Denise 0:00
Hi, Welcome again to Myth, Magic , Medicine, Season 3 is a very special season. I have only guests who are who are immigrant doctors. When they got to the US they were coming from a different healthcare system, but fully trained doctors. And I thought as an immigrant who came before she went to medical school that will be an interesting thing for people and you've got 12 weeks to decide - thank you very much for joining us. My first guest is Dr. Mamta Kumar, as you would imagine from India, which part of India?
Mamta 0:34
I'm from North India, from Bihar. Okay.
Denise 0:38
And you are an internist. Correct?
Mamta 0:40
Yes, that's right.
Denise 0:41
and also integrative and functional medicine, fabulous. Now, how did you get here? Don't tell me it was on a plane. What brought you to America?
Mamta 0:52
So, I was born and raised in India, of course, and I went to medical college in back in India, and I got married in fourth year of medical college. And my husband, he was the IT guy who was working for IT company and they had a project - he was here in the United States for a year.
Denise 1:10
One second. How long is med school in your part of India? It's four years here...
Mamta 1:15
At that time, it was six and a half years, like five and a half years [plus internship]. Yeah. But after that, I think the policies have changed. You have to do two years of internship. I did one year of internship. And after that, I was fine.
Denise 1:28
So internship is part of medical school. It is in most of Europe as well.
Mamta 1:32
Part of medical school there.
Denise 1:34
Yeah. Okay. So you are a married woman in India with a husband in the US?
Mamta 1:42
Because I was in the medical college at that time. Yeah, that's how it was. Ours was ana differenet dealranged marriage back in 2000. You know, I always forget
Denise 1:54
This is this is not the scope of this conversation. But can I just put up a plug for 'it was an arranged marriage', not a forced marriage. it's the Indian version of match.com. Yes.
Mamta 2:11
Families with aunties, people. Yeah. The aunties brought us together. We met in person in front of the family and after that we met. separately. We talked over the phone, we knew each other's goal, which were in alignment, and we agreed to proceed with a marriage
Denise 2:28
that's out of the way now. So so they you spent an additional two years with after you married before you could come to the US?
Mamta 2:41
and my husband, we agreed that we were even though we were married, he was just not ready to settle down already. Because he was working for the company. He was getting promoted. And there was, you know, opportunity for him to come here. We didn't know for how long so he moved here.
Denise 2:55
So you got married. And he came, I thought he was over here already. He Yeah,
Speaker 2 3:00
we got married. He went to London. He stayed in the UK for six months. And after that, he came back to India. And it was all project dependent, because he was still working for the Indian company, but they were taking the projects and he was traveling, you know, depending upon whereever the project needs were. So after coming back to India, he came back here in Phoenix. So I finished my graduation, we were like, okay, so what should I do that I came and join him here, my intention was to go back to India, I brought a lot of books here, like a whole suitcase like 20 kgs, which was allowed back, you know, the one travel backpack, we have, like, I bought all the books so that I could prepare here and go back to India and give my you know, post graduation entrance exam. So that's what the initial plan was, because we didn't want to stay here. He didn't want to stay here because all our family's back in India. So our intention was to just kind of spend a year or two here, depending upon his project and then go back
Denise 3:54
So your intention was not to stay at any point. You weren't expecting to do postgraduate here. No. Did you want to do internal medicine in India? Also? Was that the plan? Yes, yeah. Okay. So what changed? You fell in love with Pheonix or...
Mamta 4:10
Not necessarily, I think a lot changed. I was still kind of here. And I was noticing that back in India, the post graduation and like in India is different. It's not the school, which matters, it's the top, you know, 10% or top 2000 people will only get the seats. And the worst part of that was like I was born and raised in north part of India, which is in Bihar. And I was in very top of the list when you know, when the, you know, when I was given an opportunity to choose the medical college. So you depending upon your rank, you get to choose a medical college. So I obviously was going to be able to choose the top 10 Medical Colleges in India, and that's what I did like I chose the fifth Medical College back in India at that time, but I have to stay away from my family. You know, I choose a medical college in Mumbai, which was a way and my Parents were in Bihar. My husband's family was somebody somewhere else. So I realized if my husband was here, and I was going to be going through that exam again, then I didn't know what state I would fall into. That would mean for two years we would be living separately.
Denise 5:18
Yeah, just just for clarification, I'm not sure whether I'm going to edit this to make it smoother, maybe not. I tend to be very lazy. The system is so very different. So you're still attached. I mean, obviously, we're still attached to academic institutions when we're postgraduate training, but you have to actually apply to the college. And when they will then tell you which hospital you're going to be apprenticed to. Okay.
Mamta 5:41
Oh, well, at that time, you know, after two years, I was like, you know, what, what am I doing?
Denise 5:47
I'm a married woman. I'm not with my family. And I'm not with my husband either.
Mamta 5:50
So what would they do like for three years? And I don't know, like India is very varied. Some parts of the country are very, very remote villages. And I had to go for one rotation to one of those villages. Not necessarily, I have to say anything bad or good about it. But it was very remote for my liking. And I just, I was like, oh, gosh, I don't know how I would survive. If I was posted in that place for good three years. With no phone, no internet connection. Not even like, you know, lights and stuff.
Denise 6:18
Yes, it's a different world. Let's, let's talk just a little bit about the practice of medicine in India. I mean, there is such a long history with Ayurveda
too, do you do that? There's so there's so much what the the conversation I had with one of the people who will be on later in the season, which prompted this series was she was talking about how she what things she could say to a patient. Or if it was bad news was you can tell somebody to go home. That's everybody's happy with that. But if you're going to tell somebody, they're probably not going to be able to be discharged from the hospital. She was not allowed. It just you just didn't give bad news to family members. And so there are so many things that are different that are so culturally specific, what's the attitude towards health. And,
Mamta 7:12
You know, India is definitely different. At that time when I was in the medical school right now, definitely people have health insurances. At that time they didn't. I was in the public and all the government hospital where the government hospital would provide all the medicines, they would take care of all the hospitalizations, and stuff like that you were supposed to pay minimal sliding scale co payment or something like that. That's what I was aware of. I never practiced independently in India. I was always like supervised with my attendings and everything. So I honestly cannot speak much to that, because I always was in that trainee mindset, where I would do the whole critical the way we do it over here, like, you know, collecting the whole the history, and then coming up for the whole examination, coming up with a plan differential diagnosis, doing the full physical exam, but and then kind of coming over the plan, like, what are we going to do? I did have my conversations, but I cannot speak much about like, you know, I never remember having those conversations with the patients were like, Hey, I believe this is what do you have? Because I was like, Oh, I think that attending we will be back for the attending.
Denise 8:20
You use the UK system, consultant and then the firm.
Mamta 8:28
Yeah, Exactly the same here. Like, you know, like if they told you what, as an intern, like intern here would not go and tell them the whole unless it's confirmed by the attending. So that's how it was.
Denise 8:38
Intern, intern, resident resident attending, attending? Yeah, yeah. Yes, I think things I mean, things have changed. Definitely. I for a very brief moment, when I was in the UK before I came to the US, I was a nurse. And if a consultant walked into an office, the nurses were expected to stand that was that was the background I was from. Okay, that's gone. doesn't happen anymore. Do you think that? Do you think that Indian patients in India, obviously there's a large diaspora, but Indians in India have a different attitude to whether they expect to get better or not? Whether they expect? There's a certain amount of karma?
Mamta 9:27
Yes, the Indian that the way the medicine works over there is definitely different. And honestly, what I saw back there in like 2000, and currently right now, it's still very different. But physicians are still very well respected for their time. And now there is still quite a bit of respect out there. And then even in the society, they could have their own private practice or private hospitals. So they can have quite a bit of autonomy over there, since they can directly charge the patients and I wouldn't think honestly, it's kind with reasonable ways, compared to what we have over here, honestly, I'm my husband and I talking about like, you know, how the healthcare system is here right now, that at one point, you know, if we have to give certain kinds of treatment in India, yeah. It's like, get it done, because you still have that freedom. And the doctors are always going to be doing what's best for the patient, there is no insurance people, middlemen and the business people in between, like guarding, oh, you can't prescribe this medication to this patient or you can't do this. There is no, no third party controlling. For the most part, if you're not using insurance, I think the rates are very reasonable. And you can get it done. Things Done For You.
Denise 10:45
Of course, if you have money, yeah, a lot, a lot of
Mamta 10:50
help let you know the government system and stuff. And they might not be that advanced, just because the government doesn't have that much funds too.
Denise 10:58
So you, you, you came over to the Phoenix area. And you decided then that you weren't going to go back to India?
Mamta 11:05
Did you know I was still a at that time? I don't know. And I think my husband stayed there for like a year. And then we went back India again, and again to Charlotte again. And I still have my whole load of books, which I was preparing. Then I met virtually met there was some time, I don't know if what did we have Facebook at that time? Was it awkward? I don't know what it was. But I connected with a few of my classmates. And they were already doing their Masters here, MPH here. And then they were like preparing for the USMLE. And everybody was getting 99. And we were talking about all that. And then he was like, so do you have? So you have given your USMLE? I'm like no, I'm not. And I so then that put that seed inside me going, like, you know what, how about even though we don't want to go back, but it seems like we have been here for two years on and off. We could extend for three years. And I could just do my residency here. And the residency here is valid back in India. That was one of my things. I was like, Oh, if I do a post graduation here, in fact, it could add, I could stay with him, you know, as a family, we can stay together, I can do my post graduation, and we can go back. So that's what kind of got me into that. And I got all the books, which was needed. It just didn't take much expensive courses or anything like that I almost DIY everything, sat down, lock myself up for four months. And then I got 99 percentile. So I was like, well, this means something that my husband was like, why not? You just pursue this? You know, we'll see what happens.
So that was Step 1 Yes. And and did it was CS in at that time.
We still had it. So I think that was still the April when I had passed. So from April to November, basically I locked myself out for good nine months. So I was like, you know, nine months people have babies, like we would have babies and I gave this like, you know all the exams back to back and I had the ECFMG certification. So I was certified by the year end.
Denise 12:59
Yeah. For anybody listening who isn't a physician, there are three main steps. Actually, they've gotten rid of that. clinical skills, one that that trips up a lot of people because if they're coming from abroad, they're going to come to this country to one of six centers to take the exam before they know whether they're going to be in America or not. And it's pretty expensive. It's expensive to take the exam , never mind the travel and the hotel and all the rest of the
Mamta 13:24
I'm glad my husband was here working, you know, so we didn't have to convert for rupees to dollars to do this. But yeah, he had to support me through this.
Denise 13:33
Did you take Step 3? Or do you did residency first?
Mamta 13:37
I did the residency first, because I had only done the CS So I got in fact pre- matched. So I took the offer and then I just kind of just continued and then I did the step 3 in the third year of residency
Denise 13:49
Where were you in residency?
Mamta 13:51
Texas Tech, Amarillo
Denise 13:53
Okay. Was your husband able to be local to you?
Mamta 13:56
Yeah, so what we did, you know, everything was kind of very planned to when I moved there, but his plan was to get into MBA. So he left his job. He did an MBA, and he joined Texas Tech Lubbock, which was an hour and a half driving distance. So he would go there, stay there and do his course and stuff. And on the weekends, he would come back. So that's how we spent our years.
Denise 14:19
And some of those weekends you weren't conscious
Mamta 14:22
Yeah. and he would bring food to me,
Denise 14:30
So when did you decide you were going to stay in the US?
Mamta 14:33
I really think for the longest time we were like, oh, whatever happens and whenever we decide to go back, we'll go back. I think things got a little more complex, and complicated after having these, after we became attending and I had some complex pregnancies, and mostly my youngest daughter she was born 24 weeks, so she's NICU for five months and after that all the therapies and everything. You know that almost like feeling bad for you know, I don't think she'll be able to kind of get that much care level of care back in India. So we're going to be just staying here. Not so you won't need that. But our life is just way more settled now, we know the American system way better than the Indian system now because we have spent so many years. So with each passing year, it's like, okay, we are going to be here.
Denise 15:22
Do you ever go back?
Mamta 15:24
I do go back for travel only, you know, we'll just go back. And stay there for a month and come back. But our last travel was right before pandemic in 2019. Hopefully we can go back now. With the pandemic we didn't want to travel.
Denise 15:40
But awful, awful long time in a sealed container. Yep. But all of the children had been to India?
Mamta 15:49
Yes, both of them has been to India? Not necessarily they remember much. But yeah, we have been there. So let's,
Denise 15:57
let's talk a little bit. Do you think the what what do you think were the biggest surprises to you, when you started practicing medicine here, I'll be having gone from a fully fledged doctor to suddenly being on the beginner rung again in the American system,
Mamta 16:12
I believe the American system was very, very different. Like, you know, going into medicine was not necessarily like, oh, I wanted to become a doctor. Like everything I was the first doctor in my family, let a little bit be a female doctor. So coming over here. So I really think in the medicine the way I was taught there was art in you know, science to it. But it seems like Well, I came here I remember back in college in India, we will talk a lot about art part of it, like you know, the bedside, you know, physical examinations and stuff like that. Here. It's always sciency. And, like, you know, very different logical, like you need something some information, oh, go ahead and order this blood test. Go ahead and order this echogram, MRI, CT, whatever. And sometimes, you know, even the conversation with the patients, even though something else is ailing them, we just stick to the science, technological part of it and you just forget, or like there's not enough time, honestly, I realized, with the insurance requirements, there's not enough time to provide that care what patient came for. They didn't complete CBC, they didn't come for this or that. They came for a headache, or shortness of breath or whatever. And we forget to address like how it matters or how it affects the day-to-day life.
Denise 17:30
Yeah, the the amount of time spent in physical examination that is true of pretty much of western medicine, I think you may even find parts of India have changed because things just seem to be going faster and faster. I was really being my age, I now use Medicare and I went for the you know, the annual wellness checkup. And if I brought up any new symptom, they've turned it into a different have worked. What's the point of having the wellness checkup? If I don't have enough, I can tell them everything is going on? Why bother? And I have very nice Indian doctor who's practiced here for a long time, too. But yeah, we've seemed to where I think we are becoming over reliant on the tests and less on our gut instinct. And on both
Mamta 18:13
sides, not necessarily just the doctors, the patients who just want ,
Denise 18:17
yes, if you if you don't do the test, and yes,
Mamta 18:19
that's a problem for them. But yeah, that doesn't get as coming to a diagnosis does not necessarily help you. You know, what you're going through?
Denise 18:31
No. And of course, we also adopt to this throughout the world, I suspect that suspect is that you must have medication for it no matter what it is, there has to be an answer. And of course, for so many things, there aren't.. There are medications we can give you that might help you cope with the symptoms, but they are not necessarily going to help you the issue. Did you find...did you miss aspects of Indian medicine? When you were here? Were there things that you would have done in India that you wish you had been able to get past the data science?
Mamta 19:06
You know, it's kind of interesting that even though I was the first doctor back in India, who was trained, but Ayurveda
and the way of living back in India is very different. Like, like in India, there is not much dementia there. Like you know, my grandma just died right now. I think probably she was a 90s she still have very sharp memory until 80s. And I realized that when I came back here, I was diagnosed with autoimmune illness back in 2016. Yeah, somewhere around that time where I was like a full fledged doctor, I was an attending physician. And I started to kind of do all this western medicine, I was taking the medicines, you know what I was prescribed for and I realized honestly, at one point that I was having a lot of side effects. I couldn't even tell or differentiate what was the real disease and what was the side effect of the medicines because it was just a lot. So then I started after like two or three more years. started to kind of go towards Eastern medicine again. And that was the reason I started to do my fellowship and integrative medicine. But I didn't want to kind of go into woo-woo medicine again. So that's why like I looked up here in the Western culture, who are the people who are talking about this, and who resonated with me and one of them was Andrew Weil, Dr Andrew Weil and he had this program, which was like pretty acclaimed program, honestly, it was just an instant decision. I was kind of feeling sick, feeling sick. And then I was like, Gosh, it looks like my health is just declining, and it will continue to decline. I was denied disability in the private life insurance at that time. So I made this whole research and I talked to my husband, what do you think? And I'm thinking about doing this fellowship, not necessarily for the academic reasons, to become an integrative and functional doctor but I wanted to kind of understand a little bit more about my view, hold hold and feel better about it. And he was like, you know, what, if it helps you just stay where you are. And if you think it's, you know, helpful to go to do it. And I honestly didn't even know how many doctors enroll into this, you know, whatever. And I looked at the, you know, the cost of it, and that was very high. And I don't know if anybody, like American doctors will be interested into this. And I was surprised that when I enrolled for the last one there, like in that batch alone, we had 80 doctors, like from oncologists to neurologists, to critical care to all the specialties to psychiatrist and I kind of really felt at home with that environment where the holistic healing was taken into account. You know, not just physical illness where, oh, for each abnormal lab or each abnormal test, you have a medicine for that, because it doesn't equate that way.
Denise 21:43
I rather enjoy the fact that people don't like the word psychosomatic, they prefer mind body, would you please translate those two words you just use but you don't like exactly what it means? You also practice functional medicine, would you mind giving us a mini primer on the difference between the two.
Mamta 22:01
So honestly, I have done the training of both but I have never liked full fledged practiced. I did start a telemedicine practice on the side, but never marketed it a lot. But there is definitely a difference between the integrative and functional medicine. I really think integrative medicine focuses more on healing from inside out. And it will take care of all the mindset, the behaviors, the habits, and the things which we eat and the environment we are in. And it will work on changing all that to take care of the health. And the functional medicine is a little different. They go still with a little more diagnostic eyes. And I don't know and I don't want to kind of I don't know how to say it exactly. So they still advertise, they want to do certain kinds of tests, checking on your hormone levels, checking on your gut bacteria checking on this and that which I'm not sure I'm too fan off. So that's why I identify myself being more of an integrative physician than the functional, because at one point, it comes down to be monetizing that by ordering all these bunch of tests which are not covered by the insurance and then giving you this bunch of supplements which are not covered by the insurance as well, right? No, no, if that's what provides the better care about the integrative medicine, I really think you can just work on and modify all the environments with or without doing the test.
Denise 23:26
Yeah, I just got this piece out. It doesn't offend people. But I do you see a lot of other medicine adjacent people. Yes, practicing functional medicine and they're not doctors, and that's my main concern. What I like about the integrative model is that we have the body has a phenomenal ability to heal itself. Yes, not everything, somebody's going to be sick. And you can always fall down and break a leg and that's kind of health too, but But it allows your body if you have decent sleep and proper food for your body and everybody is a little bit different. All of those things would have we have a better attitude to keeping ourselves ready to heal so that we can carry on and have productive lives. Productive. sounds like you're gonna go out and make millions. So that's what I mean. I mean,a happy life. You get up in the morning, you have a nice day and then you go to bed. Do you practice differently now you've learned integrative medicine?
Mamta 24:30
Definitely. I think my whole life has changed. And earlier I felt that I had to continue to work for those 12 hour shifts seven days a week and stuff like that. Now I'm like, if my body cannot take it, I'm okay with taking it easy. And then just doing it coming to terms with that. You know, I don't push myself to extreme at all. I definitely think I change as a parent as well because you know, I really think I'm looking and raising my kids to be more well-rounded people rather than being a very academic people who are doing well in the school, but are internally very unhappy, try to chase that mirage. And also I'm definitely a very different person going through that integrated model, which resonated so well with me, and then just meeting those peers who saw who thought the same, you know, I really felt like, okay, so I'm not the only one who's crazy. Honestly, then, you know, that was definitely a lot of it, like feeling like, I'm just such an outcast. Honestly, when I enroll into integrative medicine for about a year and a half, I never told anyone, because I was working in a hospital. You know, everybody was very technical. But
Denise 25:45
a lot of the larger academic institutions have integrative medicine departments
Mamta 25:49
now, or maybe in last two years, but not like five years, I got enrolled in like 2018, I believe, if not 2019. So at that time, I think maybe it's
Denise 26:00
also region specific, because I mean, I used to go to Jefferson, like 20 years ago, they had an integrative department, or they did, it may have been more prominent over over here. But Arizona, I would have hoped...
Mamta 26:16
Austin, Texas. So in past three years, I've seen a lot of people showing up, like anonymously, even their MDs, but they are like calling themselves specialists in this arena. So that was two years ago, but I was in doing this training like a year and a half before before it kind of exploded in this town here.
Denise 26:32
So at that time, so now, how are you using your training ? What are you? What is the emphasis of your work?
Mamta 26:42
That's an interesting question, because, you know, I have been, I did start a telemedicine practice, which was integrated care MD. That was like two years ago. And I also started health coaching business on the side. But also do a full time, like, I'm investing in real estate, and I've been that has been doing well. So staying with those core values of integrative medicine, if I have autoimmune illness, and I won't believe that well balanced life, I realized that I couldn't be doing all these three professional things at one point. And now I'm coaching other medical professionals about their own financial journey. So it was like four things, which I was trying to do in limited hours, which I work, because I don't want to like
Denise 27:23
you still have two kids that still have to
Mamta 27:27
decide and let some things go. For right now. Not that doesn't mean like forever, I'll be using it. So for now, I've decided to not use or like stop working on integrative and functional medicine side of the things just focus on my real estate and helping other physicians achieve their financial freedom. So these are two focuses with my kids and my own health. So these are four priorities. And it was a very hard decision to kind of let go of something which I feel very passionate about. But what will be the point if I cannot implement what I learned or talk about so
Denise 28:02
physician heal thyself? Yeah. Yeah. Do you? Do you anticipate going back to medicine at some point, are you leaving that door open?
Mamta 28:12
I'm still licensed and I will continue to practice? No, like, I'll continue to stay licensed. And I did try to kind of go back to some peer and local job locum jobs so that I can continue to practice. But the hours requirements are still brutal. They're like, Oh, you want to do 14 shifts, you want to do seven shifts, for like this many hours, and I don't think I can handle that. So I'll probably maintain my license at one point, just kind of go back to my own private practice, which I have planned for, because my vision of having the health and the wellness is way different. Now after going through my own health issues, my daughter's and, you know, going through this integrative and functional model, mind body connection models, I really think you know, just practicing medicine where you were taking insurance during the test and prescribing the medication or which is covered by the insurance. I really think it's the insurance which is directing the care, not the doctor or the patient. So I don't want to get into that model.
Denise 29:09
Well, twofold, because there's also fear of litigation. Yes. Which drives an awful lot of testing. Yeah. brought us mentioned that attorney and doctors go quiet. Is there anything else you'd like to say because we are running out of time.
Mamta 29:29
Now I would like I think what's important is for each one of us, like either we're physicians or not physicians just kind of staying in alignment. I really think lots of diseases are even caused without like going out of alignment. We try to fit into the same box, as physicians, like all physicians are supposed to be this core, fitting in this puzzle of right over here. In each one of us. Even as physicians are human beings, we have different roles. We have different inherent characters. This is kind of very important to kind of just come in alignment and just create the Life which you seek, and which is good for you and your family. This was a late realization that after I realized this, that I have been able to kind of let go of things, which doesn't resonate with me anymore. And I really think I have like way more fulfilling life. Now, after this, all those experiences,
Denise 30:18
let's let's go with the stereotype for a moment or two, since you're Indian, Indians are not uncommonly sort of, strongly encouraged to become doctors. How do your parents feel about how does your family back home feel about your stepping away from more clinical medicine towards?
Mamta 30:36
Oh, yeah, that's kind of interesting. Because you know, my mom was here when my youngest was born, and she was in ICU. And I was kind of almost getting pressured to go back to work from work. I didn't want to, but it was very interesting to notice that my mom felt it was okay that I should go back to work. My husband felt the same too. So I couldn't voice that at all. So this time, I didn't talk to anybody. I'm like, Okay, I'm doing real estate. And they always knew that I was doing real estate on the side. And they didn't hear about me not going back to medicine unless I was successful in real estate already. So I have already seen, I'm doing fine in the real estate. So I think there has been no pushback or anything like that. Right now.
Denise 31:22
All right. So good. Yeah. Are you you said you have a course it's fully booked right now. Yeah, of course, looking for new people. Will you be doing it now, but
Mamta 31:32
we'll be probably doing it in fall again, because there's so much demand.
Denise 31:36
Okay, so we'll make sure that all your contact information are in the show notes. So but just in case someone who is listening on podcast, doesn't have a piece of paper handy to write it down? Or they're in the car. Would you say out loud? You're the the the URL for your contact? Yeah.
Mamta 31:53
So the website is fast fire md dot com. I always like best financial independence, retire early.com Even though I don't believe in retirement, but yeah, financial freedom for sure. I like freedom. I like to feel free. So yeah,
Denise 32:10
I mean, the nice thing is, be financially independent, so you can do what you really want to spend your life on Yeah. That's wonderful. Thank you so much for joining me today. Many, many more conversations or thinking about other things to talk to you about. Thank you so much.
Mamta 32:27
Same here, thank you so much.
