Many pre-medical students and international medical graduates struggle with finding opportunities to successfully engage in the United States health care system as they continue to advance their career paths, whether medical school or residency.

Historically, some pre-med students pursue a post-baccalaureate program or a “gap year” in order to gain some experiences to strengthen their applications. Others find jobs and opportunities to continue to explore whether medicine is a career path for them.

International medical graduates often seek “observerships,” un-paid clinical exposure experiences that typically do not involve any direct patient interactions, and are more of a “fly on the wall” experience. These experiences don’t typically add much in the way of mentorship and learning, and often times are completed to “check a box” to show that the individuals have had some experience to the way medicine operates here.

Interestingly enough, many large organizations have a lot of red tape and beaurocracy involved in allowing students to shadow and learn, and dedicated mentorship is not available. Direct Primary Care is a relatively young movement nationally wherein primary care physicians are generally independent and have direct authority in the operations of their practices. Many are in a micropractice model wherein there are no additional staff members, or if there are, very minimal. Growth tends to occur over a 2-3 year time span, and there is often a lot of work these physicians are doing independently. The work typically spans the full spectrum of that which a medical assistant, nurse, and office manager may do. These physicians often have the need for additional help as well as the bandwidth and interest in helping teach while they build their practices.

The 4 Elements™ Medical Externpreneur Program is our overall umbrella for educational opportunities. Currently, these fall into several categories:

  • Medical Student Rotations: We have formal academic affiliations with Quinnipiac University as well as the University of Connecticut to have medical students spend time as part of a weekly continuity clinic with us in our practice.
  • Resident Rotations: We offer a unique experience to Internal Medicine and Family Medicine Residents at the University of Connecticut to spend dedicated time with us understanding how the Direct Primary Care model works and to be able to work alongside us in seeing innovation in health care come to life.
  • Medical Externpreneur: If you are a high school student, pre-medical student or international medical graduate looking for a structured educational experience working directly with a physician mentor in the US health care system, this option is for you. We customize the experience based on your training and expertise and what your learning goals are with the end goal of ongoing learning and adding valuable experience to your portfolio. To apply, please send your CV/Resume and a Cover Letter as to why this program is of interest to you and why you feel this will help you in your career path and email it to

Customizable Deliverables by the Externpreneur:

  • Basic Certificate in Quality and Safety
  • Certificate in Ambulatory Care Risk Management (may have additional cost)
  • Vaccination program trainings
  • Patient education tools (2-3 written, 1-2 video)
  • Publication submission to a medical journal or medical humanities journal
  • Performance improvement project
  • Presentation at 1-2 BNI meetings, representing the practice
  • Competence in CLIA-waived testing and theory
  • Presentation on navigating the health system on social media
  • Comfort in interviewing skills for medical school and residency
  • Development and finessing of Curriculum Vitae/Resume
  • Letter of reference from mentor