Through the Eyes of a Woman Physician from Across the World : the Internet's Evolution as a Forum for Support and its Continuing Promise
Author: Pallavi Rohela, MBBS, MPH
Keywords: international medical graduate, ERAS, Match, residency applications, mentorship, communities of support
The service shuttle picked up speed on the empty road at night. The Midwestern town we were interviewing at had arranged for transportation back to the hotel, after the pre-interview dinner. I got talking to my co-interviewee. She was a fellow South Asian, albeit of Pakistani heritage and had grown up in the United States. We talked about our families. “My mom was a doctor in Pakistan. When she came here after marriage, she did all the USMLEs. But it did not work out that time,” she trailed off. As often happens in such situations, her mother became a full-time mom to raise her children, all of whom grew up to either work in healthcare or were studying towards becoming healthcare professionals.
That residency interview season was my fourth year after graduating from medical school in India, and the last year that I would make the filter of the five- year graduation cutoff date for most programs. I went unmatched. In the days that followed Match Day, I often revisited the years that had gone by.
I recalled losing the spot in my preferred medical school by one rank and going to another over a thousand miles away from home, right out of high school. I recalled the sheer dismay I felt when the promise of internet connectivity being an equalizer of knowledge and opportunity access, was crushed by the old government-built hostel (dormitory) attached to my medical school. The hostel lacked drinking water supply on all floors, let alone cable Internet connection. I recalled the trips I made to the nearby Internet Café which charged exorbitantly for 15 minutes of Internet access. I recalled learning about the USMLE exams an hospital electives in the United States on a social media platform called Orkut. I remembered the awe I felt when I first entered the well-equipped examination rooms in the Midwestern University Hospital I was rotating at. I remembered every positive evaluation from attendings I worked with, in different settings, and the hope it gave me to keep working towards a residency training spot.
I also reflected on how the right opportunities became scarcer to find, as my sole source of information – the Internet – reached saturation. On anonymous internet forums, the follow-through of posts and genuine, insightful discussions were not regular and unamenable to future referrals. The emails I received about the ECFMG-International Advisors Network did not specifically talk about mentorship and sponsorship and seemed more focused on providing a platform to publicize alternative career choices without sufficient context. The American physicians I had worked with, did not know how exactly they could help me - a non- US International Medical Graduate- reach the next stage in my career.
Realization dawned that in absence of a large alumni network and personal contacts, all my networking efforts would continue to be futile. My engineer spouse and his extended family of engineers, and their circle of engineer friends offered some advice, but the gulf between the nature of medicine and engineering professions left me wanting more meaningful career assistance. Further, concerns about the ticking biological clock crept in. I faced a mix of bafflement from some quarters at worrying about having a child “so young,” and questions from others at not having had a child yet!
The year I was pregnant, I focused solely on my health for multiple reasons. I experienced severe judgement about my choice and heard more express worries about the “gap in the CV” than congratulatory statements. Career anxiety enveloped my pregnancy. In moments of solitude at night, I wondered if my story too would turn out to be one of sacrifice – like my former co-interviewee’s mom.
So far, I had been following the commonly known route – study, pass the USMLEs, find electives and observerships, get recommendation letters, and apply through ERAS. What does one do after going unmatched if a return to the home country is not feasible? While I was aware of non-medical career paths I could take, I was struck by the limited information about how individuals made those choices, how fulfilled they were, or if they saw potential for continuing growth in those paths. There was no single, credible forum where people shared their journeys. There was no research on the unique challenges faced by women physicians who were non-US IMGs and had limited insider contacts. There was no avenue to find collaboration opportunities where non-US IMG women, could be matched by skill sets to willing mentors who understood their backgrounds and challenges. Women in my situation not only need career support, but they also need life advice, because starting over in a new country and raising a child with limited community involvement is difficult.
Over the years, Orkut disappeared. Facebook fell in and out of favor. Twitter emerged as an excellent vehicle for forging connections and brewing engaging conversations with individuals who are real and traceable. After a long lull, the Internet was again opening possibilities for me. It was on Twitter that I first found out about the advocacy work done by Women in Medicine Summit. I started to see how lack of timely career guidance and reproductive freedoms impacted career paths for women physicians globally. It is my sincere hope that the Women in Medicine Summit forum too will embrace the global community of women physicians as well as women like me - physicians from foreign shores who come to the United States, in pursuit of their American Dream.
About the author: Dr. Rohela is a medical doctor with training in public health, currently working to develop mobile health (m-Health) tools to improve quality of life and medication adherence in cancer survivors. Previously, she have helped develop and test a website that integrated teaching kitchens and medical group visits to improve hypertension self-management in low income groups. (Twitter: @experiential_dr).
