Once you have got an elective/observership and have your visa, the next big thing is making plans. Yes, that’s correct! It may sound easy but you have to be prepared and make smart choices so that you can not only save money but also enjoy and learn from your stay in the United States.

Buying plane tickets:

First things first! Buy air-tickets once your elective has been approved, preferably before 6 weeks of your estimated departure date. You can buy before that or even after that provided you are getting or are going to get a good deal. Also, you can skip through the tips below if you are traveling business class or are very rich!

1) Use travel websites like Skyscanner, Kayak, Goibibo, MakeMyTrip, Cleartrip, Momondo, Expedia, etc. depending on your country. Compare the fares and look for any offers. For example, I once booked a flight on Goibibo with 10% discount using a credit card of a certain bank which was an insanely crazy deal! So, look for it. Good deals do exist, you just need to look for them.
2) Try adjusting your departure-arrival dates. Flying on weekend is almost always costly.
3) If there is even a slight chance that your travel dates and plans may change, make sure you look out for crazy airline cancellation charges or other such fees and if the fare is refundable or not, before booking the ticket. The last thing you want to happen is to pay almost half of the ticket’s price to change or cancel the ticket. Better yet, make sure that you buy only after your travel dates and plans are fixed.
4) If you are traveling to smaller cities in the US and if buying a single ticket seems costly, try traveling from major hubs like New York, Chicago, Atlanta, etc. to those places using another ticket. But beware, since most US carriers charge a luggage fee which may at the end make it a costlier alternative compared to getting a single through ticket.
5) Try multicity option.! Once, I was not able to find a cheap enough ticket to Shreveport, US from Ahmedabad, India. By using multi-city option and using London as layover airport, I got a much cheaper deal!
6) Look up airline websites as well! Sometimes you might get a fare that is nowhere visible on third party websites. Often, some airlines don’t allow third-party websites to display their fares. e.g. Southwest airlines.
7) Make sure you confirm luggage policies with the airline before your travel. Usually, if traveling on a single ticket, international luggage policies apply even if you are traveling domestically in the US. That is not the case if the domestic leg is booked on a separate ticket. Hence, check before you do anything that hurts your pocket.

Accommodation:

Next big question, where am I going to live?

1) Ask elective coordinators or look through the list of places they usually almost always send. Sometimes you might get a good deal among those listings.
2) Try Airbnb. You might get a cheaper and better deal. I got a good deal even 10 days prior to my elective. It was really a good place and the host was amazing. You can use the referral link below to sign up and you will get 31$ towards your first trip! Airbnb
3) You can also give a shot to Sulekha to look for Indian roommates/rentals and another option is Craigslist where too you can look for sublets/rental places, but I have not used either of them so far and so I do not have any idea or experience with it.
4) If you can, try getting a place that is close to the hospital. Commuting is difficult and public transport in most cities in the US is not that great.
5) A word of caution, be careful while booking accommodation. Airbnb is by far the best and customer support is excellent. Compared to that, other third-party websites and random listings might be fraudulent and you might end up losing your money. So just make sure that you verify everything before you make any payments. After all, you don’t want to arrive in the US and find out only then that the place that you booked does not exist! Trust me, that might happen!

Currency/Finances

You need to buy USD?

Using your home country credit and debit cards in the US is the worst option followed by buying forex directly from banks because of the costs involved. For those in India, the best way to buy forex card and cash is through either one of these two companies: bookmyforex.com and buyforexonline.com. These are the ones that offer cheapest deals and trust me, I too was skeptical initially since they offered far more competitive forex rates compared to what banks had to offer, but they are genuine and have excellent customer support. Because of their agreements with banks, they are able to offer excellent rates to their customers.

The biggest benefits of these third-party forex companies are no loading, reloading or unloading fees, or even if they are, they are meager compared to that charged by banks if you buy directly from them. Plus, you can reload or unload your card easily and even if you are in the US. They also offer a certain number of free ATM withdrawals within the US vs 2.5$ charges if you purchase forex card with banks. However, not once during my US trip did I need to use ATM. Only catch with these companies is that you can buy forex only within 60 days prior to your travel date and you will need visa and air tickets to place order. You can unload the remaining amount once you return to India or you can use that money to pay your USMLE exam fees!

Also, carry some cash with you. Not much, but around 100 USD shall do since forex card works everywhere in the US. I carried 180 USD in cash for my first trip. I bought 180 USD in cash so that I will get even smaller denominations like 10$ or 20$ bills that are relatively easy to use compared to bigger bills.

A word of caution: somehow, I was not able to use my forex card with Uber in the US, and I had to buy a prepaid card from Walmart so that I could avoid paying 3.5% cross currency mark-up charges +taxes if I used my home country debit/credit card.

Use this referral code RFN44615 to sign up or place your first order on buyforexonline to get up to 150 INR service charge waived off!
Use this referral link on bookmyforex or referral promo code 169b94e87c3490 and you can get discounted rates or upto 500 INR off for orders over 50,000 INR!

Sim-card/Calling to India

Buy it from India or from the US. I bought a prepaid card from ATT the next day after my arrival in the US. Some of my friends used Lyca simcards which offer competitive rates compared to ATT and T-mobile and also free calling to India. If you are staying for longer periods (3 months or more), you can use Mintmobile that offers the most competitive rates for longer periods and has excellent coverage. You can also check coverage maps available on these network providers’ websites so that you can know before-hand if the area you are going to is covered or not.

If you want to call to India, Whatsapp or Facebook calling is by far the best option.

Transport within the US

It’s a nightmare! During my visit to Cleveland, I used public transport. It was cheap but hard. The freezing cold of January that often ran as low as -20 C, made it unbearable to stand for even 5-10 minutes waiting for the bus. Trust me it was no easy even though I had three layers! So, let’s lay down and talk about options for transport within the US.

1. Public transport if it is easily accessible from the place where you are going to live, is both a cheap and a convenient option. You can get monthly or weekly fare passes to use.
2. If you are rich and can afford to rent a car, do that since Cars are the best and most convenient option to travel in the US. You can use websites like Hertz, Enterprise, National, etc. You will need your home country’s driver’s license and an international driving permit to drive a car within the US. A word of caution: if under 25 years, you will be charged with an exorbitant young driver’s fee.
3. If you live nearby to your hospital, you can use a bike(bicycle). Ask your landlord if he/she has a spare one. Or better yet, you can even buy a used one and then sell it or even if you are not able to sell it, that will still end up being cheaper.
4. Uber and Lyft both are excellent but are relatively very costly. If needed, you can use either of them since prices are more or less the same. I occasionally had to use Uber and Lyft when I missed my bus! To sign up for a Lyft account you will need a US cell phone number. Use this referral code (HARSH95345) or this link (Lyft) to sign up on Lyft and you can get 5$ in ride credit valid for the first month after you sign up.
5. You can use Greyhound or Amtrak or Megabus or Boltbus for ground-level intercity transport. Wanderu combines all of these and many more transport services together and offers excellent deals for intercity transport.
6. Use Transit app that offers departure and travel times and details of public transport and also, Uber and Lyft information for comparison. Personally, it made commuting a lot easier for me. However, it is not available in all areas.
7. Before booking your accommodation, make sure what mode of transport you will use and if public transport is accessible from there or not. Personally, I would not mind paying a 100-200$ more to get a place from where commuting to the hospital is easy.

Clothes and Accessories

1. Take formal wears and formal shoes from India. At least 4-5 pairs for a month or more if staying longer. Take a few ties along. A single suit usually is enough and you can use it when you are given an opportunity to do a presentation. Also, the dress code is more or less same everywhere but it would be wise to look up the subtle differences if any, by following your university’s/hospital’s dress code and follow it.
2. Depending on the weather of the city you are going to, you can buy winter wear like jackets and snow boots if needed from India itself. It will be much cheaper compared to that in the US. Woodland and Wildcraft are the best companies to buy winter-wear and boots from in India. Also, if you are going to a place as chilly as Cleveland like I did, it would be wise to use thermal wears to layer yourself. In all, just make sure that you don’t get frostbite on your nose tip or earlobes or toes. Haha. Stay warm!
3. Take all other clothing accessories that you usually or occasionally need here. E.g., Socks, handkerchiefs, napkins, bed sheets, belts, towel, caps, shawl, under-wears, etc.
4. Take grooming and other accessories like Shave gel, aftershave, razors, toothpaste, toothbrush, mouthwash, deodorant, shampoo, comb, sunscreen, cosmetics, nail-cutters, safety pins, rubber bands, needle + threads (in case of an emergency), etc.

Food

1. Learn to cook! I didn’t and I don’t know how to cook and hence I ended up spending much more than I otherwise should have. So, learn to cook and it will save you a lot of money.
2. Take spices from here and some raw flour or other stuff if needed from here. Plan it according to your stay. It would be wise to take a small cooker as well from India if you have space for one in your luggage.

Medicines

1. You can take your own supply of medicines but make sure that you have a prescription for every medicine you are carrying. Ask the doctor to write a proper prescription that says, “XYZ person, holder of INDIAN passport number 12345 is traveling to the USA and has ABC, PQR medical conditions/problems and hence he/she needs following medicines for his/her wellbeing which are hence by prescribed.”
2. Make sure to take few band-aids, few prescription antibiotics, NSAIDs, PPIs, Antacids, Paracetamol, Domperidone, etc. and others depending on your personal needs.

Apart from all this, be prepared with all your documentation that you might be asked to present at Point of Entry while going through immigration. It’s usually a few simple questions that I am sure you will be well prepared to answer. Make sure that you are aware of this one clause from US Foreign Affairs Manual: ‘9 FAM 402.2-5(E)(3) (U) Clerkship’. Google it up and take a print out. Rarely, it might come handy.

Have fun and cheer up. It might seem scary, especially for those traveling solo and that too for the first time, but it is a far more exciting and wonderful experience that you will definitely long for once you return back to India.