Stories are meant to be heard. So here’s mine:
Nothing spectacular but nothing ordinary either. After
graduating near the top of my class from a medical school in South India, I
decided to go the MLE way. This was a conscious decision made when I was as little
as 14, when I was conversing with my best friend’s dad. An MD PhD, he completed
his neurology residency training at Washington University in St Louis back in
the 90s and headed back home to support his ageing parents. Forever an
inspiration, this impeccable man provided me with the first glimpse of
residency training in the United States through these second hand stories. In
my third year of medical school, I got in touch with a senior who matched that
year. She graduated from my college just a little before I joined. Her story
was so inspiring that it pushed me to take USMLE a little more seriously. In
that pursuit, I applied for an exchange program in my medical college. They
sent a group of four every year for a 4-6week clerkship. My first tryst with medicine in the US came at the end
of my final year when I was selected to attend this clerkship. It was an
amazing experience for me and my attending very sweetly wrote me a WAIVED LOR
two and a half years later for my residency application.
I took my step 1 in August four months after I got my degree
certificate and I blew it! While my personal life was at crossroads and I can barely
sit still for two hours leave alone 8 hours for an exam, I shall not find excuses
for my poor score. I ended up with <220! I was so ashamed to share my score
with other people simply because I was supposed to get a better score. (I
apparently graduated near the top of my class) For about a week, I went into a
shell and barely spoke to anyone. I doubted myself and felt so betrayed by my
own self. The same senior who I spoke to long long ago in third year came to my
rescue once again. I reached out to her and she repeated her story to me to
reiterate how important it is to remember that scores aren’t everything.
Hearing it from someone who had been through it motivated me to gather myself
and move on. All this happened while I was emailing several programs for an
observership. The hunt became more vigorous after I got my scores.
Meanwhile, I joined work in September in a
corporate hospital in my city which kind of simulates the American hospital
system. I familiarized myself with electronic medical records and learnt the
art of counselling and dealing with patients who asked more questions than
their rural counterparts. Getting a humble salary was an added bonus because
being 24 and bankrupt sucked! I continued to work rigorous 8-10 hour shifts
everyday (7 days a week! I am not kidding) for the next four months while
managing to prepare for Step 2 CK a little by little. By then I had heard back
from one of the places for an observership which was available only in February
and March. I immediately quit my job in December and focused on preparing for
Step 2 CK for the next 2 months. My NBME scores were dwindling with each exam
and I started panicking. However, I took my exam in the end of February for I
had no choice (my tickets to the US were booked) and two days later, I was
flying to the United States for the second time for my observership. I ended up
with a score of >230. Honestly, my first thought when I saw my score was relief
that I crossed 230 and then it was plain sadness that I couldn’t manage a
stellar score.
Since I had already done an elective, my observership went
well. I knew what being proactive meant. I went early every day and stayed back
to help the residents with new admissions. I updated their list every day,
called labs for results and a couple of times offered to write notes for them
if they didn’t mind. I wrote up a case report while I was there and my
attending so kindly wrote me a waived LOR which a couple of interviewers later
told me were very good for an observership. I made some great friends and
enjoyed the entire experience minus a few glitches here and there.
While I was completing this rotation in March, I was also
preparing for Step 2 CS which was due in mid-April for me. I found a few Skype
partners and of course my roomie who was also observing in the same hospital
(we went on to be great friends) to practice cases with. My fiancé (who is an
IM resident) helped with a couple of cases and critically judged my performance
which really helped.
As April approached, I was frantically trying to find
another observership or a research position in vain. A friend of a friend
recommended me to an attending she had worked with in her basic science lab,
who was kind enough to interview me for a spot. Without a time and place, I
showed up at the University one day to meet her (The attending was very busy
and wasn’t responding to my emails). She spoke to me and was happy to have me
over. Slowly I started building a clinical database based on her liver cancer
practice. Within a week’s time, I was observing her in her clinic as well. Not
long after, I requested very politely if I could have more participation in the
clinic and she obliged graciously. Starting May, I was seeing her patients with
her, examining them and writing notes under her supervision. While it is super
hard to find such an opportunity, I believe I simply was there at the right
place and the right time and was hugely lucky.
Diverging a little, I flew to Atlanta in the middle of April
to take my exam. Contrary to popular belief, I didn’t think it was a
disadvantage to take my exam in a place other than Houston! I felt comfortable
with most of my SPs and cases. I received my result in mid-June and passed the
exam with excellent performance in all three components with ICE being the
highest (was a little surprising because I believe my communication is a little
better than my medicine)
For the next few months I worked in the clinic and also did
my clinical research side by side. I got a really good letter of recommendation
from my attending. I worked till August (my visa ended) and came back to my
home country. Unfortunately, I was not
yet ECFMG certified during application time because my college completely
messed up the process despite starting it early in last December. (I don’t wish
to elaborate on it). I applied on September 15th without an ECFMG
certificate but all my Step results, 3 waived US LORs, 2 Indian LORs, 1 oral
presentation, 1 abstract accepted at 2 international conferences for oral
presentation, 2 published articles (one case report and one original article),
2 to be published articles (one case report and a case series) and lots of hopes
and prayers.
I received my first interview on September 17th!
I couldn’t believe my luck. It however slowed down terribly after that. Finally
managed to land 7 interviews. I did reach out to a lot of friends and seniors
who I hadn’t ever talked to. It was very heartening to hear back from ALL of
them! A few were able to help. I also was officially ECFMG certified on October
9th!
In the middle of all this drama, I got engaged officially in
November in India. This meant there were a lot of internal personal conflicts
(any Indian who is married can vouch for this – the tensions run super high
during this time) and conflicts between personal and professional life. I had
to send out a lot of emails to schedule all my interviews after November.
My first interview was scheduled for December 4th! I was so
nervous that I could barely eat anything that morning. However, the interview
season breezed by with each subsequent interview being better than the previous
one. Two of my abstracts subsequently got accepted for a poster presentation at
the annual GI ASCO meeting which I was unable to attend because of Jonas (the
storm which hit the east coast!!)
Starting February, I did nothing but think about my rank
order list and study for Step 3! I took my Step 3 on 3rd and 7th
of March and flew back home on March 10th! Landed in India on March
12th and two days later, I was opening my “Did I match” email from
NRMP with bated breath sitting on the steps outside my house all by
myself. My entire life in the last 2
years flashed by in a minute. “Congratulations, you’ve matched!” The moment is
bigger than you can ever imagine. My head was a cocktail of emotions. Emotions
that I hadn’t let myself feel in a long while (lest I jinx it). You need to live it
to believe it. Tight hugs and a couple of tears later, here I am sitting and
recollecting my match timeline briefly with all of you.
My story may not be overly inspiring. However, people who matched with me
will surely be able to relate to it all – the difficulties with finding
observerships and research spots (I sent out about 600 emails and barely got
any positive replies); simply getting a visa to go to the United States (I have
needed 3 visitor visas so far for my 3 visits. I ended up with 6 months, 4
months and a 10 year multiple entry visa during my three attempts. It meant
going to another city for the visa twice!); the delayed flights/crazy greyhound
bus experiences; trying to justify to random strangers why you’re going to
another country to learn advanced medicine when your own country has a shortage
of doctors; being so broke that you would do anything to save a few dollars; refreshing even your spam folder every 5 mins during interview season; all the posts on forums
asking for accommodation for their observerships when you had none and were
freaking out about it; being picked up at airports by friends you’ve never met;
simply trying to figure out how to reach your interviewing hospital which was
in the middle of nowhere; and most
importantly, the only journey in which you’ll get help from your own
competitors (there is good out there in the world, after all)!!
THINGS I LEARNT FROM THE MATCH:
- - Don’t pay too much heed to what is written in the forums. More often than not, they may end up intimidating you and making you feel worthless. Realize that and absorb only the positive things you find (you get a LOT of useful info too and I am grateful for it, but don't make it your life) While people have shared their experiences, I feel they are uni dimensional. (Well, so is my opinion now). What works for one, may not work for another. Discover your own strengths and create your own story!
- - I wanted to be self-made and make it big all by myself. While it’s a noble idea, it can be a little retarded. When you need help, seek help. You’ll be amazed at how gracious and willing people are with help. Don’t think of it as a sign of weakness. It’s a strength to be able to ask for help at the right time (when the going gets tough). I am so very thankful for all the contacts, the help, advice and the encouragement I’ve received along the way from seniors and friends! Moving forward, I am going to help my juniors and friends and one day you will do the same. (It’s a chain reaction of sorts)
- - I made lots and lots of new friends from all over the world. It means lots of new perspective and ideas and understanding the old ones better. It helps you grow as a person. Keep them all very close to you for they become your support system for the next couple of months. Watch out for people who are pretending to help you while trying to intimidate you. You’ll find one or two of those as well. Learn to recognize them and maintain your distance from them.
- - One of my biggest take away from this experience is that scores are NOT everything! Having said that, DON'T IGNORE YOUR EXAMS OR INVALIDATE A POOR SCORE. Even one stellar score can stand out in your application. Although I am no pro at this, I think programs can see right through fakeness. They’ve been hiring people for years now. Be true to yourself and importantly, just be yourself! If they don’t like the genuine you, it’s likely you wouldn’t enjoy working there. I cannot really comment on other aspects like year of graduation because I graduated in 2014. I can’t say much about how important research is either but it definitely gives you something to talk about at your interviews. Most of my interviewers wanted to know about my database and what kind of data we had uncovered. Nobody asked me about my observership.
- - Communicating well is an art and most of us lack tact in the way we approach people. I see a lot of people on forums very crudely asking people for their credentials or expecting to get help instantly with observerships, research, IMG friendly program lists etc. NOBODY, I repeat NOBODY is going to spoon feed you with all the information, unless they’re close friends. Do your homework before you ask for help. Would you ever buy a gadget without doing a mini research on its features? Similarly, gather information on basic things like what the USMLE is all about, how many exams are there, how to take the exams, the requirements for foreign medical graduates, what observerships mean and how you can find them! EVERYTHING IS ON GOOGLE! (Heck, Google even has “how to make your girlfriend or boyfriend jealous!!) I haven’t mastered the art of approaching people yet. However, I’ve definitely gotten better with time.
- - If, at the end of the day, you don’t match despite having a well-rounded application, don’t blame yourself. Luck has such a huge role to play in this. One of my friends who is very smart, funny, intelligent and kind with 240+ scores on both steps, published papers, adequate USCE and >7 interviews did not match. Sometimes, I wonder what I did to deserve this privilege of matching on my first attempt despite my below average scores. As they say, it’s not how hard you fall that matters but how hard you can bounce back from your fall that does. So, never give up if things don’t go your way – be it exams, observerships or the match itself. (You know who you are and I hope you're reading this! I truly hope the best for you for SOAP or the next season)
- - Most of us leave behind our families and friends, come to the US with a heart full of dreams and aspirations. The struggle is very real!! However, believe in your dreams and most importantly, in yourself! If you don’t, how will someone hiring you believe in you? I faced plenty of hurdles at each and every step of this journey! Very likely you will too. Some struggles smaller than the others. However, I learnt 'No pain, no gain' and the faster you learn to gather yourself and adapt, the better you are in this race. I’ve learnt to be very optimistic in this journey and it has really helped me overcome some difficult times in my life. As they say, tough times hardly last, but tough people for sure do! Find something to hold on to – it could be divine faith, love and courage from your loved ones or simply an unwavering belief in yourself and a good kind of destiny!
PS:
- . Thanks to Appa, Amma, my big sister and my BIL, my amazing fiance that I have recently fallen in love with (despite a whirlwind courtship for a few years), my parent in-laws, other family members, seniors and my best friends who have nothing but encouraged me for the last 2 years, put up with my tantrums and non availability always and believed in me when I lost hope and felt defeated.
- I don’t know where I have matched. I hope it is at my top choice. Irrespective of where I match, I believe it’s all about making the most of the opportunities that come knocking at your doorstep!
- I applied a little broadly (~150 programs) because I was sceptical of my scores. So not sure if its internal medicine or pediatrics for me (also, because it didn’t matter to me which age group I will be treating, as long as I can keep doing what I love – practicing good medicine; and being fascinated and challenged every single day of my life!) I had USCE in both (in University programs) and I interviewed for both (mostly community hospitals with good university affiliations!)
- I require a VISA!
