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Dr. Neena: Pulm Crit Fellow & IMG Graduate

On this week's episode we have Dr. Neena. She is a pulmonary and critical care fellow who is also an International Medical Graduate (IMG) like us. She actually happened to go to the same medical school as us, The American University of Antigua College of Medicine. In this episode, we talk about what got her interested in her field of choice, her journey throughout medicine, working on the front lines and more. If you haven't yet listened to the episode CLICK HERE. Come back here for the show notes:


Who is Neena?


Neena is a regular human like the rest of us! On her free time she likes to read, watch tv and sleep. Don't we all?! She also finished medical school and completed her medical residency at the University of Pittsburgh Medical Center. Currently she is completing here fellowship in pulmonary medicine and critical care at Wayne State University in Detroit. She is originally from Florida where her husband currently is working!


Why did she choose an IMG program?


While Neena was applying to medical school she was looking into all of her options and was in an accelerated (8 year total) medical program. She knew that her MCAT score wasn't as competitive for some of the US programs and she stumbled upon AUA. She liked what they were offering, their responsiveness as well as, communication to their students. Additionally, they had a relationship through FIU's program where medical students can rotate through when getting off the island.


Why did she choose medicine and specifically, pulmonary/critical care?


Neena always knew she wanted to do fellowship. But her spark for medicine may have been influenced by her family. Her mom and sister are both physicians so that helped. She also remembers initially loving hematology and oncology. During her fourth year of medical school she stumbled upon a critical care/ICU rotation. At that time, she was unsure what she was going to do but fell in love with this rotation. She enjoyed how you get to take of each system, the physiology, the hands-on experience and how fast paced everything was in the ICU setting. The more she went through this rotation the more she noted how the pulmonary or lungs stuck out the most for her.


What are some things that you would've or wouldn't have changed throughout this journey?


When applying to medical school she would've recommended to have more things on her application. By that she means sprucing up her resume. She also reports she maybe would've

tried to reach out more, get more experience, maybe even take a mission trip to better yourself and also see from a clinical perspective what you are getting yourself into.


When applying to residency she would have done more research such as, work on more manuscripts as they are time consuming, case reports and publications in general.


What she recommends:


GET A MENTOR

The very big part of Caribbean program or for IMG programs in general is that we don't have as many options as our US counterparts. This is also something many people don't know.


She wishes that many of these institutions develop and cultivate a good research curriculum to set medical students on the right track!


We agree and believe that it is important to let other people know whats going on! There are a lot of things you need to do that none of us knew when we were getting into this. I guess, this can be said about anything...


What was the experience during COVID with respect to the ICU environment?


So initially she heard about this virus and at that time people were kind of confused about what it is or if it's real and if it's going to make it to the United States. She noticed that around February more and more people were getting sick. The consult list started to grow and you just kind of rolled with the punches. It wasn't until March when she was doing her night shift that she noted she was admitting people with respiratory failure left and right. She noted that they were coming in with a low blood pressure requiring remarkable amounts of oxygen support. She would go from room to room with patients going into acute respiratory distress syndrome requiring intubation. This all began with the elderly population and soon she started noting similar outcomes in younger people. A once shocking realization, the youngest patient she has seen was a thirty two year old.


Treatment options have also been shifting from week to week. Initially, no one was using steroids and then two weeks later they were. Additionally, plaquenil was administered to everybody. Around that time, she noticed she was doing cardioversions on these patients more in one night then, in her entire residency experience. Then the protocols changed regarding plaquenil and now antivirals are being used. She compared this pandemic to contagion because it is a new disease that no one knows anything about.


Michigan was third to NY and NJ in cases and the mortality was really rough which required everyone to work really hard. Patients would come in immediately with shortness of breath and they would crash hours later turning into a code blue. So the people who were working needed to be experienced at intubations and taking care of these patients.


How was the PPE?


In early March they would reuse yellow gowns from room to room unless they were doing aerosolized procedures or bronchoscopies which have the highest risk of transmission. They were restricted to one n95 a shift and would use surgical masks. She believes that what saved her and her co-fellows was that they bought their own respirators off of Ebay. So she highly recommends that, if you can afford your own respirator you should get one!


How is the situation now?

(At the time of this recording it was June)


Neena states that the numbers are decreasing in her hospital, at least the ICU numbers.


Thoughts on the second wave?


She notes that she believed there would be second peak but that there is no way to predict if the cases will go up like a hill or a mountain. She noted that we would likely see a larger increase in the fall as adding COVID with the flu will lead to a very busy season. Neena states that she "can't even imagine anything SCARIER than the first wave".


As I'm writing this from Sunny California in July that statement has become reality.

Thought's on a vaccine?


She hopes that it's coming. She notes that the company Moderna has tried and thus far has had good results. She states that looking back there is a lot of, "coulda, shoulda, woulda" but that we are where we're at now and should do all that we can to minimize progression.


Since this episode aired there has been a very promising trial that came out showing promise with a vaccine

Secret Tips


  1. Obviously wear a mask

  2. Avoid anyone who is sick

  3. Sneeze or cough into your elbow

  4. Try not to cough without covering your mouth (as it may or may not be airborne)

  5. Immunocompromised patients are still at higher risk

  6. Avoid flying at this time unless it's necessary or until there is a vaccine


How do you feel about everything reopening?


It is very hard because the whole economy is suffering. This situation is either a win win or a lose lose. So she just recommends that everyone should be cautious when reopening.


Future Plans


There are a lot of fellowship options through the pulmonary critical care track but then COVID came and it is obviously not a fun time to be in. She was in the ICU for 5 months and actually got called in earlier. Since she's from Florida originally and her family is there she would like to settle down in Florida.


Secret Tips


  1. When choosing a medical school be open

  2. Don't be closed off because of any stigmas

  3. Start doing research early in residency if you want to do fellowship

  4. Figure out what you want to do and be focused to get there


Find her at:

Instagram: @neenzie

This is the platform she uses to share her day to day, ICU and exam tips!


Neenzie obviously has an amazing story and we thank her for being a life saver as well as, a health hero! That's all for this week, don't forget to leave us feedback, rate, review, subscribe and send in your questions so we can continue to improve as well as, provide you high quality content. Disclaimer: The Content on our podcast/website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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