| This is not meant to be just another boring blog entry but is a true account. An account of my year long road to residency. I think People who have joined Residency or are on their road to one can understand it in a much better way.
Please forgive me for my language and grammar which I know isn't very good. Internship (2003) Well everything started with my internship at Dayanand Medical College & Hospital, Ludhiana (INDIA). I was truly double minded between Canada and USA as which way to go regarding pursuing for post graduation. After doing considerable research, it was clear that prospects of finding a post graduation spot in Canada were quite bleak as far as IMGs are concerned. Especially in my province i.e. British Columbia where all they have in the name of IMG program are only 6 positions and that too only in the speciality of Family Practice. Hence I decided to exclusively focus on USMLE which though not easy was certainly doable. Throughout my internship I kept myself busy with extra curricular activities like partying, sports and 'aish' apart from the usual hospital duties. Info from seniors regarding books and how to approach the exams was often incomplete and contradictory. Retrospectively I can say only few offered me genuine advice which now I think is a common 'desi' mentality. Anyways lot of time when I studied I wasted time on stuff that wasnt neither required nor was asked in exam. Only by the end of my internship I started taking it 'bit' more seriously. Well I didn�t have any other option I guess cuz time was flying by fast. March (2004) My internship ended on 31st Dec. And finally after months of preparation and anxiety I appeared for my USMLE step 1 in New Delhi. Exam went OK. Wasn't sure that whether I did OK or I blew it up but the most important thing was that it was over. On one side I was relieved that finally I am done with it and on other hand now the tension over the result started building up slowly. Following my exam, I started collecting Letters of Recommendations from different attending and completing other paper work from college and university. You can very well imagine how much time these things can take in a typical Indian system April (2004) Well April month was full of fun. Party time all month except times when I use to deal with administrative staff of my hospital for completing all the paper work. Some people just don�t like to do their work even when they are being paid for doing that. Wasted whole month in getting few certificates and LORs. Also went to Chandigarh and registered myself with Punjab Medical Council. Started winding up my stuff and shifting it from Ludhiana to Jalandhar. It was increasingly becoming clear that days of my stay in India were pretty limited now. May (2004) Pressure from parents was growing with every passing day and Canadamade changes in the rules and requirements for its permanent residents which meant that It was time to go so finally I packed my bags, said good bye to everybody and moved to VANCOUVER. Same shit just different places...at least for me I guess. Again opened my books and started preparing now USMLE step 2. I knew unlike step 1, I didn�t had much time for preparation for this one. ECFMG was moving from CSA to CS pattern. It was becoming increasingly clear that results for CS will be delayed. Getting an Examination date was becoming more and more difficult with each passing day. June-July (2004) Not much of a change. Same routine. Books, booze and TV. :) August (2004) Not much days were left for the exam now. But I had other things to do along with preparing for the exam i.e. researching about the programs. The programs I was supposed to apply, emailing them, calling them, reading forums and other website to finalise the list of programs can be a real pain in ass. Most of the programs don't even bother to reply to your emails and some of them who do have often pre-drafted attachment which often doesn't clearly answer your all queries. Than came 24th of August and I took USMLE step 2 here in Vancouver. Exam went similar to step 1. Had no idea how I performed which is a characteristic feeling after any USMLE exam. Now though I was done with step 2, there wasnt a moment of rest. USMLE step 2CS was in 3 weeks time. I didn't want to take any risk with this one because failing this would have meant wasting one whole year. Hence I booked One day practice course by Kaplan at Mount Sinai Hospital, New York and than started preparing for CS. Research on programs was also going along with and so was work on the most important thing in your application after your credentials i.e. your personal statement. Believe me, I was the busiest man on earth and Trust me, writing a personal statement is not easy. It�s not just another essay. By now you must have imagined from my English how much difficult it would have been especially for me to write a decent one. Thanks to Shell (and others too for their input) who spent hours and hours of their precious time helping me to write a decent personal statement. Also did ACLS course in between. Thought it will add something to my CV even if its not something very big. Something is always better than nothing. September (2004) 1st Sept - ERAS opened and people started applying and here I was still preparing for my CS exam. Tension was building up with every passing day. Flew to NY for Kaplan prep course. It really helped me a lot. 1000$s well spent I guess. From NY took a flight to LA and reached their 1 and half day earlier. Met with a guy who had taken exam that day and he gave me few good pieces of advice and I was all set to kick some butt next day. Took exam and the very evening flew back to Vancouver and started working on my application. Believe me, Application, CV etc take helluva time. You can�t afford to make even a single mistake. In few days though my application was ready to go and list of hospitals to be applied final, I wasn't able to apply as I was still waiting for results of USMLE step 2. I didn't want to take a risk of applying with only one score i.e. only step 1. Instead I decided to take a risk and waited for my step 2 results. Finally in last week of September I got my results. I passed with a score of 96/238. Not bad considering the time I had for prep. The very next day, I applied to approximately 90 Internal Medicine (Categorical) programs. Some might say that its an huge number and is just plain wastage of money. But me and few others agreed that to maximise the chances of getting good number of interviews it was important to apply to maximum possible number of programs. I knew my application was weak. I had only 2 scores, CS result and ECFMG certificate were still pending, I didn't had any US Clinical Experience (something that you can get only if you have connections...at least in most cases) and above it I needed a program that can sponsor me a visa. Almost all the hospitals that I applied to were H1 sponsoring programs and few of them sponsored at least J1 Visa. Now my job was to sit tight and wait for interview invitations (if any) from the programs I applied to. I knew I applied bit late i.e in last week of sept (i think it was 28th) but Ii was really surprised to find out that many programs had already filled their interview spots. One being Abington Memorial Hospital from Philadelphia. I received mail from them and they said as result they have given me a spot on waiting list and will contact me in case there are any cancellations.(I seriously doubted if there will be any ) October (2004) October 1, my B'day but not the luckiest day of my life. Everything started on a very bad note as I rejections from few programs begin to drop in my mailbox. Those suckers didn't even waited for my whole application to upload especially my USMLE transcripts and they decided not to invite me for an interview. I guess just the fact that I was an FMG with zero US clinical experience, was enough for them to reject my application. Whatever. Few days later I received my first Invitation. It was from a small New York community hospital. It was followed by few more but still all of them were from small community hospitals from NY area. Still number of rejections was much more than invitations. On other front there was still no sign of release of CS results. ECFMG was screwing us big time. Things were getting worse with every passing day. But i had no option other than to just hang on and wait. Meanwhile I started scheduling my interviews. I clustered all my NY interviews for the month of November and all non-NY interviews for January. December though an ideal time for interviewing, wasn't an option for me as I needed few days of break and time to prepare for my MCCEExam which I was suppose to take on 6th January. Canadian idealistic system and rules suck sometimes. Just to be eligible to be sponsored for J1 visa, you need to pass this exam and only than Canadian health Dept. issue you a statement of need something that you can get easily without any hassles if you are coming from INDIA. November (2004) Flew to NY for interviews. Total 6 of them. My debut interview was a horrible experience. Interfaith Medical Center in Brooklyn. Terrible program, bad interview and worst possible day overall due to screwed up logistics. Its interesting that interviews at the weaker programs are the toughtest. They are the ones that don't give you any options for interview dates. They are the ones that require original documents just to interview. They are the ones with the case histories and case managements etc. On the contrary good university based or community program interviews are very cool and laid back. Those are more chats than interviews. I think its because the weaker programs are trying to show that they are more academic/rigorous than the stronger ones (almost an inferiority complex, they feel they have to prove themselves)? Or maybe they feel that IMGs need to be screened harder than US grads? But with time things started to improve. With every passing interview, program quality was getting better and me too was getting a hang of the whole interview process. 23rd November- I went for interview at Sound Shore Medical Center in a NY suburb. The Program Director in a way offered me a pre-match (residency position out of match). He said,� We would like to have you in our program'. I gave him the only answer you can give in this type of situation, 'I need some time to think and I'll let you know soon.' I was happy. Not that program was very great but that was first ray of hope for me. I liked the program. It was small friendly community hospital in a New York suburb. The surrounding area though expensive, was very good. Program was community but with academic standards of a Univ program. One major negative point was the limited scope of fellowships. 30th Nov- My last interview in NY. at St. Luke's Roosevelt Hospital Center. It was joint program by 2 hospitals situated in downtown Manhattan. Avery big program with 45 categorical IM positions. Hospitals were state of the art and fellowship opportunities were good. My interview too went well and after the interview I was dying to get a position there. But there was no way to tell that whether they'll choose me or not as they already had large number of well qualified applicants. Many among them were American graduates. December (2004) December started with release of CS results but guess what only from few centers which didn�t included LA the one where I took my exam. Where ECFMG was playing with our futures now and screwing us big time, I went for yet another interview at a small community hospital in Trenton, New Jersey. Honestly, I didn't like that program at all and I was sure at least I am not going there. That hospital had more number of seats in their cafeteria than they had beds in their wards. That hospital had a huge cafeteria. It was followed by an interview at Sinai Grace Hospital/Wayne state university @ Detroit. Detroit maybe the home of America�s big car manufacturers like General Motors, Ford and Daimler-Chrysler but as far as city is concerned, Its total crap and the whether there is terrible too. Came back to Vancouver after more than a month. Now there was no interview till 10th of January but only an exam. (MCCEE) Hence I was back to my study table with my same old books. Meanwhile I was still receiving rejections from programs from all over states. But along with them there were few invitations too. Few of them were from good hospitals though all of them were community hospitals. As there were still no signs of CS results. The problem with that is that lot of good programs don't invite applicants unless they have their CS results with them. Situation was getting worse day by day as precious time was going away and so were chances of new interviews from good programs. Few programs even emailed me to ask me about my CS result but there was no option other than cutting a sorry figure. For example Pennsylvania State has lot of Foreign Graduate friendly programs but I didn't received any interview from there just because of delay in my CS results. Stupid ECFMG people! ECFMG should have told us that scores for different centers will be released at different times. I would have scheduled my exam at some other center. Its was so disappointeing. There was no way I could afford to lose a year for the sake of H1. After all the work.....i thought i was finally running out of luck. Also by that time I was getting tired of this whole exams and interviews and travelling and sending mails which were often not replied etc etc Hence by that time, as a result I had gone so desperate that I was ready to go anywhere no matter where the program is or how good it is. I was in a dilemma that whether I should accept the pre-match offer from Sound Shore or Should wait, attend all the interviews and stick it out in Match in March. Participating in Match is a two edge sword. You can either get a program of your choice or in a worst case scenario you might end up with nothing. Ya right after years of hard work and the end result might be nada. So by that time it was clear that the match is going to be a big gamble. I consulted few people and got mixed responses. Some liked the security of an out of match position and didn't wanted to take any risk that year and were ready to take a prematch even if it wasn't from their first tier of wanted programs whereas others asked me not to under sell myself and go for a better program. But everybody agreed on one thing that this year's match was crazy and highly competitive especially due to confusion regarding CS results. After number of sleepless nights, I finally decided to forget about prematch and go with rest of the interviews and stick it out in match. I knew it was big risk but than somebody rightly said, "The person who risks nothing, does nothing, has nothing and is nothing." January-February (2005) 6th January- Roads were full with snow and traffic was slow like snail after heavy snowfall all night. Shivering morning woke up early and I went to take MCCEExam (The Canadian version of step 1). Just needed to pass it even if it is with a minimum passing score so as to be eligible for J1 visa. (just in case I am not able to get H1 B visa) Exam was significantly easier than USMLE but had a lot of Canadian content which is quite different from USMLE. Also it was loang time since I had a paper-pencil exam. Missed filling those small balloons with a HB pencil. Reminded me of my PMT days. Than one fine day I received an email from University of Missouri @ Kansas City asking me to schedule an interview date with them. Interview season was almost finished and here I was getting my first interview from a Univ program. I called them and found that they have only one date left that is still open. 1st Feb. Their last day for interviewing applicants and it was literally end of interview season. Even program quotas are fixed after 31st January leaving no chances of pre-match what so ever. Without any hesitation I snapped that date (Feb 1). Second half of January- Went to Chicago and attended 2 more interviews. I liked the St Francis Hospital at Evanston which is a nice suburb outside Chicago city. Michael Reese Hospital in Chicago was ok but only sponsored J1 visa. Stayed there for 4 full days and chicago was the only city during my interviews where I did some sort of sight seeing. Well there wasn't anything else to do :) Few days later flew to Cincinnati, OHIO to attend my second last interview at Jewish Hospital. This was my most expensive air ticket till now (approx 950 CADs). Bills were getting overboard now. Anyways, Jewish Hospital is a nice program though again a small community hospital. After months of wait, I finally received results of my USMLE step 2CS. Results of applicants from some centers including mine i.e. LA were significantly delayed. But the fact that i passed made be forget all the ache in a minute. Got ECFMG certificate within 10 days of receiving CS results. The very next day I applied for USMLE step3 online and sent the verification document by next business day delivery. Luckily the step 3 application process especially for the state board of Connecticut was pretty quick and soon I received my scheduling permit. I scheduled my exam for March 7th and 8th at SEATTLE. There was no earlier date available. Again, after few days of rest after MCCEE, I started preparing for USMLE step 3. It seemed as these exams will never end. 1st Feb My last interview at UMKC. I liked the city , the program, people and the interview went excellent too. By that time I was ECFMG certified too hence I had a good feeling there and I was seriously hoping them to rank me in their list for the match. Last week of Feb.- Received results of MCCEE. I passed with scores of 590. Not bad I thought. March (2005) Took a Grey hound bus ride to south of border in order to take USMLE step 3, the final step in the series of Exams that took whole 1 year to complete. Exam went so-so but that wasn�t something unexpected. Lack of time for preparation, burnt out brain and anxiety regarding upcoming match were the obvious reasons. But as long as I get a passing score, these things won�t matter. After all, I only needed a pass score to be eligible for H1B visa. I finally submitted my Rank Order List (ROL) which had 11 programs out of 12 I was Interviewed at. Interfaith (my last choice) had already withdrawn from match. I ranked UMKC as my first choice above SLRHC of NY and I ranked J1 sponsoring hospitals at the bottom of my list. As the match day came closer, I started preparing for the worst case scenario i.e. of ending up unmatched. Ordered internet fax number, scanned all documents in PDF and JPEG format in order to keep them ready to be faxed to unfilled programs in case I don't get a residency position. Also tried sending few test faxes just to ensure that there are no surprises at the crucial time 14th March-Match Day... Woke up early and opened my NRMP account and was finally Relieved......when I read the words 'Congratulations you have matched' A successful end to the longest and most tense ordeal of my life. 17th March- Final match day. Proved to be another lucky day. I was on cloud nine when I Found out that I got residency position at my first choice program i.e. UMKC. April-May (2005) Now days busy with license application, Visa application and Residency Contract 4th April Received my step 3 result. Passed it with a score of 86/210. It was much more than what I was hoping for. With that my long lasting affair with USMLE is now officially over. Good bye USMLE and don't worry I won't miss you. |
 |
   |
| Road to Residency |
 |
|
|
|
| "If you think you can or if you think you cannot, you are absolutely right." |
|
|
|