is to train here, and that's equally fine as You don't necessarily have to disclose those plans to the person that you're rotating or with the medical association, but you can. I encourage you, however, to especially disclose to your attendings who you're working because your goal, again, is to build relationship with them over a period of time. The reason being you don't want them to be surprised when you come by to get a letter of recommendation, for example, or when you ask for them to proofread your personal statement when the time is right. It is important that I emphasize that the visiting student learning opportunities from the VSLO program of the American Medical Association is a great way for students that are enrolled in foreign medical schools to come into the United States for a month at a time and participate in exchange opportunities to learn from the US system. But that could also be your gateway to asking for a LOR or gaining a relationship with a preceptor that allows them to be the ones to proofread your statement at a later So the pandemic brought about several disruptions to this program, but things are slowly easing I want to encourage you to still look up these programs and ask them if they still have these opportunities open and available. Your school would have to fill out a lot of paperwork on your behalf, but with the backing of your school, you may be the one to open up this door for other future students. I think this is the best way for anyone that's wanting clinical experience. Because you come in as a student, it makes it so much easier. You can interact with patients, you can examine patients, you interact with your attending physicians, you're working within the group, you're meeting other US students, and you're really interacting with them and learning what they are doing differently in preparing for their board exams or even preparing towards residency application. So let's move on to the next thing, which is externships. Externships are rotations that you participate in after you graduate medical And so this is for the person who's already a physician in their home country or has already graduated medical school, and they're in the United States. And so maybe they can no longer have a clinical rotation where they get a grade and it's designated on the transcript. And so you can still participate in clinical rotations under the guise of an It allows you for hands on experience. And so many private practices also do offer externships. They're typically paid opportunities, meaning you pay to get into them. Those sum are also free as you provide a service to that In essence, you're functioning like an intern in residency. So, in this module, at the very end, when you scroll down, you'll find a list of programs that have offered electives externships observerships to IMGs in the This list is not all inclusive, but it's a great place to If you're completely oblivious about where to begin, I strongly recommend that you go through that list and start your search Look each program up on the World Wide Web, things have Programs have closed down, some have opened up. So use Google to your advantage throughout the scores. I strongly recommend that you get familiar with any search engine of your but it's important that you're doing a lot of your own research. Again, this program is for self-starters. It's for people who are ready to take So instead of being to be spoon fed the material, go right now and get Google fingers. Right. So, observerships, you are an observer. A shadower you're looking. You're gaining some amount of knowledge, but you're not participating in hands on experience. So you can talk to the patient, but you probably cannot examine the patient. Some attendees may let you write They may let you shadow in the operating room, they may let you scrub in on cases, but you maybe can't cut, you can't sew, or you can't do anything directly on the There are a lot of legal reasons why that Because the law doesn't allow for an observer to see or touch patients. They have to get medical malpractice insurance to cover every medical student. And so when you come in as an observer, you don't have those same protections. And that's why there's legal parameters about what you can or can't do. So again, if you can do an elective while in medical school, that's always your best bet for hands-on experience. Because even with observerships, you can get letters of recommendation, but it maybe would not speak to your hands-on work, especially if you're going. For surgical specialty or surgical subspecialty. So why the US Local experience and why should you obtain Well, it is a reassurance to your exposure to the US medical system. It speaks to your awareness towards our educational system here. And really, a lot of programs require it. Not all, but So they want to feel programs want to feel their applicants are not oblivious to how medicine operates or to how the culture of medicine is in the For a lot of programs, it's a selling if you have it, especially if they require it of Some programs would ask for a month, some two months, but I've seen on average, some of them ask for three to six months, which is a and some may even ask for up to twelve So it's important that you look at it from a program specific standpoint. So look at each program you're applying into which we'll talk about in module three as to how to find IMG friendly programs and figure out what their requirements But I don't want you to feel discouraged that if you only have one or two that would mean that you would not match. That is not true. I think you still apply anyway, but one you could still match without US local experience. I've had students in my program before who did not have twelve months of experience and still match, or six months even. And with the pandemic there's been an open onslaught of telehealth rotations which have substituted in person experiences. But remember, US local experience can help make up for poor scores. If they get to learn about your work ethic, they get to see how you operate or function in the workplace. If it also helps the program to be reassured that there will be less cultural adaptation needed, especially if you're a non-US IMG. If you're a non-US citizen. Or non-US person. It may open up a door for familiarity to know that you have that experience. It definitely looks good on your CV, and it definitely acts as a point to where when they're reviewing your CV, they can say, oh, this student rotated at Methodist Health downtown, for example. I worked there, I rotated there. And that builds familiarity between you and the reviewer. So those are just some points to consider. The limitations in obtaining these US experiences vary, like I said, for the VSLO program, they may be limited by pandemic related issues or partnerships that are lacking between your primary home institution and that US Medical institution. But I want tell you right now that even if your school doesn't have that existing relationship, you can be the reason that such a relationship is created. You can actually be the one to seek out an observership by yourself. And I'll show you how to do that in this So whatever your credentials are or whatever your credentials that you're seeking out, remember that you don't have to be shy or intimidated throughout this If your school doesn't have opportunity laid out for you can create your own opportunities. That's the whole of creating your own medical success stories. You're stepping out on a limb, and you're creating opportunities when none have previously existed. And that is possible. Other limitations are going to be listed in your notes, in the notes section that you're going to see at the bottom of But I want you to look through the list of programs that have previously offered IMG's US. Clinical experience. A lot of them have cut offs, maybe some with scores. Some with requirements, and each program differs. So there is no umbrella statement as to all programs. There's no such It's important that you read through each single one. Take the put it in a search engine, look them up, and see what their current day requirements I've seen programs that have score requirements that they don't necessarily always honor, because, again, scores are not a universal definition of a student's potential. You may call a program up if you're in the United States. You may say something like, I'm interested in your program. I would like to come by to shadow, to observe, or to participate in an I'm trying to determine if there's the score requirement that I should be aware of before I do What are your requirements? And these are questions that great for the program coordinator to respond Another thing is the limited number of spots that are available. Each of these programs. Sometimes you want to book way ahead of So if you're planning to apply into residency in 2030, this is your cue to start looking at this. Maybe in 2027, right? Give yourself ample time so that you get on the schedule. It's important to start early. If you know you're going to apply the following year, then you want to start now. Now don't wait till the last minute. Every single year I see I'm just do this time and time The other thing to remember is some institutions may require a sponsor, and the sponsor would have to be faculty at that And for you, maybe you do not know anyone in person at that location. But this may be a cue for you to look up the faculty members and see if you can maybe find them through LinkedIn or other professional networking that you can reach out to to ask if they would be to support your application. So the key thing is visit the program look through what they offer, look through their requirements, reach out to their coordinators, and ask specific questions to each of Now, if you do not have any idea as to where to well, start with where you're located, for example, or where you have family ties. So if you're in another locale and you have family ties in another state, that may be where you start your networking because at least you know you have family that you could reside with while you participate in that clinical rotation. Another key thing is you may be surprised to find out that there's other people from your school, your hometown, that are now in faculty at a certain program. That may be a great opportunity to send a cold email. You don't always need to know people when you're That's the point of networking, is you're trying to establish and build and grow relationships. But it's important that you introduce And in this section we're going to have several templates for emails that you can use when you're beginning your networking process and searching for a sponsor. We have provided you email templates so that you can go through them. Not to copy verbatim, but so you can use them as inspiration in drafting your own networking Cold emailing? Yeah, I know it's nerve wracking to think but sometimes you'd be surprised what actually comes out of Another limitation I've seen IMGs deal with is a lack of access to the knowledge as to what programs offer and to what extent that they offer So you're really not going to know unless you reach out to them, communicate with their coordinator, visit their website, or maybe even have a phone call or meet them at a local In the notes, amongst the programs listed, there are some programs, for example in Pennsylvania, have been known to offer specifically an Acculturation program to IMGs. This was actually prior to the pandemic, and since the pandemic came, that halted that program. But you may be surprised that there are other places like So the only way you would know is by doing your research. Another point to consider is HIPAA laws, right? So HIPAA is the Insurance Portability and Accountability which prohibits us as attending physicians to share information with non-healthcare providers. So some of those laws extend across the board, and you are not allowed to talk about your patients outside of the clinical These are things that you should consider because when you're participating in any of these rotations, you will have the same standard as your supervising Another key area is a visa issue. If you're a non-US citizen and you have to obtain a visitors visa to come into the United States to do an observership, sometimes they want you to get your own health insurance, they want you to get your own travel insurance. So there are expenses to consider and there are other types of insurance that could become a burden for the IMG. So the financial cost is another part of the equation. But going through certain proof, dedicated agencies can help you navigate some of these And I'll tell you exactly the agencies that I recommend as a part of this program. So when it comes to what kind of US local experience obtained, the bottom line is you should look for opportunities within academic An academic center is a hospital that is affiliated with a teaching program and they're typically located at a university. You can have an academic center that's part of a university, and then they have affiliate teaching hospitals out of community centers or community So either one of these, in my opinion, are your best bet. You get a better quality of education, you get a better exposure, and you stand a better chance at making a better impression. Lots of vetters So these teaching hospitals are usually IMG-friendly. They're usually aware of having foreign medical graduates or US. Persons who have been to foreign medical institutions as Community based teaching hospitals with affiliations to medical schools are also another great academic opportunity. The reason I emphasize this is your acting internships, your Sub-Is, which is something that a lot of US medical students participate They really pursue at academic medical So, for example, if a US. Medical student is going to pursue ophthalmology, what they'll typically do in the third year is they'll begin to plan for rotation in the fourth year at an academic center that offers a clinical rotation in ophthalmology but also has a residency program so that they can work in that environment and they can be considered an acting intern. So they taking notes and acting like an intern. And the whole goal of that month in that program is to audition for a position or to audition for an So they assess how you behave on the wards, how do you interact with the residents, how you interact with the program director, how you write how you function as an intern. You're not expected to know everything, but you're expected to perform as someone that they're willing to teach in the future. And we'll have a whole separate section on how to impress during clinical rotations or observership and So it's called an addition rotation or a sub-internship because you're working underneath an 'intern' or like, an A lot of fourth-year students leverage even the ones I've taught in the past as part of this program, I've acting internships and sub-internships. It's not a foreign concept to reach out to a program and ask for an opportunity to participate in a sub-internship next that is perfectly okay. By the time they work with you, they would have already had an idea at the end of your three or four-week stint with to know if they like you enough to interview with So that's a key way that American medical students target their because after spending a month there, then they only have to apply to few programs because they've had four or five of and so they know they have four or five solid which one or two are definitely going to rank them So let's pivot into how to find us clinical experience.

In this section, I'll teach you how to find US clinical experience on your So in the prior sections we've talked about USCE in general and the value of that at networking at conferences. But getting clinical experience on your own is a hot topic because usually it involves a lower cost to you and you don't have to pay for most of these opportunities, but they're few and far between and there are multiple paid options on the Internet. And I go over that extensively with an agency, which we'll talk about at another time. But today I really want us to focus on how you can start this process on your own, what you can do differently, how you can navigate it on your own. I know it's scary to think about it from the get but I must acknowledge, however, that it was a lot easier prior to the pandemic that hit in 2020 because there were less restrictions and hospitals were open and things were just less restricted. And now. Since ever. 2020 There's been more restrictions, but things are opening up a little bit more to where you can gain some of these experiences again. So instead of going to an agency, you can network on your own to find these experiences. And really what that means is you have to do all the work. And I'm here to show you exactly how to do it. It's so simple, you will not even believe So first off, you have to start off with the location that you're interested And oftentimes you may want to use a website such as FREIDA or any online website. Doximity offers a list of residency programs and even just a Google search. Okay? Or you may use a paid program that allows you to obtain a list of residency programs in a certain location if you're not familiar, like Match a So what that means is we'll start with the alphabetical order. So you're looking at Alabama, for example. And you're saying, what are the residency programs in Alabama? And you go to FREIDA Online, which is a part of the American Medical Association's website, and they have a list of residency programs in each state. And so you start off by pulling that out and say, okay, in Alabama, how many residency programs are there for Neurology? Because that's what I'm interested in. And you can apply this to any program and any specialty. And so you pull up the list of Neurology programs in Alabama, and you have a list of, let's just say, hypothetically, there could be 15 The next step would be your take to research the contact information for that program. By inputting that name of program from FREIDA into Google, you can search and find where that program is located, what their contact information is, who the residency coordinator and then the follow up step from that is, utilizing one of the templates that we have here. In the course form in the course portal for to email these programs, asking for opportunity to rotate with It's that easy. It is literally that easy. That's how I did it back when I applied into getting AI at the Cook County Hospital. But you can do it. And I've had many of my students this formula in so many different ways and it's literally that easy. So first thing you pick up a specialty, the next thing you pick up a location. And you can start with the alphabet from A to Z. Then the third thing you're going to do is you find the hospitals in that location that have residency programs by using free search in like American Medical Association Frida Online, which is Freida Online. Doximity also offers a list like that. And there are so many websites now that would make you pay for a list like that as well. So just match your resident and that's up to you if you choose to use that. You can, however, get a code called IMGRoadmap15, to get a percentage of your purchase. But you gather your specialty of interest, your location, and then you look up the programs. And then you email, cold email each individual program and you're emailing them, asking specifically for opportunity to rotate with If you're a student, you could ask for an opportunity for an elective rotation. If you're a graduate, you may ask an opportunity for observership. I must, however, warn you, though, you will get several no's, you will get many rejections, but that should not stop you from continuing on. Just to give you an example, on average, if you contact about 100 places, 100 programs, you may only get five to ten approvals, if any. And you can make this you can expand this across all different specialties and use this process, whether it's for pathology, whether it's for a surgical specialty or a medical specialty. But that is you putting yourself out there and seeking opportunities to network in person. I hope you give it a try and do let me know how that works out for you.

So on How to Find Clinical Experience in the United States the first drawback is that programs change each year. So what you may have found last year may not be available this year or the following year. Or new programs may sprout up over time. So I want you to start by using the list that's included in this module in the notes section, but use it only as a Nothing is guaranteed, especially following the changes related to You can use this list to start your search depending on your specialty of interest. However, you can also initiate a local search without a list like So hypothetically, let's say you have family in Wyoming or you are located in Wyoming. You can start off by just looking up the hospitals in your area. And once you find a list of the hospital hospitals in your area, then you can start by contacting some of the physicians listed on that hospital site, or if the hospital has a designated. Or volunteer office. You can reach out to them to ask for opportunities to volunteer or shadow a physician. I've had many students reach out to me that way, and there's never any offense with doing I want you to ditch that negative self talk that's telling you nobody wants to hear from you, nobody cares about you, nobody wants to listen to what you have to say. But I want you to get on Google and start your Hospitals in my zip code could be what you start off with, and that zip code number could be whatever five digits are for you. And when you look at their website, you're looking to see they have a graduate medical education site or any kind of visitor or volunteer The volunteer program could be one way that you get to volunteer at the hospital, so it allows you to set foot in the hospital, meet the officials there, and then maybe see what opportunities you can create for yourself. This brings us to the end of this first section on networking. But I'll see you in. The next section on networking where we will be talking about networking at conferences.

How to network at medical conferences. So back to how to find US clinical experience. But now we're going to talk about networking at medical conferences. So hear me out. You may be wondering how, where, or why, right? But clinical rotation, clinical rotations are a good way to network because it gives you, you know, a whole month with a physician and a program and allows them to really get to know you on a personal and professional level. And I'll tell you a story from when I was in medical school. I went to a Caribbean medical school, right? So in my third year, I was in the Chicago area, and I realized that I wanted to do pediatrics at the And so I applied by emailing the Cook County Hospital and their academic division and asking about how to get a rotation at their hospital. My intention was for it to be an acting internship, but I just asked for. Rotation in pediatrics. The only person that I looked up and found was the program director that was Heme Onc physician hematology oncology pediatrician. And I decided that's who I wanted to work with, right? So I was like, I want to rotate on the Heme Onc And my whole point was I wanted to be as close to the decision makers as possible so I could meet with them and network with them. And I thought, if I'm going to be a pediatrician and I'm going to train at Cook County, well, I want the program director to be able to assess my work ethic and like me enough to give me an interview. At the time, the truth is, I wasn't convinced on peds. I wanted IM as well, but the IMdepartment didn't have any opportunities for shadowing or networking or rotations for And so I think they were all booked up and such, so I had to go with the next best thing, which was the Ped's option. So while I was there, I gave him my best. I showed up early. And I asked for opportunity to work on actually, I got an opportunity to work on a research project as a facilitator in the internal medicine department. It was a volunteer opportunity just by speaking with people and really kind of trying to figure out what projects were ongoing that I could participate in. So I was asking if the residents were needing help. I was looking for ways to help. I was that person that walk into the room after the residents have seen the patient and counsel the patients on fecal immunochemical testing for colon cancer screening. Right. That was my work as a research facilitator, was getting people enrolled into our small scale study that they were doing. I was just actually a helper in But again, I was able to put that research experience on my application that I worked as a research facilitator. It even though I couldn't take credit for the final paper because I was never included in it and I didn't do any work on that But I could say I gained two things from that experience. One, working. With the I think it was the assistant program director, not the PD, and then also being able to gain this other experience over in the Department of Internal Medicine as a research facilitator. And so I remember towards the end of my rotation, the assistant PD called me to the and she asked me if I had decided on what I was going to do, because she'll be very happy to interview me for a position at her program. And it literally close as it comes to having sort of a pre match offer in my lap, where you're being told by assistant PD that they like, you right, and mark you. I had a 198 on step one, so they hadn't even seen my score at that point. And it was just a matter how dedicated I showed up to work every day. and how much I put my foot forward. I obviously did not take on that offer. I instead asked her to put in a word for me in internal medicine. Throughout that month, I actually realized that peds was not for And she did say, yeah, she was going to try to put in a word for me in the department of internal medicine. Long story short, I never heard back from the internal medicine department I applied to I am an both and ended up matching in FM in Kentucky. So the point I share that story is I know we're talking about net working at conferences today, but I share that story with you because I want you to know that you can network wherever you're at, whether it's a rotation, a volunteer experience, it's all about your personal interaction. Remember that definition for networking your interaction with the association and those affiliated with in an attempt to advance your So if you are interested in whatever specialty, you should become a member of the association of that specialty. So for pediatricians or those with interest in Pediatrics, you may want to become a member of the American Association of Pediatrics, If you're interested in family medicine, you may want to become a member of the American Association of Family Physicians. If you are interested in IM, that may be American College of Physicians. If you're interested in surgery, that could be American College of But being a member gives you so much inside information that you would not otherwise So what does membership offer you? One, you get on the listserv of programs, on the listserv of the association, I should and that allows you to get information of upcoming events that you could potentially participate Two, you get information as to conferences when those are scheduled for a year or so in advance so that you can prepare your posters, presentations, like we talk about in the research section that you'll be able to submit for publication. Matter of fact, the other day I just got a message from one my students. In this program who had just received her approval for publication in a Pulmonology So the whole point of being a member is just not to say you are a member on your final eras application, but it's so that you can begin to provided information by virtue of being on that listserv regarding opportunity for local conferences and meetings which are networking opportunities for you. Also, you get the opportunity to learn about where you could present a poster or presentation or where you could become a member or participate as a member in an in person meeting. I know, for example, the AFP has a Kansas City meeting once a year where they bring together students who are interested in family medicine. They don't typically accept graduates, but they have students who come together and they learn. family medicine programs across the country, and they get to meet faculty members at that meeting. And that's become a great area where a lot of students are meeting potential residency programs, ready to interview And I'm talking without scores, okay? Nobody's asking for your board exam scores at that point. This is you just showcasing yourself to programs at such So if you're interested in getting with the American college of surgeons would allow you to know when is the annual meeting? When are they accepting abstracts? What abstracts can I submit, and how can I be a member there? How can I show up there? That's a great place that students, even residents and fellows, go to network. And that's where a lot of people meet other future mentors, employers, recruiters, and they build their careers based on in person meetings at conferences. Student prices for these conferences are often lower than the attend. Rates or the resident rate. And so don't be shy. Don't feel like you may not stand a chance. Your Caribbean medical school student. Go for it. Present a poster. Even if you're a student in a foreign country and you've done a poster that you presented in your local country, you can still take your poster and submit it to this new conference and present it there. So that's how you can participate in a conference for free is by having a poster. Because once you do a poster submission and they agree, then you get to participate in the conference for free. Your lodging is paid for. Oftentimes your presence at the conference is free. But if not, you have to pay a student fee. And student fees are often highly discounted. If you're going to require a visa to attend a conference, whatever the case may be, whether it's a B1 or B2, then you want to your planning process way ahead of time so that your visa can be issued prior to the conference. That way, you're here in person in the United States to present your post or your case report or your original research paper. So speak with your attendings at your medical schools. For those of you in Caribbean medical schools, speak to your prior alumni, graduate from your schools. Talk to them because they have conferences that they've presented at that you may not be aware Speak with them and ask, hey, where did you present? Did you ever go to conference? How did you do research? What kind of research did you do so that you can replicate from their examples? So, another thing we talked about throughout this program, obviously, PubMed or indexed publications are highly regarded, but smaller scale online publications StatPearls and the likes of are other ways that you can get your name out there in the world publications. So. You know, getting to the conference, that's just the first Once you're at the conference in person, then you have to meet people. You know, sometimes people make business cards. Don't be so fixated on what your business cards look like. I mean, half the time, most people don't even look at business cards anymore. You really want to talk to people and interact. Talk to faculty, to chief residents, to residents, to program coordinators. Go to the exhibition That's where all the pharmaceutical companies, the drug companies, the drug reps, and the residency program station themselves. They're usually open for interaction. Walk up to their tables, to their collect their information, ask them questions, engage them in conversation. Your goal will be to go to each table of each residency program that's there present that day and engage them in conversation. That's the point of building likability. You smile, you maintain eye contact. You ask open ended questions so that they can. Give you a response And in this module we have a separate section, one of our bonuses, which are questions that you can ask program directors at conferences. Again, these are templates that we're providing for you that you can use to initiate conversation, especially if you feel like you get tongue tied or you're not sure what you're going to say. I've been to many medical conferences where I've met medical students in the exhibition hall, networking meeting programs, exchanging email information and following up afterwards. And that's how they get invited for rotations, electives, observerships and So what I would do is present myself to the conference. I will print out the questions I can ask a program director from bonus section of this course, and take that with me to the exhibition hall so that I can pinpoint one or two talking points to start up conversation. Another thing you can do. Is, before you go to a conference, you look who the sponsors, the exhibition hall members are, and you can know exactly what programs will be there in person. Research the programs ahead of time, make little cliff about what their score requirements are, what their entry requirements are, visa versus non visa, IMG versus non IMG friendly. And even the whole concept of IMG friend is very fluid. So don't let that stop you. Don't let that be a hindrance. You could be the first IMG at that program. So I would typically present myself to each table and say, hello, I am Nina Lum. I'm a third year or fourth year medical student or a graduate of such and such medical foreign school. I currently reside in Virginia. I'm really interested in learning about, you know, what your program has to offer. I looked you I found this particular item about your program that sparked my interest, and I pull up. Notebook and I say, I read that here are your requirements. But I have this specific question because I have this and this and this as far as meeting your requirements, but I'm lacking in this aspect. Are there any recommendations that you have for me today that I can use to overcome that? Because I'm fairly interested in your program and that allows that coordinator Chief Resident Program Director to tell you specifically what they're looking for and what you can do as an individual to change the course of events for yourself so you can ask to communicate with them afterwards. How can I keep in contact with you about an Observership in the future? Is it possible for me to come visit the program? Asking such open ended question allows them to give you yes or no answers, but to also to expand on what they're looking And if nothing comes out of this and they say no, we're not interested in having. Which would be really odd. They would never say anything like that. But if nothing comes out of it, at least you have built the fortitude, the mental fortitude of reaching out to people who you're not previously familiar But I bet you through these interactions and after coaching hundreds of IMGs that have been through these interactions, you may contact 10, 15 programs or reach out to a set number our program, and end up with a small pool that accepts you. But that's all you So you may start off by choosing to just create a poster, an abstract for your original research and taking it to a conference. And that's usually a great way, because that could be something that you can talk about. But you have to do your research before presenting yourself to a conference. And more notes. In the bottom this module, we have the notes that you can use to initiate or spark conversation. So does templates for So some key points to remember and you can do this for any medical conference. One, you want to, first, be a member of that society organization. Two, you want to incorporate some of the techniques, the networking. Three, you want to make sure you have open ended questions for faculty there. Four, you want to be engaging, you want to smile. You want to bring something to the table, whether that is talking about your publication or your poster that you're here to present. But in all, remember, it's all about building professional relationships that will last beyond the conference, so that you can take that the next step and ask for an opportunity to observe. You can ask for an opportunity to visit, an opportunity to do an AI, an elective or rotation. I'll also have a separate section with. One organization that I've partnered where we will share about some elective opportunities and rotation opportunities that you can get. And stay tuned for that because it would be in this module section as well

Welcome to the section on telehealth or telemedicine So I know a lot of you have questions because I get this all the time. I am just want to know if telehealth rotations are worth the time, the money or the Are they worth the quality? I know that's a big question. You another one I hear all the time is do programs really care about telehealth rotations? So let me give you some perspective right now in the United States, a majority of outpatient visits are still happening virtually. Now, does that mean in person visits no longer occur? No, we have both virtual and in person visits. I was actually trying to get a primary care appointment the other day and every option I had available to me was That means telehealth is becoming the mainstay for non urgent, non surgical, non procedural So what does that mean? If a visit can be done virtually, it is being done virtually, meaning telemedicine is definitely here to stay. And it's the future for some specialties and even for some of our So the way that you learn about medicine will also That means if we were often delivering health care in person, and now we're delivering it virtually, then academics is shifting as Programs are still in that preliminary phase of coming into the new normal ever since the pandemic and determining how much of it is here to So the programs that will care about your telehealth rotations is really not about the fact that it's a telehealth rotation. It's about what you obtain from So it really depends on the program and the specialty. I'll tell you right now, surgical specialties, there's really no benefit in a telehealth rotation, in my because there's no opportunity for them to sort measure or define your dexterity, your fine motor skills, your procedural skills, or how you perform under pressure through a telehealth platform. It is really great for. Specialties that require more conversational tap encounters, such as building a long term patient doctoral relationship or performing a virtual examination. And by all means, those are the specialties that will value telehealth's rotation. So what do I mean by For example, when you look at specialties that will be great for telehealth, that's radiology, maybe not the interventional radiologist, maybe not the breast radiologist, but the diagnostic radiologist could work virtually. So doing a virtual diagnostic radiology rotation very easily understandable, psychiatry will be another where you need to have a conversation with the physician, and you can do that virtually just as much as in person. You can do interpretation of images virtually with diagnostic radiology, but maybe you can't perform a biopsy virtually, and you have to see the patient in person. So those are the only nuances when it comes to telemedicine versus in person. And so that transfers as into your process. Into residency. When you're seeking us clinical experience, there are certain primary care specialties where you can perform well child not well, maybe not well child visits, but certain primary care encounters can be performed virtually, and others that require an in person examination. So IM, FM, PEDs are great specialties where you can substitute one elective here and there, one rotation here and there with an with a virtual rotation by all means. In person still trumps virtual. In person is always going to be better than virtual. But in the event where you can't afford to have an in person rotation, you can still get a telehealth rotation in some select specialties now rotations where I would say don't bother with telehealth to be orthopedic surgery because there's no surgery you can do on the internet, right? General surgery. Any surgical field that requires hands on that requires assessment of your dexterity. Of your fine motor skills. You have to cut a patient, or you have to sew anything back up. You're just not getting that assessment done accurately on a virtual platform. So it may be not 100% beneficial for the surgical aspirant if you're aspiring for a surgical position, that may not be beneficial for you to do a telehealth rotation per se, but if you're looking at a primary care specialty like we've mentioned, psych, radiology, diagnostic, that it may be a place to So there's a little bit of a caveat, too, that there are ways that you can leverage these telehealth opportunities, because even if it's a telehealth opportunity, you can still get a letter of recommendation from You can still build relationship and have someone that can proofread your application or even be a sponsor for you and given a word on your behalf to a program that they're affiliated with. So building relationships is a really good goal to have. Beyond just getting an LoR. You're building long lasting relationships that can carry on even into residency. And even when you go into the workforce, that person becomes your colleague, even though they were once your preceptor. So it's important that you remember that telehealth rotations can still be beneficial for your LoR. Now, I get this question often from IMGs, who ask me, if I did a telehealth rotation and I get an LoR from it, is that regarded as high as maybe if I did it in person? I don't think that that matters whether you got your Lor from telehealth or in person, as much as what matters is the content of the LoR. And I'll talk about that in depth in the module on letters of recommendations. So stay tuned for that module, because that's important. You need to know what kinds of letters matter, and I will tell you right now, the content of your letter letter would always trump the context of your So if your letter obtained from a telehealth rotation and the content of that letter. Speaks to you and your personal attributes and your workplace ethic. It's way better than an in person rotation where you get a generic, you know, you get a generic LoR. So telehealth rotations can also be a networking opportunity, all right? You get to meet with the physician virtually. You may meet other students on that network as well who are rotating with you, who could become study buddies as There are several other things you can get from it. You can also get a poster presentation from a telehealth rotation. You could be able to do a presentation on a virtual case that you saw. There are so many ways you can leverage without necessarily have to be point of contention. A case presentation that can be done virtually, maybe an oral presentation as well. You could present virtually at a conference, so you're not there in person, but you're able to project into a meeting. There's an All things that you could later on present on your eras form as I teach you in module seven. So how can you make the best of your telehealth rotation? You do the same things that you would do in person. You show up early, you'll be interested, you'll be engaged, you'll participate. You can gain mentorship through the supervising physician that you work on under or the sponsor. That person may put in a word on your behalf to a program that they may be affiliated Again, these are all opportunities that you have to explore and you have to be in a position to want to explore So you may not know whether they're going to give you an LoR right off the bat or not, but that's something that you should ask prior to completing or even securing that elective, is you want to ensure that this is a rotation that they'll feel comfortable providing you an LoR. Otherwise you don't want to invest your time, effort and money into that and not be able to gain a letter of recommendation afterwards. And these are questions that are fair to ask. You can ask the agency you're working with or the coordinator you're working whether this is a potential now, at the end of the rotation, depending on your performance, the physician may decide whether or not to support your application for residency with the But at least you should be able to know if there's a possibility of that occurring at least prior to going in to do the rotation. So remember that virtual medicine is here to stay and programs are conforming to that as well. They're seeing patients virtually and they will acknowledge your virtual experiences as Remember that interviews have been done virtually since 2020 because of the pandemic as well. And so a lot of students are finding themselves interviewing for residency from across the So in that direction of change, I expect that this is an area of opportunity that healthcare is leveraging. And so you should as My bottom line is do not disregard telehealth rotations, especially if that's the only experience that you're able to lay hands I'll see you in the next section where we'll speak about research.

So let's talk about research. How should IMGs approach research? This is a big topic, and the first question I get is, is research even mandatory for getting into residency? Well, the short answer is research is not mandatory. But we know research has been shown to provide a competitive especially within specialties that esteem research that highly so in specialties such as orthopedic surgery, plastic surgery. They have put themselves down to say we want students that have fundamental research experience, the key word being Historically, we've seen that happen where the majority of people that match into those specialties tend to have some kind of dedicated, true bench research background. I'm talking about people who've taken time off for a year to do Research fellowship. They've actually participated in Irv protocols, PubMed, indexed research, high quality randomized clinical control trials. Okay, so not every IMG is going to have that opportunity to have true scientific research, right? But your ERAS allows for you to have a list of scholarly activities that you can share on your Eras form, which we talk about in module seven. So for the purpose of research, we're going to talk about not so much the large scale randomized control trial research that everybody seeks to obtain, but we'll talk about the small scale So I read this from The Successful Matchbook, and it says, in order to be a research sure, you have to be a self starter. And the research heavy specialties are usually ENT plastics, ortho, ophthalmology and surgery. These are the specialties. Where if you're applying into these and you want to be a competitive applicant, you want your application to be looked upon and you want to get called back for an interview, then you need to have some amount of research for Otherwise you may be tossed to the side. So you need to remember your application is being compared to your American medical students, right? So unless you're coming from a background that's research heavy, you may not up already have enough to compete with them, right? So maybe if you're a researcher in your home country and you've done some amount of research in medicine, then that could be to your advantage because you can list that research work on your ERAS CV. So we're saying that several American medical graduates are going into those specialties that I listed. They have some amount of research and they know about the need to have that, so they start working on that way early in their process. They're not waiting till the end to make it Right? So they're being from 1st, 2nd. Year to start preparing and getting them competitive for that process when it's their turn to apply into residency. Now, what if you cannot find that opportunity, that institutional backup, which is a huge hindrance. One of the key hindrances that I just experienced is we don't have the institutional backup to get that randomized control trial published or to get a PubMed indexed paper published. And so we have to seek it out on our Yes. If you put two IMG side by side compared to one another, and one person has their they have the same scores, they have the same or, similar personal statements, similar clinical experience, and one has research and the other doesn't, the one with research definitely appears more competitive than the other counterpart. That's just a given. We're in a highly academic society in medicine, in, and we revere research. Why? Because research means that we're innovative enough to ask pertinent clinical questions or try to. Answer pertinent clinical questions that can change the landscape of healthcare. So if you want to have a compelling application, you want to increase your competitiveness, then you want to consider some level of research. So what programs want research and what programs don't want research? Well, that's a requirement that is actually program specific, so no one can predict what program is going to want your research versus when you do. Look at the NRMP score or the NRMP data papers that they produce each year, and they give you an average of the number of research papers that match versus unmatched applicants have for each cycle. From my extrapolation, the average is about two to three. So you have some applicants that come in with a portfolio of 10, 15, 20 papers, but on average, most people end up having two to what I want to encourage you to do today is if you cannot get the PubMed, PubMed indexed publication or a randomized control trial maybe consider other smaller scale online publications, case reports, poster presentations, scientific monographs, metaanalysis, and things that you can create on your own, even without having proper institutional backup. The other misconception that I see in our community is we think we must be the first author for our research to be valuable for residents application. But that is just fundamentally untrue because you're not expected to be a key researcher at this stage in your career. Remember, application is ideally meant for fourth year medical students. So the expectation is, over the course of your career, as you evolve, as you grow, you will become more and more. Of a researcher and produce more higher quality studies. What programs are really looking for is they want to know that you have a fundamental understanding of reading and understanding and comprehending the value of research in So they just need to know that you have an understanding of interpreting and making deductions based on research papers. They need to know that you have an inclination for evidencebased medicine. That you know how to apply scientific material in the direct care of your patients. That even though you may not find it as a hard stop requirement on your website, having research on your portfolio does improve your competitiveness. When you can say I have on the back end. Been working on getting answers to certain healthcare questions that we And so research is bringing answers to clinicians. At the bedside. And so when a program sees you the applicant that does some amount of that, it makes you look competitive. Now, there are other programs that do not even participate in research during the residency and so they may not be keen on you having research as a hard stop requirement, but it's always an appealing factor. and if for nothing you do not want your ERAS application to miss a whole portion at the very end where they ask for publications and research, you don't want to leave that empty. But again, depending on what program you're applying into and what specialty you're applying into, they're not all made Academic institutions, highly Ivy League institutions are going to value research a lot differently from community programs. Smaller role programs are going to value research a little bit. than your larger academic institutions based out of university Most of the best papers that we read in medicine come out of your highly ranked academic institutions. And so by virtue of that, they're looking for people that will come into the program and continue to foster that material and continue to produce more and more of that They want people that will grow in reputation and advance the specialty through research and publications. So if you're going for a very competitive residency program, then you want to be the one to produce indexed papers, PubMed approved papers, peer reviewed papers, and peer reviews huge in the academic because that means you've been approved by members of that same specialty So some of them do emphasize research, especially if they're heavily focused on academics. And I'll say that and say that again, because depending on where you're going. You may need more research than other but if you're focusing on rural programs, smaller skill programs, then you may be able to get by with a case report, two case reports, some oral presentations, some podium presentations, some online publications in less revered journals that may take you somewhere. Depending on where you're going, you will notice that maybe you, University of XYZ may have a higher propensity for taking IMGs who have research experience compared to St. Mercy Hospital down the road, right? So each program values it differently and therefore we cannot give you a hard stop to say. You must have five published research papers that are peer reviewed versus two oral presentations versus It varies, from program to program. But I think ultimately as an international medical graduate, as I read once before in the book The Successful. to be a researcher, you need to be a selfstarter. You need to be innovative to be able to how can I create an answer to a problem that I'm facing today or that we're seeing in the workplace as it is right That's the bottom line. Because if you're not able to step out and ask those critical questions, then who will? And no one's going to give you a research idea unless you hop in on someone else's research that they're already doing. But what you could do is you can focus on creating questions that you believe you can get answers to and create a small scale work for scholarly activity that you can put on your eras application that will be better than having nothing else on it because you couldn't get reviewed. Publication. It's an added edge. It improves your competitiveness and it helps you be innovative. And so I call some of that clinical work, which is clinical scholarly activity, which is very different from basic science research or benz research or clinical research that requires it's, cumbersome, requires IRB approval, requires peer review, and oftentimes doesn't get accepted in several major journals. Now, if you can get that and you participate in clinical trials and you already do that kind of work, that's great. Keep with it because that is obviously our highest quality material comes from clinical But easier targets could be poster presentations. Those are easy to because it could be a poster in a case that you saw during a clinical rotation. If I was interested in neurology, for example, and I was participating at a certain hospital and I had a patient who had a neurological complication of a certain disease, maybe they were infected with the coronavirus and ended up with some neurological sequelae that has not been well defined in the literature. That may be an opportunity to create a case report. That case report can later on translate into a poster presentation at a which is what a lot of third and fourth year medical students at American medical schools do. And your poster could focus on walking through the path of physiology, the presentation of the patient, your interventions, and your That's a very easy way to get started is with poster presentations.

So the reason research is important is on your ERAS application, and we'll talk about this in module seven in detail. You'll see a sample ERAS application, and on there you'll notice that there's a second section under Research and Publication that allows you to put the types of poster presentations where you presented them, the title, the meeting, and so And so, even if you cannot obtain these large basic science research, randomized controlled trials, PubMed publications, that's another important area that you can target and get activity that you can include under those sections. So it doesn't always have to be within the States as well. You can do your poster clinical presentation wherever you're located, in Europe, South America, in Africa, Asia, the Caribbean. The key is that you are actively involved in research. I get this question all the time. We think that the research must only be within the United States. Yes, if it's within the United States, it's understandable people can relate with it. But if you're answering clinical questions in another country and still getting publications and published in that country, then you still have the experience, and that's fundamentally what they're looking for. So things that do make applicants competitive certainly incorporates research Oral presentations are another easy target that an IMG can obtain. Now, the misconception is we want to go right about the oral presentations that we did while we were on the wards. That's not what they're asking for. That's part of your usual day to day work. But if you present at grand rounds or you present on the research day at your hospital and you do oral presentation in front of the entire medical school or the entire medical society, a noon conference where you are presenting to a faculty group or those of you who did thesis as part of your medical graduation requirement. Those are aspects that can be included in your final ERAS as an oral presentation. So on your day to day life, as you're on the ward rotating, I want you to think about cases that you can write a case report about or opportunity where you can opt to present at Grand with case reports as well. You can form a poster out of a case report, or you can actually present an oral presentation at a conference on a poster that you previously created. oral presentations from the very get go was really meant. For podium presentations that are done at conferences and that's what that area of the application typically was asking for. But over time, things have evolved and students started to represent other kinds of oral presentations on their application. I think that's fair. So when you're looking at an oral presentation, you want to be able to create some type of analysis or a synopsis of case and then the lesson learned and the outcome that you're expecting and that's what you're sharing with public or the crowd that you're presenting Another way is during your rotations and your observerships, you can ask for opportunity to present and talk to the preceptors. They typically know what's happening in the local area. They'll be aware of opportunity for publications and presentations and such. So do speak to them, because you'll be surprised what your attendings have as information that you may not be privy to. I've had students walk up to me and ask hey, can I write a case report on a case that we saw on the wards? And the answer is always a yes. So when you're rotating with the physician, if it's an observership or elective or rotation, take the challenge. When you see an interesting case, ask them for the opportunity to be able to present that case or to write a poster or a presentation on that so that you can present it at a The benefit of this is your attending can become a co- author on that project, even though you end up working on it alone. And they may be privy to other journals where you can submit your abstract or your work to for publication. So you may also have the opportunity to work with a group of friends. So if you're in the live portion of this course where we're having breakout sessions and we're working together, you may gather with a group of IMGs and work on a paper together. There are several ways you can do a metaanalysis using past data. You could do a clinical review on a subject. There are little arenas, a smaller scale arenas to publish, such as with, StatPearls or Cureus. C-U-R-E-U-S. Even if you're in the process of working on something that's yet to be published and has not been approved, there's an area for that on My ERAS where you can put that in as a paper that is yet to be published or has been published online, maybe not in Peer reviewed publications are obviously the ultimate type of papers that you want to publish. But you also have an opportunity to do a peer review online publication as opposed to a peer review in print publication. The key with the peer review paper is it's been reviewed by peers of the same specialty. So it has more credibility, ability. It's likely to make it into higher tier journals, it's more rigorous to come up but just a run through all I've told you. We've talked about case presentations, poster presentations, oral presentations, case writing, case summaries, peer reviewed publications, and online peer reviewed material that has not yet been All of these are attainable while you're on a rotation, an observership, an acting internship, or an externship in order to improve your competitiveness into residency. what does this mean? Means right now, I want you to start asking yourself this question which one of these can create readily, realistically, in the next one to three Maybe for you it would be a poster presentation. Maybe for the next person it would be a case presentation. But I want you to think of one case that you've seen over the course of the last month that you can write a case presentation or a poster And I want you to prepare that or start preparing and it's as easy as, again, another Google search. How to create a case presentation, how to create a poster presentation. And there's a lot of free material on there that you can study from or even visiting your medical school library and learning about. The bottom line is, when the time comes for you to fill out the ERAS form, I want you to be able to have some scholarly work that you can include on your ERAS form that does in this show how you are a self starter. Because even if you didn't have the institutional backup of your program to create evidence based research or clinical trial, for example, you have easily been able to produce two or three case reports that went on to be posters, that went on to be oral presentations or podium presentations. And that's it. That would be a place to start. Now, does everyone need to be a researcher? The answer is Some of us don't have interest in clinical research, and some of us You just need to be able to show that you have work within your specialty and you have an understanding of basic clinical research. You need to be able to show that you have an understanding of what a clinical paper looks like and how you can make deductions from And the best way to prove that to a program is by actually producing one of your And that brings me to the end of this section on teaching you about the research that matters for your ERAS application. I hope you join us in person in the live section of this course so that we can do some one on one work together.

All right, how to find a mentor as an img. Let's get into it. So a mentor is an experienced and trusted advisor, someone who shares similar goals or professional career interest as you do. So in this pathway, because we're talking about getting to residency, you're looking at someone that is in residency, recently matched into residency, or is, has already graduated residency, is a fellow, or even better if they are in academics, as a attending position and making decisions about who comes into a residency program. So it's important we talk about the difference between a mentor and a sponsor. A mentor obviously gives you guidance, they give you advice, they give you recommendations, usually their experience in the field of your interests. Right. A sponsor, on the other hand, may not necessarily always give you guidance and direction, but they advocate on behalf of you. Meaning a sponsor is the kind of person who gets you an interview invitation. A sponsor is the kind of person who talks to another program director on your behalf. They may not necessarily review your application, they may not review your personal statement, they may not advise your path, but they advocate for you. Meaning they represent you or they present you in front of programs. A sponsor may help you get interviews. A sponsor may help you secure a match after an interview by putting in a word on your behalf. There are few and far between to find, but there are a few of them out there. So it's important you know the difference between both. Now, who can mentor you on your journey to residency? I believe that one of the key areas that we make a mistake as IMG Is focusing on one mentor when we could have a variety. So with who can get you into residency or who can mentor you. Literally, it could be an IMG who has graduated residency, an IMG who is newly minted into residency. Anyone from a PGY1 to a PGY5 or 7. It could be a physician who's already in practice. It could be a physician who is in practice at a residency program, a program director. There's so many options. And we'll talk about how to divide and conquer today. So there's cold lead mentorship and there's warm lead mentorship. Cold lead mentorship means you are requesting mentorship of someone who has no pre existing knowledge of who you are. So you do not know them, they don't know you. There's no pre existing knowledge either one of you by both parties. Often cold lead mentorship starts off by emailing or social networking. So Qmed, Twitter, right? This is where LinkedIn comes into play, where you are seeking Mentorship based on your search of someone in your geographic location that meets the criteria of being a physician in practice, a resident in practice, and so Right? Warm lead mentorship could be different. The warm part there means you know something about this person, that person may know something about you. Right? So they're alumni from your medical school. They are faculty members that you may be rotated with when you were a third or fourth year medical student and now you're a graduate. They're friends, people you rotated with and who matched. And maybe you didn't right? Or their family members or friends of family members or physicians that you know, people who know them, so they introduce you to So either way that it goes, it doesn't matter if it's a cold or warm lead. The most important thing is that you're able to get your one question answered by them or your one outcome that you desire in that relationship. All right, so co lead mentorship could be from any residents that are in the specialty of your interest. Maybe you find them through Med Twitter or through LinkedIn or Instagram or Facebook. Right. Attending physicians, alumni from your medical school who may not have heard about you, but because you're both from the same medical school, that becomes your opening line. So you're almost shifting them over into a warm lead. Right? Because then there's something in common with both of Recently matched imgs, American medical school graduates as well, physicians within your specialty of interest all make up cold Right. Now, where do you start your search for such a person? Let's say you don't have an alumni in your medical school that has come to the US or there are few and far between that have done this specific specialty that you want. Well, one place to look at are physician cultural organizations. So physician culture organizations are organizations of a group of physicians who have a similar cultural background that are in the United States. Usually you find this amongst, like by nationality. So you can have an association of physicians of Indian origin in the United States. That would be a place that another IMG from India may want to initiate their networking process with. You can have a physician association group from Nepal or the Philippines or, you know, se several different Latin American countries have their organization groups as well. Several African countries, Nigeria, Cameroon, South Africa, Egypt. So you join these physician cultural organizations because they're other physicians there who have a similar cultural background as you, and they can also serve as mentors. And some of them do have mentorship divisions dedicated to medical students. But even as an img, you may Be a better fit for that part of the organization. So medical professional societies is a huge area where you can get mentorship. And you want to focus on the one professional society that represents the specialty of your interest. The key being there are several professional societies in the United but not every single one of them is the designated professional society for your specialty. have an example here on the other slide, which gives you some example organizations that are considered the leading professional organization for your specialty interest. So the most, the specialty with the most number of residency spots is internal medicine. And so American College of Physicians is the organization that leads that specialty. Doesn't mean that in internal medicine you don't have other organizations. Yes, there are other subdivision organizations. There's Society of Hospital Medicine, there's other smaller organizations that sprout off of it. But if you want to meet as many internists in one room, which also equates with meeting as many internal medicine residency programs in one room, then you want to be at ACP's annual meeting. You could also consider ACP's chapter meeting in your state. You could also consider ACP'S division or regional meeting in your area. Okay, now that translates for every other specialty. Now, if you're looking at, for example, dermatology, they have the American Academy of Dermatology, they have an annual meeting, they have a mentorship division for medical students. Same thing with ACOG. This is an example from ACOG's website. When you're a member of ACOG as a medical student, you can join Mentor City, which is their own organization's mentorship program, and they link you up with a formal mentor mentee relationship. When I lived in Lexington, Kentucky, we had Lexington Medical Society. It's not representative of one specialty, was just for all physicians practicing in that area. And thus they had a mentorship division. And they linked us up with students from University of Kentucky who were looking for mentors. So you can look up about any medical society in your area in your geographic location. But this is a place to start. You want to start with the American college that represents that society or the academy that represents that specialty. Now, going back to other places, you can find mentors. The social Media, you have LinkedIn and Twitter. Primarily on Twitter, you're looking for the hashtag medtwitter, Twitter. So met Twitter is where you're going to find a lot of information regarding the match free information regarding programs that have open houses, program directors that have live sessions coming up, residents, chief residents hosting open houses, and so on and so So in addition to creating your hustle email, which we talked about in Module 1, your next task is to create a Twitter account that's professional tied to that email so that you can use that to seek out upcoming opportunities that you could be a part of. Now, physicians in your geography is another way to find mentors, right? So looking up the hospital in your locale and then the physicians that work at it, and that's like really a cold emailing sort of technique. There nothing wrong with that. You get several people who will not read it, but the few that will could potentially respond to you. You have medical school alumni, so that's people from your medical school who are now in that specialty that you're interested in. Caribbean medical schools do a great job at keeping record of where every alumni ends up going. So you may want to start by reaching out to your school if you're a Caribbean medical student and asking them for a list of where the alumni ended up matching at so you can one, reach out to the alumni. Or two, you have a list of places that have taken IMGs from your specific school in the past. Now local hospitals as well, you may be able to directly network with physicians, especially if you work in healthcare. So some of us work in clinical documentation integrity, some of us work as medical assistants, some of us work as clerks at the hospital or in ancillary roles within a health care facility. This is a time to adopt your growth mindset and be open to meeting people and introducing yourself to them and asking to learn a little bit more about what they do. And even therefore taking that extra step to ask for an opportunity to shadow with them. Right? It takes a lot of courage to do that. But courage is the name of the game here. Closed mouths never get fed. You probably heard that before. And so it's okay to seek out networking opportunities on your own and initiate that conversation. Nothing wrong with that. This is your cue to go ahead and go for it. No one is going to come attack you or, or ban you or you know, blacklist you because you sent them a simple email. That's an irrational fear and it's not going to happen. Another area, I do the img roadmap podcast. And every time I do a podcast, I ask the guest at the very end. If you listen to each episode to the end, they tell you how you can reach out to them, how you can meet So contacting some of those guests and asking if they're open to answering a question or two for you is a way to start. you think about it, any physician who has a social media presence wants to be social. And so it's okay to reach out to them to foster a social, professional, quasi relationship. Nothing wrong with that. So now moving into crowdsourcing, your mentorship. What I mean by this is we often get fixated on one person. Person, one goal, when indeed we could break it down, right? We could say, hey, I'm going to seek out more than one mentor, maybe five, maybe six. I'm going to split their roles. need two people that review my personal statement and give me feedback. need one that I can shadow and observe just to see what it's like to be a surgeon. need another one that maybe I could work with on their research project so I can be maybe a second, third, fourth author on their project. I just need someone to critique my decision making. I'm confused as to what specialty to pursue. Maybe I'll this other person out and then maybe another person just for general advice, bouncing off ideas and whatnot. It's okay to crowdsource your mentorship. It's sort of like having a board of directors for yourself, a board of mentors, as long as you can split the rules and say, I'm going to utilize this person for this and this one for this. So that you're not consistently bombarding just one person. That may be easily turned off by you, but you're utilizing the strengths of each one of these people to come up with your plan. So if there is a surgeon in your town and you want to do general surgery, and this person is really well known within the acs, they're not the person to review your personal statement. They're the person you want to go sit in the or with or stand or with and do a surgery or two with and learn from. That person is more likely to become a sponsor, maybe not a mentor. But then the general surgery resident may be more likely to be the one to review your personal statement, give you feedback on your lor writers and such. It's important that you have your own board of mentors. So a tip on co lead mentorship. It's much like dating, right? You don't have to assign a label. Oh, you're now my mentor in the very beginning. it should just be a conversational, as I mentioned before, especially if you're using social media, LinkedIn, med, Twitter. You want to just start off with general conversation and let it flow. Obtain what you desire, give what you can. If you can, give something back to your mentor relationship, that always works well, because we're all human. We love give and take relationships. That's human psychology. We get worn out or burned out easy if we feel like we're consistently giving, giving, and nothing's come back to you don't have to give anything. Financial doesn't have to be monetary. It could be time. could be volunteering to help them with a project. Volunteering to help them on their next research paper. Right. Sometimes it's giving your desire. There are some mentors who love to teach, they want you to be attentive. And so giving your attention sometimes is good enough. Because when they see your hunger and your strive, then they want to foster it. They want to see it grow and blossom. So cold tip. Mentorship tip. Don't email and say, can you be my mentor on your first email? Well, first, I don't know you. They don't know you. What do you need mentorship with specifically? I may not be the best person for your personal statement, but I could be the best person for your strategy. So it's important that you differentiate for yourself exactly you need from each mentor just seek to create a relationship without necessarily seeking to label When can you actually label it? After you've had one win win situation, mentor feels like they're imparting something into your life and you feel like you've been able to impart something into their life. Yeah. Then you can go ahead and label that if you want. other option is if you are making a request of them, you want to set an end date to allow an exit plan for So can I reach out to you quarterly on this issue? Can I reach out to you monthly on this issue? So they know that this is going to go on once a month for X number of months and it's going to end as opposed to them having to shoulder the responsibility of the unknown. Right. Laying a foundation goes a long way with establishing your relationship. Email communication for cold mentorship We have some samples on here in this module, but the purpose is to build relationship first. You want to make it easy for them to say yes. so when we go over the anatomy of a networking email, I want you to pay close attention because it's so easy it's so short that sometimes you wonder like, whoa, is that all it takes? you want to open your email with a common reference such as citing the work that they have done, what you admire and why, and then you quickly segue into the one thing about yourself that they can easily identify with. So your writing is in with their point of view. So it's really hard to do this sometimes because we're so much involved with ourselves and we always want to talk about ourselves. But sometimes you step away from yourself and you talk about, I read your paper in the New England Journal of Medicine last week on tumor necrosis factor 1 and its effect on cancer. And you write about what you learned from that paper. But then you segue into I did some research in my home country on something similar and that's what's sparking your intrigue, right, with reaching out to But because you both have that common interest in that research topic that allows that person to want to continue to read your email. And then you end with your ask, which in your case could be. I'll be willing to volunteer sometime virtually to assist you if you have any upcoming projects. Do you have any of such openings? Question mark. So you have one question at the end to encourage a reply. And the question must always end with a question mark. So it must end with a question mark so that they have a chance to hit reply and respond to your question. You can't have 10 questions in one email. just will not be beneficial. You'll miss the mark and it may be cumbersome for the person on the other end to respond with a good specific answer for you. Instead, write those questions down, break them down into a series of communication emails with them one at a time. Now remember, you may not get a response on the first email you send out. You may not get a response on the first 20 emails you send But when you do, it could result in a high quality continuous communication. The email may also be responded to in a week or two weeks. And that's okay. I usually say reach back out about two weeks in if you don't hear from So in summary, key things to remember, you don't want to focus on one individual. Instead focus on having a board of mentors, okay. That can assist you with key areas, whether it's decision making on your career, whether it's picking a specialty, whether it's reviewing your personal statement, whether it's reviewing your eras application, whether it is putting in a word for you. These all don't have to be done by one person. Finding an observership, acting internship. I'll give you an example. Getting an AI or personal statement review or a CV review. Those may be best suited for resident physicians who are willing to mentor you, who could have been your seniors in school or people that you've met through social media networking. On the contrary, the person who reviews or gives you feedback on how to select your LoR writers may be best suited for the person in practice because that is their colleague. That's someone that they potentially work with and so they can pick out who could be the best lor to submit for this specialty for this program. So you don't need to focus on one individual. Instead, create a board of mentors. Second, when you reach out to the mentor, especially if it's a cold lead mentor or potential mentor, because you haven't established a relationship yet, need to have a specific plan, you need to have a specific you don't know what you need from them, they wouldn't know how to help If you do not know what you need from them, they wouldn't know how to Part of adult learning is being able to be introspective to determine what you need and request what you need of your mentors. Don't give up when you don't get a response immediately. These mentors have other activities, responsibilities, life roles that they play in their own personal lives. may also have their own personal struggles that you know nothing about. So a delay is not a denial or rejection. No response doesn't mean they don't want to hear from It could just be not. It could just be that it's not a great time for them. So it's important that you're cautious not to interpret no response as an automatic So in finding a mentor, your challenge today is one, using our email templates as an inspiration. Two, learning about the anatomy of a networking email, which could even be way shorter than the email templates we provide to you. Three, is considering a board of mentors, so targeting different people with different specific questions. Four, is having a specific plan for yourself, so so that when you reach out to them, you know exactly what you need from them, avoiding generalizations such as would you be my mentor? What if they said yes? What do you follow up you expect them to create the mentorship plan, or do you have a list of things that you want to achieve and so you're coming to them with specific questions. That is the more mature, more adult, more professional way to get your answers is approaching your mentors with a specific plan. And how do you find that plan? You need to be writing down each day what you need clarity on, you can follow the rubric in this course. Do I need clarity on my networking, my lors, my personal statement, my eras form, my mindset, the way I'm picking out a specialty. Those are seven areas already. so you can identify what do I need from this specific mentor? Do I need them to help me with my USCE and my networking? So that's my Do I need this person to help me with my personal statement. That's my ask. So you know what you need because it's already outlined for you here in this program. just need to extrapolate from it And go ahead and start your mentorship seeking process.

All right, so we're going to talk about the anatomy of a networking email. And so what you see on here is the Google document where I put down sort of how long it should look. As you can see, it's very short, it's concise, it's to the point. Okay, so it starts off with inserting the professional title of the person you're trying to reach. Maybe you found them on med, Twitter or LinkedIn, or you found them through a website or clinicaltrials.gov, whatever the case may be. Now, your introduction, your first line, is where I want you to insert an intro that tells the reader how you discover their professional work. Okay, so what is it about them that is attracting you to write this email? Is it usually their academic work, such as their research? The fact that you met them at a conference, they were a keynote speaker, they spoke at a roundtable event, you heard them speak at a breakout session, you met them through a virtual meet and greet, you met them at a virtual Zoom meeting, or you found their website or their social media presence, you've been following them. Whatever the case may be, I want you to insert that introduction that draws the reader into why they should continue to be interested in what you have to say. And just by basis of the way our human psychology works, if you are reaching out to another human being and you're expressing to them something about their work, complimenting their work, they're more likely to continue to pay attention to what you have to say. Because if I walk into a room and I called your name and I said, nina Loom, guess who's going to turn around? I would. Kathy will not turn around. Paul will not turn around, because I did not call their name. So when you address a professional, especially in academics and medicine, by citing their work in the beginning as the attraction point, they're more likely to listen because that's something they've dedicated time and effort to and they want their work to be recognized. So being able to use that as your opening would always invite the reader to continue to read on. Now, what this is different from is sending an email and opening with, I am a 4th year medical student and I want you to help me with That's not going to get you much anywhere right now. After you've invited them into reading your email by citing their work, giving a compliment how you found them, giving them a point of reference, then you follow quickly with a brief introduction, one line maximum. And that introduction doesn't have to be a general introduction into who you are, it should give them an idea or insight about something that you have also done that's related to what they are interested in. So you're speaking in light of their clinical interest, their clinical expertise, what they are known for, what they stand out and you're presenting yourself as a complement to that. So, example. Dear Dr. Brave, I read your article from BMJ last week where you talked about sickle cell disease in Sub Saharan Africans. I was impressed by. And you list out whatever that article sparked inside of you, and you say, I am Nina Lum of origin in that particular region of the world, or I have participated in similar research in da da, da, da da. And then you segue into your which your ask could vary from person to person, right? You know best what you need from them, right? So you may be asking for an opportunity to volunteer with them virtually as a research assistant because you want to be listed under future research. You may be asking for an opportunity to shadow them for a day in the office this summer or this fall or next winter. You may be asking for their critique of your own paper that you're writing that's on a similar topic. But whatever the case, you must ask a question that ends with a question mark just so that you can enable and facilitate for them to turn around and give you a response. So you must have a specific ask, and that's what you close All right, now this is a suggestion. It's a guide. Doesn't mean that you don't have to introduce yourself beyond one line, right? You could use two lines and that's okay. You could use three lines and that's okay. But I just don't want you to go overboard sending a long A4 introduction email. When you're trying to network, want to make it easy for that person to respond and then keep the conversation going. Shorter emails are much easier to address psychologically. When you look at a page worth of text, you think to yourself, I have to take time to do it, right? You may have seen this course and you're like, wow, that's a lot of information. I don't have time. And now you're doing the course and you realize, oh, wow, I actually did have the time to do it. Psychologically, when we see a load in front of we see a burden. We see we need to block out time to review it. So a longer email creates that same cognitive load on the recipient. And so to reduce that cognitive load, you want to send a shorter email that allows them to click open Read quickly and reply from their cell phone. They don't have to feel like they have to get to the office and sit at a desk to respond. They can respond on the go, in the car, on the train, or whatever the case may be. In closing, hopefully this is already embedded into your Hustle email address your name with the credentials. Even if you're a medical student, you include your medical year and your email's already. You're sending this from your Hustle email. So they already see your first name, last name email. But then your contact number is included on there just in case this person is driving and they don't want to, they don't want to reply by email. They can call you. I do this often if I get a ton of emails. Sometimes I call the contact number because it's much easier to call somebody and talk than it is to type out a page worth of You may include your institution, our new AMC AAMC ID if you have one. And a small image is optional, it definitely adds to your personality. It gives perspective as to who is talking and maybe a point of invitation. So, in summary, your networking email has three paragraphs. It must always open with an introduction. And the introduction is about the recipient. How you discovered their work, a compliment to their professionalism, their academic achievements, why you admire them, what is it about them that drew you to their profile or to send that email? Tie it in with a brief introduction of yourself, preferably along the same theme as the first opening paragraph. And your last paragraph is a quick ask. And your ask could be as easy as is it okay if I ask you some questions about my pathway into general surgery residency? I believe that will be a very simple initial question. Is it okay if I reach out to you with a follow up email with some questions I have about matching into pediatrics that allows that person to say yes or no. And then you can follow up with, okay, so here's my plan. What do you How would you address this And. Or it could be a follow up that says, okay, can I get 15 minutes with you on a zoom call at any time that's convenient for right? But because your ask is so specific, it allows the recipient to determine if they're best suited to help out or not. Now here's my challenge to you. You have on the course, you have links to prior programs that have offered observerships. You have a list of programs that have given IMGs opportunities before for networking, for USCE. And if that's what you're seeking. Here is the rubric. Write out that email. You can use a template from the program, but what if you use the formula here to create yours from scratch start it your networking Let's go.

All right, so another way to find programs is through Doximity. And Doximity has a residency navigator. So the residency navigator is right here. So if you click on it, usually they want you to have a membership and you just have to create an account for it. But you can sign into your account and it gives you a little bit more information on U.S. residency programs by your peers. So people have written reviews, residents and you know, prior faculty, prior residents at these programs. So you can go on the drop down menu and you can pick out your specialty. So let's go Emergency medicine for example. And it gives you this list of how big the program is, where it's located and so on. Obviously Doximity wants you to have an account so you can see everything that's on there. So you have to sign in for full access. But just to give you perspective, all of the US you can sort by reputation and things like that. You can sort by the map, you can sort by step and USMLE scores, which is really, really important because you can kind you know, know versus like what, what these program looked at applicants who match with what scores and so on and so forth. Right. So programs is really where you're going to end up you know, in Doximity. So internal medicine is now a specialty here. And it gives you obviously the top four or five IM programs in the country. Johns Hopkins, mgh UCSF and Brigham's Women's Hospital. But if you sign in you're going to get more options for different even community based, academic, hospital based programs. And then you can use the same method I showed you in the prior video, extrapolating the name of the program, putting it into Google and searching them specifically. Obviously they put the top on here. Doesn't mean that you must only focus on these. But just to give you perspective another area too, especially when you're looking for research, is instead of Doximity, so you can go to clinical trials, um.gov trials.gov so the here. So clinical trial.gov is where you find all the database of currently private and public funded clinical studies conducted around the world. So because you're looking for research opportunity in the United States, I would suggest you select United States. If you already know about someone doing a study, maybe because you saw them tweeted on Twitter, you can definitely put that on here. But maybe you don't and you only have a condition and so you can tweet that, you can add that on there. So let's stay on Classic. Now what you could do with this site is you can find active research where you're located. So if you're in the United States right now and you're in Florida, for example, you can click Florida and you can put whatever city. But let's just say you don't have a preference yet because you're searching and then you search. What this would do is it'll bring up all the clinical trials that are happening right now in Florida area and it gives you like if they're recruiting or the title. And by recruiting, they're probably talking more about recruiting participants. So maybe the study still in the. They're not, haven't started the actual study, but they're recruiting yet, or maybe they're not yet recruiting like down here. But it's important that you only look for things that actually you have true interest in, such as they're in your specialty of interest. So obviously if you're going for ophthalmology, yeah, you definitely want to be interested in this glare and visual comfort for patients with visual impairment because you will be seeing patients related to vision problem. With vision problems if you are looking into IM or then anything that's obviously cancer related would definitely suit you because that's where you get to do oncology and breast cancer. So just giving you an idea like that if you're obviously a surgery aspirant, then you know this, that has to do with the pancreatico duodenectomy will definitely be something of interest for you. Right. So whatever the case may be, you're just perusing, you're just looking through to see what opportunities are in your area. But what's really key here is the way that I use this is to find who is the principal investigator and to see if I can reach out to them to see if they need any help. Right. So you, on this left hand column here, you have several different statuses, right. And then you also have like study, like study phase. So where are they at? Right. Early phase. If you're joining an early phase study, that means maybe a couple years before you get to see the result. So you may not get what you're looking for for residency, which is more something that's going to be out here in a little bit, in a couple months. Right. So but that's just some information you can definitely filter through and see what, you know, what your interests are. But way that I use this for networking is, for example, let's say that I was indeed interested in, you know I live in Jacksonville, Florida and this hospital program, Brooks Rehabilitation Hospital Jacksonville, is participating or recruiting for post stroke care. Well, maybe I have an interest in PM&R, right. Physical medicine and rehabilitation, and I'm applying to pmr. And so therefore I feel like this is something that, you know, I'll be interested in just because I have a PM&R interest. But more importantly, when I'm writing about my meaningful experiences, I may be able to extrapolate from this experience and write about it too. So I click on that and on here I can read a little bit more about who the sponsor who the responsible party is, but more so I'm trying to find the PI information. And so here is where they're actually telling me when it starts. It started in 2020 and it's going to be completed in 2024. So am I really going to get much out of this for my application? Maybe not. But if I was applying in 2025, then yeah, at least I know that if I get involved with this study in some form of fashion I may be able to speak to the results at that time. Now, they used to have the PI information and that's what I'm seeking to find here is who to contact. So down here you have your contacts and location and you have the PhD Dorian Caroes and Barbara Smith, they have their email on here. So if I was already in Jacksonville, Florida, I would email Dorian K. Rose and Barbara Smith using, for example, the email template that you have in the course. Right. And where is that email template? Right down here. Sample emails. see research assistant sample email, for example. So let's open this and we say, okay, well, we have these, this sample email that we can use and we're going to use this kind of draft to input our own information and make it sound like we are interested in working with Dorian Tay Rose. Right. And we send them that email asking if they're looking for an assistant on their project. Right. Because you have a goal of eventually applying into residency in PM and R. And this is something that you're interested in in stroke rehabilitation. So that could be one. Another thing that you can do is you can go back to your very homepage and you can filter by whatever you know. You can have 100 on a page, you can change your location and you can do this process in so many different states, looking for active recruiting projects in your area, reading through each of them, identifying the deadlines, identifying who the PI is. Who to contact and pitching your work. Like you could volunteer to be a remote worker or whatever the case may be if you're really, really angsty about having some experience in research. So that brings us to the end of this demo.

How should IMGs approach research? This is a big topic. The first question I get is, “Is research even mandatory?” Research is not mandatory, but research has been shown to provide a competitive edge, especially for specialties that esteem research that highly. A specialty such as orthopedic surgery, plastic surgery, they have put themselves down to say, “We want students that have fundamental research experience. Historically, we have seen that happen where the majority of people that match into those specialties tend to have some kind of research background or participate in research.” That is where you see the variances. It is specialty specific. There are tons of IMGs who matched without any research experience. But I will tell you some other things that are considered under the research and publication umbrella that you need to consider when pursuing or creating your own portfolio.

Let us get right into it. The next thing I want us to touch on are, “What are the research heavy specialties?” Following the evidence, this is from a research paper and also from The Successful Match Book. The research heavy specialties include ENT, plastics, ortho, ophthalmology, and surgery. These are the specialties where if you are applying into these and want to be a competitive applicant. Meaning you want your application to be looked upon and you get called back for interview. You need to have some amount of research experience, otherwise you may be tossed to the pow. You need to remember your application is being compared to American graduates, unless you are coming from a background that is research heavy. Maybe you are already a researcher in your country, then it is important for you to seek out at least one or two research opportunities to help you become as competitive. Because what we are seeing is that American graduates are going into these specialties listed on here. They have some amount of research experience during their medical education, they are being prepped for this. They are being prepped to be  competitive by participating in some amount of research. Definitely this is really something to consider. 

The next thing we will talk about is the impact of research on the competitiveness of an applicant. Research does make the applicant competitive. What does that mean? If two IMGs are put and compared side-by-side with their scores, personal statements and clinical experience. One has research and the other one doesn’t. The one with research appears to be more competitive than their counterpart. It doesn’t mean that if you don’t have research, you would not match. It just means if you want to have a compelling application and increase your competitiveness, you should be considering some kind of research. The question is, “What programs want research and what programs don’t want research?”

Remember, research experience as a requirement is program specific. If a program wants only applicants who have research experience, they will put on their websites. It will be a requirement. Because of that, you will find that there are so many programs that don’t have any specifications around research. Some of them would say research experience is preferred. Some of them would not say anything about it. Even though they do not explicitly say that on their websites. They don’t because in America, residency training is where you gain your level of expertise. 

Residency training is where you will be taught to become an expert and where you will probably publish the most. Most of your publications will probably come after your training, to be honest. They already know that. They are not expecting you to come in as the first author, the researcher with the best experience. What they want to know is that you have a fundamental understanding of the specialty. What they want to know is that you have a fundamental understanding of the specialty. What they want to know is that you have a fundamental understanding of the specialty. I said that three times because I want you to understand how important that is. 

They want to know that you have a fundamental understanding of reading and understanding research and its value in medicine. They also need to know that you can interpret and make deductions based on a research paper on your own. Because that is how you apply that scientific material to take care of your patients. Even though you may not find that as a requirement, it does improve your competitiveness when you say I have been in the backend working on getting answers to the world’s problems, for example, because that is what research is. Research is bringing answers to the clinicians and research is bringing answers to the bedside. Again, it will be be program specific and actually specialty specific. But no matter the specialty, if you have some level of research in that specialty, what it does is it shows that you are interested in moving that specialty forward. That you are interested in the advancement of the specialty. Those are key things that programs are looking for when they are looking for their residents.

As we mentioned, it is program specific, but academic institutions tend to favor research more than community-based programs. What do I mean by that? Academic institutions are university centers, what you would think of as a university based program. They typically are more focused on publications in general. Most of your best papers come out of your highly ranked academic institutions. By virtue of that, they are looking for people that will come into the program and continue to foster that material. They will continue to grow that reputation and continue to advance the specialty through research and publications.

Community based programs are not so much into research compared to their academic counterparts. It doesn’t mean that if you go to a community based program, you will not do research. Some do emphasize research, especially if they are heavily focused on academics. There are some others that are smaller, rural and less likely to lean into performing research on their own. They are more of the consumers of research. Depending on where you are going, you will notice that maybe the University of XYZ may have a higher propensity of taking IMGs who have research experience compared to St. Francis down the road that has a teaching program but is not the producer of research papers. That is where you see a variance also.

The next thing is the types of research to consider and how to find research opportunities. To be honest, I like this and learned it from when I read The Successful Match Book. They said, “To be a researcher, you need to be a self-starter.” You need to be able to be innovative to think, “How can I create an answer to a problem that we are all facing and you need to create a question that people want answers to, and you need to answer it.” That is really the bottom line. A lot of us when we think of research, we think of a PhD or we think of being in the lab all day, which is why I have this image up here. That is not what is required of you. You are not required to have a PhD in research to apply into residency. You are not required to spend three years in the lab in order to be eligible for residency. It is not a requirement. This is just an added edge to improve your competitiveness. 

Now, how you can attain this level of research is what I would call clinical research. There is basic science research and clinical research. Clinical research is usually easier to attain. You can be in a clinical trial or you can be a clinical coordinator, so on and so forth. But there are smaller things that you can also do to get some credibility for wanting to foster the specialty that you are interested in.

We will talk about those as well. Number one is a poster presentation. A poster presentation is very easy to get, because this would be a case that you have seen while you were rotating in that specialty. So if I am interested in neurology and I was doing a rotation and we had a patient that had COVID, and maybe had a complication of COVID and had the Ramsay Hunt Syndrome or a Bell's Palsy. That would be a good poster presentation. All that would look like is gathering the facts of the case, writing it up, getting your attending to proofread and creating a poster out of it focusing on the pathophysiology or how that came about that the person experienced a facial nerve palsy and other complications that came from it. What was done for the patient and probably their outcome. That is a very easy way to get what we consider a clinical based research work.

The reason this is important is, on your ERAS application, which you will see in the very last module, Module 7. You will see a sample ERAS application. On there, you will notice that there is a section under research and publications that allows you to put in the types of poster presentations, where you presented the title of your presentation and so on and so forth.

That is why it is important when you are going through this process of preparing yourself to apply. You are looking for opportunities to have a poster presentation. It does not have to only be in the states also. You could do a poster presentation on the island in the Caribbean, Europe, South Africa, wherever you are located, you can do a poster presentation there. Because fundamentally once you present that at a local conference, you can include that on your ERAS application as, “I have some experience in creating posters”, “I have some experience in presenting at a conference.” Those things do show that you are interested in the specialty and that makes you a more competitive applicant.

The next thing we will talk about is oral presentations are easy to get. You can do this one on the wards. You could do it on grand rounds. I am not talking about just presenting your case in the morning during rounds. That is not what I am referring to. What I’m referring to is presenting an oral presentation in front of a crowd. Maybe it is a Friday noon conference, and you are the one presenting about the complications of an ischemic stroke in front of your coworkers and your attendings. You are getting graded and you’re getting asked questions about it. Oral presentations are also a great way to get something to include under your ERAS application, under research publications and presentations.

The next thing is a case report. A case report could be in the form of a poster or a discussion that you write and go into the details. You are going into the case itself, the presentation, the past history, the specialties that were involved and even getting those specialists opine upon it. You go into the background, pathology, you’re looking at the slides of that patient. You are looking at the numbers, detailing out lab values and radiology. Then you create sort of an analysis of the entire synopsis of the case at the end, a lesson learned and outcome of what you are expecting to see from this in the future. That is a case report. This will be something that you can identify while you are on a rotation or observership. You can identify something that is case that is unique and offer to write a report on it.

The key here is being a self-starter, meaning you are the one initiating the question of, “Hey, Dr. Lum, can I write a case report on this patient that we saw? Would you back me up?” I want you to take initiative to ask for the opportunity because the attending is not going to tell you, “You should write a case report or you should try to submit this.” Some will, very few and far between, some like me maybe but a lot of times they just carry on because it is usual practice for them. But to you, that is a case that you can use to get some kind of recognition in the discipline that you are interested in.

Peer review journal publications, these are usually a little bit more tedious to find because you have to be a part of a researcher’s paper or your attending’s paper, but definitely not an area that you should ignore. You also have if it is a peer review or it has not really gone through peer review, but it’s in the process or it wasn’t published, it wasn’t approved. ERAS allows you to include that on your application. Even if you are still working on something that is in the process of being published. It has been approved and not yet published, or it is in the works or published online. There is room for that as well. 

That is where we come into the peer reviewed online publication is another great arena because you can get your papers published without the pain of going through a print or a paper publication. Online publications are also looked upon nicely by ERAS and people that review your ERAS applications. 

Just a run through, all that I’ve told you, case presentations, poster presentations, oral presentations, case summary, peer reviewed publications, and online peer reviewed material that has not yet been published.

Those are all things that you can do while you are doing a rotation, observership, acting internship, and an externship in order to improve your competitiveness. What does that mean? It means that right now, I want you to be asking yourself this question, “Which one of these can I create quickly right now?” Maybe for you, it is a poster presentation or a case presentation. I want you right now to think of one case that you have seen over the last week that you can write a case presentation or a poster presentation on.

I have presented this before multiple times on this course. I have received emails from students who have taken initiatives and presented something and had a publication that went on their ERAS file that was asked upon during an interview. They eventually matched because they had something cool to speak about with the interviewer.

It is just the spiral. The things that you do today add up to where you want to go tomorrow. Definitely think of, “Which one of these can I create easily?” I bet you can do at least one or two, which would be a good starting point. If you have 5 or 10 publications. Hooray! You do not need to do it anymore, but if you don’t have any, you can start here and start now.

Does everyone need to be a researcher? The answer is no. Not everyone needs to be a researcher. You just need to show interest in the clinical specialty, understanding of basic clinical research, understanding of what a clinical paper looks like and how to make deductions from it. The best way to prove that you have an understanding of these things is by producing one of your own.