A Day in the Life of an IMG During Clinical Rotations

 Stepping into the bustling corridors of a U.S. hospital as an international medical graduate (IMG) is a mix of nerves and excitement. For many, it’s the culmination of years of study and perseverance. Walking this path means not only mastering clinical skills but also navigating an entirely new ecosystem. Here’s a closer look at what a typical day looks like during these clinical rotations—through the lens of an IMG.

5:30 AM – The Morning Rush

The day begins early—sometimes earlier than you’d like. By 5:30 AM, the alarm blares, breaking into the short hours of sleep that still feel too precious. A quick moment to gather yourself, a bite of breakfast (if time allows), and then you’re out the door. The drive or commute to the hospital presents a brief pocket of mental preparation—a time to review patient notes, anticipate today’s tasks, or simply take a few deep breaths.

Many IMGs find this pre-shift ritual grounding. While the sun rises, so does their determination to make each day count. The badge is slung over the neck, the white coat feels heavier with expectations—and opportunities await.

7:00 AM – Pre-Rounds Begin

The hospital, alive even before dawn, hums with activity. At 7 AM, pre-rounds are the first stop. This is where you meet your patients for the day, comb through the latest lab results, and check vital signs. It’s the IMG’s chance to refresh their understanding of each case before joining the larger team.

Here’s where the challenge of adapting to a different healthcare system becomes apparent. Understanding how patient information is documented in the electronic medical records (EMRs), navigating cultural nuances in communication, and ensuring concise yet accurate notes are all part of the learning curve.

There’s also the delicate balance of patient interaction. Some patients are curious about your background—“Where are you from?”—and others might be less receptive. Still, every conversation is an opportunity to build trust, a skill that transcends borders.

8:00 AM – Morning Rounds with the Team

By 8 AM, the patient cases are discussed in rounds, led by the attending physician. For an IMG, this can feel equal parts inspiring and intimidating. It’s not just about presenting your patient cases; here, sharp clinical reasoning and clear communication hold enormous weight.

“Tell me, why do you think this patient is exhibiting these symptoms?” An attending might ask directly, expecting quick yet thoughtful responses. The pace is swift, requiring you to stay sharp, confident, and adaptable. This is an opportunity to demonstrate your medical knowledge while staying humble enough to accept constructive feedback.

The teamwork within the U.S. healthcare system often surprises IMGs. Residents, students, nurses, and allied health professionals are all integral sticks in this wheel. Understanding how to collaborate across hierarchies and departments starts here.

10:30 AM – Hands-On Learning

After rounds wrap up, the day dives deeper into clinical work. There may be procedures to observe or assist with—suturing a laceration, drawing blood, or participating in the placement of an IV line. Each interaction becomes a chance to sharpen technical skills while learning bedside manners unique to the U.S. setting.

It’s not uncommon for IMGs to notice how patient autonomy takes center stage. Doctors in the U.S. empower patients by explaining their conditions and involving them in decision-making processes. These moments of interaction are an opportunity to absorb not just the medical approach, but also the human side of healthcare delivery.

12:00 PM – A Quick Break (If You’re Lucky)

Lunch might mean sitting down for 10 rushed minutes with a sandwich in hand. Other days, it’s a granola bar grabbed between patients. A casual conversation with a fellow resident or attending physician during this time can often serve as a form of networking—IMGS learn early that these connections are crucial for recommendations and career progression.

1:00 PM – Afternoon Consultations and Independent Study

The afternoon is a blend of patient follow-ups, shadowing senior doctors, and finding time to read articles on new treatments or guidelines. This is where participating actively matters—asking questions, clarifying doubts, and showing your willingness to learn.

For many IMGs, staying up-to-date feels especially important, as they’re balancing this with preparation for exams like the USMLE Step 2 CK. It’s a juggling act, but one that slowly becomes manageable with practice.

4:00 PM – Check-Ups and Notes

The last leg of the day involves revisiting assigned patients, adding updates to documentation, and reviewing what was learned. For IMGs, the U.S. emphasis on detailed documentation can feel tedious at first. However, over time, the process reveals itself as a valuable tool for communication and continuity of care.

Before leaving the hospital, there’s often a brief meeting with the resident team. Here, your experiences for the day are discussed, and expectations for tomorrow are outlined. The long list of “what’s next” offers both challenge and motivation.

6:30 PM – Reflection and Recharge

By the time you head home—roughly around 6 or 7 PM—you’re mentally and physically taxed. Yet, amid all the exhaustion lies a sense of purpose. Many IMGs reflect on their day during their commute home. “What did I learn today?” “How could I have handled X scenario differently?” These moments of self-assessment shape not just better physicians, but better individuals.

At home, it’s a quick dinner, a bit of study time, and perhaps a phone call to family back home before unwinding. Sleep comes easy after a day like this—though tomorrow, everything starts all over again.

The Value of the Experience

The life of an IMG during clinical rotations isn’t for the faint-hearted. It’s rigorous, emotional, and deeply humbling. Every day reveals something new—insights into the complexities of the U.S. healthcare system, moments of connection with patients, and opportunities for personal growth.

On the tougher days, when challenges pile up, it’s worth remembering why you began this path. Clinical rotations offer more than just a stepping stone to residency; they are a molding ground for resilience, compassion, and adaptability. And each day brings you closer to the physician you aspire to become.

For many IMGs, these rotations are more than just work. They’re a bridge between dreams and reality. It’s not just about learning to treat patients but learning to thrive in a system that values both competence and care. And that, in itself, is a lesson worth every ounce of effort.