I thought the USMLE books would just be a bigger version of the ones I studied in Seoul

Staring at the weight of Harrison’s Principles of Internal Medicine again

I remember sitting in my room looking at my stack of medical books, wondering if I had truly lost my mind. I had spent years in the Korean medical system, where everything felt like it had a predictable, if brutal, rhythm. Then, for reasons I still can’t quite explain to my parents, I decided to peek at the USMLE materials. I had heard about Harrison’s and Tintinalli’s Emergency Medicine before, but holding them in my hands felt different. It wasn’t just the sheer physical weight of the books—though that alone was enough to make my desk groan—it was the realization that the entire language of my profession was about to be reconfigured. In Korea, we were so focused on the national board exams that we developed a very specific, shorthand way of thinking. Now, looking at these American textbooks, I felt like I was learning how to speak a language I thought I was already fluent in.

The endless hours spent in the library

I spent about six months just trying to figure out if I was actually capable of absorbing this much information. I wasn’t working in a Big 5 hospital like some of my colleagues who were already talking about moving to the States; I was just a regular doctor trying to see if there was another path. I remember taking the train to a study room in Gangnam, paying around 15,000 KRW for a daily pass, just to escape the distractions of my apartment. I watched people studying for the DEET or preparing for nursing certifications, and I wondered if they felt the same creeping anxiety. The study room was quiet, but the mental noise was deafening. I would look at a single page of clinical vignettes and realize I had been staring at it for twenty minutes without processing a single word.

Realizing that knowledge is not the same as a license

One of the weirdest parts about this whole process was realizing that passing an exam doesn’t actually make you an American doctor. I kept reading about these ‘alternative tracks’ for specialists, which sounded great in news articles, but the reality was much grayer. You read about these professors from major Seoul hospitals going abroad, and you think it’s a straightforward move. Then you actually start looking into the state-by-state licensing requirements. It’s not just about the test; it’s about the endless paperwork, the notarized translations of your degrees, and the persistent doubt about whether a hospital in Texas or California would even know how to evaluate your training. It wasn’t a path; it was a labyrinth.

The temptation to just give up

There were days when I seriously considered selling my study guides on a second-hand market and just forgetting the whole thing. I looked at the cost of the exam fees—which were quite high, costing over a thousand dollars for the various steps—and I compared it to the comfort of my existing, albeit exhausting, clinical practice in Korea. I remember talking to a friend who had finished their residency, and they looked at me like I was chasing a phantom. They asked me if it was worth the potential gap in my career. I didn’t have a good answer then, and honestly, I still don’t have one now. I just keep coming back to the desk, staring at the USMLE prep sites, and wondering if I’m just stalling in a state of limbo.

Why I keep checking the exam dates

I don’t know if I’ll ever actually sit for the exam. Sometimes I think I’m just doing this to keep the option open, like a security blanket for my career. Every few weeks, I log into the application portal, check the requirements, and then close the tab without doing anything. It’s this weird, hovering state of existence. My colleagues think I’m just being diligent, and my family thinks I’m doing something noble, but mostly, I’m just trying to figure out if I can survive in a system that doesn’t know who I am yet. Maybe I’ll study more this weekend, or maybe I’ll just go for a walk and ignore the stack of books for another two days. There’s no rush, right?