MetaCast

In the inaugural episode of MetaCast, the podcast of the Meta-Analysis Academy, Rhanderson Cardoso chats with Julyana Dantas, a medical doctor from Universidade Federal do Rio Grande do Norte (Brazil) who's about to start her Neurology residency in Boston, USA. We talk all about what it takes to Match into a medical residency program in the USA. Julyana shares her experience and gives the lowdown on everything from the application process to getting a VISA and medical license. If you're curious about how to make it in a US medical residency, you won't want to miss this episode!

Creators & Guests

Host
Rhanderson Cardoso
Clinical Cardiologist and Cardiac Imaging @BrighamWomens @harvardmed | Former cardiology fellow @hopkinsheart @ciccaronecenter
Guest
Julyana Dantas
MD from Brazil / Neurology Resident in Boston (USA)

What is MetaCast?

The PodCast of the Meta-Analysis Academy!

Rhanderson Cardoso:

Hello, everyone, and welcome to MetaCast. This is the podcast of the Meta Analysis Academy. My name is Rhanderson Cardoso. I will be your host for Metacast, and I have the honor of receiving here today a very special guest, Julyana Dantas, who's gonna tell us all about her journey from Portugal to Brazil to now residency in the United States at Tufts Medical Center in neurology residency. Here in the Medicast, we share successful stories of doctors, medical students, and other health care professionals who've done extraordinarily well in their careers so far.

Rhanderson Cardoso:

And I can't think of a better example than Juliana. It should tell us all about her story. We're going to talk about transitions from Portugal to Brazil, transitions from Brazil to the United States, and then also she's gonna tell us all about what happens after the match. Going from match to actually starting residency, which is the point in her career right now. So Juliana, welcome.

Rhanderson Cardoso:

I'm so glad to have you. Could you please introduce yourself to everyone?

Julyana Dantas:

Thank you for for letting me come here, doctor Cardoso. My name is Julyana. I'm so happy to be here with all of you. And, I'm a doctor. I graduated from Brazil.

Julyana Dantas:

I grew up in Portugal. And now I'm in the process of starting residency here at Boston at Tufts Medical Center and Leahy Hospital. I'm gonna start my orientation in a couple of days in, like, 3 days, so I'm really excited about it.

Rhanderson Cardoso:

So we're going to talk all about this incredible journey from Portugal to Brazil to Boston for neurology residency. And before we start, before I ask, Julyana all about how, she went through this incredible journey, I just want to give an important announcement that Meta Analysis Academy is not affiliated with Hartford Medical School, where I currently work, with Tufts University, or to, any other institution. Also, I want to let you guys know that, the meta analysis academy does not guarantee publications. What we do is we teach our students, our learners, how to achieve high level publications with systematic reviews and meta analysis. We do not do publications, obviously, for our students, and Julianna, So, Juliana, let's start with, your a little bit of this chronological history.

Rhanderson Cardoso:

You you you were raised in Portugal, as I understand it, and, then you moved to Brazil. When did that happen, and, what was the motivation for that move?

Julyana Dantas:

Alright. So, it was in 2, 009, I think, that I I went back to Brazil. I was around 15, 16. And the reason really why I did that change was because I knew I wanted to pursue medical school. And, if you know anything about that time, you remember that around 2008 there was a big economical crisis in Europe.

Julyana Dantas:

So I knew that my family was not gonna be able to get me through medical school there, even though it's much cheaper than in the US, it's still a considerable amount. And in Brazil, if you get into a federal school, you actually can get free higher education. So my plan was to go there and go to free university, and that's that's basically what I did. It was a conscious decision because I wanted to be a doctor.

Rhanderson Cardoso:

That's that's incredible. And, it's it's interesting how, you know, people move countries, you know, all over the world to do medical school in Brazil. As you know, a lot of people go to to other countries in South America, like Argentina, Bolivia, and others. And, and I know that happens in Europe. It's interesting to see that you went from Portugal to Brazil to do medical school, for, for these financial reasons.

Rhanderson Cardoso:

How was the transition, you know, growing up in Portugal where Mhmm. A lot of our listeners are in Brazil. You know, they're curious to see what our culture looks like to someone who's coming from outside.

Julyana Dantas:

Yeah. It was actually really tough on me at the time because, you know, I was basically a teenager, and, being a teenager in Europe is vastly different experience than being a teenager in Brazil because you have a lot of freedom there. I was used to, you know, being at 2 AM in the morning alone in the middle of the road and I wouldn't bat an eye on it. But when I went back to Brazil I started to realize that I had to be much more cautious about the world in general. And my husband kind of jokes about it saying to him, oh, you're too pure.

Julyana Dantas:

You're too naive. And that but that's just the culture that I grew up in. So it was a bit of a tough transition for me. But, you know, Brazil is a great country regardless, and I did have a good few years there.

Rhanderson Cardoso:

And, where did you move to in Brazil?

Julyana Dantas:

I moved to Natal, but 1 of the the countries in the northeast 1 of the countries, 1 of the the states in the northeast that's known as the city of the sun.

Rhanderson Cardoso:

Nice. Very good. So, we're gonna jump ahead because I I wanna focus on this, meta cast here today on this transition after the match. Of course, we're also gonna talk about your application and, you know, how you got this amazing result of of matching, into neurology here in the United States. But, specifically, a lot of people have questions about what happens after the match in those 3 to 4 months between match day and between applicate between starting residency.

Rhanderson Cardoso:

Mhmm. So I want to talk about the j 1 visa. I want to talk about medical license, but we're gonna start with match day. What was it like, you know, that match week, you know, Monday, I think, you got that email saying that you matched. What was that like?

Julyana Dantas:

Oh, it was so stressful, honestly, because, you get a day that you say, oh, you have fully matched or you have partially matched, and then you have to hit, like, 5 or 4 days before knowing where you're going to spend the next 3 to 4 years of your life. And that way, it is just so stressful because, you know, you're excited. You wanna start the next chapter of your life. You wanna start planning things, and you just can't. So it's just a waiting game that's, that was really tough, but, you know, exciting at the same time.

Rhanderson Cardoso:

Yeah. No. I I thought you were gonna say it was amazing. It was the best day of my life or something along those lines because, but, there's obviously a lot of stress involved.

Julyana Dantas:

I am a worrywart. That's something you you will see recurrently in this podcast.

Rhanderson Cardoso:

But but you but you got the email, you know, that that couldn't have been stressed. So stress was probably until then, but when you got that email, I'm sure you you were

Julyana Dantas:

Very relieved.

Rhanderson Cardoso:

Yeah. For sure. That's awesome. So, and then eventually you found out later on that you matched into this great academic program here in Boston, a neurology program at Tufts University, you're starting residency in the next 2 weeks, and then I wanna focus I wanna do a deep dive on what happens in the transition.

Julyana Dantas:

Mhmm.

Rhanderson Cardoso:

As I understand it, you're starting residency on AJ1 visa. Is that right?

Julyana Dantas:

That's right.

Rhanderson Cardoso:

Okay. So I'm just gonna give folks a quick overview of the j visa just because I trained for 9 years under a j visa. The j is a phenomenal visa for you to do your residency training and then fellowship and then even another fellowship if you're interested in. It it really takes the burden of the program out of the program to get your visa and puts it in the hands of ECFMG, educational commission for foreign medical graduates. So the programs love it.

Rhanderson Cardoso:

You know? I'm sure Tufts and other academic centers, they love to bring foreign medical graduates under the j visa. The the downside or the the 1 of the components of the j visa is that when you finish your training, you have to go back to your home country for 2 years, and that's called the 2 year home requirement. In other episodes, we may talk about how to obtain a waiver for that, for that to your home requirement. But I wanna talk specifically now, Julian, about getting that j visa, about putting about the barriers, the, you know, the the the paperwork that's involved in this process.

Rhanderson Cardoso:

So once you matched, how long did it take for your residency program for Tufts in your case to kick off, to start, the talks about visa and paperworks related to the j 1?

Julyana Dantas:

Yeah. That's the thing that really changes between programs, something that I, you know, realized talking to other people have much. In my case, I think the first thing that you need to get is your contract. So you need to get your contract and you need to sign it. For my case, I think it's, it was around 1 month until I received it after match day.

Julyana Dantas:

And after that, we we sign it. And then, the program coordinator, someone from GME that's responsible will create an account for you in FCVS. I think that's 1 of the that's the website that you need to, validate your credentials. So they will create an account for that for you on that and on OASIS. That's the the ECFMG website.

Julyana Dantas:

So there are 2 things that are happening at the same time. You need to get your visa and you need to get your credentials verified so you can get a state license to practice pretty much. So pretty much it's all online that you have to do. You have to send a bunch of documents and that your program liaison has to upload there, and then you just wait for the programs to analyze your documents and get back to you.

Rhanderson Cardoso:

So, let's, let's break that down a little bit further. So first step is the contract.

Julyana Dantas:

Yeah.

Rhanderson Cardoso:

That took a few weeks. When you got the contract, I suppose there was standard language. There wasn't any negotiation involved, of course, because because you're we have no bar bargaining power. You know, we're we're loved. We wanna come here.

Rhanderson Cardoso:

We we love to do residency. We'd like to do it. So, but but there wasn't anything particular on that contract that required clarification or anything else. So you got it. You signed it.

Rhanderson Cardoso:

You send it back to them. Yeah. Okay. Obviously, there's a, a dollar amount in that contract. You know, that is will differ based on states and different residency programs.

Rhanderson Cardoso:

And Boston actually tends to be a little bit higher than other places just because

Julyana Dantas:

Living here is

Rhanderson Cardoso:

because of, cost of living. Just give us a ballpark for the 1st year residency in the in Boston. I would imagine it's probably in the order of around $60, 000 per year. Or

Julyana Dantas:

No. It's actually a bit a little bit higher. It's, from what I've seen in other programs in my own is between 70.80.

Rhanderson Cardoso:

That's amazing.

Julyana Dantas:

K per year.

Rhanderson Cardoso:

Yeah.

Julyana Dantas:

Yeah. And some programs also give you some stipend for moving and

Rhanderson Cardoso:

Education. Yeah.

Julyana Dantas:

Education I think everyone, every program gives you like a set amount per year that you can spend for books and other educational things.

Rhanderson Cardoso:

Yeah. Keep in mind, guys, that, this this dollar amount that we just talked about around 70, maybe 75 $1, 000 per year if you're here in Boston. In other cities, it may be a little bit less. There's obviously taxes in it. So, it it'll also depend how much you actually get paid, depends on your, if you're married, if you're not.

Rhanderson Cardoso:

It depends on individual tax situations. It depends on whether there's state tax in your your state, like Massachusetts will have on top of federal tax, will have state tax. So we could talk all about salaries for residents in the United States on a on a separate, MediCast session. But we're gonna continue here, Juliana, beyond that initial contract. So you assigned the contract, and now you have to get a visa.

Rhanderson Cardoso:

You mentioned 2 processes, the processes, the visa and the state medical license. Let's talk about, OASIS, which you said is a platform for ECFMG and, getting the j 1 visa. So I I presume that the first contact for, starting the visa comes from that program liaison. Right? The program liaison sends you, a list, I suppose, with documents they need from you to get the j 1 visa.

Julyana Dantas:

Yes. You, they give you a list. You send it back to them. They open a process from you in OASIS, and they upload most of the documents there. They may ask you to upload some of them, but I think most of the the liaisons just upload the things themselves.

Julyana Dantas:

And, after that, you just have to provide some additional things, such as the statement of need. That's a thing that you get. You send an email or a letter to your country's Ministry of Health saying that you need a statement of need from them. Pretty much is a letter saying that your country would benefit from having someone doing residency here in the United States. And it has to be signed by the Ministry of Health.

Julyana Dantas:

So they send this back to you. And you also have to create some documents saying that you are aware that there is a 2 year home requirements and that you understand that you do will comply with this and you have to sign it. You have to notarize, pretty much everything and then send it back to the program and the program will put all of those things in OASIS.

Rhanderson Cardoso:

Perfect.

Julyana Dantas:

After everything's put in OASIS, it takes about 4 to 8 weeks for the for EC FMG to create your DS 2019 and send back to your program.

Rhanderson Cardoso:

Okay. So a lot to unpack there. They're going to the program liaison is going to send you a list of documents that you need. You mentioned 1 of these documents, the statement of need. We're gonna talk a little bit more about that and then, also the other components.

Rhanderson Cardoso:

So the statement of need, as you as you mentioned, is signed by the Ministry of Health of your home country stating that they need, in your case, neurologists. They stating that they need, folks to to do clinical work in Brazil, and it would be helpful, to have neurologists there. How was the process of getting the statement of need, you know, from, from the Ministry of Health?

Julyana Dantas:

In Brazil, it was surprisingly easy. We just, I sent an email saying that I've received the proposal to start residency in the United States. Here is my contract that I signed. I need, this letter saying that the statement of need. And they literally got back to me with the signed letter in less than 24 hours.

Rhanderson Cardoso:

That's incredible. That is not how it used to be when I did this. You know? We had to call Brasilia, like, 50 times and, ask for favors. It was it's really hard to get the the statement of need.

Rhanderson Cardoso:

No. I wouldn't say really hard, but you had to work for it. Yeah. And I'm glad that that process is more streamlined. Recently, I had a student from, in the meta analysis academy from Mozambique, who had a hard time also getting, a statement of need from them.

Rhanderson Cardoso:

She may have been the 1st or 1 of the first, residents ever from the country of Mozambique, so they weren't to get a residency in the United States. So they weren't as familiar with doing the statement of need there. But,

Julyana Dantas:

I I just forgot something. You do have to send some documents by mail to them.

Rhanderson Cardoso:

But To Brazilian?

Julyana Dantas:

To Brazilian.

Rhanderson Cardoso:

Yeah.

Julyana Dantas:

But, once they they get it, they apparently, for me, they send the the document right away after the year arrived there. Okay.

Rhanderson Cardoso:

And then they send that statement of need to, your program in Boston or sorry. The CSFMG. Perfect. Great. So that's 1 of the components, the statement of need.

Rhanderson Cardoso:

You have that letter saying that you're aware, of the of the to your home requirement. What are the other documents needed to obtain AJ1 visa? I assume ECFMG certificate or what else?

Julyana Dantas:

There's the ECFMG certificate, your contracts. You need your passports. You also need a CV that's organized by month year. You just have regular CV. And you need copies of previous stuff that you had from visas, if you did a research fellow, for example, or you are renewing your visa because it's the the second year, you have to to have the copies of the previous documentation, and you need the statement of need.

Julyana Dantas:

I think that's pretty much it.

Rhanderson Cardoso:

Okay. The ECFMG certificate, do they get it directly from you, or do they go to ESFMG directly? Do you remember that?

Julyana Dantas:

I I think they they get it from ESFMG directly.

Rhanderson Cardoso:

Perfect. So you submit all of this or your program liaison by the way, the program liaison is a person in each program, each university residency program, that will take care of submitting these documents and helping the incoming residents or the residents to get their j 1 visa. So the program liaison gets this list of documents and then, sends it to, up OASIS, uploads it all. How long after that does ecfmg take to issue you this important document called the DS 2019?

Julyana Dantas:

So it takes about between 4 to 8 weeks is their general ballpark. Also, I think I forgot to mention that may be interesting to some people. For if you are married or you have children, those dependents can get a G2 visa. And to get there, that's pretty much it's pretty easy. In additional to all of the things that I just mentioned that you have to upload in OASIS, you have to upload the passports from your dependent and also a proof of our relationship.

Julyana Dantas:

So that would be marriage certificate or a birth certificate. Perfect. And everything, if it is in a different language than English, has to be, translated to English.

Rhanderson Cardoso:

Okay. So a a few weeks after you upload this, do you get the ECFMG, ECFMG gives you the DS 2019. Actually, they send it to the program. The program sends it to you, and then you get to go to the embassy to get the visa. Correct?

Rhanderson Cardoso:

That process was straightforward. Once you got the DS 2019, you should get the j 1 visa stamp on your passport.

Julyana Dantas:

Yeah. So when you when they issue the d s 2019, you get a number. That's the CV's number. You have to pay a fee and with that number you can schedule the interview. To schedule the interview, in addition to that, you have to fill out, I think that's DS160.

Julyana Dantas:

That's standard for all of the visas, I think. So you can get a tourist visa. You also need a DS 160. You fill out everything. It takes a long time.

Julyana Dantas:

It's a lot of questions. And once you get everything filled, you get to schedule your interview. In Brazil at this moment, it wasn't taking a long time. I got my interview for the week after that I that I was scheduling. And after that, I just went there.

Julyana Dantas:

It was super quick of an interview in, Hasif in the northeast. And, 4 4 business days later, I think they already sent me back my passport with the

Rhanderson Cardoso:

Great. So question, which 1 was easier, to get a match or to get AJ1 visa? Or which 1 was harder? Because it's a it's a long process, June.

Julyana Dantas:

It was harder to get the match, but I think I got more stressed with all of the bureaucracy of getting a visa.

Rhanderson Cardoso:

Totally. But, yeah, you're still you're here on time. Today is what? June 20th? Or yeah.

Rhanderson Cardoso:

Today is June 22nd already. And, you're here on time to start residency, so congratulations to you. So let me summarize here in just, 60 seconds how it is to get AJ1 visa after you match. Okay? So first thing, you're going to get a contract.

Rhanderson Cardoso:

You're going to sign the contract, submit it to the program where you match. The program where you match will then have a program liaison, a person that will help you get the visa. This person will send you a list of documents that you need to send them so they can upload to ecfmg OASIS. It's a platform platform from EC FMG. That list includes your EC FMG certificate.

Rhanderson Cardoso:

It includes, your USMLE transcripts and a statement of need, a letter that you have to write acknowledging the true year home requirement. Once you get all those documents, the program liaison uploads it into ecfmg. Ecfmg will will analyze it and submit ADS 2019 to the program that gets mailed to you. Once that gets mailed to you, you get the d s 2019, pay the Sevis fee, SEVIS, and then with the d s 2019 and the Sevis fee, you go to the embassy in your home country. And then you get AJ1 visa, And that's just part of the process because now we have to talk about the medical license, the state medical license.

Rhanderson Cardoso:

Juliana is starting in Massachusetts, so she had to apply to the Massachusetts Board of Medicine. Mhmm. Juliana, what was the process for getting the medical license in Massachusetts?

Julyana Dantas:

Alright. So your program liaison also creates an account for you in the website of the the medical board, and you will receive something in an email. You have to fill out the things there. It's pretty standard, but then at some point they're gonna ask you if you want your medical credentials verified by a third party. That's usually the FCVS.

Julyana Dantas:

I think that's what it's called. And, you can also you have the option of doing everything yourself with your medical school. It's significantly cheaper, but I don't know the steps for that. And, I don't really know if there's a place that you can get all the steps.

Rhanderson Cardoso:

Let me just add something else about FCVS. You know? So FCVS, just to be clear, is a separate institution that will help in the process of verifying that you are a doctor, that you graduated a valid medical school, that you have an ECFMG certificate. So they will be a third party that will make the bridge between you and the state medical board, in this case, Massachusetts, to help you get that process done faster. They charge a fee.

Rhanderson Cardoso:

Do you remember how much it is?

Julyana Dantas:

In total, I think it was about 600.

Rhanderson Cardoso:

Okay. So we may be a little bit off on that, but if if that's the number I vaguely remember. So you pay FCVS, and FCVS will help you. They will get the transcripts from your medical school. They they will be in touch with your medical school, with ECFMG, with, USMLEACH.

Rhanderson Cardoso:

They will do a lot of work to get the documents that the medical board requires. But there's another major advantage from SCVS that you may not be aware of yet, which is when you go do fellowship, if you go to another state, or if you finish residency and you go to another state, FCVS already has all of that. Mhmm. So they don't have to do it again. But if you had done in yourself, now you have when with Massachusetts, now you have to do it in Florida or in Georgia or whatever.

Rhanderson Cardoso:

So, I I also for the first half of my career until fellowship, I did it in Florida. I did it in Maryland myself with the board, and that was such a pain. And then eventually, I said, I'm just gonna pay the fee and get it done with FCVS, and then FCVS helped me Massachusetts. But then I haven't needed it anymore because I've been in Massachusetts ever since. But so FCVS helped you with that.

Rhanderson Cardoso:

So they they did this process of contacting ECFMG and getting your eosimelis transcripts and all of that. Is that right?

Julyana Dantas:

Yeah. They also contact your medical school from what I understand Yeah. To get your diploma and your transcripts.

Rhanderson Cardoso:

Do they translate it or do you have to translate it?

Julyana Dantas:

I think if your medical school already sends the the translated documents, they they don't charge you anything for it. So you might want to contact your medical school before, just saying, hey. Hey. In case they contact you, here is the documents that I have previously translated.

Rhanderson Cardoso:

Great. How long did it take you from starting the Massachusetts license process to actually getting Massachusetts medical license.

Julyana Dantas:

Oh, I think it was anywhere between 2 to 3 months. It took a while.

Rhanderson Cardoso:

That may be a Massachusetts record, okay? I'm just this is of course just a joke. I have no idea how long they usually take, but my mine actually took a little bit longer than that. It was a different time too, of course. I was just coming in here at the time of the pandemic, but, that's that sounds reasonable, you know, 2 to 3 months.

Rhanderson Cardoso:

So I I guess it would be important for you to start early, but you also depend on the program to start some of this. So make sure once you guys match that you, you know, follow-up with your programs. Don't wait until May to start all of this because then you're gonna be in trouble to start on time. And people have had to delay their start of residency before because either of visa or medical license issues. This license that you got from Massachusetts, how long, is it valid for?

Julyana Dantas:

I think it's just valid for 1 year, and then you have to keep updating it.

Rhanderson Cardoso:

Yeah. Well, I I don't remember how long the trainee licenses in Massachusetts. It might be the 1 year might be just because it's your first 1 and that they will renew it for a longer time. But for attendings, like, I finished my trainee, so it's for my my Massachusetts medical license expires every 2 years on the month of your birthday. So every 2 years, you have to, reapply for the the state medical license.

Julyana Dantas:

I don't know if it's just my 1st years because I'm in a preliminary year. Because I, yeah, gonna do 1st year of intern year in internal medicine, and then I'm gonna do my 3 years in neurology.

Rhanderson Cardoso:

Okay. So this was fantastic, Juliana. We talked about j 1 visa. We talked about Massachusetts medical license. Let's talk about moving the transition.

Rhanderson Cardoso:

Obviously, this will depend on everyone's own situation where you're moving, but what has it been like to move to Boston?

Julyana Dantas:

Well, moving anywhere even within your own country is a hurdle. You're gonna go into some difficulties that you haven't expected. It's always a challenge and always surprising in some way. There are a couple of ways that you can make things go smoother, such as already having a place to stay when you arrive, having figured out which companies do you want to do most of your stuff, like internet and mobile phones. So what you could do and what I did was that I called ahead a couple of different providers and I asked them for an estimate of how much it would cost.

Julyana Dantas:

I did all of my analysis before coming here and decided which companies I wanted to close a contract with. I already had my apartment when I came here as well, which cut some costs down with hotels and Airbnbs and stuff like that. And what else did I do? Oh, I called ahead in some insurances to get some for example, I have 3 pets. As you know, 3 little cats.

Julyana Dantas:

And, they have all of them have insurance, and I have contracted before I came here.

Rhanderson Cardoso:

Sounds like a lot of work.

Julyana Dantas:

Yeah. It is. So you have to sit down and put everything on paper and saying, what do I need to get done and just creating yourself some to do lists.

Rhanderson Cardoso:

Can you give everyone a sense of, rent prices? You've been looking for apartments. I'm sure. Just just a ballpark, of course. Like, for 1 bedroom and bathroom apartments, you know, in the Boston area, how much are we looking in terms of rent today?

Julyana Dantas:

Well, rent here is, I think, just a tiny bit less than in New York, but it's still pretty expensive here.

Rhanderson Cardoso:

It's outrageous, actually.

Julyana Dantas:

Yes. It is. I'm living at the moment in Woburn. That's, like, 30, 40 minutes away from the center of Boston. So and even then I'm paying around 2, 000, a month And it was a fine.

Rhanderson Cardoso:

It was Is it a studio or a 1 bedroom?

Julyana Dantas:

It's a 1 bedroom. But everything that I've seen in the area and in and around the the Boston area for 1 bedroom or studios were between 2 100, 220 200 and no. $2, 200 to 2, 800.

Rhanderson Cardoso:

Yeah. I would say that that's probably depending on where you are in the city, on the lower side. So Juliana is outside the city because her 1st year is not in, like, the downtown area of Boston. Tufts, you would do your prelim year in another institution. And

Julyana Dantas:

then Leahy.

Rhanderson Cardoso:

Leahy. And then which is outside the city. So maybe rents are a little bit cheap maybe rent's a little bit cheaper there. And then, in Boston, I can tell you guys probably that close to Brigham where I work, close to Massachusetts, generally, I would assume the same, we're probably talking closer to 3, 000 for a 1 bedroom, 1 bathroom. So it is quite expensive rent here, cost of living in general, but there are things that are cheaper.

Rhanderson Cardoso:

You will find out that gas transportation is cheap. You know, groceries have gone up in price over recent years, but still, I think, overall affordable on the resident salary. So just to give people a sense of this, it it is generally enough for 1 resident salary to keep a household of 2, like husband and wife, for example. But, but it doesn't you won't have a lot of money left over at the end of the month, Generally, it's good enough to meet their needs, but not a whole lot more.

Julyana Dantas:

Yeah. And, I would say that there are a lot of ways that you can save some money. For example, doing most of your own food at home. I know as residents, we don't have a lot of time to cook. Fortunately, I have my husband with me and I'm counting that he will do that for me.

Julyana Dantas:

But eating out here is actually pretty expensive, and there are not a lot of healthy options, I have to say. So, that's 1 way to save money is cooking your own food, taking your own food.

Rhanderson Cardoso:

We have, Jerome over here. So we have to get him on camera saying that that he's gonna he's gonna help out.

Julyana Dantas:

We already

Rhanderson Cardoso:

talked about that. Okay. It's already all set. Very good. Alright, guys.

Rhanderson Cardoso:

So, I wanna talk now, Juliana. Thank you so much for that great overview of the process of the transition from match to beginning residency. Maybe we'll bring you back in 6 months, and you can tell us how was your first 6 months of residency. But now I wanna go back in time to your actual application. When did you know in medical school that you wanted to come to res to do residency in the United States?

Rhanderson Cardoso:

Which year of medical school?

Julyana Dantas:

I think it was around the either the 4th or the 5th year, when I was doing my practical training. Because once I realized I wanted to do neurology and I realized, you know, neurology is an area, a field that's expanding so much in the recent years. There's a lot of new technologies, a lot of new drugs being developed. And it's not everywhere in the world that you have access to all of those different things. And whether you like it or not, here in the United States is the place that you can get most research, that everything is most up to date.

Julyana Dantas:

So it's a great place to train if you would like to learn all of the new things that are coming and learning how to apply them.

Rhanderson Cardoso:

So let's talk a little bit about this journey since from when you decided into the match itself.

Julyana Dantas:

Mhmm.

Rhanderson Cardoso:

Do you mind giving everyone a 10, 000 feet view of just, like, an overview of the strength of your application?

Julyana Dantas:

Mhmm.

Rhanderson Cardoso:

Just on overall how you did on the exams and what kind of rotations you did. What were some of the strengths, maybe weaknesses of your applications? Just a general sense of how strong was your application.

Julyana Dantas:

Alright. I think my application was pretty balanced in the sense that I don't think there was an area in which I liked a lot. So my scores were above average. I did have step 1 being pass fail but my step 2 was a little bit above average. I did, as for research, I didn't have anything up to doing the Math Analysis Academy.

Julyana Dantas:

After that I did have some great results. I've been first author in a couple of publications, which was great. And but as for the rotations, yes, sorry. I did have observership here at Toast Medical Center, which was really great. I had to do I do a lot of connections.

Julyana Dantas:

I met a lot of the residents, And it was great. I got to have a lot of insights on how an actual academic program works here in the States. And then I did a a hands on, rotation back in Houston.

Rhanderson Cardoso:

Okay. So if I got that right, step 1, pass first attempt. It was already pass fail, and you passed first attempt. And then you said above average score on step 2. And then, you did these 2 rotations.

Rhanderson Cardoso:

Just 2 rotations, you said? Yeah. And you got your letters of recommendations. Yeah. Were you really confident on the strength of your letters?

Rhanderson Cardoso:

Like, do you feel like on these rotations, you really impressed people and they wrote you extraordinary letters?

Julyana Dantas:

1 of them, I was very confident because, the the attending that wrote them said actually I went to ask for the letter and she was like oh absolutely and by the way I never write those letters because I don't think that you can get a lot of sense about the person in an observership, but for you, I'm pretty happy to write it. I it's the, I think, the the second person I'm writing a letter in this observership.

Rhanderson Cardoso:

So I

Julyana Dantas:

was really happy about that, and I knew that was going to be a good letter.

Rhanderson Cardoso:

Yeah. You and I shared that in common because you did an observership and matched into the same program. I did the same thing. I did the rotations in Miami when I was a in a 5th year medical student, and then I ended up matching in the same program.

Julyana Dantas:

Yeah.

Rhanderson Cardoso:

Great. So let's talk a little bit more about these research opportunities or experiences that you had. If I remember correctly, you just said that prior to the meta analysis academy, you didn't have any publications. But then ultimately after you did our program and between then and when you applied, what type of results did you actually have? You said first author publications.

Rhanderson Cardoso:

How many in total? Where were the journals? Or or give us a sense of the strength of your research component in your application, please.

Julyana Dantas:

Alright. I don't think I had a lot of super powerful publications, but the thing is, throughout medical school, I tried to get involved with research. I went to different mentors. I said I would volunteer, I would do anything that took. At some point it was pretty stressful for me because I'm gonna be a bit vulnerable here.

Julyana Dantas:

But at some point, I I thought I was almost humiliating myself and I would cry. My husband would say, just stop all of this because it's not doing you any good. And but, you know, I really wanted because it's something that I really always wanted to do, get involved with research. But ultimately, I couldn't. And when I graduated, I heard about the Meta Analysis Academy.

Julyana Dantas:

And I thought, well, this is great because because I can do everything on my own and I don't need to depend on other people to do it, other people senior to me. So I took it. And then during the program itself, I already started having ideas and putting together some projects. By the time the program ended, I had already have been a co author in an abstract that had been accepted to the AAN.

Rhanderson Cardoso:

American Academy of Neurology.

Julyana Dantas:

Yes. And a couple of months after, I I had 2 first author publications. My first publications full publications were as a first author, which was unthinkable to me before the program. And again, they weren't super JAMA, neurology publications, but they were still in good journals. And the thing is, I think doing doing science and doing research really adds up to your knowledge as a doctor, as your knowledge to how to interpret the evidence that you will use ultimately to apply to your patients.

Julyana Dantas:

And just knowing the insights of how the evidence that you use is being produced. So it really adds up even if you don't want to be a researcher. Awesome.

Rhanderson Cardoso:

No. That's that's fantastic. So at the end of this, before you applied between Meta Analysis Academy and applying, how many publications did you have and how many abstracts? Just an overall ballpark.

Julyana Dantas:

At the point that I submitted my application, I don't think I had any any papers published.

Rhanderson Cardoso:

But they have been submitted. Yes?

Julyana Dantas:

They have been submitted. But they

Rhanderson Cardoso:

have been submitted. Your application.

Julyana Dantas:

Yep. They were there as submitted. You can actually put everything that is submitted Yep. In your ERAS. Mhmm.

Julyana Dantas:

And I by that time, I think I had either 5 or 6 presentations, and that was that was it, I think.

Rhanderson Cardoso:

Congratulations. And then you also served as director of education of the meta analysis academy. You were Juliana was a tutor in our program. She's extraordinarily well. She, served as the director of education, spearheading, the initiatives in education during our program.

Rhanderson Cardoso:

Can you share a little bit about that experience?

Julyana Dantas:

Yes. Actually, that's the thing. First of all, I would I would never expect that I would serve as a role, in a millennials, but it was something that actually the programs took a lot of interest in because they heard the name, Math Analysis Academy. What is that? I've never heard of it.

Julyana Dantas:

And they were really interested. So I pretty much spoke of the Meta Analysis Academy in all of my interviews, and people were really excited about it. And I had to explain a lot of the responsibilities that I had. And I think that overall makes you a good candidate, Having positions of leadership, having positions in which you have a lot of responsibility over other people and projects, because it shows that you are versatile and that you are a responsible person and they that ultimately those are good characteristics for a resident.

Rhanderson Cardoso:

Yeah. Absolutely. We talk about a lot about publications in the Meta Analysis Academy. Of course, we help our students get those. But the application for residents in United States, it's a multi factor it's a multifactorial system.

Rhanderson Cardoso:

So you have to do well on your steps. You have to take advantage of these other components too, volunteer activities, leadership skills. And these experiences are valuable. You never know what's going to catch the attention of an interviewer. And, the research opportunities that, for example, meta analysis will afford you will help you also develop these connections, these collaborations, these additional skills.

Rhanderson Cardoso:

Like in your case, it was teaching you as a tutor in our program. So here, I wanna do a shout out to those listening who've done the meta analysis academy. If you wanna become an ambassador, tutor, a teaching assistant, we'd love to have you and potentially may even help you grow as a person, build your curriculum, and potentially even help you get get into the door in, in residency application.

Julyana Dantas:

Absolutely.

Rhanderson Cardoso:

So then in this trend in this journey, you know, since 4th year, 5th year medical school, you decided to come and then you did the steps. You didn't. The research and the meta analysis academy, the rotations, all of that. What was the biggest hurdle, the biggest obstacle, like, the biggest challenge that you had to overcome in this process to to get in the door?

Julyana Dantas:

Alright. So the what's most difficult really changes between people. Unfortunately, I already have a pretty good English by the time I started all of this, so it wasn't really too much of a challenge for me, even in the the rotations. But I think the 1 thing that, it was harder was the the financial costs, because it is it is pretty expensive to come here and find a place to stay and eat while you're not working, while you're just spending money doing your rotations. So I was very fortunate to have my husband help me with all of this.

Julyana Dantas:

He's also a doctor and he graduated a little bit earlier than me. So he started working and supporting both of us while we were doing the process. And we've decided to focus on my process before And now he will, you know, start his application.

Rhanderson Cardoso:

That's great. And everyone has their own financial story on how they they they finance the process. Like in my case, during the earlier, years, I had a lost lot of support from my parents. And then after I finished medical school and sort of transitioned into working, I sort of financed the the remaining components myself. And, in your case, you were, throughout some of this, you were already graduated.

Rhanderson Cardoso:

You were working. You you had a job as a physician in Brazil, which obviously helps, but then you mentioned this this very valuable support from your partner. Right? And how important was this to you, like, in in in the process, of course, of ultimately, succeeding?

Julyana Dantas:

Well, I have to say, to me, it was integral because would I be able to do it without his support? Probably. But it would take me at least twice as long, and would, take I I would absolutely take it all on my mental health. So I am really, really grateful for everything he's done and for all of his support and all of his, just being there for me.

Rhanderson Cardoso:

And he's a physician, and he also will apply for for the process. Right? Well, how far advanced in the process is he?

Julyana Dantas:

He's just gonna start starting now.

Rhanderson Cardoso:

So that that was a I bet a strategic decision on your guys' part to focus first on you, then he he joins in. And then I wanna leave a message for all of those who are coming with a wife or husband. The j visa we were talking about earlier has a great advantage for spouses because you the spouse could potentially apply for through the JU Chu visa for a work permit.

Julyana Dantas:

Mhmm.

Rhanderson Cardoso:

And then a lot of spouses of j 1 residents will work during the time they're here. When when my wife and I got married, I was a resident. I was a 2nd year resident into 3rd year, and then she joined here. And she had different jobs as, you know, even as a as a secretary first, and then she worked for enterprise rent a car in the car rental industry. And, that income was really important for us, to, you know, start our financial life together.

Rhanderson Cardoso:

So, the j Chu visa offers that great opportunity for for spouses to work to apply for a work permit. Obviously, your husband is gonna be focused on the steps and all that, but that's also a possibility for the for the j twos.

Julyana Dantas:

Yeah. And I believe he can actually be a resident on the j 2.

Rhanderson Cardoso:

Yeah.

Julyana Dantas:

Yeah. So it I think it it depends on whether the program will want to have a resident on a j 2, but it's absolutely possible.

Rhanderson Cardoso:

Oh, the the programs generally won't mind. It's a beautiful thing to do residency on the j 2 because as I was just saying, you get the work permit. It's funny because AJ1 visa holder can't get the work permit, but the j Chu can't. So what does that mean in terms of practical terms and residency? It means that the j Chu can moonlight, can work outside residency.

Rhanderson Cardoso:

So just like in Brazil where we're from, you know, people in residency can work outside. In the United States, programs may have different policies, but, generally, that's allowed, especially after 2nd year. You can take extra shifts. You can pick up extra work for extra money, but you're essentially hired not as a resident to do those moonlighting shifts is what they're called. But you can't do it under AJ1.

Rhanderson Cardoso:

But under AJ2, if you have a work permit, you can. So I know a few couples where j 1 and they J2J1, just works in residency, and they j 2 visa holder works in residency and make some extra income for the couple. Couple. So that's that's something to look out for, and I would definitely, try to do the residency for him onto Jeju if he could. Mhmm.

Rhanderson Cardoso:

Were there any particular people or, that inspired you in the in this process, mentors that were really important in this journey of getting leaving Brazil and then getting a residency in neurology here at Tufts?

Julyana Dantas:

There are couple of people have inspired me always to to look, for better opportunities for to to improve myself. And I have to say that mostly all of the teachers that I had throughout, even when I was a child, they always inspired me to to get further. I don't think there's a particular person per se, but everyone in my life has always been very supportive of my dreams.

Rhanderson Cardoso:

Too many people just say names. Right? You run into out of trouble by saying that. I totally get you. So we thank everyone, but they were all important.

Rhanderson Cardoso:

I'm sure they were. Very good. So, Julianna, you know, your journey is incredible. It's inspiring. It's exactly what we wanna showcase here, in Metacast, The careers of people who've done extraordinarily well.

Rhanderson Cardoso:

And you've done so well, you know, leaving Portugal for medical school in Brazil, now coming to the United States for residency. Do you see what's next in your career? Obviously, the first goal is just to survive residency, survive 1st year. But do you sort of have a vision of the type of neurologist you wanna be, if academic, if private, if you want to do a particular area in neurology, or is it too early to know the next step in your journey of excellence?

Julyana Dantas:

The the thing I know is that I want to be involved with medical education. So ideally I would go to an academic program and be entertaining there, where I could teach medical students and perhaps residents. As for the area, I'm still not sure I'll be able to explore everything during residency and by the end hopefully I will decide on an area.

Rhanderson Cardoso:

No. That that's that's a good way to to get into residency. It's to keep an open mindset and see where things will take you. And then eventually, once that plan becomes solid, like it was at some point for you, residency in the United States came into your horizon, and then it really became a solid plan. Once you develop that, you pursue with passion that goal just like you have until now.

Rhanderson Cardoso:

So, Juliana, this has been extraordinary to have you here in meta sessions in meta cast. Excuse me. I'm so grateful to have, your support, your partnership, your collaboration, all that you've done for the students of the Meta Analysis Academy as director of education, as a mentor to some of our students. And I really wanna congratulate you for this, incredible and outstanding journey here so far. Any final words of advice for people who wanna come to United States, for people who want to do neurology, for people that want to do publications, for people that get inspired by your story and wanna have a similar trajectory?

Julyana Dantas:

Just do the best you can and go somewhere where people will appreciate you because that's what I found in the Math Analysis Academy community. It's that the work that I did and the work that I put in was very appreciated and it hadn't been before. So being in a supportive environment really does a world of difference and if you can, don't neglect your support your your friends, your family, your partner, and being they they they've been there with you really helps you maintain your integrity and your, sanity pretty much. It is difficult, process.

Rhanderson Cardoso:

So that's it, everyone. I just spoke to with Juliana Dantes here in the meta cast, where where we discussed successful careers. Juliana moved from Portugal to Brazil for medical school, and then she decided to come to residency in the United States. She passed her USMLEs, got a good score on step 2, did her rotations here in Boston and in Texas. She, did the meta analysis academy, published a few papers, had a lot of abstracts accepted in great neurology conferences.

Rhanderson Cardoso:

She applied. She had excellent interviews. She matched into Tufts. She's going to start in a couple of weeks, in just 2 weeks. She just moved here to Boston, and that's her success story until now.

Rhanderson Cardoso:

I can't wait to see the next chapters on your career. Thank you so much, Julianna, and it was a pleasure having you here today.

Julyana Dantas:

Thank you for having me.