Different Types of Clinical Experience: Clerkships, Internships, Transitional Years & Research Fello

Whether you’re an IMG, current U.S. medical student or recent graduate, it’s important to understand the differences between clerkships, internships, transitional years, and research fellowships. All four offer clinical exposure and experience that will build upon your knowledge and expand your network for future opportunities.

Clerkships are the most crucial source of clinical experience
Traditionally, clerkships are rotations that medical students complete in order to gain clinical knowledge. Most required clerkships are concluded with a summative assessment (usually a shelf exam) and a subjective evaluation that leads to the assignment of a grade. Both fourth year medical students and IMGs can apply as visiting students for clerkships in specialties of interest or as an “audition” if interested in pursuing residency training at that particular institution.

Internships open the door to advanced residency positions
There are types of preliminary internships–medicine and surgery. Certain specialties (e.g. dermatology, ophthalmology, radiology, anesthesiology, etc) have advanced residency positions. This means they require a one-year internship to be secured separately from the residency position. This may mean that you complete your first year of residency (PGY1- postgraduate year) at a separate hospital from your specialty training.

For graduating medical students (both U.S. grads and IMGs) that do not match, often there are open preliminary internship spots to SOAP into. By working hard and showing your clinical acumen as a preliminary year intern, it is possible to be offered a residency position during the next cycle at the same institution. It also allows for application to PGY2 positions in various specialties.

Transitional years benefit applicants to advanced programs
A transitional year program is similar to preliminary internships. However, they are typically more competitive to obtain due to their options for electives. Many applicants do advanced residency positions that require a separate internship wish to match into a transitional year program for their flexibility. I personally completed a Transitional Year and highly recommend it for applicants to advanced programs.

Research fellowships can improve your future applications
These programs can be done either during medical school (as a gap year) or after graduation. Some programs have an application process while others are more informal. They can last a year or more, depending on the project and program. Often, unmatched applicants to competitive specialties opt for this route as it can provide a way to improve their application and build their network for a future application cycle.

Though different, all four of these clinical experiences offer the opportunity to build on your clinical foundation. They also provide exposure to faculty that can serve as mentors, letter of recommendation writers, or advocates for your candidacy as a residency applicant.



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