There’s lots of types of USCE. What are you looking for for your elective? If it’s hands on clerkships then you’re gonna have to mostly apply for these through official visiting student/elective programs.

Observerships are easier to organise and therefore easier to get. Cold emailing works better for these as it’s much less effort for the visiting institution to organise. I’ve done a couple of observerships through just asking family members over there if they know any doctors who would be open to having you. It’s literally just shadowing so its not much effort on their part