Personal accounts - United States

ACADEMIC

• Beginning of R4 year

• Little support from the residency site, except for the program director with respect to the Master’s

• Recruiting site requires him to do 1 academic fellowship year and 1 clinical fellowship year
• First year: Master’s in Medical Education (Harvard Medical School)
• Currently taking steps to obtain a 1-year fellowship position at Boston Medical Center in Peripheral Vascular Surgery

• Candidate applied and was interviewed (via Skype) to obtain the Master’s student position.
• Currently seeking the clinical fellowship position

• Test of English as a Foreign Language (TOEFL) English exam

• Awaiting responses for a bursary (notably Dean’s and Royal College bursaries) for the academic component
  Paid for the clinical year by CHU de Québec (recruiting site) Vascular Surgery department

• Not required

• Not for Master’s

• F-1 visa (student)
  Additional steps to follow for the clinical fellowship once confirmed

 PERSONAL  

• Yes, plus Blue Cross with the University, which offered student packages

• Requirement to take out insurance in the U.S. host site (remember costs are higher in the USA)

• Harvard University offers students a banking service. It gave his student number, and an account was opened for him. He then transferred money from his account in Quebec via international transfer. Note that transfers of amounts over $2,500 have to be carried out at the branch in person

• Took a room in a Harvard University residence, simple and much cheaper
• Also, other benefits are included, such as parking and Internet

• No changes were needed 

• Went to the RAMQ office in person to ask for his file to be kept open
• Proof of acceptance for the fellowship outside Quebec is all that’s required

ACADEMIC

• End of R5 year, once the PEM was confirmed

• None

• One year at Stanford University
• Procedures are very complicated
• There is little information on the subject
• No program provided what he was offered as a fellowship, i.e., a combined fellowship in clinical work and research
• He wasted a lot of time looking for a site, but was finally able to apply to a clinical program, which is standard in the field
• After reading a lot about equivalences and whether or not it was necessary to take the United States Medical Licensing Exams (USMLE), he was able to select a few sites
• He had a first interview that did not lead to a position
• He then applied to Stanford, where he was told they could not take him because of the visa requirement. Finally, after checking with the university directly, he was interviewed and obtained the position
• The choice of subspecialty was a personal one

• Candidate had two on-site interviews: one in Tampa, the other at Stanford

• None required

• Paid by the facility/R7 level

• None required

• Application process went smoothly
• Lots of red tape, but the host university was very helpful

PERSONAL

• Health insurance provided by the hospital in the work contract

• Too complicated to acquire a car
• The candidate preferred to rent an apartment near the hospital and get hold of a bicycle, to move around more easily
• He occasionally rents a car when he wants to do long distances on weekends

• It is necessary to open a bank account in the U.S.
• The easiest thing is to open one once you are on site

• It is hard to find anywhere furnished, and rents are very high (between $3,500 and $4,000 per month for a 3½)
• It is impossible to reserve ahead of time
• The university offers apartments, and can place you on a waiting list for lower-cost units
• They can call you only 1-2 months before you arrive. But you are unlikely to get one of the apartments near the university

• The Quebec driver’s licence is valid in the USA (occasional driving)

• Notified RAMQ before leaving. RAMQ covers emergencies only for the U.S., so you need to take out other insurance to cover health care.
• Health insurance is offered by the host site on clinical fellowships associated with a salary

• For all clinical fellowships, you will need a U.S. Social Security number, which you can apply for only when you have already been in the USA for 10 days
• Plan to arrive more than 24 hours ahead of your first day, if possible
• You cannot work without a Social Security number, as your medical licence will not be available without that number (at least in California)

ACADEMIC

• Beginning of R4 year 

• None 

• Sent an application with all required documents (resumé, 3 letters of reference, residency evaluations, and copies of her undergraduate [preMD] transcript)
• Answer received 1 month later
• Informal, 2-hour meeting with department head at American Society of Anesthesiologists Conference
• Formal, 9½-hour interview in early December 2018. Meeting with 10 department members
• Official positive response in January 2020 for 2020-2021
• Subspecialty was a personal choice shared with the establishment

• Interview on site (better than via Skype because it allows you to visit the site, and meet with members of the department, even if it entails considerable cost) 

• TOEFL English test 

• Bursary from Quebec university where she will have a position
• Additional salary from the facility, as she will work 2 days a week as staff physician and the other days as fellow
• Fellowship self-funded

• Not required 

• J-1 Visa 

• J-1 Visa

 PERSONAL

• Will be alone

ACADEMIC

• Procedure for returning to his recruiting site: halfway through R2 year
• Procedure for fellowship: start of R3 year

• Helped mainly by the head of the Pediatrics Department (to which he will be returning after the training)

• Training site was chosen in line with his personal interests
• Fellowship was chosen on the basis of his personal interests first of all, but also of the current needs of the clinical setting offering a position

• Harvard: Videoconference interview via WebEx (similar to Skype)
• UPenn: No interview

• Harvard: TOEFL English test
• UPenn: No special exam or test, but they ask for transcripts to be sent via a private company (WES), and that is complicated. Start the procedure well in advance

• Paid via bursaries (one of which represents matched funding between his training site and the hospital foundation)

• No

• Student visa only

• Steps to be completed. But considerable support from the sites where he applied for his fellowships (comprehensive coaching when requested)

 PERSONAL

• no

• Fellowship programs in Medical Education require mostly all the same elements:
  o 2-3 letters of support
  o Resumé
  o Transcripts translated into English (some programs require going via a company to approve transcripts)
  o Letter of intent for entering the program
  o Entrance tests (highly variable, depending on the program): either nothing at all, or some want TOEFL for knowledge of English, or GRE for general knowledge
  o Have an idea for a research project in the near future, and be very clear on your research interests

ACADEMIC

• End of R3 year 

• Letters of reference from 2 staff physicians and program director 

• Subspecialization was his personal choice, but he was told he stood a better chance of getting a PEM if he did his fellowship in Boston  

• On site 

• None required 

• Salary from the hospital ($100,000/year) 

• Not required 

• J-1 Visa

• J-1 Visa

 PERSONAL

• To be dealt with on site 

• To be dealt with on site 

• Accompanied by his spouse.
• She will be able to work with a J-1 Visa