An open letter to anyone who believes being an IMG (International Medical Graduate) and doing medicine abroad is the easy way out,
Let me tell you my dear, I wish being an IMG was simple. But it simply is not, it is frustrating. You constantly have to have your elevator pitch of why you went abroad ready to fire. Imagine having to explain to every new person you meet why you aren’t in a relationship, why you haven’t gotten married yet or had kids. It’s the same concept. The question may be well-intentioned but it’s often laced with judgement and feels a bit intrusive. It’s hard to summarise your entire life story and do it justice in a few sentences. And I never know what kind of comment to expect at the end of it. Some people are so supportive, and others have a major God-complex that becomes very apparent. Either way, my attempts at being nonchalant during my pitch are usually caught out by my shaking hands, fidgeting leg and stress sweat (not a cute look, folks). The off-handed comments, the pity associated with “so how many times did you apply before moving”, and the underlying assumptions that it must be so much “easier” are quite unnerving. I can tell this irritates my family as well who know how hard I have worked to get to where I am today. They are quick to jump in and provide titbits of my accolades.
Being an IMG is not the easy way out. It comes with continual scrutiny and an unrelenting need to prove and defend yourself. I will have to do both Canadian and American boards (each has multiple parts), as well as all of my Irish exams. Residency spots are harder to get. We have to score higher on boards than our North American counterparts. We have to fight harder during electives to prove that our skillset and knowledge base are not only sound, but very strong. It’s not for the faint of heart.
At RCSI, we hit the ground running from day one, year one. There is no easing in, no orientation week. Our first lecture was on the anatomy of the femoral triangle. In hindsight, it was so simple, but you best believe I went home and cried that day from sheer panic and pressure. Our first year consisted of quizzes every fortnight, covering all the material since the last exam. We spent a lot of time in the Anatomy lab every week and had card signings (a terrifying British tradition) every other week. At RCSI, there is no pass or fail. Everyone is graded and ranked. Everyone is grinding at max capacity. The thought of matching to residency back home exists as an unrelenting, nagging voice in the back of my brain. It fuels my long hours of studying and need to keep pushing forward, even when my spark and passion feels dimmed. To sum it up: we study our asses off from the get-go and there is no slowing down.
Not to mention, the majority of us are extremely far from home. Medicine is never easy, but the added dimension of navigating life in a new country (and continent) does not exactly lighten the burden. In fact, it’s incredibly trying, especially at the beginning. The time difference means staying connected with loved ones requires quite a bit of planning and effort (my family is primarily in Western Canada and my best friends live all around the world). In addition, we don’t have the luxury of going home for holidays outside of Christmas and short stints in the summer. Summers are all about improving your odds of matching back home, with everyone having their own goals and priorities. Not to mention the massive financial undertaking of being an IMG which is always lurking at the back of our minds. AND…God forbid we have any medical emergencies, because getting family here on a whim to provide support is no easy feat. I had a major medical issue this year. I sat in the ER by myself for nearly 24 hours. Prior to this, I suffered silently for two weeks because I didn’t want to stress out my family who were so far away. My parents dropped everything, bought an incredibly expensive flight for the next day and flew 10 hours to be by my side after I was admitted to hospital. It was an emotional rollercoaster to say the least.
But despite all of these things, I wouldn’t change it for anything. Sometimes my own strength and resilience surprises me. I love the challenge of being somewhere completely new. I love that I get to meet and learn from people from all around the world. I am grateful to experience another culture and learn from the more laid back European mentality (compared to our North American edge and competitiveness). I am travelling more than I ever could have had I stayed in Canada for school. How many people can say they went to Barcelona, Paris or Croatia for the weekend? My best friends in med school have such diverse backgrounds. We learn so much from each other and are constantly pushing each other to be better. While the thought of so many board examinations is stress-inducing, I know it will make me a better resident and physician for my patients, so I am up for the challenge. I am realizing that the North American way is not always the best way for everyone, but it took me stepping outside of that bubble to figure this out. I could have never imagined that my path to medicine would have been this unique. But I thank God that it was and I can’t wait to see what else this adventure brings forward.
If you have any questions about applying to medical schools abroad or life as an IMG, please shoot me an email or comment below!

Hello Dear,
This is Amir, father of Shayan who has been accepted in RCSI as an international student coming from Canada. Shayan says that according to his information it’s not possible for anybody who graduates in RCSI to become a resident most importantly in the US, but nor in Ireland, or even in the UK.
Being entirely anxious as his parents, may I kindly request you to verify Shayan’s information, letting us know if that’s correct or not.
The very sad thing is that for the above reason he wants to drop RCSI and go to Western Universities in London, Ontario.
Bearing in mind that there isn’t much time left to make the right decision.
But, together with your kind response would you please let us know how long it would take him to complete his residency after his initial 6 years in RCSI.
Your earliest reply would be much appreciated.
Sincerely
Amir Behzadi
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Hi Amir,
Firstly, congratulations to your family on his acceptance, that is a big deal and RCSI is a great school! Canadians who are International Medical Graduates can absolutely match to both Canadian and American residency programs. Most Canadians in my program take all the required board exams for Canada and the US, and historically RCSI matches very well across North America! For UK residency, I do believe you need to be a citizen of an EU country (although need to double check this- please email me, I will find out). To land an Irish Intern year spot and do residency in Ireland, you ideally would need EU citizenship. North American students can apply but it is much more competitive as eligible EU students take precedence for spots. The high majority of North American students who apply do end up returning to either Canada or America. My email is milliemohan@rcsi.com if you have further questions!
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Hello again dear,
Just wanted to thank you so much for your time and the detailed response.
Much appreciated,
Amir
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