The IMG Roadmap Series #17: Dr. Vasquez-Garagatti (IM & ID)
  • Today’s guest is near and dear to me. We worked within the same group during my first 2 years out of residency. He quickly became a supportive IMG big brother when I first moved for my current job. We were the only two doctors in the group that were on J1 visas. It always helped to work with someone who understood the process a lot better by experience.

    Dr. Lum: Please tell us a bit about yourself.
    Dr. Vasquez-Garagatti: As you know Nina, I am Raul Vasquez-Garagatti from Lima, Peru. I grew up in a house of healthcare practitioners – my father; a surgeon and my mother a dietician. In 2004 I graduated from Universidad St Martin De Porres with a Doctor of Medicine degree. Right after that, I worked as a sports medicine physician at a sports medicine lab for 3 whole years and took call throughout. I mean back then I was paid like $3/hour and was on call for 24 hrs. Can you believe that?

    Right now, life is much better. I am an attending physician at the University of Tennessee Medical Center, I am also double- board certified In Internal Medicine (IM) and Infectious Disease (ID) specialist. I “dabble” in real estate and entrepreneurship; by being a medical adviser for a telemedicine company that focuses on diabetes prevention. I guess I got that from my mother.

Dr. Raul Vasquez-Garagatti
  1. Dr. Lum: Tell us about your USMLE experience.
    Dr. Vasquez-Garagatti: I took step 1 in 2005 in Lima, Peru at the only Prometric center back then. I was not fluent in English at the time and it literally was like Chinese to me. I think there was “divine help” in my examination room [laughs]. Our results were in the double digits back then and I honestly do not remember my exact score. I believe it was in the upper 80’s. I also took step 2 CK while still in Lima.
    My best advice is not to feel pressured, give it your best shot, don’t fret the small stuff. Timing is critical. You need to plan ahead, set out a schedule and work towards it. If anyone is reading this from Peru, remember that high scores are great but you need to have more to offer beyond your scores. Other parts of your application are great but you need more. Be confident in yourself during this process.

    My biggest take-home point is this: do A LOT of practice questions. When I studied I did 40% practice questions and 60% reading theoretical material. Today, I recall that I struggled through the test because I did not do as many questions as I possibly could have. I strongly recommend that you do questions 60% of the time when you study and theory ( i.e: videos/reading) only 40% of the time. These tests need you to understand the question style and there is so much logic that goes into it, so you need to know that active studying with critical thinking is necessary to score well.

    Dr. Lum: So if you struggled with English, how did you maneuver the USMLE CS exam.
    Dr. Vasquez-Garagatti: I was intimidated by the clinical skills exam but I knew that I had to pass it in order to open the door to my success. I worked extremely hard, sacrificed everything & moved to Atlanta to live with my best friend for 1 month before the test. The key was I found a study buddy. We met on an online USMLE prep forum and practiced with one another. A local friend from Georgia helped me with grammar as well. I studied the cases and became well versed with them. That was the icing on the cake; I knew exactly what questions to ask.

    Dr. Lum: Did you have any gaps in your education? Can you tell us how you spent that time and what the best use of a gap year would be in your opinion?
    Dr. Vasquez-Garagatti: Yes, I took some time off in Peru to study for USMLE step 1 & 2 while continuing to work at a sports medicine/urgent care center. I think if you are outside of the States and preparing for this test, you should start early. It can take a whole year to feel prepared, give it your best shot. But stay clinically relevant during gap years!

    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. Vasquez-Garagatti: Yes, actually I did one observership for 2 months in Cincinnati, Ohio. It was at a program where half of the current residents were IMG’s. While in Peru I contacted two physicians who worked there ( one was from Peru and the other from the Dominican Republic) and they were gracious to grant me the opportunity to observe. I came into Ohio and during that time I spent 6 weeks with them. But the truth is my process was not that easy. After completing the observership, I got an LoR from them. I did not have any guidance, no one told me what I needed to do. At the end of my observership I thought the ECFMG took care of everything. I applied late as this was in January and as a result only got 3 or 4 interview invitations. So at the end of my observership my visa was about to expire and I couldnt attend all my interviews. I did attend the interview at the program I observed at and right after that I had to leave. I left without knowledge of the NRMP/Rank Order List (ROL) and its respective deadline. Looking back, I remember my friend called me in Peru on the day the ROL was due date to ask if I had completed mine and I had no clue what he was referring to. I am eternally grateful to this friend of mine who is now a pathologist in TX. I would have missed my shot if I did not submit my list on that fateful day.

    As for Infectious Diseases; I pre-matched. Meaning I didn’t have to go through the NRMP match for ID. Here is how that happened; I always thought I was going to just be an internist who was interested in infectious diseases. But then during training, I applied for an away rotation at the University of Louisville. This was during my 2nd year of Internal Medicine residency. Spent 6 weeks with them and after publishing a few posters during that time, I was offered the opportunity to come there for fellowship training. You bet I took them up on it! So yeah research experience is a good segway into some academic programs.

    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. Vasquez-Garagatti: I will advise anyone reading this later to understand that this pathway is a humbling experience. I was not humble when I first started, but I learned real quick that a smile goes a long way. Be open to learning something new. You do not know everything. Do not compare yourself with others. It’s like the plague to me when I see IMGs comparing scores because that just makes you feel bad. Do not let other people’s successes blind you on your path. The biggest reward in medicine is that you heal people and you get paid for that. What a gift!

    Dr. Lum: What is your mantra for your success thus far?
    Dr. Vasquez-Garagatti: Be grateful for what you have every day, be grateful for your path as an IMG even if it is hard. On the other side of that difficulty lies is a really great career. Again: how many other careers heal people and get paid well? Not a lot. Also, I choose to remember that as a physician, I am inherently good at so many other things. I advise you to explore that mindset. Embrace mistakes; you learn more from your mistakes than you do from your awards.
Dr. Vasquez- Garagatti

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