Applying for an Elective in the USA

So you want to go to the United States of America. This is a great choice for an elective that will impact your practice for the rest of your career. As is often discussed in the news, there is no universal healthcare in the USA. This means that if an individual needs any kind of treatment or procedure, someone will have to pay for it. Therefore, many Americans have health insurance either privately or through their employer. The US spends almost 17% of their entire GDP on healthcare and are a leading system to study and benefit from as a visiting student.    

Applying for your elective can be a scary or confusing time. The USA has various processes for placement applications that apply to both internal and external students. Here is everything you need to know before you begin your application, and to help you decide if the US is the right location for you.


One thing to be aware of when considering an elective in the USA is the USMLE Step 1 (United States Medical Licensing Examination); this is the test every medical student in the USA must take at the end of their second year before they can continue their studies. Students normally take six months to revise for this standardised preclinical exam, that lasts eight hours.  

Many hospitals will require this be passed before a medical student, even an international like yourself, can work in a hospital. Without passing the USMLE, the number of places you can take an elective are reduced so do keep an eye out for the requirements the hospital lists before contacting them.  

But wait! Before jumping in to researching and studying for the USMLE because you are desperate to go the States for your placement, there is more. The cost of this exam can be in the region of $1000 which is a huge amount of money. You should consider if this is definitely what you want to do. We have spoken at length with students who took an elective in the USA and many said not to bother with the USMLE and instead look at a non-clinical options.

Time and Money

Even if you decide not to pursue the USMLE Step 1, there are still plenty of expenses to consider when applying to the US for an elective. Accommodation, travel, visas, the list can feel endless. We have plenty of tips and guides on our website to help you start saving and also to prepare you for what costs you might encounter.  

You should also bear in mind that there will most likely be a fee associated with your elective to cover administrative costs for the hospital. These will vary depending on the institution you would like to attend so make sure you do your research before applying.  

Most people will begin organising their elective between a year and 18 months before their planned departure. Again, you will need to check very carefully on the institution's website regarding any application deadlines as these will be different for each hospital or placement.  

There are still plenty of tasks to complete prior to application and you must research first to find out if a placement there is viable. It is also worth considering a non-clinical elective or placement at a charity, advocacy group, or similar. These can help you learn so much, not just about medical practices, but community projects and how they benefit health systems. Take a look at our database for more inspiration on non-clinical opportunities in the USA and beyond.    


Remember, we are always here should you have any queries or problems.  


Good luck!

Advice on applying for an elective in Canada can be found here.