Welcome to my new blog. The purpose of this blog is to help guide other Foreign Medical Graduates (FMGs) navigate the waters of American medicine during and after completing residency/fellowship and starting the next stage in their lives and careers.
Before diving in on a variety of topics, both medical and non-medical, I will start by recounting my own journey that started in Central America almost 20 years ago and has now arrived as of a year ago to the Pacific Northwest.
I was born and raised in Central American. Like some in medicine, I have relatives that are doctors (surgeons, specifically), that had done part of their training in the United States. This was certainly a strong driver for me to pursue postgraduate training abroad and to have some idea of what would be needed in order to achieve the goal of getting a residency spot.
Like many other countries, medical school started right after high school. Was I mature enough to really know what I wanted to do in life? Certainly not. However, I was confident that I wanted to become a surgeon. As part of my master plan I decided I would purchase my medical books in English to start getting used to the terminology used both in actual clinical practice, but more importantly at that point, to get used to the precise terms used in all standardized texts. My friends thought I was mad, but thankfully, I had a good and solid understanding of the English language, and most medical terms are easily translatable (thanks to our long gone Greek and Latin-writing colleagues). I took Step 1 in my fifth year of medical school and Step 2 CK in my sixth year, completing Step 2 CS while finishing up my thesis.
During my med school years, I also had the fortune of going to the US during my winter breaks. These were long breaks, because the Academic year ends in October and the year restarted in February. I used two of these long breaks to do rotations in a pathology department at a large academic institution in California. This helped immensely, because it allowed me to start acclimating to the American medical system. More importantly, I was able to meet physicians that would later help establish a connection with surgeons that would help me get an observership during my elective 2 month rotation as a fifth year medical student. The latter rotation was incredible, because I was able to see the world of American surgery firsthand. Even though I was not allowed to scrub in cases, I did show up every day, rounded with the team, observed as many cases as I could, and even completed a small research project that ended up getting published. After med school I returned to work with the same surgeons as a research fellow for about 18 months.
When it came time to apply to residency, I applied broadly, as most FMGs do. I applied to about 90 programs, and, as expected, got 4 interviews. One in California, one in Seattle, one in Boston, and one in Minnesota. I matched as a non-categorical General Surgery preliminary resident in California, was asked to do a second non-categorical year, and towards the end of that year, was offered as categorical spot in General Surgery at the same training program. This could not have worked out any better, because I did not have to repeat any years. I was at an academic institution, so I did do a year of research, so 5 clinical years and one year of research (but really 8 total when counting pre-residency research).
There are many obstacles along the way that if I were to delve in deeper, I would never finish typing, and you may never want to finish reading. That said, some of the challenges were related to getting a medical license in a state with many requirements and having a medical school that is very slow to process any paperwork, visa challenges, and starting residency late due to paperwork troubles.
There are also the less tangible obstacles that include culture shock, being homesick, missing out on family and friend events, the feeling of rejection when applying to nearly a hundred programs and being rejected by most, the different tenor and treatment of the non-designated prelim resident, and throughout the process, dealing with learning how to navigate a completely different medical system in a country that is beautifully diverse. Now that I am on the other side, I can say it was worth it. However, it was one of the hardest things I have ever done and could not be any happier with how things turned out.
After residency I matched into a 2-year surgical subspecialty fellowship. Graduated in 2016. Moved to the Pacific Northwest a year ago and am currently on my second (and hopefully last) job. I am married, have three kids and a dog. Also own a home, three cars (all bought used, not fancy and all paid for), and as of a few months ago, have helped pay off my wife’s student loans.
Well, enough about me. Let’s focus on the task at hand, which is setting yourself up for post-postgraduate life in the United States as a Foreign Medical Graduate. Thank you for your patience while reading this long post.