Thread by @IDdocAdi

1. PASSED MY ID BOARDS!! You are now looking at a board certified ID physician! This ends a decade long journey in medical training as a Foreign Medical Graduate (FMG). This was a challenging & fulfilling journey, with many people to thank. My journey as an FMG, in a thread 🧵

2. At age 17-18, I made many questionable decisions (like this hair style/beard choice) but thinking of studying for med school, was the BEST decision I have made in my life!

3. Sometime around third year in med school (pic), I decided to apply to clinical electives in the US to garner the mythical & crucial "US clinical experience" without which an FMG stands no chance to match into residency in the US. These are competitive & expensive clerkships

4. This was challenging as it needed a US visa. I had a US tourist visa application rejected TWICE before & hence it was third time lucky or forget about your dream. Thankfully, my visa was approved & I was able to fly to the US & experience US clinical medicine at first hand

5. Once I was actually working clinically, the quality of the teaching environment & opportunity for merit-based advancement in the workplace made me want to build my medical career in the United States.

6. After completing medical training in India, I returned to the US as an unpaid research assistant in Chicago before applying for residency. This isn’t unusual for FMGs, & I was grateful for this opportunity, but I racked up debt/stress/uncertainty living in an expensive city.

7. Special gratitude to Dr David Meltzer & Dr Vineet Arora @FutureDocs for allowing me experience in clinical research as part of the summer program in outcomes research training (SPORT) where I met colleagues, friends & mentors @nvhstewart @DrAelaf @atanksley @tanayamitshah

8. This was followed by residency training @ACMCIMRes The three years spent as an IM resident were amongst the best of my life, with lifelong friendships & rigorous medical training. Forever thankful to @ENDOUNO @eternalkota who had more belief in me than I had in myself!

9. I was fortunate to then have matched for fellowship in ID @MayoClinicINFD Here I met my eventual mentor/guide & now a colleague/friend in @jcohoro Incredibly thankful also to the leadership led by @RazonableMD for matching me to train at such an amazing program!

10. This was followed by the most challenging year of my life with looking for an academic ID job in the middle of a pandemic in an immigration climate which was suboptimal to say the least. Most visas were banned, travel was banned & rules were changing by the day!

11. The approval or renewal of of these visas requires a Gordian knot of paperwork, processing & uncertainty while living under severe restrictions to maintain eligibility. As a consequence, many of us FMGs are unable to visit our home countries for years at end.

12. I was incredibly fortunate/lucky to have the support of an incredible organization @MayoClinic as I joined staff at @MayoClinicINFD , my DREAM JOB!!!

13. My visa needed support from leaders in the field & I will always remain indebted to Dr @PaulSaxMD & Dr @SandySpringerMD for their support in addition to tremendous support from @MayoClinicINFD ! Once my visa was approved, however, this journey was far from over.

14. To activate my visa, I had to leave the country, during a pandemic, fly to India to stamp my visa & fly back to the US

https://twitter.com/IDdocAdi/status/1287022578834354178?s=20

15. I returned to the US, & began my job on the COVID Service within days of landing. I, like thousands of other FMGs, want to work here & love the clinical, academic & personal opportunities in the US. We also have a deep sense of love/appreciation/gratitude for the US public.

16. FMGs comprise close to 29 percent of the US health care system. FMGs apply to hundreds of programs for a handful of high stakes interviews. We need US clinical experience, research experience, high scores etc to match. It is not uncommon to face visa/immigration challenges.

17. When I flew to the US for residency interviews, I was stopped by customs/spent several hours explaining to an officer that I was coming here to continue an unpaid position as a research assistant/interview for a position as a medical resident

18. He found this story, common for FMGs, so unbelievable that he searched my bags, phone, e-mails & texts several times before he was satisfied I had no nefarious intent. These experiences are not uncommon for FMGs. Just ask them & they will have these stories.

19. I made 3 major mistakes along the way.
A. I neglected my mental well being/peace of mind. I now consciously attempt to not work/check emails in my time off
B. I also never celebrated wins, as the next challenge was already there, occupying space in my mind.

20. C. At times, I over focused on things NOT in my control. I now try to activate all my senses, taste, smell, vision, touch, hearing & balance, & try to remain in the present as opposed to worrying about the uncontrollables. Exercise/sports/cooking have helped

21. My take aways from this journey (if you are still reading) (especially other FMGs starting their journey)
- If an average person like me, average test taker/scorer like me can do it, YOU CAN TOO
- When stressed, keep in mind that you are doing this for the good of the patient

22. - Work hard, be honest & things will fall in place.
- Make contacts at every step of your journey & keep in touch with these contacts
- Be nice
- Try never to be selfish, remember, this is about the PATIENT, not YOU
- Short term hardships lead to long term fruits of labor

23. - Don't neglect your family in your home city/state/country. Family comes first
- Keep in touch with your residency friends
- Don't take yourself too seriously (especially on social media)
- Always try & mentor others
- VISA REJECTIONS ARE NOT THE END OF YOUR DREAM

24. My future journey is just beginning, I am excited & eager to help patients, do research, collaborate & work as hard as possible to benefit our patients! I am VERY HAPPY today to have completed training/passed my boards

25. Lastly, thank you Twitter family for always supporting my humor, my tweets, my career, my life & me. Humor is a way to alleviate stress. I frequently use humor as a coping mechanism for stress. My silly jokes on here, are at times, a projection of my stress. THANK YOU!

Celebrating tonight by cooking some Kadai Vege Masala 😋