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I am a senior IM resident in Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia. I'll be Saudi and Arab Board Certified in Internal Medicine upon completion of my 4-year program and exams. If I take all the steps exams and am ECFMG certified, will it be possible for me to do a fellowship program (in Cardio, Hem/Onc, or ICU) without re-doing IM residency in US? What are the requirements? Will it help to do an observership or an elective rotation in the US during or after residency? My aim is to work in my country after fellowship and not to practice in the US.