Handling Doubters after a Successful Match

March 15th has come and gone, and the Match is over. Congratulations! You are now a first-year resident. You are also still an International Medical Graduate (IMG), and you might still face some criticism because of it. Don’t let this alter your excitement about your program. After a successful Match, every resident should be proud of their accomplishments.

You may have heard that people don’t care where you went to medical school. This is true, but only after you’ve established yourself. This means you may get asked and face unwanted opinions until about your second year as a resident.

Why Does IMG Criticism Persist?

The biggest problem medical professionals and the public have with international schools is that they are unfamiliar.  For the average American, The Medical School for International Health at Ben-Gurion University of the Negev could just as easily be a fraud as it could be a reputable medical school.

Additionally, fraudulent and substandard medical schools have made it to news headlines. Certain medical schools in the Caribbean have been criticized for overcrowding, high drop-out rates, and low Match rates. People don’t remember good stories. They remember the bad, and any bad press builds a bad reputation. Regardless of the truth, people associate foreign education with substandard education.

Of course, this is not the truth, and you wouldn’t be Matched if you didn’t receive a good education. So, what can you do about this persistent doubt people, even colleagues, have about your educational background?

What to do when they doubt your education:

  1. Be Proud.

You know what you had to do to get your medical degree. You know why you chose your medical school. Not only that, but you know what it took to get certified by the ECFMG. None of these things are easy, and you should be proud of what it took to get where you are today.

Furthermore, you must be sure of yourself in order to practice medicine well. If you are seeing patients and doubting your education, then you won’t be able to correctly make life-saving decisions.

Lastly, you are now a resident, but that does not mean you won’t burn out. You still have crazy schedules, stressful situations, and not much time for personal life. If you add guilt over your education, it may be too much. Be proud of your accomplishments because you should be proud, and that pride will give you the boost you need to practice good medicine.

  1. State Facts.

If you must, defend yourself. The ECFMG won’t certify a person that was education in a substandard institution. Also, all IMGs take the same USMLE exam as non-IMGs. The criteria are the same for all medical students. Explain to people how you took the same tests and went through the same Match process, and open their eyes.

Many opinions about foreign education are not well thought out. It’s more of a prejudice than a real opinion. It’s like thinking all Germans like beer and all Chinese like math. Nobody logically believes that this overgeneralization can be true, but people will think they believe things until presented with facts.

Even your peers and colleagues may unintentionally harbor prejudices against your training abroad. Simply reminding them that you had to face the same hurdles as other residents can be a good reminder to them, so they don’t forget and fall back on their prejudice. Just remember, don’t get defensive. As the saying goes, the best defense is a good offense. Be prepared with facts, but don’t get offended.

  1. Ignore it.

If you can muster the internal fortitude to ignore criticism, go ahead! This too shall pass, and eventually you will either show people your ability, or eventually people will stop caring where you went to medical school. You are a physician, and once you get through residency, most everyone will accept that you are trained well.

Ignoring criticism about your education is only an option, and if you must say something, that is fine. Opt for ignoring criticism when it will not help the situation or when you fear you may get argumentative.

  1. Engage.

Don’t hide from people, so they don’t find out that you went to an international medical school. Engage with people. Throw it in their face. The more they have to work with you, the more you will validate your education. Not only will this help others to appreciate your education, but it will help you to build pride in yourself.

  1. Make Connections.

Make sure you take care of your mental health by making connections. Join a social media group, or network with friends, so you can have a forum for discussing things like this. It is difficult to find time for things like this during residency, but you must. If you face a lot of criticism, it may get into your head. There’s nothing like like-minded friends to get you back on your feet.

Congratulations!

You have Matched, and your training and experience are awesome, which is why you Matched. Unfortunately, you will face a bit more judgement about your education abroad, but dealing with it appropriately will help you through this. Be proud! You deserve to be here!

Strategy, Stamina and Truth: The Path to a Residency

There are many motivating factors that influence one to enter medical school, and some of them are better than others. Your passion for medicine is a good one, and it may be coupled with family pressure or monetary expectations. These are not bad motivations, but becoming a doctor is more difficult than motivation, and if you are preparing for the Match, your path to a Match is far from over. That is why there are a few tools you can use to mentally prep yourself into a successful medical career.

Three Tools for a Successful Match

Strategy

Strategy is basically the planning process. You don’t just go to medical school, get a couple good recommendations, and Match in a residency program. Of course, there are the tests necessary to apply for residency, such as USMLE step 1 and USMLE step 2. However, more importantly is knowing what you need to get into the program you want.

When you entered medical school, you probably had an idea of the direction you would go. Maybe you were interested in pathology or plastic surgery. By your third year in medical school, you should have it narrowed down to one or two specialties.

After you know where to focus your efforts, you need to look at the requirements. What test scores are required to be considered for that residency program? How are you going to study for the boards? Are there sub-internships available? Find an overseas rotation in the U.S. and make sure you are doing it.

Your efforts should be targeted, and the target should be clear. This will make all of your efforts efficient, so you won’t waste time where it doesn’t need to be spent. You don’t need to study 12 hours a day to get into the residency of your dreams. In fact, over studying can diminish retention. So, focus and plan your efforts to a Match.

Stamina

You must already have a can-do attitude, or you wouldn’t have made it this far. From now on, any procrastinating tendencies you have must be disregarded for committed action. This means committed action in all walks of life.

It is natural to find excuses why you cannot or should not do something. When faced with adversity, our natural inclination is to preserve and protect instead of fight until the end. Some physicians will reflect on residency as “not that bad” or “most people could do it if they tried.” This is not true! They are either remembering incorrectly in a fit of nostalgia, or they are one of a handful of geniuses on the planet gifted with unreasonable talent.

Don’t expect anything to be easy, and don’t plan on waiting for anything. If you want to do something to prep for the Match, get started now and keep going.

Truth

There is some hard honesty that must be had during this journey. One of those truths involves self-reflection. If you are holding on to dreams of a surgical residency, but you just don’t fit in with that group of people or are having second thoughts for other reasons, go with your gut! This is going to be your life. Good physicians don’t clock out at 5 p.m. on the dot, and neither do happy physicians. Recognize the places where you fit, and you’ll shine.

It can cost some money to prepare for your tests, but you need those scores to get into your program of choice. Accept the reality that prep courses work, and you’ll maximize every second spent studying. Some courses to consider are Kaplan, UWorld, and Doctors in Training. You may spend thousands on prep, but think about the time and money you’ll save in the long run. A couple thousand is worth it to capitalize on the hundreds of thousands you may have spent on education.

Lastly, be honest about the integrity of the advice you receive. Listen to the person who bombed their step tests, but take any advice with a grain of salt. They don’t know how to get to where you want to be, as they weren’t able to do it themselves. Unfortunately, these people are typically forthcoming with their advice.

Learn from the mistakes of others, but seek out advice from people who have been successful. They know how to get over the hurdles of residency. Hopefully, they are willing to share. You don’t need to know how not to pass the USMLE or how not to succeed in an interview. The accounts of people who have failed may contain a few useful do-nots, but they contain no how-tos. The tips from successful applicants will be much more valuable.

You are getting so close to becoming a physician, but you still have a long and tough road to travel. With strategy, stamina, and truth, you will be able to reach the end of that road with a career that was meant to be, and one which you will be able to enjoy. Success is not just about money and prestige…but you can have it all in your medical career if you listen to yourself and plan accordingly.