Where There’s a Woman, There’s a Way

This year is the 70th anniversary of the National Residency Match Program organization. For many medical graduates, the path to pathology is turbulent and sacrifice is often great – particularly for women working in low and middle-income countries. From preparing for the United States Medical Licensing Examination (USMLE) to applying and interviewing for residency, new hurdles always present themselves. 

Here, I present the stories of two Chinese women – and mothers – who have suffered, struggled, and succeeded in becoming pathologists despite the odds stacked against them.

Dr. W’s story
 

Dr. W – a mom with twin girls – graduated from a medical school in China more than 15 years ago. She obtained low scores in the USMLE Step 1 and Step 2, had no previous clinical experience, and failed to match for pathology. Desperately, she traveled to New York to take part in my externship. She studied and worked hard with extreme enthusiasm. She practiced lab techniques such as grossing and staining, read the relevant chapters based on daytime sign-out cases, and shadowed me around the physicians' office. 

She was very careful with details and always worked independently. She worked hard to write notes, case summaries, and reports – sometimes completing more than three a week. After completing her externship, she continued to write for a social media platform that aimed to help medical graduates applying for pathology residency in mainland China; these graduates had encountered difficult cases in their clinical work. She then generously shared her writings with other students without reservation. She wrote 55 case summaries until she matched into residency the following year – that’s more than one piece per week!

When she started her residency, she immediately stood out for her basic lab skills. In her first internship month, she was the first trainee who was allowed to rotate and independently carry out frozen sections. Before, her program only allowed residents to rotate frozen sections at PGY-2.

After completing PGY-2, she was recognized by her program director as one of the best trainees he had ever had. She was, of course, one of the best externship trainees I had taught in the past 15 years. She eventually received acceptance for a genitourinary pathology fellowship at Johns Hopkins Hospital.

Dr. Q’s story
 

Dr. Q finished her PhD in Japan and completed postdoctoral training at a university in New York. To become a pathologist, she pursued an additional four-year education at a Caribbean medical school. However, she failed to gain acceptance into a pathology residency program. When the COVID-19 pandemic started, she called me and requested pathology externship training. I agreed and accepted her. 

At the time, she was working on a NIH program at a university in Chicago. Her husband was a busy internal medicine hospitalist, and she had two children, so could only stay in New York for a maximum of one week at a time. After finishing her work on Friday afternoon, she drove 12 hours – overnight – to New York. The next morning, she immediately started rotations in the lab and attended lectures and daytime sign-out cases in the clinic.

In the lab, she took every opportunity to study gross surgical specimens, practice preparation of cytology specimens, and practice frozen sections. She made significant progress in all the subjects I intentionally designed for her in an intensive, short period. After one extremely busy week of training, she drove back to Chicago on Sunday afternoon to make it back for work on Monday morning. She did this twice – but never complained and always retained her enthusiasm.

Eventually, her sacrifice and hard work paid off. She was accepted into the university program where she had completed her postdoctoral training. She had an excellent performance in her PGY-1 training and was very productive. She had three articles published in different pathology journals and two abstracts presented at the USCAP. Now, she is in her PGY-2 and is starting to consider her fellowship options for the future.

The stories of these two Chinese graduate residents touched my heart deeply. Their commitment and tenacity have inspired so many new students on their pathology journey in the US, and I hope their stories can encourage the next generation of women looking to enter the lab.