michael ott md, m.sc. schulich school of medicine university of western ontario london health...
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Michael Ott MD, M.Sc.
Schulich School of Medicine
University of Western Ontario
London Health Sciences Centre
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Goals To give a brief overview of the process Give you a start on how to collect information
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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FellowshipInterest
ECFMG
DetermineEligibility
ERAS
ACGME
FRIEDA
US Customs and
Immigration
Immigration Visa
Social Security Number
EFDO
NRMP
FSMB
State Medical Board
Educational or
permanent License
USMLE
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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
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FellowshipInterest
DetermineEligibility
ERAS
EFDO
NRMP
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EFDOERAS 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
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ERASElectronic 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
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ERASElectronic 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
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Function of ERAS and EFDO
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ERAS Deadlines Example for 2008 cycle
June 2007 EDFO tokens generated July 1 2007 ERAS opens for application
production and supporting documents
July 15 2007 Open to programs to transmit documents
http://www.aamc.org/students/eras/start.htm
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FellowshipInterest
ECFMG
DetermineEligibility
ERAS
ACGME
FRIEDA
EFDO
NRMP
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ACGME The Accreditation Council for Graduate Medical Education
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
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FRIEDAFellowship and Residency Electronic International Data Base
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
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ECFMGThe Educational Commission for Foreign Medical Graduates
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
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ECFMGThe Educational Commission for Foreign Medical Graduates
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:
○ Medical degree○ Transcripts○ Letter from dean of medical school○ MCCQE exams
http://www.ecfmg.org/
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NRMPNational Residency Matching Program
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
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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
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FellowshipInterest
ECFMG
DetermineEligibility
ERAS
ACGME
FRIEDA
US Customs and
Immigration
Immigration Visa
Social Security Number
EFDO
NRMP
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Immigration Visa 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
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Qualifying for J1 Visa At a minimum, applicants must:
○ Register with SEVIS (Student and Exchange Visitor Information 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
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SEVISStudent and Exchange Visitor Information System
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
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Other Non-Immigrant Visa J1 – Exchange visitor F1 – Academic student
○ (need enrollment in University) H1b – Temporary specialty worker
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FellowshipInterest
ECFMG
DetermineEligibility
ERAS
ACGME
FRIEDA
US Customs and
Immigration
Immigration Visa
Social Security Number
EFDO
NRMP
FSMB
State Medical Board
Educational or
permanent License
USMLE
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USMLEUnited 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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USMLEUnited 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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USMLEUnited States Medical Licensing Exam
Several States require USMLE 1 and 2 for licensure:California ColoradoDelaware IdahoIndiana LouisianaMaine MassachusettsMississippi MontanaNew Hampshire OklahomaPennsylvania South DakotaTennessee
Federation of State Medical Boards publishes all the requirements for license
http://www.fsmb.org/
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Costs EDFO token application charge $ 75 ERAS (up to 10 programs) $ 60 USMLE transcript fees $ 50 COMPLEX fee $ 50 International medical Graduates fee $ 75 NRMP $ 40 ECFMG sponsorship of J1 Visa $ 200 SEVIS fee $ 100 J1 Visa application Fee $ 100 USMLE 1,2,3 $ 1715
Total $ 2465