Doctors Training Abroad

Treinamento Médico nos Estados Unidos

What is a Clerkship?

In medical education, a clerkship, or rotation, refers to the practice of medicine by medical students during their latter years of study. Usually, the first half of medical school trains students in the classroom setting, and the second half takes place in a teaching hospital. Clerkships give students experiences in all parts of the hospital setting, including the operating room, emergency department, and various other departments that allow learning by viewing and doing.

During this training, students are required to rotate through different medical specialties and treat patients under the supervision of physicians. Students elicit patient histories, complete physical examinations, write progress notes, and assist in surgeries and medical procedures. The work hours are that of a full-time job, generally similar to that of residents. Students may also be required work on weekends and to be on call.

In the United States, medical school lasts four years. Medical students spend the third and fourth years rotating through a combination of required clerkships and electives. Most medical schools require rotations in internal medicine, surgery, pediatrics, psychiatry, obstetrics and gynecology, family medicine, radiology, and neurology. Some schools additionally require emergency medicine and intensive-care medicine. Furthermore, a common graduation requirement is to complete a sub-internship in a specialty, where the medical student acts as an intern.

What is an Observership?

An observership is a period of time spent observing clinical practice with no patient contact.

•    Normally lasts between one week to a month
•    Does not involve a service commitment or salary
•    Non-accredited
•    You may have to pay for the privilege
•    Linked with a supervising doctor
•    No patient contact
•    No responsibility for the patient
•    You basically learn by observing
•    Do not normally need malpractice insurance as there is no patient contact
•    Typical day: attending clinical meetings or tutorials (usually held twice/day)
ward rounds, clinics, watching procedures or operations, doing a research
project, using the medical school resources to learn independently (i.e.,
library, online journals)

What is an Externship?

Externships are sometimes available in the United States. Very often they are designed to offer clinical exposure and hands on training to medical students.

•    Essentially a residency position that is unpaid
•    Need malpractice insurance to get an externship
•    Have some extent of contact with patients
•    Perform some procedures
•    Usually cannot work as the house officer, or write formal orders
•    Not for academic credit

Residency

It’s a stage of graduate medical training. A resident physician or resident(also called a house officer / senior house officer in the United Kingdom and several Commonwealth countries) is a person who has received a medical degree and who practices medicine under the supervision of fully licensed physicians, usually in a hospital or clinic.

A residency may follow the internship year or include the internship year as the first year of residency. The residency can also be followed by a fellowship, during which the physician is trained in a sub-specialty. Successful completion of residency training is a requirement to practice medicine in many jurisdictions.

Fellowship

A fellowship is the period of medical training in the United States and Canada that a physician may undertake after completing a specialty training program (residency). During this time (usually more than one year), the physician is known as a fellow.

Fellows are capable of acting as attending physician or consultant physician in the generalist field in which they were trained, such as internal medicine or pediatrics.

After completing a fellowship in the relevant sub-specialty, the physician is permitted to practice without direct supervision by other physicians in that sub-specialty, such as cardiology or oncology.