The Unconventionals: Henna Sawhney, MD and Mohamed Khalif, MBBS.

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Paging dr. cook paging dr. cook.
Dr. cook you’re wanted in the o.r. dr. KO you’re wanted in the office.

[1:11] Music.

[1:33] Hello everyone and welcome to prescription for Success I’m dr. Randy cook your host for the podcast which is a production of mg coaches.
Providing leadership and Executive coaching for Physicians by physicians to overcome burnout transition your career develop as a leader,
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[2:11] Well I have a pair of guests on the podcast today both of them have had very personal experiences with that frequently excruciating experience of finding a residency in the US
if you’ve been through it you know how unnerving it can be it’s what we call very simply the match.

[2:33] Dr. Mohamed Khalifa and Doctor henna sahni joined me to share their personal experiences so let’s hear that conversation.

[2:43] I’m really excited about.
Today’s interview I’m talking to a couple of really interesting people about what I think is.

[2:57] Probably the most significant issue facing all.

[3:05] Medical graduates who intend to practice in the US without question and the difficulties that we’ve had and.
Getting that selection process straightened out so today we have dr. henna Sonic.
Who’s coming to us from.

[3:27] I believe the San Francisco Bay area in my guess incorrectly on that henna yes yes your man how nice that I got it right and dr. Mohamed Khalifa and the Seattle-Tacoma area that I get it right again.
Yep that’s right lucky me our and these two people.

[3:48] Fortunately for all us medical graduates.
I have had the great wisdom to try to do something about the.

[4:02] Medical student residency matching program and we’re going to talk about that in some detail.
But to begin with an i and Mohammad we like to learn a little bit about.
Everybody’s origin story so Hannah tell us.

[4:21] At about what period in your life did you begin to think you might want to career in medicine,
so it’s a quite young I was about 10 years old I was very interested in biological sciences and
I had this teacher in sixth grade that one of our like biology topics was like the signs of cancer and that’s what really.
I mean it sounds more of it but I was just very interested in like the diagnosis of it and and the reason is because I’ve actually I’m.
Had a lot of people very close to me including my grandmother and an aunt that had cancer and passed away from it and for me medicine wasn’t just about.

[5:09] You know learning science and getting rich or you know having that respect for me it was allowing me to bring two things that I love is serving others and.
The Sciences and putting it together
and making a difference at the individual level you know you can be interested in lab work you can do the same thing in many different ways
but it was really the human aspect of medicine and its relation to the sciences that really drew me to it.
I can’t think of any better motivation than that but the the really interesting thing and I think I’ve got this right you actually.

[5:51] I grew up in this country but you got your medical education in the UK right.
Yes yes it that come about so I’ve had an interested in global medicine growing up here.

[6:06] I so I actually stayed in the Bay Area my entire life until Medical School grew up,
here in the East Bay as well as in San Francisco and then went to Berkeley for undergrad and while I was at Berkeley I decided to do.
Something unconventional such as going into a women’s Studies major instead of doing my like pre-medical Majors like.
Biological science or chemistry that most people do that is unusual yeah and the reason was.
One of my high school teachers she had gone to Berkeley and she said the best course she ever took was in women’s studies and it was an easy way to clear off a general education course so I took one
and I loved it and I took another and another and it was all for Gen Ed and I realized I could make a major out of it and.
It was it was interesting to learn about privilege and.
How that relates to society and how political things can be personal and people make personal things political and it really drew me to it and.

[7:21] When I start I was always interested in studying abroad and I at the time I was in college you know.
Globalization was just starting and people were starting to think outside of just the United States and.
So I thought it would be really interesting to learn about medicine outside because.
The teaching is the same because you’re learning the same diagnostic diagnosed it a diagnostic criteria as you’re learning how to treat patients
but the approach is very different in every country is always this approach to society is yes completely different right.

[8:00] Exactly exactly and so.
I took a leap of faith and decided to go to the UK and this particular program was an international program so my classmates came from all over the world.
Asia Europe Australia somewhere like.
A few were even in Palestine and Syria and had like just narrowly escaped what was going on there and Canadian as well and just hearing how medicine was practice,
and the differences between their country and what we did in the US was very eye-opening and I think by far the best experience I ever had had been quite an experience and.

[8:50] It was and the UK I think this also really showed me.

[8:59] The flaws when I came back to the us and our system especially and Education and Training and and parts of practice like I think because I had this exposure of,
how it’s different outside I had more of a cultural shock coming back home and saying well this why are we doing it this way when there is a better way that other countries are doing it
and.

[9:25] I think that really has pushed me in a lot of ways to find innovative.
Innovative processes and other options rather than sticking to what is the main like the what is
the norm of society so like with residency I pursued it actively for many years and I always got feedback that you know you’ll get in you’ll make a great doctor you have a sound education
and I like even working when I was in Missouri which we can speak about later.
Being able to practice their I got the same feedback but the problem wasn’t my capability as an individual physician the problem was breaking through the system that we have established,
and being given a chance to do what I’ve been trained for I’m going to I’m going to hold you right there.
And I’m going to see if I can bring you both to the same point which I think.
Is going to be pretty easy but I’m going to go to you Muhammad now henna actually.

[10:34] I had a somewhat different approach to Medical to Medical Education as,
compared to what we usually do in the US but you certainly did and and I think perhaps in them in a much more.
Convoluted fashion as well so tell us about your decision to get into medicine and and where you got your magic you’re at your education and I was born in the 1990 right after the Civil War in Somalia.
I just immediately after the Civil War in Somalia and my parents fled the country because there was a huge conflict there and.

[11:16] It was very brutal and we had to Fleet the neighboring Kenya for almost let’s say two years till 1992 we were fortunate enough to you know immigrated here to the United States so,
I came to this country when I was 2 years old,
you know started doing my early year daycare Elementary School here and you know just kind of like coming to a new country was I really vividly remember like,
that transition for my parents was very hard because of that trauma,
and you know some of the things yeah they had to go through there is here in the story is sometimes of all the bullets they missed and how fortunate they were,
to find safety was just a really remarkable story from them.

[12:07] So in 90s or early in my childhood you know I remember,
you know in elementary school my teachers used to ask me here in Seattle what do you want to be when you grow up I always used to say I want to be a doctor,
you know I used to dress up as a doctor and during Halloween.
Yeah very very early in your cherry early in my childhood it’s something that I just
always wanted to do and I think it but I did you get that from television doctors or your family doctor where did that come from I think that became been you know when you aliens come through they go through a lot of medical screenings and they often you know I did unless I had some,
you know conditions is why I had you know I took the classes.
And you know I had to go to the doctors more most frequently and I think being being around and pediatricians and you know International medicine clinics just put that spark in them.

[13:06] And,
after that my father started a business and you know he started the business because he realized that most of the Immigrant Community here in Seattle
did not have some of the some of the
things that they used to have back home so whether it’s like clothing or decorations or in other products that they used to enjoy you couldn’t find it here anymore so he started a business
with some other colleagues of his,
and after that you know we were just on the road I did ever from middle school all the way to medical school I did it in other countries so I was in Amsterdam I was in Pakistan I was in China,
I was in Dubai I was in Kenya so I lived in 5 different countries and did School,
and all those different countries eventually I did my high school,
and medical school in China because that’s where most of the manufacturing was happening in my dad was living the most at that time,
so you never really saw very much of the u.s. educational system at any level is yes what yes not only Elementary School I did all the way too.
Elementary School here but from middle school to medical school I was around the way.

[14:22] Okay all right we’ll pick up the story again yeah and after that you know I just.
When I came back you know my dad lost his business unfortunately in 2008 because of the recession.
And you know what we came back when I came back here after medical school,
he drove a cab after he lost his business try to get me out of medical school in China he was here and when I came back it was a total different story for me because,
then I had to go to the challenges that I think we’ll talk about later of trying to get into residency and try to get into the match and it was a very different you know experience for me but.
In short that was my experience on the you know how I became a doctor and then let’s spark that interest.

[15:13] Anywhere along the way did you think well gee I made a mistake or were you still,
pretty well motivated that was very motivated I was very motivated I had my eye on the target this is something that I always wanted to do and this is something that I always spoke about as a child,
and I had huge support from my family because of that because they knew like this is what I wanted to do and they were supporting me who have the time and,
yeah I never thought for a second that yeah wanted to change it for you.
So so we’ve gotten Medical School done for the both of you and we got to talk about the really next big step.
And that is that both of you had to face the infamous matching program.

[16:07] And henna I’m going to go back to you tell us about your experiences with that.
I graduated in 2018 and I had just moved back home to the Bay Area from Chicago,
finished you know the u.s. Emily’s was get it gearing up for residency match and I was working at UCSF at the time as a cleanup clinical research coordinator
because the feedback I had gotten at that time was since even though I’m born and raised American I mean my parents are immigrants oh,
if I faced it you know the balancing of two cultures but my,
like my entire life has been in the US and then coming from a foreign medical school they said even though you are American you’re will have some setbacks as a foreign what someone with a foreign degree and so.

[17:01] I was doing research because they said that getting some Publications and you know getting that stain clinically involved to some degree would help get into residency so I started the application process had.
My Lor is everything ready to go and I didn’t get any interviews the first time the first two years I applied actually.
The feedback was maybe I wasn’t applying everywhere you know my,
the number of programs I wasn’t applying was it enough or it wasn’t focused I got a lot of feedback and there was always something that I was told wasn’t
enough from my end as an applicant and just to give you some numbers I applied to over 400 programs across the country every year I have applied.
Except this last year.

[17:54] Cost-wise that’s up to about 10 thousand dollars a year that I have saved.
Luckily I have the support of my parents and and my family and I was able to stay at home and didn’t have to worry about.
You know living costs because of them so whatever money I had made you know as a research coordinator what directly into the match process because that was my personal investment into my future.

[18:25] And the first two years I always found a reason that I didn’t get in.
You know my scores weren’t high enough I didn’t have enough research experience I didn’t,
do enough clinical rotations but I mean even though I went to a foreign Medical School my third and fourth year Medical School rotations were actually here in Chicago I.

[18:49] I had clinical rotations prior to that in Cyprus where my first two years were located since we were in an international program but the core clinical rotations were all in the US so there was no
Gap in terms of trying to understand how the medical system worked in the US and,
all my Lor writer like all the doctors are owe me a letter of recommendation where us doctors but I wasn’t getting through.
Whatever filters there were for these programs the first two years
the third year I applied I got one interview and it was in the middle of the pandemic and it was sheer
dumb luck to be honest
I had gone on this rant on Twitter and that’s actually how Mohamed and I were connected to create a horror found our nonprofit
and this program director just happened to have been on Twitter and he reached out to me and he asked why haven’t you matched and I,
I started speaking to this program director and.

[19:55] Luckily it was just prior like it was just after match and prior to the new season and after reviewing my application and seeing how dedicated I was.
They said they would consider me for an interview for a residency and they did interview me.
It was the first time I got an interview for residency and so I was very excited but I also had gone through it twice knowing what can happen and how you can’t have your hopes too high because the fall is much worse,
so the interview went well.
I wasn’t I wasn’t expecting anything I was keeping my heart like I was hopeful more than previous years but I was just trying to be realistic as well and so.

[20:44] I didn’t match and.
That year my mom was the most devastated she is has been my support and rock through all of this like
she’s told me many times like is it worth the emotional and mental distress you’ve put yourself through all these years and I keep saying yes it is and she says okay then I will support you and so seeing how it affected her.
After match that I didn’t get it really brought it to prospective to me like is this worth doing it anymore and it’s not about
is it worth to practice medicine but is it the process we have created in this country worth the struggle to be able to practice medicine and.
So after that year I got feedback from the program director he said.
Funnily enough that the other the other faculty had said that I had too much research on my application.
And it was too much research focused and so.

[21:50] At that moment I kind of shifted my perspective on residency I was like.
This is not the end all be all that I’ve been putting it for for the past couple of years
I moved out to Missouri to practice medicine with the license that they give the assistant position license I also got a job as
I work with the CDC and have been working on their covid teams at the San Francisco quarantine station.
And I kind of left to research because although it was interesting and I liked it it wasn’t what I was pursuing as a career it was and it was always going to be a stepping stone.
No not at all the experience is great and I’ve utilized it and I will continue to utilize it and possibly see another career option
but it wasn’t what I wanted to do and so last year was the last time I applied for residency and I remember.

[22:49] The application had just opened and we had to pay the fee for it and the registration fee and,
the day I applied for that and paid it.

[23:00] After that for what almost like three weeks I just laid in bed I other than going to the Urgent Care Clinic or the volunteer things I was doing.
I was just in bed because I was just so distraught from the process and it was I was actually having a traumatic response to it.
And so I was like this is this is the last time I’ll put all my effort into this and then after that if I get into residency that’s great but if I don’t.

[23:31] It’s just not worth the struggle anymore for me
I was fortunate enough for my friends to advocate for me in the last cycle so I got two interviews but unfortunately it was the same thing I just did it match and for whatever reason
and it’s just an it’s a numbers game and.
A lot of our colleagues they’ve applied for five times and some of them have gotten consistent interviews every year and,
the year they match they happened to have gotten maybe only one interview or it was with the program they didn’t even think they had a chance with,
so there’s no consistent there’s no real.
You know checklist you can fill to say this is the type of applicant that will get in especially for people with foreign degrees whether your u.s. born or.
Like was Muhammad have traveled the world and had different experiences or if you’re an immigrant into the country so.

[24:33] For me now residency is not something I’m pursuing and it’s not because I’ve given up.
On being a physician it’s because the process of becoming a physician is to talk second display my recollection is.
I think they actually officially pardoned me.
Put the match system into place in the early 50s like 1952 and they’ve tweaked it every single year since that time but clearly there are.
Some additional problems and so Mohammed I’m going to go back to you,
tell us about your experience with the match just to show us how many ways it could go bad so I graduated medical school in the end of 2014 I came back here,
into the United States you know but by that time you know my family was in a very difficult spot financially.
Because you know my dad was driving cab to try to get me out of medical school after you lost the business.
There’s a lot of financial problems my mom was sick as well.
And you know I just really had to you know not only no.

[25:47] Finish the prerequisites that are required to enter the notch which is the u.s. Emily exam I had to I had to study for those kids.
During in China when I did my medical school there you know I have to prepare their boards and I didn’t have the time.
To prepare the u.s. Emily to you know get into the process faster so.

[26:08] I had to first of all have to find a job because I don’t have no money to pay a thousand dollars for the test because,
that’s how much you know that would cost me to do the test for each test so I needed some money so I was looking for jobs so that was the first thing.
That I did and I applied everywhere I applied to every Clinic.

[26:30] Every hospital in even the regular jobs is very difficult than me because everybody was like hey you’re a doctor you know you’re overqualified you know we’re not going to give you this job.

[26:40] And it was really difficult and you know and somebody else just you know recommend a dismissed remove the doctor degree,
from your resume and Irene I think they’ll make it difficult for you to get a job and once I remove that everybody was like well you don’t have no education,
it was a catch-22 a really difficult process for me and so I had to you know eventually to make ends meet after work I had to work in a lot of odd jobs so I worked as a security guard,
I worked at a pie Factory you know cooking pie.
I did a lot of things just so I can make some money to prepare and take the tests,
you know eventually I was able to save our some money take my tests no pass my tests and you know I was ready to apply for The Residency match and you know 2017.
And,
after that you know I just I think so I didn’t have enough money because you know everybody tells especially if you’re a you know graduated from international school you have to apply really really badly,
as it’s very difficult so I had to you know sell a lot of things I have to borrow,
so I invested ten thousand dollars in the first year.

[28:01] And try to apply it as wide as well I always wanted to me I was going to be a primary care physician I want to be a family doc.
So that’s where I applied nothing no other Specialties and this applied very broadly the first here.
And I got I got zero interviews it was it was very devastating experience from the you know putting all that money and energy and time to test send,
everything I was very difficult so what I did was I tried again the next year.

[28:36] And the next year I applied to multiple different specialties.
Because I thought maybe you know because I applied to one specialty maybe that was the problem I didn’t get in.
And I know I went on LinkedIn I made some connections you know with local hospitals here I spoke with some program directors,
and the next year I was fortunate enough to get one interview from the University of Washington u-dub Family Medicine here in Seattle,
and I was really excited and stoked because that was the first interview that I got to the most residents in The Residency process.

[29:14] Are down which is a one interview error think it’s 500 hype oh it’s you,
and it was and I knew that you know my odds were very less but I was still very hopeful because I thought you know what if I knew this was the hospital that system that I came to,
and this country when I was an immigrant you know child and the doctors here were the doctors who inspired me to become a physician I have history here,
you know I didn’t know the community really well and I thought that I would be very competitive,
but you know unfortunately one match they came I did not get in and I asked you know feedback.
For the program and you know the program is its response to us that you know we just had so many applicants and it was very difficult for us to make a decision so.

[30:08] And it’ll be I like these days each family by recent IPO a it’s like so thousands 3,000 applications for 88 spots.
Because of the way the applications in the medical schools are rising compared to the applicants and.

[30:24] I didn’t realize it was that competitive yeah right now it is very competitive and each program director is you know that I spoke with and saying hey like I have
the people one program director I spoke with told me no I have people who doing rotations here have you know people who are coming from away rotations I have
thousands and it’s we don’t even review every application right we have a filtering process you know if you’re if you’re under 250 or 240.
You know win again I get a chance here and review your application so that really happy right now they made step one pass fail because I think.
If that was in place you know when I was applying maybe that maybe I would have more better chances because,
I think now that puts a lot of stress and a lot of people in that probably that will force a lot of,
programs to review more applications and do a more holistic review as well so a lot of people don’t get filtered out but I think the biggest problem that I faced is,
the 99 times out of 10 if I reached out to somebody if I were able to speak with a secret.
Program director and I was able to tell them about my story like you know henna described.
And I did I mean those times if you get lucky that way it’s easier to get an interview but you just yeah but applying.

[31:47] You know it’s really hard and there’s so many program directors that you can get a hold of so yes my that was my challenge in the match.

[31:58] So
It comes as no surprise to me that things have changed I entered the match.
Back in the days when the Earth was starting to cool and it was my understanding that they were quite a number of residency slots that went unfilled,
in those days and it was actually my impression that there are still unfilled residency spots even today but it sounds as if.

[32:34] The spots that are not available are those in primary care and I’ll put that question out for the two of you what what do you guys think about that.
Yeah so basically there’s two process late and I’ve seen this no conversation for a while and then I think so and I can jump in,
basically there’s two processes through the soap system right and there’s you know the scramble system after the soap,
but you know a lot of people don’t understand that the applicants who end up applying for those scramble and soap system after the match those quote-unquote leftover spots,
are still very minimal compared to the thousands of people that are competing for a less top spot so and henna maybe you can add to that.

[33:22] Yeah so I haven’t come for doing research for three years I’ve.
I’ve approached this issue with data.
Because I think that’s the best way to really open people’s eyes about this so just going back into the little bit of history of this,
so
dr. cook when you are applying for residency there were ample spots there for everyone it was just a matter of finding it whether you were,
you know a medical student here in the US and immigrant into the u.s. or someone that had never stepped foot set foot in the US and was trying to come in and practice here
but in 92 I believe it was 92 or 96 97 96 actually.

[34:17] I was 97 thank you Mohammed so 1997 they there a cap was put on the number of residency spots because of this fear that there would be too many doctors
oh you can share and what that has done sorry to to coin a phrase from
I can’t even remember which comedian said it all the time but what I said was you can’t be serious,
that was that was a perception that we would be having too many physicians in the workforce and not enough people to treat and not enough jobs for those Physicians and so that’s why that cap was made by the balanced budget Act
and since then it has been an uphill battle now yes yes it’s a federal.

[35:07] And so since then there’s been an uphill battle to increase or lift this cap especially now that we have a physician shortage
and so,
what has been happening for and I think has been heightened maybe in the last 5 to 10 years is that,
our residency system is built a little differently than other countries we are an open market in terms of who can apply
if you go to Canada they have a tiered system where they give preference to Canadian medical graduates and then Canadian citizens and then whatever is left over after it goes to anyone
in the UK so I with me as a UK someone who holds a UK degree.

[35:58] I could have gone to the UK and practice unfortunately my situation was a little different because the year I graduated was brexit and at that time they were not giving any Visas so
they were only you had to have a UK degree but you also had to either be a you EU citizen a citizen of the Commonwealth or citizen of the UK to be able to get into
their training programs so for me my option was to come back and when I came here I realized that,
you know we don’t just have us medical graduates applying for this so we have the you,
you know the 4th year medical students in the US that are applying then we have graduates that might have taken a research year or didn’t match the previous year that are applying
then you have immigrants these are people that.

[36:51] Have completed their degree maybe even training in a foreign country and have immigrated into the country and either on green card or even said it citizens that are applying
then you have people like me that are born and bred in the US and decided to go abroad for an education and coming back and then there’s another group of people that are.
I have never even maybe set foot in the US that are applying for visas to come into our residency training and,
so what ends up happening is you have this huge pool of applicants but not enough spots for all of those people and there’s no tiered system either like Canada or other countries where there’s a preference there is a
you know unspoken rule that us.
Medical graduates us so people that have attended u.s. medical schools get preference and that’s true because 98 to 99 percent of those students will match unless they have something.

[37:54] Like there’s something really bad on their application but nowadays you even see that it’s not.

[38:01] Even because they have red flags or weren’t doing well in medical school you’re getting highly qualified applicants.
Even from u.s. medical just speak with another day of residency in Utah so he graduated from Utah medical school and he’s working with.
Dutch Mary Tipton henna so he’s he’s doing associate position because then you can see here like.
24250 scores but he he said basically if he was applying to Utah and he wanted to get into the West Coast Area so and it was very difficult for him to even get a good at get an interview that fossil so.
Yeah it’s challenging regardless of you know where you graduate from medical school because of the overwhelming competition yeah and.

[38:46] Numbers-wise so I think a colleague of mine Farina con so she is also a co-founder of our
nonprofit and mash into residency in the previous cycle and just started her pgy to and family medicine but we were.
Looking into the numbers again and this year what n RM P reports is that there was,
11600 something applicants that did not get into residency,
so out of 46 thousand applicants and so that’s about 25% of applicants don’t get into residency however that’s actually.
An understatement of the actual number because the way they calculated is number of positions available.
And the number of active applicants and the way they say active.
Is someone that has submitted a ranked list or ranked at least one program on their rank list for residency
so this astonish me because someone like me my first two years I applied for residency when I didn’t get any interviews and had no rank list I wasn’t considered in that unmatched pool.
Because according to an rmp I was in an active applicant.

[40:05] No same with Muhammad and several of our other colleagues and a lot of other people I met so when we did the calculation and,
broaden the numbers of all applicants including those that did not have a ranked list
it actually comes out to about 13,600 something applicants that don’t get it but did not get into residency and this last cycle so the 2021 to 2022 cycle.

[40:34] Out of 46 and.
Then there’s a lot of people that you know may have withdrawn their application but had submitted but had submitted it or they ended up being an eligible for residency for some reason for this cycle so.

[40:52] The but the.

[40:55] The unmatched rate is 25% consistently and if you do 13,000 number it’s actually 29 percent so it’s actually a almost a third of applicants.
I will not get into English for me demoralizing numbers and it’s just getting worse.

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[43:21] And now let’s get back to today’s interview go ahead and tell us a little bit about the ASP in and what their goals really are,
so what I was and you know just going off the last conversation,
now after being unsuccessful at u-dub and not getting into residency know what that one interview I had you know I.
I went out to different nonprofits and I spoken different nonprofits in the community and I talked to them about this issue that hey like hey I’m the physician,
and you know I can’t get into residency for some reason I just asked their foot advice you know back then I don’t know why I even went to them I just wanted to get some more information,
and have people to talk to and they you know they found this interesting and they told me about hey do you have any data on how many people in Washington State.
Have the similar issue so you know I started you know social media page on Facebook and I started a WhatsApp group,
and I you know just posted some you know posts about is there anybody in the same situation I am,
and I just spoke with different people and I told hey if you ever see like a physician that’s not able to get into residency here.
Definitely you know have them reach out to me.
In the it was really astonishing because the first day we had like I think so one person joined the group.

[44:51] And then the next week we had two people and then the third week we had like 40 people.

[44:57] And then it just went up and up and up and it’s you know by the end of the year that year in 2019,
we got to almost 600 people on that Facebook group,
all n what’s up with living in Washington state that were having the same similar issue.

[45:14] And you know I went back to not profit and they asked me as a follow-up hey did you so did you get anybody and I said yes I found 600 people,
and they were and they were really shocked there were like six hundred people 600 Physicians that have you know finish all the tests and everything and not able to get into residency and like yes.
They’re all here and you know so they didn’t believe me so we did a you know a meeting at a you know at a hall that are local library kind of rents out so we did that and we got all six hundred people and meeting.

[45:49] And it was it was mind-blowing we only even had the local no Senator or representative come to the meeting and talked we talked about the issue we saw the problem and that’s how I got into you know lobbying and legislative work.

[46:03] And soon after that you know we created a nonprofit called Washington Academy for International Medical graduates which back then I thought the only problem,
that this problem only affected International Medical graduates living in Washington state for some reason but boy was I wrong.

[46:21] Because you know a lot of those people that I know figured out later we’re actually us medical graduates from local schools and you know people who graduated from other states having similar issues,
then we you know we started doing yoga but you say it work we work with our state to create a program that would create,
a path to residency process which is a license where people could practice for four years until they get a residency right now we found almost I think so almost 20 people are working with the test,
working with this license and the reason it’s so low is because our you know we’re having a lot of you know back and forth with insurance companies and reimbursement in Billings but,
this year were able to you know have a lot of success on that so we’re able to get a lot of people into this program right now,
and no during that during this time and you know about understanding this issue and understanding people involved I just went on Twitter,
and I saw a lot of posts like I think so 20 posts from this girl named Hannah so I about talk shit must have been fairly popular yeah.

[47:42] I was really upset I think that’s what it was so I just emailed him a message on Twitter Hey I said you want to like get together because I’m I have this group in Washington I’m trying to.
You know bringing a larger National Group to create a national nonprofit that could work on these issues,
and she was very excited and that’s how I met henna and,
and we reached out to a lot of other medical graduates and soon we found like I think of the first cohort of ASP was kind of it was eight people nine of us nine of us yes.

[48:20] Nine of us and then that’s how ASP was born and we then basically you know got into a lot of movements we got into this particular movement,
we got together with a lot of other physicians in different states we work with the map community and Missouri.
And we just basically I grew from there and I think Hannah can add more of her new perspective on those plans.
Yeah and I think so.
The reason I was on Twitter it’s I actually my supervisor at the time at UCSF where I was doing research had mentioned that if you,
Twitter is a really good place to engage with other Physicians and,
kind of brand yourself as a physician and so they said that if you make a professional Twitter account will tag you in our,
projects or when we go to conferences or other things like that like our Publications and then you can connect with other doctors and hopefully that’ll get you into the networking
through social media for residency.
I was not active on Twitter prior to that so I just gave it a shot and then I didn’t match into residency and went on this rant about my frustrations it was it was cathartic and it was,
it was nice to see that there was a lot of support and then.

[49:46] But the most surprising thing wasn’t just the support from other Physicians was actually all these other people saying I’m in the same boat as you,
and then that’s how Muhammad and our other colleagues and I we met virtually through that and created a SP.
As I started looking more into it and.
All of us started trying to understand what is the problem we realize this is not just a problem
of the bottleneck of residency but their problems
for pre-meds and medical students and then those in residency have issues and then physician when we start talking to practicing Physicians and they’re like it doesn’t end once you get residency like.
That these problems it’s a systemic problem that starts from.

[50:37] Trying to get into the medical system as a pre-medical student all the way through practicing medicine.
So we started off advocating for those that were unmatched like Mohamed Said.
These licenses that are certain States like the one Muhammad has and his groups his group has promoted and implemented in Washington summer license in Arizona and.
Um Missouri and Utah and we found out there’s been a license similar to this in Florida since the 80s.
So
we this license to on to license unmatched medical graduates and those that haven’t completed residency so they can practice under supervision that’s a license I was speaking of that’s called an assistant position license in.
In Missouri and Associate physician license and in Utah and I think Arkansas as well one said so Pursuits,
to know trying to get into the medical system and then it’s trying to survive in it yes yes,
and that’s what we’ve noticed like and the problems are getting worse every year like I’ve connected with some medical students and.

[51:56] I I was blinded to this because I went to an America to a UK medical school,
but they’re also focused on their scores for the u.s. Emily’s they don’t think about learning medicine and like the art of medicine and the practice of Medicine,
they’re learning and so they can get the highest score on the test and.
When I saw that I was really really disappointed because you lose out on so much of that learning when you’re just focusing on
how to get that number and not really learning about
what’s the best practice for the patient to streamline things for you as a physician so you can spend the most time with your patient and really develop that relationship.
And provide them the best care so we um.

[52:45] We have our mission is to create a collection of not just
pretty stupid medical students and Physicians but healthcare workers and professionals as well as the community who want to make the medical system better our goal is to to,
make it s ethically.
And morally just as well as providing opportunities that are equal to all because a lot of.
Like one issue I’ve noticed which I myself went through was and one of our colleagues will Leah a GCF she’s been
trying to figure out how to quantify this in data is there is a discrepancy in who gets into medical school in this country versus who doesn’t and there are certain demographics that.

[53:39] Are privy to getting and or there’s a lot of discrimination in certain ways like.
And then there’s the issue of gender like I face that when I was in clinical rotations not just abroad but here in the US where no one really took me seriously because I was a woman of color and so.

[54:00] There are so many issues that we are just like kind of making this list of and.
Really thinking about what is the best way to approach these issues and.

[54:13] Why not one thing that has been really disappointing to me is that you know coming from,
I’ve worked both in research public health and clinical medicine Innovation is applauded and research and even Public Health but when it comes to the practice of clinical medicine.
They want to stay with the old ways they are not as readily or eager to change this fascinating isn’t it.

[54:41] Yes so for us it’s about this change but the change for the better and.
If we don’t get the opportunity to try and take these risks we probably won’t ever find out if there is a better way,
to practice medicine to train residents and even to teach our medical students and.

[55:07] Mohamed and his group like wa imj they’ve done a great job of showing how you can take those risks and.
Implement sustainable and very.
You know advantageous bills within the state that have helped bridge the gap and not just the number of Physicians working and practicing but also in the Gap in care in these
really underserved and Rural communities that.
I need that type of care so so it’s very it’s very hard right now too.
To Simply State what we’re doing with ASP and it’s really a part of our growing pain as a new nonprofit but our main goal is this coalition.
That allows everyone the opportunity to practice medicine and to get the quality Education and Training required for it and to provide a service,
to these communities that are so desperately needed I’m going to have to say that I think that you are two of the.

[56:14] Wisest young people that I have run across in a long time
and it certainly sounds to me as if you have your eyes on exactly the right target or targets and it really gives me.
A really good feeling
to know that that there are young people like you who have a that kind of wisdom and be the motivation and the intensity of motivation to go ahead and get the job done
so I’m really looking forward to
seeing what you guys are going to do and I’ll have to tell you that we have we were about to give birth to a companion program for
prescription for Success it’s called what have we learned today where we like to expand on the topics that
topics that we’ve talked about here and I hope that you will plan to be with us on that because,
this is a huge subject and it needs a great deal more time than we’ve given it today and we’d love to be able to give you a platform but.
At this point I am going to give you a little more time and we are at the part of the program that I like the best and that’s when I close my mic and get out of the way and let you people speak on your own so we’ll begin with dr. henna,
sorry I’m going to be quiet while you give us your prescriptions for success.

[57:43] Alright so my prescription for success.

[57:49] I think one of the biggest things that has shaped myself and that I think really is.

[57:57] What what is profound and.

[58:02] Special just to us as human beings is being able to help others there’s this.
Ideology in India called savea and it’s about being of service to others but it’s an altruistic like you’re not doing it for anything in return is just from the good of your heart and that’s something I’ve taken too
that’s kind of been my motto in life is to be to do savea for others and I think that is something that.

[58:34] Really is important especially nowadays doing what’s good for not just you but the community around you making that change around you I.
I was fortunate enough that in high school I had I had a little stronger Foundation you could say than my peers in high school for my education prior and.
My high school was very low income and one my,
I felt like I wasn’t challenged enough and I would kind of complain you know it’s a 14 15 year-old think I’m bored in school to my professor or sorry my the principal and say I want to be challenged more and while they did provide a lot of
like resources for me one thing he said was that.

[59:26] Instead of just thinking about lifting yourself think about lifting those around you and that’s really what’s Ava is and Compass encompasses as well is providing.

[59:37] Service and doing service for yourself and those around you and building up together.

[59:44] And that’s what I feel is really important about medicine especially right now.
It’s not about competing with your colleagues it’s not about.
Being the best doctor just for yourself it’s about this higher calling I mean we take the Hippocratic Oath about.

[1:00:05] Being doing the best for the patient and doing the best for those around you and I think that’s very important.
But even though you are of service at others to make sure that you’re checking in with yourself that’s something I neglected a lot of time and,
I feel I should have listened to a lot of my
especially my medical school professors and the attending saying that this is the time to rest make sure you’re taking care of yourself just like they say on an airplane
put the mask on yourself before you put help others in an emergency and that’s very true.

[1:00:47] The last thing I would say is.
Don’t be afraid to take risks there is nothing in this world that really is set in stone.
Everything can be changed for the better and usually your gut feeling is Right compared to others.
I-i’ve never been someone that’s fit into boxes or what typically people see I’ve always found another way to reach my goal whether whatever obstacles are in there and.
I think this really stems from my parents because I mean they came here as immigrants with almost nothing to their name and they’ve built the life,
for my sister and I and one of the things I was really struggling with when I didn’t get into residency was that I was failing all their hard work and so being able to.

[1:01:44] Find another route where I can be happy and.

[1:01:51] Succeed on my own terms is what my mom always says is that nothing succeeds like success and success is how you define it.
So overall just.
My prescriptions for success is be of service to others and yourself take care of yourself don’t be afraid to take risks.
And Define your success yourself don’t let others Define it for you.

[1:02:20] Well thank you Hannah a lot of wisdom packed into all that and we appreciate you sharing with us and I’m going to move on to dr. Mohamed Khalifa and your prescriptions for success,
yeah well I think my prescription for success is going to be very similar to Hannah’s prescription,
and I’ve struggled with one thing ever since I got into this world when of different issues and you know problems because success for me was always about.

[1:02:51] You know becoming a licensed Physicians and you know getting into that room with the patients that you want to serve and you know changing people’s lives sitting down with family,
and you know helping people become more healthy being a community leader.
In the only way I saw that to get to that point was this residency system and the prophet the problems that I went to.
And and I struggled with this word for a long time success in is it that and once I took a different route,
in say I want to own a different arrays in the match and now I want to become a non-profit leader and I wanted to come,
an advocate for this is I realized in that moment that I Define my own success,
I am and you know the biggest by biggest prescription is that Define your own success.
Don’t be forced to live in society’s version of success in a lot of times you know that’s the case and that was the case for me as well,
I always lived in a society’s version of success I never had a definition of what success looked like for me.

[1:04:08] And everybody needs to prescribe their own success and sometimes that involves risk as henna said.
And risk can be scary we can be uncomfortable and it can be something that we do not run to all the time but I think.
We need to experience fear I think we need to experience uncertainty,
I am need to put ourselves in situations that are uncomfortable to be successful because that’s it that’s what it takes to be successful.
I mean if people if somebody doesn’t like if you don’t like your job.
I think you should take that risk you know if you don’t like your employer or administrative breathing down your neck.
If you want to open up your own practice you might not open it up today but you can see you can make the building blocks you can start one day at a time right you can you can transition to a part-time job and try to run your practice on the side,
and I love this coke my next prescription for Success would be this book.
By Carol dweck called mindset if she talks about the concept of growth mindset.
Which is really I loved that book that book changed my life.
And I would recommend that book to anybody listening because it is so you know valuable some of the things that she talks about on mindset and growth.
In my last prescription for success is.

[1:05:35] Find others right and whether it’s you know reaching out on social media and today we’re very fortunate as we’re also connected,
through social media and other platforms and it’s very you know easy to find people in the same boat like you know I found and I was very fortunate enough,
I to find it amazing friend like her and of co-founder that you know has helped us reach to potentials that we might have not reached and other co-founders of ASD as well,
energy same saying in Africa which is
the go fast go alone go far go together and if you want to go far to find other people and like-minded,
so you can reach that point so and to summarize my prescriptions for success
is one Define your own success to is be uncomfortable 3 is read that book growth mindset by Carol dweck.
And the fourth is fine other so those are my prescriptions pieces.
For dr. Mohamed Khalifa and Doctor henna Sony I thank you so much for sharing your wisdom with us today.

[1:06:49] And you are both very wise.
Particularly for your years and we are honored to have had you before we go I want to give both of you an opportunity to let people know where you can be found and how they can.
Follow you in whatever way you wish to be followed so.
Start again with henna thank you I first want to thank you for giving us this opportunity to speak about this issue and really appreciate what you’re doing with prescription forceps success and.
We are very excited to collaborate with you and anyone else so you can find our,
organization American society physicians at a s Physicians dot-org we have a Twitter as well and it is.

[1:07:45] ASP underscore underscore 0rg we have about 1800 followers which were very excited and hoping to collaborate and,
expand our platform with them you can find myself at at,
henna hean nmd on Twitter you’re also welcome to add us on LinkedIn as well we have a page for American society positions as well as our own.

[1:08:14] And to learn more about our organization definitely see the website since we have a lot of information on the events we’ve done
other are other co-founders in the work they’ve done and our collaborators and we will also be attending the Freda character Muhammad and I will be attending the Frita care conference and Austin on from September 15th to 17th
so if anyone is there and either would like to attend or would like to meet us there please reach out and we look forward to that and again,
Mohamed anything to add yes so you can find my and Twitter handle my Twitter handle is at pres and wa I mg so pres is,
p as in cancel re Z press w a I’m G and you can find this on our website a.s. Physicians dot r dot org and I’ll also be at the conference with Hannah,
and excited to meet anybody there so that’s all I would add thank you so much again for inviting us to this podcast we’re very honored to share our story and,
you have your listeners listen as well thank you so much well dr. head of Shawnee and dr. Mohamed Khalifa thank you once again for being with us on prescription for success.

[1:09:35] Thank you so much for joining us today we’d really appreciate a review from you and a five-star rating helps give our podcast much more visibility,
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[1:10:11] Special thanks to Ryan Jones who created and performs our theme music and remember,
be sure to fill your prescription for success with my next episode.