Long before Azan Virji entered medical school, a college counselor back home in Tanzania tried to dissuade him from coming to the U.S. to pursue a medical degree. The odds, he was told, would not be in his favor. Fewer than 3% of medical school applicants in the U.S. are international students, and only 0.5% of all medical school enrollees are from abroad.

But because Virji, now a second-year student at Harvard Medical School, had always aspired to become a physician and knew the quality of the schools here in the U.S., he kept on. Now he and several other international medical students have launched a mentorship network that helps prospective and current international medical students wade through the application process, tackle the logistics of financing their education, and handle the pressures of school once theyre enrolled in a program.

In the three months since the start of F-1 Doctors named after the visa type that most international students need in order to study in the U.S. nearly 80 mentors from more than 30 countries have signed up to be a part of the program, as have more than 60 mentees.

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A lot of the mentees are so happy to speak to someone who is an international student at a medical school they see themselves represented, Virji said.

U.S. citizens who are prospective medical students often have networks to tap into to navigate the difficult medical school application process, from premedical advisers at their undergraduate institution to family members or peers who have applied before. And while international students may also have these resources, the added complexities that they face due to their visa status often mean they dont have many others to turn to for guidance.

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Virji, who earned his undergraduate and masters degrees from Yale University, said he constantly felt like his credentials werent good enough to get him into a U.S. medical school.

The anxiety of not knowing whether or not youd be able to get in was a lot, Virji said. And thinking that not getting in is due to your foreign-born status is the biggest anxiety factor.

Beyond that, Virji didnt feel like there were others whom he could ask for help.

I couldnt find anyone to speak to who would tell me that I would be OK, that I still had a shot, Virji said.

The stressors international medical students face were further heightened last month when U.S. Immigration and Customs Enforcement issued a now-rescinded rule requiring those on F-1 visas to leave the country if their school planned on only having classes online in the fall as a result of the Covid-19 pandemic.

Even without these uncertainties, however, international students who come to the U.S. with the hopes of attending medical school often have an uphill climb. Of the nearly 175 medical schools in the U.S., only 48 indicated in 2019 that they accept international students.

I would have students who are great candidates but wouldnt get accepted into [U.S. medical] schools because they had limited options, said Jennifer Kimble, who was a health careers adviser at Emory University and at Georgia Institute of Technology. Kimble, whos now the director of admissions at Vanderbilt University School of Medicine, also explained that most state medical schools dont accept international students because of how state funding is allocated. This, she said, drastically narrows the pool of schools that foreign-born students can apply to.

A lot of the mentees are so happy to speak to someone who is an international student at a medical school they see themselves represented.

Azan Virji, F-1 Doctors mentor and Harvard Medical School student

Some mentees said that simply wanting to know their chances of getting into medical school which can be a gamble regardless of citizenship status is a major reason why they signed up with F-1 Doctors.

Even something as easy as finding statistics, theres really not a lot of resources online about your chances, said Ziad Saade, a rising senior at Columbia University who is being mentored by Virji. Saade said Virji has already offered tips on preparing for medical school interviews, including how the topic of medical ethics may come up during those conversations.

Saade, who is originally from Lebanon and on a premedical track, said he heard about F-1 Doctors through a friend and that hes since felt much less alone in the application process.

I had never met an international student in medical school, but F-1 Doctors helped me do that. Ive met three different people who are currently in medical school or have been accepted to medical school, and one of them happens to be from Lebanon, Saade said.

Mentoring through F-1 Doctors looks different for everyone, which is why the program has prospective mentees look through a directory of mentors and reach out to those with similar backgrounds and interests. Some, like Saade, want to get a sense of the kinds of scores and qualities they should highlight in the application process. Mentors have also offered feedback on admissions essays.

For international students to be able to talk to others [like them] is always a good thing, said Kristin McJunkins, director of health careers advising at Yale University who now shares information about F-1 Doctors with any international students she works with.

But the process doesnt end when these students enter medical school. Figuring out how to pay for school which is also a big task for domestic students is especially complicated for non-citizens. Theyre not eligible for loans through the federal government because of their citizenship status, for instance, and many schools dont have big endowments to support students fully.

Larger institutions such as Harvard and Vanderbilt often have the funds to partially or in some cases fully support international students. Some smaller schools, however, not only have policies that deem international students ineligible for financial support, but also require students to pay multiple years of tuition upfront. That was the case with Pranav Somasekhar, a third-year medical student at Saint Louis University School of Medicine.

I had to pay all four years upfront, Somasekhar said. The total about $250,000 had to be put in a third-party escrow account before Somasekhar could begin his schooling.

One of F-1 Doctors goals is to be a resource for students such as Somasekhar who are navigating thorny financial issues. The groups website has information for students on different loan options, and is in talks to partner with at least one company that will host webinars on financing a medical education in the U.S. F-1 Doctors has also created a spreadsheet with different schools financial aid policies for international students.

Somasekhar, who mostly grew up in India, moved to the U.S. in 2008 and went to both high school and college here. But because of massive delays in immigration processes in recent years, Somasekhar aged out of being listed as a dependent on his parents green card application, and had to reapply to stay on in the U.S. as an international student.

There are very few people who have fallen through these cracks and are in a similar situation as me, Somasekhar said. But since joining F-1 Doctors as a mentor, Somasekhar has had a few others like him reach out for advice. The three or four mentees Ive talked to all say that Im the only person they know who is in a similar boat, which is exactly why Im doing this, he said.

Somasekhar is himself looking to take advantage of mentoring through F-1 Doctors, since the programs mentors include medical residents and attending physicians. Theres no information on matching [with residency programs] for medical school seniors on an F-1 visa, Somasekhar said.

F-1 Doctors now wants to expand to other health professions, including nurses and physician assistants. Already, there are some dental students in F-1 Doctors, and the group recently added its first mentor who is pursuing a doctor of osteopathic medicine degree (versus an M.D.). The program, which is currently based out of Brown University, is also looking to set up local chapters at other universities, so that mentors and mentees at the same school can get together in person after the pandemic. Brown University currently helps fund F-1 Doctors activities, including webinars for students across the globe. In future, F-1 Doctors may also consider hiring an immigration lawyer to help navigate visa rules.

Virji is hopeful that as more international students go through the medical school application process, theyll connect with F-1 Doctors.

It has been easy to get mentors so far because you know how hard it is, he said, and you want to be able to help those on the other side.

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International med students ease the path for others with new mentor group - STAT