As you know, this series has been pivotal in highlighting stories from doctors who are graduates of foreign medical schools affectionately called IMG’s (International Medical Graduates). On the other side of the international student’s spectrum, you have students from other countries who are admitted into the United States on a study visa called the F-1 visa.
Due to the fact that I have experience with being a foreign medical student who was also admitted to the States on an F-1 visa, I get tons of emails from students who are in the USA on an F-1 visa pursuing different undergraduate degrees. But I did not pursue undergraduate education here, so I am seeking out answers from doctors with the first-hand experience. Hence, I will take a break from usual programming to share an interview with Dr. Assam, a newly minted medical doctor who made it this far; even as an F-1 student. A visa status that some consider a hindrance to entering a US medical school. Read her take on common questions international pre-med students and med enthusiasts ask.
Dr. Lum: Can you please tell us about yourself?
Dr. Assam: Hi everybody! My name is Larissa Ndiep Assam. I went to SUNY Oswego for Undergrad and studied Biology and French. In May 2019 I graduated from SUNY Upstate Medical University. I am about to begin a Family Medicine residency with interests in Integrative Medicine, trauma-informed care and medical education. I have had an F1 (student) visa throughout my education in America.
Dr: Lum: What do you recommend is the best way to utilize a gap year? How can one avoid a gap year? Do you recommend a gap year?
Dr. Assam: The best way to utilize the gap year is to do something that enhances your career prospects in medicine. If you are set on going to medical school, you can spend your gap year doing a post-baccalaureate program, doing research, getting a job, pursuing another passion or, doing a combination of these. One thing which I have learned over the years is that there is no “one-size-fits-all” answer or method for getting into medical school but those who win in the end, are those who keep their eyes locked in on the vision- to become a physician. A gap year can also be a good time to make sure that medicine is what you want to do. Medical school is mentally and physically challenging and I personally believe that you should only pursue medicine if you are truly passionate about it. A gap year can be a good time to surround yourself around physicians in specialties you are considering to get a glimpse of what a day in their lives could be. Forming connections with these people during this year could also make it possible for you to have letters of recommendation. Speaking of vision, your decision to take a gap year should not only come at the end of your senior year of college. If you can decide in advance that you will take a gap year, this will enable you to pace when to study for and take the MCAT.
Now, if you decide NOT to take a gap year, you will need to do some planning. I should mention that I am one of the people who did not take a gap year because I wanted to move on to medical school and I was also nervous about a gap year as an international student. I gathered my letters of recommendation during the Spring semester of junior year and studied for my MCAT during the first 6 weeks of the summer of my junior year. This way, I had completed all the requirements before August when programs started responding with secondary applications. I did this intentionally, to give myself a margin of time to dedicate to responding to secondaries in a timely fashion.
Would I recommend a gap year? Yes! If I could do it all over again, I would take a gap year. Grinding non-stop from the summer of my junior year to completing an independent research study by the time I was graduating was a lot. I tried my best to rest in between but I was mentally exhausted. Looking back, that fear of what to do during a gap year was really fear of deviating from my original life plan. Physician burnout and medical student burnout are very real and when I burned out, I learned that I had been in a cat race that no one put me in. If you want to take a gap year because you could use a little break, take one! Space out your medical school application requirements a little bit and pursue your other passions! As long as you stay focused on your vision to go to medical school and have the RIGHT people advising you, it will happen, and you won’t be as stressed.
Dr. Lum: Thank you for the detailed explanation. Now unto OPT, this is another area I get tons of questions about. Can you elaborate?
Dr. Assam: OPT stands for Optional Practical Training and is 12-month temporary employment. If you were to decide to take a gap year, you will be on OPT for that year. When you get into medical school, you will be back on an F1 visa. OPT can be up to 3 years long for STEM majors with Bachelor’s degrees and for 1 year after completing graduate and postgraduate degrees. I know… It doesn’t make sense haha.
Dr. Lum: What are do you recommend an F-1 pre-med should pursue in order to ‘strengthen” their application for medical school in the USA? (Particularly for those who completed primary and secondary education in Africa or other countries)
Dr. Assam: For context, I completed primary and secondary education in Cameroon and it was the best experience ever! I don’t regret it at all. I would say to learn the importance of networking from day 1. Growing up in Cameroon, people talked poorly about having connections when in fact, this was networking. When I moved to America, I had to learn how to speak about myself. Culturally, there is a conflict here because this is not how we are wired for the most part as Africans- to market our strengths.
Your education and life growing up outside of America is actually your greatest asset if you can have the right perspective to see how it shaped you and motivated you to be driven and to pursue medicine. Let’s stop talking about growing up African( or foreign) as though it is a bad thing when in fact it is a blessing. I cannot tell you how many doors it opened for me because I was unique. I was different and I didn’t try to fit in. I worked at being excellent in everything I did and I think that spoke for me.
Dr. Lum: What are your thoughts on an F-1 student (enrolled in a US undergraduate program) going to a Caribbean medical school?
Dr. Assam: There are good medical schools in the Caribbean. If you can get into an American medical school based in America, that is your best bet. The harsh reality is that for whatever reason (to be honest, this makes no sense to me), IMGs are looked down upon by some residency programs. If that is your only option, by all means, go to a Caribbean medical school. Knowing this reality, you will need a strategy from day 1, start planning your holidays forming connections through coffee meetings with attendings in the US or securing research opportunities. You can and you will match. You just need a good strategy and Dr. Lum is awesome for literally dedicating her blog to helping IMG’s!
Dr. Lum: What are your recommended options for financial aid? How to pursue, obtain, etc?
Dr. Assam: Oh financial aid! Let’s be real… It is tough for international students. This was my biggest struggle. Some people’s governments or other organizations were able to sponsor them. My parents started off paying my medical school tuition and then paying 65K a year from Cameroon got real, very quickly so, I took out student loans. Do EVERYTHING in your might not to take out student loans! There are apps like Scholly that post scholarships regularly. At some point, I actually went to my school’s financial aid office and told them that I could not afford school. You never know until you ask. They covered my housing and covered my tuition during my final year of medical school. Also, be real with your professors. One of my professors made it possible for me to get a 16K scholarship.
Long story short, be bold. Growing up in Cameroon, many people kept their financial struggles private. That doesn’t work in America. Don’t tell the whole world but if you want help, you HAVE to tell the people who can actually do something about it. It is so so important throughout medical education to be at an institution where you feel supported.
Dr. Lum: What will you consider an ideal MCAT score? Why so?
Dr. Assam: As high as you can possibly score. Unfortunately, standardized exams are still used by some medical schools as screening tools and scoring high will open more doors for you. I did not score high on my MCAT. I don’t know what the average score is now but I got a 25 and I still got into medical school. Your MCAT score is not your total worth. If you have an average score, work on other parts of your application (GPA, research, community service and, most importantly, connections) to maximize your chances of getting in.
Dr. Lum: What tools do you recommend for MCAT preparation? Did you take any courses? If so, which ones?
Dr. Assam: I took a Kaplan in-person class because I wanted structure when I was studying for the MCAT. Some people took Princeton Review and also liked that. I would say ask yourself what type of student you are. Do you like structure? Maybe a class will be good for you? Do you like and need flexibility? You can study on your own.
Dr. Lum: What general advice would you give an F-1 undergraduate student who has the goal of pursuing medical school in the US as you did? Dr. Assam: This process is grueling and challenging but it is doable. Submitting your medical school or residency application is not the end. Don’t rest until schools have admitted you or offered you interviews. Call them over and over again. Go to every event your top 5 schools are offering. If I could go back, I would have been more aggressive with calling medical schools after I submitted my application. I thought I had to wait and see what they said. After a series of rejections and no responses, my uncle told me that I needed to stop crying and fight. We went to an open house at my current medical school the following Saturday. I was called for an interview on Monday and had my interview that Wednesday. You might have to fake confidence some days but honestly; that is okay. It will build your strength. Above all, know that you can do this! It is so so mental. I am not special. If I got into med school in America, you can too!
Dr. Lum: What are some lessons you learned through this journey that you would like to share?
Dr. Assam: I have learned not to blame others when life doesn’t go well. I remember being frustrated with my MCAT practice scores and being snappy with my family. Understand that you chose this journey and the people around you who are supporting you should not have to suffer because you cannot control your emotions. No one ever said medicine was easy and so please don’t come into it ignoring the fact that there is some real emotional struggle that comes with the territory. Time and time again, I had to ask myself if I really wanted to do this. I think that this is a very important question. If you are undecided about medicine, don’t do it. Honestly, it’s too much work if you don’t feel like this is your calling or purpose in life. I learned to be persistent. “No” isn’t really “No” until I have exhausted every single option of convincing you about what I want. I didn’t know that at the time but all the rejection with applying to medical school was grooming me for entrepreneurship and teaching me how to apply to residency smarter. My residency application process has been relatively smooth thus far and I think it is because I applied what I learned early on.
Dr. Lum: What are some limitations you experienced because of your visa and how did you overcome those?
Dr. Assam: There were many! I remember wanting to apply to summer programs and not being eligible because I was not a US citizen or permanent resident. I remember not applying to medical schools and now residency programs because they did not accept international students or sponsor work visas.
I overcame these by being intentional. I did a lot of talking with my undergrad advisor to find summer opportunities for myself. The opportunities are out there, you just have to look. Google is your best friend! For medical schools, I looked up which schools accepted international students and which ones did not. This actually helped me condense my list because there are so many med schools to choose from. Perspective is key. For residency programs, I searched and then called to confirm that all the programs I was looking at either sponsored H1B or J1 visas. This also helped me narrow down my residency program search by geographic location and visa status.
The biggest obstacle I faced was financial strain. I ended up taking over 100K in student loans and was so afraid of the growing loan burden as l had high-interest rates. By the way, don’t do variable interest student loans and read Dr. Lum’s post about paying off student loans. I think she is done!
I really wish I had had a more affordable route through school. It makes no sense to be in debt for pursuing education and no matter how much people try to justify debt, I am really not a fan of it. I overcame this by finally going to my school and telling them I could not afford school. If you’re taking out loans, you cannot afford school. They gave me over 80K worth of funding for my senior year so in the end, I finished school. I should also mention that there were many tough and discouraging days along this journey as you might imagine. My relationship with God deepened because of medical school. I prayed that I did not want to take out more loans and He answered my prayers through people. I would also encourage every single person in medicine or considering medicine to take Financial Peace University. Even though I still have loans, I have a plan to pay them off quickly because I have learned to budget.