International medical graduate shares perspective on US residency

“Is it all worth it?” reads the title of the Reddit post from an international medical graduate community. I wake up to these posts ever so frequently; I think to myself and slide the notification away.

I call my mother more than 8,000 miles away and smile at the daily updates she gives me about life back in India. I hurry up with my morning routine, catch the transit and within the next few hours I am at my patient’s bedside: “Hi, I’m Dr. Byroju, the resident taking care of you. How are you?”

While talking to my patients who I dearly care for, I notice my foreignness when I have trouble discussing scores of the city’s favorite sports team and the big news on TV. I brush it off, thinking to myself that I never ventured into either of these anyway. When I talk about my patients with my colleagues, my plans for their care have a touch of my training experiences in another country. When I’m back in the call room, the warmth is felt when a colleague brings in a box of cookies. And when things aren’t busy, the discussions of different cultures and experiences remind me of the beauty of diversity. When I continue striking through my task list, an email from the Educational Commission for Foreign Medical Graduates arrives, seeking my participation in a wellness survey, essentially driving me into introspection.

While answering the survey’s multiple choice questions, I think of the new style of questions I had to handle if I wanted to train in the United States. The board exams, I realized later, were the easy part. Everything else in the journey was hard: the visa struggles, the cultural competence, the ever-changing rules and the lifestyle adjustment. While support from colleagues and the training site is tremendous, these factors are still challenging, although not distressing. What’s distressing is the experience of racism and discrimination that a few colleagues faced and continue to do so.

Internationally trained physicians have great training, research presence and work ethic and continue to adapt to a rapidly evolving system in a fast-paced nation. A significant number of them do not have family members in the U.S. and make their friends their family. Although they miss their homes, celebrations and countries, they lovingly participate in American celebrations. They continue to learn new hobbies, adapt to new cultures and broaden their horizons to life beyond health care.

In search of superior training and career opportunities, foreign-trained physicians like me pursue graduate training in the U.S. While our joy demonstrates our gratitude, our silence speaks of our struggles. But then again, no place or phase is perfect. The smiles and blessings of many patients outweigh the slurs of a few, and this is what keeps me going. This is what keeps us, a quarter of the physician force of America, going. And to us, it is worth it.

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Vishnu Byroju, MD, is a resident at Cooper University Hospital in Camden, N.J.