Choosing a Fellowship as a SheMD

It was February of the year 2007. I was an Intern, a PGY-1 internal medicine resident. Only a few more months as the junior most doctor doing scutwork in the hospital. I couldn’t wait for July to come around when I could wear the mantle of an experienced PGY 2. A second year resident, supervising interns, teaching them valuable skills on how to survive “Intern Year”.

Towards the end of this intern year, we were starting to think about fellowships and the application process. Back then, one had to apply in the first few months as a second year resident. It was time to take stock of our experiences so far, what rotations we enjoyed and the ones we were good at. Our intern class had seven men and two women.

I went to medical school in India which had an equal number of male and female students each year. My aunts were amongst the five women medical students in their class of fifty, back in the sixties. This was the nineties and being a woman doctor wasn’t a big deal anymore. I was now a foreign medical graduate in residency training in the United States, which I assumed, was more liberal as a society.

I was doing my CCU or Cardiac Care Unit rotation. It was a struggle to wake up at 5 AM in order to make it to the sign out from the night team at 6 AM. This was followed by intern rounds at 6:30 AM and then attending rounds at 8 AM. I loved the fast paced thrill of working in an acute care setting. It was fascinating to see patients who had survived a cardiac arrest, those awaiting cardiac bypass surgery and others recovering from their stents or balloon pumps. The staff there was on point and I learned a lot from them. The patients were sicker and we got to do many procedures. I experienced what instant gratification in Medicine was, seeing the results of my intervention as a physician right away. It was very satisfying and I felt at home. I talked to my senior residents about pursuing cardiology or critical care. Both were demanding, grueling, and competitive fellowship programs.

Our hospital had two female critical care physicians and one female cardiologist. I didn’t think much of it. When I met my program director for advice regarding fellowship, he asked me what my interests were. My eyes sparkled with excitement as I described my experience in the CCU and mentioned cardiology.

He sighed and took a long deep breath. And proceeded to tell me what a tough choice that was. I told him I agreed, it was a competitive field, which is why I was coming to him for research projects and guidance. He took another deep breath and I asked what was wrong. He told me to reconsider. When I asked why, he told me “Let me be honest. As a woman and a foreign medical graduate, you will not be able to get into a cardiology fellowship”.

I went in expecting my mentor to help me pursue my passion and instead was introduced to an alternate uncomfortable reality. I was hoping to get involved in cardiology research projects and possibly directed to residents who had gotten into the fellowship. Instead I was reassured about my capabilities as a resident and yet turned away from what I wanted to work towards. Livid as I was, I managed a terse smile and thanked him, before walking out of his office. I remember telling my mother about this, indignant and enraged. She simply said to me “Maybe he is right.” I hung up and thought, even if he is, it felt utterly wrong to believe that version of truth and go with it.

Maybe, it was the truth of his day and age. But wasn’t it the twenty-first century and a time when a woman could do whatever she wanted? Besides, as human beings, isn’t life about finding your purpose and fighting all odds to live out that dream? During this conversation I had, my competence as a physician didn’t seem to matter, when it came to fellowship. What about my potential, work ethic and all my strengths that could possibly shadow the other “truths” that were apparent obstacles? A world where gender, race and ethnicity came before your potential? I simply could not digest this.

I applied for a transfer and moved to New York City, an immigrant friendly city. I joined a residency program where I was happy to find that the interventional cardiologist was a woman and two critical care attendings were women. One of the cardiothoracic surgeons was a woman. It was a place where it wasn’t a novel idea to pick a demanding field as a woman. In fact, being a woman seemed to be a non-issue. I had plenty of women to confer with in the residency program I went to. Our program director was male and our assistant program director was female. There were a number of female attendings. The ratio was still skewed towards more male physicians in acute care settings, yet I felt more than reassured about following my own ambitions.

I ended up choosing to do a critical care fellowship. I have been a critical care attending physician in teaching hospitals for 6 years now. My only other female classmate during intern year of internal medicine residency is now a cardiologist. 😃