For those unfamiliar, the USMLE is a 3-step examination that assesses a physician's or medical student's ability to practice medicine in the United States. It is the US medical board exam in essence.
A quick Google search found approximately 6700 international applicants for various residency positions last year, driven by poor training environment at their home countries, unreasonable workload, or the American dream. Once matched, these international medical graduates will (re)start residency in a totally different medical environment - one that emphasizes research, clinical trials, and cutting edge technology that has shaped medicine into what it is. The pay is more than enough, in US dollars; and working hours are more humane compared to back home. However, most of them will be halfway around the Earth from home with very few friends and family, enduring culture shocks and racial discrimination like any of their predecessors, and patiently waiting for their breakthrough day.
I had deliberated on taking the USMLE during my one-month elective in New York last summer, setting it aside after learning that foreign medical graduates have only about 50% matching rates even after completion of all 3 steps, and most of them end up in second- or third-rate hospitals. I summarized "it is better to stay the village champion than the city loser." Deep inside I was just too afraid to go through another series of exams and the associated brain freeze and physical breakdown. I'm not the exam type.
However, Prof. Chang's comments breathed in fresh perspective. "You do medicine for the knowledge, and money, maybe. But in Taiwan, you achieve none, picking up lots of bad habits instead."
It would be easy if I could set it aside and say I'll try when I've completed my Taiwan residency. Plenty of graduates restart their US residency upon matching anyway. But timing is everything in life. I'm not sure if I'll have drive to do this when I'm 30, say. When a partner, children (not that I will have any) comes into the picture, it's not that easy anymore.
Maybe I'm still uncertain of how much I want for my medical career now. Am I satisfied being a "village champion" or shall I strive for more? Will I be satisfied with my Taiwanese lifestyle or happier with an American one? These are questions I hope I have clear answers to, but not now.
I just hope when I look back in future that I won't regret making, or not making a decision. One cannot be overly calculative in life, and I believe every decision has its own rewards.