The IMG Roadmap Series #15: Dr. Mikhael (REI) (click on image to learn more)

Instagram has introduced me to tons of amazing #womeninmedicine virtually (and IRL). This is exactly how I  connected with our IMG spotlight for the week who is in REI fellowship training. If you don’t know what that is, then you need to keep reading

Also, if you are wondering about the new photo above and haven’t joined the online course where I am coaching IMG’s that are preparing for a successful application season, then join here. We are on our 3rd coaching session but it is never too late to join as I have a plan for you to catch up! Let’s jump right into the Q&A.

Dr. Lum: Please tell us about yourself.
Dr. Mikhael: I am a Canadian citizen who went to Saba University School of Medicine (located on the island of Saba). I graduated in 2014 and proceeded to do my OBGYN residency at Providence Hospital/Michigan State University in Southfield MI. I got into a very competitive specialty: Reproductive endocrinology and infertility at the Medical College of Georgia as the only IMG fellow at our institution in the department of OBGYN. Canadian medical schools are very competitive and often require more than a competitive GPA, decent MCAT scores, and a long list of extracurriculars. I didn’t do enough research and my mentor recommended I proceed with graduate studies prior to medical school. In order to expedite extra years for a degree I didn’t necessarily care to have, I did my research and went to a Caribbean school that was reputable with excellent match rates into competitive specialties and university programs.

Dr. Lum: Impressive! When did you take USMLE step 1? Tell us about that.
Dr. Mikhael: I took it at the end of my 2 years of basic sciences. I received a 220, which was much lower than my goal.

Dr. Lum: What studying technique worked best for you?
Dr. Mikhael: At first my studying goal was to memorize everything, which is what lead to my lower Step 1 score. I quickly realized that simply understanding the material through powerpoint slides, youtube videos or whatever various resources helped me understand the fundamentals of the subjects I was studying with repeating practice questions over and over again I started to do much better. I think studying smart is much more effective than studying hard. Yes, you need to put in the time, but you can’t let your life be solely dedicated to studying. Implementing a 30-minute work-out (and yes I had to force myself to step away from my books) and maintaining a healthy diet helped me do much better. Getting adequate sleep is absolutely crucial. It’s about keeping focus (quality over quantity). I didn’t have any delays luckily.

Dr. Lum: Can you walk us through how you prepared for the test? Include books used, videos, courses etc.
Dr. Mikhael: I used pathoma, first aid, Kaplan videos, Uworld questions, DIT; I truly believe if I used 1-2 resources with repeated that material over and over again I would have achieved a much higher score.

Dr. Lum: When did you take USMLE step 2?
Dr. Mikhael: I took Step 2 at the end of my 3rd year following all my core rotations at the earliest possible date to leave enough time to receive my score prior to applications. I received at 237 on Step 2.

Dr. Lum: What studying techniques do you attribute to your success on step 2? What books, resources do you attribute to your success on CK and/or CS?
Dr. Mikhael: I used master the boards, uworld and Step 2 secrets exclusively and reviewed the first two mentioned resources 3 times in its entirety.

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 in step 3? Did you require to step a 3 score to match into residency?
Dr. Mikhael: I took Step 3 prior to starting residency. Everyone told me not to study prior to residency but I really did not want to study for this exam while I’m a struggling intern. I didn’t require it for residency at all. I used Uworld & master the boards. I didn’t study too much for this exam but passed without any problems.

Dr. Lum: Did you take either one of these tests more than once?
Dr. Mikhael: No

Dr. Lum: If you did not repeat any tests, can you tell us what to do if someone fails any of the steps?
Dr. Mikhael: If you fail step I highly recommend obtaining a research position and publishing A LOT. Submit abstracts to conferences of the specialty you’re wanting to go into and make many many connections. It’s the only way around that.

Dr. Lum: Did you have a gap year? Or are you a non-traditional student?
Dr. Mikhael: I’m not into taking time off. It makes it harder to go back I believe. I just do everything the first possible date I can to get things over with!

Dr. Lum: Did you have children during this process?
Dr. Mikhael: I did not have children. I plan to have children in my last year of training. I do however think there’s never ever a good time. So if you wish it, just do it if you have the right support system.

Dr. Lum: How do you recommend IMG’s go about securing interviews?
Dr. Mikhael: Audition rotations are the best way of going about it! If a program doesn’t allow IMGs to rotate, in my experience I wouldn’t hold your breath on that program, unfortunately. You can certainly still try but it’s hard to change certain PD’s ways of thinking regarding IMG status (sad but true).

Dr. Lum: How did you match into your residency program? What are your best tips for anyone on matching into residency?
Dr. Mikhael: I did a rotation there and worked harder than anyone. Always the first to show up and the last to leave no matter what! I always tried to see where residents needed help and tried to quickly learn to be able to make their lives easier. The better you make the residents look, the better your chances of matching there. Be personable, professional but yourself. Never argue with a resident or try to show them up/look better than them in front of an attending. It won’t bode well for you.

Dr. Lum: In your observation why are some IMG’s struggling to get into residency? And what can they do about that?
Dr. Mikhael: I think scores play a major factor and lack of research experience. There are minimum step cutoffs many programs have and won’t even see your application if you don’t meet that cut-off. If you don’t have good scores you have to make up for that somehow. Don’t be afraid to approach someone you look up to for mentorship and help! It’s ok to ask for help, you’re not alone and shouldn’t have to figure it out alone!

Dr. Lum: Did you participate in clinical rotations at any US hospital prior to match day? Was this helpful to your match process?
Dr. Mikhael: I did all rotations in the US. I think it helped somewhat. I’m not sure how big of an impact it has on the match, to be honest.

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. Mikhael: I did minimal research, but I also did not have many university program interviews as a result. I relied heavily on my scores and networking at conferences.

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?
Dr. Mikhael: Don’t underestimate what you can accomplish. I did so much more as a resident when I started to believe in myself and thus got into a very competitive fellowship. I didn’t think I was capable enough in medical school and did not expand my CV as a result. I was also too afraid to discuss my insecurities with anyone and kept it to myself. I could have accomplished so much more if I didn’t shut down my own potential.

Dr. Lum: Can an IMG connect with you? If so, how?
Dr. Mikhael: Yes, please! Anytime! @sashamikhaelmd I’m happy to provide encouragement and advise.

 Dr. Lum: If you need a visa (F1, H1B, J1 or B1/B2) for any parts of your training or time in the USA, can you please share important tips on the process? What should everyone attempting this process know?
Dr. Mikhael: I am on a J-1 visa now but am getting married soon. Unfortunately, it’s hard to get out of the J-1 return of service (which doesn’t exist for REI) so am currently working with a lawyer to determine if we can qualify for a hardship waiver as we are trying to conceive.

Dr. Lum: What mantra do you live by?
Dr. Mikhael: Don’t wish for it, work for it.

Tell me what you think.