Prelude: Coming To America

Dear Readers,

I have been preparing a story for which I find it hard to choose a suitable title. It is based on a true story, my life story with respect to my ongoing struggles as a foreign-trained physician. Having lived and studied the world over, mostly thanks to my father's diplomatic career, I graduated from a Nigerian medical school in 1998. After this I stayed on for a year of internship and then a year of national service. Later I got a job with a mission hospital in my home state where I worked for a little over two years. This was one of the happiest, most peaceful, times of my life. My resignation came when I accepted an assignment in Liberia, another country in West Africa, where I would work with the United Nations Mission Medical Section. At the end of twenty months the desire to pursue specialist training in Family Practice waxed stronger. This led me to America where, only a decade earlier, I had attended college and developed a high esteem of both the U.S. educational and medical establishments. I had had excellent American professors while in the American medical school in Grenada. They left a wonderful impression on me and true to their word had set in me a strong foundation of medical knowledge.

I came to America to join a professional preparation course and take the required Board exams. It was tough. I eventually completed the first three exams and eagerly applied for residency training as directed. It is all done electronically nowadays so you never get to speak to, or meet, anyone. Instead, according to a friend's brother who happens to be a computer technology expert, applications are weeded out automatically by special software designed for just such a purpose. It reminds me of when I call a business and get an automated voice at the other end. Sometimes after taking me through a whole series of steps, my initial question remains unanswered as the voice abruptly says goodbye and ends the call. How maddening! That's how I feel about the electronic residency application system. After undergoing so much unexpected and unwarranted stress, my getting no interviews finally caused me to realize that things were not quite as they were made out to be. Frustration quickly set in. Then slowly came denial... anger... bargaining... depression and hopefully one day I shall reach the point of acceptance. Acceptance of a system that I believe is ineffectual and certainly leaves a lot to be desired. Of course with all the unwritten disclaimers and middle men, what is one to do? In case you are not in the medical field or specifically have never been privy to the experiences of an IMG as they love to label us- International Medical Graduate (or FMGs- Foreign Medical Graduates), I shall give you an idea of my frustration with the entire process. Some hospitals claim that they accept doctors for training regardless of their year of graduation, yet at the end of the day they always opt for recent graduates. Some say that they don't mind how many times a doctor had to sit the exams before passing them, yet of course it mattered. Many hospitals welcome you to call for an appointment or to schedule a visit of their facilities, however phone calls are not returned.

The truth is that its all about IM (or IMM). In my language this means To Know Someone, i.e. connections. For this reason they call us third world because to get jobs and positions one often needs to know someone important to get one into the system. A few prominent nice American doctors actually advised us that we need to get to know the right people in hospitals in order to get in. Sad but true. And who do I know? Unfortunately I am not the daughter of a program director, nor do I have any of them as relatives or family friends. One physician told us this story: An IMG of European origin came here and faced the same frustrations that many of us face. She was very outgoing (whether by nature or out of sheer desperation I will never know) and attended medical conferences in order to meet the big guys. Meet them she did. One day she called a particular hospital to follow up on her application. They couldn't find her application as it had been tossed out, oops- I mean sorted out, because of her low score. When she reminded the program director of her name and how she had met him at so-and-so place, the application was found and by June she was preparing to commence residency training at that hospital. This was said to be a true story.

Of course, I have been told of, and met, doctors who were accepted into training with lower scores than mine; failed each exam three or more times; graduated long before 1998; etc. While in the depression stage of mourning my disappointment in a system I once regarded highly, I arrived at the conclusion that my inability to secure a position is due to the fact that I have too many strikes against me. If I had only one issue, things might have turned out differently. But I don't. I have many. Permit me to mention them: I graduated in 1998 and they prefer graduation dates after 2005; my scores are above 81 but they prefer 91; I took the exams twice and although people have been accepted with three or four efforts, I am told one attempt is best; my surname sticks out like a sore thumb (i.e. last name or family name as some know it)... it screams A-L-I-E-N! If per chance you were wondering, the name on my blog is a recently acquired married name which might possibly eliminate the disadvantage of having such an ethnic name, should I be brave enough to apply again in future. Last year a doctor had actually suggested that I change my name just to increase my chances. Fancy that! I am proud of my heritage and fortunately I was already engaged at the time to a lovely man with a simple English name, otherwise I might have been tempted. It makes me wonder how many others have done just that; changed their names for just such reason- to secure a position of some sort. Human nature shall never cease to amaze me... how far one would go to accomplish a goal. In case you have not been counting, that was 4 strikes against me. The fifth is the fact that I needed a visa to enable me work here and many hospitals do not sponsor visas. Frankly the paperwork is all a bit of a hassle so I do understand why these hospitals opt not to bother. Nevertheless it affects me negatively because it means that to all these hospitals I am ineligible to apply. Well, the visa concern may no longer be a factor once I file for a change of status. This still leaves 3 unchangeable factors- my graduation year; my scores; number of attempts. Without further ado let me retell the story of Coming To America through the eyes of an IMG...