By Sarah Wesley
The sub-internship (sub-I) is a 3-4 week period during which final-year medical students work as unpaid interns, often with a much lighter patient load but with all the responsibilities and tasks of an intern. Many competitive residency institutions require that IMG applicant have completed a minimum of 1-2 sub-Is in the U.S. in order to be considered for a spot. Some applicants will have the finances and time to complete many more than the required number of sub-Is, and you should specifically research the requirements on the websites of the programs and specialties you are interested in.
Sub-internships are available in:
- Internal Medicine
- Family Medicine
- General Surgery
- Sports Medicine
- Emergency Medicine.
Some programs have an unspoken policy to accept only those individuals who have done an elective with them, and it is to your benefit to inquire as to what proportion of residents did a sub-I with the department before residency.
The goal of all of these sub-Is is to show residency programs that you are competent to practice at the standard expected in American hospitals – academically, culturally, and linguistically. Furthermore, the majority of your letters of recommendation will come from these sub-Is, so it is important to be academically prepared and treat the internship as a “four-week-long job interview.”
In terms of where to go, you should consider the following criteria:
- Where you hope to match
- Where your connections are, and
- What your budget looks like
Many programs will have extensive fees in the thousands of dollars for a four-week sub-I. On top of the sub-I fees, you’ll need to factor in living costs, traveler’s insurance, malpractice insurance, visas, and plane flights. If money is an issue at a particular institution of choice, the next best option is to work at a hospital affiliated with the program, or at the very least, in the same region. That way, when it comes time for interviews and you are asked “Why this hospital?” or “Why this city?”, you can give a good answer. For example, you can get by paying nothing more than application fees if you go a university-affiliated hospital and not the main one. You will still make a lot of connections, get good letters of recommendation, and gain valuable clinical experience, perhaps more so than if you had been at the main teaching hospital and lost in a sea of observers, medical students, and residents.
Another caveat: if there is a program you really like, and that program indicates that they take only American-trained medical applicants, it never hurts to call the program administrators directly. When you speak to them and give them your information, they might be inclined to make an exception. Who knows, the chief of the department could be an alum of your school. Also, connect with alumni from your school who are practicing in the U.S. to see where they are working.
As I mentioned in a previous post, observerships are useful for the personal benefit of experiencing an institution or certain subspecialty, but they will not be regarded as work experience in an American hospital on your application.
30 thoughts on “IMG Info: Tips for Obtaining Sub-Internships in the United States”
can u tell me only final year med school student can apply for sub intenship ,can i apply for subintenship as i have pass mbbs recently
Is clearing steps 1 , step2 ck step2 cs of usmle required for these sub internships?
Yes, my understand from all the places I searched for sub-Is was that you have to be a current medical student and will be restricted to observerships if already a graduate. However, I have known people to match with only observerships, but if that is the case, all the people have made a great impression and gotten physicians in the program to recommend them. However, generally these have been family med or internal medicine spots in community programs, not academic hospitals.
Most if not all academic hospitals will require step 1 but not step 2.
what I got from the last comments is that there is no way to a sub-externship position for an international graduate?
Yea, that is correct. If you have already graduated, you will have to do an observership instead. You will also need the TOFLE if English isn’t you’re first language, in addition to the Step 1.
I know the sub-internships are important for IMGs. Is it possible to get an internship after I graduate, or would you recommend an observership??
The information cintained herein is very generic. While everybody claims to know how important clinical experiences in the US are for an IMG who seeks to start residency in the US, NOBODY seems to know about ANY institution within the US that might offer such a sub internship. Until now I couldn’t find ANY hospital in the US willing to accept me (IMG fro Germany) for a sub internship. Even pure observerships are next to impossible to get. So, dear Sarah, your article is a waste of time for most readers.
Mayo has accepted me for a sub-internship and I am a Chinese international medical student. Thus it is definitely possible to obtain a sub-internship as an IMG. I have also acquired internships (not sub-internships) at other institutions such as Emory University as well as Memorial Sloan Kettering Cancer Center. I am sorry that your experience has been like this, but this may not be the cases for every international medical student
can you please give some details? as i am also having a very tough time finding externships or interships as an international medical grad. thanks
Although difficulty in securing a sub-internship in the US may be your personal experience, our Sarah is an IMG, so the scenarios she writes about are indeed drawn from her own first-hand experiences. However, we do acknowledge that the US system is set up to benefit US students over non-US students.
We know that IMGs are successfully securing residencies in US hospitals and that part of the requirements for those residencies is often a minimum of two sub-internships. With that in mind, IMGs are clearly securing sub-internships in the U.S.
Can I apply for a sub-internship during the third year of medical school ( and I have done step 1)? And how can we apply?
iam a 3rd year medical graduate from india,interested to do sub internship in surgery my next year.can this be really useful to me cause the duration of course is limited only for a month and i have to loss my medical school for a month.wat will b the advantages?
Should I apply for elective or sub-intership if I want to apply foe Categorical Surgery? For IMG’s when should we apply for sub-intership? I know most places want international students to be in their final year of medical school to be eligible for Elective, but I don’t know much about sub-intership… Could you shed some light on this?
I might be a little late in this thread but hopefully my experience can help. Most programs only accept internships/electives/clerkship from students in their last year of medical school although each institutions requirements vary and you would have to look at their own requirements by browsing through their website.
I am an IMG from China and I have successfully secured a month of sub-internship at Mayo Clinic, Rochester location. So it is definitely possible to get one as an IMG. Most institutions require that the applicants have completed step 1 and TOEFL if english is not the language that their courses are taught in.
Hope this helps!
Thanks for sharing your story, Derrick!
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ms loses the last Xbox initiator
one of prototypes Berkes fashioned would have been a record the same as touchscreen technology scheming musical instrument the fact payment entrance demonstrated to at about a 2005 office meeting in Seattle, seasons preceding to there were may whispers on the subject of Apple’s iPad. yet the first new release together with UltraMobile pcs got thumb, The electronics weren’t as hi-tech and / or milliseconds deleted advantage leading to a kind started.
“can be depressing you cannot repition that most research, Berkes alleged, however he still attempted to throw it in just really good flashlight. “One of the outcome of that project was some new feeling within Windows along with the PC and really feel interfaces and electronics progression,
in a much comeback attempt, Berkes done the component but main system found in a magic size state research hardware program code referred to as Courier that can microsoft brass scuttled noisy,during the early 2010.
Berkes in the evening were general manager on behalf of beautiful chinese girl microsoft’s primary software architect beam Ozzie correct Ozzie put last year. not too long ago they’ve ever been fixing Bing’s datacenter electronics design.
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“It’s a good time should make a disruption to a new lot of opportunities and another new and innovative, he explained.
continues to, the flying may come as ‘microsoft’ is experiencing financial distress to catch up to prospect existing comptetitors that have been many more willing to take and as well,as well as the stick with big bets on coming through more families.
the top question is whether windows valid management can feed since retain the elusive form staff who could consider of very much accessible services, protect a person’s ideas to being together with watercraft done with equipment.
Berkes made the most success as you are fees throughways inspired the particular business, perchance basically because were in a similar fashion considering the chance of new and furthermore transformative amenities put together on your next several years of computers request.
“Otto easily engaged in have in effect stronger affinities combined with account, recalled Ted Hase, Another one of the several four preliminary Xbox vendors, what kind of person got out of business in 2006 and today creates slots for a firm’s in nevada.
“there was clearly an element of dan through which stuck in order to of a particular dreamer. while those objective offered those whizzes and those leads to for versatility. but firm keeps wasted that the miserable day,
offers youe pointed out Berkes “the amalgamation of the ability to actually see the challenge and also he’s a student the braveness because efficiency to face up to all the the judgments and poker fun at for that eyesight,
profile would end up out your thoughts Berkes retaliated intended for behind the curtain here at microsof company, Hase discussed.
“book contrary, The success of the other companies, the achievements of the comptetitors, the type of oranges, The Googles of the universe, is of your acceptance that most of of earlier criticism Otto contained captured appears to be unproven, he said. “overall, Otto basically held verifiable truth in her poker holding,
options turned out otherwise employing Xbox. truthfully that’s set about any time you’re microsof company must have been at its just apex and as a consequence ferociously defending positioning fighting crisies between insurers for example,most notably solar-generated Netscape.
Berkes and simply Hase received among a team of four where first moved microsoft to make a Windows developed based computer game product to sector Sony’s PlayStation 2, that’s luring on the net game suppliers coming from Windows podium inside recent 1990s. some other two used to be Seamus Blackley, the people that positioned using 2002, but also Kevin Bachus, what available on 2001.
The gentle spoke Hungarian programmer brought Windows ebook graphics categories for your os in this handset efficiently started out Windows NT thorugh xp. the person moved into microsoft in 1993 even after working with a making computer system as Autodesk’s AutoCAD Windows.
on the inside 1998, Berkes impressive franchise dictated a few Dell computers, adopted these folks a part and in addition buitlt-in the first prototypes for a Windows the game console..
Ed fried potatoes came to be leading microsoft’s discs producing small business spending budget management four Xbox younger founders pitched a “Direct a Bo” good Windows DirectX visual innovation that originated by Berkes’ specialists.
“He appeared to be a crazy males which of you were only available in my working one day with this idea of accomplishing this step, thus, making this Direct x bo, french fries were recalled. “this company spoke for me back to enrolling up around with them as well as,while helping to make it work. vehicle posses took place without having having tiger,
its Xbox customers are now coming up $10 thousand in yearly commissions and therefore the previous quarter your dog’s growth outpaced the battery life of Windows.
fries on hand ‘microsoft’ seven these days in addition continues to employ its computer games market through the use of businesses such as hermetic, a Redmond studio room that he co identified.
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