By Dr. Svatava Merkle, Dr. Ayse Irem Sonmez, Dr. Tolulope Odebunmi, and Dr. Mats Steffi Jennifer Masilamani
We are a group of four International Medical Graduates (IMGs) training at the University of Minnesota School of Medicine: Dr. Svatava Merkle, a PGY-3 from the Czech Republic specializing in pediatrics; Dr. Ayse Irem Sonmez, a PGY-3 from Turkey specializing in psychiatry; Dr. Toulope Odebunmi, a PGY-4 from Nigeria also specializing in psychiatry; and Dr. Mats Steffi Jennifer Masilamani, a PGY-4 from India specializing in pediatric cardiology.
Since the beginning of the 21st century, palliative care has emerged as a prominent aspect of medicine. Palliative care focuses mostly on improving the quality of life in severely ill patients, but it also involves comfort-based care for terminally ill patients. Despite increased awareness of palliative care among health care providers, decisions made in respect to end-of-life treatment are often difficult because they can be subjective.
Dear fellow international medical graduates (IMGs):
We, like our U.S.-graduate counterparts, are hardworking and highly resilient in our pursuit of residency. We are all excited yet daunted by the prospect of transitioning from medical school to internship, as this new phase brings increased responsibility and autonomy. We all rush to meet deadlines and gather stack upon stack of required paperwork to jump off the page and qualify for selection. However, IMGs often face unique obstacles that we must overcome in preparation for and as we matriculate in our residencies in the United States. For example, as a Lebanese applicant, I was faced with regular electricity outages, civil rights movements interrupting my normal workflow, and severe financial limitations due to the fastest rate of hyperinflation in modern history in my country. I had to embrace instability and uncertainty and always aim to thrive from within the chaos. I am certain that many of my fellow IMGs faced similar challenges in their efforts to begin residency in the United States. Especially in this time of the pandemic, we all dealt with some level of economic and political instability in our homelands, not to mention the multiple waves of quarantine, uncertainty, and fear. If you are going through this process now, I send you a message of strength: you will persevere.
Six months into my medical residency, I have grown more comfortable waking up earlier than usual and at colder temperatures. I have learned to embrace procedure and operate on a regularly irregular schedule. Today on my way to work, I watch the fog clear and feel my pulse synchronize with my pace.
The COVID-19 patient did not speak English, so we communicated using a translator phone. He taught me a few words and sentences so that I could ask simple questions to other patients who shared his native language. “I can’t breathe” were the last words that I could understand before he was intubated. I wondered if he ever imagined that his last words would be spoken to someone who did not speak his language. Did he imagine that he would be taken care of in his final days by someone born thousands of miles away?