Naturalized US-Citizen-U.S. Doctor Washes Dishes, Works at Fast Food Restaurants!

I am writing this story to any authorities who care about our country’s future healthcare system and those who pursue justice and transparency.

I am a foreign graduate physician who’s a naturalized US citizen who has had difficulties for the past few years to secure a residency spot in my desired specialty which is Internal Medicine. I am ECFMG certified with scores above 220 on step 1, 2 and CS pass- All 1st attempts on the USMLE’s.



Soon after I came to this beautiful country, I started seeking employment like many other migrants. I was naïve enough to not understand that my skill-set as a physician could not secure me a job in a hospital or outpatient setting since working as a medical assistant or phlebotomist required a degree and training.

I had to apply for other jobs, after numerous unsuccessful attempts I decided to work on hospitality jobs (Washing dishes at a nightclub, Papa John’s pizza store, Jimmy Johns sandwich shop, WaitersToGo, Lyft, and so many others).

Years passed by and I completed all my US Medical Licensing Exam to get closer to an ultimate goal that is aligned with my skills, working as a physician.

But ECFMG certification wasn’t the whole requirement to be able to apply for residency programs, I needed recommendation letters and unfortunately, most hospitals charge applicants who want to observe an attending physician for a month or two and there is a fee of at least 500$/week and very few hospitals were offering free of cost observership unless you have a relationship with the attending you want to observe.

This highlights the fact that whoever has the financial support most probably wins the game, which is matching into a residency program.

I found out that the system gives these attending physicians and even those who work as primary care physicians in their clinics enough power to abuse IMGs who require a letter to apply for the match. The ridiculous fact about it is that these individuals believe they are doing you a big favor by hiring you as free labor in research sectors or their clinics in exchange for a letter after a year of free labor! If you complain you will be portrayed as a lazy or demanding individual who is not a good fit for residency.

I was among those who had to work as free labor to just gain enough letters of recommendation to upload on my ERAS app.

I worked nearly one year in one of the Harvard-affiliated hospitals and around the same time in one of Florida’s well-known University hospitals. During this time, I got to know many foreign graduates like myself who were working hard for zero money and among them, they were many on J1 visas. Because of issuing a J1 visa and receiving duration of status, they were fine with working for free since their visa extension is literally in the hands of a faculty physician who wants them as free laborers in the research sector. The ridiculous fact about these volunteer research positions is there is a high demand for it among J1 visa applicants and believe me or not nowadays even volunteer research (i.e free labor) is hard to find for US citizen IMGs.

Many of these individuals each year match into residency programs where they have friends and connections and their scores or year of graduation would not hold them back because they match based on ethnic nepotism and not based on transparent selection criteria. I’ve known many who had failed attempts on their Step1 or Clinical Skill exam and they could barely communicate in the English language yet they made it to residency!!!

Dr. Pinsky stated that we need these talented individuals who happened to be IMGs on J1/H1B visas and they are well-deserved for residency positions! My question to Dr. Pinsky, CEO of ECFMG is why not ask the program directors of such corrupted community and University-affiliated hospitals to be a little transparent about their selection criteria and release these talented IMGs USMLE scores and year of graduations? To see how many of these talented future physicians had met with program requirements fair and square!

Many community programs in the State of NY and other big cities do not even bother to release the current resident’s name and photographs on their website let alone release their USMLE scores but guess what? It does not take much intelligence to understand the pattern of an applicant’s acceptance in such programs.

Ethnic nepotism and free labor is what this country’s healthcare system is dealing with and they can not hold a US citizen physician as a volunteer (i.e free labor) for their research sector because we do not need their duration of status extension and J1 visa assistance and we can leave on our will but a visa to this country is a big deal for someone who is not a US citizen and he or she may stay for longer and work as a happy slave.

While working in volunteer research at Harvard, I witnessed the children of wealthy Iranian government officials who are being given J1 visas first hand, they were not exceptional students, many were not fluent in spoken English. These are the people ECFMG is concerned about the most!! While they claim there is a ban on Iranians from entering the country!! I strongly believe ECGMG is either misinformed or is deliberately spreading false information to the American people.

As many as 30 Iranian, Indian, Pakistani and Nigerian students were granted J1 visa in exchange for free labor in that single research institute. And this is the only one among many other research departments within one hospital in which there are many free laborers on J1 visas. I am not surprised why ECGMG or any other organization is that much concerned about new J1 visa restrictions because they all benefit from this free labor market. These IMGs on J1 may hold Post-doc, research assistant, or coordinator positions in NIH funded grants. This may be in violation of NIH rules as well.

Institutions such as Harvard is knowingly doing this and benefiting from this free labor.

There are no shortage of physicians while thousands of us are left unmatched. I hope that we, US citizens and green card holders come together once and break this unholy chain of corruption in the residency match.

Thank you,

N.N. MD