Most American-based international medical schools are located in the Caribbean, Central America (primarily Mexico), India, Poland, Czech Republic or Russia (just to name a few), and offer a unique avenue to medical students who plan to complete any portion of their clinical rotations in the United States prior to obtaining a medical degree from those institutions. We at AmeriClerkships Medical Society try not to refer to student clinicals as “Green Book” or “Blue Book,” since summarizing the complete scope of clinicals and their effects on future licensure using colors is misleading. Let us explain (once again, the response is very lengthy but definitely worth reading).
Green Book vs. Blue Book Clerkships
We advise against using “Green Book” or “Blue Book” to describe the connection of a rotation to a teaching hospital since U.S. medical schools do not use these terms. These terms were coined by International Medical Students (IMSs) and International Medical Graduates (IMGs) who typically attend Caribbean medical schools and want to complete their clinicals in a similar manner as U.S. medical students, in an attempt to compete for U.S. medical residency slots. Generally speaking, Green Book refers to a rotation where the IMS is able to set foot in a hospital that is listed in ACGME or AOA (with or without permission from that hospital); Blue Book generally refers to the same, but that hospital has a “family medicine residency” associated with it (again, student’s entry into the hospital may or may not have been authorized). As one can easily ascertain, this fails to capture what would truly resemble clinicals conducted by U.S. medical students, since conducting student type clerkships is much more than being able to set foot on hospital grounds; furthermore, international medical schools typically do not own nor manage their own teaching hospitals or sponsor their own residency programs, which minimizes their footprint in the medical education arena. For these reasons, AmeriClerkships strongly discourages the usage of the terms Green or Blue Book, since they often mislead an IMS into believing that the rotations are somehow sanctioned by that hospital, and also by ignoring the many clerkship verification policies that have long been implemented by all U.S. medical boards and jurisdictions.
What AmeriClerkships Is Doing to Address These Issues
Each state licensing body has individual rules, policies, regulations and requirements of licensure applicants who graduate from non-LCME accredited schools. Although not the most important, one such requirement has to do with clinical rotations conducted by students before they graduate (clinicals after graduation is a whole other subject). Other regulations that are specific to IMSs who intend to complete any portion of their clinical clerkships in the United States at the time of licensure include:
- The quality of clinical clerkships is monitored (20 states)
- Clinical clerkships are regulated (13 states)
- IMS clinical clerkships are forbidden in the state (3 states)
- Clinical clerkships are accepted in hospital departments with ACGME-accredited residency programs (22 states)
- Additional regulations exist regarding regulation of clerkships provided to students of foreign medical schools (9 states)
Click the states below for available details on their clerkships policies for visiting non-US medical students: