It is an honor and privilege to chair the APPNA YPC (Young Physicians committee) for 2023. I would like to thank APPNA President. Dr. Arshad Rehan and the Board of Directors of APPNA for placing their trust and confidence in me to serve in this role. The goal of APPNA YPC is to assist young physicians in navigating the complicated and often overwhelming process of obtaining US residency and fellowship positions.

I have been a member of YPC for the last two years, and these past two years have made me appreciate the hard work that all our members put in to help young Pakistani Physicians and medical students.  As a chair, I would like to thank all the members of the YPC and welcome everyone back for another productive year!

We will continue all our previous activities of the YPC and, in addition, have the following specific goals to achieve this year:

Design a comprehensive program that will emphasize training students in professionalism, medical ethics, scholarly work, and DEI (diversity, equity, and inclusion). This program will start in the initial years of medical school training of IMGs to prepare them for the US Graduate Medical Education system.

Work with all our affiliate organizations to create a robust mentorship program to strengthen our existing resources and programs for visa assistance, observerships, research opportunities, residency application, and interview preparation.

Organize a series of webinars this year for early-career physicians to facilitate a smooth transition into residency and provide career guidance beyond residency.

Create residency and medical education resource videos for the APPNA YouTube channel.

As always, we are open to and enthusiastic about suggestions for improvement, so feel free to contact us with any new ideas, comments, or questions. You can reach us @ [email protected] or through our Facebook page at https://www.facebook.com/groups/308140919099/.

Nauman Ashraf (Chair)
Tamour Tareen (Co-Chair)
Sarah Makhdoom (Co-Chair)

Attique Mirza (Advisor)

Members:
Ezza Fatima Tariq
Umar Tariq
Gohar Habib Dar
Gulrayz Ahmed
Urooba Faheem
Ariba Khan
Siddique Khurram
Faraz Alam
Raheel Imtiaz Memon
Aisha Khattak
Irfan Suleman

YPC Webinars Subcommittee:
Gulrayz Ahmed
Ahmad Rehan Khan
Asra Nayab
Munis Raza
Siddique Khurram
Urooba Faheem
Shahram Maroof
Asadur Rehman

YPC Facebook Subcommittee:
Namirah Jamshed
Ahmad Rehan Khan
Siddique Khurram

YPC Advocacy Subcommittee:
Ahmad Rehan Khan
Mohammad Fateh Shahzad

YPC Observership/Research Subcommittee:
Siddique Khurram
Muhammad Zeeshan
Aisha Khattak
Ammar Javed

YPC Medical Student Curriculum Subcommittee:
Namirah Jamshed
Manal Khan
Faraz Alam
Kiran Khalid
Noor Khan
Faisal Qureshi
Tahir Hussain

YPC Media Subcommittee:
Umar Tariq
Faran Ahmad

YPC Program Directors Subcommittee:
Sadiq Naveed
Namirah Jamshed
Adbul Waheed
Faisal Aziz
Ahmad Hameed
Asif Hayat Khan
Fahd Sultan
Farooq Mohyuddin
Nausherwan Khan
Sara Kiani
Salma Malik
Sajid Mir
Zheala Qayyum
Naveed Saqib
Saba Afzal
Mujjahid Abbas

APPNA YPC Obversvership Program
The APPNA YPC Observership program aims to acculturate international medical graduates to American medical practices and help prepare them for residency. Programs will typically last from two to four weeks per rotation or specialty. These are not for-profit and all APPNA physicians volunteer their time and efforts. All clinical activities as an observer should be performed under the supervision of an attending. Learning objectives include:

  • Monitor how a physician interacts with patients, noting how to take a history, perform an examination and diagnosis, recommend a treatment, code, write prescriptions and enter information on the patient’s chart, etc.
  • Study professional communication and interaction between the physician and all members of the health care delivery team and hospital administration
  • Understand and use American colloquialisms (slang, euphemisms, medical jargon, etc.)
  • Observe the delivery of health care in a private practice, hospital or clinical setting
  • Gain exposure to electronic medical records, and learn how to access and enter data
  •  

The following two forms are to volunteer as a preceptor and apply for an observership. This is a wonderful opportunity both preceptors and graduates to prepare for residency or any choices that involve the American healthcare system.

Requirements:
– Medical school degree/diploma
– ECFMG certificate if certified
– Passport and Visa copy
– One LOR
– A non-refundable fee of $100 will be charged after confirmation of placement
– Requests from applicants who are in the US, or have a valid visa to enter the US, will be considered.  ECFMG certification is preferred (not required).
– No letters for visa interviews will be provided.

Visa application /interview tips.
– Apply for visa interview appointment as soon as You have been issued DS2019 and SEVIS ID.

  • each dependent will be issued a separate DS2019 and SEVIS ID
  • Each dependent will need separate DS160 application and fee.
  • Ask for group interview if you have dependents .
  • Duration for stay can be any where from 3-7 years depending on your residency speciality and fellowship plans.
  • J-1 visa will be valid only for a year but you can stay without getting visa stamped on passport for longer time.
  • You will be given new DS2019 every year and allowed to work even if your J-1 visa is expired on passport .
  • If you travel outside USA and visa is still valid , you can return to USA without getting visa Re stamped on passport.
  • If you travel outside USA and visa is expired you will need to have visa Re stamped on passport and will need to go through new DS160 , fee and visa interview. There is possibility of visa going in administrative processing even if you have been in USA and working as resident . It is highly recommended to travel outside USA while your visa is valid or only if you HAVE to go for something very important.
  • H-1 B is usually valid for 3 years and can be extended for another 3 years.

Emergency/expedited visa interview appointments :
– If you don’t get appointment date in May or early June , get whatever appointment is available. Then use the system and ask for expedited/ emergency visa interview appointment date. You may ask for group interview if you have dependents.

Interview :

  • For interview , dress professionally and be on time.
  • Take your dependents with you for interview even if they are not traveling with you in June.
  • Answer all questions honestly and to the best of your knowledge . If you are not sure about any question ask politely,the person on window , “can you repeat the question please “ . And if you don’t know the answer for sure , tell the person I don’t know . Don’t just guess.
  • Take all supporting documents with you including Ds2019, contract letter, letter from program to the consulate , previous/ expired passports if you have traveled to USA in the past. Take bank statements to provide proof that your previous visit to USA was financed by yourself or a family member. If you opened up an account in USA , take copy of last statement and if you received any funds in USA from family and or friends , take proof and have details of the person who gave you the money including relationship, name , and address of the person. You want to make sure that the visa section officer is satisfied you did not work and got paid in USA on visit visa.
  • Write down the dates and duration of your previous trips to the US with addresses where you stayed /did observer-ship/ rotations in the USA.
  • Be confident and respectful to the staff and look into the eyes when talking to them.
  • Technically, it is not recommended to do an observership on a B-1/B-2 visa. If you have done , be truthful and tell the officer. Make sure to tell “It was voluntary, unpaid and without direct patient contact. If you did clinical rotation as a student, nothing to worry about if you had direct patient contact as it is allowed for students.
  • It is possible that your visa may undergo an administrative process and the paper officer will handover to you may say “refused” .
  • Don’t worry it is a routine screening and will get done in 1-2 weeks in most of the cases. Let APPNA know about it and we will try our best to get it expedited.
  • The officer might ask you to provide an answer to a few written questions like your previous addresses, details of previous trips out of Pakistan, details of your family, details of your social media accounts, copies of phone records, etc. Don’t rush and don’t panic. Discuss and formulate a complete and accurate response.

Social media accounts :
Please review your social media accounts and remove any objectionable pictures, like
Photos with firearms etc. Also, delete any hateful posts or anti-USA posts.

FAQ on Fellowships for accredited and non-accredited fellowships in the US for International Medical Graduates (IMG) without completing an ACGME approved residency program

This document was created due to the need highlighted by multiple trainees on the APPNA YPC Facebook forum. This document serves as a “guide” and will be updated occasionally.

Direct fellowship is a pathway for a very small group of exceptionally qualified applicants. APPNA YPC recommends IMGs to seek residency through conventional pathways.

1-What are the pre-requisites for applying?

A Review Committee may grant the following exception to the fellowship eligibility requirements: An ACGME-accredited fellowship program may accept an exceptionally qualified applicant, who does not satisfy the standard eligibility requirements

An exceptionally qualified applicant has

1) completed a non-ACGME accredited residency program in the core specialty, and (2) demonstrated clinical excellence, in comparison to peers, throughout training. Additional evidence of exceptional qualifications is required, which may include one of the following:

(a) participation in additional clinical or research training in the specialty or sub-specialty.

(b) demonstrated scholarship in the specialty or sub-specialty.

(c) demonstrated leadership during or after residency training.

(d) completion of an ACGME-International-accredited residency program.

  • USMLE Step1 and 2, Valid and current ECFMG certificate in addition to other requirements unless applicant is a medical graduate of Canada/Puerto Rico
  • In Canada the only mandatory requirements are clinical experience in home country and passing of TOEFL or IELTS. In USA mandatory requirements are clinical experience in home country and passing of USMLE steps 1-3.
  • For General Surgery programs require 5 years General Surgery training including boards in the country of training

2-Which specialties offer fellowships for IMGs who have not completed an ACGME accredited Residency Program?

  • Allergy and Immunology* Yes
  • Anesthesiology Subspecialties Yes
  • Dermatology Subspecialties Yes
  • Diagnostic Radiology Subspecialties Yes
  • Emergency Medicine Subspecialties Yes
  • Family Medicine Subspecialties Yes
  • Internal Medicine Subspecialties Yes
  • Medical Genetics and Genomics Subspecialties No
  • Neurological Surgery Subspecialties No
  • Neurology Subspecialties No
  • Nuclear Medicine* Yes
  • Obstetrics and Gynecology Subspecialties No
  • Ophthalmology Subspecialties Yes
  • Orthopedic Surgery Subspecialties Yes
  • Otolaryngology Subspecialties No
  • Pathology Subspecialties Yes
  • Pediatrics Subspecialties Yes P
  • Physical Medicine and Rehabilitation Subspecialties No
  • Plastic Surgery Subspecialties No
  • Preventive Medicine Subspecialties Yes
  • Psychiatry Subspecialties No
  • Radiation Oncology Subspecialties No
  • Surgery Subspecialties No
  • Thoracic Surgery Subspecialties No
  • Urology Subspecialties No

http://www.acgme.org/portals/0/pdfs/eligibility-exception-decisions-byspecialty.pdf

* The Review Committee does allow the exception to the eligibility requirements for residency programs that require completion of a prerequisite residency program prior to admission.

3-How to search for these fellowships ?

4-Are there any advantages to doing a fellowship in the U.S. and Canada without completing an ACGME accredited residency?

  • Gaining expertise
  • Possibility of Job in the US if eligible for medical license
  • completing a US fellowship can count towards training requirements to for a medical license in certain states in the United States, if that is a goal.

5-Are high USMLE Scores a requirement?

  • Successful completion USMLE is required for applications.
  • Competitive fellowships will likely prefer candidates with higher scores. However, there are other considerations including research, letters of recommendation, and activities during residency.
  • Interviews play a significant role

6-Can you practice in the US and Canada after 1 year of fellowship training?

  • Ability to practice in the is dependent on eligibility for State Medical License.
  • Most State Medical Boards require a minimum of two years of training in the US to be eligible for a license.
  • check the State license requirements for eligibility to work in the US after one year.

7-How can applicants find programs that are willing to accept IMGs without US or Canadian residency training?

  • Individual programs indicate whether they accept applicants without residency training.
  • Refer to individual program webpages for more information regarding this.

8-Is it only applicable for fellowships that go unmatched or can candidates apply during the match cycle?

Candidates can apply during the usual match cycle

9-Which states allow candidates to practice after fellowship without a US residency? Are these jobs eligible for a Conrad 30 waiver or O1 visa sponsorship?

  • Any state can allow a surgeon to practice as long as he/she has the license to practice medicine.
  • It would also depend on the hospital if it would allow credentialing of a physician without ACGME accredited residency training.
  • One has to have ACGME accredited fellowship experience of at least 2 years to qualify for a medical license in most states.
  • If someone does a non- accredited fellowship, one may not get a license. In that case, you can’t practice in United States.

10-Is candidate eligible for board certification after completion of fellowship?

Orthopedics ( ABOS) and Radiology programs allow a person to sit for boards exam after practicing in an academic setting for 5 years.  In Orthopedics, it’s called Academic pathway for boards certification.

Majority fellowships do NOT allow Board Certification after completion of fellowship without residency training in an ACGME accredited residency training program.

Orthopedic Surgery Training and Experience – Required prior to Part 1 Written exam:

All applicants must have completed both a PGY-1 program or accredited internship and an Orthopedic Surgery residency program approved by the Accreditation Council of Graduate Medical Education (ACGME), the American Osteopathic Association (AOA), or the Royal College of Physicians and Surgeons of Canada (RCPSC). The ABPS accepts ALL medical residencies approved by the RCPSC, including approved residencies outside Canada.

Academic Pathway (if residency completed outside of US or Canada)

An Orthopedic surgeon who completed his or her graduate medical education outside of the United States or Canada and does not meet the requirement above may be eligible, provided he or she has been engaged as a full-time teaching faculty member in an ACGME accredited orthopedic surgery residency program for a minimum of four continuous years immediately preceding application and meets all other eligibility requirements.

Applicants qualifying under 1. A. above must submit documentation of satisfactory completion of an orthopedic surgery residency outside the U.S. or Canada verified by the Program Director and institution, and letters from the applicant’s current Department Chair and Program Director verifying the resident teaching experience.

Other Resources:

https://ecfmg.org/

https://www.aamc.org/services/eras-for-institutions/program-staff

https://freida.ama-assn.org/

https://www.ama-assn.org/education/international-medical-education

https://www.ama-assn.or/resident-students/residency/non-acgme-open-residency-fellowship-positions

https://www.uclahealth.org/pathology/requirements

https://www.aafprs.org/Professionals/Development/Fellowship_Programs/ERF/Fellowship_Programs.aspx

https://www.absurgery.org/default.jsp?policycredforeign

https://www.theabr.org/diagnostic-radiology/initial-certification/alternate-pathways/international-medical-graduates

The APPNA Young Physician’s Committee (YPC) is dedicated to helping young physicians of Pakistani origin excel in their professional endeavors. The YPC Facebook page serves an essential function in collating and disseminating information relevant to our mission, namely advocating and advancing the careers of young Pakistani-origin physicians seeking postgraduate training in North America.

Policy for posts:
1. All posts to the YPC Facebook page should follow guidelines for collegial and respectful communication as outlined in APPNA bylaws. All such posts also need to be in accordance with Facebook policies. The APPNA YPC Social Media Team will remove posts it deems in contradiction to these policies.

2. All posts to the YPC Facebook page should be in accordance with the committee’s mission as laid out by the parent organization (APPNA); namely, all posts should be made in the spirit of sharing information and resources that empower young Pakistani-origin physicians. Posts that are not in concordance with this theme are better shared in other forums and may be removed from the page in an effort to declutter and make essential information more readily available and visible.

3. All anonymous posts that do not contain any sensitive information will be removed.

4. Please share information regarding advocacy, mentorship, and other topics pertinent to advancing young Pakistani American physicians in their careers. Your contributions are much appreciated.

*This policy will be re-evaluated periodically.

YPC Webinar Series

Navigating Fellowship Match: Journey Beyond Residency

Click here YouTube video link for the webinar

APPNA Visa Residency Seminar

Click here YouTube video link for the webinar

Rank Order List: How Does it Work?

Click here YouTube video link for the webinar

 

Conducting Research using publicly available data. A conversation with Dr. Khosa and RCOP

Click here YouTube video link for the webinar

 

Supplemental Offer and Acceptance Program (SOAP) Made Simple!

Click here YouTube video link for the webinar

 

Immigration Visa Options for International ​Medical Graduates​!

Click here YouTube video link for the webinar

 

Residency Pathway for IMG for Internal Medicine

Click here YouTube video link for the webinar

 

Financial Planning for Resident and Young Physicians

Click here YouTube video link for the webinar

 

FAQ for PMC (former PMDC) Licensing

Do physicians in North America, who have never had a permanent license need to pay the penalty?
· Currently, we are charging late fees surcharge from doctors who have a Permanent /Full license that has expired. Any doctor who had a provisional license from PMDC can get a permanent license first time without any late payment surcharge after fulfilling the requisite criteria for a permanent license.

Can the application be emailed?
· Yes, payment can be made online in PMC bank account as mentioned on the website. The application & the financial transaction details can be emailed to [email protected] . We are in the process of launching our online portal where all doctors can register & process the application themselves along with the payment. We hope to start this facility soon.

Will there be a way to pay for the application via email?
· Yes, as above.

What advise do you have for physicians who want to volunteer in Pakistan for medical care?
· We want all doctors who want to indulge in clinical practice to have a valid license first. There is a policy coming in effect soon wherein any doctor can voluntarily hold his valid license on an application form or reactivate it when required. The license should be active to hold it for a certain period of time. Detailed SOPs to this effect will be on the website soon.

If a physician in North America did have a permanent license, and did not renew it, will they need to pay the penalty?
· Yes as is being done by all local & overseas doctors. We will request our worthy President to give an extension to all overseas doctors in late payment surcharge deadline as per old rates till 30 April. Currently deadline for old rates late payment surcharge is 31 March 2021.

Can the renewed license be sent to the international address in north America and how? 
· Yes, there is an additional fee of Rs. 4000/- for overseas courier service. If fees is paid along with proper address & cell number, it can be delivered to that address.

How soon should we expect the license after submitting our application? 
· Normally it takes 2-3 weeks in confirming the overseas financial transactions due too certain restrictions on payments from abroad. In some cases we have seen transactions being returned back to sender & we don’t get timely information. After confirming the transaction, we take a maximum of 7-10 working days in processing the renewal license.

Is there a charge for changing the permanent address on the new PMC license? 
· Yes, there  is a separate form & fee for that mentioned on the website.

If the payment is for applicant within Pakistan, can we still email them the form and transfer money on line?
· YES

What is the final date for the new penalty of Rs 2000 per month? 
· At present it is 31 March, but I would request the President PMC to give an extension specially to overseas Pakistani Doctors till 30 April, if possible.