One of my clients recently asked when he should try to schedule observerships in the United States. He thought that because residency interviews don't usually start until October, and might not happen until January, there was no reason to fly to the United States until August at the earliest. But I'll tell you why I disagree. Residency directors think that United States clinical experience (USCE) is incredibly valuable, much more than the training you get in your home country. Even if you would only be an observer here but back home you were allowed to carry your own patients, it's still important to have some USCE on your application, and the earlier, the better.
Timing is crucial. If you're applying to the 2014 Match, you'll be submitting your application in September 2013. If you don't complete your observership until the end of August, there's a good chance that your LOR won't be ready at the time you apply. Remember that your attending has to make time to write the LOR (or will ask you to create a rough draft), and then the letter needs to be processed by the ECFMG. Just like USCE compared to international experience, an American LOR is more valuable. Residency directors trust these letters and they will increase the value of your application.
Of course, USCE in September or even later is better than none at all. If your upcoming observership has been confirmed but has not yet started when your certify your Common Application Form in ERAS, you might consider adding that upcoming training to your CAF. You will need to be very clear that it has not started yet, and never lie about it. If you have not received a confirmation from the clinic/hospital, do not include it in ERAS! You can always share new information with a residency director during an interview.
There are other ways to get USCE. For example, many graduates of the Universidad Autonoma de Guadalajara in Mexico and similar schools have completed the Pre-Internship Program (originally called "Fifth Pathway") at New York Medical College. If you are not a graduate of UAG but you think you meet the program's criteria, I encourage you to contact NYMC for more information. Training there typically starts in either July or January; if you start in July 2013 then you should be able to get several LORs from American doctors in plenty of time to support your 2013-2014 residency application.
Speaking of UAG, there's a great article in the May 13, 2013 issue of The New Yorker about Elmhurst Hospital in New York, and it specifically focuses on diagnostician and clinical educator Dr. Joseph Lieber, who is a graduate of Universidad Autonoma de Guadalajara. He is incredibly knowledgeable, well-respected, and inspirational. Imagine the main character from the television show House, but loved by everyone. Here is a link to the first few paragraphs of the article; if you have access to a library where you can read the entire article, I encourage you to do so. It will inspire you and could be a useful topic of conversation during a residency interview.
As always, please contact me if you have any questions about the residency application process. I am happy to provide a free assessment of your application. I can help you develop your personal statement and CV, advise you about your strengths and weaknesses, and much more!