There is a kind of discipline that develops quietly over time, shaped not by certainty, but by persistence. I often think of it as the Mamba Mentality: a commitment to steady improvement, resilience, and focus on the process rather than the outcome.

For many immigrants, this mindset is not aspirational. It is necessary.

My own journey reflects this reality.

Before coming to the United States in 2007, I spent one year in the United Kingdom earning a master’s degree in biochemistry at the University of Nottingham. From there, I was fortunate to receive a scholarship to pursue a PhD in biochemistry and molecular biology at the University of Louisville. Completing that doctoral training required five years of intensive study and research.

After earning my PhD, I continued with two additional years as a postdoctoral research fellow. During this period, I was also navigating the uncertainty of immigration status while applying for permanent residency. It took seven years after arriving in the United States to finally obtain a green card.

Even then, my path was not complete.

The long road to practice

I made the decision to begin again, this time in medicine. I applied to medical school with the hope of remaining at the University of Louisville, where I had already trained extensively, but I was not accepted. Rather than stopping, I enrolled at Ross University School of Medicine.

Medical school itself required adaptability. I spent 16 months completing classroom and laboratory training on the Caribbean island of Dominica. After this foundational phase, I returned to the United States to complete my clinical rotations, training across multiple hospitals in different states. These rotations took me to College Park and Baltimore, Maryland; Pontiac, Michigan; Chicago, Illinois; and Miami, Florida, among other sites.

During this time, stability was rare. I often lived in short-term housing, moving from one city to another every few months, navigating new hospitals, new teams, and new systems while continuing my medical education. This phase of training was both professionally formative and personally humbling, requiring constant adjustment and perseverance.

After completing four years of medical school, I applied for residency training. Once again, my goal was to return to Louisville, but I matched at the University of Central Florida, where I completed three years of internal medicine residency.

I then pursued cardiology fellowship training and was fortunate to return to the University of Louisville, where I completed three additional years of subspecialty training in cardiology.

Today, I am a practicing cardiologist.

Reflecting on the timeline

When I reflect on the totality of this journey, the length still surprises me. After high school, the path included:

• 3 years of undergraduate education.
• 1 year for a master’s degree in biochemistry.
• 5 years for a PhD in biochemistry and molecular biology.
• 2 years of postdoctoral research.
• 4 years of medical school.
• 3 years of internal medicine residency.
• 3 years of cardiology fellowship.

In total, this represents more than two decades of continuous education and training.

At times, I ask myself how I managed to sustain the effort, and whether I would choose the same path again. The answer is yes. Not because the road was easy, but because progress was made one step at a time, without shortcuts.

The essence of the Mamba Mentality

Throughout this journey, I have met many others with similar stories, individuals from different parts of the world who shared the same quiet commitment to growth. When these experiences are described, the response is often disbelief: “I don’t think I could do that.”

That reaction simply highlights a difference in perspective. For many immigrants, long-term effort is not an abstract ideal; it is the path forward.

This is the essence of the Mamba Mentality, not intensity for its own sake, but discipline applied patiently over time. It is the willingness to begin again when necessary, to adapt when plans change, and to remain focused on improvement.

These journeys are rarely visible. They unfold quietly across classrooms, laboratories, hospitals, and communities. Yet they shape the individuals who walk them, and, in turn, the spaces they enter.

The long road does not guarantee success. But it builds resilience, clarity, and purpose along the way.

Joshua Salabei is a cardiologist.