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39-472: My Own Country: A Doctor's Story is Abraham Verghese 's first book. First published in 1994, it made that year's New York Times Notable Book list. It is used in colleges and medical schools throughout North America and across the world because of the way it communicates the sense of empathy and compassion so often missing in medical school education in an era of high technology and reliance on computers as primary diagnostic tools. My Own Country traces

78-594: A Postgraduate Training Authorization Letter (PTAL), colloquially called a "California Letter". PTAL was discontinued by the California Medical Board in 2020. Applicants now need a post-graduate training license similar to the one issued by other states. Concerning visa requirements, non-U.S.-citizen doctors usually enter via the J1 or the H-1B visa. The J1 requires a 2-year home residence after completion of training in

117-654: A Master of Fine Arts . Later that year, The New Yorker magazine published his short story Lilacs about an AIDS patient who commits suicide. In 1994, while teaching in El Paso, he published his first book, My Own Country: A Doctor's Story , about his experiences in East Tennessee. In the book, he reflects on his work with the patients he cared for and gives his insights into his personal transformation from being "homoignorant", as he describes it. He also ponders themes of displacement, diaspora , responses to foreignness and

156-464: A 2023 interview, Verghese commented on how his writing skills help him pay more attention to patients' stories and ask more questions that can lead to better diagnoses. Verghese's emphasis on the physical examination has been dismissed by some as a form of irrelevant nostalgia. As Robert Goodman writes: "Lamenting lost clinical skills is possibly one of our profession's oldest pastimes, dating back centuries, if not millennia...Should we spend more time at

195-509: A U.S. residency position, and three-quarters began a residency after five years. It also indicated that IMGs were considerably older when they first applied for a residency position than are most U.S. medical graduates, with mean age of IMGs when the ECFMG certificate was issued being 32.4 years, with a standard deviation of 5.8 years. Applicants to residency programs in California previously needed

234-1042: A candidate is required to pass 12 out of 16 cases: including one compulsory case in both gynecology and pediatrics. IMGs who have passed the necessary exams and obtained AMC certification can then apply to Australian specialty training positions. Australia is in the process of establishing a national registration process for all the doctors under the Medical Board of Australia. In 2010 the Minister for Health and Ageing launched an Inquiry process into registration and accreditation processes for international medical graduates which reported in 2012. In Canada, international medical graduates include all graduates from outside Canada. For IMGs to be eligible for full licensure in every Canadian province and territory, they must hold: The candidate must also: However, some provinces may have alternate paths to licensure, e.g. British Columbia. Alberta province, with six other provinces across Canada, has

273-500: A caring, two-way patient-doctor relationship that benefits not only patients and their families but also the physician. At Stanford University he continues to explore the importance of patient-centered bedside medicine and the physical exam, both in techniques and in the importance of the ritual of the physician's presence at the bedside. "The Stanford 25", is an initiative developed to showcase and teach 25 fundamental physical exam skills and their diagnostic benefits to interns. In

312-584: A period of dramatic political change in Ethiopia, a time of great loss for the author, who, as an expatriate, had to leave the country of his birth. Cutting for Stone reached #1 on the Independent Booksellers list and was optioned as a movie. The Covenant of Water was published in May 2023 by Grove Atlantic and was chosen for Oprah's Book Club . Inspired by the life story of the author's mother, to whom

351-660: A position as Professor of Medicine and Chief of the Division of Infectious Diseases at Texas Tech Health Sciences Center in El Paso , Texas Despite his title, he was the sole infectious disease physician at Thomason Hospital. He was awarded the Grover E. Murray Distinguished Professorship of Medicine at the Texas Tech School of Medicine. Eleven years later, Verghese became founding Director of The Center for Medical Humanities and Ethics at

390-470: A program called Practice Ready Assessment (PRA) which enables eligible IMGs to start practice under supervision and leading to their independence where they need to fulfill certain requirements. IMGs in Canada have a harder time getting into residency programs compared to Canadian graduates—only ten percent of IMG applicants get a position. Several organizations have put pressure on the government such as

429-406: A residency program. Those IMGs who have passed the necessary USMLE exams, obtained the ECFMG certification and matched to a residency position can then begin training in a residency program. USMLE exam scores are considered in the matching process for entering a residency program. One study came to the result that almost half of IMGs were unsuccessful in their first attempts in the pursuit of

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468-598: Is also often asked to speak about his ideas on medical care and about his life story and his books. For example: Foreign medical graduate Medical schools around the world vary in education standards, curricula, and evaluation methods. Many countries have their own certification program, equivalent to the ECFMG in the United States. The purpose of ECFMG Certification is to assess the readiness of international medical graduates to enter clinical specialty training programs as resident physicians and fellowship programs in

507-406: Is no cure. Often, he was the only one at his patients' bedside when family and friends, fearful of or in denial about the disease stayed away. From the sorrow of so many deaths and ugly displays of prejudice, from his giving of so much time and comfort, and the unraveling of his own domestic life and from the seeming hopelessness of the situation came a book of such richness and humanity that the story

546-957: Is noted as follows. "One-quarter of practicing physicians in the United States are graduates of international medical schools. The quality of care provided by doctors educated abroad has been the subject of ongoing concern. Our analysis of 244,153 hospitalizations in Pennsylvania found that patients of doctors who graduated from international medical schools and were not U.S. citizens at the time they entered medical school had significantly lower mortality rates than patients cared for by doctors who graduated from U.S. medical schools or who were U.S. citizens and received their degrees abroad. The patient population consisted of those with congestive heart failure or acute myocardial infarction. We found no significant mortality difference when comparing all international medical graduates with all U.S. medical school graduates". Data on older Medicare patients admitted to hospital in

585-641: Is the founder and director of the Presence program, which "champions the human experience in medicine." Overwhelmed by the nature of his work with his AIDS patients in Tennessee, and with his first marriage under strain, Verghese joined the Iowa Writers Workshop at the University of Iowa . He cashed in his retirement plan and his tenured position to move to Iowa City with his young family. In 1991, he completed

624-713: Is through the National Resident Matching Program (abbreviated NRMP, also called "the Match"). To participate in the NRMP match, an IMG is required to be ECFMG verified. IMGs who have not met the examination requirements for ECFMG Certification by the Rank Order List deadline *usually in February" cannot participate in the Match. However, for most IMGs it is advisable to have an ECFMG certification prior to participating in

663-473: Is uplifting and hopeful even as it plumbs the depths of human sadness. The book was adapted for a 1998 TV movie starring Naveen Andrews . This article about a medical book is a stub . You can help Misplaced Pages by expanding it . Abraham Verghese Abraham Verghese (born 1955) is an American physician and author. He is the Linda R. Meier and Joan F. Lane Provostial Professor of Medicine, Vice Chair for

702-715: The United States . The requirements to obtain a license to practice varies by country and often by state, province, or territory. IMGs (or Overseas Trained Doctors) who wish to be licensed in Australia must apply to the Australian Medical Council (AMC) to arrange an appropriate assessment pathway. The standard pathway involves an IMG sitting a series of assessments, including an AMC MCQ Exam and an AMC clinical exam. The AMC MCQ Exam consists of 150 MCQs organized through computer adaptive scoring. For AMC clinical exam,

741-678: The University of Texas Health Science Center at San Antonio . At San Antonio, he held the Joaquin Cigarroa Chair and the Marvin Forland Distinguished Professorship. After five years in San Antonio, he joined Stanford University School of Medicine in 2007 as a tenured professor for the Theory and Practice of Medicine and Associate Chair of Internal Medicine. He is a hospitalist for Stanford Medical Center and

780-571: The Arts and Humanities. President Barack Obama presented him with the National Humanities Medal in 2015. In 2023, he was awarded a Guggenheim Fellowship . He has received six honorary doctorate degrees . Verghese was born in Ethiopia to Orthodox Christian parents from Kerala , India , who worked as teachers. As a child, he was an avid reader, and it was reading that introduced him to

819-472: The Association For Access to Health Care Services, Alberta International Medical Graduates Association, and Association of International Physicians and Surgeons of Ontario . However, other organizations deny there is a physician shortage that requires Canada to import more physicians. In the United States , an international medical graduate (IMG) is a graduate from a medical school located outside

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858-581: The Theory & Practice of Medicine, and Internal Medicine Clerkship Director at Stanford University Medical School . In addition, he is the author of four best-selling books: two memoirs and two novels. He is the co-host with Eric Topol of the Medscape podcast Medicine and the Machine. In 2011, Verghese was elected a member of the Institute of Medicine . In 2014, he received the 19th Annual Heinz Award in

897-601: The U.S. The H-1B visa does not have this 2-year home residence requirement, but further requires the USMLE Step 3 . And initially, a B-1 visitor visa is required for taking the USMLE Step 2 clinical skills examination and the USMLE Step 3. Indian physicians with a MBBS are qualified to take the USMLE . However, since the 2010s, the process of obtaining a license has become increasingly complicated. India has exported more physicians to

936-454: The US showed that patients treated by international graduates had lower mortality than patients cared for by US graduates. This difficulty in attaining success to become licensed physician in their newly adopted countries, many IMGs end up taking survival jobs completely unrelated to their educational and training backgrounds. In doing so, these highly skilled immigrant health professionals have become

975-417: The United States and Canada need to complete USMLE Steps 1 and 2 as well, but can participate in the NRMP while still doing their final year of medical school before acquiring their medical diplomas. In effect, taking regular administrative delays into account, and with residency programs starting around July, there is a gap of at least half a year for IMGs between graduation from medical school and beginning of

1014-432: The United States and Canada. Graduates of Canadian M.D. programs are not considered IMGs in the United States. IMGs may be either United States citizens or non-citizens who were educated in a school outside U.S. or Canada. The main process for IMGs who wish to be licensed as physicians in the United States requires them to complete a U.S. residency hospital program. The general method to apply for residency programs

1053-629: The United States than any other foreign nation. The largest number of licensed International Medical Graduates comes from schools in India, the Caribbean, Pakistan and the Philippines. Medical graduates from schools in the Caribbean have had the largest growth in the period between 2010 and 2018. Their numbers have increased from 22,820 to 40,689 physicians, or 78%. Source: 2018 FSMB Census One study examining quality of care by international medical graduates

1092-631: The bedside? Certainly...But... we should spend this time not divining for ascitic fluid (ultrasound is better) but, instead, talking to our patients. Verghese has written articles for medical journals such as The New England Journal of Medicine , JAMA , The Lancet , and The American Journal of Medicine . He has also contributed to general-interest publications like The New Yorker , Texas Monthly , Atlantic , The New York Times , Granta , Forbes , and The Wall Street Journal , among others. Verghese has also written four books based on his life experiences and his medical knowledge. Verghese

1131-503: The book is dedicated, the story is set between 1900 and the 1970s in Kerala, a coastal territory at the southern tip of India. It follows three generations of a family in which one or more people in each generation has mysteriously died from drowning. The book stayed on The New York Times bestseller list for 37 weeks. and was listed by the newspaper as one of its 100 Notable Books of 2023. In January 2024, Oprah announced that she had optioned

1170-460: The early signs of the urban HIV epidemic. Returning to Johnson City in 1985 as assistant professor of medicine, he saw the first signs of a second epidemic, that of rural AIDS . Expecting to have one or two HIV patients a year, he soon had 100 in a small town. Although at the time he had no ambition to become a writer, he decided he wanted to tell the story of this tragedy, so he took a break from medicine to study writing. In 1991 Verghese accepted

1209-464: The film rights. Verghese's early experience of working as a hospital orderly gave him a deep understanding of the patient's hospital situation with its varying levels of treatment and care. He has said the insights he gained from this work helped him to become a more empathic physician and resulted in the motto, "Imagining the Patient's Experience", that defined his later work. His focus in San Antonio

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1248-551: The many individuals and families affected by the AIDS epidemic. This book was one of five chosen as 'Best Book of the Year' by Time magazine, and in 1998 it was made into a TV movie directed by Mira Nair. His second memoir, The Tennis Partner: A Story of Friendship and Loss , was also written during his time in El Paso. It tells the story of his friend and tennis partner, a medical resident in recovery from drug addiction. The story deals with

1287-486: The match as many program directors decide not to grant interviews. The purpose of ECFMG Certification is to assess whether graduates of these schools are ready to enter U.S. residency and fellowship programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). To acquire an ECFMG certification, the main requirements are: In comparison, regular graduates from medical schools in

1326-570: The story of a young infectious-disease physician in the mid-1980s in Johnson City, Tennessee , who began to treat patients with a then unknown disease. Because of the seemingly un-ending influx of patients with the same symptoms and for whom there was, as yet, no effective treatment, Dr. Verghese became, of necessity, the town's AIDS expert. As much as he gave to his patients in terms of caring and empathetic treatment, he gained back in terms of understanding and lasting lessons in how to heal when there

1365-503: The ultimate death of his friend and explores the issue and prevalence of physician drug abuse. It also charts the breakdown of his first marriage, an integral part of the narrative in both My Own Country and The Tennis Partner . This book was reissued in 2009. In 2009, Knopf published his first novel Cutting for Stone . In 2010, Random House published the paperback version of the book, and it remained on The New York Times list for over two years. Cutting for Stone describes

1404-414: The world of medicine. He has three children, two sons by his first marriage and a third by his second marriage. His elder brother, George Verghese, is an engineering professor at MIT and his younger brother, Phil Verghese, is a former software engineer at Google . Verghese began his medical training in Ethiopia. In 1974, his education was interrupted by the civil unrest when emperor Haile Selassie

1443-501: Was awarded a Bachelor of Medicine degree from Madras University in 1979, finishing an internship there. Returning to the United States as a foreign medical graduate seeking an open residency position, he joined a new program in Johnson City , Tennessee , affiliated with East Tennessee State University . After completing his residency in 1983, he took a fellowship at Boston University School of Medicine . He worked for two years at Boston City Hospital , where he encountered

1482-406: Was deposed and a Marxist military government took over. He left the country and joined his parents, who had emigrated to America. There, Verghese worked as a hospital orderly for a year. In his written work, he refers to that experience as deeply influential in confirming his desire to finish his medical training. He went to India to complete his medical studies at Madras Medical College and

1521-403: Was developing medical humanities as a way to preserve doctors' innate empathy and sensitivity. He developed a formal humanities and ethics curriculum integrated into all four years of the medical school program. He also invited medical students to accompany him on bedside rounds as a way of demonstrating his conviction in the value of the physical examination in diagnosing patients and in developing

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