Resident Redux

Shortly after reading the poignant essay published in this issue (1), I was invited to give grand rounds at a leading medical school. Later, I sat in on a residents' journal club in a cozy room in a brick building that was part of the original hospital. We were packed around a table laden with sandwiches and soda. Latecomers either stood or sat crosslegged on the floor. The paper being discussed dealt with whether there was a benefit to a “drug holiday” during antiretroviral therapy.

Suddenly, I experienced an acute sense of dislocation: It was as if a time warp had taken me back 25 years when I had just arrived from India to be an intern in the United States. This feeling had come over me because the faces and name tags around me were indisputably Filipino, Haitian, Indian, Pakistani, Nigerian, and Chinese, to name the most obvious nations of origin. Caucasians were in the room, but it seemed to me that they were outnumbered (as they had been during my residency) by the “ethnic” faces, and most of the Caucasians were faculty (as they had been during my residency). But what made this journal club different was that when the residents spoke, they did so with the most fluent American patois that I imagined was shaped in places like Queens, Brooklyn Heights, Westchester, Saddlebrook, Newton, or Shaker Heights, and was further refined at a good college and U.S. medical school.

My own internship and residency felt a world away, although it was actually only a few hours away. As a foreign medical graduate (and I prefer “foreign medical graduate” [FMG] to “international medical graduate,” which I have always seen as a patronizing and purely cosmetic attempt at political correctness), I would not have had a prayer of …