IMG Roadmap Series #8: Dr. Brown (EM)

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Dr. Brown is a vivacious, charismatic ER physician whom I met at the inaugural “Women in White Coats Wellness Retreat & Conference” at Chateau Elan in Braselton, GA where I spoke on “Common physician pitfalls with documentation”.  Kimberly’s vibe is contagious! So when I ran into her again at the Momentum in Medicine Conference in Atlanta, GA last week I knew I had to share her story! 



Thank you, Doctor, for accepting to be interviewed by theencouragingdoc.com. We will jump right into the Q& A.

 Dr. LumPlease tell us about yourself.
Dr. Brown: My name is Kimberly Brown, MD, MPH and I am an attending emergency physician currently working in the greater Memphis, TN area. I was a part of the inaugural class of emergency medicine residents at the University of Tennessee Health Science Center in 2018. I graduated from Ross University School of Medicine in Dominica (now in Barbados) in 2014. I was born and raised in Milwaukee, WI and went to Fisk University in Nashville, TN for undergrad. Hence; I am a US IMG. I have also earned a Master of Public Health degree with a concentration in Public Health Management and Policy from the University of Florida in Gainesville, FL.

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Dr. Lum: As a US citizen, how did you end up in a Caribbean school?

Dr. Brown: Going to a Caribbean school was not my initial choice. I was preliminarily accepted to medical school through a joint program with my undergrad institution. However, I needed to make a certain score on my MCAT in order to maintain my spot. I really struggled with my MCAT and I ended up losing my seat in the joint program. 

I ended up taking the MCAT two other times, each time, not scoring well. In the midst of re-taking my MCAT, I also applied to medical school traditionally several times and was rejected. 

I decided to pursue a Master of Public Health degree at the University of Florida to strengthen my application to medical school. During my time at UF, some friends I made in college began attending Ross. I saw their pics on Facebook and statuses about studying and enjoying the island. I had heard about Caribbean school being an option for students to pursue medicine, but never seriously considered it an option for myself.

During my second year of my master’s program, I began to apply to medical school again. The rejections came rolling in, and I got very frustrated. I was sitting on a friend of mine’s couch when he asked me why I hadn’t applied to a Caribbean school. I told him my hesitation about applying. He told me that he had several friends that went to Caribbean schools and they were doing well as attending physicians. That conversation completely shifted my thought process around Caribbean schools, and I decided to apply on that day. Ross was at the top of my list since my friends were there, and were going through the program. I like if I was going to leave the country for medical school, I should at least go somewhere that I knew someone. After several years of applying, retaking my MCAT and being rejected, in February 2010, I was accepted to Ross University’s Class of 2014 beginning in January 2011!

Dr. Lum: That is a story of triumph! Thank you for sharing. Please, tell me more about your time in medical school.
Dr. Brown: My medical school journey started off really rocky. Before I left home, I had a lot of family issues that I tried to leave behind when I was on the island. My first two exams I failed. Between failing my exams and the family drama back at home, I began to panic.  Everyone I know KNEW that I have been wanting to be a doctor since birth. They knew I struggled to get into medical school. There was no way my pride was going to let me go back to the US telling people that I failed out the first semester.
Ross had a department named “Academic Success”, they supported students academically with tutoring sessions and educational counseling. I never thought that I was “that student” that needed a tutor. I was always the one tutoring everyone else. But I realized that what I was doing wasn’t working, so I needed to do something different. Out of desperation and fear, I set up a meeting with the counselors there and cried my eyes out, in fear that I was going to fail out. My counselor let me cry, then helped me get down to business. She found me some tutors, got me on a study schedule, and gave me tools and resources to actually help me learn how to study.
The next exam I almost aced (anatomy was never my strong suit)! My confidence soared and from that point on, I was able to learn the material and continue to score well on my exams.  I left the island in August 2012 and completed my clinical rotations in Dominica, South Africa, Wisconsin, Michigan, and Illinois.

 

Dr. Lum: How did you perform on the exams? When did you take USMLE step 1? Do you feel comfortable sharing your step 1 score?
Dr. Brown: I scored 217 on Step 1. Ross has a requirement that you have to take and pass Step 1 before going on to clinical rotations. After I left Dominica in August 2012, I took a week to get comfortable back in the US and took my test in October 2012.

Dr. Lum: What studying technique worked best for you? Or what do you recommend as the ideal study schedule for a great score? Did you have any extenuating circumstances that caused delays, and how did you handle that? 
Dr. Brown: To prepare for Step 1, I used Doctors in Training, NBME Exams, Pathoma, Goljan Audio (does anyone still listen to those?) and UWorld questions.


Dr. Lum: Absolutely! (“Papi” lives on). Can you walk us through how you prepared for the test? Include books used, videos, courses etc.
Dr. Brown: I had about 2 months to study for Step 1, so I made a study schedule, based on the DIT course materials. I would do the videos in the morning, and questions in the afternoon. I would listen to Dr. Goljan’s audios when I was bumming around the house or in the car. I also made time to take NBME and UWorld tests on the weekend to gauge my progress and estimate my score for the actual exam. I didn’t take much time off, which I regret. Studying for Step 1, I would ignore the material I didn’t like or was a struggle for me (biochem!) and kept studying the things that made me feel good. That approach definitely hurt me on exam day. I scored the worst on the biochem section and did fairly well in every other subject.

 

Dr. Lum: The detail was appreciated, Dr. Brown. So many students use our mistakes to do better. When did you take USMLE step 2? Tell us more about your experience.
Dr. Brown: I took Step 2 in January 2013, right before starting my emergency medicine rotations. I had 2 weeks of an easy rotation (anesthesia) and one solid month off to study. I did pretty much everything I did for Step 1, including DIT, Step Up to Medicine and UWorld. My goal was to get a 240. I knew that I wanted to match into emergency medicine and that it was competitive. I also realized that I hadn’t done as well as I hoped in Step 1 so I had to show some improvement.
I again put myself on a study schedule where I would do DIT in the morning, questions and review in the afternoon/evening. After I got home from studying, I did NOTHING medically related. I worked out, watched TV, anything except for review. I also made a point to review over and over again material that I wasn’t comfortable with. The day before the exam, I only briefly reviewed some fast facts, then put everything down. I got a manicure and pedicure, had a great meal, watched some reality TV and went to bed at a decent time.

 Dr. Lum: What studying techniques do you attribute to your success on step 2? Tell us more about your experience (test day anxiety etc). What books, resources do you attribute to your success on CK and/or CS?
Dr. Brown: Sticking to my schedule and prescribed study plan worked for me. I knew I covered everything in a high yield fashion and no piece of material was left unturned. Questions, questions and MORE questions are also very helpful. Make sure you not only answer them but go back and read the explanations. Reword the questions in your head to make other answers true. Go back and do the questions that you got wrong.

Before I take any standardized test, I pray. I quiet my mind, thank God that I have made it this far in my journey and ask for his guidance on the exam. I ask Him to guide me if I am confused between one answer choice an another to guide me to the right answer. In high school, I had really bad test anxiety and struggled. These techniques helped me tremendously.

Dr. Lum:  When did you take step 3? Can you give us any advice on how to prepare for step 3? What study technique do you attribute to your success on step 3? Did you require step a 3 score to match into residency?
Dr. Brown: I took Step 3 before the end of my second year of residency. I don’t have much advice because I didn’t study much!  I used UWorld questions and that was it. I made sure to go over the software on the official USMLE website. If I could do it again, I would have studied more statistics.

 Dr. Lum: Did you take either one of these tests more than once? If so, can you expatiate on factors that you can attribute to the failed attempts (academic, personal or environmental)?
Dr. Brown: I passed all of my USMLE exams on my first attempt.

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Dr. Lum: If you did not repeat any tests, can you tell us what to do if someone fails any of the steps?
 Dr. Brown: If you happen to fail any of the steps, allow yourself time to grieve. You worked hard and you didn’t get what you wanted. After you’re ready, get back in the saddle. What happened? What didn’t you cover? What can you do differently? Come up with a plan to succeed and stick to it.
More importantly, don’t suffer alone. There are plenty of people that are willing to help you study and win the next go around. Suffering in silence is isolating and lonely. You need a village to help you be successful. Don’t shut out your cheerleaders. 

Dr. Lum: Did you have a gap year? Or are you a non-traditional student? What did you do during that time? What do you recommend to do if a person has a gap year?
 Dr. Brown: I finished my rotations in September 2014, just shy of making the 2014 match. In preparation for the 2015 Match, I reached out to an independent physician-owned clinic and worked as a medical assistant. I also interviewed for residency while working there.

 Dr. Lum:  How do you recommend IMGs go about securing interviews?
Dr. Brown: Apply broadly and don’t be afraid to call and follow up if you haven’t heard from a program that you’re interested in. Be polite! Also, send the program director an email expressing interest in their program. Be honest about your interest, however. The program director community is very small, and they talk to each other frequently. 

 

Dr. Lum: How did you match into your residency program? What are your best tips for anyone on matching into residency?
 Dr. Brown: Emergency medicine can be challenging for an IMG to match into. You must receive SLOEs (standard letters of evaluation) in order to match. SLOEs are given from attendings, APDs, and PDs from emergency medicine residency programs where you would do your audition rotations. More recently, many of the schools that have EM residency programs are not friendly to IMGs rotating for aways.I was able to rotate at a program that had an EM residency and was affiliated with Ross. Six months before I planned to actually rotate, I searched vigorously for another rotation as an IMG and made lots of phone calls and sent lots of emails.
When it came time to apply for residency, I applied extremely broadly. I applied to 80 EM residencies and 20 IM residencies. I also attended conferences geared towards medical students interested in matching into EM (AAEM Medical Student Symposium and ACEP’s Scientific Assembly) and met with program directors. I met who would be my program director at ACEP’s Scientific Assembly and ended up receiving an email for an interview while I was there!
The best advice I can say about matching is network, do as well as possible on USMLEs and apply broadly. Do a lot of research online about where previous students have matched or programs that have IMGs already in their residency class and put them at the top of your list. As well, target brand new residency programs. They are more friendly to IMGs.

 Dr. Lum: In your observation why are some IMG’s struggling to get into residency? And what can they do about that?
Dr. Brown: I believe some IMGs are struggling to get into  residency for several reasons. There is a stigma attached to IMGs that they aren’t as smart or capable as students that attended school stateside. Programs are labeled not as rigorous or academically strong as another if they have many IMG residents. Because of these reasons, many residencies will not even interview IMGs, no matter what their scores are.
Also, many programs aren’t familiar with the medical schools that IMGs apply from, so they are hesitant to accept applicants from those schools.
The people that I know that didn’t match into residency had failed USMLEs once or several times. Failing USMLEs is a red flag to program directors that you may not be able to pass your specialty boards.
The only thing I would suggest an IMG do is be friendly, approachable, score well on USMLEs, get as much stateside experience as possible and apply broadly. Just because it’s a struggle doesn’t mean its impossible. There will be a program that will take you.

Dr. Lum: Did you participate in clinical rotations at any US hospital prior to match day? Was this helpful to your match process? If so, please explain.
Dr. Brown: Ross University’s rotations are almost 100% in the US. All of my cores and most of my electives were stateside. I actually was asked more about the rotation I completed internationally (Durban, South Africa). Having stateside rotations was one of the major reasons why I attended Ross. Having stateside rotations helps expose you to the US healthcare system, which is unlike any other in the world. Having that experience will expose you to attendings who can write recommendation letters, call in favors to academic centers and residency programs and truly build your residency application for success.

Dr. Lum:  Did you participate in research or an observership at any US hospital? Can you share what you learned from this experience? Was it beneficial to how or where you matched?
Dr. Brown: I didn’t do any research in medical school.

Dr. Lum: Looking back at the journey to get to where you are at, what advice would you give to yourself looking back at the process? What is your mantra for your success thus far?
Dr. Brown: would have gotten over my negative thoughts around Caribbean medical school and pursued it as an option a lot sooner than I did. After I changed my mindset, I was successful and was able to accomplish my lifelong goal. My mantra is if at first you don’t succeed, try try again!

Dr. Lum: Can an IMG connect with you? If so, how? (Sharesocial media handle, websites, blogs or emails only. Are you willing to mentor an IMG? If so say so here)
Dr. Brown: I am on Instagram as @drkimberlyb, Facebook www.facebook.com/drkimberlyb Twitter: @drkimberlyb_ I also have a website www.drkimberlybrownmd.com

Dr. Lum: What mantra do you live by?
Dr. Brown: Well behaved women seldom make history.


 

Guys, we can rightfully conclude that Dr. Brown is a boss as she dropped the mic and exited the entire department! Haha … I am blown away. She said, “don’t shut down your cheerleaders”. If you ask me she is cheerleading every student in a Caribbean medical school who is struggling through a failed class RIGHT NOW with her revealing interview. Read her story,  but don’t be entertained. Instead … learn her methods and practice them! I have no doubts that success is waiting for you on the other side.

Co-Signed,

Dr. Lum.

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