Posted August 10, 2001. It has been a long 10 years since I stepped foot in the land of plenty (or should I say, "super-size-this, super-size-that economy"). I guess, looking back at the road traveled, I can say I have no regrets. It was tough coming here to an uncertain future, but it was worth the journey.

     I came to America just after my Philippine Medical Boards. Beaming with pride after learning my recent accomplishment of passing the test of all tests. I am apparently, one of those lucky ones, who married a nurse; and during those days (1990s) they (nurses, and is today) were hot commodity. I never thought I would have gone this far. I thought I was to take over my father's practice. Well destiny has it's own way of writing things. That was then.

     LESSON #1: MARRY A NURSE. WELL, I JUST GOT LUCKY.

     I easily thought I could get my US boards finished off and do residency in a matter of a year. Unfortunately, my arrogance and overconfidence took the best of me. The boards were no laughing matter to contend with. It is not just enrolling in a review class. It is a "life-and-death" effort of getting the right answers and the right topic to study. To be exposed to all the information in so little time was overwhelming. What made it worst, was how to manage your time. There were no jeeps or public transportation where we lived (which was in the suburbs). So you have to drive to your review place. Spend a half-hour driving and study in a cramped classroom by yourself. The review was self-paced and really did not provide a good crop of information. Thus, all the data I had was taken from the exams I failed and created a whole set of new information base that eventually led me to pass the boards in 1994.

     LESSON #2: TAKE YOUR STUDIES SERIOUSLY, NOTHING IS EASY (it could be costly at that time exam costs was at $400 per test)

     By some twist of faith, I was getting discouraged ... maybe even depressed, with a trampled-down ego and self-esteem. But I had no one to turn to and had no career options in hand. With a multitude of prayers, and the dream of fulfilling my destiny, I continued burning my candle at both ends studying ever so hard. Then one day, I found my star. An idea that revolutionized the way I studied the books. Yes, It was slower. But I could retain the knowledge longer and I was an active participant in my study and not just memorizing data. It was a certain technique of studying reviewers that led me to pass part II of USMLE, Then part one. I employed the same technique with part III and passed it at one try and then the Family Practice Certification boards.

     LESSON#3: THERE ARE EFFICIENT AND BETTER WAYS TO STUDY. FIND IT.

     With renewed confidence, I was so proud that finally I was ECFMG certified, passing parts I & II of the USMLE. I was on top of the mountain, I could do everything! Only for a while. The next step was applying for residency. To do this you send out numerous applications - probably 50 for me to residencies of your choice. My first pick was family medicine, then internal med, then transitional slots. Out of the 50, I only had 3 responses. The next thing was the Residency Matching. This is a confusing process: the residency chooses their pick for new first years ( probably 5 among hundreds), you, the applicant had to choose your top pick of residencies too. Then the computer, picks or matches the residencies with the applicants. To my shock, I did not match! I felt the whole sack of potatoes break … I was in a panic !!! The next few days were really nerve wrecking. During the application process, I discovered a lump on my left neck. This turned out to be a cold nodule and the suspicion for cancer was high. Thus, I was in a dilemma of fearing for my life and my career. During my diagnostic studies, I was calling residency after residency. I bought a Fax machine (the best investment I ever made …and is still with me until now) despite being broke, and faxed my CV and credentials to as many as 100 programs (maybe I'm exaggerating). The responses were frustrating, programs after programs were closing and accepting applicants left and right. Then on the second day, an assistant-program director called me. At that time we lived in Maryland. The program was in Reading, Pennsylvania, a 2-hour drive from where we lived. At an instant, I decided I will be there the next day. I had 2-3 competitions for the slot. One was another Pinoy (eventually they ended up admitting two of us in the residency, and him becoming our chief resident in the years to come). Finally, I was a resident … I could wear my White Coat beaming proud with success, even if it was 100 degrees Fahrenheit.

     LESSON# 4: BUY A FAX MACHINE? NO! PERSEVERE …. KEEP ON … DO NOT GIVE UP ON YOUR DREAMS, NO MATTER WHAT THE COST (for me it was $265 for the fax, and close to $300 for long distance and cell phone costs - charge to your credit card)

     I got into a family residency because I felt more comfortable at doing a lot of things and keep focused on the whole issue. Plus it was the trend of our time. We were the Gate Keepers. The specialist were at our mercy to send them referrals. Residency was a breeze. I enjoyed it. I'll never do it again. Do you know how hard it was to be away from your wife and newborn for the next 3 years of your life? Because we were buried in debt at that time, my wife had to stay in Maryland. We were blessed by the fact that my wife's mother stayed with us to help. We had bought a house in Maryland to get some investment and offset some taxes. We also had our first Baby on September 1994. By July 1, 1995, I started my residency program and would go back to Maryland at least twice a week. I would go home on Fridays, If I am not on-call that weekend. I would also snatch a quick trip home around Wednesday to drive two hours to Maryland then back to Pennsylvania leaving Maryland at 4:30 AM. This I did for 3 years. During my first year, I was diagnosed with Thyroid cancer papillary type. I underwent surgery April 1995 but it was a disaster. My surgeon never had much experienced with treating thyroid cancers that I had to be under the knife 2 more times. I was off residency for 3 weeks. But made it back in good effort. I was now dependent on my thyroid hormone for sustence since all my thyroid tissue were gone.

LESSON# 5: YOU ARE CAPABLE OF PATIENCE. LOOK AT THE END RESULTS, AND YOU WILL KNOW WHERE YOU STAND.

     I am now in my 3rd year of practice as a family doctor here in the foothills of the BlueRidge Mountains. I see mostly elderly folks and comprises at least 40 to 50% of my practice. I occasionally see kids and newborns. I think the last time I performed circumscision was 2 years ago. The last time I delivered a baby was 3 years ago. But I am happy here. Life is slow paced. Yes… Stat means the next day … well a few hours if you get lucky. Don't get me wrong, we are closed to a big city and just an hour away to a major metropolitan south, east, and west from us.

     LESSON#6: KEEP ON. YOU ARE WHAT YOU WANT YOURSELF TO BE. YOU TAKE CONTROL OF YOUR DESTINY.

     Well, If you have any questions for me and If I can be of help. Just e-mail at jrconsing@manofmed.com. Visit our website too to keep track on how we are at http://www.manofmed.com/main.html. Goodluck. God Bless. I hope I have encouraged people and provide them with how life is in the ol' USA - my version of it, anyway. The others might have had an easier transition. For that, they are blessed too. Adiyos.

     LESSON# 7: IF ALL ELSE FAILS. GOD NEVER FAILS. PRAYERS ARE A MUST. BE STRONG. DO IT AGAIN. THIS TIME WISELY. LEARN FROM YOUR MISTAKES.

     E-mail the author at jrconsing@manofmed.com

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