International Medical Student Handbook Addendum

-Success in your UIC DFM Rotation –

We, as a department are happy to welcome you to spend some time with us. We know that you will integrate rapidly into our family, and we hope that your experience will be all that you anticipate and beyond. Our primary goal for your visit is your success. With your success comes healthy patients and communities now and into the future. We know that in many ways your visit with us will be challenging beyond the “normal” challenges of medical education. We, together, will be confronted by additional barriers in your receiving a quality experience during this particular rotation. Language, cultural, and systematic issues will be consistently present and may even surprise us at times that we don’t expect. Our commitment to you is to work with you and support you as best we are able. If we confront these challenges through open communication, we will both succeed: you as a guest and learner, and we as hosts and teachers. This addendum to the Student Handbook is meant to provide you with some guidance as to what you might realistically expect and what we will be expecting of you. We hope that you find this information valuable. We are looking forward to meeting you soon.

Recommendations to Students:

    • Prepare for success prior to your visit.
      • Read the Handbook. Know the basic expectations of the rotation.
        • Among other things this includes references and suggested learning guides, policies and procedures, professional expectations, evaluation policy, and additional resources.
      • Become familiar with professional expectations of US medical education. By following this advice, you will be much more likely to have a great experience. If you have questions about any of these suggestions, ask now, prior to your arrival, so as to clarify expectations.
        • Communicate – Always keep others informed as to your whereabouts and issues that impact your responsibilities. This includes your supervisors, the course coordinator, and your colleagues.
        • Arrive on time, stay until the work is done, make honest and timely communications about any late arrivals or missed activities. Timeliness is very important in your success on a rotation with us.
        • Students should be very clear concerning to whom they are reporting and check in frequently with that supervisor for feedback on performance and expectations. Ask how you are doing and how you can improve. Let your team know that you are doing your best and that you desire to improve.
        • Be proactive. Ask for responsibility. Ultimately, your learning is up to you. Take that responsibility seriously and engage yourself as best you can.
        • Be patient if people are busy. If you have some down time while you are waiting on others, fill that time wisely. Do some research on your patient. Look up some additional information or find some primary literature on a clinical question that you may have. When you get the opportunity, share that information with others. This will be helpful to the team and will enhance your learning.
      • Become familiar with cultural expectations in the US. We have included a very brief overview at the end of this document for your perusal.
      • Recognize areas of skill and knowledge deficits that you may have and strengthen your base prior to your visit. If you are unsure, ask your supervisors in your home country what you should work on prior to your arrival at UIC. As well, use your visit to UIC as an opportunity to strengthen these identified areas.
      • Meet with students who have visited UIC or other American medical schools about their experiences. Ask them how you can best succeed.
      • Succeed during your visit.
        • Address the Language Barrier
          • Ask for clarification if you do not understand – ALWAYS. Supervisors and colleagues would much rather repeat instructions than find out later that you have not completed your responsibilities.
          • Repeat instructions back so as to be sure that you have understood completely.
          • Confirm with patients if they are being understood and are understanding what is being said. Patients may sometimes assume that you are understanding them completely. If you are not, it is your responsibility to find assistance through a colleague or an interpreter.
        • Avoid Cultural mistakes
          • Be cognizant of others actions and behaviors. If you are confused about the way you should be acting / reacting, don’t hesitate to ask for guidance.
          • Communicate openly with others. People are very willing to discuss cultural issues with you if you ask. This includes sensitive topics as well as everyday / routine cultural norms.
          • Teach others about your culture as a way of learning about theirs. Be open to learning and teaching. This exchange is valuable and rewarding.
        • Know you have support
          • Ask, Always, Anyone, Anytime!

Major American Cultural Elements

The following is adapted from The University of Iowa Intensive English Program


The cornerstone of American Culture is individual freedom. The Constitution of the United States of America ensures that the people retain certain rights and freedoms. It limits the influence the government has on the personal lives of the citizens. Americans who respect the rights of other citizens are free to work, play, worship, travel, and live as they please.


American families are small by comparison to many of the world’s cultures. The average American family has 2 or fewer children. Most American children live in two parent households. 60% of American mothers have jobs outside the home. Parents of adult children generally live independently, maintaining their own homes though it is common for the elderly to live with their adult children late in life.


The Constitution of the United States ensures a separation of Church and State. There is no religious requirement to be a citizen of the United States. The majority of American citizens are Christian though all of the World’s religions are openly and freely practiced here. However, given that most of the citizens are Christian certain religious consolations are made. Sunday is not included in the workweek and one religious holiday is recognized.

Christmas (December 25th) is the only religious holiday celebrated nationally. It is a celebration of the birth of Christ. It is a one-day holiday for Federal and State Government employees. Most businesses are closed.

Thanksgiving (the 4th Thursday in November) is a generic religious holiday. Many churches have services, but it is not an officially recognized holiday by any religion. It is a time for all Americans to give thanks for the blessings they have.


You can get a good idea about American food preferences by looking at the menu of a typical American restaurant. Restaurants serve the food people are most interested in eating. You can see what Americans typically call breakfast, lunch, and dinner. Americans generally eat their largest meal of the day in the evening – dinner. These meals seem to revolve around some form of meat (mostly red meats or chicken) served with a starch (potatoes are most common, rice is readily available) and vegetables. Many evening meals start with a lettuce-based salad. Most Americans are understanding of multicultural dietary needs, and special requests can be accommodated in most instances, including vegetarian, Kosher, or Halal foods.

Daily Routines

Americans typically use a 40-hour workweek, 8-hour days, Monday through Friday. Actual working hours vary but usually begin before 9 a.m. and end before 6 p.m. Forty-two percent of the American workforce are women. Lunch breaks are usually an hour or less. That’s why the evening meal has become the big meal of the day for many Americans. Most Americans sleep only once a day from 10 or 11 p.m. until 6 or 7 a.m. Weekends are personal time. Recognizing differences between American routines and those you may be used to will help you understand the culture and people of the United States.


Working Americans dress in a manner that presents a professional and neat personal appearance in accordance with the expectations of the job. It is understood that all employees maintain normal and reasonable personal hygiene and grooming standards. Clothing or accessories that are safety concerns such as open toed shoes, sandals, or excessive jewelry are not permitted to be worn by employees or students who work in patient care areas. Reasonable accommodations based on religious and/or cultural observances or practices such as, but not limited to, style of dress, head coverings, and grooming requirements are considered acceptable. Clothing should be clean and pressed and jewelry is worn in moderation. All students and employees are required to wear name badges while on duty in American patient care facilities. The badge is expected to be displayed above the waist and worn in such a manner that the person’s name can be easily read by patients and visitors.


People coming to work or to meeting each other in a routine setting will usually use a verbal greeting and response. Additionally, in small or rural communities, strangers simply passing on the sidewalk may exchange simple greetings. This is less common is larger cities but still may occur. Verbal greetings vary depending on where you are in the U.S. and the familiarity of the people exchanging the greeting.

Simple verbal greetings

These greetings can be repeated as a response.

      • “Good Morning/Afternoon/Evening” varies with the time of day. (Often shortened to “Morning/Afternoon/Evening” informally).
      • “Hello” is a very common telephone greeting and is also used face to face.
      • “Hi” is a shortened form of Hello.
      • Other common verbal greetings require a more advance response and invite conversation. These may follow up a simple greeting.
      • “How ya doin?” is an abbreviated form of “How are you doing?” A common response might be, “Good, and you? (Returning the question).
      • “What’s up?” is a way of asking how busy you are. Responses vary from “Nothing much” to “Working hard” followed by “What’s up with you?” or “How you doin’?”

Physical Greetings

A wave of the hand or nod of the head may be used to acknowledge a friend in situations where a verbal greeting is not appropriate. A handshake is a common greeting used by adults of either sex, however, it is generally used upon first meeting someone or greeting someone you have not seen for an extended period of time. Americans generally do not exchange handshakes daily.A hug or kiss on the cheek is a common greeting among family members or very close friends of opposite sexes especially if they have not seen each other for an extended period of time.

Personal Space

Americans comfortably stand about 30 inches (75cm) apart when they are talking. Many international students come from cultures where people stand closer together. Standing too close to an American may make them feel uncomfortable or crowded. If you are aware of personal space it will be easier to talk to people and help others to feel comfortable around you.

Timeliness and Professionalism

Professionally, being on time is very important. In social situations Americans are more understanding. If you are more than a few minutes late, it is a good idea to apologize. An excuse is usually not necessary. If you will be more than 10 or 15 minutes late, it is considered polite to call and inform your host of your delay. Professionalism, as a larger ideal, involves additional components beyond timeliness, however. It literally means to act as a professional. This includes being on time, acting courteously, fulfilling your responsibilities, presenting yourself in a manner appropriate for a professional, and abiding by an accepted code of ethics.

Social Situations

Your sponsor or someone you meet here may invite you to their home. Arriving on time makes a good impression. Gifts are usually not expected, but always appreciated. A small memento from your country is an excellent gift. Flowers or chocolate are also popular gifts. Wine is a nice gift if you are sure the individuals drink alcohol. If you are unsure, avoid taking alcoholic beverages as a gift. Your host should tell you if food is involved. Let them know if you have any restrictions to your diet. You will not be expected to eat anything you do not want. Your host may serve you or allow you to serve yourself. If you serve yourself, don’t take more than you can eat. It is better to get a second serving than leave a large portion on your plate. Many Americans will offer a second serving (called “seconds”) only one time. They will not usually force a second serving once it is declined. It is O.K. to ask for a second serving. Many Americans who cook think of this as a compliment. Americans are indirect about when to end an evening. They may make a comment about how late it is getting or how early they might have to get up tomorrow. This is a sign that it is time to end the evening in preparation for tomorrow’s activities.


Major American Cultural Elements, The University of Iowa Intensive English Program, accessed June 2011.