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2.22.2008

An IMG Experience.....

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I am Posting the story of a poor immigrant who managed walking up the hill on residency and finally succeeded ....Thanks To Intelligentdoc For sharing this With me...
And i hope this will be Inspirational to our members....

An IMG Experience

I graduated in 1998 from medical school and was not able to start my residency right away. In my country, residencies are not paid, so the majority of residents have to live with their parents or be sponsored by their wifes/husbands, coming from a humble family, and being single, that was not my situation.
I immigrated to the US in 2002, and started to re-learn English, those were tough times, no job, no english, and not a single clue about how to continue with my education. Finally after spending 2 years learning english and understanding the intrincacies of the ECFMG Certification - Match I decided to start, by then I was already 28 Years old, been out of medical school for 5 years, and the worst part, I wanted to do Surgery.
Talking to a lot of people, I quickly realized that things were going to be harder than I thought, I got a job as a computer programmer (!), and started from there, the long hours in front the computer, so far from what I love (my patients) made study every day a difficult task. after a couple of months fighting against the routine I was able to get started.
Setting up goals
The first thing I did, which, I think was key to success, was to stablish a detailed plan, all the way from Step 1 to residency. I joined several forums and was aquainted with the general timing of the exams, I learned that in order to be ready and on time, I would need to have my last exam done by the end of September (1st Rule of thumb), and that would allow me to start my residency by june Next year.
I decided to go in order, Step 1, CK, CS, that mean that I would tackle the hardest one first and would work my way through Step 2 without much problems.
Step 1
I decided to study for a full 8 months for step 1, and here comes my second rule of thumb for the USMLE: You will never be as ready as you would like to be for the Exam, just set a timing goal and adhere to it, if you wait to set the dates for the exam once you are ready, most likely that time is going to be more than what you really need.
After gathering the materias, I took the kaplan 150 question practice exam just to see and gauge an starting point. The results were not any good, I was close to 38%!!! in some of the areas, and my best score was not better than 60%. I took the decision to distribuite the time as follows:
6 months reading the Kaplan Lecture notes (3 Huge books by then)
1 month reading and reviewing First Aid
1 final month exclusively doing practice questions.
In between I started doing the Kaplan Qbank in tutor mode, that helps a lot, but in the end that final month was to be done simulating the actual conditions of the exam, in weekdays I use to do timed blocks of 50 questions and in the weekends try to do as many blocks as possible. In the final days of review I was doing an average of 75% in kaplan, enough to pass the Exam, I took the exam in the end of 2004 and got 85. It was not the score I would like to have, but I was relieved it was over.
Getting into a hands on clinical possition - Possible?
Just after getting my results on the exam, I was told by a friend that there was a position available for Foreign Graduated Physicians in a Hospital in Miami, the position is called House Physician, the state of Florida let people like me work as physician, mostly doing History and Physical exam in patients that either are going to surgery or are admitted in the wards. I was able to secure a position and started seeing patients again. Check in your state with the local department of health, they may have this type of position available.
Step 2 -
I Started to study for Step 2 a few weeks after taking Step 1. for step 2 I used only Kaplan Lecture notes and USMLEworld, after reading the book I did every single one of the 2000+ questions, and was able to repeat at least 800 of them. My final score for USMLE World was 58%, I was confident that this score would guarantee at least 90 in the exam. I spend 5 months preparing the exam, and I still remember taking Step 2, Everything seemed so easy, I got 92, almost 93.
Having fun, that’s what matter
By then I had been on my job as a physician for 6 months, doing at least 12 - 15 Cases a day, Step 2 CS was going to be a breeze, I prepared the exam for 15 days, mostly reading the material of First Aid, and the USMLE video, took the exam in Atlanta, in September, Last year, just as I had envisioned 2 years before… The first case was difficult, because I was very nervous, as soon as I exit trhough the door, somehow I realized that my dream was fulfilled, there were only 11 doors, between me and my ECFMG certificate, I just needed to have some fun in between. Results arrived 4 weeks later, I was a certified physician now.
Here comes the difficult part… maybe not
Getting into Surgical residency was going to be hard, I knew, my scores were not perfect, I had no research experience, and my age (30) and the time after my graduation (7 years) was a handicap in my application, but first I needed to get the Letters of recommendation, and after receiving 2 negative answers from attendings, I was able to get letters, from the chairman of the Surgical department at my hospital, a prominent Laparoscopic surgeon and the medical director of the hospital.
Next step was to compose my Personal Statement, it got to be something that while being true to myself also allow me to get the attention of the committees, I received help from a friend who was able to capture my ideas, and at the end the result was better that I was hoping for. I applied for a whooping 92 programs nationwide on the national residency matching program, spending close to $2000 in the process, I did this trying to cover my deficiencies with a massive ammount of program applications.
and then I started to receive emails from the different programs, the first 30 Emails were negatives, something like “thank you very much for applying, but you are not getting an interview here” It was November last year, when a friend told me that someone got into surgery after completing an Observership in a very big and important hospital in my city. despite everybody telling me that it was going to be near impossible to get a position in such that institution, I decided to try to sign up for an observership.
I was lucky enough to fill a position of someone who had already signed up but was unable to attend, that was the only spot that was available for the next 6 months in the trauma unit of the hospital, I was there 3 months, Dec, Jan and Feb, working around the clock with the Surgery intern and the Senior Resident.
At the same time I applied for residency in that hospital, and talked to the Senior Resident, letting him know that I wanted to stay for my residency. Somehow, they called me for interview, I was astonished. it was the end of 2005 when I got my interview, minutes before I was going to talk to the program director, the Senior resident Popped in and talked to him privately for a couple of minutes. My interview was a breeze.
Now, after writing this, I am heading to Jackson Memorial Hospital in Miami, FL; to finish the paperwork and to do the physical, I signed the contract in December,2005; 3 months before the match, and I will be starting my residency in General Surgery in June… Although I am anxious, I know that everything is going to be all right, I am confident that with hard work and the help of who is now my wife, that has supported me since I was in my country, I am going to be able to go through my residency, being successful, but most of all, having fun, enjoying it, as I have enjoyed every single step of the way, experiences, that happen only once, but last for a life time.
By the way, I was called by 13 different programs across the nation, never went to a single interview!
Hope This Helps...

Dr Pavan

7 comments

Anonymous said...

Hello Dr. Pawan,

I am struggling to get some kind of obervership . Do u have any advise to get it

thanks
sherin

Lata's designs said...

Dear Dr. Pavan,

My sister is in the same boat as you were 5 years back. I hope these avenues you have pointed out still applies. Thanks for sharing your experience. I know it has been a long while since you entered this blog & I truly hope you're continuing to follow responses here. She has had a very tough time even finding a opening for an observership around here. Is there anything she can do, are there any hospitals that continue to provide observership for FMGs. I will be happy to give you the specifics. Anything you can do is greatly appreciated. Thank you! Latha

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