For medical students and international medical graduates (IMGs) planning for Residency in United States, clinical rotations are essential for gaining hands-on experience in a US healthcare setting. These rotations provide exposure to clinical practices, patient care, and hospital systems, ultimately enhancing a student's medical knowledge and increasing their competitiveness when applying for residency programs. When deciding between a telerotation and an observership, several factors should be considered, including the type of experience desired (Inpatient/OutPatient), individual goals (Like – Personalized LORs, Rotation under Program Director), and personal circumstances (Budget, Location, Community, Track Records).

Telerotation

A telerotation is a remote clinical rotation where students participate virtually in clinical activities under the supervision of medical professionals. This is typically facilitated through video calls, online platforms, and virtual case discussions. Telerotations have gained popularity, particularly among IMGs, as they offer an alternative to traditional, in-person rotations. They became especially prominent during the COVID-19 pandemic when travel restrictions and safety concerns limited physical access to hospitals.

Advantages of Telerotation:

1. Flexibility: One of the most notable advantages of a telerotation is its flexibility. Students can complete the rotation from their home country, eliminating the need to travel. This is particularly beneficial for IMGs who may face visa issues or other logistical challenges when traveling to the U.S. or other countries.

2. Cost-effective: Telerotations are generally more affordable than in-person observerships. They eliminate expenses such as travel, accommodation, and daily living costs. This makes telerotations an attractive option for students with limited financial resources.

3. Variety of Specialties: Telerotations often offer the opportunity to participate in multiple specialties. Students can explore diverse fields such as internal medicine, pediatrics, and cardiology, broadening their clinical exposure without geographical constraints.

4. Access to Renowned Institutions: Through telerotations, students may gain exposure to top-tier medical institutions and well-known physicians, which can enhance their academic credentials

Disadvantages of Telerotation:

1. Limited Patient Interaction: A significant drawback of telerotations is the restricted direct contact with patients. Although students may participate in virtual patient consultations and case discussions, they miss out on the physical examination and bedside interaction, which are critical aspects of clinical training.

2. Perception by Residency Programs: Not all residency programs value telerotations equally. Some may view them as less substantial compared to in-person experiences. This can be a limiting factor for students relying heavily on these rotations to strengthen their applications.

3. Technology Barriers: Students from regions with limited internet connectivity may face difficulties participating in telerotations effectively. Technical issues can disrupt learning and reduce the overall quality of the experience.

Observership

An observership is an in-person clinical experience that allows students and graduates to observe the day-to-day practice of physicians in a hospital or clinic. While the primary role is observation, some observerships may provide limited opportunities for students to interact with patients and assist in non-invasive clinical tasks.

Advantages of Observership

1. Hands-on Experience: Although the extent of hands-on activities may be restricted, observerships often allow students to witness real-time patient care, clinical procedures, and diagnostic processes. This provides a more comprehensive understanding of the clinical environment compared to telerotations.

2. Networking Opportunities: Being physically present in a healthcare setting allows students to build relationships with physicians, residents, and medical staff. Networking can be invaluable when seeking letters of recommendation (LoRs) and future residency opportunities.

3. Exposure to Healthcare Systems: Observerships offer firsthand experience of the healthcare system in a particular country, especially the U.S. IMGs seeking residency in the U.S. can familiarize themselves with medical protocols, electronic health records, and patient care standards

Challenges During Observership

1. Cost: Observerships can be expensive. Participants often bear the costs of travel, accommodation, meals, and other living expenses. These costs can add up, particularly if the observership is in a major city or lasts several weeks.

2. Limited Clinical Participation: While observerships provide proximity to patient care, they do not always permit students to engage in direct patient management or perform clinical procedures. This can be frustrating for those seeking hands-on experience.

3. Visa and Legal Barriers: IMGs may face challenges obtaining a visa to enter certain countries for observerships. Additionally, institutions may have specific legal requirements, such as immunizations or background checks, which can complicate the process.

Key Considerations When Choosing Between Telerotation and Observership

1. Career Goals: If your goal is to gain hands-on clinical experience and build relationships with physicians for strong LoRs, an in-person observership may be more suitable. Conversely, if you aim to enhance your knowledge in multiple specialties or are constrained by location and budget, a telerotation could be the better choice.

2. Residency Program Preferences: Research the requirements and preferences of the residency programs you are interested in. Some programs value in-person U.S. clinical experience more than virtual rotations.

3. Financial Resources: Evaluate your budget. Observerships can be costly, while telerotations are often more affordable. Consider the return on investment in terms of experience, networking, and future residency prospects.

4. Accessibility: Consider visa requirements, travel logistics, and personal obligations. Telerotations are more accessible for those facing travel restrictions, while observerships offer immersion in clinical settings.

5. Letters of Recommendation: Strong LoRs from U.S. physicians can enhance your residency application. Observerships may facilitate stronger, more personalized LoRs compared to telerotations.