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Dr.Iqbal: Clinical knowledge is important in electives!

Our guest is Dr.Sameena Iqbal. Dr.Iqbal is the program director for the Nephrology training program at McGill University.

 

Interviewer: Dr.Iqbal, I welcome you as a guest on our website. Thank you for accepting our invitation.

Dr.Iqbal: It is my pleasure.

 

I: Could you tell us a little bit about yourself?

Dr.I: I am an attending nephrologist at the Montreal General Hospital and have been in practice for about ten years. I did my undergraduate studies at Queen’s University. I completed Internal Medicine training at the same university. I continued with a nephrology fellowship at McGill University and finished a master’s in epidemiology at Queen’s University.

Currently, I carry on a very full clinical practice. I also teach residents, students and am a practicing physician and carry out some research. The teaching aspect includes being the program director of the Nephrology training program , which I have been doing for seven years. The program by itself is a small one, because it is a sub-specialty program. It requires that we have one or two residents per year. We are planning to expand it to a research fellowship as well and we are working on the process as we speak. Most of our trainees are from Quebec or are international medical graduates, who come from all parts of the world, as long as they have their own funding.

 

I: How does the selection process go?

Dr.I: we have a selection committee that is formed each year. It contains doctors and residents. The resident is usually a senior resident, an R5.

 

I: Dr.Iqbal, you have interviewed many applicants from the Middle East and I am sure that you have formed your own impressions. In your opinion, what would make a good candidate for the Internal Medicine specialties?

Dr.I: The application process incorporates looking at the applicants’ medical degrees. What we call their academic performance, which include their transcripts from medical school, their LMCCEE exam results. As they are applying for a subspecialty, we also look at their MCCQE I & II results and their Internal Medicine rotation evaluations.

So for someone coming from the Middle East, we look at their ability to speak English. We also look at the letters of recommendation, and the Medical School they come from. We also like to see that the applicant passed some elective rotations in North American Universities. Because if they did not pass any time in North American health care system, we would not have a clear image about how they will perform.

 

I: Ok, Dr.Iqbal, we were talking about the Nephrology program. What about if we wanted to talk about Internal Medicine in general?

Dr.I: So when you look at the Internal Medicine application forms, there are two parts for assessment; their initial application package, that is graded, and then the interview process. So the package is in general what I just said. They look at the performance at the Medical School level and the letters of recommendation.  These aspects are important, especially if the recommendations are coming from people in an institution who are well known..  So if it is coming from a cardiologist that is working here and it is positive, so they will realize that this is a good candidate as apposed to coming from someone that they do not know.

 

I: Let me interrupt you here Dr.Iqbal if you do not mind. So you are implying that it is important to take electives here to increase the chances of acceptance?

Dr.I: Yes, absolutely!

 

I: So, if I am coming here to do an elective, what is your advice for me to leave the best possible impression?

Dr.I: When you can come here to do an observership or an elective, it implies interest. You should be prepared. People who come for an elective in nephrology for an instance and they have minimal knowledge. It shows poor interest! You will not get a good mark and will never be able to get into the program, but if you come, well prepared and show interest, you are coming with a good background knowledge, reading around all cases seen and being proactive. Those individuals will have much better chances of obtaining good letters of recommendation, and then chances of Successful entries in the programs.

 

I: So you are advising people who want to come to here to have good academic standing and have strong letter of references. And a good way of achieving this is to come here and do electives.

Dr.I: With people they want to work in the future, yes.

 

I: Based on your experience, some people come here to do electives and do great but others do not do as much. Why is that?

Dr.I: They should come later in their training, in their medical school senior years. Do not come at the beginning of your clerkship years, when your knowledge base is still at the beginning. Come later, so you can have the best experience and also your knowledge base is strong.

 

I: As you know the work culture here is different from Saudi, so some applicants may face challenges with this respect. Have you seen any challenges of this sort and what is your advice to approach it?

Dr.I: Well, in the interview process itself, you can clearly recognize you can identify certain professionalism such as timeliness, showing eye contact when talking, and shaking hands for instance. If it is a female vs. a male or vice versa it can be taken be as much as an insult if there was no hand shake. So these things for example would indicate lack of comfort with the North American environment. They are subtle but very important when training in North America.

 

I: As this is an academic institute, what would a good candidate have in terms of this aspect?

Dr.I: Someone interested in research should know what is their interest and with whom they want to do it, for example a master’s program. They should gather information before arriving at the NA institution. And then, deciding very quickly on who their supervisor should be, because this is their area of interest. They should not waste time in saying: OK, I am going to wait and wait. They should decide as soon as they arrive to do an elective and say: Look, I am interested in this field so who is the best person to do with? Networking! If you ask and search you will find the right people and connect. This is the best way to approach it.

 

I: Is it necessary to have publications to be accepted in the Internal Medicine program?

Dr.I: Not necessary. But you will be more competitive if you have a publication before hand but it is not a must. If you have shown that you are worked in that direction and you are working to finish a project that would be beneficial. But again if you have a publication that would put you a one notch above the other applicants who do not have.

 

I: What about Master’s degree?

Dr.I: So a Master’s before getting accepted into residency is also strong. If you have done a master’s before applying to a medical residency program, you are more likely to have publications. And it shows a mature student, when you are coming as a resident and maturity gives you an advantage because medical residency is not easy. Emotional stability and overall maturity will help with  the many stresses for someone coming to North America: emotional, financial, time, family, and work. With all residency related stresses, you put on top of that a different culture. So it is best if someone has a strong support system before arriving. It is good for someone who comes to bring their family with them because it really helps them adjust. You can tell the difference when you see IMG residents here, because I had a few, residents who had their families with them. Those are much more emotionally stable especially at exam times.

 

I: So I am from the Middle East and I just graduated from medical school. What is your advice for me to get accepted in the Internal Medicine program?

Dr.I: You should be sure that you researched what the program offers. And what are the differences in such a program compared to others across Canada and the States. Identify the strengths and weakness of the program to begin with. And the only way to do that is by talking to the graduates that have gone through that before hand, doing some research before hand. Next step is being strong in your knowledge base before applying, with a serious commitment. Making sure that your English is good. Also here in McGill, if you know French it would look good on your CV. Third, having done research, in the process of doing research or having a research back ground looks very good in the CV, too. Completing electives in areas that you enjoy and you are strong in. Because if you do an elective in an area where you are weak in you will not get good letters of reference. Your aim is to get amazing reference letters. And finally, performing well in the interview. You want to walk into the interview and you are will prepared for it. Know why do you want this program and your own shortcomings and how are you going to overcome them when you come into the program. Where do you see yourself going in the future? These are the things that they are looking for in the interview. Someone that knows what they are doing, well spoken, recognized their strengths and weaknesses, knows where they are going, and have selected options. Those are the people that do well.

 

I: would you like to add any other thing?

Dr.I: I think the key is to recognize that speaking to other people that have gone through the same program is really the essence in this process. They are subtle things that you do not recognize unless you have spoken to someone. My prospective is going to be very different than someone who have walked through the door and have undergone the interview process, as an interviewee, as apposed to an interviewer. I am giving you what I expect to see from them, but they can give you other tips that they may had to go through.

 

I: Thank you very much Dr.Iqbal for your time.

Dr.I: You are most welcome and best of luck.

 

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