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Med School Minutes
Med School Minutes is where we discuss all things related to medical education. Provided by Saint James School of Medicine, this podcast tries to educate students on selecting and successfully completing a medical school. Our topics are fun and educational, and our hosts are knowledgeable and fun.
Med School Minutes
Med School Minutes- Ep. 48- IMGs & Residency: The Real Story with Dr. Youssef Majed
Dr. Youssef Majed, Chief Academic Officer at South Texas Health System, shares insider insights on Caribbean medical grads, residency selection, and breaking the IMG stigma. Does the appointment of Dr. Janette Nesheiwat as a Surgeon General of United States help alleviate that stigma?
🔹 What do residency directors really look for?
🔹 Has the perception of IMGs changed?
🔹 How can Caribbean grads boost their match chances?
Don’t miss these expert tips!
0:00 - Intro & Meet Dr. Youssef Majed
1:02 - The Changing Perception of Caribbean Med Grads
7:45 - How Residency Directors Evaluate IMGs
18:09 - Do IMGs Have a Harder Time Matching?
35:29 - What is a Transitional Year in Residency?
45:43 - Final Advice for Residency Applicants
#MedSchoolMinutes #IMGResidency #CaribbeanMedStudents #ResidencyMatch #SJSM #MedicalEducation #USMLE #FutureDoctors #IMGSuccess #ResidencyTips #MedicalSchool #DoctorJourney #MatchDay #MedicalTraining #USResidency #MedSchoolLife
Hello and welcome to another episode of the Med School Minutes podcast, where we discuss what it takes to attend and successfully complete a medical program. This show is brought to you by St James School of Medicine. Here is your host, kaushik Guha.
Speaker 2:Hello everyone and thank you for joining us on another episode of Med School Minutes, where we talk about everything MD related, with the focus on international students, specifically students from the Caribbean. Today we have Dr Yusuf Majid, who is the Chief Academic Officer of the South Texas Health System, as well as the ACGME Designated Institutional Officer for South Texas as well designated institutional officer for South Texas as well. We are going to be talking a little bit about the perception of Caribbean medical students and how it's changed since he started his career nearly two decades ago to today, where we are talking about appointing a Caribbean medical graduate as the Surgeon General of the United States of America. So this is truly an issue of pride for all Caribbean students and all IMGs across the board. Without further ado, let's welcome Dr Yusuf Majid. Hello, dr Majid, thank you so much for coming back to our podcast once again. It is always a pleasure. So, but for viewers who aren't familiar with you, can you let us know? Can you tell us a little bit about your background?
Speaker 3:Sure, my name is Yousef Majid. I'm an MD, graduated in 2007. All my life dedicated to medical education. Since then, and even a little bit before I have graduated, I started with Kaplan, downtown Chicago, trying to fill the gaps and make it as easy as possible for medical students to have a comprehensive one-stop and focusing on the main important points to finish their USMLEs and move on with their lives. From there I grew up to have my own program, usmle review, and then we used to have about 300 students to 400 students a year.
Speaker 3:We grew up very rapidly and from there on I got involved more in the hospital setting, working on discharge committees and I worked on the patient care, trying to see again how we can bring this gap and bridge it and have a vertical integration from starting medical schools all the way to residency Okay, okay, and then in between trying to see, okay, where are the deficits? And try to fix them up. Recently I have hired as a DIO and chief academic officer for South Texas Health System. I've been in this position for at least three years now. Within the three years, we have established three residency programs under my leadership, and that's family medicine complement of 30, and internal medicine complement of 60, emergency medicine complement of 30. Currently working on surgery for 2026, and then we're working on neurology for 2026, and we're working on psychiatry for 2026, as well as at least three fellowships for 2025, starting in 2026 as well.
Speaker 2:Wow, that's excellent. So at St James we have a nickname for you. We call you Dr Mountain Mover Majid, and I think that's very, very appropriate. That's phenomenal. Going back to your experience when you started out, which year did you start out in Kaplan?
Speaker 3:About 2006.
Speaker 2:2006. Wow, so you've been in the industry for nearly 18 years now.
Speaker 3:Correct.
Speaker 2:And that's not nearly more than 18 years actually. So you know you're an IMG as well, is that right? So one thing I do want to talk about a little bit is the impression that people have about IMG, specifically Caribbean medical students. When you started, what was the scenario or landscape like for IMG specifically, specifically for Caribbean students?
Speaker 3:So there are two things. For my undergrad I went to Wayne State University and then the question says like okay, how did you even hear about the Caribbean medical schools At that time? They were new to us. You're talking about 2002. 2002 Caribbean market it wasn't very popular and at the same time this is when the DO schools were starting also to open their classes. So there was the Caribbean schools and DO schools but, with all due respect, we were not very knowledgeable about DO as well as the Caribbean. So to us it was kind of like equal.
Speaker 3:I don't know much about DO schools, I don't know much about Caribbean schools. And then it was a word of mouth. Somebody would come and then they're getting residency here, says I went to this school, and then somehow we follow their lead without knowing the ins and outs. And really, what does it take for you to go to a Caribbean school, at least back then? With over time, caribbean schools has grown in numbers and DO schools has grown in numbers. The DO schools have built a reputation, obviously being in the US, they have the support, the resources etc. Which was regulated also by the LCMEs Accreditation Bodies, whether it's allopathic or osteopathic school. So the standards are there.
Speaker 3:Unfortunately, with the Caribbean schools it was kind of like an open market Somebody comes in, they had no knowledge, no idea. They look at it at that time from a business point of view, but students did not know that this market is built on a business, so over time it created a lot of stigma. Instead of keeping it regulated and making it really meet the benchmark that the US especially most of the market there is US students it was kind of like open-loose you will go in there, you take a building, you open a medical school, no accreditation, or it shuts down, et cetera, and then students end up being loose. So Astegna has built around that that if you are a Caribbean student, you go there, you can sit on the beach, get a degree, come back here, and this is, of course, not true, but it was harshly judged based on the many schools that it's been opened and they did not meet the standard of the US, especially if you're sending students back to the US.
Speaker 2:Right. So I mean, let's talk about that perception a little bit, about sitting on the beach sipping Mai Tais and then going through medicine. So that's most certainly not true, because every US graduate and every Caribbean graduate has to take the exact same exam. Is that right? Okay? And even and this is more so not true now, because people who started in the early 2000s are in pretty prominent positions of leadership in medical education, like yourself. So, for example, now do you think, considering you started in 2006 versus anybody who's graduating from a Caribbean medical school and I must say accredited medical school, right, I mean, or do you think any Caribbean school has the same perception across the board?
Speaker 3:No, so being accredited, yes, but finish your question first and then.
Speaker 2:So the question I'm trying to say is somebody who graduated in 2006 from, say, st James St James was around in 2006 versus in 2024, 2025, do you think that they have an easier time now or a harder time now, or it still remains the same? What's your opinion?
Speaker 3:That's good. So I myself, I oversee the programs. I see how the program directors, what they're looking for, et cetera, and ranking overall what we look for, et cetera. So I can be fully honest with you. Today it's easier because a lot of the schools who could not maintain accreditation in the Caribbean have shut down. And not only that maintain accreditation in the Caribbean has shut down, and not only that. Korean students have proved themselves coming back home and over the time since 2006 till now, a lot of them are quite few are practicing physicians.
Speaker 3:What I've said, that formula is, if you look at the osteopathic, allopathic, admission and graduation and getting a job within first tier versus Caribbean schools as a whole, and that's the problem they're judged all in the group, one group. So people here don't know that this is St James, this is this, this is that these are our critic schools, which we call them tier one, right, but then they look at them as Caribbean medical school. The same thing. We are judged. We look at the schools in the United States, american medical schools, so it's the same concept. We both judge each other. We stereotype, saying this is an American, but we do say this is Caribbean, without differentiating.
Speaker 3:We don't go into school by school, say this is Caribbean, without differentiating. We don't go into school by school so that students have contributed to decreasing that stigma to a certain extent by working so hard, by achieving their goals and moving up in the chain to take positions back home in the United States and be able to prove. Yes, I went a couple of years to the Caribbean school, but that stigma that you're thinking of me, I have a less quality of education, it is not true. But if you look at it as a whole, the stigma is still there. Why? Because, again, the admission criteria versus how many students graduate versus how many, gets matched in the first year for the whole entire offshore, not only specifically for one school.
Speaker 2:Right, right, so, and again, I mean, I do want to point out that for people like yourself having and I'm being an IMG, all of you are in positions of power, I deal with a lot of program directors, a lot of these program directors, and I would go out on a limb and say actually, uh, the majority of the ones that I deal with, at least, are actually imgs themselves, and they've mentioned and and you yourself, dr maj Majid, have taken and not just now, but since you've been dealing with students for so many decades have dealt with American students, have dealt with Caribbean students. What is your impression of Caribbean students who are coming out from, say, accredited programs and going through the step one, step two and going to residency? 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:So there's a pros and cons and the issues that we face today are different than 2006 and 2010. In 2006, 2010, we all worked so hard and we learned how to say the yes, sir. Uh, very respectful for our physicians, uh, we will. We will come in earlier, leaving after the physician, or the physician will have to kick us out. So just go home, go rest, et cetera. Uh. But at the same time, we were working so hard but we did not have the resources we have today, because these Caribbean medical schools were also new in the market. There, they were learning the curve as well how to meet the accreditation body and what is it that the student need in order to excel on the steps. While today we do have these resources, everything is online, we have comprehensive libraries, all these programs, etc. The generation has changed. We have entitlement and there is misconception I go in, I don't care, I'll just pass my exam and I'll go in.
Speaker 3:And that's not true. So the personalities has changed since then, even though resources has changed. It was less resources back then. We had to work harder, now we have more resources and support. But back then I believe the way we presented ourselves is it was much better, more respectful, less entitlement, and again we worked very hard. Less entitlement, and again we worked very hard.
Speaker 3:Today you talk to somebody who says can I go to lunch? While your physician is still their head is in the foot of the patient trying to figure it out Physician looks and says yeah, sure, go ahead. And then you come back and says oh, it's 4 o'clock. Can I go home? I need to study. You see, there is that and I'm not saying only Caribbean schools, but maybe because I deal a lot with offshore medical schools, I see that.
Speaker 2:Okay, so as far as that perception is concerned and you know, and again, we have a lot of students in South Texas and as well as other places and you've been dealing with not just St James but several Caribbean medical schools, I know you deal mostly with not mostly almost exclusively with only accredited schools American students, do you think that what you just described is really just a generational thing, as opposed to? I went to the Caribbean, I was on the beach and I drank a lot of Mai Tais or, passing my exams.
Speaker 3:What are your thoughts on that? So that stigma has came down, but it's not okay. So again, it also depends on the program, the program director, how new they are, how long they've been running the show where they graduated from as well. So in our programs we do have img program directors and we have amgs program directors and hannah, and I'm gonna be honest 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:So here's what we look for.
Speaker 3:We give priority to AMGs and we won't hide this because but we don't want to stigmatize also our program we're very careful.
Speaker 3:For example, when we say AMGs is osteopathic, allopathic, they take a priority. We would like to have a bigger portion or the majority of portion from there we would like to have our. Second is that formula is for offshore medical students versus totally foreign medical grads. Why offshore medical students from accredited school? Because they come and they rotate two years in the States. They have done their undergrad year. For the most part they do understand the culture and we have noticed not necessarily here, but I was in different states where totally thought a medical grad with no US experience, not knowing the culture, you feel like a fourth year medical student. Sometimes they can operate better 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 approach the patient, care and the quality and creating a space and respect. All this here is given. I don't have to teach you that.
Speaker 2:Right, I got you.
Speaker 3:So our second in line is the offshore medical school and third in line will be totally foreign medical grad. Now when we look at the offshore, which is the caribbean schools, we look as that they do their undergrad here. That helps, I mean, it's not well the end of the world, but what's important to us. Have they rotated in the united states. That makes a big difference to us. Okay, because we noticed these two years of rotations.
Speaker 3:It does make a huge difference versus someone who did not rotate at all in the United States, okay, but we look for also scores, attempts, a lot of recommendations and their connection to the area, which is also something very important to us.
Speaker 2:Are they?
Speaker 3:for us Texas. Are we in Texas? Are you in Texas? So yes, ok, good, how close are you to us? Have you rotated with us before? Do we know you?
Speaker 2:And that's, that's a big assurance us before, do we know you, and that's a big assurance. Okay, so I do want to point out that our president, donald Trump, he's nominated Dr Neshawat 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 is from a Caribbean school. Do you think that this sort of an appointment would potentially change perceptions, if they haven't already?
Speaker 3:Eventually, if you know how to use it, the same thing I'm telling you. Like when first Caribbean school started, nobody knew anything about them, good or bad.
Speaker 3:It's kind of like if there is a stigma, we brought it to ourselves and the problem is it wasn't up to one person to decide, because we don't have regulatory that for every Caribbean medical school that must 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 position to be appointed for a fan of medical grad or IMG, which in general is given to people who are qualified as an AMG. But Dr Nashawat is more than a qualified person.
Speaker 3:If you look at her history, she grew up in New York. She did her undergrad, I believe, in New York and she did. Is it New York? No, yeah, new York. And then she went two years to AUC basic sciences. She came back with her rotations in the States. So these are the positive stuff I was just telling you about earlier. She has followed all these footsteps and she has done her residency in Florida. So, beside that, she's not your everyday doctor. She was involved in politics long before she was appointed. She was given opinions to Fox News, so that put her right there, above the benchmark for a regular physician who I just have an MD degree.
Speaker 3:It doesn't matter, but do you really have the qualifications? So Dr Neshawat has that qualification. Is it unusual for such physician as a surgeon general to be held by a foreign medical grad? Yes, but it's not. I don't see it as like oh my God, like wow, now let's go ahead and would the stigma go down a little bit? Yes, but again, it depends on who's watching Dr Neshawat and who's not. So it depends on what side of the politics are you in as well?
Speaker 2:Well, I mean, that's true. But, politics aside, it almost seems like and in my experience this seems like, you know, as I said, I speak to so many program directors, including your program directors as well as you, as well as people in leadership Seems like the only real stigma typically comes from people who don't know anything about medical education. That's what I've typically seen For most people. Every time I would talk to a program director, they'd say well, have they passed step one, step two, as you said, number of attempts? Where have they done their rotations? What is the temperament of the student If all that checks out?
Speaker 2:99% of physicians don't really care where you study, because the USMLE or the medical licensing 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 the United States, you took the test, you'd got a good score. You passed in one attempt. As a result, you're at par with basically any American student.
Speaker 2:However, this perception that we're really talking about it seems to entirely reside with non-medicos, as they call it, the average person on the street.
Speaker 2:You walk into your cornered bodega and they will talk about you know, people have opinions on everything. So they're talking about medical education and they'll say that, oh yeah, caribbean schools or IMGs are really not at par. But in my opinion, it seems like the people who know anything, like yourself or program directors, they definitely know how to parse out the information. And at the same time, it also seems like from what you're saying that just because they're from an AMG does not necessarily mean that it's a slam dunk and they're going to be accepted into a residency program. But keeping that in mind, do you think so? For example, I mean, last year we had, as a school, we had a record number of students. We had 117 mansion to residency. That number is just going up, up and up. Considering everything that is happening and Dr Neshawat whether she gets confirmed or not, I don't necessarily know, but her very appointment do you think it is a moment of pride for Caribbean medical schools?
Speaker 3:It is, but I feel like it's more of a unilateral moment of pride. It is a big deal for AUC obviously because they're gonna send it. Says like, wow, auc, would the Caribbean school look at it? Says, oh my god, look at it. Yes, but it doesn't really, truly, in reality, doesn't make a difference. That's the.
Speaker 2:I mean, does it I? I don't know, do you think it maybe?
Speaker 3:it will decrease the stigma again a little bit, but I don't think it will erase. Everyone at the end of the day is held to the standards A lot of our students are really confused about transitional year.
Speaker 2:They don't really know what that means. Can you let us know what a transitional year really is?
Speaker 3:Yes, sure, but before I go into this I just want to let you know, sure, but before I go into this, I just want to let you know, even though I'm an American Lebanese IMG, my undergrad here, two years offshore, two years technical rotations here, been here is not just because, let's say, dr Nisho is an IMG, we're going to start giving free passes. Hey, imgs, come over here, here you go. No, so at the end is when we look, we oversee the whole entire program and what's important to us maybe the other side, the students, might not be aware it is important for us to build a strong program on a national level, passing the board 100%, because without this that will hinder the quality of the program and then we will put on probation and we will lose the program. So we are held at a benchmark. We look at people how many people are we going to train and how many are we going to stay with us? This is a very important question for us because we are building these residency programs to have a better quality care for the community and if we cannot achieve that at the end, we have failed.
Speaker 3:So there are so many metrics that the programs overall, each one comes with authority but also with responsibility. So it is a lot that we look at behind the scene when we are looking at candidates. That's why we look at the tiniest, like if somebody coming from the Midwest AMGs or a foreign medical graduate here in the Valley. I take probably this one here because I know I don't have to groom them and teach them the culture of the Valley. 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:There's no set like one plus one equal to Right right, and I think it's very important to highlight that a residency program, at the end of the 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 the same time, I know that you have accreditation responsibilities. You have responsibilities to not just to the student that you're taking, in making sure that they learn what they're supposed to be learning. They have requirements that you need 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 there are no. In the bigger scheme of things, there are no healthcare deserts in the United States as such, or at least in the areas that you're operating.
Speaker 3:With all this that you just said, a perfect match list would be if they all match in the program. It would be, I would say, 60% to 80% AMG, 20% to 40% offshore, with diversity. Right, that will be a perfect ranking list if you will be able to match them all. So not only we look at that when it comes to diversity. Here you have to diverse because you don't want to stigmatize the program, as this is only AMG. So a US citizen who took a loan for a quarter of a million dollars coming back home, they have nowhere else to go. You don't want to stigmatize. It says OK, you're going to be flipping burgers at McDonald's. That's not right. Also, don't forget every four students that don't match who went offshore and they have loans. They make up $1 million and this eventually is going to be written off if they don't end up having jobs and the taxpayer is going to end up being responsible for it. All this, at least in the back of my mind, individually, is taken in consideration. That's why I said number one.
Speaker 3:I would like to have the AMGs. If I could have 60% to 80%, perfect. If I have 20% to 40% of the offshore who are US citizens coming back home. I'm not talking about total farming. That would be perfect. Why? Because eventually I'm helping also the citizens of this country to pay back their loans and then establishing a family. Also, we look at diversity. I don't want anybody to say that this is an American grad-only program. I don't want anybody to say this is only a Caribbean program. I don't want them to say this is only affiliated with this medical school in the United States. Versus that school we want to stay as neutral as possible. It is in our interest to do so.
Speaker 2:Right, right, and I do want to point out like, within the residency, you know the NRMP application process there are some programs that just very clearly say that if you're not an American citizen, we won't even consider you and whatever the requirements of the program are, there are certain programs that focus entirely on American citizens, irrespective of whether they went to a Caribbean school or a US school, and I believe one of your programs tend to be like that If you're an American citizen, that's when you're coming in, or a permanent resident, not just an American citizen. Is that right?
Speaker 3:Correct. So we don't sponsor visas. We do have enough applicants from the States to fill our programs every year. We have people who come rotate with us. They signal us as gold and you know there's so many signals nowadays with the new platform that you can send to our program. So all ways in, but we do absolutely look at US or how do you say it? Rather than US citizen working eligibility in the United States.
Speaker 2:Okay, awesome. Going back to the question of the transitional year, what is the transitional year? Because I get that a lot from students. They're like why should I apply for a transitional year? I mean, it's so uncertain, I don't know what's going to happen after that. What are your thoughts on that?
Speaker 3:So transitional years could be the best thing that happened to you in your life and could be the worst thing that happened to you in your life.
Speaker 2:Oh, wow, okay, Please elaborate.
Speaker 3: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, programs who are, let's say, four years, but they need a transitional year to begin with. So they go through, let's say OB-GYN, let's say neurology, but the hospital itself, they have the neurology program. It's total, let's say, of four years including the transitional year.
Speaker 3:A transitional year, usually a year that you work one to two months in each department. It's kind of like a jack of all trades One couple months at the emergency, one, two months on the floor in the IM, one to two months on the emergency, one, two months on the floor in the IM, one to two months in the family. It depends on which residency programs in your institution has sponsored that transitional year. So if we say IM, the program directors and the faculty of IM, family and emergency sponsored that transition in the year. Obviously they're going to end up rotating at all these sites and there is a schedule in there. Some of them will be outpatient, couple of elective research. Everything is the same as any first year.
Speaker 3:What can you do with this year? Why? This is now the good part we said that could be the best thing happened to you. Yes, normally if you go into a program who is an advanced program, they don't have transitional year but they do have the actual program. Let's say neurology in state X. You apply in the match and then you get accepted but they say, okay, now go find your own transitional year, right? So that same candidate applies separately in ERAS for a transitional year and they ask you in ERAS, have you been accepted somewhere else? You say, yes, I've been accepted at so-so hospital in this state, but I do need that transitional year. We prefer to give that transitional year to this person.
Speaker 2:Okay.
Speaker 3:Now, why is that? Why do we prefer to give it to this person? Because it is our responsibility and this is our nightmare here, as a program to help people who went into transitional year to move up to PGY2.
Speaker 2:And in our program we don't have the means to out up to PGY2.
Speaker 3:And we don't have in our program. We don't have the mean to take on to PGY2, because all our programs are categorical which they start from day one. They have all the years they need. We don't need, we don't have a program standing alone and it needs a transitional year. So for us that's a program. It's a nightmare If this person does not have a PGY-2 somewhere lined up. So if you come, in with. Pgy-2,. We would love to have you, If you don't it's going to be a big question mark.
Speaker 3:Now this is the good side, that basically it could be the best thing happen to you in your life because you have matched into an advanced program and you're missing this year. And here we are, we're looking for someone who matched in an advanced program and they need that one year. So it's kind of like working for both of us. Now you have your PGY-2. I don't have to worry about supporting you finding a residency as a program. You just need my transitional year Perfect. Now how could it be a nightmare If you do transitional year and you have not secured PGY-2, and then you decided the following year to go ahead and apply for a program, that program. There's potential this program might lose funding for that year that you have done. Oh, okay.
Speaker 3:So you might stigmatize yourself and a lot of programming might qualify for them. They want it to take you, but then they say that you already exhausted one year of funding from what you're eligible for.
Speaker 3:I give it to you as a different example. Let's say I apply for family medicine. I get in, I do one year and I get out. 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 to do 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're going to pay the first two years and the next three years has to be coming from the hospital target okay, so is it very common for students to get advanced placements in PGY2 in the first year that they're applying for residency?
Speaker 3:yes, so through ERAS, because now you have all the what do you call it? All the hospitals, all the programs in front of you. Once you match into Awan, all we need is basically yes, I have matched into this program, then, hey, transitional year is yours. And a lot of time we try to build relationships with programs who have advanced programs and they need a transitional year. That will be the easiest thing to do.
Speaker 2:Okay, so currently does your program have any tie-ups or memorandums of understanding or anything like that with any program that might help a potential transition leader when you do start the program?
Speaker 3:so so I I don't have an official memorandum of understanding, uh for transitioning, and I don't think should be one, uh, to make it fair, should be fair for everyone. But we could have an understanding without the memorandum.
Speaker 2:Okay.
Speaker 3:So I do. Recently came across occupational health residency.
Speaker 3:And from what I noticed, from what I understood also, is the biggest hurdle for the people who are applying for such program was the transitional year. They needed one year and the occupational medicine. I don't want to say they're having a hard time finding like having their candidates matching in a year, but it's not as easy. And so there are two potential candidates we're talking about. They said if we are able to secure transitional year for them, then definitely these will be on a top list for us. Of course they will go through ERAs like anybody else and they will apply, et cetera, et cetera, et cetera. We'll make sure we qualify for our transitional year and they qualify for their program year and they qualify for their program. So, yes, there is kind of like an understanding and would like to collaborate with more programs if possible to offer these transitional years to help the students be able to secure a full program without worrying about the transition year.
Speaker 2:Okay, so tell me a little bit more about this occupational medicine residency. I've never really heard of that before. What, what is that?
Speaker 3: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 been busy with preparing for programs for next year, but it is on the agenda to look more. But here's what I understood from a nutshell. Being an occupational medicine physician, you go through ERAS like anybody else. Mainly you work. Obviously the name gives it up occupational medicine. I see that you're working for GM Ford Microsoft so these big companies, and then the focus might be, yeah, these big companies, and then the focus might be the track.
Speaker 3:I'm assuming they could be like an OSHA, hipaa, et cetera. They'll be more knowledgeable about these subjects as well. I myself work in GM when I was a student going to college, so I do remember having our own medical center, a few or many medical center, so anything happened that you go there. That physician is familiar with what goes on. What are the common injuries that happen? Something went into my eye at that time. Right, I see it could be from welding a car.
Speaker 2:Right right, right right.
Speaker 3:So right away they'll be able to fix you up. It depends on the resources they have. If they don't have the resource, they send you immediately to again to an occupational physician contracted with them, which they have more resources. So you are a physician, you're a doctor, you're practicing. You're a doctor, you're practicing, just your setting. I'm assuming it's not the typical setting that we heard of. You go to the clinic and you see everyone that walks in. You're mainly dedicated for that particular company.
Speaker 2:And these are the companies. So one of the biggest complaints with medicine is that the hours are really long, but this almost sounds like there might be a possibility that this is essentially a 9-to-5 job for a doctor. Is that right?
Speaker 3:Could be. Could be and the resources and the money they have at that particular company, right? Okay, so when it comes about, could it be nine to five? Could it be?
Speaker 3:this depends on the supply and demand, depends where you are okay if you have resources that they need and they can't find it anywhere else, obviously you will have a card to bargain and say that's what I want and within reasons right, uh, okay. But if you don't and the area is saturated, you are in a big city in California, in Chicago, etc. You demand something that doesn't work for us. It says okay, next in line. That goes to everyone, I guess right. Not only that.
Speaker 2:That's very interesting. So what about earning potential? You did talk about salary. Do you think that these particular students have, or these particular residents on finishing residency? Do they have, the potential to earn as much as a person who finished internal medicine or family medicine once they graduate?
Speaker 3:Absolutely. It depends who you compare them to, right, they might make more money. So if you send me in a big brand name company who have the money, it becomes peanuts to them, right, they just need the commitment, etc. If you compare those to a family medicine or internal medicine physician in a big area that is saturated, they go by the average, pay maybe a little bit more. I give you an example In Chicago, if you go to a brand name hospitals in general I don't want to say this is a stigma, but you end up being paid less. Why? I've heard that yeah, and you go up a little bit in the suburbs, you might make twice of that. Just go to an area that's called like Sandwich, rockford, sandwich area or whatever they say, almost like sandwich area or whatever they say like almost double. I'm telling.
Speaker 2:Yeah, no, I've definitely seen that. I mean people getting post-residency, getting jobs at, say, within the city city of Chicago, versus getting a job at Rockford, which is a little over an hour away from Chicago. And you're right, that salary jump was insane. I mean I would totally do that, drive, yeah. I'll tell you another example that salary jump was insane. I mean I would totally do that drive, yeah, I'll tell you another example.
Speaker 3:That's in Illinois as well. Because I lived there for a long time 16 years was enough for me to understand the market. An ER physician in the city of Chicago might make less than a family medicine holding an ER or handling an ER in the suburbs in a smaller community.
Speaker 2:Right. So why is this not? You know, like everybody you talk to, they want to do family medicine, internal medicine, ob surgery, pediatrics. Why is this occupational medicine not very well-renowned?
Speaker 3:I think it's lack of education. On marketing as well. It's the same like you and I. We just said together that I never heard of it before. I said my info is limited, right, so it's more of marketing and education that falls on the shoulder of the hospital that is holding such program to market more and educate people, and on the program director and the faculty to market out. It says, okay, what are the benefits actually of occupational medicine? To me it sounds great. Are the benefits actually of occupational medicine? To me it sounds great. I do remember interacting with occupational medicine physician in GM at that time back in 1994 or 5.
Speaker 3:But again, I, never knew that this is an occupational medicine. Five, but again, I never knew that this is an occupational medicine. The next thing I know about occupational is normally they let's say big companies who don't have that physician on site et cetera, and they don't have the resources to evaluate workers' compensation et cetera, they might end up contracting with urgent care that is closely down and so if something happened to somebody at work they can obviously go down the street to the urgent care to be taken care of and they could be on some sort of a contract or maybe I don't know how the billing goes exactly. But those who don't have, let's say, a big car dealer right, food, whatever, there's a strip of car dealers and there are big companies BMW, usually you find them all on the same street, right, right?
Speaker 1:right.
Speaker 3:BMW, volkswagen, ford, et cetera, range Rover, these employees, they get benefits and they 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 a physician there maybe it will cater to all these guys as possible it depends on the number or they end up contracting with someone down the street who have an urgent care, a family medicine, for example. Who?
Speaker 2:have an urgent care, a family, medicine for example.
Speaker 2:Yes, wow, this is so awesome. I never really realized that there would be residency programs that I wouldn't know about. That's very, very interesting. So, but, dr Majid, thank you so much for all that information. I hope what we talked about today really was an eye-opener for some of our audience and viewers, and this influences them and maybe even influences them to make different career choices based on some of the information that you gave us. But, once again, thank you so much for your time. But once again, thank you so much for your time. And one parting question. This is when you were talking about Dr Neshawat. Is there any point where you guys actually crossed paths at any point?
Speaker 2:I don't believe so because there was a lot of familiarity with which you talked about her.
Speaker 3:Yes, her background is originally from Jordan. I see so we do have a Middle Eastern background both of us but definitely I want to congratulate her with all this that I don't know her personally on that position and it was well deserved. Based on her background she's not new to this position. I think she qualifies more than a lot of people who are probably coming from any medical school. I'm not going to name any of them, but in general.
Speaker 3:it's well-deserved and definitely she will do a great job. I hope that, like me myself, be able to, with this position, decrease the stigma on IMGs, and I hope the IMG schools as well, in general, and the ministers of the island in general, realize that bringing a bad apple can really mess up the whole entire box. Be more regulated, respect the accreditation bodies, why they're there and live up to the benchmark where you want the students to practice. If your students want to come to the States and this is the market you're targeting please have the resources for them and make sure that you meet these benchmarks. If they want to go to the uk, same thing I would say look at the uk benchmarks and make sure they qualify to be there. Otherwise, I want to encourage all your students, especially st james school of medicine. We're very, very happy and pleased to have you here. They have created a pipeline for us and then on the first patch we take one to two students. It does make a difference to us how hard they work, because that and then next year we say, okay, you know what this is really working.
Speaker 3:Know that every student comes into any program and I'm telling you this is under the table that where you come from your school, you could leave a good or bad stigma, regardless of where you come from, you could. You could leave a good or bad stigma, regardless of where you come from. You could be from the best schools in the United States and you come out with an attitude and you don't contribute to the program. You leave a bitterness next year and people might end up indirectly judging, even though we all take courses about being unbiased and how to explore and recognize bias inside of us. So we don't discriminate against anybody, at least directly or knowingly, but know that working hard and contribute to the program it definitely opens up the road for your colleague, for your friends, for your school road for your colleague, for your friends, for your school, awesome.
Speaker 2:Final thought Dr Majid.
Speaker 3:With residency so close, any words of wisdom and advice for the students who are lining up for the match in March this year. Sure, so, especially for again. Here we need to differentiate a little bit, unfortunately for IMGs or Caribbean. If you do not, first of all, once you submit your application and you're set, please do not start emailing every single one and bring me somebody to vouch for you. Tell me this is the prince of Himalaya, the son of the king, whoever, I don't care who's your father would all respect. We respect that, of course, but we don't care. We care about what you're bringing. Don't go and have somebody call me from Yale University giving you a letter of recommendation that should have been given to you from day one and submitted to 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 and be eminent of what you want. You want family medicine. Just go for family medicine Once you submit your application.
Speaker 3:Unless there is something really important, like, let's say, you have taken step 3, then I will send an email says there has been a change, an update in my status and just want to inform you that respectfully, and that's it. And this is bringing us to another thing. Does it make a difference? Yes, having step 3 for an IMG makes a huge difference. And this is bringing us to another thing. Does it make a difference? Yes, having Step 3 for an IMG makes a huge difference. Huge.
Speaker 3:You're going to kind of like get a pass because now you have passed Step 1, you have very good scores on Step 2 CK, and guess what? You closed Step 3, which I don't have to worry about you moving from PGY1 to PGY2. So I do encourage students IMG, specifically Caribbean, to take step three, but under these conditions, if you are a fresh graduate, you have done very well. Obviously, you passed step one. You have done very well on step two CK, you scored 230, 240. Let's say 240. Would you take step three? I would not, because now you're expected to score higher on step three right.
Speaker 3:Or maybe 230, 10 points less, 10 points more. So we're going to hold you to that standard, Otherwise we're going to say like what happened to you. Let's say you didn't perform well on step 2CK. Then, yes, rock the step 3 and show us like look, yes, my step 2CK was not the best, but here's what. Here's a step 3, even a higher level exam without PGY1, and look what I got.
Speaker 2:I got you Well. Thank you so much for the words of advice. I think that's very, very helpful. That's really good to know because that's a question we get a lot. Should I take step three? Should I wait? And it almost seems like there's a strategic decision point at that point whether, hey, I did really well in step two, let's wait for step three until I get residency, versus I got okay scores on step two, maybe step three has a chance to improve my application.
Speaker 3:Absolutely it would. And then this is the strategic decision that I make if I'm there.
Speaker 2:Awesome. Well, thank you so much, dr Majid, as always, and what a pleasure to have you on our show. And again, from myself as well as on behalf of St James and all the students, thank you for everything that you do for specifically St James and, just generally, imgs across the board. I know you've been a very, very big advocate of IMGs, whether they're Caribbean students or international students. You've opened doors for so many of them, so we really really thank you for that. Thank you so much.
Speaker 3:Thank you for having me. I'm humbled and honored to be here Again. Thank you, mr Koshet Guha, for this podcast and hope we can meet again on different topics that could benefit the students and the educational arena in general. I want to thank St James School of Medicine for the awesome students that they send us here. I want to thank St James School of Medicine for the awesome students that they send us here and they are contributing to our programs. We look forward not only for them that they have matched, but to retain them in the valley as we are growing Awesome. Thank you.
Speaker 2:Thank you so much, dr Yusuf Majid, for those words of wisdom and your insights on really the changing perception of Caribbean medical students and about your residency programs. Truly, the achievements that you've made and the strides that you've taken for South Texas Health Systems and as South Texas Health Systems by starting these residency programs, it's really really amazing. Again, thank you. It's really really amazing. Again, thank you. A heartfelt thank you from the entire IMG community, as well as all the Caribbean schools, for everything that you do for the medical community in the United States in general. Thank you so much and if you like our content and if you found this interesting, please do not forget to give us a like and follow. It means a lot for us and it helps us keep going and really inspires to keep doing this for you. If you like the podcast, download more episodes and more content like this from any of your favorite streaming services, services like Spotify. But again, remember there is no shortcut to becoming an MD. Thank you so much.
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