Sleep To Live Well Foundation

International Medical Graduate (IMG) Observership/Externship Program

U.S. Medical School Placement Support

20 Years of Mentorship: The Real Reason IMGs Struggle

Don’t Just Observe. Participate, Engage, and Perform.​

  • Most IMG clinical training programs expect you to be a quiet, invisible participant. We provide the behavioral training needed to shed deferential habits and hit the ground running on your very first day—fully prepared for the high-stakes moment an attending asks, “What do you think?“

  • Physician-led performance training designed to teach you how to behave, communicate, and present with the same authority as a U.S.-trained MD so you can earn a strong LOR.

Registration:

  • Premium Tier: Strictly limited to 6 participants for high-intensity mentorship.
  • Foundation Tier: Open registration; immediate access to U.S. clinical systems.
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The IMG Problem is The Fly on the Wall Clinical Experience

  • The discontinuation of USMLE Step 2 CS created a critical gap in mastering U.S. patient interaction. However, the real danger in most rotations is the “Fly on the Wall” syndrome.

  • Many IMG training programs expect IMGs to be reticent and wait until spoken to. In a U.S. clinic, that behavior is often interpreted as a lack of engagement, knowledge, and clinical curiosity. If you remain a silent observer, you will not earn the “Strongly Recommended” Letter of Recommendation (LOR) required to match.

Stop Reviewing Medicine. Start Practicing Your U.S. Clinical Persona

IMGs already know medicine. We teach the expected behavior of a successful U.S. clinician. We build your U.S. Clinical Persona through simulated participation. We provide the instruction you need to communicate with the confidence of a U.S. resident—mastering the unwritten rules of the American clinic that cannot be learned by simply watching from the sidelines.

Program Options - Performance Incubator

FeatureFoundation TierPremium Tier
Investment$600$1,000
Batch SizeFlexibleStrictly Limited to 6 Participants
ParticipationObserver & LearnPresent cases & high yield clinical briefings
Clinical SessionsRecorded ContentLive Mentorship + Standardized
FeedbackNot ApplicableIndividualized Physician-Level Feedback
EMR TrainingOrientation VideoLive EMR Demonstration & SOAP Note Review
OutcomeLetter of ParticipationPersonalized LOR (Based on Performance)
SECURE YOUR SPOT

Beyond Medicine: Learn The U.S. Clinical Ecosystem

Instead of a passive schedule, we orient you to the mechanics of the U.S. Healthcare System and the "Reflexes" of a U.S. Physician:

  • The Efficient U.S. EMR Workflow: A deep-dive orientation into creating Progress Notes (SOAP format) the “U.S. Way.” Includes a live demonstration of transforming a submitted SOAP note into a high-level medical record.
  • The “Professional Hook”: Training in clinical cadence. Adopt the art of the 15-second “Bottom Line Up Front” (BLUF) presentation.
  • The Resident-as-Teacher Model (Premium Only): You will have the opportunity to provide fellow participants with feedback in a collegial fashion. This allows you to practice the leadership and communication skills expected of U.S. residents.
  • Understanding the U.S. Healthcare Landscape: Essential orientation to the “Gatekeeper” system and the economic “Reflexes” of U.S. medicine:
    • The Payor System: Understanding Capitation, Copays, Deductibles, and the difference between HMOs and Fee-for-Service.
    • Operational Standards: Tiered Formularies, the PCP as Gatekeeper, Defensive Medicine, and the Community Standard of Care.
    • Modern Clinical Paradigms: Trauma-Informed Care, Value-Based Care, Patient as Consumer, and Patient Safety/Quality of Care metrics.

The Letter Policy

  • Foundation Tier: Receive a Letter of Participation verifying your orientation to U.S. clinical documentation and healthcare system mechanics.
  • Premium Tier: A strong Letter of Recommendation is earned through performance. Receive a personalized LOR based on your demonstrated clinical voice and your ability to transition from a reticent observer to an active contributor.

What Participants Say

Ada Taymoori This Externship Was A Fabulous Journey

Dr. Washington is welcoming, compassionate, extremely smart, and a role model in professionalism and ethics. The externship was greatly organized, perfectly scheduled, and designed to give externs an immersive and involving experience. I was never stressed during these 4 weeks of externship but focused and excited to learn more. I had chances for presentations and it was always easy to ask questions and receive excellent answers. It is quite a fantastic feeling to experience acceptance and to see someone with the accomplishments of Dr. Washington believe you can move forward and succeed. I specifically enjoyed the extent of education in communication and patience as valuable clinical skills. The variety of cases is pretty interesting. I feel a new level of confidence now that I am coming to the end of this wonderful experience. I confidently recommend this incredibly valuable externship to all fellow IMGs whether you are at the beginning of your journey or have been trying for residency for a while. This is a life-changing experience. Join with hope and confidence. You will enjoy it, you will learn a lot, and you will come out stronger and more confident. Come join this great team, my friends. This is the right place to be. Be ready to be surprised by Dr. Washington’s polyglotism. 🙂 My warmest appreciation for Dr. Washington’s time, kindness, and great teaching, and many thanks to his team for this great experience.

Dr. Priyanka K Every Shift Was Productive And I Had Something To Learn

I recently completed my externship at Dr. Washington’s clinic. I had an opportunity to get hands-on clinical experience, including taking history and performing physical examinations under his supervision. He provides autonomy in working on the Electronic Health Record (EHR) and discusses any changes in the notes he would recommend. In addition, we had one-on-one sessions at the end of the shift every day to discuss interview skills, patient care, and the latest research studies.

Anna Hernandez An Amazing Experience

I am so grateful for the time I had with Dr. Roger Washington to expand my US medical experience as well as gain confidence in myself and my capabilities. Being an IMG who was familiar with the US medical system, prior to my externship I felt unsure of myself and my clinical knowledge since I was trained abroad. Dr. Washington allowed me to present patients, perform presentations, as well as work alongside other IMGs to better prepare me for Residency training in the US. I am so grateful to him and his team for being so welcoming and helping me along in my journey in medicine. I would highly recommend his in-person externship experience if possible, if not there is still much to gain from the virtual externship.

Dr Sonia Goyal What An Amazing Learning Experience!!

I have done telerotation with Dr. Washington and it was an amazing opportunity to learn so much about primary care. Everyday i learned something new about communication skills, insurance policies, importance of sleep. The skill to listen to patients and then explaining and consulting with them about their issues will really help me grow as a doctor. I really thank Dr. Washington for this wonderful opportunity.

Take the Next Step in Your Medical Journey

Don’t waste your next on-site externship by being invisible. Be ready to contribute with confidence from Day 1 in the U.S. healthcare system. Secure your spot.

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SECURE YOUR SPOT

Excerpt from sample Letter of Participation

Dear Administrator,

As a Fellow of the American Academy of Family Physicians, I have practiced family medicine in San Jose, California, for over 35 years. Over the years, I have been an associate clinical professor at the Stanford Medical School affiliated with the San Jose Family Medicine Residency program and a department chairman of the Good Samaritan Hospital in San Jose. I have also served as a preceptor for the learning experience of Stanford medical students, physician assistant students, family practice residents, and international medical graduates.

On (date), the (IMG Participant) completed a four-week Observership-type clinical experience designed to provide an international medical graduate with a comprehensive introduction to US Healthcare…

During the four weeks, I discussed and gave participants insight into the following:

  • daily responsibilities and various roles of the primary care physician, including the role of gatekeeper for referral to specialists, Administrator for paperwork such as state disability, work and jury duty excuses, and adjudication for the DMV
  • patient-centered, integrated, holistic approach to patient care
  • …