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Go for a tone. We don't want you to burn al life. See, that's you guys on. Hello? Hi guys, I'm Melanie. Um I don't if I want to introduce yourself, Sandra. Yeah, welcome to the USA and Canada breakout room. Um So we're gonna give you tips and tricks on how to plan an elective in Canada and the USA and share a little bit about our journey and what we like and what we don't like et cetera. Um So I think Sara is gonna get first and talk about Canada. Yeah, so I'm gonna spend like the first kind of 20 to 25 minutes on Canada and then Melanie will do the US and then we'll have uh 10 minutes at the end for questions. I think you said there are 54 people. So I don't know, we're like at 26 right now. So I might just give it like two more minutes and then get started. Um If you have any questions throughout just like type them in the chat and then as soon as we're done, like we'll take a look at them and address them. Um Good. You seem to be stopped on 26 so maybe it's only 26. Yeah, maybe we all start on 26. Yeah, maybe I'll just get started then. Sounds good. Ok. Um So as I said, my name is Sandra. I'm a final year student at Queens University Belfast and today I'm gonna be talking about medical electives in Canada. Um This is my email at the bottom and I'm gonna also have it on the last side. If anybody wants to email me any questions, I'm more than happy to help out. Um So to start off, so some of the things I'm gonna be talking about are just common terms that you're gonna be hearing. Um If you do an elective in Canada, I'm gonna talk about my experience and how to decide like what elective you wanna do and what hospital you wanna do and things like that. I'm gonna talk a bit about the application portal, how to choose a university when to apply for an elective, the steps, the applying and the documents that you're gonna require. Um So the first thing that I'm gonna do is just talk about common terms because I found that there are like some different terminology that they use there versus um in the UK or Ireland. So over there, you'll find them referring to rotations, which is basically what we call placements. Um attending or staff are consultants. Um A resident is the first step that they kind of take post meed school, which is equivalent to specialty training in the UK. And clerkship is what they call their 3rd and 4th year of medical school, um which is kind of similar to, I guess the UK, like 3rd, 4th and 5th year for them. It's just like those two years, an observer ship is different than an elective in the sense that observer observer ship is just shadowing. So um there's limited or no patient contact. And as I said, um so residents is in residency. So it's like post meed school, um specialty training. And so my experience, so I am a Canadian student. Um And obviously, I study in Belfast. Um But because I'm a Canadian student, I've been able to kind of have more experience in Canada because my university loves me. Um So I've done a four week elective in GP and most uh three of my electives are in Ontario. So I did four weeks of GP, two weeks of internal medicine, um two weeks of G I and then a four week uh elective in rheumatology in Nova Scotia. Some of these pictures like at the top are just like pictures from my experience. Um I just wanted to kind of mention like on this slide, like I had like a really great experience in my electives in Canada. But just before I even get into any of the details, I do wanna emphasize that an elective in Canada is much more intense than an elective in like kind of any other country just because medical students, there are really treated as a part of the team. So you get your own patience, you get, you do your own consultations, you're very like integrated into the system. So I found that I didn't have as much free time as people think that they would have. I'm an elective and I kind of just want to mention that from the beginning because people usually think like, oh, I like, I'm elective in Canada. Like, that's great. Like I'm gonna travel and adventure and this and this and it's, it's really hard to do that because of the schedule that you're gonna have. So I just wanna kind of prep this. Um but just to get started, I'll kind of talk about um deciding on doing an elective in Canada. So as I said, like, it's a steep learning curve from what we're kind of used to in Ireland and the UK because I don't know about you guys. But most of my experience like here has kind of just been like closing curtains and like sitting in the corner of like the clinic kind of just listening. Whereas they're like, I ran my own clinics and then I would go talk to the attendings and the attendings would come back in with me and I would be the one to make the treatment plans and it was very much like just a different level of expectations than um in the UK. Um in my opinion, doing an elective in Canada is kind of ideal for students who think that they'd like to practice in Canada in the future because it kind of prepares you for residency and how the, the healthcare system works. Um And it's just like a different level of responsibility, whereas, like, if you're kind of hoping for like a chill elective and like, maybe just to kind of see a bit about like the healthcare system there, but like, spend most of your time, like, doing other stuff. I don't think that it's quite feasible in a lot of like these, um, bigger, like university hospitals. It might be like possible in the rural hospitals. But that's just like something to keep in mind. Um, in terms of number of weeks, I would say that the ideal is kind of between, um, 4 to 6 weeks. You can do, um, less than four weeks. Like, I think you can do two weeks, but just bear in mind that sometimes when it comes to cost, for example, like a four week, um, internal medicine elective could be like $1000 for example. Um, but if you wanna do just two weeks, it'll still be $2000 or $1000. Um, so just bear that in mind. Um And then that kind of ties on to like the whole split elective thing. Like you can apply to do like two weeks, internal medicine, two weeks, G I, but most of the time you'll find that they charge you based on like the specialty rather than the length of time of the elective in terms of um choosing a specialty that's all based on interest. And it's also based on how um like labor intensive the specialties. So for example, like if you choose to do like a and Gyne, like, do you expect that you're gonna be in like six out of seven days of the week and you'll be doing a lot of on call shifts with the residents and in terms of locations, it also it's kind of based on interest. Um But with Canada in specific, it's still kind of based on COVID restrictions as well because when COVID kind of first kicked in the um elective portal in Canada shut down for many like years. Um and is just opening back up again for some of the universities in January 2024. Most of them should be open by then, but some of them still aren't. So just bear in mind like that, like you might not be able to go, like if you wanna go like Toronto, sometimes, like some of those universities might still be closed. Um So it's important to kind of check the A F MC website, which I'm gonna talk about a bit later. But um it's like under useful resources that first line that's like the Canadian Elective portal So that's what you're gonna be using to figure out. Like, ok, what, which universities are open? What electives are available? Am I eligible and things like that? Um And then the second resource that I just wanted to mention that I actually found yesterday and I wish I had found it before I applied for. My electives is the elective network. Um, the elect Elective network has like a million different, like, country profiles and they actually have one for Canada as well. I did find that some of the information might be like a tad outdated, but it's nice. Um If you wanna kind of just locate like what hospitals are available to me, what kind? Um sorry, what provinces are available to me. Um And it's also you, you need like an account to access it, but uh it's free for MD U students or 10 lbs a year, which is kind of worth it like 10 lbs for 12 months. Like I would say it's worth it if you don't really know much about the different provinces. And um like what life would be like in each of those different um provinces. And the next thing I will talk about is the portal. So I mentioned this before. This is the A F MC in the background. You can kind of see all the universities that are available, some of the top ones are cut off, but there are 17 medical schools in Canada and you can apply to do an elective at any of them, obviously just bearing COVID restrictions in mind. Um This is the only application portal for all 17 medical schools in Canada through this portal. Um You can create an account and pay like a base fee to make that account. Um And then you are able to look at all of the electives that they offer. It takes you to kind of like a, a separate portal. Um And you can filter by like university or by city or by whatever you wanna filter by and it shows everything that's available and the date that you're gonna be requesting, each university has a profile on this portal. And once you kind of click on it, I think maybe there's a screenshot later on my app application. Uh sorry, my presentation, but once you click on it, you're gonna kind of see like policies and requirements costs and like it breaks everything down and this is like, make this your like besty like this is what you're gonna be visiting every day to check for any changes um to check if you're eligible and costs and things like that. Um Just as a little side note. So as I said, this is the only way that you can apply for like an official elective in Canada. It is possible to organize your own elective just like with connections that you know, but just be very careful with the way that you do that because a lot of the hospitals in Canada, like, you can't actually have any patient contact unless you are through a FNC. So I would say that if you're thinking of doing something like GP, that would be fine because a lot of the GP practices there, um, don't have association or affiliations with universities, but if you want to work in a hospital, try not to like, go through somebody, you know, and just apply through a F MC, even if it's like an annoying process, just go through this because that's how you're gonna get access to like patient charts and like um like medical protection and things like that. So this is kind of the only like one stop shop for electives in Canada. So the next thing that I'm gonna be talking about is obviously choosing the university. So this is the screenshot that I was mentioning. So for example, I picked like University of Toronto. So once you click on their profile, you're gonna see like general policy requirements, special electives, fees, health and safety, travel and accommodation. So they have everything that you can kind of need to know whether this would be like a good fit for you. Um But the main thing that I kind of want to point out is these policies and requirements. So once you click on it, you can kind of see a tab for Canadian students, for international students and for MD extension program. So the one that you're gonna be kind of focusing on is the international students one. And when you collect that one, you'll see everything that you kind of need to check off in order to be eligible for them to consider you for an elective. So University of Toronto, for example, like the way that their system works because they're very like ultracompetitive, you would need to enter into our lottery. And then if you get selected, then you can apply for an elective. Whereas other universities like Western or some of like the other maybe less competitive ones, you can just apply straight away and you'll likely get accepted if you apply early enough. Um I would keep checking each universities profile regularly because they do change things from time to time and they do like update based on like new um developments. So again, make it your best friend and just check it regularly. Um I will say that because of COVID, Canada started really cutting down on the types of students that they were accepting. So you might find that some universities don't allow you to do an elective there unless you have like Canadian citizenship or unless like your university, like your home university has an affiliation with that. So UFT has like a list of universities that they have affiliation with and then you can kind of apply. So the policies that are just to like reiterate the policies that are requirements, like that's the most important tab that you're gonna be checking frequently and then when to apply. So I have like just on the slide, just a couple of examples of the different universities. Um And the only reason I put some examples is that just to show that each university has different deadlines, um The best advice that I can give is to apply as early as possible. Um Usually people say like 3 to 4 months in advance, but obviously, as you can see, like some universities, you can't apply before like 28 weeks before. So, um the best thing to kind of do is to go on a AF MC, look at all the university profiles, find the universities that you want, write down their deadlines and then apply based on their deadlines. Um So it's hard for me to kind of give you like a specific date to apply by, but the best advice I can give is just write everything down and write their specific deadlines down just so you don't miss anything. So application steps. Um So the first thing that you do is check eligibility and you do that by going on policies and requirements. So every like host school has different requirements. As I said, like some require you to be Canadian Citizen, some require you to have like an affiliation with them. Um Some require you to if you have, I don't know if you guys have heard of like if MS A like you can kind of go through them as well. Um, but like just check that you are eligible before you apply because you'll end up paying and they'll reject you and they won't refund you. So just be sure that you're doing that. And then the next thing would be to register and make an account on the A F MC website and to do that, you need to complete the homeschool verification form. And um that's like a pretty simple step. It's just like you like put your own information and then um you put like a contact from your school that can vouch for you that you're a student at the school and then it that gets sent back to A F MC. And then you get granted access to the portal. When you get granted access to the portal, you get an ability to kind of view all of the different electives that are available at the specific time that you would like. And when you kind of find, find one that you like, you're then able to upload all of the documents, I'm gonna be talking about those later. Um but you can upload all of the documents that they require of you. You get to rank all the electives that you would kind of like and then you submit your application and you find out on that portal whether or not you've been accepted. This is usually for like the less competitive schools, this is a pretty fast process. Like when I went to Nova Scotia, I think I found that in like two days. Um But then the schools that have like a lottery process. So like mcmaster uh University of Toronto, it might take a bit longer for those because they have some hurdles along the way and this is just a slide of the documents required. So as you can see, they're like 10 different things that you're gonna need. Um And I just want to emphasize that not every school has all 10 of these, I just decided to kind of like because I had applied to a couple of different places. These were like the most common ones that I was asked for. Um the most important thing that I'm just gonna like mention right off the bat is that you need an immunization form completed by your GP. And you also are gonna need like some like lab tests and serology as well. So sorry that like might take a bit longer, especially like if you find that you can't get an appointment with your GP. So this is kind of the first thing that I would work on in getting that done. Canada has a lot of vaccine requirements. So you need to have all of them and it's like not like a negotiable thing like they won't accept you if you're missing one of them. So I would recommend that you kind of download the form look at um what they require all of the universities. It doesn't matter which university like they all have the same form. So you're gonna need all of the same vaccines. So download the form, figure out, figure out which ones you're missing, get the GP to complete the form but also like make appointments to get the ones that you're missing. And then the second check. Uh sorry, the second thing is the police record check and the criminal, criminal record disclosure and consent form. Both of those um need to be from your home country. So wherever country you're um like a citizen in, you need to get both of those documents. Um and those also take quite a while. Like, I think in the UK, I don't, I don't remember exactly how long it took, but I remember like one of them was like six weeks or something like that. So again, like start early, don't start this like four, like four months in advance, like start doing this kind of now because these are things that you just need to kind of check off. So the earlier you, you have them, the better that it is and this is the cost slide. So I really struggled to make the slide because I found that like every elective that I did, like, I spent a different amount of money and it was hard to like, and like, Canada is really big. So it was hard for me to say like, oh, like rent in Toronto would be the same as rent in Nova Scotia because they're just completely different vibes. So I kind of put like ranges. Um I found that the cost of the elective itself. So to make a profile on the A F MC website, that was 650 Canadian dollars and then you have to apply or pay to apply to each elective. And that also varied based on the university. So for example, like Dalhousie, Nova Scotia, I think it was 100 whereas like, um I don't remember, I think it was mcmaster, it was a 400 to apply. Um So the cost for applying is different per school and there's also an acceptance fee after which is also different per school. So that's why like, again, a F MC, your best friend you're gonna have like, it's gonna clearly tell you how much you're gonna need to pay. Um And there's like one big chart that has all the universities that has all of the acceptance fees and then all of the or sorry, the application fees and then the acceptance fees. Um There are some other like miscellaneous things that you're gonna need to pay for like vaccines, BLS, certifications, background checks, um, visas, travel insurance. Um I found that every university had you, like, you have to get the travel insurance through them and that was around $300. Um And the other thing to know is that like unfortunately A F and C it doesn't also cover like flights and accommodation. So those are gonna be separate things. So with flights and accommodation apply as early as possible flights I recommend with Air Canada. But honestly you can whatever is like cheapest accommodation, you'll find that on the university. Sorry, this like is like let me just move for a second. Um You'll find that like on the A F MC uh university profiles, there's like a tab for accommodation and they have like a lot of recommendations there. And then there's also like Air B and BKGG, like Facebook marketplace, all those things. Um But most likely like you'll have to be like subletting off of someone and like that's kind of the cheapest way to do it. And then I just have an overall slide. Um So again, make a F MC your best friend. Like this is the one stop shop. Like you'll find out anything you need to know from that website. Um Just to reiterate my point from before, like lectures in Canada. Like I learned so much and I feel more prepared for like F one and F two just based on that experience. But it's not like a like if you're looking for like a chill like vibe, you're not gonna find it there just because of how serious they take like their medical students, like you will kind of get assigned your own clinics and you'll get assigned like your own on call shifts, which just means like, you might be in the hospital for like overnight or like 24 hours de again, depending on the specialty. Like you, you pick G GP that's not gonna happen. Um But it is more intense in that way. And um the most important thing that I can kind of say is just like, set a good impression, like kind of do your due diligence before going learn how they formulate their notes, like soap notes, um practice exams and like presenting histories and just like kind of really suck up to them and like offer to do extra things and offer like, you know, like if they're a clinic without a medical student, like offered to be there. Um And the last thing is just like, make your supervisor aware of your home university's evaluation forms. I know like my school had that. I'm not sure if every school does, but I just wanted to mention that because a lot of the time, like the supervisors aren't really aware of your homes schools requirements. So it's important to make them aware of that. And that is me, sorry if I went a little bit over. Um But I'm happy to take any questions. There are like a million other things that I could have mentioned, but 25 minutes is a really limited time. So I'm fully aware that like, there are some things that I Miss, but I'm happy to answer them at any point. Yeah, thank you. Ok, brilliant. It's my turn. Um So let me try and present slides. Ok? I'll set a timer so that I can see how long I'm talking for. Co I don't know how long this is gonna run for, but hi guys, my name is Melanie Lewis. I'm 1/5 year medical student at the University of Bristol. Um I haven't put my email address because honestly, you're likely to get faster replies from me. If you dm me on Instagram, that's my handle right there. Shameless plug. And I'm also on youtube and um Tik Tok, but Instagram's my main handle. So let's get into it. Ok. So kind of like what Sandra said, if you're thinking of working in the US, using your elective as a sort of dry run, like, do I see myself being here in the future? It's a really good opportunity for you to um see if you'd want to be in the US. Like, is it compatible with your personality? Is it compatible with what you want for your future? Um It's such a good opportunity to do that. So that's why I decided to do my elective in the U SI um You know, I was thinking of working over there or here, I'm currently on my elective now, if that's not obvious. Um So I'm literally in the middle of my elective now and um the University of Bristol gives us two months. So I um decided to be out here for the entire two months and I split my elective in two. Um So for one month, I was in Atlanta and one month I'm in Miami. So I'm currently in Miami now and uh I've put here a letter of recommendation requirements because if you are considering moving to the US to um be out here for residency. I'm glad that Sandra explained all the terminology beforehand. If you want to be out here for residency, um one of the requirements is that you need letters of recommendation when you're applying for residency. And uh one of the main requirements for each letter of recommendation for it to qualify for your application is that you need to be in a rotation or placement for one month. So technically, because I'm out here for two months, I'm working on getting two letters of recommendation. If that doesn't make any sense, I'll answer any questions you have afterwards. So deciding on specialty, I want to um be a cardiac surgeon in the future. And uh out here in America, you can either apply directly to cardiac surgery or you can apply to general surgery for residency and then do a fellowship in cardiac surgery because I'm from England. Um I'm technically an international medical graduate and a lot of us from England aren't even used to calling ourselves that, but to Americans, we are international medical graduates. Um when we do eventually graduate, which means we're in the same boat as everyone else in the world. And, um, because of that, it's extremely competitive. We're competing with home students in the US for these places and they obviously prioritize their own students. So you have to be extra competitive with your applications if you're from any other country in the world. Um And so for me, I'm applying to general surgery because statistically, it's easier to get accepted into general surgery than going directly into cardiac surgery. Um And why that matters is it costs a lot of money, these applications. So if you fail um around that's going, that's money down the drain basically. So I'm trying to hedge my bets on where I'm more likely to be successful if that makes sense. Um Deciding on location. I basically emailed a lot of people and DM Ed, a lot of people actually on Instagram and whoever responded first and took me seriously. That's kind of how I decide on my location. I was a bit lax with that. I didn't really care where in America, I got experience. I just wanted some experience, um and useful resources to decide like where you want to go. I'll talk more about this in the future. I've touched on Instagram a bit, but there's this website called AM O and I think that's on the next slide. Yes. So that's a really, really small screenshot of the AM O website. Um AM O is a website organized by past international medical graduates who are currently either doctors or who have been accepted into residency in America. And they saw um a void in the system where lots of us needed to find out um how we can find places for electives and hands on experience for us clinical experience. So they've created this website um for us basically. So it's like an amazing catalog for loads of opportunities that accept and are international medical graduate friendly. And that's what you want. You want to go to places that understand that you're not from the, from America and understand that um you want hands on experience or whatever you want on like an observer ship like Sandra mentioned earlier. Um and it's more fitted for you because there are experiences in, in America that aren't suitable for um international medical graduates. They just uh yeah, they're just not as friendly in terms of that. So this is a very good gateway um to sort of cut away all that mess. Um So I was a bit naughty, even though I use this website, I didn't use the website and I'll explain why. Um obviously nothing is free. Cash is king, right? This is America cash is king and the um all these places they charge you fees to go to their um establishments and their institutions. But am o adds on fees on top of that, right? So you're spending extra thousands of pounds or dollars wherever you're from. Um Just for the hook up essentially. And I didn't want that. So I'm being naughty and I'm sharing this tip with you. What I did was I looked for the institutions on this website. Um Sometimes they're a bit sneaky. They don't tell you all the information, but you can reverse search on Google search with the images and you can find the institution um where these pieces are that and then you can directly apply to these institutions and save thousands and thousands of pounds. Ok. So that's my hook up for you. I wouldn't go directly through AM O I know I'm probably like cutting someone's back. I'm sorry. But um we need to save money out here because America is so, so, so expensive. So I would say um start planning six months in advance because they're not doing your well, they're not doing us a favor. Um Well, we're not doing them a favor, they're doing us a favor. And so some people really don't care about you. They don't care to respond and I found that out the hard way. Um So you kind of need to be aggressive if you're not going through AM O I'll say if you're not going through AM O you need to be aggressive and assertive and write lovely emails slide into their DM. That's exactly what I did. Um Be friendly, be bubbly and someone will like you and they'll respond and they'll tell you how to apply directly to them and you will save thousands. I mean, thousands um, documents required similar to Sandra. I won't go deeply into it. You need a visa. If you're from the UK, you likely only need an E A&E a sort of a political shortcut. I think, I think the UK and the US have this deal. Um I don't know if Canada has something similar but you don't need a visa. You just need Lunesta, which you apply for and you get approved hopefully within 24 hours. If you don't have a criminal record, you'll probably get approved basically. And then you don't need a visa and it's only $21. Um I won't go over some stuff because I feel like I'll just be repeating what Sandra said. Um But I would say one thing that was quite interesting about here is that I had to get an international driving permit. Um because American roads are very different to British roads. They're very purpose built. So they have one area, lots of roads and another area, lots of roads. You can't walk anywhere. Basically. It's not like England where you can hop on the bus walk. You know, a lot of us are walkers, we walk somewhere, you can't take the tube. Um It depends which city you're in. If you're in New York, obviously, you can't drive. That would make no sense. Only use public transport. Um but where I was in Atlanta and Miami everywhere is far and you literally need a car to get anywhere. And what we consider to be far in England Americans do not consider that to be far because everyone has cars. So the mindsets completely different. Um So that's another caveat if you're scared about driving um in the US, um you can take Ubers, which to be honest, I think works out to the same price or maybe even cheaper. But if you rent a car which was recommended by um the institutions that I've been with, uh you just have a lot more freedom just to buy groceries to leave whenever you want. You know, it's just luxury essentially. So you don't necessarily need to drive if you don't want to. Um So yeah, I put here agency or self organize. I did both. I kind of sly used AM O but didn't use them. Um I traveled by myself, which is obviously more expensive than traveling in a group. If you travel in a group, you can share accommodation with people and that will definitely cut down costs. Um And in terms of flights, I went from London to Atlanta and then I took a domestic flight from Atlanta to Miami. And then obviously when I finish in Miami, I'll go back home, I've decided to use Air B and B. I'm currently in my final Air B and B in Miami. Um And I think that's the best way you can stay in hotels. But uh if you like to cook, that's kind of going to be a problem. I wanted to cook whilst I was out here to try and cut down on costs. Um But again, completely up to you travel insurance. I got that free through my bank account. Um So you kind of have to finesse as much as possible. I think if you want to go to Canada or America, you need to be as creative as possible because out here everyone wants money from you. Ok? They don't care, they just give you a fee and expect you to pay and then you'll get it. That's the simple, simple maths, simple American maths pay, you get whatever you want. Um but we in England, we don't like to tip, we don't want to spend money. So if you have a bank account, honestly open a bank account just to get the free travel insurance. If you can, if your parents have um travel insurance on their account, just check with them some bank accounts, your, their kids like you're covered under Children are covered under that as well. So just try and be very creative as possible. Um Phone Sims, I didn't buy a phone sim out here. Uh I'm a part of the EE network and you can actually pay 15 lbs a month to use your um your normal contract and buy this ee roam abroad. Pass Um, so that's what I did and I literally just call whoever I want without, like, I don't even need to use whatsapp. So that's quite useful. I know some people here aren't from the UK buying a SIM would be better. I've heard they're quite reasonable as well. So maybe like $25 a month or $20 a month in the US. Ok. Moving on, I try and speed up. Um, so my flights in total, they cost 1400 lbs. Er, this can be cheaper if you do a round trip. So like if I was just in Miami or just in Atlanta, it would have been a lot cheaper but because I had to buy like a one way trip to Atlanta, er, like a domestic flight from Atlanta to Miami and then a one way trip back from Miami to England. Uh that, that made it more expensive um, accommodation just like Sandra said, it really varies depending on the state. It could be completely free. Er, if you have family, if you have family, use your family and stay with them, um, or it can go up to like 3000 lbs a month. I personally, um, didn't stay with family because I'm literally using the selective as a dryer and I want to see if I could live out here by myself and what that would be like. Um, so I was willing to pay for that, but that's a luxury and you don't have to do that. Um, vaccines again, varies by state in Atlanta. They didn't require any vaccinations in, um, Miami. Oh, my goodness. I had to do a 10 panel blur, um, a 10 panel drug test. Ridiculous. I had to take blood tests for like every disease under the sun to, I had to prove that I, I had chicken pox, which is ridiculous. I literally had records that I've had chicken pox before and they, that wasn't acceptable. Um So just bear in mind that depending on where you go, it can get pretty pricey. But if you're in the UK and you're funded by NHS Bursary, you can claim all of this back, um which is beautiful um medical checks kind of check. Uh kind of talked about that. So all my blood tests, they came to around 400 lbs. Again, you can claim this back on the NHS Bursary travel insurance. I got that free through uni and through my bank account. Um and the cost of the elective can be free or it can go up to 5000 lbs per place. Then I know that sounds ridiculous. Um If you're going to book through AM O it can honestly go up to 6000 lbs. Um But there are some that literally are as cheap as 400 lbs as well. Um I say cheap, but that's a, that's basically the cheapest I've seen or 300 lbs, maybe um you can get it free if you know someone I wouldn't say the, the um the like picking your electives is as um official and formal as the process with Canada Sandra described it very much is like who, you know, think of like the American dreams who, you know, who you network with, um how you screws basically. And um if you don't know people out here, Instagram is your friend. Emails are your friend. Um Just uh try and use all contacts that you've got, I'm now a contact for you. So you can like feel free to like message me on Instagram and I can try and help you as much as possible. Um In terms of transport, I rented a car and that costs like each month that costs about 1000 lbs per month. I know that's quite a lot. Um But as again, I said, like I had saved. So I wanted the luxury of having my own car and going wherever I wanted to go. Ok. So funding, I think being as organized as possible will be your best friend. This is kind of a snapshot of my, of how I broke down my costs for the US. And I just want to preface, preface all of this with saying that America is expensive. Ok? If, if you aren't willing to pay money to be in America, then maybe it's not the elector fee. There are much, much cheaper options out there. Um, but if you're considering to work in the US, what a lot of students consider is that you will be fairly compensated in the future based on how much money essentially you earn as a doctor out here in America. So you have to see as a um, a pre invesment for yourself. So it's a lot of money, um, for some people, it runs up to 10,000 lbs and that sounds ridiculous. 10,000 lbs for a two month elective. Um But yeah, surgeons out here earn up to 500,000 a year, a million a year, which sounds ridiculous. You're not earning that in England really? Um Unless you're maybe a surgeon to the king, but how many surgeons does the king need? Really? Uh So yeah, money is completely different out here. So don't let it scare you too much with how funding is. If you really are serious about working in the US, then see it as a little blip before you take off. Ok. So, um that's my excel sheet. I got a bit of funding through a touring award from UNI and I got 1500 lbs. Um I'm also quite frugal so I'd saved a lot beforehand. So it was just a good opportunity at the time. I had quite a bit of money in my bank account that I could have used to invest in myself. And um I also took out a couple of credit cards with 0% offers and I know some people don't like that, but honestly, 0% offers that you don't have to pay back within the next 3 to 5 years. That's as good as like having your own money. You can just pay it back whenever you want. That's just like having a student overdraft. Um That's just what I did. Ok. Moving on. Ok. So typical week in Atlanta. Um, I had clinics on Monday and then on Tuesday I had clinics and Ba Baria Bariatric surgery. Um, on Wednesday, I might have clinics and cosmetics surgery, which has become one of my favorites. I love cosmetic surgery now, um, and then Thursday clinics and general surgery. Um and then on Friday there would be clinics and gynecological surgery, but you can, depending on where you go, it's all different. Oh, here some photos of my elective. I just wanted to show off my really cute surgical caps cos I just think they're so cute. Um There are a couple of pictures with me in surgery. So as Sandra said, you can really, really get hands on experience over here and I would say similar to Canada, you can't play around here. You're not gonna be, you know, popping off cliffs and whatnot and swimming with dolphins like you do in Australia. That's what it seems like. Anyway, like everyone, I think everyone's like having loads more free time and loads of fun. Um, which I really love that for everyone else. But here it's really, really hard hitting, especially if you're working for your letter of recommendation. You are trying to impress, you're trying to smooth, you cannot leave early. You have to turn up on time. You have to be punctual. You are trying to get the letter of recommendation for a lifetime. So you are literally auditioning for a month when you're with your institution and that can get very intense because if there's an emergency case that runs until 8 p.m. you better be there until 8 p.m. You don't have to be. But you know, you, you like, you have to just kind of use your common sense like what looks better to the surgeon and maybe just for you yourself, this is gonna be your future job in the su in the future like this is what the life of the surgeon will be like. So, you know, dig your feet in and see what it's really like. Er, I've assisted with multiple surgeries out here, which I just think is sick. I'll just see that. Um ok, so positives you get hands on experience, you cut patients, you present patients to attending a, a consultant as Sandra had said you get to scrub it and assist in many surgeries. Are you involved in the team? Yes, I'd say more so than in England. They take you a lot more seriously as a medical student out here, I think that's because out here, they have to do a degree first. So most people are mature students. Whilst in England, most people are like 18 when they start medical school. Right. So, you're actually, you spent a lot of money in your, um, in your education, you've invested a lot and if you decide to go to medical school out here, you're very, very, very serious about medicine. So they take you seriously and they basically want you to be a rock star and they make sure that you dig in deep. Um If you're keen, they'll let you do anything you want, er, other travel opportunities. Yes. But it costs money if you're free on the weekend travel anywhere you want. Like, I don't know what to say. You could literally like if you're anywhere in, in um America, you could literally travel to Miami on the weekend. That's what most um Americans do like Miami's like AAA massive destination spot, holiday destination spot for them. Um And time off, you get weekends and some days you get half days off. Ok? We've got five minutes left. Let's go through it. So, negatives, uh potential negatives depends how you think. Uh There are some language barriers. So Spanish, there are lots of Hispanic um people in America um especially in Miami. So if you're used to being around, most people who speak English as we are in the UK, you're definitely going to be in the minority in places like Miami where most people speak Spanish and they choose if they want to speak English. So you're basically privileged if they speak English to you. Um But you might not be used to that. Um So that's just one thing to consider the cost. It's very expensive. It can be. Um Is it difficult to organize? I'd say medium to hard difficulty, medium if you use um for um platforms like AM o but it will be more expensive and I'd say hard if you do it all by yourself, but it's worth it because it's really, really a lit out here. I can't II I can't emphasize that enough. Um Travel. If you don't drive, that might be a problem. If you don't just want to take Ubers um that might be a problem. You can't walk anywhere really places like Atlanta, the public transport is dreadful. Um Miami, the public transport is dreadful. Uh uh So for my letter of recommendation in Atlanta, I needed to conduct research. Um So yes, I had to conduct research. I should say so. Yes, there definitely are research opportunities. And um are there any interesting clinics, theaters, projects to get involved with? Yes, literally anything you want to do you can do your imagination is the only limiting factor with America. It's the land of dreams for a reason. Yeah. Um A story from my lecture. I just wanted to quickly talk about my mentor. I've met my mentor when I was in Atlanta, a fabulous, fabulous woman. Um, she inspired me so much. She, er, is, um, a triple board certified cosmetic surgeon, which so she's certified in, um, trauma. She's certified in general surgery and cosmetic surgery and she owns multiple businesses. She's actually a celebrity surgeon. Um, she's Tik Tok. Famous. She literally rocks up to surgery in our heels, which I think is crazy, but she's absolutely fabulous. Um, she sees herself as a brand and she literally sells that to her patients and she is so, so, so um she's so so, so driven and ambitious and she really inspired me. She got me in on all of her surgeries. Her first surgery, that eye witness was a facelift, which is crazy. It's like something out of a horror film, seeing someone's face off and like you can understand how people can literally get face transplants when you see that. Um And then it was just so cool to see her in that situation finish the operation and consult with her patient afterwards and she's just so sassy and fabulous and I love her. Um I think America's a really great place to be inspired because they have more of an entrepreneurial spirit over here. And literally your imagination is the limiting factor. Whilst England isn't really like that. There's um there's more a format to everything and everyone sort of goes along the same path. America, there's no, there's no traditional path I wouldn't say. Um which is inspiring. And that's the end of my presentation. Did I have time? Yes, two minutes under two minutes to go. So, yeah, that's me. OK. We have 11 minutes for questions just before we take questions. I just want to say like one quick little thing I feel like from Melanie and I's like presentations, we probably sound very like intense and that be scaring you about like this experience. But like I can say that like, and I'm sure Melanie can agree like this probably like doing an elective in Canada or like in the States like as difficult as it is like it is so rewarding because I feel like as medical students, like we're constantly just like wanting to be involved and wanting to know more and I don't feel like sometimes we get that like in our home institutions. So like as difficult as it is like it is really rewarding. So don't like let that hold you back in any way. Absolutely agree. OK. Any questions? Let's look in the chart. So yeah, type in the chat. Um If you have any questions. Oh OK. So this one's for me when you are applying to the US. Did you have to complete any step exams? No. So some US clinical experiences um you do need to but with AM O all the ones on AM O you don't so use and abuse AM O OK. Um Is this one for me, Gary? And accepted. So with a issues I guess I don't ok for a, to um there's no like guarantee that you'll be accepted which like, I find really annoying wording because to be honest, like the way that it works is like, you'll end up like ranking like five choices, like under one hospital for your or sorry. Um One university. So for Dalhousie, um I got to look at all the internal medicine electives that they offer and then rank five of them. And like if the first one's not available and the second one's not available and the third one's not a available like you will get one, but they always say it's not guaranteed. But like honestly, as long as you apply early enough, like you should be fine. Um Is there a guarantee with A O? OK. Yes. So with AM O if you apply early enough, I would say there's a Yeah, you're guaranteed because out here, all they care about is money. So if you're gonna pay your money, you're gonna get it. If you do early enough, I'll just be complete honest. If you're willing to pay, you will get it. And if you do early enough, as I said, um I think minimum, the minimum amount of time you should leave with America is six months because it's not a, it's not straightforward or formal. Like the um application process, I think with Canada, you read, you have to work at networking which takes time. Yeah. But, but the other caveat is that it is guaranteed, in my opinion. Um What was the greatest challenge you have personally faced with your elective, especially being away from your home environment. Um That's an interesting question. Um I think at first I was really scared about driving on the opposite side of the road. Uh But then I got over it and now I'm a big boss driver, so I'm really proud of myself. Um The other thing I suppose was, yeah, not having your like family around you in le it really has helped me to grow up a lot. I really feel like a big girl out here. Um Which in one sense makes me feel like I definitely can do it. So now I've proved to myself I could move out here. Um Yes, that was a challenge, but I've definitely like grown a lot. I feel like I've matured a lot being out here. I feel like a big girl basically. Uh Do you want to answer that one, Sandra? Um Yeah, it's a little like different for me because obviously like my, my home is Canada. But I think the greatest challenge was just like, how much they like expect of you there. Like I really had to like step up and be confident. Like, even if I didn't know what I was talking about, like you have to say something because they were look at you until like, you answer. Like, if they ask you, ok, how do you think this patient should be treated? Even if you have no idea? Like you'll sit there and you'll have to figure it out on the spot, which I, I wasn't used to because I feel like in my experience, like, if you don't know, you don't know, kind of thing, but they're like, they really, really, really push you to become the best possible student and doctor that you can be. And I just wasn't used to that. Yeah. Um How did you go about knowing who you should d on Instagram for lactose? Uh So I OK, so am o is your best friend? I would find electives through AM O And then I would look for emails online if I couldn't find emails online doing like the reverse Google images, search and all of that stuff. If that doesn't work, I would just ins like, I try and find their Instagram handle and then I would DM and it's usually like a social media manager. So they're not even like official doctors or real or like real admin. You just have to like, they have to like you and then they'll pass on useful information. Um And how long does it take to send ad M you can literally have a, like a stock statement that's really bubbly, really lovely, you know, gassed them up, made them feel great and um a lot of them, they love the British as well. I'll tell you that. So if you, like, go in hard about, you know, I'm from England, from a medical school, blah, blah. They'll like really like that because that sort of can increase their clout that people from England are coming over to America. Um, cos not many of us do go over to America. I know there are other people who aren't from England in the chat. Um, so, yeah, I know you wouldn't be able to say that you're from England, but you can still dm them, trust me and they will respond and if they don't respond, move on to the next one, there are so many opportunities on AM O um Is it better to contact individual doctors or hospital departments? Uh Both if you're doing, wait, is this for Canada or we can do both of them, I guess. Yeah, if it's for America, um, if you want to do like GP contacting an individual doctor is absolutely fine. Um If it's someone from a private practice and they own the practice, contacting them is absolutely fine. Um If you want uh something like a surgical placement, like I did, you need to contact the hospital department or the university again, use AM O because sometimes you need to apply directly to the, the clinic or the hospital. Um But if it's through the hospital, it's likely going to be through a university. Um for Canada, you can't apply directly to hospital departments, you have to apply through the university. So you'd have to go on a F MC, find the specific university. And then after you make an account, then it shows you like all of the available hospitals under that university. Um and also the departments that are offering electives. The one exception to that is GP, because a majority of GP clinics don't actually have an affiliation with the university. So you can kind of just go through them and do it that way. The one thing that I will say is like if you are thinking of applying for residency in Canada, at any point, I would recommend that you stay away from these like self organ like things and just go through A MC because um you're technically not allowed to do an elective unless it's through A MC. Like you're not allowed to have patient contact unless through F MC. But some doctors will kind of just let you do it cause they'll trust through or they'll know you or think it's not that serious. Um So do that if you just kinda wanna go experience Canada, but if you are thinking of working here, try to do it officially. So that again, as Melanie said, you can get a letter recommendation, you can get like unlimited, I guess access to like patient notes and patient care. Uh What's the next one when you use a MO did you go to the hospitals listed on the website and find and specialty you are interested in and email them. Um No. So I found the hospitals or? Well, I found the clinics I should say and institutions, if it's a hospital, you need to go through the institution like a university. Um So I find the institution or the clinic and then usually on their website, they have a section there for electives. So they already have a procedure, an official procedure. All you're doing is cutting out the middle man. Am o sorry, am o and you're doing the same application, you're just doing all the legwork for yourself. Um So they'll have an email for electives. Um They might have an email for internships, which is actually better than an elective. That's another tip. Um If you want, you can dm an email about, do you do subin internships? That's way better if you, if you want a letter of recommendation um for residency, they prefer subin internships to um to electives and a subin internship literally means that you're doing the same jobs as a resident. If you are a resident there, you're doing exactly the same jobs. And my last patient in Atlanta, I was a subintern. So I was literally working as an intern. I, there's nothing I didn't do that I wouldn't have done if I was a general surgery resident whilst here in Miami, I, I'm on an elective, so I'm a bit more limited in terms of supervision. I can't see patients without a supervisor, but I'm still doing everything. I was in um Atlanta just with a supervisor. But yeah, I didn't have any supervision in Atlanta, which was crazy kind of like um what Sandra was saying. So you, you kind of do um develop your confidence in your clinical skills very, very quickly. Uh Would you recommend inquiring about ongoing research projects in advance? Um If you really are keen, uh I didn't do that. Um I personally didn't do that, but you'll find lots of attendings that currently have research projects. They would love if someone does all their grant work. So you'll get very easy publications if you really want to. Like, there's always like work that you can lap up if you really want. Um If you've got a research project in mind beforehand that you want to do by yourself, you can start before you're elective. There's no real way about doing it. Oh, yeah. And next questions about the portal for Canda. So yes, you do have to pay just to make an account. Like it's honestly like they will take your money in every possible way. Like I think anyway, um so to make an account on the portal, it's 650 Canadian dollars, which sounds ridiculous because it is like it like it should not be that much. Um But I will say that like the only way that you can figure out exactly the electives that are being offered is by making an account. But you can also find out, like, which departments are offering electives before you even make an account, just like in the university profile. Um, I don't remember what the tab is called but one of the tabs, like, you can go see, like, I think it's just called, like, electives are offered electives or something and you'll see, like, neurosurgery em, Mr, like, you'll see like different like departments. Um So you can kind of figure out from there where you wanna apply to then make an account and then use like their other like second portal to like make your application. Um I did say so, ok, I can't like there's no specific cost, like I can't say that two weeks of internal medicine costs $1000 because that differs at every single university. So um I did my two weeks of internal medicine in, I did it through like kind of like a, like the Ontario, like the province has a rural portal which is different from a AF MC. Cause A F MC does like all the um academic centers but rural Ontario medical program, they do all like the kind of suburban, like places in Ontario. And I applied through there and for my two weeks of internal medicine and two weeks of G I in total, I paid 1000 300. Um but for Dalhousie, um I had wanted to do like two weeks of rheumatology and two weeks of, I don't even know what the other one that I wanted to do was. And I remember they had told me that it's like 700 for four weeks of rheumatology total or 700 for two weeks of rheumatology. And then another 700 for two weeks of, let's say cardio or something. So it like they charge per specialty rather than per week if that makes sense. Um Are there any rotations which are less competitive when applying for electives? Um I wouldn't say rotations, I would say universities. So there are some universities that are way more competitive like University of Toronto. Um I think mcmaster would also be one of them. Those are the ones that have like a lottery based system because they know that everybody wants to apply there because it's kind of like in, you know, like mainland Toronto kind of. Um So it's more competitive for uh those. OK. Uh OK. Are there any rotations? Oh yeah. Um We just answered that. I think internal medicine here and GP because they're just so many gps everywhere. So I'll just say that quickly. Just answer one more question. I'm doing GP in Canada to, it's only worth applying through a F MC if you were thinking of working there, like in Canada in the future, if not just find someone, you know, and do it through the like them like it'll be cheaper, it'll be probably more lenient and easier. Um, it's just do it through a F MC if you are wanting like it to be kind of like on paper that you did your elective there and you want a letter recommendation. Um, William, we've ran out of time. So what you can do is just DM me here and I'll answer your question if you really wanna know that I didn't do cardiac surgery though. I just wanna preface that. I did general surgery. Ok. Ok. I'm gonna write my email in the chat. Um, email me if you have any more questions. Can you go and elective? The UN University? I cool. Uh, yeah, just email me. Sorry, we have to go to the next one. Yeah, we have to go. Ok. Thank you very much. Have a good rest of your day guys. Bye.