A medical student recently approached me for clerkship rotation in the university where I work. She obtained my information from my parents back in my home country. She contacted me through WhatsApp informally . She made some mistakes that I see other IMGs making in formal email communications as well. If you identify what mistakes others make, you will not make them yourself. Here is our WhatsApp conversation:
Student: Hi Dr. D, I got your number from your father. I need your help
Dr. D: Hi, I was aware you will get in touch. How can I help you?
Student: I am finishing up my medical school and internship in 2016. I will give USMLE step 1 after that. I want to do pediatrics in US. How are the chances for IMG?
Dr. D: I am glad you are thinking ahead. Chances for an IMG are pretty good.
Student: How is the pay in pediatrics?
Dr. D: The pay is variable depending on the practice and specialization.
Student: Can you give me a general letter of recommendation?
Dr. D: I don’t know your work so I cannot give you a LOR. Also, there is no general recommendation letter. Get a letter in the field you are going to apply. I have a few friends who practice pediatrics. I can arrange for you to work with them and if they like your work they will give you a strong LOR on university letter head.
Student: When can I come for pediatric elective? Where will I live? Also, I want to get some research published in PubMed. Can you help me?
Dr. D: Pubmed is a database of research journals. If you get your research published in one of the major journals, it will show up on PubMed. If you have worked on some research, I can guide you to get it published or presented at a major conference. We can arrange for you to come in January- Feb for pediatric rotation. Once your travel plans are set, we will make accommodation arrangements.
First of all, I must applaud this student for working on her application in advance. She is also well aware of things she will need to build a strong application. If she would tweak her approach a little bit, she will have much better results with her application. Since, my father’s friends referred her, I was patient with her. When I get emails like this from people I do not know, I am not as receptive. Here is how she could make people say yes more often to her requests:
- Do not mention pay in any of your conversation with people. This was an informal communication, so it is somewhat acceptable. But not at the beginning of conversation. We all think about it; we just don’t talk about it. That is what google is for.
- There is no such thing as a general recommendation letter. Always try to get your letter of recommendation in the field you are interested in. If one or more of your letters are from another field, ask them to write about something specific. They can write about your work ethics, professionalism, communication etc.
I learnt this after my cardiology observership. At the end of my rotation, I requested the cardiologist for a LOR. He asked me what I wanted him to write in the letter. I did not know the answer to that. He explained me that since it was an observership, he could not mention clinical skills in the letter. I was always there on time, pretended that I was super interested all day (even though I was tired) and discussed cardiology topics with him. So he mentioned my professionalism, enthusiasm and knowledge of cardiology concepts in the letter.
Some letter writers will ask you to write a letter for them, which they will edit and sign. Keep these things in mind when you are writing a letter for yourself
- Most doctors are busy and do not have time or incentive to host a medical student for a rotation. So make it easy for them to say yes. In this case, student asked me when can she come for the rotation, where will she live etc. She is making it hard for me to say yes. First get the rotation schedule. Then you can arrange for accommodation letter. There are online resources to find an apartment or room (rent.com, trulia, craigslist, university student group, Airbnb etc). You can ask the physician for recommendation on safe neighborhoods around the hospital.
- When asking for research publications or experience, it is better to look up what research the physician is working on. Then you can be a part of it if you are interested. If you are not, you can ask their guidance to proceed with your own research interest
In this case, after a lot of back and forth, I was able to schedule a rotation for this student in pediatrics with my friend who practices general pediatrics . She had some research work in medical school which she presented in an international pediatric conference.
We, IMGs are the most competitive residency candidates for residency programs. 1 out of every 3 doctors in the US is an IMG and there is still need for more doctors. But we lose our confidence for reasons like low scores, accent problems, old IMGs, social anxiety or sometimes just feeling inferior to American graduates for no clear cause. The medical student I mentioned above seems bright and proactive. She just needs a little confidence boost and a little guidance to get her a great residency spot.