Transcript U.S. Fellowships

Michael Ott MD, M.Sc.
Schulich School of Medicine
University of Western Ontario
London Health Sciences Centre
Goals
To give a brief overview of the process
 Give you a start on how to collect information
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Disclaimer:
 Primarily based on my own experience in the
Colorectal Surgery Match
The process can be confusing
 Best advice I can give is to start early
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Fellowship
Interest
Determine
Eligibility
USMLE
EFDO
ACGME
US Customs and
Immigration
FSMB
FRIEDA
Immigration
Visa
ECFMG
State
Medical
Board
Social
Security
Number
ERAS
NRMP
Fellowship
Program
Educational
or permanent
License
Eligibility
Need to determine fellowship of interest and
determine eligibility
 Need to complete applications as soon as
deadline as some programs will stop accepting
applications
 Majority of programs will have a co-coordinator /
secretary whom can be contacted for details
 Some fellowships begin matching in R4 year

Fellowship
Interest
Determine
Eligibility
EFDO
ERAS
NRMP
Fellowship
Program
EFDO
ERAS Fellowships Document Office
Fellowship applicants contact the EFDO to get an
electronic token to access the ERAS system
 Easy application process need just a SSN or SIN
to apply
 EFDO token just allows you access to the ERAS
site
 It is the first step in the electronic application
process

ERAS
Electronic Residency Application Service

A service that transmits
○ Fellowship applications
○ Letters of recommendation
○ Performance evaluations
○ Medical school transcripts
○ USMLE/COMLEX transcripts

Essentially a electronic document warehouse
ERAS
Electronic Residency Application Service
All application information is done through ERAS
electronically
 Applications are transmitted to program directors
via ERAS
 Need EDFO (ERAS Fellowships document office)
token to apply to ERAS
 EDFO Token application July 1 usually

Function of ERAS and EFDO
ERAS Deadlines

Example for 2008 cycle
June 2007
 July 1 2007

EDFO tokens generated
ERAS opens for application
production and supporting
documents
Open to programs to transmit
documents

July 15 2007

http://www.aamc.org/students/eras/start.htm
Fellowship
Interest
Determine
Eligibility
EFDO
ACGME
ERAS
FRIEDA
ECFMG
NRMP
Fellowship
Program
ACGME
The Accreditation Council for Graduate Medical Education
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ACGME is responsible for the Accreditation of
post-MD medical training programs within the
United States
Accreditation is accomplished through a peer
review process and is based upon established
standards and guidelines
Allows you to ensure that the program applied
to is accredited
Used to track duties hours and log cases
Need to apply so that your institution that you
have trained in is accredited
Canadian schools are accredited
FRIEDA
Fellowship and Residency Electronic International Data Base
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FREIDA lists information for all the graduate medical
education programs accredited in the U.S.
Program data are collected by the AMA and the
Association of American Medical Colleges
FREIDA displays aggregate training program statistics
for each specialty and subspecialty
Information on recent graduates of training programs is
also available on FREIDA
Data about the programs and applicants from past years
Need to apply to FRIEDA so you can be recognized for
the NRMP
http://www.ama-assn.org/ama/pub/category/2997.html
ECFMG
The Educational Commission for Foreign Medical Graduates

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Program of certification for international medical graduates
ECFMG issues the Standard ECFMG Certificate to applicants
who meet all of the examination and medical education
credential requirements
○ Students completing their medical education in schools outside the
United States and Canada are considered international medical
graduates
○ Non-U.S. citizens who have graduated from medical schools in the
U.S. and Canada are not considered international medical
graduates

Canadian Graduates can obtain ECFMG # without USMLE
exams
ECFMG
The Educational Commission for Foreign Medical Graduates
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Applicants for ECFMG Certification must satisfy both the
medical science examination and clinical skills requirements
Applicants must pass Step 1 and Step 2 of the United States
Medical Licensing Examination (USMLE)
Canadian graduates can obtain ECFMG # without USMLE
exams but require:
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Medical degree
Transcripts
Letter from dean of medical school
MCCQE exams
http://www.ecfmg.org/
NRMP
National Residency Matching Program
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Use a system similar to CaRMS for matching
Not All fellowships are through the NRMP so check
early
Specialty matches occur throughout the year all have
different dates
Each requires its own registration process with the
NRMP
NRMP allows ranking of programs and a matching
algorithm similar to CaRMS
www.nrmp.org
Application to NRMP
Applicants interested in fellowships apply to the
NRMP in order to be involved in the ranking and
matching process
 Registration requires:

○ USMLE ID #, ECFMG #
○ Enrolment in ERAS
 Electronic Residency Application Service
○ ACGME accreditation
 Accreditation Center for Graduate Medical education
○ FRIEDA enrollment
 Fellowship and Residency Electronic International Data Base
Fellowship
Interest
Determine
Eligibility
EFDO
ACGME
US Customs and
Immigration
FRIEDA
Immigration
Visa
ECFMG
Social
Security
Number
ERAS
NRMP
Fellowship
Program
Immigration Visa
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ECFMG is authorized by the U.S. Department of State to
sponsor foreign national physicians as J-1 Exchange Visitors
J-1 is for resident alien in programs of graduate medical
education and training
The duration of stay for a J-1 Exchange Visitor physician is
limited to the time to complete the advanced medical
education program
J1 visa is the easiest to obtain
Need to apply through U.S. Citizenship and immigration
services
www.uscis.gov
Qualifying for J1 Visa

At a minimum, applicants must:
○ Register with SEVIS (Student and Exchange Visitor Information
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System)
Have passed USMLE Step 1 and Step 2 or an acceptable combination
thereof ( Canadian Graduates exempt )
Standard ECFMG Certificate
Contract or an official letter of offer for a position in a program
Provide a statement of need from the Ministry of Health of the country
of most recent legal permanent residence
 Federal and Provincial letters required
- Statement must provide written assurance that
- The country needs specialists in the area in which the Exchange Visitor
will receive training
- Confirm the physician’s commitment to return to that country upon
completion of training in the United States
SEVIS
Student and Exchange Visitor Information System
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SEVIS is an Internet-based system that provides tracking and
monitoring of nonimmigrant students (F and M visa) and
exchange visitors (J visa), and their dependents (F-2, M-2,
and J-2)
SEVIS application is done through the Department of
Homeland Security
Must Pay SEVIS fee to have valid visa
Other Non-Immigrant Visa
J1 – Exchange visitor
 F1 – Academic student
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○ (need enrollment in University)
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H1b – Temporary specialty worker
Fellowship
Interest
Determine
Eligibility
USMLE
EFDO
ACGME
US Customs and
Immigration
FSMB
FRIEDA
Immigration
Visa
ECFMG
State
Medical
Board
Social
Security
Number
ERAS
NRMP
Fellowship
Program
Educational
or permanent
License
USMLE
United States Medical Licensing Exam
Each medical licensing authority sets its own
rules and regulations
 The USMLE provides them with a common
evaluation system for applicants for initial medical
licensure
 3 Steps required
 Not essential in all States
 Needed to obtain medical license in majority of
US states
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USMLE
United States Medical Licensing Exam
Can obtain a educational license in most
states for the purpose of fellowship
training
 Can not moon light with an educational
license
 Need to ensure that programs do not
base your salary on shadow billing or
assist billing
 Most ACGME programs have a straight
salary
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USMLE
United States Medical Licensing Exam

Several States require USMLE 1 and 2 for licensure:
California
Delaware
Indiana
Maine
Mississippi
New Hampshire
Pennsylvania
Tennessee
Colorado
Idaho
Louisiana
Massachusetts
Montana
Oklahoma
South Dakota
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Federation of State Medical Boards publishes all the
requirements for license

http://www.fsmb.org/
Costs
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EDFO token application charge
ERAS (up to 10 programs)
USMLE transcript fees
COMPLEX fee
International medical Graduates fee
NRMP
ECFMG sponsorship of J1 Visa
SEVIS fee
J1 Visa application Fee
USMLE 1,2,3
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Total
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$ 75
$ 60
$ 50
$ 50
$ 75
$ 40
$ 200
$ 100
$ 100
$ 1715
$ 2465