I am a pediatric intensivist, and I am from Nigeria. As an intensivist in the US, I offer multi-disciplinary care to children who are critically ill, in an ICU environment. Our team offers various forms of support for any organ-system failure ranging from tracheal intubation/mechanical ventilation to extracorporeal membrane oxygenation (ECMO). However, in Nigeria and most other low and middle income (LMIC) countries, children who are critically ill are not cared for in an ICU environment. Most of the hospitals in these resource-limited settings lack the capacity and resources to intubate and mechanically ventilate children who are in respiratory failure from varied causes. As you read this blog, if a child goes to any of the major tertiary pediatric institutions in these regions, in respiratory failure or has any major organ-systems dysfunction, the fate of that child is grim. There are millions of such children, even at this moment.
As I sit in a dear friend’s apartment in New York, basking in the nothingness of vacation, I realize that the time left in the intern year of my Internal Medicine training can no longer be measured in months. It has been quite the year and I am part trepid, part excited to transition into a senior role in the next academic year.
This is not the first of such transitions for me, and neither was Match Day 2018 my first dance with the NRMP. I first moved to the United States in 2016 to begin an Anatomic Pathology/Clinical Pathology (AP/CP) residency. I remember putting all I owned into two travel bags – more like haphazardly stuffing the bags – and getting on the long-haul flight to Chicago, to begin the next phase of my seemingly never-ending medical training. I was excited and grateful to be part of the next group of exchange visitor physicians.
The arduous winding journey for international medical graduates seeking to continue medical education in the United States is one only for the brave at heart. From the grueling USMLE exams to the apprehension of Visa interviews at the US embassies, with a melange of sweetness whenever that FedEx envelope arrives with your ECFMG certification, culminating on Match Day where you finally get to know if you have been accepted into a program— is a summary of years of hard work, dedication and huge financial commitment. For those who make the mistake of thinking the process of getting in is the hardest, they soon learn that staying in is probably harder, confronted with an entirely new system of medical practice, far away from loved ones and the comfort of a familiar environment. What has kept many international graduates going is finding your purpose, understanding why you put in so much of your life to get to this point.