International Medical Education

Daniel Rivers talks U.S. clinical experience opportunities for IMGs


AMA's Moving Medicine video series amplifies physician voices and highlights developments and achievements throughout medicine.



In today’s episode of Moving Medicine, in honor of the AMA’s International Medical Graduate, or IMG, Recognition Week, AMA Chief Experience Officer Todd Unger talks with Daniel Rivers, partnerships director at AMOpportunities in Chicago, about the benefits of a United States Clinical Experience (USCE), including what they are and how to land one. 

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  • Daniel Rivers, partnerships director, AMOpportunities

Moving Medicine video series

AMA's Moving Medicine video series amplifies physician voices and highlights developments and achievements throughout medicine.

Unger: Hello. This is the American Medical Association's Moving Medicine video and podcast in honor of AMA's International Medical Graduate, or IMG, Recognition Week. Today we're talking to Daniel Rivers, partnerships director at AMOpportunities in Chicago about the benefits of a United States clinical experience, including what they are and how to land one. I'm Todd Unger, AMA's chief experience officer in Chicago. Daniel, thanks so much for joining us today. For those that don't know what it is, can you begin by explaining what a USCE, or United States clinical experience is?

Rivers: Sure. Well, welcome everyone and thanks. When we started our organization about a decade ago, it was really just medical students from abroad, known as IMGs for graduates, international medical graduates mostly and students coming to the United States for in-person either observership or hands-on. Now with the pandemic so much has changed with the U.S. residency match and we've grown quite a bit and we now offer many different types of USCE, United States clinical experience that can be research or hands-on rotations, observerships, kind of advanced study and that can be either virtual or in-person now. So there's this whole world of virtual USCE that also qualifies for the U.S. residency.

Unger: Well let's talk a little bit more about what is a clinical experience and for U.S. and international medical graduates. So can you talk a little bit more specifically about what that looks like?

Rivers: Sure. Well, the majority are either observerships or hands on, our visitors. And that's where you are actually going into a clinical setting either virtually or in person, interacting with patients, doing your differential diagnoses, giving active case presentations, really learning the U.S. health care system and also the specialty that you're rotating in.

Unger: I guess I should have asked just to start, why do one of these? Where does that take you and kind of what's the advantage of the program?

Rivers: Sure. Well, the U.S. is still a leader in medical education and there are quite a lot of medical students and graduates who simply want to do one away rotation in the U.S. or maybe they're already a doctor and they want some advanced training. So that's one reason. I would say at least 50 to 60% of our visitors really want to go through the U.S. residency match process and it is a requirement to have experience in the U.S. health care system and earn your letters of recommendation.

Unger: And this lasts about ... how long did you say?

Rivers: So all of our programs are four weeks. They can be stacked but we feel it takes at least four weeks to develop a relationship with a preceptor, really learn the specialty and how it's practiced in the United States in order to earn a very good and personalized letter of recommendation.

Unger: Now you mentioned upfront about virtual options, obviously people are having to make adjustments for the pandemic, how's that affected the program, I'm curious?

Rivers: Well I think that's the biggest misconception if anything out there is that virtual is the not kind of equivalent in person. Now it is specialty dependent but with I believe 80% of U.S. physicians right now using online telehealth in some capacity in their practice it has become extremely important for all medical students and recent graduates to have at least one clinic experience virtually so they can see what kind of cases can you diagnose virtually and how is a surgical rotation done virtually and all those questions. But as far as the U.S. residency match there have been plenty of visitors that did their clinical experience virtually, earned their letters and applied for the U.S. residency match.

Unger: Now I know that international medical graduates are a huge part and very important to the health care system here in the United States. Can you talk a little bit about the benefits to our health care system of a program like this?

Rivers: Sure. About 27% of U.S. physicians are foreign trained, or what we call IMGs. Now that includes U.S. IMGs, non-U.S. IMGs but 27% of the U.S. health care workforce. So it's extremely important that student graduates from all over the world who want to pursue residency in the United States have a clear and simple pathway to pursue that. And that kind of starts with doing a U.S. clinical experience, make sure that you understand the U.S. health care system and this is something you want to pursue.

Unger: I think people would probably be stunned at that figure that you gave about the percent of international medical graduates and I think in some areas of the country extremely critical to our health care systems. And I think one other thing that I've of course learned over the past few years just the number of obstacles that IMGs face. It's really neat that a program like this can be part of the support system. Can you tell us what the support system is in place for students and graduates who participate in these programs?

Rivers: Sure. With AMO we have more than 250 clinical sites active on our platform at any given time. We're partnered with more than 350 private practices, clinics, hospitals and we will ensure all your documents are collected. We will assign you a success coach that you can bounce ideas off, help you with flights, housing, malpractice insurance. We know that medical students and graduates, medical school graduates, are extremely busy. We've helped more than 4,000 now participate in our programs and we just want to make the process easy and simple. And there also are a lot of support services in terms of throughout the COVID pandemic. The great thing about AMO and our programs is that we never stop. As certain hospitals maybe closed and couldn't accept medical students, even U.S. medical students, we have such an extensive network that we can suggest to the visitors other sites they can rotate at. We would never make changes without the students or the visitor's permission but we have that network. So there are always more options for you. You are always supported coming through AMO.

Unger: Just listening to those obstacles that's enough to stop almost anybody in their tracks, it's a lot of work and a lot of support that you're providing. Can any international medical student or graduate apply?

Rivers: Yes, our programs are guaranteed, I think that's what's set us apart from other ways of going about getting U.S. clinical experience. You can create an account for free through the AMA, you can create applications for free and then once you're approved, you can schedule a meeting with an advisor and discuss it and decide if this is right for you. But you simply need to be either a current medical student or graduate, and as long as you are in good standing and you graduated in good standing, you can participate. Although some programs do require USMLE Step 1, it is only a handful of programs. The vast majority of our programs do not require any board exams. You simply need again to be either a medical student or graduate, although we also have other types of programs for premed students, as well as nurses, dentists and physical therapists.

Unger: And for those who are interested how do they find out more about the program and begin the application process?

Rivers: We often post webinars with the AMA, I would say join one of our full webinars and create an account with the link that you will see in the comments.

Unger: All right, we'll find out more at that link and look into the program, it sounds like a huge benefit. That wraps up our episode. Daniel, thanks for sharing this important information.

The AMA will be hosting a Facebook Live with AMOpportunities in the AMA IMG section Facebook group on October 20 at 7:00 p.m. Central time. I hope you'll join us there. We'll be back with another Moving Medicine video and podcast shortly. Never miss an episode by subscribing to AMA's YouTube channel or podcasts at Apple, Spotify or wherever you listen to your podcasts. Find all of our videos and podcasts at Thanks for listening, please take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.