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to survive, you have to learn american culture

This topic is dedicated to sharing personal experiences about unsuccessful residency, non renewed contracts, evil PDs and upper levels, etc. Posting your story you help others not to make the same mistake. This topic is anonymous, your identity is protected.

to survive, you have to learn american culture

Postby gli3 » Fri Aug 31, 2007 9:41 pm

I posted my message about a month ago. Here, I would like to post another message, to share what I really learned from this harsh world. TO me, most of the bad experience we IMG had was because of culture difference.

I think most of us (IMGs) are critically lacking is the awareness of american culture. I definately believe nobody or very few IMG have ever talked about it here. See how americans interact with each other? and how "close" they are? Do you know the hometown baseball team? football team? Hot american Nescar driver?

See, a lot of times a small topic can get you "very close" with american, and you have to learn to find the common ground with them. If you have common interest with them and find a common topic, they will talk to you and possibly like you. IT IS NOT ALWAYS ABOUT MEDICINE IN YOUR RESIDENCY TRAINING. Most of the time you have to be well rounded and well liked. You have to learn how to talk trash, how to gossip, and how to bullshit at certain times. THIS IS THE WAY IT IS, HERE IN THIS COUNTRY. I also spent years and made expensive mistakes, but I figured out this eventually.

PDs are usually the top tier of doctors in the department. They certainly are knowledgeable, know how to play politics, and to some degree powerful. This is the person you have to find a way to get close, from your first day of training. You have to learn what he/she likes, what is his/her hobby, etc. This are the non-medical stuff but critical important for your survival.

I know this is probably against your value, but this is the reality. It sucks, isn't it?

In my opinion, it is 60% medical knowledge and 40% interpersonal skill to make you a VERY SUCCESSFUL resident. Remember, after your residency training, you are depending on the PD's recommendation letter to land you a job. You can end up practicing in a wealthy surburb near a big city or end up in a rural area like most IMGS, don't you think it is crucial to make sure PD like you?

Anyway, I trust God. Most things are out of your owncontrol. At least you can work things in your favor.

The above is my two cents. Hope it helps and hope you can spread my words to other IMGs. I hope our "bad experience" will not repeat again and again.

Thanks for viewing my message.
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Postby 6h35knw2u80aqf5 » Thu Nov 15, 2007 5:47 pm

I wish it was that simple, my friend. I'm also an attending who went through all the steps to finally settle in this beautiful country. However, I beg to differ from your views.
I have read some of your posts, and I see that you are doing well (financially). I'm happy for you. I wish exactly the same for all other fellow IMGs. Unfortunately, most non European foreign physicians have to practice in professional ghettos. What are professional ghettos? When you see them, you will know. They are whole departments with foreign-only physicians, always overworked and underpaid. Do you think those places hire IMGs because they love us dearly? Unfortunately not. It's because it's easier to abuse us and take advantage of us.
Please note that hiring you does not mean accepting you. Let me guess; they were probably short on anesthesiologists at the time, right? Don't delude yourself into believing that "whites" count you among their own. You are still an outsider (below standards for them) and, when the time comes, you will see it and, more importantly, you will feel it. Remember, hostility towards IMGs does not end with residency; you will have to deal with it all your life (a colleague and friend who has worked at a prestigious medical institution 30 years now still has to suffer it).
Your tips on how to endear yourself to "whites" (WASPS) are good, but not different to the "power and politics" games people play all over the world to survive in organizations, especially the most corrupt ones. Do you think other IMGs don't know these tricks? Many of them were probably born knowing all those little games in their respective countries; they are universal survival strategies.
Are you advising our International colleagues to suck up to their boss (PD) to get ahead in life? Do you think they don't know that? I'm sure many of them are doing just that, 24/7.
From your poor writing skills in English I can see that you have not followed your own advise and therefore know very little from the English (and Western) culture. Don't get me wrong; I'm sure you're a fine physician, way better than Americans; otherwise, you wouldn't be here.
Well, here is one important cultural fact. Racial prejudice is a reality in this country, my friend. You cannot sugarcoat it. The great majority of "whites", as you call the WASPs (White Anglo Saxon Protestant Americans) discriminate against virtually all other ethnic groups, including Europeans of different origins; it has been that way for thousands of years. Read Western history, my friend. They are intolerant to other cultures and other beliefs, but they strive to hide it, because none of them wants to look politically incorrect.
I could spend hours writing about this but, just like you, I have to make money. Going back to your post, you are right on one thing; to survive you have to learn the local culture, by all possible means. But you also have to acknowledge that you are a target for local physicians' hatred. They DON'T want you here. They believe you don't have any right to practice here, despite your USMLE scores, your skills or your performance during residency; no matter what, they think "you don't belong here". How many threatening posts from haters do you think the moderators of this forum have to delete on a periodical basis? Understand this fact and learn to deal with it. Even better, learn how to counteract it. Over all, defend your cultural identity; do not try to "Americanize" yourself; you will feel and look ridiculous and it will not help you to get accepted by them (on the other hand, why would you like them to accept you?). IMGs, you can succeed.
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Postby sgudoc » Sun Nov 18, 2007 6:26 pm

You people are INSANE & SAD!!! :cry: If America is SOOOO BAD :evil: , then by all means please head back to your country of origin!!! Most Non-American IMG's get a FREE medical education in their homeland and then run as fast as they can to either the UK, Canada or America!! Why is that the case?????

Just focus on becoming the BEST possible doctor, helping/healing your patients and perhaps thanking this GREATland(USA) for allowing you to become the best doctor/attending you could be. Try saying Thank YOU for once and STOP focusing on the negatives!! I can say this b/c I have studied outside the states and every country has their racists, bigots, White hating people as well!! So, PLEASE Stop painting America as the EVIL one, B/c if that were TRUe, non of you would have come to such an AWFUL place!!!

Believe me when I say the UK is 10x worse to IMG's than america will ever be. Try becoming an attending/consultant in the UK, virtually impossible, especially if your from India or pakistan!!! I experienced this in London, the Midlands & in York,UK during my medical exchange during med school!!!

Try making your space, where ever it may be, as POSITIVE and Happy as possible!!!

Cheers, Doc T. :lol:
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Location: NYC

Postby 6h35knw2u80aqf5 » Thu Dec 06, 2007 9:18 pm

Geez… I leave you guys for a few weeks and return to find that I got flamed by another American colleague. How distressing!

Let’s look at the bright side. The post above belongs rather to the “soft” type of hateful message, but it illustrates well the anti-IMG mentality I was talking about. Let’s dissect it.

"You people are INSANE & SAD!!!"
So, on your eyes, people who stand for their rights (like M L King and Mr. Ghandi) are INSANE and SAD? I don’t think my posts or the Chinese colleague’s above are showing insanity or sadness. Actually, we are pretty happy.

"by all means please head back to your country of origin!!!"
That advise is so original. I think I’ve read it a million times on these forums over the years, always from wasp students. Where on our posts did you read anything about the USA being bad? Actually we like it here, and we don’t have any plans to leave any time soon. Does that bother you? Here is an idea. If you don’t like to see SO MANY IMGs next to you, breathing the same air as you do, why don’t YOU LEAVE this country?

"Most Non-American IMG's get a FREE medical education in their homeland and then run as fast as they can to either the UK, Canada or America!!"
Actually, very few physicians leave their countries to work in the USA; you think we are many because every one of us is one too many for you. What does our FREE education have to do with this? In what sense is it relevant? Does it outrage you knowing that you paid a fortune to learn the same things we learned for free? You poor little thing! You could have come to any of our countries and have the same free education; you could have spent those years very comfortably, safe and what is most important, you would not have ANY STUDENT DEBT right now. Unlike you, we welcome foreign students.

"Try saying Thank YOU for once"
Actually, we are always very thankful, and happy to contribute to this country. In case you haven’t noticed, we immigrants made this country what it is. Most of the technology you are using right now, with your typical laziness and oblivion, was created by immigrants. You could start thanking us immigrants, for giving to the USA what we are bringing here. Without us, this country would collapse in a minute. Your pathetic attitude (anti IMG) is not only unethical, but ANTI-AMERICAN. . Without us, this country would collapse in a minute.

"I have studied outside the states and every country has their racists, bigots, White hating people as well!!"
That is a very typical lie from haters to justify their hatred. Instead of addressing the issue, they come up with the “everybody does it” excuse. Only some places are known for intolerance and hatred. Where did you see white hating people? Maybe you are referring to the ones that use their blood when they die to sprinkle the whities. Bastards! How dare them?

So you have studied in the UK. Why didn’t you say so? They are the original source of civilization, of everything that is good and true. Whatever they do has to be the right, no doubt about it.

"Believe me when I say the UK is 10x worse to IMG's than america will ever be."
I believe you. Don’t you understand that this was precisely the point of my previous post? You are so clever.
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IMGs, you have all the reasons to be optimistic

Postby 6h35knw2u80aqf5 » Thu Dec 06, 2007 9:33 pm

All you have to do is get organized in every hospital where you work and support each other.
Don't be afraid. USA needs you. That is why you will succeed no matter how much the haters try to scare you off.
The following page, although a little harsh, describes very accurately the haters' attitude towards immigrants.
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Postby sgudoc » Fri Dec 07, 2007 8:21 pm

Great response!! :wink: I am an AMERICAN IMG( Proud of it), work & train w/ several IMG's, have even more friends around the globe that are IMG's, so PLEASE, spare me your dissection of my post!! Simply trying to convey that we should all take the GOOD from where ever we are training, care for our patients and leave the HATE behind as there is enough of that around this WONDERUL planet!! Thanks for the lengthy reply, makes for some GOOD reading!! GL everyone on your career paths and most importantly in life overall!!!!

Cheers :lol:
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Postby sgudoc » Fri Dec 07, 2007 8:31 pm

PS. My family legally immigrated from Italy & I am 1st generation Italian-American, you ding-dong!! As to your free education, how about remaining in your country & giving back to those that paid the taxes for your privileged _______!!! Take and run as I like to call it!!

I LOVE the fact that I have PAID my own way & relied on no one but myself and support of family & friends!! Rely on ones-self rather than take, take, take from the gov't!!

And Please, if you, the immigrant, were not here, our country would collapse, LOL,!!!, that discussion would take days and many pages to reply in an educated manner & I just don't have the energy after 27 hrs on-call!!!

GL to you and all that read these FUNNY posts!! They lend a laugh to a very STRESSFUL medicine on-call month of nights!!!

Cheers, 8)
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Postby 6h35knw2u80aqf5 » Sat Dec 15, 2007 9:16 pm

Thanks for your all your posts, sgudoc. I believe that, along with mine (funny or not), they make interesting reading for all IMGs on these forums.
I know you don’t like dissections (you don’t like surgeons?). However, I’m sure the others find them quite motivating; so let’s humor them. Plus, writing here is something I can enjoy now.

“My family legally immigrated from Italy & I am 1st generation Italian-American”

I’m sorry that you had to reveal your ethnicity. I would have told you in private not to do it, to spare you the shame. While it was obvious for everyone here that you are an American born who studied medicine abroad (who else could write what you wrote?), there was no way to know that your parents were immigrants. Now you are not only spreading ANTI-AMERICAN ideas (by insulting us and our education and by telling us to leave by all means, something that would seriously hurt this country’s economy). You are also betraying your parents’ culture and values. Does your mom know WHAT YOU WRITE on this forum? Would she be proud after reading it? When you see your parents, do you also tell them to leave?
Could you write your next post in Italian? Please, it would be very nice if you could do that.

“you ding-dong!!”

Thank you for calling me ding-dong. That’s very professional. What do you call your non-wasp patients? What do you call real Italians when you see them?

“As to your free education, how about remaining in your country & giving back to those that paid the taxes for your privileged _______!!! Take and run as I like to call it!!”

My privileged what? Very courteous language for someone with an MD degree. Thanks again. So we all IMGs (born and raised in other countries) are thieves and criminals just because we move around the world for professional reasons? I didn’t know that.
You keep telling us to remain in our countries or go back immediately, once we have been so evil to come and offer our abilities to the USA.

“relied on no one but myself and support of family & friends!!”

That clearly means that your parents were the ones who paid for your education. I can see that you are very different from us IMGs; we have never made any effort in our lives, not even mastering this primitive language. We just live off the governments all our lives.
It’s interesting of you to initially brag about having studied in England, like it was something extraordinary. Why didn’t you study in Italy instead? The medical education there is way better and also much less expensive. I’m sure all IMGs here are dying to know why.

LOL,!!!, that discussion would take days and many pages to reply in an educated manner

Without us, this country would collapse in a minute. If this statement was so preposterous, WHY WOULD IT TAKE YOU HOURS TO REBUT IT? Wouldn’t its absurdity be immediately obvious to everyone? What would you have to say to take you hours?
I’m sorry that you have to make stressful medicine calls to try to get out of debt. But if you really want to get out of debt you should learn something about the world. Let me give you a clue. Google these words: immigrant, US, technology, science, economy. Subscribe to the Wall Street Journal (I’m serious) or something similar. Educate yourself. It pays off. Believe me.

I hope that on your next post you tell us to go back to our countries, this time in Italian. We’ll be waiting!!
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My response is under a new topic/here we go again, last resp

Postby sgudoc » Mon Dec 17, 2007 8:45 pm


Cheers everyone!! Happy new Year!!!
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Postby 6h35knw2u80aqf5 » Sat Apr 12, 2008 7:10 am

Here are some take-home messages from this thread:

1. Xenophobic attitudes towards IMGs are more common than a casual first glance could suggest. The “sad stories” posted on this forum are just the tip of the iceberg.

2. Open, blatant anti-IMG actions are the exception, not the rule. Instead, cowardly underhanded attacks are the norm.

3. Slander is one preferred weapon against IMGs. For this weapon, your best defense and preventive measure is DOCUMENT, DOCUMENT, DOCUMENT. If you can, keep your own copies of relevant records (do not infringe HIPPA, though). If possible, also keep a log of your exchanges with supervisors and coworkers. It will prove useful when they start distorting the facts.

4. A significant number of haters will keep quiet while you are being discriminated against. They will only stick up their necks when you begin to talk back and protest. Observe the hater on this thread. She finds assertiveness and counteractions from IMGs highly offensive. According to her, WE DON’T HAVE THE RIGHT to fight back or even to SPEAK OUT. This type of complicity is very common.

5. If you find yourself in a desperate situation against haters, don’t hesitate to call an attorney (a labor or civil rights lawyer). The first consult is usually FREE. There have been several examples of IMGs successfully suing the aggressors. If you don’t believe me, google it.

6. Haters JUST LOVE to see us afraid. They know that fear can paralyze anybody. That is why they lurk these forums; they want to terrorize you. If you are paralyzed by fear, then the haters win.

7. Observe the hater on this thread. Her central motivation is GREED. That is why she chose our (alleged) FREE EDUCATION as a target for her attack.

8. Many haters descend from immigrants. That should not surprise or puzzle anybody. Don’t forget that many immigrant families in the US tend to lose their original culture completely, for a number of reasons, one of them being that they did not possess too much of a culture to start with, since they were paupers in their former countries; otherwise, why would they want to immigrate?

These were my two cents. I won’t be frequenting these forums in the future. Good luck to all of you. I hope you make it, since I haven’t found any serious competition lately, and it’s getting boring. I hope to see you guys around. I’ll buy you a cup of coffee.
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Re: to survive, you have to learn american culture

Postby Guest » Sat Jul 12, 2008 9:12 pm

Come on everyone, lets join the 6h35 Hate "The White Man" Movement, b/c as we all know, all the troubles in this world is solely due to the white man 8) !!! Youa re soooo very Sad :shock: & I pity your patients or lack there of for having to receive their medical care from someone like you!! So filled w/ hate and so little compassion!! May God bless you someday??/ By the way, am I male or female?? You seem to think female, MAYBE!!! :twisted:

Ciao Bello/Bella,


Re: to survive, you have to learn american culture

Postby Guest » Mon Oct 27, 2008 6:40 am

hey i'm pakistani and i live in the US and having lived in pakistan and dubai, I think professional life in US is the best out of the three. i do agree that although a white guy who speaks fluent english is at an advantage, it is only because people like those similar to themselves!! it is simple human fact. it is not just white people; most people around the world prefer to see a doctor fluent in their own language and with a similar background! the original poster gave very good advice (in perfectly fine English, if I may add) that interpersonal skills are very important. I know that even though I was born here, having a Pakistani face might put a patient at unease initially. But 99% of the patients warm up when they see how well i manage their cases, and then they move beyond my color. I don't see any of my fellow American doctors (not even Pakistani-American doctors) going to any other country to practice; it's not perfect here but statistics speak for themselves. I don't think you will ever find a foreign doctor of any nationality trying to get a residency in Multan.

Re: to survive, you have to learn american culture

Postby ohio » Sun Feb 17, 2013 8:13 pm

Quite informative
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Re: to survive, you have to learn american culture

Postby romavia » Mon May 06, 2013 7:51 am

This is really very obvious that where we want to live we should know the culture of such state. Not only the culture in fact the rules, restrictions and applied laws of such state because we may not adjust at the place where we have no idea to survive. And, knowing about the laws of country may lead us to reduce the ratio of crime.
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Re: to survive, you have to learn american culture

Postby analu83 » Thu Aug 29, 2013 12:24 pm

I agree that you have to try to blend into the environment of the place your are living in, if you want to be happy and have an easier life. Some people will be receptive towards you even if you are foreign and if you share common interests with them, you might make some friends. However this does not mean that as IMGs we will not face hardships or that we will succesfully reach the finish line if we learn american culture. I am a third year resident and all this time I have suffered to the point that many times I regret my decision of coming here for training. My program openly takes in IMGs, but that doesen't mean you will be trully accepted and treated the same way as an AMG. I am probably one of the most hardworking people in my class. I am not a genious, but I do thing I'm smart and good at what I do. The vast majority of my evaluations are marginally average, while many AMGs get above average evals all the time. I have chased attendings like a puppy looking for support for projects and I've got some more or less average ones, that I know are not at the level of the institution where I'm working. I've come with a couple of ideas of my own, but have not recieved much support. My fellow AMG residents, on the other hand, have tons of project offerings from attendings, and usually the ones that get you platform presentations at meetings and publications in good journals. Even in the personal field, I have realized attendings and other residents are not as open and friendly to me as they are with other Americans. People won't blantly disciminate against you or make racist jokes or comments, because they will get in big trouble for that. It is much more sutile, but present nonetheless. I know that people probably do not care much about what happens to you as an IMG, specially in my case, since I have a J1 visa, as you probably won't stay in the US after residency. They just want to train you and be done with you. I do want to be good, and have tried really hard, but in an environment like this it's just like slamming your head against a wall. I really wanted to do academic work in the US after fellowship, but the way things are going, I don't think I'll be trully happy here and probably will never get that good of a job opportunity anyways. I'm really happy for the people that have made it. It is a great accomplishment.
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