Thanks to Michelle for reminding me to finish writing this post.
A common source of despair for many pre-medical students, especially the ones who are relatively competitive applicants, is when do you cash in your chips and take your chances abroad? There’s unfortunately no “one size fits all” answer to this question but I’ll borrow from the stages of change behavioral theory and give you 6 phases – one of which you may find yourself in currently.
Phase 1 – Pre-contemplation
The highlights of this phase are denial and ignoring the problem. Usually you’ll be in high school through second year undergraduate when in this phase. At that time, you still believe that even your wildest dreams are attainable (and they might be). Personally, I think if you’re set on a career in medicine at a young age then you should be in this phase and working your hardest to reach your goals.
Phase 2 – Contemplation
This feels like the classic stage that most people get caught in – irrespective of career: a period of ambivalence and constantly conflicted emotions. I believe you will reach this stage at numerous points in your life. In medicine you’ll have first had this when you’re thinking about what career, then where to go to school, what specialty, subspecialty, scope of practice, etc.
Typically this will be a second year undergraduate student to as far as a Masters or PhD graduate student; even on occasion someone who has finished school, had a job and now is thinking about changing careers. At this stage, students need to have a high degree of introspection to critically evaluate themselves and their competitiveness. In evaluating their competitiveness, students will be need to assess the likelihood of them (a) having the admission requirements and (b) probability of obtaining a spot in a regional medical school. When evaluating themselves, students need identify (a) if they really want to be a doctor and (b) what sacrifices are they willing to make. Often helpful is a pros and cons list of medicine vs not medicine and MD vs DO vs Foreign MD programs (I’ll try to help you out with that one in a future post).
Phase 3 – Preparation
The preparation stage is very exciting, at this point you’ve become open to other ideas – whether in medicine or otherwise. Hallmarks of this stage will be exploring all of your options and collecting information. This is where you start to notice the flyer for the foreign school on the wall of your biology building, which you just never saw before or you’ll start Google searching for non-traditional routes to a medical degree. This can really happen at any stage in your academic career – commonly in the third year of undergraduate studies. The best advice I can offer is to make a list of your goals and build a roadmap for how you’ll obtain them. It’s always helpful to seek out the advice of others who have been in a similar situation – believe me, with medicine, there are. Ask questions, take in as much as you can and don’t immediately dismiss any option.
Phase 4 – Action
Time to execute! Now you’ve attended the information sessions, you’ve weighed the advantages and disadvantages and you’ve by laid out your plan. At this point, you have full acceptance of going abroad. There is recognition of being unable to obtain a position in a regional medical school and you’re ok with it – because you’ve found another option that you believe is viable.
It’s important to recognize that you may not get accepted to whatever program abroad that you’ve applied to – that’s ok. Hopefully, you have a plan B and if not, you can revert back to Phase 3 and figure out how to better improve your application.
Phase 5 – Maintenance
Congratulations! You’re in! Stick to your plan and remember residency applications are up next. You get to repeat the whole process again – what specialty, how to be competitive, which residency, etc.
Phase 6 – Relapse
There will be days of doubt, days when you will hesitate and wonder if leaving home in pursuit of your dream was the right decision – everyone has these. Keep going, talk to others about how you feel and know that you’re not alone.
You may also experience this if part of your plan doesn’t work out – like not getting into the residency of your choice. Persistence is key; chances are if you’re willing to go abroad for medical school, you’re persistent at heart. Finally, others will often question your decision – hold your head high, don’t be ashamed, International Medical Graduates have proudly contributed and will continue to contribute to the health of others; embrace joining their ranks.