What is the difference between observership and externship?

An observership is a shadowing-only experience where you watch physicians practice without direct patient contact. An externship (clinical rotation) is a hands-on experience where you actively participate in patient care, write notes, and present cases. Externships carry more weight in residency applications but typically require ECFMG certification or passing USMLE Step 1 and Step 2 CK.

How much does a clinical observership cost in the USA?

Clinical observership costs range from free to several thousand dollars depending on the institution and duration. Many university-affiliated programs charge $500-$2,000 for a 4-week rotation, while some community hospitals and clinics offer free observerships. Always verify fees directly with the institution before applying.

Do I need ECFMG certification for an observership?

Most observerships do not require ECFMG certification since observers do not have direct patient contact. However, externships and hands-on clinical rotations typically require ECFMG certification or at minimum passing USMLE Step 1 and Step 2 CK. Requirements vary by program, so check each listing carefully.

Can I do an observership on a B1/B2 visa?

Yes, most observerships can be completed on a B1/B2 visitor visa since they involve observation only, with no patient contact or compensation. The B1 visa is more appropriate than the B2 for clinical observation. For hands-on externships, a J-1 or other sponsored visa is typically required.

Which hospitals offer free observerships for IMGs?

Several hospitals offer free or low-cost observerships for IMGs, particularly community hospitals and some academic medical centers. Programs at NYC Health + Hospitals facilities, some VA hospitals, and community-based clinics may waive fees. USCEHub lets you filter listings by cost to find free programs across the United States.

How do I find a research fellowship as an IMG?

The most effective approach is cold-emailing Principal Investigators (PIs) at academic medical centers with a tailored message referencing their recent publications. Expect a 2-5% response rate, so plan to send 50-100+ emails. You can also browse research fellowship listings on USCEHub and check institutional websites for posted positions.

What is USCE and why do I need it?

USCE stands for United States Clinical Experience, encompassing observerships, externships, and clinical rotations at U.S. healthcare facilities. It is considered essential for IMGs applying to residency because it demonstrates your ability to function in the American healthcare system and provides opportunities for U.S.-based Letters of Recommendation.

How long does an observership typically last?

Most observerships last 2 to 4 weeks, though some programs offer rotations of up to 12 weeks. The ideal duration depends on your goals: a minimum of 4 weeks is recommended to build enough rapport with an attending to secure a meaningful Letter of Recommendation.

Can I get a letter of recommendation from an observership?

Yes, many observership programs offer the possibility of obtaining a Letter of Recommendation, though it is not guaranteed. The quality depends on the duration of your program, your level of engagement, and the attending physician's willingness. Discuss LOR expectations early in your rotation.

What is the best time to do an observership before applying to residency?

The ideal time is 6-12 months before the ERAS application opens in September. This allows enough time to complete the experience, secure Letters of Recommendation, and incorporate the experience into your personal statement. Many applicants complete observerships between January and June of their application year.

Browse Opportunities

88 listings found

Free Programs OnlyVisa SupportWhat's the difference?

Observership88 Clerkship5 MD/DO Visiting (VSLO)94 Research16

Always confirm details on the official institution page before applying. Requirements, fees, and deadlines can change.

Browse Opportunities

Grady Health System Medical Education Observership

Baptist Health International Observerships

UW Madison Pathology Observership

UT Southwestern Plastic Surgery Observership

BIDMC Department of Radiology — Observerships

Mount Sinai Medical Center — Miami Beach

Penn Dermatopathology International Observership

University of Utah Moran Eye International Observership

Mercy Catholic Medical Center — Observership

Brookdale Hospital — Psychiatry Externship Program

NYU Langone Academic Observership — Otolaryngology (ENT)

Boston Children's Hospital — Observership

Memorial Sloan Kettering International Observership

UHealth Clinical Observership Program — University of Miami

University of Minnesota Pathology Observership

UCSF Neuropathology Visiting Scholars Program

UNMC International Neurology Observership

Trinity Health St. Mary Clinical Observership Program

USF Morsani International Medical Trainee (IMT) Observership

Baptist Health South Florida

International Trainee Pediatric Observership — CU Anschutz / Children's Colorado

CHOP International Observership Program

SAMS — Clinical Observership (Nonprofit)

Indiana University SOM Global Outreach Pathology Observership

Columbia Neurology Visiting Physicians and Scientists — Clinical Observership

Drexel University — International Observership

USC Keck Medical Center

University of Kentucky Neurology Observership

UC Davis Health — International Observership

University of Kansas Medical Center (KUMC)

Montefiore Einstein Anesthesiology — Observerships & Visiting Clerkship

UVA Breast Imaging International Visiting Scholars

USF Health — International Training

NYU Langone International Observership — General and Medical Dermatology

UCLA Health International Physician Observership

Griffin Hospital (Yale-affiliated) Clinical Observership

University of Kentucky Radiology Observership

Cincinnati Children's Hospital — International Visitor Program

Penn Radiology Visiting Observers Program

Cleveland Clinic

Harrington Global Observership — University of Miami Miller SOM

Houston Methodist Hospital

UTHealth Houston — Observer Program

University of Chicago Medicine

UAB International Visiting Medical Observership

NYU Langone Observer Program — Plastic Surgery

University of Louisville — Medical Observership Program

Thomas Jefferson University Clinical Observerships

MSK MSO — Observership (San Diego)

BronxCare Psychiatry Residency — Volunteer & Observership

USF Health Neurosurgery Observer Program

CommonSpirit Health International — Clinical Observation

Hurley Medical Center (MSU) — Observership

Georgetown / Ruesch Center — International GI Observership

Ochsner Health — International Observership

Brooklyn USCE — Clinical Rotations

MD Anderson Cancer Center

WashU International Physician Observer — Head & Neck Surgery

Columbia Psychiatry Observerships

Stanford Health Care

NYU Rusk Rehabilitation Physician Observership

Ohio State Wexner International Visiting Scholars Program

Cleveland Clinic Florida

Saint Louis University Otolaryngology Observership

Mercy Hospital — St. Louis

University of Washington Medical Center

Panamerican Trauma / VCU International Observership

NYU Langone International Observership — Dermatologic Surgery and Cosmetics

Penn ENT International Visiting Physician Program

NAMC Internal Medicine Observership

Vanderbilt University Medical Center

UW DLMP Global Observership (Pathology)

UW Madison International Observership in Urology

NYU Langone Visiting International Physicians Program — Orthopedic Surgery

Trinity Health Nazareth Clinical Observership Program

NYU Langone International Observership — Hair Disorders

MCG Anesthesiology Clinical Observership (Currently Paused)

Orlando Health Pediatric Neurosurgery Clinical Observership

Orlando Health Medical Staff Services Observership