The perspective of an international graduate
Out here, the nights are long, the days are lonely. I think of you and I’m working on a dream. I’m working on a dream
Bruce Springsteen
The story you will read is about an international medical graduate who went to the US searching for research opportunities. His path was non-traditional (and still is), but it brought him to the top of world academic research.
The ‘ American Dream’, or the possibility to achieve professional success through just hard work, has been driving the lives of thousands of human beings that move to the US every year from all kinds of backgrounds, including medicine.
A medical degree is something that, still today, holds a lot of value regardless of the nation that you live in. However, wide heterogeneity exists among countries. As with other careers, an MD graduating in Catania, Sicily (every reference is purely casual), can live a very different life than a young Harvard Medical School graduate, and not necessarily for the worse or, the better.
When I was approaching the end of my education, I felt I wanted to do more. After attending as a visiting student Humanitas University (Milan, IT), Cambridge University (Cambridge, UK) and Harvard Medical School (Boston, US), I decided that I did not want to stay in Italy or Europe, and I choose that I wanted to go to America, to the United States.
To achieve this goal, an international medical graduate has two main options:
- Apply for a residency in the US that ultimately will train you to work in the clinical world;
- Apply for research jobs (assistant, post-doc fellowship, research fellowship, etc.) and focus on academia.
I was unsure if I wanted to do clinical work from the beginning, so I decided that I wanted to know more about this country, explore the research opportunities and strengthen my CV for future career choices. I graduated on the 27th of July, 2019. On the 1st of August, I landed at JFK airport, New York City.
A clinical researcher in the United States
I started as a research fellow at Rothman Orthopaedic Institute in august 2019, and since then, I have never left. I am very lucky to be part of the most productive orthopaedic department of the United States and the world in terms of the number of peer-reviewed articles per year. Here, I had the opportunity to learn, test my own ideas, succeed, and fail. As many would say, the sky is the limit when you do research in a place like this.
When you move to the United States and you land a research job, it is much easier to get decent pay and a good institution if you have bench/wet lab experience. As a matter of fact, there are so many labs in the US, that almost any good applicant will have multiple offers right after graduation. However, I did not want to do bench work as a medical doctor, and my search was hard.
The best way to work in clinical research is to find academic departments of your interest and reach out to the physician that handles most of the publications/grant associated with it. That is what I did, and despite the difficulties, I ended up in my first choice.
Requirements
Other than graduation, there is no requirement for such a position. The job is usually minimally advertised through classical channels and relies upon word of mouth and the proactive interest of the candidates. So you should not wait and email the people you want to work with. Most of the positions are covered 8-12 months before the supposed start date (usually Summer).
Despite no formal requirement, some institutions require proof of English knowledge (TOEFL or IELTS) and/or Step 1 (a test part of the path to medical licensing in the US). I had both, but I was not asked to present any.
Day to day
Most of my work focuses on large clinical studies in orthopaedic surgery. I had the chance to do retrospective and prospective studies and I am now managing several clinical trials. Some institutions give the possibility to do some bench work, so again, there are numberless opportunities.
A usual workday lasts 8-10h but you go over 12h a day at least 2-3 times per week. Weekends are usually free, but you have to catch up a few hours per day most of the time. It is not easy to sustain these rhythms, but I also have to highlight that you have the possibility to do less, as much as you can do more. It is entirely up to you. As my mentors often say, from experience like this, you get out of it what you put into it.
A glimpse into the future
I was supposed to stay one year, then I decided to prolong to two years, now I am in a Ph.D. program focused on clinical research and I do not know what I will do next. I know that I have been happy with my work here, I had some successes and I faced failure. As per the American dream, I do not know if I will ever want or achieve it, but as often happens, it is all about the journey, not the destination.