These are some of defining terms that you may find useful.

In most cases, the terms ‘Clerkships’ or ‘Electives’ are clinical rotations granted by US Medical schools to medical students. Note that I said students and Not graduates. This implies that you need to be still enrolled in the 4th year of your home-country medical school while applying and will be doing part (one to three months) of those 4th year rotations in the US. Such rotations, besides being accepted by the US Medical school, also needs a “NOC” – No Objection Certificate, from the Dean of your own medical school or University.

Note: The term ‘4th year medical school’ is often referred to as internship year in some places like India. While in the USA, an Intern is the First year candidate in any Residency program , also called PGY1

Experience-wise, Electives are like doing a medical school internship in another hospital which gives a good hands-on experience, you are allowed to do physical exams, touch the patients besides histories, case presentations and lab-result followups. You are not held liable for errors because of your student status.

Once you graduate out of your Medical school you become an “IMG” for US purposes and you no longer qualify for Electives / Clerkships in the USA, (unless you re-enroll in a US Medical school – Yeah, some rich fellas do so). Instead, IMGs can avail of the following kinds of USCE.

You do the same thing as an externships, except that you are still a ‘medical student’ – not a medical graduate.

Externships are clinical rotations for International Medical Graduates that give a solid hands-on experience working as a resident under supervision. You do almost everything that a PGY1 resident does except that your medical notes need to be approved by a resident or attending and you will not have the authority to write orders and prescriptions.

Often an externship spans a single department, while a sub-internship or mini-residency may be longer over several specialties.

An Observership or shadowing (Sometimes also called as a preceptorship) means exactly what the english word means – to see and note without touching the patient ! In most cases they consist of attending morning rounds, seminars, student lectures and attending case presentations. You cannot touch the patients and perform physicals.

Some places may also call Externships as or a Sub-internships or a Mini-Residency, but the terms are not always strictly externships. Likewise, at times, when a program says “externship” it may actually mean an Observership – so it’s upto you find out beforehand, the nature of the rotation.

Thus, Externships, Sub-internships, Mini-Residencies, Clerkships or Electives are considered true USCE since they give you ‘hands-on’ clinical experience, whereas Observerships or Shadowing only give you a chance to be a passive observer without being allowed to touch the patient.

Sometimes a program may explicity mention that Observerships do not count as USCE ! For example, the University of Michigan psychiatry residency program at Ann Harbour. An example of a “Mini-residency” is the Mt. Sinai Mini Residency Program at Miami, Florida, in 13 Specialty areas (300$ per area) . For registration, Info and contacting – Click Here

Be advised that in terms of importance for getting considered for a Residency position :

“Hands-on Experience is Better than Observerships”

Thanks to original writer.



  1. hi, thank you for the valuable info
    please can you tell is there a maximum limit for clerkship? as you said above its for one or three months( in a single school), can we take up clerkship for like 4 or 5 months collectively( for eg 1 month in one school, 2 months in another schl and 2 mre months in diff schl)???

    • If you can…. you can do as many times as you want..
      Here clerkships correlates with internship period of our indian colleges. you ought to having special permission from your college regarding this.

  2. I’m currently in the very beginning of my final year( med,surg,ped n obg- exam going in dec 2010) in lndia. I went through the eligibility criteria of most visiting student clinical elective programs.. tey requires me to be in final year in my medical school.. I’m in confusion.. does THIS final year mean my internship or my actual final year (as of said in our Indian colleges)
    Pls help me out..

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