Posts Tagged ‘observer’

Observership List

January 3, 2012 4 comments


I am thrilled to announce the launch of a HMS Global Academy Course for IMGs. Founded by Harvard Medical School, the HMS Global Academy is an online learning destination offering high-quality courses to learners everywhere.


I am the director and instructor for the HMS Global Academy Course on the Introduction to the Practice of American Medicine. This is a self-paced inexpensive online course with lectures on topics that are geared towards IMGs who are applying to residency through the match. We have recorded and produced the course with the goal of assisting IMG applicants to be as successful as possible in attaining a residency match.  You can enroll here.

Observership List

As promised, here is an up-to-date list (as of June 2016) of observership opportunities at programs that open to international graduates. I have confirmed that these programs do have observership programs.  Most of these are internal medicine related but I have included some surgery observerships. I advise you to do observerships in several places if possible and focus on those programs that have a history of taking IMGs.

Observerships at Large University Hospitals
Dana-Farber/Boston Children’s Cancer and Blood Disorders Center
Cleveland Clinic International Physician Observer Program fee $500
Cleveland Clinic Global Clinical Observer Program designed for 12 “highly qualified participants” for “a four-week shadowing experience” fee $1000
Johns Hopkins “We recommend that you directly contact the department you’d like to observe”
University of Pittsburgh Critical Care Medicine
Sparrow Hospital/Michigan State University Program
Beth Israel Medical Center, University Hospital for the Albert Einstein College of Medicine
University of Chicago Center for Global Health Clinical Observer.  Requires faculty sponsorship.
University of Texas Health Science Center Houston offers observerships once a faculty sponsor is identified.  Application is here and requires a fee to apply.
University of Texas MD Anderson Cancer Center (Integrative Medicine, Anesthesia/Critical Care)
University of Texas MD Anderson Cancer Center (Pulmonary Medicine)
Thomas Jefferson (applicant must have letter from Thomas Jefferson Faculty member to be accepted)
George Washington University Hospital
University of Miami Observership Program (Foreign nationals may be eligible for a 3-month Observership Program) Contact Olivia Cata (
University of Washington
UCLA Family Medicine three month Observership program.  Geared towards candidates who speak Spanish.

Observerships at hospitals with Internal Medicine Programs that have taken a large % of IMGs
Griffin Hospital Program
Cleveland Clinic (Florida) Program
Mercy Health Partners/Mercy Hospital St. Louis
MedStar Montgomery Medical Center – observership offered only after the match to matched candidates
Wayne State University/Detroit Medical Center Program
St John’s Mercy Medical Center Program
University of Texas Health Science Center at San Antonio Lower Rio Grande Valley RAHC Program IMG physicians currently enrolled in training programs
Drexel University College of Medicine/Hahnemann University Hospital Program Offers a Structured Physician Refresher/Re-entry program which is expensive
Hurley Medical Center See information under “Do you allow applicants to observe in your hospital before the interview?” USMLE steps 1 and 2 must be > 220.
Mount Sinai Medical Center Miami Beach Florida International Post Graduate Observership Course, 4 weeks in Cardiology, Infectious Disease or Internal Medicine.  USMLE steps 1 and 2 must be > 235. Application is here.
Good Shepherd Medical Center Observership in Internal Medicine, contact 903-315-5171
Einstein Medical Center Philadelphia

Other Observership opportunities
Children’s Hospital Boston
Florida Hospital Medical Center Program
contact Nicole Yates, Residency Coordinator
Baptist Health South Florida
Washington Hospital Center
Harbor Hospital
University of South Florida
Methodist Hospital, Houston TX
Allegheny General Hospital–Western Pennsylvania Hospital Internal Medicine Residency Program call International Services (412) 359-5269 or e-mail:
Jackson Memorial Hospital/Jackson Health System Program
Moffitt Cancer Center – Tampa, FL and here
Children’s Hospital Boston
Brigham and Women’s Hospital Radiology

General Surgery Observerships
Association for Academic Surgery (lists 68 Hospitals with Surgery related Observerships)
Cleveland Clinic Florida
Cleveland Clinic
Einstein Medical Center Philadelphia
Mount Sinai, New York

Other Surgery Observerships
NYU Orthopedic Surgery
MD Anderson Cancer Center Thoracic & Cardiovascular Surgery
Children’s Boston Congenital Cardiac Surgery, Pediatric Otolaryngology, Pediatric Surgery
Orthopedic Surgery Hospital for Special Surgery New York requires faculty host
University of Pittsburgh Surgical Critical Care
Plastic Surgery Major Toronto Hospitals

Updated 06/02/2016. If you do find a link that no longer works please send a message to

The views expressed in this post are those of Kenneth Christopher, MD and do not necessarily reflect the views of Dr. Christopher’s employer Partners HealthCare.

“Externship” doesn’t mean anything

“Externship” is a meaningless word.  I cringe at the word “Observership.”  As far as I am concerned, if you are a medical school graduate seeing patient care with an attending supervisor you are an observer.  There is a huge difference between observing and doing a clinical rotation as a student at a hospital in the US.  Rules on observers are in place to ensure compliance with state and federal laws and hospital accreditation standards as well as ensure the legal safety of observers, staff and patients.  Some programs do not consider your USCE as clinical experience unless you have done clerkships in the US as students or have done a PGY1 year in the US.

As an observer you don’t have malpractice insurance.  That is one reason that you cannot legally examine patients and a big reason why so many hospitals do not allow observers.  If you examine patients (even if your resident says its OK) and a patient complains, you are the one that will take the heat and likely asked to leave.   In the presence of a patient or in any patient care area, observers cannot not be asked or allowed to answer specific questions about a patient’s care or treatment, or otherwise provide medical or professional opinions.  The observer is permitted only to view patient care, and in some hospitals only with patient consent. Observers cannot have direct patient contact or provide any type of medical care.  Protect yourself and don’t cross the line.  Don’t write notes, don’t talk to patients, and don’t examine patients.  You never know when a patient (who is a lawyer) will say “and who is this?” when you are listening to his heart.  Your answer “Um, I’m a doctor from Antarctica and I’m just an observer and I don’t um have a US license to touch patients or um malpractice insurance to cover me if you decide to sue me…OK?”

I often see letters that inflate how much an observer has done.  Sometimes I have to look at the date of graduation and the date of the USCE to figure out if it was a student rotation or time as an observer.  I hate that.  The letter writers who laud their observer’s clinical skills are lying or they were foolish to allow an uninsured observer to touch / talk to a patient.  When I see these inflation letters I wonder about the judgement of the letter writers which reflects badly on the candidate (you).  Letters from a time of observation need to have the following statement: “Our hospital policy on observers forbids any patient contact so I am not able to directly comment on the observer’s clinical skills.”  The letters can and should comment on how much they liked you as a person and how good your English is.

Observer time does not allow you to showcase your organizational skills or clinical skills. Those are very important for program directors to know. Observer time is an opportunity to show off your knowledge base, your social skills and your flair for the English language.  These are also important for program directors to know.

Time spent as an observer can be quite fruitful.  Try to get observer time at IMG friendly hospitals were you can spend time getting to know the hospital and especially the program director.  If you are liked at that IMG friendly hospital, you will probably get an interview there.  Candidates that I know only got interviews at hospitals where they did observerships.

If you are lucky enough to have had time as an observer describe it in your application as “Observer at Man’s Greatest Hospital in the Hematology Department, July 2011”  and not “Externship in Hematology, Man’s Greatest Hospital, July 2011.”