“Every time I moved I had left things behind – like not being around when my best friend gets married, or when another close friend has a baby – and I needed to tell myself that I was okay missing out on those things.“
Pursuing residency (specialty training) in the US was something that I had considered even as a medical student. I was keen on pursuing a faster, more rigorous training programme, but at the time the thought of going through additional exams and the application process during my busy medical school years had put me off. Meeting my husband (an American) was the push I needed to go through with this and so I moved to the US in January 2020.
Moving countries was challenging as it required adapting to a different culture and a different way of doing things. Even though I grew up in Australia, a “Western,” English-speaking country, I found that small, simple things – like how people behave on public transport, or how others treat you at the grocery store – were different, and that required picking up on small cultural quirks that I wasn’t used to back home. Additionally, the system in the US often puts IMGs at a disadvantage, as many hospitals prefer local graduates and find the visa and licensing requirements of IMGs a hassle. It’s often quite difficult to get positions, regardless of how successful you may be academically.
When I first moved here, I didn’t know anyone else. The COVID-19 pandemic was also just getting started, which meant that I couldn’t go home to see my family for two and a half years and was stuck at home most of the time. My biggest struggle at the time was navigating the Residency Match, which is a process so complex, intricate and unique that it was difficult to find others who could relate to my struggle. I found it very isolating having to go through this journey all by myself, in a new country, where I didn’t know anyone.
Unfortunately, over the course of that first year my mental health suffered, and I found myself unexpectedly spiralling into depression. I became so numb to the point where I couldn’t do anything. Thankfully, my friends and family back home encouraged me to see someone, and my best friend even googled up Psychiatrists in my area! I eventually did see a psychiatrist, who referred me for therapy and started me on medication.
What also helped me to get through that difficult time were my friends, my family, and my faith. My friends sent me food and small gifts like spa vouchers to make sure I was taking care of myself, while my parents would constantly remind me that I wasn’t alone and that God was in control regardless of the circumstances. Speaking to my therapist also helped me to see that I had never taken the time to process what I was leaving behind as an IMG. Having moved countries several times to pursue my training, I had never really grieved the process between my moves. Every time I moved I had left things behind – like not being around when my best friend gets married, or when another close friend has a baby – and I needed to tell myself that I was okay missing out on those things.
Realising that I had reached a point where I actually needed to seek help was a huge wake-up call for me. Firstly, being from an Asian background, we rarely speak about mental health or share our struggles openly with others. Secondly, as a doctor and academic, I had studied depression and even prescribed for it but had never envisaged that I would be on the receiving end. Medication helps with mental health conditions in the same way that they help with other illnesses, and without medical treatment I may have continued spiralling to a point that would be unthinkable for me. Now, there are still some days where I fall back into negative thoughts or feel like there’s a black cloud hanging over me. But the good days definitely outnumber the bad days now and are part and parcel of the struggle with mental health that we all face.
Many IMGs don’t realise that they struggle with their mental health, and often brush it off by focusing on studies or work until something hits them and they realise that they were struggling all along. We need to acknowledge that it’s never easy to leave the comfort area of home, but what helps in this struggle is knowing that you’re not alone – there are countless other IMGs in the same boat. Most importantly, always remember the big picture of why you’re doing it, and that is to accomplish your dreams! I often speak to young medics who want to move overseas, but they don’t know where to start and are afraid of leaving friends and family behind. As someone who was once in their shoes, my advice would be that even though this journey isn’t easy, pursuing medicine is a lifelong commitment – so just go for it!
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