The following reflection on personal impact and growth was originally published in the March 2025 issue of HOPA News. To discover even more articles in that issue and beyond, visit the HOPA News archive.
Around this time five years ago, I was about a third of the way through my PGY1 residency. As I prepared for Midyear, I remember feeling so overwhelmed that I began second-guessing my decision to pursue a PGY2 immediately after completing PGY1. In less than three years, I had moved from Saudi Arabia to Canada, followed by a cross-border move to the United States, and then a cross-country relocation from San Diego, CA, to Columbus, GA. By the time I started my PGY1 residency, I was utterly exhausted. Adding to this whirlwind of transitions, I had been married for less than a year and longed for some downtime to enjoy my first year of marriage.
Despite my uncertainty and doubts, and with the unwavering support of my husband, family, and friends, I pushed through and pursued a PGY2 in Medication Use Safety and Policy (MUSP) immediately after PGY1. However, that decision was driven by circumstance rather than a carefully laid plan. My true passion was oncology, but at the time, pursuing that dream simply wasn’t possible.
Fast forward to today: I am now pursuing my second PGY2 in my field of choice - oncology, a discipline that resonates deeply with me on a personal level. Reflecting on my journey, I realize it has been anything but linear. In this essay, I will share insights into my non-traditional path and the lessons I have learned along the way.
A Wish Is Not a Plan
My journey toward oncology began in middle school, shaped by a deeply personal and transformative experience. When my younger brother was diagnosed with a brain tumor, our family faced what felt like an impossible reality. With few options available, we moved to London, UK, so he could participate in an experimental trial - our only hope at the time. The months that followed were fraught with fear and uncertainty, but they also brought an unexpected gift: The trial succeeded, and my brother recovered. What began as a traumatic chapter in our lives ended with gratitude and inspiration. It was during that time that I first felt the pull toward oncology, realizing how deeply the field could impact not just patients but entire families.
That early desire stayed with me, guiding my path as I pursued my PharmD and made the bold move to North America to chase my dream of practicing oncology at the highest level. Yet, while my wish was clear, my plan was not. I started in Vancouver, Canada, drawn by the comfort of having family nearby as I adjusted to a new country. However, I quickly realized the limited opportunities for oncology residencies in the area and struggled to gain traction with the few programs that seemed like a good fit. It became clear that I needed to pivot.
This realization led me to the bridge-to-residency program at the University of California, San Diego. Moving to a city where I had no connections felt overwhelming, but I sought out local communities online and found a supportive family willing to rent me a room. Their kindness gave me the courage to take the leap. At UCSD, I gained clinical skills and made invaluable connections, but I still lacked a deliberate plan. Much of what I achieved - like securing an oncology investigational drug service internship - came down to luck rather than intention.
That realization was pivotal. A wish may spark a journey, but it’s not enough to see it through. I knew I had to move beyond navigating passively and start shaping my path with purpose. This shift in mindset became the first step in turning my dream into reality.
A Plan Is Not a Sentence
Before starting my PGY1 residency, I crafted a detailed plan to achieve my oncology career goals. My plan focused on strengthening my clinical knowledge, refining my skills, and gaining as much oncology exposure as possible to become a competitive PGY2 candidate.
The first months of PGY1 went well, though not without challenges. By Midyear, the signs of burnout became hard to ignore. Years of relentless change, international moves, and the demands of residency had taken their toll. Adding to this, my family dynamics shifted when my husband found a career opportunity in Atlanta, GA. After much thought, we decided to focus on Atlanta, which meant letting go of out-of-state PGY2 opportunities. Unfortunately, the only oncology PGY2 program in Atlanta that I was interested in had already early-committed its slots, leaving me at an impasse.
Faced with this unexpected reality, I had to pivot - again. Instead of pursuing a PGY2 immediately, I chose to enter the workforce and postpone my plans. Around this time, the Residency Program Director of an Atlanta-based MUSP program offered me a post-match interview. While medication safety had never been part of my plan, I recognized its potential to enhance my clinical profile. The decision to pursue the program was also made easier thanks to a generous scholarship that more than offset the financial impact of forgoing a traditional pharmacist role.
After completing the PGY2 MUSP residency, I transitioned to two PRN roles in pain management and internal medicine, which offered the flexibility I needed as a new mother. Pain management, in particular, felt like the closest connection to oncology I could find at the time. Though this wasn’t part of my original plan, I viewed it as a logical step forward.
Rejection: Not Always a Setback
Three years later, I believed my credentials and experience in pain management, internal medicine, and medication safety - combined with my BCPS certification - were more than enough to resume my pursuit of an oncology career. I applied for an inpatient oncology specialist position and made it through two screening interviews. However, less than a week before the final on-campus interview, I received a devastating call: I was no longer a contender for the position. The reason? The job required a PGY2 in oncology to qualify under a Collaborative Practice Agreement. The rejection was hard to stomach; I felt devastated and was stuck in a cycle of helplessness and self-doubt, questioning whether I had made the right decisions in my career path.
My husband, however, helped me reframe the situation. “You can sit here and cry, or you can do something about it,” he said. “Why don’t you pursue a PGY2 in oncology?” His words challenged me to confront my fears and reminded me that success and fulfillment often lie on the other side of fear. We spoke about my responsibilities as a wife and mother and agreed that we could manage as a team. We also spoke about the financial implications of me losing two thirds of my paycheck, and, again, we determined that we could manage. Despite all of that, the fear was still real. But now, I was determined to get to the other side of it.
I reached out to my network for support and letters of recommendation, completed shadowing sessions with the Emory oncology team, and submitted my application. Four months later, I matched with my dream program (Emory) and was absolutely overjoyed.
Hindsight Reflections and Parting Thoughts
Looking back, I see how the detours, though unexpected, made my journey more formative and rewarding. By the time I started my PGY2 in Oncology, I had a solid foundation and a clear sense of what I needed to accomplish. Rather than approaching the program in exploration mode, I arrived with specific goals and a clear plan for how to achieve them. The unplanned turns have also equipped me with unique skills that continue to shape my clinical practice today. For example, I am more attentive to safety risks and more appreciative of the value of continuous improvement than I could have been without my Med. Safety background. I am also a better clinician than I could have been without my pre-PGY2 clinical experiences.
Beyond the direct career benefits that my non-traditional journey afforded me, I am thankful for so many life lessons that I learned along the way. Here are a few that I hope will resonate with some of you.
- Support Systems Matter: Success is rarely a solo effort. Building and nurturing relationships with mentors, colleagues, and loved ones is essential.
- Ask for Help: Don't hesitate to seek guidance. Most people are willing to help if you show genuine interest and effort.
- Focus on Your Growth: Comparing yourself to others is unproductive. Instead, track your progress and focus on becoming a better version of yourself.
- Embrace Uncertainty: Outcomes may not always meet expectations, but effort is what truly counts. I've come to remind myself, "I owe my best effort, not a guaranteed result."
- Take Action: Clarity about your goals and purpose makes a difference. Don't let fear or doubt hold you back - focus on your "why," and the "how" will follow.
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