Contributing Writer
Johns Hopkins Bayview
Sagar Chapagain, MD is an internal medicine resident physician in the General Internal Medicine/Primary Care track at Johns Hopkins Bayview Medical Center. A Jack Kent Cooke Scholar, his written work on health policy, health care disparities, and higher education policy has been featured in national and regional publications. Follow him on LinkedIn for updates.
Third year feels different. Intern year taught me how to work. Every note, every consult, every long night sharpened the mechanics of patient care. You learn to move efficiently, anticipate needs, and steady your hands when everything feels new. It is a year of doing, of survival, of quiet endurance.
Intern year is demanding. It gets easier. You will grow. You will build confidence. And one day, you’ll look back and realize just how far you’ve come.
‘Twas the day after Christmas and all was not well. In a string of unfortunate events that would make Lemony Snicket jealous, my father had come down with the flu, the presents were indefinitely delayed and I found myself – an internal medicine intern – losing the battle to maintain my consciousness in the team workroom. The holiday season, usually my favorite part of the year, was definitely on my naughty list. At least there …
Since the COVID-19 pandemic and 2020 protests against systemic racism, efforts toward eradicating the effects of bias and discrimination in medicine has reentered the national consciousness. While this is a good start, it may be better to try to overhaul — or at least make deeper efforts to heal– medicine’s social environment to foster safety and reduce disparately harmful effects of chronic social stress. For this, we can look to the queer community.
Very early in the morning on Wednesday, October 18, 2023, I stumbled into the emergency department with my hair in a tangled mess and accidentally still wearing my house shoes.
The second week of September was the epitome of emotional whiplash. Monday the 12th, we celebrated our one-year engagement anniversary in the ICU. We had gotten engaged in an apple orchard, so I brought in apple cider and cider donuts. She still wanted to keep fighting and didn’t want her doctors to give up on her. She was on four mcg/min of norepinephrine to keep her blood pressure up.
I had just started my residency in Burlington, Vermont when she started having symptoms again. She was to receive her treatment in Rochester, New York, which meant we were apart most of the year. I had been planning to propose in October, but now all plans were out the window. Despite the fear that swelled inside, I made sure to propose before she started chemo, to show that I would be with her no matter what.
Residency is hard. Anyone who has gone through it can attest to that. While I was getting intimately acquainted with this reality in August, 1.5 months into the first year of my internal medicine residency, my soon-to-be fiancé was diagnosed with cancer.
I did not learn in nursing school what and who is a resident physician. It was briefly mentioned that the attending was in charge with residents below them, and that was the beginning and the end of the discussion on residents. But at the end of my first year as a new nurse on a medical floor, I could recite the names of the internal medicine doctors I spent my days and nights mostly working with — residents. By the time I left that job, I knew just a few of the attendings’ full names.
“A lot of the men in my unit started getting sick and never got better. And we just didn’t know. I mean, all I want is to help build a group big enough that we might finally understand more about what’s happening to us.”
Your mom gets tetanus (Tdap) / before you’re born, / Plus COVID and flu / are the norm.
A few months have passed since I wrote my last column article, so now it’s time to get back into it. What has happened in the meantime? Well, I had baby #2, which meant I was lucky enough to take seven weeks of maternity leave from residency.
Resident Physician Columnist
Hillsboro Medical Center
Aline went to medical school at the University of Essen in Germany. She started training at the University Hospital Essen in Internal Medicine with the focus on GI/Hepatology. She then followed one of her former supervisors in 2017 to the University Hospital Magdeburg and continued her training for two years. In 2019, she started a two-year research fellowship at Johns Hopkins University with a scholarship by the German Research Foundation. During that time, she decided not to return to Germany and instead attempt to become a physician in the US. She has started her internal medicine residency this year at Hillsboro Medical Center in Oregon.
Surviving IM/G
I am an international medical graduate in internal medicine residency (IM/G), sharing my experiences with all of you. If you are an IMG, hopefully you can relate to some of the stories and feel encouraged, because we are not alone. If you are an American-based resident: I hope these stories help you better understand your IMG colleagues a bit better. And above all, I am hoping to hear from you as well: let's share knowledge, experiences, and pave a path for the many other IMGs seeking to fulfill their dreams in the United States.
