Sunbal Ashraf
@_mooncube
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CL + HIV psychiatrist. Reproductive justice. #NarrativeMedicine . Clinician educator. Mind the gender pay gap. Canadian in the South 🇨🇦
Joined August 2009
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We don’t talk about the trickle down effects of hierarchy in residency training programs. The bullying, the affinity bias, how IMG’s and less competitive residents may not be treated as equal or are viewed with a scrutinizing and less forgiving lens.
I’ll talk about it. One day.
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Being on a J1 visa is like being shackled to medicine. It takes away any kind of control over your career and we don’t talk about this enough.
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Older generation Pakistani IMG doctors, please be nicer to younger aspiring physicians. Your cliques, Tesla’s and Gucci kitty parties are truly uninspiring.
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I teared up in clinic today. I have been seeing a patient who is a formally an opiate user and has been off of methadone. Significant PTSD and interpersonal conflicts. I started her on fluoxetine and today she seemed like a brand new person. Her words struck me:
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Diversity and inclusion also means making sure we recognize religious minorities.
For the longest time I was the only Muslim female resident in my residency program - as we approach the Holy month of Ramadan let’s be mindful and support our Muslim colleagues.
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‘I don’t feel like dying anymore’ I stayed with her in that moment as her eyes welled up. This is why I chose medicine. We are literally saving people’s lives daily. So keep showing up for yourself, don’t lose hope because one day you will be changing peoples lives for the better
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You 👏 do NOT 👏 need research 👏 to match.
Residency programs want you to be efficient and competant clinicians - that requires:
1. Take a history
2. Do a physical/mental status exam
3. Work well others
4. Respond well to feedback
Everything else is a cherry on top.
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Speaking purely on my own experience, the road to medicine was deeply humbling, especially as an IMG. I didn’t come from generational wealth, I didn’t have family in medicine, I worked v hard + by God’s Grace I’m here. I am trying to understand the opposite lens very respectfully
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So residency programs, please look beyond scores and a numerical value; these candidates are much more than their test taking ability. We all possess unique qualities that truly impact patient care whether that’s cultural sensitivity, being a parent, or being an immigrant.
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@JustinTrudeau
Justin are we still using dehumanizing language? Palestinians are humans deserving of safety, food, medicine and life. I can’t believe after 20,000 lives lost we are still using the same language and tactics.
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The medical system is so twisted + one sided that only IMG's feel the need to publicly post their Step scores on social media. Why?
B/c as IMG's we are so invalidated that when we feel we rise above the average on standardized tests, we need to prove that we belong + are worthy.
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We don’t appreciate and celebrate clinical work as much as scholarly activity and ‘research’ - let me ask you, did you go to medical school to treat patients or write papers?
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Incoming interns - you haven’t reached your destination yet, you have 3-6 years, then boards, early career, etc. There will be many times that residency will break your spirit - try not to let it. Learn, listen and stay humble - nothing is personal.
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Residency programs and ppl working on websites in particular - please update your application criteria for the upcoming cycle. If you are a program that no longer accommodates J1/H1b visas, please state so. It saves applicants and you a lot of time and money.
#Match2023
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ERAS submission soon! IMG’s, I will retweet you, all the best!! Rooting for all of you, you deserve to be here 👏
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@arghavan_salles
when they only recommend alternating between acetaminophen and ibuprofen post C section (while learning how to nurse and take care of a baby) then you know how bad it is.
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A psych np is not a psychiatrist - would you call a np who works in a cardiology a cardiologist? In psychiatry, we have been thwarted, swatted like flies when we try to advocate for our presence and distinguishment. In this case, language matters b/c our skill set is different!
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Every resident from every specialty should do a month of consult psychiatry so they know how to do capacity evals.
What’s your unpopular medical opinion that would land you in this position?
Drop it in this thread
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There’s an open PGY 1 rural psychiatry program that will be looking at applicants AFTER SOAP. Can DM me for details.
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Once you decide you want to pursue residency in the US, they don't tell you about the lost friendships, romances, experiences and departures you must face along the way. It leaves you wanting a sense of belonging, comfort and a space where you feel welcome and accepted.
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Fellow Pakistaniyion, as you gain success + ‘status’ after you ‘make it’ in America, please don’t forget what it took + the opportunities ppl gave to get to where you are.
I see it all the time, the elitism, the classism, thinking b/c they’re finally docs. Shoulda stayed in PK.
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I’ve had some students reach out about the J1 visa process. This is something you will need for residency after you match if you are a Non USIMG.
I will be holding another
#IMG
session next month and will continue to do so as
#match2022
approaches us.
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IMGs are the backbone of the primary health care system in America. We work in some of the busiest, underfunded cities and towns in America. We don’t get to choose competitive specialities because we don’t stand a chance, but we are grateful to serve our communities
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Medicine will let you down, it will break yr heart, won't appreciate you.
The ego's + narcissism of academia will tear you apart. Remember why you chose this field- the joy, excitement, + fulfillment comes from how you treat your patients, their stories, how you made them feel.
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When you’ve sacrificed so much for medicine and realize after having kids that the only thing that matters is a job you love close to your family. That is IT.
I am officially done my J1 waiver 🙏🏼
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Once yr on the other side of medicine - you realize success is a byproduct of how much privilege you have. Your parents education level, your legal status, your culture, your finances - ALL of it. So if you’re a first gen + have made it this far - you are BRILLIANT.
#Match2024
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#Match2023
And for those applying for
#Match2024
Please don’t apply to psychiatry as a backup. Believe me, we find out pretty quickly by speaking with you and looking at your application.
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It baffles me when I hear that programs don’t prefer
#IMGs
for the sheer fact that they’re not from here. Do we understand how harmful that is? What makes medicine unique + powerful is our collective experiences, cultures, backgrounds + knowledge for the betterment of patients.
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For
#IMG
's applying for the
#match2022
cycle, in case you didn't already know this. If there are no IMG's listed in the resident profiles, then you you and your money are better off applying to places that have a history of matching them consistently.
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Believe me when I say that even after you train in residency for 3-6 years, those years don’t count towards you obtaining permanent residency in the US. You will then need to complete an additional 3 years in an underserved health care area and then you MAY be eligible for a GC.
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#MedTwitter
Why does clinical research make ones application more competitive if someone just wants to do clinical medicine, train in a community hospital and take care of patients?
Why we do push for research so much?
Fact: I haven’t done research.
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@autefeh
ya'll love talking about diversity and inclusion but when a resident is requesting for a social event to be inclusive, all hands up in the air :/
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Let me be clear. Connecting w/ the 🇵🇰 community is hard unless you act + look a certain way. I have seen they only prefer their own medical college alumni. This is not everyone but as healers + representatives of 🇵🇰, we should be setting a better example.
Older generation Pakistani IMG doctors, please be nicer to younger aspiring physicians. Your cliques, Tesla’s and Gucci kitty parties are truly uninspiring.
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My fellow IMG's, please be weary of people who DM you or attempt to contact you through unofficial ways to 'help you'
This is another harmful way to feed off your vulnerability especially when they offer tools to improve your app, promise you USCE - always do your research
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Yikes some of the LOR’s I’ve read which are supposed to be detailed, personal + reflective of the writer’s direct experience with the candidate are abysmal + poor. Candidates deserve a chance at someone writing a strong letter of rec for their application. If you can’t then don’t
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If there are researchers, scientists and post docs willing to take on international medical graduates for assistance in their labs and other projects, please reach out.
#match2022
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Candidates wouldn’t need to spend thousands and thousands of dollars if programs did their part and updated and kept their selection criteria transparent.
Even programs don’t want to go through thousands of apps to give maybe 100 interviews for ~ 6 spots.
#Match2024
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I’ve lost count how many Eids I’ve spent w/out my parents. Being an
#IMG
will do that to you. This may be your first Ramadan + Eid w/out familiarity, comfort + loved ones. Sometimes our community doesn’t do a good job in welcoming our own either which further leads to loneliness.
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All of the systems - ECFMG, the J1 visa, the J1 waiver process and the excruciatingly long road to permanent residency is predatory and manipulates the helplessness of
#IMG
’s.
There’s a doctor shortage but no ease in allowing doctors to work.
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I wanted to share something with all of you on the Match and residency grind - it does get better. This is the first year in what seems like a life time that I am able to enjoy a ‘normal summer’ - no exams, no moving. You will get through it, believe in the perserverence 👊🏽
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A clear distinction between US IMG’s + non US IMG’s
1. The former doesn’t need a visa
2. Most if not all programs only offer J1’s which don’t allow you to moonlight - part H1b’s aren’t given as often
3. Even if your partner is a citizen + youre on j1, you still require a visa
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#Match
applicants - you want to be proactive in your approach when seeking out mentorship, USCE, and research. I know how valuable Twitter has become as a tool to connect but posting + retweeting the above won’t land you those positions - it is rather a passive attempt.
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This is a shout out to Pakistani women in medicine - I am in awe of your passion, spirit and dedication in defying structural norms and paving a way for other young girls to pursue their goals in a country that fetishizes marriage.
#Womeninmedicine
#match2022
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@mahad_minhas
child and adolescent psychiatry, geriatric psychiatry, forensic psychiatry, basically all of psychiatry.
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Good luck to all applying to this year's Match!
July 1, I will be hosting the
#IMG
webinar via Zoom, look out for an invitation in your emails.
#Match2022
#IMGMatch
@Inside_TheMatch
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Stop being racist to IMG’s especially when they’re in your residency program. I’m looking at all the Karen’s who make it so hard to exist as a trainee.
#IMG
#MedEd
#MedTwitter
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This time is especially difficult for our
#IMGs
who belong to many ethnic diaspora’s across the world. They have worked hard and are also trying to navigate a biased medical system through the Match. I can’t imagine what they’re going through too. Support them, advocate for them.
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I am grateful for the US allowing me to pursue residency training.
I am from Canada where during the past 2 years, the country was in several long lockdowns, hospitals were at capacity and YET the gov of Canada didn't think Canadian IMG's were good enough to care for Canadians.
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You know what makes you an excellent physician?
Your ability to listen and understand.
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@SamanSSiddiqui
@DrMunaSaleh
Ina lillahi wa ina ilayhi rajioon. May Allah grant them Jannah and grant this young boy health, strength and so much healing. I am heartbroken for their family =(
#islamophobia
in Canada is very real.
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IMG’s who are SOAP’ing + have not matched yet, those observing the start of Ramadan this week, feeling alone + not amongst community while navigating a confusing system.
Pls take care of yourselves, reach out to local MSA’s, Zoom iftars w/ friends, call home, always reach out.
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@arghavan_salles
Thanks for sharing and sorry you had to experience this. So appalled that people are misunderstanding your point. You connected with someone from your home and only someone who knows what it feels like to be the ‘other’ will relate to this.
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Every residency program should have protected time for their trainees to make appointments, therapy.
We boast about wellness but we don’t make the structural changes to implement.
Even as attendings, we have to ask for admin time.
#MedTwitter
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It is so heart warming to see so many international medical graduates from all over this beautiful world; it's vibrant, it brings so much diversity, culture and unites all of as individuals who want to improve the better good. I hope to learn from all of you one day :D
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IMG’s already face discrimination + constant scrutiny by their community members, colleagues + the general medical community b/c there’s an assumption they ‘weren’t good enough for a US allopathic school’.
I encourage you to talk to an IMG + ask them about their medical journey.
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Hello
#medtwitter
mamas,
For those interested, I’d like to start a group for
#momsinmedicine
, where we support + build a community that many of us have lost during the past 2 years. It’s been hard, expecially for those who’s families are far. Please share + let’s connect.
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I am a Canadian IMG + am so grateful for the ongoing opportunities America has allowed me to serve its people. An opportunity Canada denied me since I graduated college when my advisor said I had no hope + my only option was to join the work force.
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Hoping to check in with all of you since we are only a couple of months away from
#Match2022
Please DM me your email address and I will plan to hold another Zoom session in June to navigate prep and process for the next cycle, open to everyone but my focus will be on
#img
's
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I wanted to check in: it is a difficult time to process all the atrocities happening in the world. For my
#IMGS
who are preparing for
#Match2022
, don't lose your resolve and focus. We need your determination more than ever, we need you to be advocates for your people.
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@ArifSohab
@drmunapsych
Women docs get this all the time; especially desi aunties who think women can’t have family + career.
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@temafudge
In South Asian culture we would call this woman an ‘Aunty’ - one who knows nothing but has an opionion about everyone and everything.
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How about allowing Canadian IMG’s an easier path to return home and provide care? When will the gov of Canada realize this?
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1. Curate your CV so your most recent US work is first
2. When seeking mentorship, USCE, focus on what interests you - be detailed + specific - email researchers, docs, yourself + follow up
3. If you can visit the dept that interests you, arrange to meet with respective person
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@mollymulshine
The only member you truly feel sympathetic for besides Di is Margaret; her whole life was a compromise.
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@debbie_fadoju
Empathy can’t be taught! I wish we respected and gave importance to bed side manner before it becomes too late.
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Not every good student is a good doctor and not every good doctor is a good student.
#FoodForThought
#Match2023
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Twitter has become an echo chamber for Match and residency advice. There is no fixed formula for any one speciality or credentials. Some people have mentors, exposure to produce quality research, and some knock boards out of the park.
Above all, do what feels right.
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For IMG's preparing to submit their application: You do not need to be ECFMG certified to apply! ECFMG certification needs to be complete before rank!
#Match2022
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All primary care specialties should offer visas for
#IMGs
And programs that don’t, you’d rather not fill and have qualified doctors take those spots than your biases against international medical grads. We bring stigma to ourselves, within ourselves.
#MedTwitter
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@mahad_minhas
This. Especially when mid levels get paid on average 100k with the level of training they get.
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Pay attention to the people in your life who celebrate you through all your highs and lows.
When it appears to people you have finally ‘made it’, watch who still shows up for you. That circle will close but I promise it’s for the better.
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People needing visas for any kind of job are always exploited.
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Staying ‘at home’ for residency is such a privilege. I am happy for all who have that opportunity. For many
#IMGs
we have to make a ‘home’ every couple of years.
As those who embark on this next journey, find those who provide you comfort, a sense of belonging.
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We need to talk about the emotional toll of what it means to be a foreign doctor in a faraway land.
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Canada only likes IMG’s from English speaking countries, there I said it.
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And as interview season comes to a close, I am in awe of all the first gen medical students, I am humbled by your family’s journies to this country to seek a certain American Dream.
You all bring your own unique and colorful talents to this field. Be proud of that ❤️🧡💛💙💚💜
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@DrAlrahmani
Not to mention the money that goes to locums, recruitment agencies to assist in the gap.
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Palliative medicine should be a part of every specialty’s training but so should psychiatry 😀✌🏼
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We need more affordable and quality childcare. Most hospitals don't even have staff care available for their children.
If the U.S. wants women to invest more in the birthrate, then the U.S. needs to first invest more in women. Period.
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539
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7
46
Take on a chance on people, especially in the professional world.
There is no entrance exam for kindness and compassion. We need more people like this, especially in medicine. If i was PD, I would choose diversity, kindness and emotional intelligence over everything else.
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Love what
@rarebeauty
stands for. It truly acknowledges and advocates for mental health especially in women by designing products that are so easy to use and make you feel beautiful ❤️
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@DrCasteelEM
@ImprovNutrition
Have you met a mother? Or insulin resistance? As doctors we can’t simplify lifestyle to just basic nutrition, sleep and exercise. Ozempic has blown UP among celebrities? Why?
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Did you know most people who die by suicide don’t have a preceding psychiatric disorder.
So it’s not obvious, there may not be warning signs but there will be something. Pay attention to those little things.
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If anyone would like to have a discussion about the challenges and inequities Caribbean IMG’s face and learning about the J1 and J1 waiver process, please reach out
#psychtwitter
#MedTwitter
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Congratulations once again to all who matched in Psychiatry - we need all of you + are looking forward to your talents + skills to improve our broken MH system. We are the most underfunded/under appreciated field in hospitals across the US. I hope we can change this together.
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As we head into
#Match2024
week, I want each of you to know that you ALL are the future of medicine and we can make strides and changes to ensure there is equity in recruitment, retention and a focus on wellbeing for all.
Goodluck, I can’t wait to hear where you all go.
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5
44
Normalize testing anxiety. I had crippling anxiety when it came to standardized tests. I would run out of time b/c I would overthink and reread the questions because I just couldn’t process it in time. If you’ve passed ANY exam and suffer from testing anxiety, this is a huge win.
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42
@DrAlrahmani
Why do we need to do this to our female faculty? People need to realize mat leave is not a vacation.
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0
42
Observations of recent Match results, taking into consideration excellent step scores (CK), IMG’s who matched into historically AMG only specialties had excellent mentors, support, maybe a post doc at top tier institutions and probably most of all consistency in their apps.
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Passing this along:
We have a PGY3 opening starting July 1 at Cambridge Health Alliance/ Harvard Medical School. If interested, please your CV and a brief letter explaining why you'd like to transfer and why you feel you'd be a good fit to jcollier
@challiance
.org.
Thank you!
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Ramadan has allowed me to accept that I am the most productive in the early AM hours
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Not affiliated but passing along:
Two Pgy 2 positions at Texas Tech University Permian Basin Internal medicine open starting July 2024.
Must have completed
TY or Pgy 1
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