Why Clinical Experience in the US is Crucial for Medical School Applicants and IMGs

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Gaining hands-on clinical experience is one of the most important steps for medical school applicants and international medical graduates (IMGs) hoping to practice medicine in the US. Clinical experience provides critical opportunities to understand what it’s like to work in a clinical setting, interact directly with patients, and gain exposure to the US healthcare system.

In this comprehensive guide, we’ll cover the Value of Clinical Experience, where to find clinical opportunities, why clinical experience is so vital for your medical school application and residency, and how IMGs can obtain this crucial experience in the US.

 Why Clinical Experience Matters for Medical School

Clinical experience allows you to answer the all-important question admissions committees will have: Why do you want to be a doctor? Through hands-on learning in a clinical environment, you’ll gain insight into what motivates you to pursue this profession and develop the skills needed to care for patients.

Direct patient interaction helps you understand the medical field and confirms your commitment to becoming a physician. It also allows you to ask physicians questions, shadow their work, and gain exposure to healthcare delivery.

According to the Association of American Medical Colleges (AAMC), clinical exposure is invaluable during the medical school application process. Admissions committees want to see that applicants understand the rigors and responsibilities of working in healthcare.

Additionally, clinical experience demonstrates you have the motivation and commitment required to take on medical training. It shows your willingness to step outside your comfort zone to care for others.

 Types of Clinical Experience for Pre-Meds

There are several ways for pre-medical students to gain clinical experience during their undergraduate years:

  • Shadowing physicians: Students shadow doctors in various specialties like family medicine, internal medicine, pediatrics, surgery, etc. This allows them to observe the physician’s responsibilities and day-to-day work.
  • Volunteering in hospitals: Volunteering gives hands-on experience in a clinical setting, such as working in the ER or patient transport.
  • Clinical research: Students assist with clinical trials, data analysis, and interacting with patients in a research setting.
  • Medical scribing: Scribes document patient encounters under a physician’s supervision. This provides exposure to patient care and workflows.
  • Certified nursing assistant work: CNAs help patients with activities of daily living and gain experience providing hands-on care.
  • EMT experience: Emergency medical technicians develop skills in emergency care and work on ambulances to transport patients.

Ideally, pre-meds should pursue a combination of these activities to build robust clinical experience profiles. Gaining exposure in various healthcare roles and settings is invaluable preparation for medical school.

 Why Clinical Experience is Critical for IMGs

For international medical graduates, hands-on US clinical experience can make or break their residency applications. IMGs are competing against US MD and DO graduates for coveted residency program spots.

Residency programs want to see IMGs have experience with the US healthcare system, exposure to advanced medical technology, and an understanding of care protocols and workflows. As an IMG without US clinical experience, you’ll be at a significant disadvantage compared to US graduates.

That’s why it’s absolutely essential for IMGs to spend time gaining US clinical experience through rotations and hands-on learning. This shows residency programs you can provide care up to US standards and thrive in fast-paced American clinical environments.

Clinical Rotations for IMGs in the US 

There are a few ways IMGs can obtain clinical experience in the US:

  • Observerships: Observerships allow IMGs to shadow physicians and residents during their daily work. This gives exposure to workflows, treatment protocols, technologies, and documentation.
  • Clinical electives: These are short 2-4 week rotations at US hospitals and clinics open to international students. Electives provide hands-on learning in various specialties.
  • Externships: Externships are 1-3 month clinical training programs, often in primary care fields. IMGs get supervised clinical experience and earn LORs.
  • Research: Many hospitals and universities allow international students to assist with medical research projects. This can provide patient interaction and letters of recommendation.
  • Residency: Getting into a US residency program is the ultimate goal. Residencies give in-depth clinical training in your chosen specialty.

Because residency spots are scarce, IMGs should pursue clinical experiences like observerships and externships to strengthen their applications. These demonstrate your ability to excel in US clinical environments.

 Finding Opportunities for US Clinical Experience

Here are some tips for finding clinical experience opportunities in the US:

  • Network with family, friends, and your school’s alumni network. Personal connections can help open doors.
  • Identify hospitals, clinics, or physicians in your target location willing to take on volunteers or allow shadowing.
  • Look for hospitals that offer observership and externship programs catered towards IMGs.
  • Search online platforms like Observership Academy, Clinical Rotations, and AMCAS for clinical electives open to IMGs.
  • Attend medical conferences and networking events to connect with residency programs and physicians.
  • Consider clinical experience programs through ECFMG and AAMC.
  • Contact medical schools near your desired location, many host summer research or externship opportunities.

 Why US Clinical Experience is Key for Residency

Gaining US clinical experience can make or break an IMG’s chances of matching into a good residency program. According to NRMP data, IMGs with US clinical experience matched at nearly double the rate of those without it in 2022.

Here’s why US clinical experience is so crucial:

  • Shows you can thrive and provide high-quality care in fast-paced US healthcare environments.
  • Demonstrates you can work effectively as part of an American medical team.
  • Gives exposure to advanced US medical technologies and treatments.
  • Provides opportunity to build relationships with American physicians who can write you strong letters of recommendation.
  • Allows you to adjust to American clinical culture.
  • Gives hands-on experience with US documentation, workflows, treatment protocols and regulations.
  • Shows your commitment to understanding the US healthcare system.

Without clinical experience in the US, it’s incredibly difficult for IMGs to convince residency programs they’ll adapt well to American medical practice. That’s why this should be your top priority.

 Getting the Most Out of Your Clinical Experiences

To gain maximum benefit from your clinical experiences:

  • Be proactive and engaged on rotations – ask questions, assist with hands-on care, and learn protocols.
  • Take detailed notes about patients, procedures, medications, technologies etc.
  • Build strong relationships with physicians and administrators who can mentor you.
  • Learn electronic health record systems and documentation requirements. 
  • Brush up on your patient communication skills.
  • Study disease presentations, diagnostic methods, and treatments you encounter.
  • Clarify expectations up front – will you observe, assist, document charts, or directly participate?
  • Ask for regular feedback on your performance.
  • Request strong letters of recommendation from physicians highlighting your clinical capabilities.


Gaining robust clinical experience is a must for aspiring physicians before applying to medical school or residency in the US. Direct patient care helps develop vital medical knowledge and skills.

For pre-meds, focus on shadowing physicians, hospital volunteering, clinical research, working as an EMT, and similar hands-on roles.

IMGs should prioritize US clinical rotations, observerships, externships, and residency electives. These experiences demonstrate your ability to excel in American healthcare environments.

With strong letters of recommendation from US physicians, you’ll prove to admissions committees and residency programs your preparedness for medical practice in America. Don’t underestimate the immense value of high-quality clinical experience in the US. It can make all the difference in realizing your physician dreams.

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