Indian doctors in US ; Fellowship and Practice in US

Hi Guys,

I have seen lot of traffic on my blog searching for "Indian Doctors in US" of course which is the main theme for my Blog!
I started this blog just out of fancy keeping myself in mind who is obviously an Indian doctor.
I started my life searching here and there how to get into US medical system.Today I wanna post a blog what are our chances of getting into this system.

If you are a Medical student you can do electives here.In any branch you want and which is like doing our Internship/House surgency in India.but just doing only selective departmenmts which help in our chosen career.For e.g., if you want to pursue Internal Medicine...You can do any IM related i.e., Gastro or cardio "Elective" in any med school.These days getting electives are also getting tough.Some are paid and some are non-paid.Once you are done you will be having hands-on clinical experience which helps you in smooth transition into residency.But you wont get any degree here that you have done electives but,Some LORs(Letter Of Recommendations).

If you are a Physician ,have done Internship and got MBBS degree,you are not eligible to do electives in US.
OR
If you are a MD or MS Physician the fate is same but here comes the option of PRACTICE in US
Residency is what we call post graduate training in India or simply PG

In Order to practice in US u need to get state license which requires at least 2-3 yrs of "Accredited American Graduate medical education"(RESIDENCY) according to AMA(American Medical Education) found ...HERE

and if u r Board Certified it adds to authenticity and value ...!

Basically to practice in US one need NOT ! be BOARD CERTIFIED according to certiFACT

"Board certification is a voluntary process and over 80% of the physicians in the U.S. are board certified; however, a physician is licensed by the state to “practice medicine and surgery” and board certification is not a requirement for licensure. A licensed physician may practice in whatever area of medical interest they have and can legally hold themselves out to be practicing in that field of interest without necessarily having obtained a residency or fellowship providing advanced training in that area. Board certification, however, means that the physician’s skill and knowledge in the specialty/subspecialty has been examined and tested and meets standardized requirements"
"Most International Medical Graduates need to complete some required training in this country before they are able to take a particular board’s exam if all the postgraduate training was completed in another country. Exceptions are made and vary with each board. (Some boards may accept Canadian and/or United Kingdom residencies. Call the Member Board for further information on this.)"

also

"If a doctor is "licensed to practice medicine" does that mean he/she is certified?

No. Obtaining a medical license and being certified as a medical specialist by an ABMS Member Board are two different and separate processes. A license, legally required in order to treat patients, is issued and required by the state or territory in which a doctor practices medicine. A specialty certificate is issued by a medical specialty certifying board, which is valid nationwide. Although certification is not required for an individual physician to practice medicine, most hospitals and managed care organizations require that at least a certain percentage of their staff be, " board certified." Today, approximately 89% of licensed physicians are certified by one or more ABMS Member Boards."

You must have gone through atleast 3 years of residency training apart from CME credits and other requirements) and cleared the state specialty board examination.For e.g., ABIM (American Board of Internal Medicine) has to be cleared to be BOARD CERTIFIED in US in the case of IM

But I came to know that if you have done residency here,You can start practicing here as affiliated with a hospital called "HOSPITALIST" and you will be given 3yrs time to clear the board exam.
At the beginning of residency people apply for Initial Medical licnsure and its requirements vary by state and if you are an IMG
In order to get this initial licensure, you have to finish USMLE Step 3 and which in turn requires the clearance of step1,2(CK ,CS).
For clearing STEP3 the criteria vary by state.some require at least one year of residency training,where as some don't need any special requirements.
So in order to practice here,you need to finish all the USMLE steps includin Step3.

More info can be found here

This is what mentioned on FSMB(www.fsmb.org)

"In the United States and its territories, a license to practice medicine is a privilege granted only by the individual licensing authority (i.e., "state medical board") of the various jurisdictions. All decisions regarding acceptance of USMLE results and/or licensure eligibility are made by the individual state medical boards of the United States.

It is important to note that eligibility to sit for the USMLE Step 3 for a specific state medical board does not automatically signify your eligibility for medical licensure in that jurisdiction.

To obtain complete licensure information, you should contact the state medical board directly where you intend to seek your medical license. The FSMB provides a listing of all state medical boards and their contact information."

Here is a sample Licensure for Alabama state http://www.albme.org/Documents/540-X-3%20ER.pdf

and the website is http://www.albme.org/

If you don't wanna practice in US but want to do Fellowship (which is Superspeciality in India)
Most of them require the residency in US.So ,for them Indian PG is not valid.
But here is an exception for some fellowships like Ophthalmic Oncology and Emergency Care (i dont have the complete list and it will be on Individual hospital websites for how to get the list see below)where you can directly apply for them.you don't have to go through all the USMLE steps.Even you dont have to go through all the ERAS process.(For ERAS go through my other blogs).
Once you are done you can use that training in your home country but cannot practice herer.

For these list of programs,

1.go to http://www0.ama-assn.org/vapp/freida/srch/
2.select "Choose specialty"
3.select the "Subspecialty/fellowship" you are interested in
4.select the "Choose Location" select the states you wanted
5.Click on "Optional Criteria"
in National Resident Matching Program: select DO NOT PARTICIPATE IN NRMP
in ERAS drop down select DO NOT PARTICIPATE IN ERAS
These are the programs have their own criteria like "atleast 3 yrs of PG training back in home country"
Now you have to contact the individual programs.

Indian Doctors who came to US back in 70's 80's have done radiology and some competetive specialties.Now its real tough even to get into residency.

Those who want to do residency and then Fellowship...read my other blogs..

Hope this Helps
Pavan
_________________________________________________________________
*i've done background research for myself.It may be incomplete or may have some flaws but for most part its how the system in US is.If you have any doubts or comments post them.Once I start my residency I will know more abt the system!

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Read or Listen to latest 4 largest medical journals !!

This is a collection of articles I have found interesting in the weekly editions of the "big five" medical journals: NEJM, JAMA, Annals, Lancet and BMJ (a few more journals are included occasionally). Please see the end of the post for a suggested time-efficient way to stay up-to-date with the medical literature.

Medical Journals tab: A screenshot of iGoogle with RSS feeds from the major medical journals.

1. Subscribe to the RSS feeds of the 5 major medical journals (NEJM, JAMA, BMJ, Lancet and Annals) plus 2-3 subpecialty journals in your field of interest. RSS is a Really simple syndication where u will get the head lines of latest updates to your desktop....


2. Read the journal on the day it is published online, for example, NEJM on Wednesdays.

3. Listen to journal podcasts. Click here to subscribe the podcasts of the 4 major journals in iGoogle. Add the subscriptions to yourigoogle. Igoogle is little advanced than classic google search. just type www.igoogle.com in your browser and login with your gmail account. you can add the links of podcasts in your igoogle.
Alternate way is open reader.google.com and add the links i am giving below

1. NEJM,
Feed: http://podcast.nejm.org/nejm_audio_summaries.xml

2. Lancet,
Feed: http://podcast.thelancet.com/lancet.xml

3. JAMA,
Feed: http://jama.ama-assn.org/misc/jamapodcasts2006.rss

4. BMJ, (the podcast is not active now).

5. Annals,
Feed: http://media.acponline.org/feeds/annals.xml

just copy the links and go to "add subscription" in Google Reader and add the links given

Hope You read these journals and apply them for better patient care !

Dr Pavan

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Question Yourself before Chosing USMLE !

Hi Friends I wanted to post a blog on how USMLE can be
The questions you must ask to urself before coming to US or taking USMLE.....

First let me clarify that USMLE is a longer process than expected. It takes years to get into the system.Its money consuming and it tests ur patience.you will be facing lot of hurdles and there will be moments of despair and loneliness and deserted feeling.i am not scaring u its the truth.The competition is that severe.The people coming here are not just the graduates of foreign med school.Some people are even taking MPH or certain other courses just for the sake of getting residency.There is no genuine reason behind doing MPH(Master's in Public Health) 'cuz they r not gonna continue it as their career anyway.But being in US with legal status to work, some of them are doing research and even having publications.Also for being here,they r learning the culture of this country which helps them get absorbed in to this system quickly.So,that shows the level of competition.I don't suggest u do F1 courses.But they have some edge over ordinary IMG's.Of course u can work as a volunteer in any research with your Non-Immigrant visa too (Like B1/B2) but the chances r slim.
The questions U shud ask to urself are :

1. Are you academecially bright or hard woker to get good score?'cuz score bring you interviews and ur communication skills help u get selected in the interview
2. Are you financially sound?-Its gonna cost you a ton - Can be upto a maximum of $25000
3. Do u have relatives here in US? They will help u for food shelter and may get you some observership or even recommendation?!
4. Are you patient enough? - It takes years as I said atlest 1-2 years and as you know its a once an yearly process and the interview process it self takes 6months
5. Do you have moral support? As I said some times u get lost in this alien country....so u need good friend it can be your spouce or some one who can give u very good advices..
6. Do you have good communication skills?- I mean if you r shy U cannot go anywhere / do any thing in this country.Apart from that getting into residency requires this vital skill...thats what make you get selected for the interview...

Hope This Helps....!

Pavan

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