IMG externships: Career investment

International medical graduates find having U.S. clinical experience critical for landing residencies.

By Myrle Croasdale, AMNews staff. March 26, 2007.

Dr. Greg Tampus graduated from medical school in the Philippines before he and his wife moved to the United States four years ago.

His wife found a job here as a nurse, but when Dr. Tampus tried to pursue his medical career, he failed to get a residency. During his interviews, each program director asked him the same thing.

"They'd ask for a year's clinical experience, so I knew I had to get that," Dr. Tampus said.

For international medical graduates such as Dr. Tampus, getting clinical experience and letters of recommendation in the United States can mean the difference between becoming a practicing physician or not.

With the number of IMGs seeking U.S. residencies rising and the number of positions almost unchanged, competition is fierce. As a result, more IMGs are seeking to get an edge with externship experience, prompting the emergence of companies offering this service for a fee, a service that until now has been offered free through a hodgepodge of physician organizations and hospitals.

Dr. Tampus, desperate to succeed, paid a firm $1,200 a month for his externships. Web sites for these companies encourage IMGs to sign on for three to six months.

Physician leaders are hesitant to say how much is too much for this service, but many would like to see externships remain a nonprofit effort.

Gamini S. Soori, MD, an oncologist-hematologist in Nebraska, is a member of the American Medical Association's IMG Section, which is working to develop guidelines to standardize externship training.