Beyond Borders: The Life of a Nigerian-Indian Pediatrician in the USA - Dr. Sana Khan (Part- 2)
There may be times when you come across difficult and sensitive cases. How do you handle them emotionally and physically?
There are indeed different types of cases, and sometimes they can involve difficult parents as well. In such situations, teamwork becomes crucial. It is important to approach the parents with empathy and try to understand their perspective. It is essential to communicate with them empathetically, acknowledging and validating their emotions. In many difficult cases, parents are often anxious and scared. Therefore, it is necessary to provide explanations and reassurance.
Furthermore, in cases where a definitive diagnosis is still being worked on, involving the parents in the process becomes vital. This approach is known as patient-centered practice, where the focus is on including the parents in every decision-making step. This involvement helps them feel valued and informed.
In the medical field, new advancements and discoveries are continually being made. How do you keep yourself up to date?
There are excellent journals available in the field of medicine, including numerous pediatric journals. There are also lectures and Continuing Medical Education (CME) programs specifically focused on pediatrics. Regularly reading these journals and attending lectures and CMEs, you can stay up to date with the latest advancements and changes in medicine and it is important to recognize that medicine is constantly evolving, with new developments emerging daily. The monthly publications of pediatric journals often cover these new updates. Keeping yourself engaged in such resources helps you stay current and informed.
Since the COVID-19 pandemic, people have started preferring telemedicine. What are your thoughts on the progress of telemedicine and technology?
I believe it is excellent and very beneficial. Consider a situation where you have a minor issue or concern at home; there is no need to rush to the hospital. Telemedicine works very well, particularly in pediatrics, where not every situation is life-threatening. If the concern is mild, there is no necessity to visit the hospital for follow-ups. Even if a patient has visited the hospital for the first time, subsequent follow-up appointments can be conducted through telemedicine. This approach enables you to catch up and continue care remotely.
Apart from that, let me ask you a question related to your USMLE preparation. When did you start preparing for it?
I started my preparation when I was in my final year of pharmacology. That's when my husband and I decided that I should dedicate myself to serious preparation because I had to take the exam by the end of the year. So, I believe I started in 2017 and completed it within two years.
Did you take any coaching, or did you study on your own?
No, I didn't take any coaching. Most of the study materials are available online, including videos on platforms like Facebook. I didn't feel the need for coaching because I enjoy studying independently. If you have study partners with whom you can discuss and strategize, it can be very helpful. I had some great study partners, and that's what really helped me.
If a student is looking forward to practicing and wants to take the USMLE exam, when should they start their preparation?
You need to be very focused on the timing. If you have one year, you should ideally be two years ahead, preferably before you apply for residency. So, if you need to take Step 1 in September, start your preparation in January. Nine months is sufficient; believe me, 6-9 months are enough for Step 2.
What is something that kept you motivated throughout the journey? Because, you know, it can get really exhausting sometimes. So, what kept you going?
I think those who didn't like me and those who kept criticizing me were my biggest motivation. My motivation came from those who said, "This won't happen" or "You won't be able to do this." For me, that is my motivation. My motivation is to prove them wrong. You know that kind of thing is what kept me motivated, and I always tell other people that if someone tells you that you can't do it, do it twice and show them that you can do it not just once but even better, you know? So, that was my own motivation, honestly.
That is a truly valuable insight at a young age. Do you have a personal mantra for success that you would like to share as advice with our aspiring healthcare professionals and students who pursue residency abroad?
I would say, firstly, it's crucial to have a reliable mentor who has experienced the journey you're embarking on. Without guidance, you might feel lost and unsure of where to go. Having someone to provide advice and support is essential to keep you on track and prevent you from getting derailed. Therefore, always seek out a mentor who can offer valuable insights.
It's important to dedicate yourself to your studies and give your best effort. You may encounter numerous individuals who doubt your ability to succeed, telling you that you won't be able to achieve your goals, especially when it comes to securing a residency in the US. They may question your chances, especially if you're considered an "old grad" like myself, having completed MBBS in 2010. However, I have proven that it's possible to overcome these obstacles, even with the responsibilities of raising two children. If I can do it, anyone can. So, my advice is to disregard those who discourage you and focus on the people who believe in your potential. Surround yourself with positivity and constantly seek out uplifting and inspiring content.
We, as human beings, tend to make mistakes. So, have you ever had to face a lot of disappointment due to a case during your entire journey so far?
Absolutely, we all make mistakes, and it's important to learn from them. Recently, I made a mistake myself. I had a delay in ordering the necessary medicines for a patient. It was late at night, around 3 am, and I thought another team could handle the ordering in the morning. I underestimated the urgency and assumed someone else would take care of it. Unfortunately, the computer system for ordering, known as the EMR, was not functioning properly, which resulted in the patient not receiving the medication on time. These are the kind of small things that can happen, but it's crucial to avoid repeating such mistakes.
From that experience, I've learned that even if it's a minor mistake, it's important not to repeat it. The following day, when I had another patient, I immediately placed the order without waiting, regardless of whether the medication would be received the next day. My belief is that if you make a mistake once, you should strive never to repeat it. It's essential to keep this mindset and always be mindful of your actions.
Ma'am, as you have studied in Nigeria and practiced at AIIMS, how does it feel for you to practice in the US?
I feel a great sense of humility myself. I come from a small town in Nigeria where I pursued my MBBS degree. Regardless of where you come from, hard work is essential. It doesn't necessarily mean pushing yourself to the limit but rather working smartly. You should know how to navigate and succeed in exams. Whether you face challenges or not, cracking the exam is crucial.
When I came to the US, things were different. Passing the exam wasn't solely based on knowledge. They wanted to assess your personality and how you interact with people, particularly with patients. It made me realize that this aspect was missing from my preparation. It was a sudden realization that each continent taught me different things. Everywhere I went, I gained valuable insights. Overall, I learned that there is so much I can learn from and communicate with people. When I return to my home country, I can share these experiences and encourage others to improve themselves in similar ways.
I read your Medsight, where you mentioned being proficient in Hindi, Bengali, Arabic, and other languages. How did you manage to acquire such cultural diversity and learn so many languages?
I speak Hindi, English and Nigerian language. However, I had a Bengali friend, so I can understand that language quite well, although I may have a bit of difficulty speaking it myself. I used to practice it but haven't done so lately. Whenever someone speaks Bengali, I can fully comprehend what they are saying. I consider myself lucky in that regard. One of the best things about childhood is that the more you are exposed to different languages, the more you learn.
Now, I want to learn Spanish since it is widely spoken in the United States.
In India, the healthcare system largely relies on manual processes and has relatively less advancement in terms of automation. This manual approach may have an impact on the quality of care provided in the healthcare sector. What are your thoughts?
When tasks are performed manually, there is a higher likelihood of errors occurring. For instance, in the case of medication prescriptions, even a simple mistake like omitting or misplacing a decimal point can have significant consequences. Writing "0.01" instead of "0.1" without including the leading zero can lead to a substantial difference in dosage. These small errors can accumulate and cause potential harm. That's why I strongly believe that electronic systems are crucial in healthcare, as they can help minimize such errors and ensure accuracy and patient safety.
Can you provide insight into the work rotations, shifts, and patterns in India and the US? Do they have similar rotations, or are there differences between the two countries?
In India, my experience included working for 6-9 months as a year in AIIMS before transitioning to pharmacology teaching and research. The clinical rotations were different, and as an junior resident in AIIMS, I worked extensively in a clinical setting. The volume of patients in Indian hospitals is considerably higher compared to here in the US. However, in the US, the workload is more manageable, allowing me to concentrate on individual patients and address their medical needs without rushing through appointments. There are regulations in place to ensure resident working hours do not exceed 80 hours per week, and any violations can be reported. In India, on the other hand, we used to work up to 36 hours, which often led to burnout without much accountability. Here, there is a requirement of 8-10 hours of rest following a 24-hour shift. Despite these improvements, some people still experience burnout, but overall, the work conditions are better in the US.
If given a choice, what alternate career would you have opted for?
I believe I mentioned earlier that if I were not a doctor, I would still explore a field related to counseling. I have a passion for communication and enjoy guiding and advising people. Perhaps something in healthcare that involves interacting with patients would be a good fit for me. I genuinely love speaking and helping others.
What are you passionate about?
Outside of my pediatric practice, I haven't been able to pursue my passion due to the feeling that I am still in a studying phase. However, my true passion lies in traveling. I thoroughly enjoy exploring new places and learning about diverse cultures. It's something I genuinely love and would like to prioritize once I complete my pediatric training. The journey so far has been a continuous pursuit of one degree after another, and after such a long time, I believe it's time to pursue my passion for travel.
I understand that regular checkups and health screenings are important, and you've noticed that this practice is not as common in India compared to the United States. Regular annual checkups are essential for individuals of all age groups. These routine examinations play a significant role in monitoring overall health and are particularly crucial for detecting potential health problems. It is important to emphasize the need for monitoring fundamental blood components and lipid profiles as part of these checkups. By doing so, healthcare professionals can identify early signs of conditions such as high cholesterol, enabling timely intervention and management.
I feel it is essential to establish a routine of regular checkups throughout life, rather than only seeking medical attention when one is already ill. By prioritizing preventive care, you believe that potential health concerns can be identified early, allowing for prompt intervention and treatment if necessary.
I am urging everyone to take this matter seriously and encouraging regular health checkups as a proactive approach to maintaining good health. This is based on your personal observations and experiences in the United States, where regular checkups are more common.
Any message to society as a healthcare worker?
What are your future goals?
I have a strong desire to become someone I admire. My goal is to help children, assist families in any way possible, and contribute to my community, potentially even abroad. Ideally, I would like to work in a field where I can share my own experiences and offer improved strategies for managing various issues that affect children. While I am primarily interested in general pediatrics, I also aim to guide many individuals who are pursuing a career in medicine. This way, I can make a positive impact on both my patients and colleagues.