0:39

Anybody who trains in a different country . You

0:41

have to do residency again to come to United States

0:43

, correct ?

0:43

Yes , yes , and this is what I feel personally

0:46

the most horrible about some of these physicians

0:48

are not just well respected , but known

0:50

. They're famous in their home country . They've done

0:52

big things , innovative things , and

0:54

in America they don't care . You

0:56

can be so famous that you're consulting physicians

0:59

in America , but when it comes time that you want to go

1:01

practice in America , they'll treat you like a PGY

1:03

one , or really a PGY Europe .

1:05

Yeah , what exactly is it that

1:07

we're not trusting if ?

1:08

I had to choose one . The fact that they're

1:11

they went to medical school abroad , especially older

1:13

program directors . They are just not gonna trust

1:15

someone who did not get top medicine

1:17

in the States . They don't care where you come from

1:19

was good everyone .

1:20

This is dr Ne . I am joined by dr Simrack

1:23

Gill With residents medical

1:25

. This is a little bit of a different episode

1:27

. Listen , we are coordinating . We

1:29

are , you know , combining our powers

1:32

and working with groups that

1:34

we think align with our Audience

1:36

, and what we found out through our

1:38

survey and through our studies is that we have quite

1:40

a few International medical graduates who

1:43

listen to docs outside the box , follow us on

1:45

Instagram as well as with

1:47

residents medical . Residents medical is a

1:49

residency placement as well as fellowship

1:51

placement Organization company that

1:54

really focuses on getting international

1:56

medical graduates into ACG and me

1:58

accredited programs . And

2:00

Listen , I know it's hard out

2:02

there . It's really hard out there for IMGs

2:04

to travel , to

2:06

pay for all of these or these tests

2:09

and board examinations and try to get

2:11

into residency in the United

2:13

States . It's very difficult and

2:15

you know we talk about all the different soft

2:17

skills that you need to do to Really

2:20

succeed as a physician here in the United States , and I

2:22

think sometimes we forget about some

2:24

of the extra added burden that our IMGs

2:26

have to face , whether it's in the Caribbean or Anywhere

2:29

else in the United States . So that's what

2:31

this show is about . That's what this episode is about

2:33

dr Simrack Gill . Welcome to

2:35

Docs outside the box . Man , how you doing ? I'm

2:37

doing good . Thank you for having me on . I appreciate it . So

2:40

I'm looking at the background . We got a whole bunch

2:42

of pictures there . Now , for

2:44

those who are watching on YouTube , there's a whole bunch

2:46

of pictures that are behind dr Gill . I'm

2:48

gonna assume are these candidates

2:50

or Doctors that you've helped

2:53

, or these like consultants ?

2:55

Exactly . No , they're candidates that we've helped in the past , over the

2:57

course of 20 years , whether it's in residency

3:00

or fellowship , throughout various specialties

3:02

that they all of these people have reached out to us

3:04

. We were able to guide them at

3:06

any point of the stage that they came to us

3:08

and we got through their dream position .

3:11

Hmm , so listen , why don't you just tell us from

3:13

the get go what is residents medical ? What is

3:15

it about ? How does it work ? How

3:19

long have you guys been out there ? Because I hear that you guys

3:21

are often duplicated but you can never really

3:23

get the original . So tell us about that .

3:25

Yeah , yeah , thank you for asking . So . Residents medical

3:27

. We're an educational consulting firm

3:29

that specializes in assisting IMGs . We

3:31

have a model that uses a network of residency

3:34

programs affiliated with US

3:36

Teaching schools and

3:38

hospitals , and we've been doing this for

3:40

over 20 years . Really , what we were

3:42

doing is we were helping , back in the day , gmes

3:45

get created and assisting hospitals and getting

3:47

ACG me accredited . So by doing

3:49

so , we we did this with

3:51

a stipulation with these programs saying hey

3:53

, because we've helped you , we

3:56

want the programs to be diverse , we want them to

3:58

be filled with IMGs , and if we have Candidates

4:01

of ours that meet the criteria of your program

4:03

, then we would wish our

4:05

counties to be considered for a position

4:07

in your residency or Fellowship . So as

4:09

a result , over 20 years later , we've

4:12

have established a network of over a hundred

4:14

programs throughout the country . We've helped

4:16

almost 2,000 candidates achieve residency , as

4:18

well as fellowship , and Not to

4:20

to our own , our own horn , but our success

4:22

rate is in the high 90 percentile . Essentially , if

4:24

I had to describe it in one sentence , what we do is

4:26

we take on the responsibility of getting you into residency

4:29

. In terms of how

4:31

we're able to do so , we we

4:33

act as your mentor where your guide throughout the journey

4:35

. Whether you're already ECF and you certified and

4:37

you're Just applying for programs ready

4:39

for to achieve residency , or

4:41

you're starting off fresh and you're about

4:43

to Prefer your step one , you just finished

4:46

med school , at any stage in your journey

4:48

we're able to assist and guide you and making

4:50

sure you're making the right decisions in the right calls .

4:53

Hmm . So I know a lot of this stuff

4:55

is proprietary . I get it , but

4:58

how does the mentoring look ? What

5:00

does that look like ? Is that something

5:02

as simple as guiding them as to the

5:04

specific residences that you guys have been

5:06

able to get folks into ? Is

5:09

it like a different , like a change in the

5:11

type of , maybe personal

5:13

statement shadowing ? Talk to us

5:15

about , like the specifics without I

5:17

know you can't get into too much specifics , but talk

5:19

to us about that mentoring process

5:21

. How does that work ?

5:23

No , thank you for the question . It's a good question , for sure . The

5:25

, the mentoring is one-on-one first

5:27

and foremost . You know I every week it's

5:30

mandatory for all the counselors on

5:32

staff that we meet with all of our candidates one-on-one

5:34

over a zoom call and we all

5:36

are reachable on our cell phones

5:39

so at any point of day and night if there's any

5:41

issue or any concern , they

5:43

, all of our candidates , know to reach out and we'll be able

5:45

to help them . As far as the

5:47

pathway that's constructed was like a , therapist , exactly

5:50

exactly the , the pathway

5:52

that's constructed . It's really about having

5:55

them showcase their clinical skills when it's

5:57

time for them to apply for residency

5:59

. Though Our model has always been about

6:01

prove yourself , we will open the doors

6:03

for you , because most of the time , img's

6:05

don't have any doors opening for them . What

6:08

we specialize in really is opening the

6:10

doors for you to go prove yourself , and by doing

6:12

so , it allows the program

6:14

directors , the APDs , to see that

6:17

they should be giving this candidate and IMG

6:19

a chance . And the way they prove themselves

6:21

is either through extensive clinical work

6:23

or research . Typically

6:26

, what we do is we place them in a program

6:28

when they do hard

6:30

hours , 14 , sometimes 16-hour

6:32

days , hands-on externships

6:35

, showcasing their patient care

6:38

, or it's the research they're doing , deep diving

6:40

and in all their research that they're doing . And we

6:42

do this . One for

6:44

a chance to program directors to see them , but two

6:47

, if they have any red flags

6:49

that exist on your CV , right , whether it's a low

6:51

score or failed attempt on their

6:53

on their boards , or whether they just

6:56

don't have enough clinical experience

6:58

. It's a chance to rehabilitate , because a

7:00

lot of times these IMG's , what they're facing

7:02

is their applications aren't even being

7:04

viewed , they're yeah

7:06

, right , and they get siphoned out easy

7:09

, exactly , I filter it out Exactly . And

7:11

so what we ? What we really

7:13

are known for , is making sure that you , these

7:15

programs within our network , they're not allowed to do that

7:17

. We , they , we want our

7:19

candidates to have an equal chance To

7:22

be viewed , and if they don't meet the criteria

7:24

, they don't meet the criteria , it's nothing . Oh , it's a fair play

7:26

. But you , what we specialize

7:28

in is making sure that , no matter what

7:30

, you're going to have a fair shot and you're going to have a chance to go

7:32

prove yourself .

7:34

So where are most of these candidates coming

7:36

? Are these because we have a huge , at

7:39

least in the United States ? We have a huge amount

7:41

of IMGs that come from

7:43

the Caribbean . We have IMGs

7:45

that come from Southeast Asia . Where

7:48

are the majority of your clients coming

7:51

from , if you can tell us that ?

7:53

No , no , no worries . So we have

7:55

helped people from literally all over the world

7:57

. Primarily , it is clients

8:00

or candidates that come from India

8:02

and Pakistan . We do have a lot of Nigerians

8:04

that reach out for help , but we

8:06

really have a strong foothold in

8:08

India and Pakistan , where the

8:10

word of mouth has spread about what it is that

8:13

we can do for these candidates

8:15

, these doctors who feel that they don't

8:17

have a chance . So in the past 20 years

8:19

we've helped many people from there , people

8:21

that are now become friends

8:23

of mine personally , that are willing to speak on

8:25

my behalf , on the company's behalf , if

8:27

anyone is interested but still has

8:29

doubts .

8:31

Why is this so hard ? Like , let's set the stage

8:33

. Why is this so hard as an international

8:35

medical graduate to practice in the United States

8:37

? Because we

8:40

always hear the stories . Even before or

8:43

while in medical school I heard the story of

9:44

there's a janitor at the job

9:46

who's working at the hospital , who

9:49

was in their own

9:51

country , was like an amazing

9:53

either hospitalist or internal

9:55

medicine doctor , what have you ? For

9:57

various reasons , they come to the United States and

9:59

they find it difficult to get into a

10:02

residency . Or maybe they're middle-aged

10:04

and they find out they have to do residency all over

10:06

again . Set the stage as to

10:08

the difficulties , the hurdles , what

10:11

it looks like for someone who graduates

10:13

and goes through all the hard work in their respective

10:15

country or their respective medical school

10:17

and then they want to come to the United States . Talk

10:20

to us about that . What makes it so difficult

10:22

?

10:23

Yeah , it's definitely an interesting question

10:25

. There's a lot of underlying

10:27

layers to it .

10:30

There's a lot of bias .

10:31

Yeah , exactly , there's a stereotype , there's a stigmatism

10:34

to anyone who

10:36

goes to med school abroad or

10:39

practices abroad . If they stayed in their

10:41

home country for a few years , programs

10:45

in America they judge it in a way and it's not to

10:47

talk bad about programs in general they

10:51

see so many applications and they

10:53

just a lot of times don't trust the

10:55

clinical skills that come from

10:58

learning medicine in a different country . As

11:00

time went by you

11:03

see the trend of these programs don't want

11:05

to take IMGs because of that . They

11:07

don't trust the clinical skills that are being taught in other countries

11:09

. When I've experienced it firsthand , I went to medical

11:12

school in Poland and when representatives

11:14

from programs would visit our school as

11:17

a kind gesture because they

11:19

knew some people that were part of the administration , they

11:21

sort of told us they said look , you have

11:24

to work twice as hard to go prove

11:26

that you're worthy of patient care because

11:28

we don't trust you . We , as in programs

11:30

majority in the United States Now there are

11:32

programs that are IMG friendly , which is great , but

11:35

a lot of programs especially programs where they're

11:38

well known and they have a

11:40

great pathways into fellowship after

11:43

you graduate from their residencies A lot

11:45

of them don't take to IMGs , a lot

11:47

of them still don't take DOs as well , if we're

11:49

really talking about the bias that exists

11:51

.

11:51

Absolutely .

11:53

That's still there too , exactly On

11:55

a smaller scale . So what they're looking at

11:57

and what they're judging in terms of red

11:59

flags to determine whether or not they'll give you a

12:02

chance to interview red flags

12:04

that aren't as strict when

12:06

it comes to American graduates . You

12:09

have your USMLE scores , which is first

12:11

and foremost . They're going to look at that to see how many times you've

12:14

failed . They're going to look at your

12:16

year graduation date . Nowadays

12:19

, a lot of programs are looking to see if you're three

12:21

years or older , but it

12:23

usually , or it used to be five years and

12:25

older . If you're right now , a 2018

12:28

grad or older , you've

12:31

missed the cutoff for a lot of these programs . If

12:34

you're an old grad , that's a major red flag and they're

12:36

not looking at your application because a lot of these programs

12:39

only want a 2019 or newer

12:41

and some of them really want a 2021

12:43

or newer . That's a major red flag there

12:45

as well . They're also looking to see how

12:48

your clinical experience is . Img

12:51

knows that if you

12:53

don't get at least three months of clinical

12:55

experience in America , then it's

12:57

going to be really tough for you to get

12:59

an interview when you're applying

13:01

for the interview season . If you get three

13:03

months . That's the basic requirement . The

13:06

problem is that a lot of rotations they're

13:08

only observerships or they're not inpatient

13:11

, outpatient . You're facing the small

13:13

hurdles which end up building up

13:15

into a big hurdle , a big red flag . You

13:18

can't touch the patient , you can't even write notes . Exactly

13:21

, that's really important , because if

13:23

these programs already have a bias of saying your

13:25

clinical skills are not up to date

13:27

or not on our part , then

13:30

how can you showcase that if a majority

13:32

of programs that do allow IMGs

13:34

to rotate are not hands-on , they're only observerships

13:36

, so it's just a back and forth for IMGs

13:39

to face .

13:40

What about visas and all that ? Does that ? Play a part too

13:42

? Is there ?

13:43

like a residency . That don't want to deal with that also 100%

13:46

because at the end of the day , medical

13:48

residency is still a business . To

13:51

have a visa sponsorship they have to pay

13:53

. The GME office has to order that

13:55

there's two types of visas . There's a J visa

13:57

and an H visa . The H visa

14:00

is the one that's really the most sought

14:02

after because it allows you to leave

14:04

the country , potentially apply for a green card

14:06

. But on a J visa you're locked into your job

14:09

. You can't move jobs , you

14:11

can't leave the country . Some of these programs

14:14

, they just flat out refuse to deal with the visa

14:16

issues . Now , luckily , the

14:18

network that we have built , the programs within our network

14:21

, they are all IMG friendly so

14:23

they are well known to give

14:25

out visas or sponsor your visa

14:27

. But that just comes part of the extra

14:29

time that IMG has to do the research

14:31

that they have to do because you're not just going to apply

14:34

to any program . You have

14:36

to go see are they willing to sponsor

14:38

you to go work for them ?

14:41

Is there any external

14:43

signs that a like

14:46

? For example , when I finished

14:48

my osteopathic medical education

14:50

in 2006,

14:53

. There was always these things

14:56

that either on student doctor net or

14:58

just kind of word of mouth that people would just be like , yeah

15:01

, you know , they're probably not ideal friendly because they

15:03

don't accept Comlex scores or they've

15:06

never had an osteopathic grad

15:08

before right . Is there

15:10

things like that that someone can

15:12

see by scouring either the website

15:14

of a residency ? Or

15:17

is there word of mouth that people know

15:19

that you can say , like that program that

15:22

ain't IMG friendly . Are there things like

15:24

that that you can see just from looking

15:26

at a website or something like that ? No

15:28

, that's a good question .

15:29

I think If

15:32

this question was asked 10 years ago

15:34

, it would have been primarily word of mouth . But

15:36

nowadays , with how society

15:38

is , the internet , how modern

15:40

is , people are constantly communicating

15:43

. And these IMGs , they have

15:45

big WhatsApp groups , they

15:48

have Twitter pages , twitter

15:50

groups . So they are they're individually

15:52

or collectively and , most importantly , privately telling

15:55

each other and their people in their home country hey

15:57

, don't apply there , it's not worth

15:59

your time , I had a bad experience

16:01

and you're going to waste your money on the application

16:04

. So these , some of these

16:06

groups , they're not public , but I've seen

16:08

them , I've heard about it from current

16:10

candidates of mine , past candidates of mine

16:12

, and they tell , they tell me , you know , we already

16:15

knew about this program because someone that's

16:17

my senior from four or five years ago told

16:19

us not to apply here . So it's very

16:21

interesting on how quick the word of mouth is

16:23

, but via social media and

16:26

how , how private they

16:28

are with this information . Because , at the end of the day

16:30

, you're also competing with other people who

16:33

are applying and you're

16:35

trying to receive an interview and you're , if

16:37

you receive the interview , you're trying to get ranked . So

16:40

these people , they're not trying to share their

16:42

secrets . They're , they're , they're holding on to it

16:44

Understandably so , because it's

16:46

it's a survival game , it's it's doggie

16:48

sometimes .

16:50

You know , a lot of times I feel like the

16:52

more people are quiet , the more

16:54

persistent like either biases

16:56

or stigmas or just

16:59

whatever advantage that someone

17:01

who has the ability to let people in or not , that

17:03

stuff continues , right , like it happens in

17:05

the doctor realm , where you know doctors will

17:08

be at a hospital and that you can have

17:10

, literally you know , multiple doctors

17:12

in the same specialty . They don't tell

17:14

each other how much they make and that

17:16

advantage ultimately falls to the hospital

17:18

, right , because they can low ball

17:20

here , they can high ball there and you

17:23

know they have the ultimate say so , you

17:25

know it's . It's very interesting perspective within

17:27

that realm . Question for you yeah

17:30

, the like . What's the

17:32

profile ? Because I know you said there's

17:34

a majority of your clients come from Southeast

17:36

Asia . What's

17:38

the profile ? Because in the United States

17:41

the average

17:43

medical school graduate

17:45

is going to be graduating with a significant

17:47

amount of debt , right , at least they're saying right

17:49

now close

17:51

to about $240,000

17:54

. That includes medical school

17:56

and undergrad , right

17:58

, and then obviously , you go through residency

18:01

and then you know , depending on what you do , that's

18:03

going to determine , in terms of specialty , how quickly you're

18:05

going to be able to pay that back . Right , we would be able to

18:07

pay that back five years , 10 years post . What

18:10

is ? How's the financial profile work

18:12

for students from ? For IMGs

18:14

, right , like there's always the star process

18:16

that , like medical school , is free . How does

18:18

that work ? Is that a myth ? Is

18:21

that a lie ? And then also , at the same time , like

18:23

, talk to us about the whole process of trying to the

18:25

financial prospects of trying to get into

18:27

the United States to do residency . Talk to

18:29

us about that .

18:30

No , that's a good question and

18:32

the further first part , the . It

18:35

is true that a lot of medical schools for

18:37

in a prospective home country

18:39

. They won't charge their students

18:42

that are coming in , whether the tuition is free

18:44

, if they meet the criteria , if they scored

18:46

well on their home exam , and

18:49

a lot of times , like in India for example , they're

18:51

called government medical colleges . These schools

18:53

are really good , they're really talented , filled

18:55

with amazing students who are going to be amazing

18:57

physicians , whether it's in their home country or they decide

19:00

to leave to America or somewhere else

19:02

. And then you have other schools

19:04

that are like in America , private schools

19:06

, not public schools , who are still good medical

19:08

schools , but they didn't meet the threshold in terms

19:10

of their scores and so with the students

19:12

that are going to those schools , they're going to have

19:14

a little bit of debt . A lot

19:16

of these home countries they don't even give loans . It's

19:19

just flat out you have to pay cash or you're not going

19:21

in . For example , my

19:23

school in Poland . The tuition was cheap . It

19:25

wasn't that expensive relatively speaking to American

19:28

med school and most

19:30

people . They didn't take loans . They just they paid

19:32

out of pocket because it was affordable to an extent

19:34

as far as

19:37

the financial implications of trying to come to

19:39

America . It's heavy , it's heavy .

19:42

Yeah , because I mean it's a couple of stacks

19:45

for step one , step

19:47

two , like in order to start to

19:49

do this , like you would recommend . They do all

19:51

the steps , right ? Is that how it works ?

19:53

Yeah , yeah , we I have all of my

19:55

, my candidates , and so does

19:57

every other counselor here . They have to take step three . It's

19:59

not , it's mandatory . If you want our help

20:01

then you have to prepare for step three prior

20:04

to us assisting you into getting

20:06

into residency . Because that three for

20:08

an IMG is so clutch

20:11

. It allows them to stand out because

20:13

these program directors tying

20:15

into the point earlier of wondering whether

20:17

or not you have the clinical skills they don't

20:19

want to be worried about you multitasking

20:22

or not having the ability to multitask

20:24

, going through residency as well as studying

20:27

for your step three . A lot of times I hear stories of

20:29

IMGs . They go to their program director and

20:31

they say I need a couple months off from

20:33

my residency to study for step three . And

20:36

no one wants to hear that . Everyone's working , everyone's tired

20:38

, these PDs , these attendings

20:40

, they have to teach and they don't

20:42

want to be stressed about that . So a lot of these programs within

20:44

our network will tell us hey , if they don't have step three done

20:46

, then don't bother presenting them to us because

20:48

we don't want to be stressed about them .

20:50

So that's a G . I'm looking at the EC

20:53

, fmg . Ec FMG

20:56

excuse me fees overall and

20:58

step one a thousand , step two

21:00

CK a thousand . Let's

21:04

see pathways application 925

21:07

for the application to a pathway

21:09

yeah , this could get pretty expensive . And

21:12

then we're talking about applications for J1

21:14

visa sponsorship $370

21:16

. So this stuff can really add

21:18

up , not to mention possibly needing

21:21

some tutorials

21:23

or even some type of board

21:25

prep .

21:26

Oh for sure . If you're buying you

21:28

worlds , the Q bank that's hundreds

21:30

of dollars right there you have to pay for your flight to

21:32

go to America to take your step three , as well

21:34

as to pay it for another flight

21:36

potentially to do your clinical rotations . Then

21:39

you got to go to the United States to take the test . Yes

21:41

, step three can only be done in America . You can't do it in any

21:43

other country in the world . It

21:46

can only be done in America yeah . So

21:49

a lot of these IMGs , what they do

21:51

, the people that are

21:53

being smart about it and are planning it out . They

21:55

take their step one and step two in their home country

21:57

and then they go crazy

21:59

with their studying for step three and when they come to America

22:01

to do their clinical experience , they

22:03

set time in between one of the months

22:06

with another month and they'll take their step three in America

22:08

. They'll knock out two things in one

22:10

trip .

22:13

So those who get in , you

22:15

get them in . What's the average

22:17

time that it takes ? Because

22:20

for us , applying to medical school

22:22

, it's a one-year process , at

22:24

least a one-year process On

22:26

average . What are we looking like when you're working

22:28

with clients who want to get

22:30

into the United States ? Like what we talk about

22:32

a year , two years , three years ?

22:34

So this is a very interesting question

22:36

. I'm glad you brought it up . It's

22:39

all a case by case basis because it's dependent

22:41

Just what have they are , it's like

22:43

a lawyer . It depends

22:45

it's true , it depends

22:47

on what they've done , first on their own , prior

22:49

to asking us for help . And

22:52

then , two , it depends on the climate

22:54

of the year , that specific

22:56

year , because I'll give you an example Someone

23:00

that signed with me that asked for

23:02

help , she's already

23:04

ECF and she's certified . She already took step one . Step

23:06

two , she already took her

23:08

English exam , because you have to pass that as well . She

23:11

was already living in America , she was on a green carder , so

23:13

they're in Chicago , and when

23:16

she signed with us she hadn't taken step

23:18

three yet , and so we prepared

23:20

for step three . She was already in the middle of her studying

23:22

and she took her exam within a month

23:24

. And we had a unique

23:26

opportunity where one of the programs within

23:29

our network offered or had a physician

23:31

off-track physician . So for any listeners

23:33

that don't know , off-track can

23:35

pop up for a multitude of reasons . One

23:37

, if a program is newly accredited , or two , they

23:40

recently fired someone , or someone quit

23:42

, which means they have to fill that position quickly , and

23:44

so the program reached out to us saying do you

23:46

have anyone that may meet the criteria ? Now

23:49

, one thing I tell IMGs all the

23:51

time is do not think that just

23:53

because you have a good profile on paper

23:55

that means you have a good shot of getting to

23:58

residency , because how you present yourself over Zoom

24:00

, how you present yourself over the phone , matters

24:02

. If you cannot articulate yourself well

24:05

, then in their mind your scores don't matter

24:07

, because how are you going to talk to your patients ? So

24:09

the one good thing about alongside other

24:11

good things , of course , but one of the good things

24:13

about this specific candidate is

24:15

she radiated good energy

24:17

on screen . So I got to her the interview

24:20

and they loved her . She killed the

24:22

interview , so she got her off-track position when

24:24

she was expecting to wait the full year . This was

24:26

months ago . She started her residency back

24:29

in October . So , to

24:31

answer your question , if they're

24:34

already ECFMG certified , we

24:37

have the ability to get them interviews

24:39

right away if

24:41

their profile is decent , or we know that

24:43

they can kill the interview If they're

24:45

ECFMG certified but with red flags , such as attempts

24:47

or low scores , we have them do the clinical

24:50

work first to go prove themselves . If

24:52

it's someone who is starting out fresh

24:54

on their journey , what I tell everyone

24:56

is the same thing the step one and step

24:59

two timeline will

25:01

determine how quick we can get you into residency

25:03

because if you , what happens not

25:05

as step one is pass fail .

25:06

Did that change anything ? The mathematics , the calculus on

25:09

any of this stuff ?

25:10

No and honestly for our candidates

25:12

, the way we approach in the trend that we've

25:14

seen since they changed the pass fail , it's been the same

25:16

for our candidates when they're

25:18

already our candidates Now . I know there's been

25:20

a statistical change for

25:23

people in general that

25:25

are taking the test . I know the percentage

25:27

has dropped slightly in terms of how many people

25:29

are successful , but in terms

25:31

of our candidates , our approach has stayed the same

25:33

.

25:36

So , basically , are you forcing it ? I'm not

25:39

forcing it , but the emphasis

25:41

has to be on really killing . Step two then

25:43

right .

25:43

Exactly because IMG's

25:46

in the past , up until the

25:48

rule change , have used step one

25:50

to their advantage to showcase hey , this

25:52

American didn't score as high

25:55

, but we're killing it . But now they lose

25:57

that advantage . So step one being

25:59

changed to pass fail has made

26:01

it even harder for IMG's and people

26:03

have complained . I've seen them complain some line .

26:06

So what about ? The one I want to ask you about is clinical

26:08

skills . What's the thought on all that

26:10

being gone now ? Is that like ? Do you guys

26:12

are like thank goodness ? Like , from my standpoint

26:14

, I'd be like thank goodness , but what are your thoughts on

26:16

that ?

26:19

I think from an IMG's perspective

26:21

it's a good thing , because

26:23

clinical skills the

26:25

PE is what I'm talking about .

26:26

Yeah .

26:27

Exactly , yeah , it's . I

26:31

think that IMG's struggle historically

26:33

with that specific step two exam . I've seen

26:35

people say for them people

26:37

that are older than me that that was the exam they

26:40

struggled the most . The other

26:42

exams straight MCQ , straight

26:44

knowledge or case study knowledge

26:46

they've been able to kill , but the talking

26:49

aspects made it a little difficult for them

26:51

and that's because these rumors

26:53

they started that exam for

26:57

that type of scenario .

26:58

That's what I heard . We don't know the , but

27:00

that's kind of the rumor and stuff .

27:02

I wouldn't be surprised . I would believe that rumor for

27:04

sure . But yeah , it's just IMG's

27:09

. Whatever they can get

27:11

away with in terms of not having to speak

27:13

, they're going to do it because they know that

27:15

they're at a disadvantage because English is not their natural

27:17

born language . So they're

27:19

already up against the wall when it comes to the

27:21

speaking aspect . What I tell everyone that's

27:23

a candidate of mine is you're still

27:26

making the choice to come to America . So don't think

27:28

that because of your cynical

27:30

knowledge and test taking skills

27:32

, that that's enough . If you don't present yourself

27:35

well , you can have a 290 or 280

27:38

on your step two and step three . They're

27:40

not going to take you , because patient care and

27:42

having the ability to empathize

27:44

with not only your patients but your coworkers

27:47

, your staff , from

27:50

PD to janitor all of that they take

27:52

into account . So you'd have to be able to articulate

27:54

yourself well , you have to be able to showcase

27:57

your emotions well All

27:59

of that matters .

28:01

Yeah , it's got to be really stressful though , because I mean , not

28:03

only now are you leaving your country , particularly

28:06

if you're deciding to work with residents medical

28:08

you're leaving your country , particularly

28:11

if you have some red flags

28:13

and you need to do some clinical rotations

28:15

. Like how does that work in terms of

28:17

you got to find housing ? You

28:20

know like you're in a different country and you're

28:22

not sure if this is going to work out

28:24

, but there's an expenditure

28:26

on that . Like , talk us through that . Like

28:29

how do you coach people through that ? Because I'm sure

28:31

there's a lot of hesitation , there's some

28:33

nervousness . Obviously , to a lot of folks

28:36

who come to you guys , you

28:38

guys are like their lifeboat

28:40

, you know their life jacket . Talk

28:43

to us about that , how serious that is and how that

28:45

works .

28:46

It's very serious . You know what I make

28:48

sure I do is , prior to you

28:50

know , having them sign with us . I break down

28:52

everything with them , I break down from the

28:54

get go Look , this is what you should be expecting

28:56

to pay , because this is where we're sending you

28:58

in terms of your clinical experience . So

29:00

let's say , hypothetically , it's in Miami

29:03

, the program's in Miami . So we , as you know

29:05

you and I both know my fellowship there it

29:07

was dope , there you go

29:09

. Miami's dope . All right , okay , so

29:12

that's then . I'm sure , as you know , it can get a little expensive

29:14

there . You got to , they're going to be living there . If they

29:16

have a bad profile , if they got

29:19

multiple red flags , you can end . You

29:21

know , especially if they're an old grad , you can expect them

29:23

to be integrating , doing the clinical work for

29:25

as long as eight , nine months . Because what

29:28

these programs are going to be telling us and we communicate

29:30

with the programs frequently they tell us , hey

29:33

, they're progressing along , but they need to keep showcasing

29:35

the clinical skills . They need to go , continue

29:37

to prove themselves . So what I tell all

29:39

of these candidates , prior to them even signing

29:41

with us , you need to expect to pay this

29:44

much , because it's not just paying us

29:46

as a residence medical that it's guaranteed

29:48

, no , it's . This doesn't work like that . What we're

29:50

all doing is opening the doors and allowing you

29:52

to go prove yourself . And all of that

29:54

still costs extra money . Because you got to go pay

29:56

for accommodation , you got to pay for

29:59

your U-worlds , your study

30:01

material . Our tutors are going to take care

30:03

of you , but the material itself you still have to go

30:05

get . You have to pay

30:07

for food and you have

30:09

to pay for anything the hospital the program requires

30:12

you to have in order to be

30:14

learning from them . So all of that , as

30:16

well as the flights , right , that comes with the terrace

30:18

, and so all of it's filled

30:21

up . And I tell everyone , look , I'm

30:23

never going to be the one sitting here trying

30:26

to coerce you to commit

30:28

to us financially . I'm not going

30:30

to do that If you have the financial

30:32

means . What I am going to do , what I'm going to make

30:34

sure I do , is get you this

30:37

residency that you're dreaming for , as long

30:39

as you commit to me and

30:41

are willing to put in

30:43

the work , because you still have to put in the work . That

30:45

comes with anything in life .

30:49

Man . So okay , got

30:52

you on that point . So when they're doing rotations

30:54

and they're rehabbing themselves

30:57

, this is rehabbing

30:59

like , almost like a sub-internship , or

31:01

is this more on

31:03

the medical student side , or are they

31:06

actually on working with residents

31:08

and they're basically considered

31:10

part of the team , but this is like

31:12

a tryout . How

31:14

does that work ?

31:16

No , that's a good question . So what I ? And

31:18

that's a common question too that people ask

31:20

when I'm doing my consultations . It

31:23

is technically a sub-I as

31:25

a graduate . So they're working with the

31:27

residents and they're listening to

31:29

the attendings , but the

31:32

program knows that we're

31:34

the ones that sent them . So they

31:36

know that we have the intention to

31:38

network on their behalf , that we have the

31:40

intention to nominate them their

31:42

candidacy for one of their interview slots

31:44

when it comes to time for interview season . But

31:48

they treat them like sub-I's because they

31:50

want them to go showcase why they deserve a

31:52

chance , while we're working in the shadows in the

31:54

background , internally contacting

31:56

the PD saying , hey , how's my , how's

31:58

my candidate doing ? Is he or she putting

32:00

in the work , what are her strengths , what are her weaknesses

32:02

? And then , when I find all that information , I relay

32:04

it back to my candidate on my weekly call with them , or

32:07

I'll give them a surprise call and say hey , I

32:09

heard you're doing really strong in this , but you're

32:12

weak in this specific area . You need to step it up

32:14

. Because they're not happy with that . I communicate all

32:16

of it with my candidates because I want them to know that

32:19

I'm an open book and the program is an open book . They're

32:21

willing to give you a chance , but you have

32:24

to go showcase that you're willing to rehab

32:26

these weaknesses that you have , whether

32:28

it's clinical or whether it's

32:30

just to showcase that your scores don't

32:32

represent who you are . Your clinical skills represent who you

32:35

are , but they do get treated as sub-I's

32:37

, with sort of a

32:39

good asterisk next to their name that this

32:41

is a residents medical candidate . So

32:44

they're hoping to get an interview from us .

32:46

Yeah , sub-i's a tough though . Yeah , because I remember doing

32:48

sub-I's for Jen Serge . I was at the hospital

32:50

by four , leaving by seven

32:53

, writing doing power points

32:55

for M&Ms and all those different things . So sub-I's

32:58

are no joke . I still remember that man

33:01

. So the because there's

33:03

got to be people that you look at and you're

33:05

like , yeah , you're not going to be a good fit . So

33:08

talk to us about those

33:10

who residents medical

33:12

is for and who it's not for , and

33:15

be honest .

33:16

No , no for sure . And that's a good question too , because obviously

33:18

these people with the horrible profile come to

33:20

us , right , someone with

33:23

many , many failed attempts , or their

33:25

scores are just absolutely horrible . But most

33:27

importantly , it's the people that are

33:30

super old graduates and I empathize

33:32

with them because it's not their fault

33:34

that they moved to America at a later stage in their life

33:36

, right , a lot of these doctors

33:38

are respective

33:41

physicians in their home country , but them

33:43

and their family decided they wanted a better life

33:46

and they moved to America . But they're already 45

33:49

, 50 years old . Their graduation date was 1995

33:52

or 2000s , like that , and so they come

33:54

and talk to us . What we do

33:56

first and foremost is we evaluate

33:59

what skills

34:01

they have and if they have

34:03

skills that we can use to our advantage

34:05

when speaking with programs , and

34:08

these skills outweigh their weaknesses on their profile

34:10

, even if they're a 1995 grad , we

34:13

know we can get them in . We have a chance Now

34:15

with these , these horrible profiles

34:17

. I tell them straight up you

34:20

are going to integrate , you're

34:23

going to integrate and do the clinical work for

34:25

a year straight , and I don't want to hear you complain

34:28

saying it's too , it's too long of a work , because

34:30

these programs I can't just set up

34:32

direct interviews . They're going to look at us like

34:34

we're crazy and say why are you offering

34:37

us a 1995 grad with a couple

34:39

of attempts ? It's sort of disrespectful

34:41

, honestly . So what we tell them is

34:43

we send them to programs that

34:45

are known to give old grads a

34:47

chance , especially if

34:50

they're a program that knows us already . We

34:52

have a , again , a proven track record of these old

34:54

grads still doing well . So they'll give these

34:56

old grads a chance . But it

34:58

requires a long , long process

35:00

of rehabilitating them and they have to

35:02

commit . And it does get

35:04

pricey sometimes , right , because they're not in

35:06

America for a few months . We're having them essentially

35:09

move here for a year just to do clinical

35:11

and they're not getting paid right . It's

35:13

an externship , oh yeah .

35:16

That's the other thing . I forgot about that . Yeah , you're

35:18

not getting paid , you're not being an income during this time .

35:20

No , no , they got to earn that . They got to earn that

35:22

. So it can get pricey

35:24

, right . And I tell them from the get go

35:26

I'm not trying to play you , I'm not trying

35:28

to fool you this

35:31

is what it's going to take . This is the approximate

35:33

cost . If you have the financial means

35:35

, we can assist you in getting your dream

35:38

residency , as long as you put in the work . If

35:40

you don't have the financial means , there are

35:42

other avenues for you to be working

35:45

clinically . It's just that residency is tough Sometimes

35:48

. It is what it is .

35:50

And no doubt anybody who trains in a different

35:52

country , and they've already practiced . You

35:54

have to do residency again to come to the United

35:56

States , correct ?

35:57

Yes , yes , and this is what

35:59

I feel personally the most horrible

36:01

about . You have these

36:03

physicians . Some of these physicians are not

36:06

just well-respected but known . They're famous

36:08

in their home country . They've done big things

36:10

in their home country , innovative things

36:12

, and in America they

36:14

don't care . These programs , the

36:16

system does not care . You can be so

36:19

famous that you're consulting physicians in America

36:22

, but when it comes time that you want to go practice in America

36:24

, they'll treat you like a PGY1 or

36:26

really a PGY0 . They don't care .

36:29

I need labs in the morning . Where's

36:32

my soap note ? Yeah , that's bad , that's horrible

36:34

, and is a lot of that

36:36

based off of something like ? Is

36:39

it just beyond like ? Is it based off

36:41

of like a real bias or

36:44

is there something to that ? What

36:46

exactly is it that we're not

36:48

trusting ? Is it the educational system we're not trusting

36:50

? Is it just cockiness

36:53

on the United States medical training system ? What

36:56

do you think is the number one issue with

36:58

that type of thought process , where people can

37:00

be even at medical schools that are well-respected

37:03

, right , like this

37:05

would be an issue , right ?

37:07

No for sure . I think all

37:09

of that comes into play a

37:11

part , a combination . But if I had

37:13

to choose one , I'm

37:15

still going to choose the fact

37:17

that they went to medical school abroad

37:20

.

37:20

Yeah , that's a big issue .

37:22

Yeah , I think that program directors , especially

37:24

older program directors , you know from back in

37:26

the day they are just

37:28

not going to trust someone who did not practice

37:31

or get top medicine in

37:33

the States . They don't care where you come from

37:35

. Even recently

37:37

, it took up to recently for

37:39

them to even give the Caribbean

37:41

a chance right , and I've heard stories of

37:44

these programs slowly not wanting

37:46

to take Caribbean school students anymore

37:48

either .

37:50

So it's come to a point where and

37:52

we still have shortages in the United States like

37:54

crazy , particularly in the Midwest

37:57

and so forth .

37:58

Yeah , yeah , but recently I mean

38:00

, a couple of these states are slowly starting

38:02

to change their rules where if

38:05

you are a prospective candidate

38:08

but you don't want to go through residency

38:10

, if you qualify they'll let them get their GP

38:12

license a limited GP license and you

38:15

can put that way , under the mentorship and

38:17

guidance of an PD

38:20

, of a residency . Now I think in

38:23

terms of all 50 states , it'll still

38:25

take like 20 , 30 years for that to happen

38:27

, but there are a few states that are considering

38:29

and almost their bill has passed . So

38:31

I think when you and I are a lot

38:33

older , the times

38:35

will be changed , but for now it'll stay

38:38

the same . Be tough .

38:39

I know you mentioned that they have direct

38:41

access to you guys through your cell phones . I'm sure

38:44

you have to do some type of pickup call or

38:46

like a pick me up , because

38:48

that's got to be tough During

38:50

this time . You're probably away from your family . You're

38:53

not sure , like we said , what's the

38:55

mindset , because we already got physician burnout

38:57

as a major issue , even among residents and

38:59

medical students , and now

39:01

you're talking about people who are spending

39:03

money to do something that's

39:05

not even guaranteed , at least if you're a medical

39:08

school in the United States . You

39:10

feel like you're plugged along that highway

39:12

that's going to eventually get you to practicing

39:15

as a physician and there's no guarantees

39:17

in this situation . What's

39:19

up with that ? Talk to us about that mindset .

39:21

No for sure I can speak

39:24

in terms of what my candidates go

39:26

through , and these candidates

39:28

, essentially , we've promised them that , if you

39:30

come , do the clinical work and spend the

39:32

time in America , away from your family

39:34

, whether it's away from their family in the States

39:37

or away from their family in their home country . But

39:39

we need you to go . We need you to go prove yourselves

39:41

. Even now it's February

39:43

, right ? They're feeling the pressure

39:45

. They're feeling the pressure because it's all coming to

39:47

an end . They don't know yet if

39:50

they've done enough . They

39:52

start to get high anxiety , they're homesick

39:54

, and it's my job to make

39:56

sure that I help

39:58

them along the way , especially right now , because

40:00

we're the ones we

40:02

as in residents , medical , we as a

40:05

counselor I'm one of the counselors we're the ones

40:07

who assure them that , if

40:09

they go along this path , that you

40:12

will end up having your dream residency

40:14

announced , and so it's

40:16

my job to make sure that I take their call

40:18

every night , every day , every

40:21

night , whether it's once , whether it's multiple

40:23

times . I'm going to talk to you . I will be available

40:25

at any stage of the day and reassure

40:28

you that , although it's gonna be really

40:30

hard right now and it's

40:33

not even March yet , so it's gonna be really hard , six

40:35

weeks up until match week and you're gonna be

40:37

really stressed . But Don't

40:39

give in to that anxiety and that stress , because

40:42

you made it to the finish line . And that doesn't

40:44

just go for all of my Canada , it's . That goes

40:46

for IMG's in general . Don't

40:48

don't have a panic attack , even

40:50

though if it's , you know it's natural , but don't you have to

40:52

be staying calm because it's it's

40:54

the last leg of the marathon . So

40:56

if you feel that burnout now when

40:59

Residency gets announced next

41:01

month , then you know It'll all

41:03

be for nothing . And I think it's really important

41:05

to say and if I'm stepping on your toes

41:08

, I'm sorry , but Even if

41:10

match you don't match next month

41:12

, that doesn't mean your , your

41:14

season is over , because soap and

41:16

post match exist .

41:18

Yeah .

41:19

I've I've seen IMG's who don't get the announcement

41:21

on the Monday of match week Just have a complete

41:23

fallout and you know they break down

41:25

and I want people that , I know that that

41:28

happened to them . I tell them hey , you

41:30

know you have to , you wanted

41:32

this . So you have to start thinking logically

41:34

and smart . Your , your time isn't

41:37

done . You still have to go through soap and

41:39

these positions that don't get filled in match

41:41

and soap , the , the programs have

41:43

to fill them , so it's not like they just go away . So

41:46

from soap up until June , these positions

41:48

are still available . So you need to do

41:50

your part and make sure you're presentable both

41:52

physically , emotionally and , most importantly

41:54

, clinically To showcase to them . All

41:57

the way up until June I've had candidates

41:59

of mine who have scratched and clawed

42:01

and they proved themselves . It took a while

42:03

. I got them an interview second week of June

42:06

. They got the residence that far in

42:08

.

42:08

Yeah , and we can go .

42:10

We can . We can go even farther . It's People

42:13

think the the stereotype of

42:15

you need to match by March

42:17

. So you start residency in July

42:19

. They , they think in those lines . It's not

42:21

black and white , it's really not , and

42:23

that's not just for IMG's , that's for AMG's . If

42:25

you go through Twitter and you can , you scroll

42:27

, scroll through the trends right now in terms

42:30

of residency . I've seen so many Americans

42:32

Tweet , saying and telling them

42:34

their stories .

42:35

That's a good point .

42:36

You know we didn't go the traditional route . It was

42:38

unorthodox . What happened to us and we're successful

42:41

attendings or in fellowship . So the

42:43

story doesn't end for you just because you don't match

42:45

the story . It will continue

42:47

to go as long as you have the

42:50

willpower and the fire to do so .

42:52

Yeah , I think Twitter , social media in general

42:55

, that's really taken the

42:57

you know it's . It's , let's

42:59

just say , used to be very opaque , the whole system

43:02

, right , and you never know who went

43:04

through their issues . Like I've , on my

43:07

show , been very clear and letting people

43:09

know that I applied to medical school twice , you

43:11

know . But to some people , like you

43:14

know , depending on when you grew up and what your generation

43:16

is , you know , having to reapply to medical

43:18

school or not , getting into match and going through

43:20

the soap process , some people may

43:22

look at that as like a , like a scarlet

43:24

letter . You know , and I think that Twitter

43:26

, social media , you have more people who are

43:29

normalizing that . Hey , you

43:31

know , for a lot of us this process is

43:33

not a smooth road . Sometimes

43:35

you hit potholes , sometimes you got to take

43:37

a detour and you know what . I'm much better

43:39

for it , right , and you

43:41

know , I think the more people that we have doing that

43:43

, the better . So I'm really glad that

43:45

you mentioned that , because I think a lot of people

43:47

like man , it's when you don't , when

43:49

you find out that you don't match , you

43:52

know it's heartbreaking .

43:54

I've seen my family , I've seen my friends

43:56

. You know , some are celebrating

43:59

and at the same time , on the same couch

44:01

, some are crying .

44:05

Yeah , you come from a family of doctors .

44:07

I have cousins and a lot

44:09

of friends that that went through medical school route

44:11

, whether it's as an IMG or as

44:13

a as an AMG in American grad . I've

44:16

seen both . I've seen both routes . So I've seen

44:18

both Hurtations , both

44:20

struggles and some some of

44:22

it is the same struggle but a lot of it is different

44:24

hmm , well , listen

44:26

guys , residents

44:28

, medical is like that .

44:30

We actually did an Instagram like

44:32

video live Several

44:34

months ago and it was very well received

44:36

. I think in that discussion we

44:39

were talking about Are

44:41

we talking about mental health ?

44:43

Yeah .

44:44

Yeah , we're as we talk . We

44:46

were talking about mental health and I kind of talked

44:48

about me doing locums , which

44:51

is basically kind of my way of kind of de-plugging

44:53

from the system . I still may be able to take care of people

44:55

, but it gives me the opportunity to be

44:57

in the system and then kind of check out

44:59

and so forth . So you

45:01

guys might find me in residents medical doing

45:03

another live , hopefully in the future . But For

45:06

anybody who wants to get in contact with residents

45:09

medical , for anybody who wants to learn

45:11

more , give us the ways

45:13

that people can get in touch with you

45:15

. You know , learn more about the organization

45:18

, the company , take it from there .

45:20

I Appreciate

45:22

you having me and I appreciate Everything

45:25

that that you guys got going on and I can't wait to

45:27

to hop back on here so we can

45:29

continue to talk about the the struggles

45:31

that that IMG's face , as well as doctors in

45:33

general . So to get in contact with residents medical

45:35

, feel free to go on our website , uh

45:37

, residents medical calm book a consultation

45:40

. Our consultations are free . If you

45:42

have a specific counselor you want to talk to , our counselor

45:44

profiles are on the website , as well as

45:46

DM us on all our socials , whether

45:48

it's Instagram , twitter or LinkedIn , and

45:51

if you see my LinkedIn my personal work LinkedIn

45:53

feel free to DM me as well . I'm always active

45:55

on there , I'm always responding and and

45:58

one of the counselors , including me , will definitely

46:00

reach out to you as well and we'll schedule a free

46:02

zoom for you .

46:03

How long is the consultation only take ? At most

46:05

an hour .

46:06

I think on average between 30

46:09

minutes to an hour . It's really where

46:11

we we get all the information

46:13

, your background information provided by

46:15

you , and we go over your

46:17

pathway where you are currently , what

46:20

is expected for you to do and how we can

46:22

help you , but typically in between 30 minutes to an hour

46:24

.

46:24

So when someone is working with you guys or

46:26

decides to work with you guys , the

46:28

onboarding process to actually

46:30

Possibly being placed

46:33

you know to do some clinical work or maybe

46:35

even getting Mentorship from

46:37

you guys officially , how long does that

46:39

process take ?

46:41

so I've seen it happen as quick

46:43

as two weeks where someone , after meeting

46:45

with them and Typically what I do

46:47

, after having a consultation , and they go back

46:49

and speak with their families or their friends

46:51

family friends and I Give

46:54

them references . So once they're speaking

46:56

with the references and they're convinced

46:59

, once they sign with us , we get them on board within

47:01

a couple of days and if they're

47:03

, if they're already in the states and they're willing

47:05

to to fly to wherever we need them , we

47:08

can get them in a clinical setting

47:10

as fast as a week after that .

47:12

Oh , wow .

47:13

Okay .

47:13

So that's . That's pretty fast , depending on if you

47:15

are in the United States or not .

47:16

Okay , yeah , if they're in a different country , let's

47:19

say India or Pakistan , it'll take them a couple

47:21

weeks to buy their flight . Because we're not , we understand

47:23

the flight prices and if you buy a international

47:25

flight a couple days prior is gonna cost you a pretty

47:28

penny . So we tell them don't worry about

47:30

it , take the two to three weeks to get the price

47:32

back to normal , and then , once you fly out here

47:34

, then you'll be ready to go . But don't

47:36

they have to get like a visa and all that

47:38

? So most , most of the

47:40

candidates of ours should at the

47:42

very least already have a travel visa

47:44

. Be one , be two . If they don't

47:46

, then we assist and we have immigration lawyers that

47:49

are friends of ours and what sort

47:51

of expedite the process To gain them the travel visa

47:53

, which has happened for sure .

47:55

Friends in high places . I see I see

47:57

, okay , okay . Well , everyone , that's

48:01

dr Simrod Gill , representing residents medical

48:03

. Listen , these are

48:05

your folks . If you are an IMG student

48:07

or IMG graduate and you are looking

48:10

for placement in medical residency or in fellowship , this

48:13

is the organization , this is the company that you

48:15

want to align yourself with . Listen , we

48:18

will put the show notes on how people can get in contact with you guys Below

48:22

if you're watching on YouTube , or it will be in the show notes if you're listening on

48:24

the podcast . But

48:27

, once again , guys , if you need help and you're an IMG student

48:30

, this might be your lifeline that you need . Dr

48:33

Gill , thank you for your time . Everybody I've

48:35

residents medical . We appreciate you collaborating with docs outside

48:37

the box . And listen , guys . We're going to catch you guys

48:40

on the next episode .

48:43

Thank you for having me , and I appreciated this .