In 2019, I completed my medical training in Russia and arrived in the United States as a Fulbright Scholar. My award carried the U.S. president’s personal signature, a powerful welcome to a country I saw as a place of opportunity, freedom, and cultural exchange. It felt like a once-in-a-lifetime honor that most foreign physicians can only dream of. Then came the COVID-19 pandemic. In early 2020, while still in the U.S., I watched hospitals plead for help. People were dying, doctors were in short supply, and I was trained to help. As a physician, I felt I had no choice but to step forward. Yet I was turned away, because I had not completed the U.S. licensing exams required of all international medical graduates.
I had spent years preparing for the exams, and Match Day felt like the final reward for all that sacrifice. When I learned I had matched into a pediatrics residency program at a large academic medical center in the United States, I was overwhelmed with relief and joy. The warmth of my interview experience had already made me think of the program as a second home, and that day felt like the beginning of the bright future I had worked so hard for. Like thousands of other international medical graduates, I believed in America’s promise: that if you worked hard and followed the rules, you would be treated fairly. Little did I know that instead of building a future, I would come to a system where unchecked power could end a career overnight.
The program director of pediatrics was celebrated as a champion of racial justice for Black physicians. At first, I truly admired this and believed it was one of the program’s greatest strengths. But as time went on, I began to feel that when residents from other backgrounds tried to share ideas or concerns, their perspectives were often brushed aside: at best dismissed, and at worst treated as outright defiance.
For many of my colleagues, speaking up about concerns did not feel easy. Over time, a culture developed in which residents became increasingly hesitant to voice disagreement or raise problems openly out of fear of professional consequences: Those individuals could find themselves subjected to focused reviews, disciplinary pressure, and the constant threat of dismissal from the program. In some cases, their professional judgment and psychological stability were also called into question.
Despite this environment, residents rotating from smaller outside institutions, along with my fellow pediatrics residents, continued to raise concerns about serious problems within the program, including inefficient scheduling, uneven workloads, staffing shortages, a toxic hierarchical culture, and instances of age discrimination. There was also a perception among residents that interpersonal relationships with the program’s leadership, including helping care for the program director’s child, could influence how individuals were viewed or evaluated. These concerns were ultimately raised with the Accreditation Council for Graduate Medical Education (ACGME), which conducted an on-site review of the program in hopes of improving oversight and support for residents.
For me, these experiences cut even deeper. Despite successfully meeting the academic expectations of the program, I remained actively involved in scholarly work, participating in conferences and preparing four research abstracts and two articles during my first year of training. Yet I found myself under increasing scrutiny. My speech was criticized because I was a non-native English speaker and my behavior was dehumanized through anonymous comparisons to artificial intelligence. My achievements, far from protecting me, only fueled further hostility. The message was unmistakable: Survival depended not on excellence but on the favor of the program director.
By the end of my first year of residency, as I began reaching out to other programs in search of a healthier training environment, my attempts turned into a personal tragedy. Without any warning, the program director accused me of dishonesty and unprofessionalism, cut off all my access to institutional systems, had me publicly escorted out of the workplace, and stopped paying my salary. During this period, I found myself without institutional, legal, or immigration support for the following two months. Although I attempted to raise concerns through institutional channels, my perspective was not meaningfully addressed. Ultimately, my journey within U.S. medical training ended abruptly, despite how deeply I had hoped to continue serving within the system I had worked so hard to join.
The same institution’s financial practices further shaped my understanding of how power could operate within it. During the COVID-19 pandemic, CNN reported that this academic medical center aggressively pursued medical debt claims against thousands of low-income patients, including members of its own workforce. Experiencing the sudden loss of salary, institutional support, and professional stability as a medical resident made those stories feel far more personal to me.
Despite the personal tragedy, I ultimately chose not to remain silent. I reached out for help to the president of the United States, who had once personally signed my invitation to come to the country through the Fulbright Program. His words about resilience, freedom, and the importance of continuing to fight for American values gave me the strength not to give up and to continue defending myself through formal channels. Encouraged by the president’s words, I pursued legal action through the Equal Employment Opportunity Commission, the Arkansas State Claims Commission, and raised concerns with the ACGME, continuing to believe in the fairness and strength of the American legal and medical systems.
I chose to speak openly about what happened not only for myself. I hope that international physicians who come to the United States to study and work will have clear, step-by-step systems of protection and support. No physician should find themselves in a legal and professional vacuum, losing their livelihood, professional standing, and stability overnight without meaningful accountability.
Vasilii Khammad is a physician and researcher originally trained in Russia who later pursued postgraduate medical training in the United States as a Fulbright Scholar. He is affiliated with Peoples’ Friendship University of Russia and The Loginov Moscow Clinical Scientific Center.
His academic and clinical interests include oncology, pediatric medicine, artificial intelligence in health care, medical education, and the experiences of international medical graduates navigating the U.S. training system. Dr. Khammad has participated in clinical research, scientific presentations, and scholarly writing in hematology, oncology, neuro-oncology, and pediatric medicine. His publications address pediatric follicular lymphoma, machine learning workflows for pediatric and adult central nervous system malignancies, AI-assisted diagnosis of primary brain tumors, and education for medical professionals on generative AI.
His current work explores the intersection of medicine, institutional power, accountability, and the human impact of professional systems, with a focus on transparency, fairness, and support for physicians in training. Additional publications are available on ResearchGate, and he shares updates on Facebook and Instagram.
