All of us have the power to make choices that define us. However, the freedom to dream is not the same for all of us. Childhood adversity, country of origin, socioeconomic status, family obligations, and our health can all shape our future. I have been fortunate to have had these factors work in my favor. While choosing medicine was exhilarating, moving to the United States in my early twenties, where I had no close family, to pursue higher training was a cause of great angst for my parents. Nevertheless, all that I received from them was love, and financial and emotional support, for an arduous year as I obtained clinical and research experience in New York City and Miami hospitals before matching into residency in 2017. I realize this privilege is uncommon for many, especially females, across the globe and I am forever indebted to my family for their support.
From my early days in medical school, I knew that I wanted to become a psychiatrist. My decision was met with mixed opinions from my family and colleagues, as stigma towards this specialty persists. But I’ve always longed to pursue a career in psychiatry and hoped to contribute to fighting the stigma and spreading awareness of mental health and illness. The exceptional approach psychiatry takes in exploring human behavior and the motivations that drive it is fascinating and deeply rewarding. It also provides a unique privilege to not only be part of the patient’s story, but also have a role in achieving a positive shift in their narrative.
Living the “American Dream” was a phrase I heard a lot while growing up because many of my relatives were settled in the USA. During medical school, I had made up my mind to pursue psychiatry as a preferred specialty. After making a thorough comparison of psychiatry training in Pakistan, the United Kingdom, and the USA, I decided to aim for training in the United States.
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.
Have you ever done something for the first time and had great anxiety about doing it? If your answer is yes, we are in the same boat.
When I started my residency training as a first-year psychiatry resident, I had many fears and worries. Imagine a doctor who has to work in another country, use English as her second language, and see patients in a diverse population. I had fear that my patients wouldn’t be able to understand my accent; fear of judgment from my colleagues; and fear of making mistakes. The working environment in the United States is far different from Thailand. I used to write paper chart back in my country, but now I have to type everything to the Electronic Medical Record (EMR). In Thailand we have Universal Health Care Coverage, unlike the healthcare system in the United States, where everyone has insurance.