How to Secure the Best US Clinical Experience (USCE) for IMGs and Maximize Your Residency Match Success
- Ash Eighaei Sedeh MD
- Mar 22
- 3 min read
For International Medical Graduates (IMGs), securing high-quality US Clinical Experience (USCE) is one of the most critical steps in strengthening your residency application. Residency Program Directors want to see that you can function in the US healthcare system, communicate effectively, and work well with teams. But with so many types of USCE available, how do you know what’s best for your application?
In this guide, we’ll break down:
✔ Types of USCE & which one is best for IMGs
✔ How USCE strengthens your ERAS application
✔ Where to find quality USCE without wasting money
✔ How to get a strong Letter of Recommendation (LoR) from USCE
What is US Clinical Experience (USCE) ?
USCE refers to any clinical exposure IMG applicants gain in the US before applying for residency. Program Directors want applicants who are already familiar with the US healthcare system, and the best way to prove that is through USCE.
Types of USCE for IMGs
🔹 Hands-On USCE (Best Option for Residency!)
✅ Externships – The best option for graduates; involves direct patient care, charting, and real clinical responsibilities
✅ Clerkships/Sub-Internships – Hospital-based, available only to final-year medical students
🔹 Observerships (Limited Value)
🚫 Shadowing Only – No direct patient interaction
🚫 Less impactful LoR – Many Program Directors prefer hands-on USCE
🔹 Virtual Rotations (Great for Budget or Visa Restrictions!)
✅ If structured properly (like ours), preceptors assign cases, assess management skills, and write personalized LoRs
✅ Best alternative if you cannot get a visa
Why USCE is Essential for IMGs Applying to Residency
💡 1. Residency Programs Prefer US-Based LoRsProgram Directors want Letters of Recommendation (LoRs) from US physicians. A strong LoR from an attending physician who has worked with you clinically can significantly increase your interview chances.
💡 2. Helps You Secure US Clinical Skills AssessmentMost IMGs have never worked in the US healthcare system, and residency programs worry about how quickly an applicant can adapt. Hands-on USCE helps prove you can function in a US hospital setting.
💡 3. Shows Commitment to Practicing Medicine in the US Program Directors prioritize IMGs with strong US experience because it shows dedication. If you don’t have any clinical exposure in the US, your application is automatically at a disadvantage.
💡 4. Some Specialties Require US Experience for InterviewsCompetitive specialties like Internal Medicine, Psychiatry, and Family Medicine often require US rotations to even consider IMGs for interviews.
How to Choose the Right USCE to Strengthen Your Application
🔹 Prioritize Hands-On USCE Over Observerships: Observerships provide exposure, but they lack patient interaction. Choose externships or sub-internships where you can actively participate in patient care.
🔹 Select a Preceptor Who Will Write a Personalized LoR: Residency Programs can tell when a Letter of Recommendation is generic. Work closely with your preceptor and aim to earn a strong, personalized LoR.
🔹 Consider USCE in IMG-Friendly States: New Jersey, New York, Florida, Michigan, and Pennsylvania are known for having IMG-friendly residency programs. Completing USCE in these locations can increase your match chances.
🔹 Get a Mix of Inpatient & Outpatient Experience: Some programs prefer inpatient experience while others focus on outpatient rotations. If possible, do both to diversify your ERAS application.
How to Secure a Strong LoR from Your USCE Rotation
🌟 Be Professional – Arrive on time, be prepared, and dress appropriately.
🌟 Engage Actively – Ask questions, take notes, and show enthusiasm.
🌟 Impress Your Preceptor – Show medical knowledge, clinical skills, and teamwork.
🌟 Ask for an LoR Early – Preferably by week 3 of a 4-week rotation to give your preceptor time to write it.
💡 Pro Tip: If a preceptor has too many students at once, their LoRs are often generic. Choose preceptors who work with only a few students at a time for a stronger, more personalized LoR.
Why Choose IMG Rotations for Your US Clinical Experience?
🌟 Exclusive Rotations with University-Affiliated & Hospital-Based Preceptors
🌟 Hands-On USCE Available – Not Just Observerships
🌟 IMG-Friendly Locations & Specialties
🌟 Preceptors Provide Personalized, High-Quality LoRs
🌟 Budget-Friendly Virtual Rotations for Those Without a Visa
📢 Limited Spots Available – Secure Your USCE Rotation Today!
🔗 Visit imgrotations.com to browse our available rotations!