The Mental Health Sacrifice of IMGs' Search for Perfection

Kathya Jimenez, MD


April 26, 2022

Every medical student in the world is required to study for 4-7 years, get exceptional grades, and be, in essence, "perfect" to achieve educational goals. According to the Cambridge Dictionary, perfection means "complete and correct in every way, of the best possible type or without fault." But the question remains: Who is perfect, who can be perfect, and should we fault ourselves for not being it?

In the United States, the word "perfection" is more important for international medical graduates (IMGs) because we have a lower probability of getting matched in a medical residency program than American graduates.

We must strive and be persistent in our perfection because IMGs are often held to higher standards. We are expected to have higher United States Medical Licensing Examination (USMLE) scores; extensive research experience; and even a flawless career trajectory just to get attention from the medical residency programs.

From being the top students in medical school to looking for the best opportunities so that you have a competitive resume for a spot in a residency program, you may have to leave behind your country and your family — and go through a world pandemic — to prep for the USMLE.

There seems to be a lot to think about that weighs on our mental health: from studying late, doing night shifts in hospitals, working part-time, receiving or not receiving financial help, taking loans, or even having to care for your loved ones. In Latin cultures, almost every IMG thinks that pursuing a medical residency in the United States is very difficult due to language, cultural barriers, and misinformation about the USMLE path.

Tell me: How do you feel? Do you take care of your mental health? Or are you trying to be perfect and reach higher standards?

There is a lot of stress on this path. One of the definitions of mental health from the World Health Organization states, "Health is a state of well-being in which an individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community."

We feel that we can't be sad or take the time to do an outdoor activity because only the weak cry or feel exhausted. The superhero complex is often praised in medicine, where we feel bad about taking a break for just 20 minutes. And if we do take a break, we feel guilty about it and don't enjoy it most of the time.

My definition of mental health is like the feeling of being calm, relaxed, and happy with yourself. Mental health is different for each person, and cultural and traditional beliefs can discourage a healthy mental environment.

There comes a point when you can't handle all the multiple tasks you have to achieve, and that leads to becoming frustrated, sad, and anxious. In almost all cases, we choose to ignore these feelings and they continue to grow.

Unfortunately, depression and anxiety are increasing among medical students, and they have become worse and more prevalent during the pandemic. Suicide is the 12th leading cause of death in all ages in the United States, with 1.20 million suicide attempts in 2020 alone. But a conducted survey demonstrates that 93% of adults think that suicide can be prevented. If so many people think suicide is preventable, what are we doing wrong?

I encourage every medical student to take time to really think about how you feel and what is best for you. Always remember that getting help will never make you weak. If you feel alone or are in emotional distress, you can call the National Suicide Prevention Hotline at 1-800-273-8255. It is 24/7 and free. You will talk with a live person who can help you.

We put up barriers to protect ourselves, but whether you are a medical student or a doctor, you are not alone in this path. Life is a blessing, so you must balance your success, effort, and internal acceptance.

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About Dr Kathya Jimenez
Kathya Jimenez, MD, is a Salvadorean doctor who graduated from Universidad Evangelica de El Salvador and is aspiring to US medical residency. "I really care about diversity and inclusion. I'm an active student of ASL (American Sign Language) so that I can be part of that change and give quality attention to patients. Also, I'm interested in researching the disparities and barriers that exist in the medical field in the United States and Latin-America. I'm a nature lover and an outdoorsy person."

Connect with Dr Jimenez on Twitter: @KathyaJimenezMD

The Duma Lab, formerly known as the Social Justice League, was founded in August 2019 and focuses on social justice issues in medicine, including discrimination and gender bias in academic and clinical medicine, cancer health disparities, and medical education.


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