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Outside the Lab Profession

Spread Your Wings

For foreign medical graduates with low USMLE scores, little US clinical experience, and previous failures to match into residency, achieving the goal of becoming a doctor in the US seems like mission impossible. Program directors don’t even glance at their CV or application files.

But there are some individuals who work so tirelessly – so relentlessly – that they defy the odds. Here, I present the stories of two Chinese medical graduates and also fathers, exploring how they suffered, struggled, but ultimately succeeded in becoming pathologists despite the many hurdles.

Dr X’s story

Dr X graduated from medical school in China more than 20 years ago. He obtained low scores in the USMLE step 1 and step 2, had no previous clinical experience, and failed residency match seven times. Desperately, he called me for help. I was deeply touched by his persistence and asked him to travel to New York to participate in my externship.

When I first met him, I realized that his situation was very complicated. His boss had run out of NIH research funding and the laboratory had closed. Dr X only had two months to find a new job. During these two months, he made the journey to New York every other week and overworked hugely for the externship. I provided him with training, including mock interviews with tough questions about his more ‘unfavorable’ deficiencies.

He started to improve day by day. Fortune is always looking for those who grab it. At the USCAP meeting, I introduced Dr X to a state university program chairman. They talked for 10 minutes and the chairman offered him an interview for his program. After rigorous interviews with attending faculty, the program director and the chief resident, he was pre-matched on site. He called me sobbing – I was so emotional! He became a pathology resident after eight attempts.

After entering the program, he used his spare time in CP rotation to join several research projects. He generated several abstracts in conferences and publications, and won a gold award for best residency research paper at the university. In his PGY-4, he won another silver award. He graduated and attended a prestigious university program for his surgical fellowship.

He thanked me for his training, and I thanked him for being such an inspiring role model – particularly to his children. I believe that I would have quit the path to pathology after trying three times, but his story taught me and many other foreign medical graduates a lesson about courage and persistence. 

JY’s story

Over 10 years ago, JY traveled to California from China as a postdoctoral fellow. He heard that foreign medical graduates could take the USMLE and become doctors in the US, therefore, he focused on his postdoctoral studies and reviewing USMLE materials. He obtained unsatisfactory scores for step 1/2, and failed his CS English test three times – only passing two months before the ECFMG’s seven year validity period had expired. His three year old child once asked him: “Daddy, when will you be a real doctor?" He started his pathology residency application track, but failed to match twice. 

He flew to New York for a pathology externship with me and was comforted by the fact that eight of my trainees had similar past experiences: long gaps after medical school graduation (the longest one was more than 23 years), low USMLE scores, and no US clinical experience. However, they all eventually succeeded and became pathologists. Inspired by these stories, he studied very hard. 

After his externship, he continued to attend his pathology department’s difficult case conferences. He observed residents grossing specimens and autopsies, and wrote down measurement data to facilitate PAD writing. All residents and chief residents highly appreciated his volunteer work and support. Although he failed that year’s match, the following April – after match day – the program director from his institution asked if he was interested in an unexpected vacancy position. He was extremely happy and immediately accepted the offer. However, the GME office needed an updated PTAL, and his exam scores were about to expire. So, he had to retake USMLE Step 1 and 2 in the space of two months!

He was successful. And after entering residency, he worked very hard. He had more than five abstracts presented at USCAP and other published articles in pathology journals. JY completed his residency and enrolled onto a GI pathology fellowship in California.

When Chinese medical graduates ask JY about his success, he always tells them: “Don’t let anyone clip your wings; spread them wide and fly high!”

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About the Author
Gang He

Consultant pathologist at Harlem Hospital—Columbia University/NYU-LI Long Island Community Hospital, New York, USA.

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