about the program

The match procedure for a United States (US) residency is a complex and difficult process. As the gap between the number of available residency positions in the US and the number of graduating United States medical students narrows, the amount of positions available to international medical graduates decrease. To successfully match into a training position there are multiple criteria such as scores on the United States Medical Licensure Examination, previous US medical experience and prior participation in research. Therefore, preparing for this process and enhancing the educational grounding of highly selected international medical graduates in research, clinical experience and exposure to the US medical system will be beneficial.

faculty lead

Leonardo Tamariz, M.D, M.P.H
Assistant Professor of Medicine
University of Miami

aims of UMPIRE

1. Identify international candidates for training in the United States who have superior clinical skills and are research oriented.
2. In a competitive residency application process, to prepare the candidates for the expectations of the matching program and improve their visibility to US residency programs.

target audience

Physicians planning to do residencies in the United States in Internal Medicine, Surgery, Obstetrics and Gynecology, Anesthesia, Neurology, and Pediatrics.

specific learning experiences:

1. Residency scholarly activity program (RSAP) click to learn more
   The objective of RSAP is to assist trainees complete an individual original research project in their area of interest. Trainees doing the 6-month track will complete a short-term project in the form of a meta-analysis and those in the 12-month track will complete secondary data analyses or primary data collection projects. The goal is that trainees are able to present their work at national meetings and/or publish it on a peer review journal.
   RSAP is a mentored research curriculum with a total of 6 faculty mentors (two faculty who serve as RSAP directors and research mentors, the Internal medicine program director, and 3 other faculty who have monthly sessions) and one administrator. During the first month, trainees are expected to meet with the research team (clinical and methods mentors), determine the hypothesis that will be tested, prepare an IRB proposal (if necessary), attend all meetings with the RSAP directors and complete all epidemiological and biostatistical online modules. During the remaining months the trainees will have weekly research in progress meetings and complete their research projects. The trainees will have a structured mentorship relationship with a clinical and research mentor. The results of the RSAP program can be seen in the 2013 February issue of the American Journal of Medicine and has shown that seventy percent of all third year residents who take this course accomplish the goal of presenting at national meetings or publishing their original research.
2. Patient safety course click to learn more
   The objective of the patient safety course will be to specifically practice a number of safety competencies such as calling for help, teamwork and communication, hand hygiene compliance; and, preventing medication and other system errors.
   The Center for Patient Safety has developed an innovative simulation-based curriculum to impart competencies related to preventing medical errors. The course consists of a lecture, interactive workshop, and a Web-based didactic component. Small-group simulation sessions allow instructors to assess baseline competence in situational awareness, hand hygiene, and patient hand-offs. In an individual exercise, trainees perform a directed physical exam on a standardized patient and their performance is assessed. In a group exercise, team performance is evaluated in accepting a hand-off from another provider and managing a deteriorating patient. The course will be tied to a patient safety assessment that is part of the Objective Structured Clinical Examination (OSCE) at the end of the course. This evaluation will give the trainees an opportunity to demonstrate their skills in recognizing patient safety hazards and communicating them to the patient and other physicians.
3. Problem based learning (PBL)
   The objective of PBL is to foster trainee centered learning and critical thinking and to develop learning skills.
   In problem-based learning (PBL), trainees will work together in small PBL groups to solve real-world patient problems like a how to work up a patient with a particular presentation or how to manage a patient presenting multiple comorbidities. The team integrates basic sciences concepts and clinical applications in an attempt to solve the problem it has jointly identified. The goal is that through inquiry and application of prior knowledge team members will reason through problems and develop their skills to understand mechanisms rather than memorize debate issues, weigh evidence as they refine the hypothesis, analyze and synthesize information provided to come up with informed conclusions. PBL is an active and iterative process that engages trainees to identify what they know, and more importantly, what they don't know and to identify learning goals for the team and practice self directed learning. Trainees will spend 1 month in the PBL group.
4. Clinical rotations click to learn more
   The objective of the clinical rotations will be to expose the trainees to the work of the residents in clinical rotations, understanding work processes and dynamics within a clinical team and develop skills in generation of evidence-based assessment and plans for patients in the team.
   The Global Observership Program of the International Medicine Institute will assign trainees to clinical teams on the Departments of Medicine, Surgery, Anesthesia, Neurology, Pediatrics or Obstetrics and Gynecology. Trainees will complete these medical rotations on the department of their preference for a 2-3 month period. The Global Observership Program will serve as the sponsor for the visa.
5. Simulation-based learning click to learn more
   The objective of the simulation-based learning will be to practice patient interview techniques and skills.
   Trainees will conduct patient interviews and their interactions will be taped and evaluated by the faculty on specific core topics in their specialty. Trainees will receive feedback on their performance.
6. Patient interviewing skills
   The objective of the patient interview sessions will be to practice real patient interview techniques.
   Trainees will conduct patient interviews in hospitalized patients according to the visiting medical student’s policies. The trainees will be supervised by a faculty member and followed up by a discussion of the disease.
7. Practice residency interview sessions
   Trainees will conduct practice interview meetings with program directors. The objective of the session will be to practice different scenarios that can arise during a residency interview.
8. Electives
   4-week cardiology rotation: Will be done at the Gordon Center for research in medical education and is case based educational program that will include both online and in class coursework. The curriculum includes clinical electrocardiography, auscultation in the cardiopulmonary patient simulator, online educational materials that will review the most common cardiology clinical scenarios.
   
   2-week neurology rotation: Will be done at the Gordon Center for research in medical education and is case based educational program that will include both online and in class coursework. The curriculum focuses on the neurological examination and reviews many neurological conditions and specifically reviews acute stroke in detail.
   
   Harvey: The cardiopulmonary patient simulator: This full-size manikin realistically simulates nearly any cardiac disease at the touch of a button by varying blood pressure, pulses, heart sounds, murmurs and breath sounds. "Harvey" is the oldest continuous university-based simulation project in medical education, and no other simulator represents cardiac bedside findings to the level of detail and fidelity found in "Harvey."
   
   Emergency training on acute coronary syndromes advanced cardiac life support, airway management, basic life support, disaster preparedness, pediatrics, stroke and trauma.
   
   Procedures: Through a well-structured simulation based curriculum, trainees will practice abdominal paracentesis, central venous line cannulation, knee arthrocentesis, medical critical event management and thoracentesis.

timeframe

Six months to one year of such training starting in September and March of each year. The timeframe depends on the track selected by the trainee. The abbreviated research track will be 6-month duration and the extended research track will be 12-month duration. Both tracks will have components of research, patient safety, problem based and simulation based learning and clinical rotations.