Episode Transcript
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Speaker 1 (00:01):
Hello and welcome to
another episode of the Med
School Minutes podcast, where wediscuss what it takes to attend
and successfully complete amedical program.
This show is brought to you bySt James School of Medicine.
Here is your host, kaushik Guha.
Speaker 2 (00:19):
Hello everyone and
thank you for joining us on
another episode of Med SchoolMinutes, where we talk about
everything MD related, with thefocus on international students,
specifically students from theCaribbean.
Today we have Dr Yusuf Majid,who is the Chief Academic
Officer of the South TexasHealth System, as well as the
ACGME Designated InstitutionalOfficer for South Texas as well
(00:43):
designated institutional officerfor South Texas as well.
We are going to be talking alittle bit about the perception
of Caribbean medical studentsand how it's changed since he
started his career nearly twodecades ago to today, where we
are talking about appointing aCaribbean medical graduate as
(01:04):
the Surgeon General of theUnited States of America.
So this is truly an issue ofpride for all Caribbean students
and all IMGs across the board.
Without further ado, let'swelcome Dr Yusuf Majid.
Hello, dr Majid, thank you somuch for coming back to our
podcast once again.
(01:25):
It is always a pleasure.
So, but for viewers who aren'tfamiliar with you, can you let
us know?
Can you tell us a little bitabout your background?
Speaker 3 (01:35):
Sure, my name is
Yousef Majid.
I'm an MD, graduated in 2007.
All my life dedicated tomedical education.
Since then, and even a littlebit before I have graduated, I
(01:59):
started with Kaplan, downtownChicago, trying to fill the gaps
and make it as easy as possiblefor medical students to have a
comprehensive one-stop andfocusing on the main important
points to finish their USMLEsand move on with their lives.
From there I grew up to have myown program, usmle review, and
(02:24):
then we used to have about 300students to 400 students a year.
We grew up very rapidly and fromthere on I got involved more in
the hospital setting, workingon discharge committees and I
worked on the patient care,trying to see again how we can
(02:46):
bring this gap and bridge it andhave a vertical integration
from starting medical schoolsall the way to residency Okay,
okay, and then in between tryingto see, okay, where are the
deficits?
And try to fix them up.
Recently I have hired as a DIOand chief academic officer for
(03:09):
South Texas Health System.
I've been in this position forat least three years now.
Within the three years, we haveestablished three residency
programs under my leadership,and that's family medicine
complement of 30, and internalmedicine complement of 60,
emergency medicine complement of30.
(03:30):
Currently working on surgeryfor 2026, and then we're working
on neurology for 2026, andwe're working on psychiatry for
2026, as well as at least threefellowships for 2025, starting
in 2026 as well.
Speaker 2 (03:52):
Wow, that's excellent
.
So at St James we have anickname for you.
We call you Dr Mountain MoverMajid, and I think that's very,
very appropriate.
That's phenomenal.
Going back to your experiencewhen you started out, which year
did you start out in Kaplan?
Speaker 3 (04:10):
About 2006.
Speaker 2 (04:12):
2006.
Wow, so you've been in theindustry for nearly 18 years now
.
Speaker 3 (04:19):
Correct.
Speaker 2 (04:22):
And that's not nearly
more than 18 years actually.
So you know you're an IMG aswell, is that right?
So one thing I do want to talkabout a little bit is the
impression that people haveabout IMG, specifically
Caribbean medical students.
When you started, what was thescenario or landscape like for
(04:47):
IMG specifically, specificallyfor Caribbean students?
Speaker 3 (04:51):
So there are two
things.
For my undergrad I went toWayne State University and then
the question says like okay, howdid you even hear about the
Caribbean medical schools Atthat time?
They were new to us.
You're talking about 2002.
2002 Caribbean market it wasn'tvery popular and at the same
(05:16):
time this is when the DO schoolswere starting also to open
their classes.
So there was the Caribbeanschools and DO schools but, with
all due respect, we were notvery knowledgeable about DO as
well as the Caribbean.
So to us it was kind of likeequal.
(05:37):
I don't know much about DOschools, I don't know much about
Caribbean schools.
And then it was a word of mouth.
Somebody would come and thenthey're getting residency here,
says I went to this school, andthen somehow we follow their
lead without knowing the ins andouts.
And really, what does it takefor you to go to a Caribbean
(05:57):
school, at least back then?
With over time, caribbeanschools has grown in numbers and
DO schools has grown in numbers.
The DO schools have built areputation, obviously being in
the US, they have the support,the resources etc.
Which was regulated also by theLCMEs Accreditation Bodies,
(06:22):
whether it's allopathic orosteopathic school.
So the standards are there.
Unfortunately, with theCaribbean schools it was kind of
like an open market Somebodycomes in, they had no knowledge,
no idea.
They look at it at that timefrom a business point of view,
but students did not know thatthis market is built on a
(06:44):
business, so over time itcreated a lot of stigma.
Instead of keeping it regulatedand making it really meet the
benchmark that the US especiallymost of the market there is US
students it was kind of likeopen-loose you will go in there,
you take a building, you open amedical school, no
(07:07):
accreditation, or it shuts down,et cetera, and then students
end up being loose.
So Astegna has built aroundthat that if you are a Caribbean
student, you go there, you cansit on the beach, get a degree,
come back here, and this is, ofcourse, not true, but it was
harshly judged based on the manyschools that it's been opened
(07:30):
and they did not meet thestandard of the US, especially
if you're sending students backto the US.
Speaker 2 (07:37):
Right.
So I mean, let's talk aboutthat perception a little bit,
about sitting on the beachsipping Mai Tais and then going
through medicine.
So that's most certainly nottrue, because every US graduate
and every Caribbean graduate hasto take the exact same exam.
Is that right?
Okay?
(07:59):
And even and this is more sonot true now, because people who
started in the early 2000s arein pretty prominent positions of
leadership in medical education, like yourself.
So, for example, now do youthink, considering you started
(08:20):
in 2006 versus anybody who'sgraduating from a Caribbean
medical school and I must sayaccredited medical school, right
, I mean, or do you think anyCaribbean school has the same
perception across the board?
Speaker 3 (08:32):
No, so being
accredited, yes, but finish your
question first and then.
Speaker 2 (08:38):
So the question I'm
trying to say is somebody who
graduated in 2006 from, say, stJames St James was around in
2006 versus in 2024, 2025, doyou think that they have an
easier time now or a harder timenow, or it still remains the
(09:01):
same?
What's your opinion?
Speaker 3 (09:03):
That's good.
So I myself, I oversee theprograms.
I see how the program directors, what they're looking for, et
cetera, and ranking overall whatwe look for, et cetera.
So I can be fully honest withyou.
Today it's easier because a lotof the schools who could not
maintain accreditation in theCaribbean have shut down.
And not only that maintainaccreditation in the Caribbean
(09:26):
has shut down, and not only that.
Korean students have provedthemselves coming back home and
over the time since 2006 tillnow, a lot of them are quite few
are practicing physicians.
What I've said, that formula is,if you look at the osteopathic,
allopathic, admission andgraduation and getting a job
within first tier versusCaribbean schools as a whole,
(09:48):
and that's the problem they'rejudged all in the group, one
group.
So people here don't know thatthis is St James, this is this,
this is that these are ourcritic schools, which we call
them tier one, right, but thenthey look at them as Caribbean
medical school.
The same thing.
We are judged.
We look at the schools in theUnited States, american medical
(10:12):
schools, so it's the sameconcept.
We both judge each other.
We stereotype, saying this isan American, but we do say this
is Caribbean, withoutdifferentiating.
We don't go into school byschool, say this is Caribbean,
without differentiating.
We don't go into school byschool so that students have
contributed to decreasing thatstigma to a certain extent by
working so hard, by achievingtheir goals and moving up in the
(10:37):
chain to take positions backhome in the United States and be
able to prove.
Yes, I went a couple of yearsto the Caribbean school, but
that stigma that you're thinkingof me, I have a less quality of
education, it is not true.
But if you look at it as awhole, the stigma is still there
(10:58):
.
Why?
Because, again, the admissioncriteria versus how many
students graduate versus howmany, gets matched in the first
year for the whole entireoffshore, not only specifically
for one school.
Speaker 2 (11:14):
Right, right, so, and
again, I mean, I do want to
point out that for people likeyourself having and I'm being an
IMG, all of you are inpositions of power, I deal with
a lot of program directors, alot of these program directors,
and I would go out on a limb andsay actually, uh, the majority
(11:36):
of the ones that I deal with, atleast, are actually imgs
themselves, and they'vementioned and and you yourself,
dr maj Majid, have taken and notjust now, but since you've been
dealing with students for somany decades have dealt with
American students, have dealtwith Caribbean students.
What is your impression ofCaribbean students who are
(11:57):
coming out from, say, accreditedprograms and going through the
step one, step two and going toresidency?
What is your experience?
Are they better, are they worse?
Are they the same?
Are they at par?
What's your thoughts on that?
Speaker 3 (12:11):
So there's a pros and
cons and the issues that we
face today are different than2006 and 2010.
In 2006, 2010, we all worked sohard and we learned how to say
the yes, sir.
Uh, very respectful for ourphysicians, uh, we will.
We will come in earlier,leaving after the physician, or
(12:32):
the physician will have to kickus out.
So just go home, go rest, etcetera.
Uh.
But at the same time, we wereworking so hard but we did not
have the resources we have today, because these Caribbean
medical schools were also new inthe market.
There, they were learning thecurve as well how to meet the
accreditation body and what isit that the student need in
(12:55):
order to excel on the steps.
While today we do have theseresources, everything is online,
we have comprehensive libraries, all these programs, etc.
The generation has changed.
We have entitlement and thereis misconception I go in, I
don't care, I'll just pass myexam and I'll go in.
(13:18):
And that's not true.
So the personalities haschanged since then, even though
resources has changed.
It was less resources back then.
We had to work harder, now wehave more resources and support.
But back then I believe the waywe presented ourselves is it
was much better, more respectful, less entitlement, and again we
(13:43):
worked very hard.
Less entitlement, and again weworked very hard.
Today you talk to somebody whosays can I go to lunch?
While your physician is stilltheir head is in the foot of the
patient trying to figure it outPhysician looks and says yeah,
sure, go ahead.
And then you come back and saysoh, it's 4 o'clock.
Can I go home?
I need to study.
(14:04):
You see, there is that and I'mnot saying only Caribbean
schools, but maybe because Ideal a lot with offshore medical
schools, I see that.
Speaker 2 (14:14):
Okay, so as far as
that perception is concerned and
you know, and again, we have alot of students in South Texas
and as well as other places andyou've been dealing with not
just St James but severalCaribbean medical schools, I
know you deal mostly with notmostly almost exclusively with
(14:35):
only accredited schools Americanstudents, do you think that
what you just described isreally just a generational thing
, as opposed to?
(14:55):
I went to the Caribbean, I wason the beach and I drank a lot
of Mai Tais or, passing my exams.
Speaker 3 (14:58):
What are your
thoughts on that?
So that stigma has came down,but it's not okay.
So again, it also depends onthe program, the program
director, how new they are, howlong they've been running the
show where they graduated fromas well.
So in our programs we do haveimg program directors and we
have amgs program directors andhannah, and I'm gonna be honest
(15:21):
with you, the stigma is there,but it's way much less so.
Now, your scores, your attitude, it makes a big difference.
Speaker 1 (15:30):
So here's what we
look for.
Speaker 3 (15:32):
We give priority to
AMGs and we won't hide this
because but we don't want tostigmatize also our program
we're very careful.
For example, when we say AMGs isosteopathic, allopathic, they
take a priority.
We would like to have a biggerportion or the majority of
portion from there we would liketo have our.
(15:54):
Second is that formula is foroffshore medical students versus
totally foreign medical grads.
Why offshore medical studentsfrom accredited school?
Because they come and theyrotate two years in the States.
They have done their undergradyear.
For the most part they dounderstand the culture and we
have noticed not necessarilyhere, but I was in different
(16:19):
states where totally thought amedical grad with no US
experience, not knowing theculture, you feel like a fourth
year medical student.
Sometimes they can operatebetter than them and I want to
say, sometimes most of the part.
Why?
Because their focus overseas,in different country, is totally
different on how to approachthe patient, care and the
(16:40):
quality and creating a space andrespect.
All this here is given.
I don't have to teach you that.
Speaker 2 (16:47):
Right, I got you.
Speaker 3 (16:48):
So our second in line
is the offshore medical school
and third in line will betotally foreign medical grad.
Now when we look at theoffshore, which is the caribbean
schools, we look as that theydo their undergrad here.
That helps, I mean, it's notwell the end of the world, but
(17:11):
what's important to us.
Have they rotated in the unitedstates.
That makes a big difference tous.
Okay, because we noticed thesetwo years of rotations.
It does make a huge differenceversus someone who did not
rotate at all in the UnitedStates, okay, but we look for
also scores, attempts, a lot ofrecommendations and their
(17:36):
connection to the area, which isalso something very important
to us.
Speaker 2 (17:42):
Are they?
Speaker 3 (17:43):
for us Texas.
Are we in Texas?
Are you in Texas?
So yes, ok, good, how close areyou to us?
Have you rotated with us before?
Do we know you?
Speaker 2 (17:54):
And that's, that's a
big assurance us before, do we
know you, and that's a bigassurance.
Okay, so I do want to point outthat our president, donald
Trump, he's nominated DrNeshawat as Surgeon General of
the United States.
I think this is a big deal,because she is a foreign medical
graduate, she is an IMG, she isfrom a Caribbean school.
(18:18):
Do you think that this sort ofan appointment would potentially
change perceptions, if theyhaven't already?
Speaker 3 (18:29):
Eventually, if you
know how to use it, the same
thing I'm telling you.
Like when first Caribbeanschool started, nobody knew
anything about them, good or bad.
It's kind of like if there is astigma, we brought it to
ourselves and the problem is itwasn't up to one person to
decide, because we don't haveregulatory that for every
(18:52):
Caribbean medical school thatmust basically operate under
these criteria.
Same thing for Dr Neshawat.
And what does it do?
Don't forget Dr Neshawat.
Is it unusual?
It's unusual for such positionto be appointed for a fan of
medical grad or IMG, which ingeneral is given to people who
(19:16):
are qualified as an AMG.
But Dr Nashawat is more than aqualified person.
If you look at her history, shegrew up in New York.
She did her undergrad, Ibelieve, in New York and she did
.
Is it New York?
No, yeah, new York.
And then she went two years toAUC basic sciences.
(19:40):
She came back with herrotations in the States.
So these are the positive stuffI was just telling you about
earlier.
She has followed all thesefootsteps and she has done her
residency in Florida.
So, beside that, she's not youreveryday doctor.
She was involved in politicslong before she was appointed.
(20:01):
She was given opinions to FoxNews, so that put her right
there, above the benchmark for aregular physician who I just
have an MD degree.
It doesn't matter, but do youreally have the qualifications?
So Dr Neshawat has thatqualification.
(20:22):
Is it unusual for suchphysician as a surgeon general
to be held by a foreign medicalgrad?
Yes, but it's not.
I don't see it as like oh myGod, like wow, now let's go
ahead and would the stigma godown a little bit?
Yes, but again, it depends onwho's watching Dr Neshawat and
(20:47):
who's not.
So it depends on what side ofthe politics are you in as well?
Speaker 2 (20:53):
Well, I mean, that's
true.
But, politics aside, it almostseems like and in my experience
this seems like, you know, as Isaid, I speak to so many program
directors, including yourprogram directors as well as you
, as well as people inleadership Seems like the only
real stigma typically comes frompeople who don't know anything
about medical education.
(21:14):
That's what I've typically seenFor most people.
Every time I would talk to aprogram director, they'd say
well, have they passed step one,step two, as you said, number
of attempts?
Where have they done theirrotations?
What is the temperament of thestudent If all that checks out?
99% of physicians don't reallycare where you study, because
(21:36):
the USMLE or the medicallicensing examination seem to be
the great leveler.
Doesn't matter where you went.
You could have gone to Timbuktu, for example, and done medicine
, but if you come back to theUnited States, you took the test
, you'd got a good score.
You passed in one attempt.
As a result, you're at par withbasically any American student.
(21:57):
However, this perception thatwe're really talking about it
seems to entirely reside withnon-medicos, as they call it,
the average person on the street.
You walk into your corneredbodega and they will talk about
you know, people have opinionson everything.
So they're talking aboutmedical education and they'll
(22:18):
say that, oh yeah, caribbeanschools or IMGs are really not
at par.
But in my opinion, it seemslike the people who know
anything, like yourself orprogram directors, they
definitely know how to parse outthe information.
And at the same time, it alsoseems like from what you're
(22:39):
saying that just because they'refrom an AMG does not
necessarily mean that it's aslam dunk and they're going to
be accepted into a residencyprogram.
But keeping that in mind, doyou think so?
For example, I mean, last yearwe had, as a school, we had a
(23:01):
record number of students.
We had 117 mansion to residency.
That number is just going up,up and up.
Considering everything that ishappening and Dr Neshawat
whether she gets confirmed ornot, I don't necessarily know,
but her very appointment do youthink it is a moment of pride
(23:24):
for Caribbean medical schools?
Speaker 3 (23:27):
It is, but I feel
like it's more of a unilateral
moment of pride.
It is a big deal for AUCobviously because they're gonna
send it.
Says like, wow, auc, would theCaribbean school look at it?
Says, oh my god, look at it.
Yes, but it doesn't really,truly, in reality, doesn't make
(23:48):
a difference.
That's the.
Speaker 2 (23:51):
I mean, does it I?
I don't know, do you think itmaybe?
Speaker 3 (23:54):
it will decrease the
stigma again a little bit, but I
don't think it will erase.
Everyone at the end of the dayis held to the standards A lot
of our students are reallyconfused about transitional year
.
Speaker 2 (24:04):
They don't really
know what that means.
Can you let us know what atransitional year really is?
Speaker 3 (24:11):
Yes, sure, but before
I go into this I just want to
let you know, sure, but before Igo into this, I just want to
(24:32):
let you know, even though I'm anAmerican Lebanese IMG, my
undergrad here, two yearsoffshore, two years technical
rotations here, been here is notjust because, let's say, dr
Nisho is an IMG, we're going tostart giving free passes.
Hey, imgs, come over here, hereyou go.
No, so at the end is when welook, we oversee the whole
entire program and what'simportant to us maybe the other
side, the students, might not beaware it is important for us to
(24:56):
build a strong program on anational level, passing the
board 100%, because without thisthat will hinder the quality of
the program and then we willput on probation and we will
lose the program.
So we are held at a benchmark.
We look at people how manypeople are we going to train and
how many are we going to staywith us?
(25:17):
This is a very importantquestion for us because we are
building these residencyprograms to have a better
quality care for the communityand if we cannot achieve that at
the end, we have failed.
So there are so many metricsthat the programs overall, each
one comes with authority butalso with responsibility.
(25:39):
So it is a lot that we look atbehind the scene when we are
looking at candidates.
That's why we look at thetiniest, like if somebody coming
from the Midwest AMGs or aforeign medical graduate here in
the Valley.
I take probably this one herebecause I know I don't have to
groom them and teach them theculture of the Valley.
(26:02):
They're very comfortable.
I know they will stay with us,knowing that their parents here,
they grew up here.
You see there's a lot of.
Speaker 2 (26:10):
There's no set like
one plus one equal to Right
right, and I think it's veryimportant to highlight that a
residency program, at the end ofthe day, is still education.
A lot of people mistake that,just because they're getting
paid, it's a job.
Yes, it is a job, but at thesame time, I know that you have
accreditation responsibilities.
You have responsibilities tonot just to the student that
(26:34):
you're taking, in making surethat they learn what they're
supposed to be learning.
They have requirements that youneed to fulfill and eventually,
you also have a commitment to,as you mentioned, the community,
because at the end of the day,you are producing physicians to
essentially ensure that thereare no.
In the bigger scheme of things,there are no healthcare deserts
(26:57):
in the United States as such,or at least in the areas that
you're operating.
Speaker 3 (27:02):
With all this that
you just said, a perfect match
list would be if they all matchin the program.
It would be, I would say, 60%to 80% AMG, 20% to 40% offshore,
with diversity.
(27:24):
Right, that will be a perfectranking list if you will be able
to match them all.
So not only we look at thatwhen it comes to diversity.
Here you have to diversebecause you don't want to
stigmatize the program, as thisis only AMG.
So a US citizen who took a loanfor a quarter of a million
(27:49):
dollars coming back home, theyhave nowhere else to go.
You don't want to stigmatize.
It says OK, you're going to beflipping burgers at McDonald's.
That's not right.
Also, don't forget every fourstudents that don't match who
went offshore and they haveloans.
They make up $1 million andthis eventually is going to be
written off if they don't end uphaving jobs and the taxpayer is
(28:13):
going to end up beingresponsible for it.
All this, at least in the backof my mind, individually, is
taken in consideration.
That's why I said number one.
I would like to have the AMGs.
If I could have 60% to 80%,perfect.
If I have 20% to 40% of theoffshore who are US citizens
coming back home.
I'm not talking about totalfarming.
(28:34):
That would be perfect.
Why?
Because eventually I'm helpingalso the citizens of this
country to pay back their loansand then establishing a family.
Also, we look at diversity.
I don't want anybody to saythat this is an American
grad-only program.
I don't want anybody to saythis is only a Caribbean program
.
I don't want them to say thisis only affiliated with this
(28:56):
medical school in the UnitedStates.
Versus that school we want tostay as neutral as possible.
It is in our interest to do so.
Speaker 2 (29:05):
Right, right, and I
do want to point out like,
within the residency, you knowthe NRMP application process
there are some programs thatjust very clearly say that if
you're not an American citizen,we won't even consider you and
whatever the requirements of theprogram are, there are certain
(29:27):
programs that focus entirely onAmerican citizens, irrespective
of whether they went to aCaribbean school or a US school,
and I believe one of yourprograms tend to be like that If
you're an American citizen,that's when you're coming in, or
a permanent resident, not justan American citizen.
Is that right?
Speaker 3 (29:45):
Correct.
So we don't sponsor visas.
We do have enough applicantsfrom the States to fill our
programs every year.
We have people who come rotatewith us.
They signal us as gold and youknow there's so many signals
nowadays with the new platformthat you can send to our program
.
So all ways in, but we doabsolutely look at US or how do
(30:11):
you say it?
Rather than US citizen workingeligibility in the United States
.
Speaker 2 (30:19):
Okay, awesome.
Going back to the question ofthe transitional year, what is
the transitional year?
Because I get that a lot fromstudents.
They're like why should I applyfor a transitional year?
I mean, it's so uncertain, Idon't know what's going to
happen after that.
What are your thoughts on that?
Speaker 3 (30:36):
So transitional years
could be the best thing that
happened to you in your life andcould be the worst thing that
happened to you in your life.
Speaker 2 (30:43):
Oh, wow, okay, Please
elaborate.
Speaker 3 (30:47):
And I bet you, a lot
of people don't know this
information.
How is it first beneficial?
So a transition year is created, mainly for programs, what we
call advanced programs, programswho are, let's say, four years,
but they need a transitionalyear to begin with.
So they go through, let's sayOB-GYN, let's say neurology, but
(31:12):
the hospital itself, they havethe neurology program.
It's total, let's say, of fouryears including the transitional
year.
A transitional year, usually ayear that you work one to two
months in each department.
It's kind of like a jack of alltrades One couple months at the
emergency, one, two months onthe floor in the IM, one to two
(31:37):
months on the emergency, one,two months on the floor in the
IM, one to two months in thefamily.
It depends on which residencyprograms in your institution has
sponsored that transitionalyear.
So if we say IM, the programdirectors and the faculty of IM,
family and emergency sponsoredthat transition in the year.
Obviously they're going to endup rotating at all these sites
(32:01):
and there is a schedule in there.
Some of them will be outpatient, couple of elective research.
Everything is the same as anyfirst year.
What can you do with this year?
Why?
This is now the good part wesaid that could be the best
thing happened to you.
Yes, normally if you go into aprogram who is an advanced
(32:21):
program, they don't havetransitional year but they do
have the actual program.
Let's say neurology in state X.
You apply in the match and thenyou get accepted but they say,
okay, now go find your owntransitional year, right?
So that same candidate appliesseparately in ERAS for a
(32:43):
transitional year and they askyou in ERAS, have you been
accepted somewhere else?
You say, yes, I've beenaccepted at so-so hospital in
this state, but I do need thattransitional year.
We prefer to give thattransitional year to this person
.
Speaker 2 (33:01):
Okay.
Speaker 3 (33:02):
Now, why is that?
Why do we prefer to give it tothis person?
Because it is ourresponsibility and this is our
nightmare here, as a program tohelp people who went into
transitional year to move up toPGY2.
Speaker 2 (33:15):
And in our program we
don't have the means to out up
to PGY2.
Speaker 3 (33:17):
And we don't have in
our program.
We don't have the mean to takeon to PGY2, because all our
programs are categorical whichthey start from day one.
They have all the years theyneed.
We don't need, we don't have aprogram standing alone and it
needs a transitional year.
So for us that's a program.
It's a nightmare If this persondoes not have a PGY-2 somewhere
(33:41):
lined up.
So if you come, in with.
Pgy-2,.
We would love to have you, Ifyou don't it's going to be a big
question mark.
Now this is the good side, thatbasically it could be the best
thing happen to you in your lifebecause you have matched into
an advanced program and you'remissing this year.
And here we are, we're lookingfor someone who matched in an
(34:01):
advanced program and they needthat one year.
So it's kind of like workingfor both of us.
Now you have your PGY-2.
I don't have to worry aboutsupporting you finding a
residency as a program.
You just need my transitionalyear Perfect.
Now how could it be a nightmareIf you do transitional year and
(34:22):
you have not secured PGY-2, andthen you decided the following
year to go ahead and apply for aprogram, that program.
There's potential this programmight lose funding for that year
that you have done.
Oh, okay.
So you might stigmatize yourselfand a lot of programming might
(34:45):
qualify for them.
They want it to take you, butthen they say that you already
exhausted one year of fundingfrom what you're eligible for.
I give it to you as a differentexample.
Let's say I apply for familymedicine.
I get in, I do one year and Iget out.
(35:08):
I go and I switch programs.
I'm lucky, I get.
I go into surgery.
It's five years.
Now what I've been approved todo by the CMS is a three years
residency.
That's what they're funding.
I have utilized one.
I have two years left.
If I go into surgery, they'regoing to pay the first two years
(35:29):
and the next three years has tobe coming from the hospital
target okay, so is it verycommon for students to get
advanced placements in PGY2 inthe first year that they're
applying for residency?
yes, so through ERAS, becausenow you have all the what do you
(35:53):
call it?
All the hospitals, all theprograms in front of you.
Once you match into Awan, allwe need is basically yes, I have
matched into this program, then, hey, transitional year is
yours.
And a lot of time we try tobuild relationships with
programs who have advancedprograms and they need a
(36:13):
transitional year.
That will be the easiest thingto do.
Speaker 2 (36:17):
Okay, so currently
does your program have any
tie-ups or memorandums ofunderstanding or anything like
that with any program that mighthelp a potential transition
leader when you do start theprogram?
Speaker 3 (36:35):
so so I I don't have
an official memorandum of
understanding, uh fortransitioning, and I don't think
should be one, uh, to make itfair, should be fair for
everyone.
But we could have anunderstanding without the
memorandum.
Speaker 2 (36:50):
Okay.
Speaker 3 (36:50):
So I do.
Recently came acrossoccupational health residency.
And from what I noticed, fromwhat I understood also, is the
biggest hurdle for the peoplewho are applying for such
program was the transitionalyear.
(37:11):
They needed one year and theoccupational medicine.
I don't want to say they'rehaving a hard time finding like
having their candidates matchingin a year, but it's not as easy
.
And so there are two potentialcandidates we're talking about.
They said if we are able tosecure transitional year for
(37:34):
them, then definitely these willbe on a top list for us.
Of course they will go throughERAs like anybody else and they
will apply, et cetera, et cetera, et cetera.
We'll make sure we qualify forour transitional year and they
qualify for their program yearand they qualify for their
program.
So, yes, there is kind of likean understanding and would like
to collaborate with moreprograms if possible to offer
(37:57):
these transitional years to helpthe students be able to secure
a full program without worryingabout the transition year.
Speaker 2 (38:08):
Okay, so tell me a
little bit more about this
occupational medicine residency.
I've never really heard of thatbefore.
What, what is that?
Speaker 3 (38:16):
the same thing.
It was new to me.
Uh, with full honesty, and okay, I haven't done my full due
diligence on it yet, I've beenbusy with preparing for programs
for next year, but it is on theagenda to look more.
But here's what I understoodfrom a nutshell.
Being an occupational medicinephysician, you go through ERAS
like anybody else.
(38:36):
Mainly you work.
Obviously the name gives it upoccupational medicine.
I see that you're working forGM Ford Microsoft so these big
companies, and then the focusmight be, yeah, these big
companies, and then the focusmight be the track.
I'm assuming they could be likean OSHA, hipaa, et cetera.
(38:57):
They'll be more knowledgeableabout these subjects as well.
I myself work in GM when I wasa student going to college, so I
do remember having our ownmedical center, a few or many
medical center, so anythinghappened that you go there.
(39:19):
That physician is familiar withwhat goes on.
What are the common injuriesthat happen?
Something went into my eye atthat time.
Right, I see it could be fromwelding a car.
Speaker 2 (39:33):
Right right, right
right.
Speaker 3 (39:35):
So right away they'll
be able to fix you up.
It depends on the resourcesthey have.
If they don't have the resource, they send you immediately to
again to an occupationalphysician contracted with them,
which they have more resources.
So you are a physician, you'rea doctor, you're practicing.
You're a doctor, you'repracticing, just your setting.
I'm assuming it's not thetypical setting that we heard of
(39:59):
.
You go to the clinic and yousee everyone that walks in.
You're mainly dedicated forthat particular company.
Speaker 2 (40:11):
And these are the
companies.
So one of the biggestcomplaints with medicine is that
the hours are really long, butthis almost sounds like there
might be a possibility that thisis essentially a 9-to-5 job for
a doctor.
Is that right?
Speaker 3 (40:23):
Could be.
Could be and the resources andthe money they have at that
particular company, right?
Okay, so when it comes about,could it be nine to five?
Could it be?
this depends on the supply anddemand, depends where you are
okay if you have resources thatthey need and they can't find it
anywhere else, obviously youwill have a card to bargain and
(40:44):
say that's what I want andwithin reasons right, uh, okay.
But if you don't and the areais saturated, you are in a big
city in California, in Chicago,etc.
You demand something thatdoesn't work for us.
It says okay, next in line.
That goes to everyone, I guessright.
Not only that.
Speaker 2 (41:05):
That's very
interesting.
So what about earning potential?
You did talk about salary.
Do you think that theseparticular students have, or
these particular residents onfinishing residency?
Do they have, the potential toearn as much as a person who
finished internal medicine orfamily medicine once they
graduate?
Speaker 3 (41:22):
Absolutely.
It depends who you compare themto, right, they might make more
money.
So if you send me in a bigbrand name company who have the
money, it becomes peanuts tothem, right, they just need the
commitment, etc.
If you compare those to afamily medicine or internal
(41:44):
medicine physician in a big areathat is saturated, they go by
the average, pay maybe a littlebit more.
I give you an example InChicago, if you go to a brand
name hospitals in general Idon't want to say this is a
stigma, but you end up beingpaid less.
Why?
I've heard that yeah, and yougo up a little bit in the
suburbs, you might make twice ofthat.
(42:05):
Just go to an area that'scalled like Sandwich, rockford,
sandwich area or whatever theysay, almost like sandwich area
or whatever they say like almostdouble.
I'm telling.
Speaker 2 (42:13):
Yeah, no, I've
definitely seen that.
I mean people gettingpost-residency, getting jobs at,
say, within the city city ofChicago, versus getting a job at
Rockford, which is a littleover an hour away from Chicago.
And you're right, that salaryjump was insane.
I mean I would totally do that,drive, yeah.
I'll tell you another examplethat salary jump was insane.
I mean I would totally do thatdrive, yeah, I'll tell you
another example.
Speaker 3 (42:35):
That's in Illinois as
well.
Because I lived there for along time 16 years was enough
for me to understand the market.
An ER physician in the city ofChicago might make less than a
family medicine holding an ER orhandling an ER in the suburbs
(42:56):
in a smaller community.
Speaker 2 (42:59):
Right.
So why is this not?
You know, like everybody youtalk to, they want to do family
medicine, internal medicine, obsurgery, pediatrics.
Why is this occupationalmedicine not very well-renowned?
Speaker 3 (43:15):
I think it's lack of
education.
On marketing as well.
It's the same like you and I.
We just said together that Inever heard of it before.
I said my info is limited,right, so it's more of marketing
and education that falls on theshoulder of the hospital that
(43:39):
is holding such program tomarket more and educate people,
and on the program director andthe faculty to market out.
It says, okay, what are thebenefits actually of
occupational medicine?
To me it sounds great.
Are the benefits actually ofoccupational medicine?
To me it sounds great.
I do remember interacting withoccupational medicine physician
(43:59):
in GM at that time back in 1994or 5.
But again, I, never knew thatthis is an occupational medicine
.
Five, but again, I never knewthat this is an occupational
medicine.
The next thing I know aboutoccupational is normally they
let's say big companies whodon't have that physician on
site et cetera, and they don'thave the resources to evaluate
(44:24):
workers' compensation et cetera,they might end up contracting
with urgent care that is closelydown and so if something
happened to somebody at workthey can obviously go down the
street to the urgent care to betaken care of and they could be
(44:46):
on some sort of a contract ormaybe I don't know how the
billing goes exactly.
But those who don't have, let'ssay, a big car dealer right,
food, whatever, there's a stripof car dealers and there are big
companies BMW, usually you findthem all on the same street,
right, right?
Speaker 1 (45:06):
right.
Speaker 3 (45:07):
BMW, volkswagen, ford
, et cetera, range Rover, these
employees, they get benefits andthey need to be taken care of.
If something happened at work,who's going to take care of it,
I see.
So either they will have aphysician there maybe it will
cater to all these guys aspossible it depends on the
number or they end upcontracting with someone down
(45:30):
the street who have an urgentcare, a family medicine, for
example.
Who?
Speaker 2 (45:34):
have an urgent care,
a family, medicine for example.
Yes, wow, this is so awesome.
I never really realized thatthere would be residency
programs that I wouldn't knowabout.
That's very, very interesting.
So, but, dr Majid, thank you somuch for all that information.
I hope what we talked abouttoday really was an eye-opener
(45:57):
for some of our audience andviewers, and this influences
them and maybe even influencesthem to make different career
choices based on some of theinformation that you gave us.
But, once again, thank you somuch for your time.
But once again, thank you somuch for your time.
And one parting question.
This is when you were talkingabout Dr Neshawat.
(46:18):
Is there any point where youguys actually crossed paths at
any point?
I don't believe so because therewas a lot of familiarity with
which you talked about her.
Speaker 3 (46:33):
Yes, her background
is originally from Jordan.
I see so we do have a MiddleEastern background both of us
but definitely I want tocongratulate her with all this
that I don't know her personallyon that position and it was
well deserved.
Based on her background she'snot new to this position.
(46:55):
I think she qualifies more thana lot of people who are
probably coming from any medicalschool.
I'm not going to name any ofthem, but in general.
it's well-deserved anddefinitely she will do a great
job.
I hope that, like me myself, beable to, with this position,
(47:15):
decrease the stigma on IMGs, andI hope the IMG schools as well,
in general, and the ministersof the island in general,
realize that bringing a badapple can really mess up the
whole entire box.
Be more regulated, respect theaccreditation bodies, why
(47:36):
they're there and live up to thebenchmark where you want the
students to practice.
If your students want to cometo the States and this is the
market you're targeting pleasehave the resources for them and
make sure that you meet thesebenchmarks.
If they want to go to the uk,same thing I would say look at
the uk benchmarks and make surethey qualify to be there.
(47:58):
Otherwise, I want to encourageall your students, especially st
james school of medicine.
We're very, very happy andpleased to have you here.
They have created a pipelinefor us and then on the first
patch we take one to twostudents.
It does make a difference to ushow hard they work, because
that and then next year we say,okay, you know what this is
(48:20):
really working.
Know that every student comesinto any program and I'm telling
you this is under the tablethat where you come from your
school, you could leave a goodor bad stigma, regardless of
where you come from, you could.
You could leave a good or badstigma, regardless of where you
come from.
You could be from the bestschools in the United States and
you come out with an attitudeand you don't contribute to the
program.
You leave a bitterness nextyear and people might end up
(48:45):
indirectly judging, even thoughwe all take courses about being
unbiased and how to explore andrecognize bias inside of us.
So we don't discriminateagainst anybody, at least
directly or knowingly, but knowthat working hard and contribute
to the program it definitelyopens up the road for your
(49:08):
colleague, for your friends, foryour school road for your
colleague, for your friends, foryour school, awesome.
Speaker 2 (49:16):
Final thought Dr
Majid.
Speaker 3 (49:23):
With residency so
close, any words of wisdom and
advice for the students who arelining up for the match in March
this year.
Sure, so, especially for again.
Here we need to differentiate alittle bit, unfortunately for
IMGs or Caribbean.
If you do not, first of all,once you submit your application
and you're set, please do notstart emailing every single one
and bring me somebody to vouchfor you.
(49:46):
Tell me this is the prince ofHimalaya, the son of the king,
whoever, I don't care who's yourfather would all respect.
We respect that, of course, butwe don't care.
We care about what you'rebringing.
Don't go and have somebody callme from Yale University giving
(50:06):
you a letter of recommendationthat should have been given to
you from day one and submittedto ERAS, your, your letter of
recommendation.
Don't make them generic.
We look at them, we read them.
They're very important.
Be committed to the program andbe eminent of what you want.
You want family medicine.
Just go for family medicineOnce you submit your application
(50:30):
.
Unless there is something reallyimportant, like, let's say, you
have taken step 3, then I willsend an email says there has
been a change, an update in mystatus and just want to inform
you that respectfully, andthat's it.
And this is bringing us toanother thing.
Does it make a difference?
(50:51):
Yes, having step 3 for an IMGmakes a huge difference.
And this is bringing us toanother thing.
Does it make a difference?
Yes, having Step 3 for an IMGmakes a huge difference.
Huge.
You're going to kind of like geta pass because now you have
passed Step 1, you have verygood scores on Step 2 CK, and
guess what?
You closed Step 3, which Idon't have to worry about you
(51:11):
moving from PGY1 to PGY2.
So I do encourage students IMG,specifically Caribbean, to take
step three, but under theseconditions, if you are a fresh
graduate, you have done verywell.
Obviously, you passed step one.
You have done very well on steptwo CK, you scored 230, 240.
(51:33):
Let's say 240.
Would you take step three?
I would not, because now you'reexpected to score higher on
step three right.
Or maybe 230, 10 points less, 10points more.
So we're going to hold you tothat standard, Otherwise we're
going to say like what happenedto you.
Let's say you didn't performwell on step 2CK.
(51:54):
Then, yes, rock the step 3 andshow us like look, yes, my step
2CK was not the best, but here'swhat.
Here's a step 3, even a higherlevel exam without PGY1, and
look what I got.
Speaker 2 (52:09):
I got you Well.
Thank you so much for the wordsof advice.
I think that's very, veryhelpful.
That's really good to knowbecause that's a question we get
a lot.
Should I take step three?
Should I wait?
And it almost seems likethere's a strategic decision
point at that point whether, hey, I did really well in step two,
let's wait for step three untilI get residency, versus I got
(52:30):
okay scores on step two, maybestep three has a chance to
improve my application.
Speaker 3 (52:33):
Absolutely it would.
And then this is the strategicdecision that I make if I'm
there.
Speaker 2 (52:40):
Awesome.
Well, thank you so much, drMajid, as always, and what a
pleasure to have you on our show.
And again, from myself as wellas on behalf of St James and all
the students, thank you foreverything that you do for
specifically St James and, justgenerally, imgs across the board
.
I know you've been a very, verybig advocate of IMGs, whether
(53:01):
they're Caribbean students orinternational students.
You've opened doors for so manyof them, so we really really
thank you for that.
Thank you so much.
Speaker 3 (53:12):
Thank you for having
me.
I'm humbled and honored to behere Again.
Thank you, mr Koshet Guha, forthis podcast and hope we can
meet again on different topicsthat could benefit the students
and the educational arena ingeneral.
I want to thank St James Schoolof Medicine for the awesome
students that they send us here.
I want to thank St James Schoolof Medicine for the awesome
(53:32):
students that they send us hereand they are contributing to our
programs.
We look forward not only forthem that they have matched, but
to retain them in the valley aswe are growing Awesome.
Thank you.
Speaker 2 (53:43):
Thank you so much, dr
Yusuf Majid, for those words of
wisdom and your insights onreally the changing perception
of Caribbean medical studentsand about your residency
programs.
Truly, the achievements thatyou've made and the strides that
you've taken for South TexasHealth Systems and as South
(54:03):
Texas Health Systems by startingthese residency programs, it's
really really amazing.
Again, thank you.
It's really really amazing.
Again, thank you.
A heartfelt thank you from theentire IMG community, as well as
all the Caribbean schools, foreverything that you do for the
medical community in the UnitedStates in general.
Thank you so much and if youlike our content and if you
(54:27):
found this interesting, pleasedo not forget to give us a like
and follow.
It means a lot for us and ithelps us keep going and really
inspires to keep doing this foryou.
If you like the podcast,download more episodes and more
content like this from any ofyour favorite streaming services
(54:47):
, services like Spotify.
But again, remember there is noshortcut to becoming an MD.
Thank you so much.
Speaker 1 (54:57):
Thank you so much for
tuning into our show.
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