In business and in life, whether you’re spending money or exerting effort, it’s understandable to expect a tangible return on what you’re investing. This is especially true for international medical graduates (IMGs) hoping an observership will help them get accepted into residency in the United States.

From coast to coast, there are several observership programs for IMGs planning to build medical careers in the US. They range from four to six weeks and can cost as much as $10,000, plus the additional costs for application fees, housing and visas. With so much at stake, we interviewed Dr. Amy Yue Yu, who oversees Johns Hopkins’ Hospital Medicine Observership Program to see how observerships can help IMGs succeed.

The Johns Hopkins observership program is a relatively new, highly competitive, six-week shadowing and mentoring experience at Bayview Medical Center, a teaching hospital in downtown Baltimore, Maryland. 

PracticeLink: How does the Johns Hopkins program help IMGs settle into the US?

Dr. Amy Yue Yu: Some observers find accommodations through their own existing relationships. For others, we’ve compiled a list of potential residential areas next to Bayview Medical Center or Johns Hopkins Downtown. This information is shared with them when they are accepted to the program

On orientation day, we provide them with a list of local restaurants and areas of interest. Throughout their observership, we invite them to award ceremonies, baby and wedding showers and different celebrations. We also have work get togethers, so they don’t feel left out while they’re in the US.

PL: How does the program help introduce American culture?

Dr. Yu: Observers are invited to cultural events, including celebrations during Hispanic month, African American month, Pacific Islander month and other ethnic and cultural observances, where we introduce cultural food issues, as well as historical and cultural lessons.

Then there’s the matter of diversity, equity and inclusion (DEI) and its role in the U.S. and American healthcare. I think it’s almost impossible to have a conversation about IMGs without talking about DEI. IMGs represent diversity in US and in healthcare. As much as we want them to respect and be mindful of cultural equality in the US, they also deserve equity and inclusion. 

In our observership program, basically half of our observers are females, and they came from 10 different countries. And remember, we’re still pretty new. We have only had 14 observers so far. It’s already a very diverse group. A few of them are MD PhDs, several have MBBS degrees, and the rest are MDs. 

They have their own preconceived notions about the US, definitely. I mean, they are in their late 20s, early 30s. They probably have a vision about things already before coming to the US. They are culturally wise, and they love to share. 

We come together like a family. One of the most wonderful feedback comments I received from our observers is how much they feel like a family at the end of their rotation. They become like brothers and sisters from different cultures.

PL: How do you make sure the IMG observership experience is successful?

Dr. Yu: I have heard that some observers in other programs reported feeling lost and angry. I am very proud to tell you that this is not the case with our observers. They are heard. They’re cared for. From day one we have a dedicated coordinator. 

By sending their orientation schedules in advance, nothing is a surprise. They know exactly where to be on day one, who they are going to be with and what their schedule looks like. It is an epic schedule and everything is laid out. You know that at 8:45 you’ll be doing this. At 9:00 you get this. You know who’s going to escort you to get your badge, and where you’re going to do your training. 

Additionally, we periodically check in prior to their arrival, because some of them may be accepted a month before her rotations actually start. We check in to make sure they’re doing okay. 

So day one is dedicated orientation and training. After that, they have several scheduled meetings with me, the program director. Then we meet on an as-needed basis. They also meet with a core faculty member, which is the observer’s weekly private meeting. And then there’s the trained RISE counselor meeting with them privately at least once throughout their rotations. 

The door to my office is always open. The observers can always get a hold of me. Sometimes I’m clinical, in which case, I’m not here. But if I’m not clinical and I’m in my office, my door’s always open. Sometimes they just reach out to me, like, “Hey, Dr. Yu, do you have five minutes to talk about something?” I’m very flexible. 

We also have a dedicated office for observers. Once you enter, it is an open area where our observers hang out. Feedback from previous observers is posted on the white board. The very first observer did it, and it just became a tradition. 

  • This program has been amazing experience offering invaluable learning opportunities and supportive mentorship. I hope you find it as enriching as I did, and wish all of us great success in the future.
  • Thank you for a wonderful learning experience. It has been an absolute privilege to have been a part of this team. I look forward to maybe crossing paths again in the future as colleagues.

PL: Does the program offer letters of recommendation?

Dr. Yu: I just wrote a letter of recommendation today. Individuals successfully completing the program can request one letter of recommendation from the program director. We encourage them not to ask individual providers they work with for a letter, because they may not have enough exposure with the person to feel comfortable doing so, and then they end up writing a letter which is not good enough for the person. 

Our program has a nickname. It’s called FAITH: the Focused Accelerated IMG Training in Healthcare program. We think every IMG needs to have FAITH. We are flexible. We understand things happen in life. We have had situations where people were accepted and booked their flights but then a family member got sick. We are flexible enough that they can start one week later. We make accommodations. Maybe instead of working five days per week, that person worked six days per week.

An observer must complete the program to earn a letter. 

PL: Should IMGs do multiple observerships?

Dr. Yu: I would suggest a “quality over quantity” kind of strategy. Residency programs look at both inpatient and outpatient experiences. If you choose to do two observations, select one that’s inpatient, and one that’s outpatient. However, applying for multiple observership programs can be financially challenging to many IMGs, so my suggestion is to find the program that is most fit for your personal goal and vision. 

PL: How can the Johns Hopkins program impact the careers of IMGs?

Dr. Yu: We offer targeted lectures, mentorship, publication opportunities, mock interviews and more. 

We survey our observers before and after their rotation. We don’t run the observership program  based solely on what we think IMGs want. We listen to them. They tell us what they like, what they don’t like, what their expectations are, and whether what we did met those expectations. 

What they gain from this observership program is not just limited to an additional line on their CV or a letter of recommendation. They receive a true understanding of how the US healthcare system actually works and how a US hospital works. They also find friends of a lifetime, they network, they publish, and they are ready for their residency and future success. So they’re always able to put their best foot forward. That’s our goal.

For more information on observerships, immigration and visa assistance, visit PracticeLink.com/resource-center.