Preparing for Residency after The Match

Once The Match is over and you have found your residency program, there are only a few months before you start your life as a bonafide medical resident. The feeling is overwhelming, and you are probably still feeling the inertia of placement. This is not the time to spin out of control with excitement an eagerness. Although post-Match time is a time for planning, it is also a time to take care of yourself. Here are a few tips to help you manage life during your time in limbo between The Match and your residency:

  1. Relax:

You’ve done it. The interviews are over. Not only have you picked your residency, but they’ve picked you too. It is especially difficult to relax as a Foreign Medical Graduate (FMG) because the Match is more difficult. The momentum change from the Match to a few months of “regular life” is difficult for the brain to process. Here are a few tips:

  • Sleep: Making sure you have a good sleep schedule is essential for your success as a resident. That may seem impossible with call schedules, but it is doable if you make it a priority. If pulling an all-nighter, make sure your free time prioritizes sleep over recreation…and sometimes over studying. Not prioritizing sleep could make all other efforts futile.
  • Exercise: Long hours and lack of sleep don’t make a person want to exercise, but it will help the mind and the soul. People who exercise are healthier and less-stressed. With that said, any opportunities for outside exercise should be taken.
  • Meditate: Everyone needs time for themselves, and the new resident is no exception. Yoga, meditation, or even people watching can give the body the self-appreciation it needs.
  1. Connect:

While relaxation may be an important thing to consider, so is making or maintaining relationships. Personal and professional relationships prevent burnout and provide opportunity.

  • Current Residents: As an FMG, it is very unlikely that you know the area where you will be a resident. Nobody is a better information source than current residents. Not only is it a great opportunity to make friends, but they know the best places to live and eat. They also can give advice on the details of the residency that you cannot get during The Match.
  • Support System: You should also keep in touch with your friends and family even if they are abroad. Keep them informed of your schedule as much as possible, so you don’t end up isolating yourself because of a busy schedule. Ultimately, you will build strong relationships during your residency, but you don’t want them in lieu of losing old relationships. Explain to them the truth about time constraints, so nobody feels left out.
  1. Maintain:

Yes, relaxation is important but not at the expense of your hard work. The few months before residency can provide time for yourself that may not be available during residency, but that doesn’t mean it’s time for a vacation. Brush up on your skills and keep your training and education fresh by continuing to study.

  • Advanced Cardiac Life Support (ACLS): You may already be certified, but observing critical care can provide a good segue into care provided as a resident. Take any opportunities to observe, and you’ll be that much more ready to start.
  • USMLE Step 3: You can only apply for step 3 of the USMLE after graduating medical school, so you may be taking this test after The Match. This means more studying!
  • Medical Journals: As a physician, learning is never finished. Medical journals should always be on the “to-do list,” as it will keep you up to date and cutting edge.

One of the biggest risks after matching into a residency program is lacking direction. Prioritizing yourself, your connections, and your education will keep you from becoming stagnant and stressed about starting the last step on your way to becoming a fully-autonomously practicing doctor.

Taking care of yourself means taking care of your personal needs as much as your professional needs. That is why things like sleep, exercise, and mediation are essential to your regrouping and preparation for residency. It is easy to become isolated during this time out of a lack of direction but also out of a lack of prioritizing relationships. Success in life is largely dependent on relationships, and cultivating relationships helps maintain friends and family while building professional networks. Lastly, physicians should all consider themselves lifelong learners, and the time between the Match is no exception. Read, study and observe to maintain and build additional skills prior to residency.

There is no such thing as an easy residency, and during this time you will be stressed, hungry, tired, and overwhelmed. That is why the time between the Match is crucial for a successful residency. It is a break from the impossible workload of the medical graduate, but it is not a time to forget about your priorities.

Rural Health Opens Opportunities for Foreign Medical Graduates

According to the Association of American Medical Colleges, the U.S. will face a doctor shortage of around 100,000 by the year 2030 if something is not done to increase new residency positions.

The shortage is happening because of an ever-growing population but also because the amount of new medical school graduates allowed into residency programs has not kept up with the pace of population growth. Why would anyone restrict residency positions in a time of projected shortages? The answer is all about the budget and how much the government will fund positions in teaching hospitals.

Thankfully, 2019 has presented some hope for residents with the introduction of the “Resident Physician Shortage Reduction Act of 2019.” This bill would open 15,000 funded residency positions within the next five years.

One of the shortages bills like the Resident Physicians Shortage Reduction Act plan to address is the rural physician shortage. A Becker’s Hospital Review article states that 20 percent of the U.S. population lives in rural communities, and the doctor shortage is revealed in their ratios compare to this population. For every rural physician, there are 2,500 rural residents.

Why is a Rural Physician Shortage a Health Crisis?

One might think the rural physician shortage is not a significant problem. After all, people do go to urban areas to shop, and they choose to live at a long distance from health care services. However, many rural communities are poor communities, so they have difficulty with travel costs. Additionally, many elderly persons live in rural communities, and they may face transportation difficulties as they age out of the driving population.

More importantly, people are unlikely to seek out cost-saving preventive health services if they are not conveniently located. They may also put off subsequent visits meant to monitor chronic health conditions. Telemedicine has attempted to bridge some of this health care gap for rural areas with telemonitors and telehealth services, but often rural communities have technology knowledge gaps and limited access to these services.

If you have ever lived in a rural community, you might understand the importance of the local physician. Everyone in the town depends on him or her for everyday health needs, and if that person retires or moves, it can stress the entire community. There needs to be motivation for physicians to train and work in the rural health care sector in order to decrease this disparity.

What Does this Mean for Foreign Medical Graduates?

For years, there has been tension between people who want to support U.S. medical graduates and those who recognize the need to fill the doctor shortage with foreign medical graduates (FMGs). As the physician shortage continues to grow, the benefits of FMGs are becoming recognized. In the past few years, there have been articles  noting the abilities of FMGs rather than only the need for them to fill the shortage. Ultimately, the U.S. is realizing that they need FMGs in order to deliver proper healthcare to all of its residents and visitors. Now, they just have to make it easier for them to get residency positions and practice in the U.S.

Rural J-1 Visa Waiver

The Rural Health Information Hub is an organization that supports the improvement of rural health services across American, and they have one page on their site dedicated to information about the J-1 Visa Waiver, an opportunity for foreign medical graduates to remain in the United States.

With a J-1 visa, a resident must return to his or her country following residency and then apply for a H1-B visa, which will allow them to work in the U.S. If a resident is willing to work in a rural community, they can apply for a waiver, and this allows that resident to stay in the U.S. to work. This is a mutually beneficial situation for rural community members who need a quality physician and the FMG who will have much less red tape to get through.

Saving Lives by Improving Access

Studies show that people who live in rural areas are more likely to die from everything from treatable chronic diseases to accidents where they cannot reach timely access to care. Increasing the number of rural physicians would help to improve these numbers.

As a FMG, you may be wanting to work in an urban area with access to high-technology and physicians who are working with the best resources available. However, it can be difficult to dodge all of the red tape that it takes to get to stay in the country after residency. Considering working in the rural area for a short while will not only give you a unique experience, but it will also allow you to practice in the states immediately after residency instead of postponing your career until you can apply for your H1-B visa.

Rural health is not only an opportunity for Foreign Medical Graduates to stay in the United States following their graduate education, but it is also a chance to save lives. Rural communities do not have access to the resources of the city, and one resource that can be brought these underserved areas are physicians.

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