He wanted to be a study physician, but the Korean environment was not so favorable to him. The professors he watched as a medical student always appeared to be exhausted from treating patients. However, the situation was entirely different in U.S. university hospitals. The professors at U.S. university hospitals were positive not just in clinical trials but researches as well. Such was the environment in America.

That explains why Professor Kang Hyun-seok went to the United States. Kang is now serving as an associate professor at the Department of Hemato-oncology in the Medical College of the University of California, San Francisco (UCSF).

Kang, who was interested in research from his days as a medical student, spent his vacations in the freshman year of the regular course of Yonsei Medical College at the laboratory of Yonsei Cancer Research Center. Also, he had the opportunity to visit MD Anderson Cancer Center of the United States as a sophomore student who could spend a relatively long vacation of two months. He sent his CV to various professors with the help of his mother’s brother, and one of them allowed Kang to come to his office.

As Kang acquired skills in molecular biology in his freshman year, he was assigned to the process of producing data needed for examining theses. The experiments progressed well and succeeded in acquiring the data, and Kang could put his name in his academic advisor’s paper.

And the experience exerted a crucial influence on Kang’s career and life.

While at the MD Anderson, Kang attended conferences like Grand Round and met doctors who worked both as physicians and researchers. They treated patients a day or two per week and operated labs positively. That was quite impressive. They compared with Korean professors who looked worn out with treating patients. If Kang had to become a study doctor, he thought it would be better to work in a better environment.

Preparations to become a study doctor

Upon graduating Yonsei University College of Medicine in 2002, Kang began to prepare for studying in the U.S. while serving as a public health doctor. As he set winning a Ph. D. degree in molecular biology in America as his goal, he prepared for graduate record examination in his third year as public health doctor. Armed with papers and good school grades, he was confident to enter a U.S. graduate school but failed. Kang felt embarrassed as the selection for interns for that year had ended.

Instead, he opted to study epidemiology and statistics in which he had been interested. He entered Yonsei University Graduate School of Public Health in 2005 after finishing services as a public health doctor and acquired a master’s degree in 2007. “Looking back, it was an excellent decision,” Kang said during a recent interview with Korea Biomedical Review. “It gave me opportunities to accumulate basis for clinical research and evidence-based medicine.”

While working as a public health doctor, Kang passed the U.S. Medical Licensing Examination (USMLE) Step. 1 and 2 (currently Step 2CK) and Clinical Skills Assessment (CSA, now Step 2CS). These were preparations to receive training as a specialist in America.

Also, while attending the graduate school of public health, he served as an observer at Emory University for one month during the summer vacation. And he passed USMLE Step 3, which could be taken only in the U.S., during this period.

After completing all preparations to receive training as a specialist in the U.S., Kang began to apply for becoming a medical resident. Because the U.S. system selected medical residents through a matching program, CV and personal statement play an essential role.

After applicants send a CV, personal statement and reference letters to hospitals through application app sites, each program selects interviewees. After the interview, applicants and programs made their lists of preference, based on which the applicants can find their hospitals of training.

“I applied for about 60 programs, was interviewed by 12 of them, and matched to one of the 12 -- St. Lukes-Roosevelt Hospital affiliated with Columbia University in New York,” Kang said.

Road to hemato-oncology professorship in America

He received training of internal medicine at St. Lukes-Roosevelt Hospital. The internal medicine training in the U.S. is a three-year course including internship, and so the departmental education is not included in it, Kang explained. Therefore, an intern mainly receives training to treat general inpatients, those who need primary medical care and outpatients in a rotation while training specialized departmental training proceed depending on individual choices.

“While I received training, I was no more than a trainee and depended on teaching specialists for important medical decisions,” Kang said. “Generally, they granted some autonomy to medical residents depending on the latter’s ability, but all responsibilities lied with teaching specialists.

Though a medical resident, Kang could afford to lead a relatively more leisurely life than in Korea. Even during the shift to treat inpatients, he could leave the hospital at 9 p.m. as other medical residents worked in night shifts. When he was not on night duty, he could go home around 4 p.m. to 5 p.m. During the outpatient shift, there were no night duties.

“Many procedures, ranging from dressing to foley, belong to nurses’ domain. Therefore, conditions are ripe for interns to take part in making medical decisions,” Kang said.
Kang completed a medical residency in 2010 and served as a fellow at the Hemato-oncology Department in the Emory University Hospital in Atlanta. In the case of the hemato-oncology department, a doctor can indulge in study after receiving clinical training for one year.

After finishing the fellow course, Kang began to work as a full-time lecturer at Johns Hopkins University Hospital in Baltimore from June 2013 and was promoted to an assistant professor in July 2015. When he moved to UCSF, he was hired as an associate professor in recognition of his career as a full-time lecturer.

“As soon as the third year began as a fellow, I sent many letters of interest in response wanted ads. I also sent emails to department heads of other schools introduced by my mentor. I even sent emails to any schools of my interest blindly. The applications letters sent recklessly failed to receive responses, but those submitted with the introduction of mentor could lead to telephone conversations at least. As there are so many openings in the U.S., you can get opportunities to start academic careers provided you build sufficient careers.

‘Nevert easy but challengeable’

Kang went to America in pursuit of his dreams, but things were never easy. Early on, he regretted his decision because of loneliness and English. As he got used to his work and had a family and a stable job, however, a sense of satisfaction replaced regrets. Kang met his wife while he was a fellow and the working couple has a child now.

“Sometimes, I wonder how long I could ‘live as a foreigner here.’ There are no outright discriminations, but I get a ‘sense of otherness’ resulting from cultural difference. However, I don’t think I could be free from such a feeling frustration even if I lived in Korea,” Kang said.

All this made Professor Kang want to help Korean doctors wishing to work in the U.S. cut back on trials and errors. That also explains why he delivers a lecture at his alma mater whenever he visits Korea.

“It is not easy to advance to the U.S. as a physician, but it is a challengeable task if you consider the balance between work and family life and has academic ambitions,” he said.