Tale of Two Journeys

On February 26, 2022, my wife, Kateryna Strubchevska, and myself, Marko Kozyk, touched down at Miami International Airport. The sun had set, and the city glowed with anxiety and promise. Not only had we arrived as Ukrainian refugees, but we were also newlyweds. We had two suitcases to our name. We also had hope. As trained physicians, we were preparing to apply to the United States’ National Resident Matching Program (NRMP). We vowed never to give up.

As refugees, we were at the mercy of the system, supported by the kindness of volunteers who would welcome us as members of their families without even knowing us. I cannot convey the depth of gratitude for their sincere words of support, providing a roof over our heads with steaming meals on the table, and, yes, the blessing of silence without warning sirens.

For Kateryna and myself, the war had brought our medical training in Ukraine to a full stop. We were genuinely afraid that we would never be able to practice medicine. Still, we had plans and did not lose hope to save our lives. We elected to flee to the United States. According to United Nations’ reports, more than 12 million Ukrainians left their homes.¹ We were very fortunate to find volunteers who welcomed us.

We were able to submit applications for the NRMP in time for the March 2022 cycle. The NRMP matches residency candidates with hospitals across the nation. The tricky question was if the NRMP would match us as husband and wife to the same institution, so we could be together. Fingers crossed.

Years ago, we had set in motion many plans for our future. By 2016, we dedicated our lives to the medical field. During our studies at Bogomolets National Medical University in Kyiv, we sacrificed family time and worked extra hours to set aside funds for the latest medical literature and newest resources. We were proactive in our academic work, producing publications, leading the students’ scientific clubs, and organizing international medical conferences.

Our professional passions led us to recognize the need and determination to take our medical exams not only in the Ukrainian language but in English as well. Our families and support groups had been behind us all the way, which proved significant in our ability to achieve higher standards and excellent results. We passed many international medical exams, including the United States Medical Licensing Examination (USMLE), which proved to be, quite literally, lifesaving. Through the USMLE, it was our intention to be on the cutting edge of medical technology and meaningfully contribute not only to medical science but also to our homeland. We have witnessed firsthand how the internet creates a world of medicine without borders and want to be a part of that. Physicians across the globe can access treatment protocols with the most up-to-date medical research from other countries.

In this way we also identify with our heritage, in that many Ukrainian scientists have likewise contributed over the centuries for the benefit of humanity. As examples, Ilya Mechnikov brought to light the process of phagocytosis, Selman Waksman discovered streptomycin and neomycin, Nikolai Amosov designed the first antithrombotic artificial heart valves, and Vladimir Betz located the giant pyramidal neurons of primary motor cortex. We are proud to stand on the shoulders of these great people and hope to one day provide broad enough shoulders of our own.

Once Russia’s full-scale invasion of Ukraine and the shelling of schools, nurseries, residential buildings, and shredded medical facilities began, we dropped everything to survive. The atrocities of murder and rape of innocents from Mariupol, Kharkiv, Chernihiv, and so many other Ukrainian cities are now well documented. Nobody knew which place would be hit next. Everything our parents gained in a lifetime of daily hard work was gone. Our only genuine hope was that we could continue to thrive as doctors and find a way to give back to others that which has been given so generously to us.

We are not the first people in our family’s history to become refugees. During World War II, our Jewish grandparents left their homes in Ukraine for safety in Siberia, Russia, because of the Nazi genocide against the Jews. Ironically, in the 21st century, my family flees Ukraine in the opposite direction, to save ourselves from Russian terrorism and war. The Russian army even bombed the Holocaust Memorial Park in Babi Yar, the location of mass graves of Jews killed by Nazis. Many countries in the world have legally declared Russia’s war against Ukraine as a genocide.^2,3

Such has been our dual journey as refugees and physicians.

Our 5 weeks in Miami with our American family stretched on forever, but March 18, 2022, finally arrived, and the fog was lifted around the NRMP. We were couple matched! We are embarking on a 3-year residency with Beaumont Hospital Royal Oak’s Internal Medicine Residency Program in Michigan. The dream of gaining invaluable medical experience in a state-of-the-art institution has become a reality.

Michigan is among the top 5 states in accepting refugees over the last decade.⁴ Being migrants ourselves, we recognize that refugees in general possess acute and chronic health conditions that differ from the general population. Refugees also face potential difficulty in obtaining access to the healthcare system, not to mention the language and cultural barriers they must overcome.

We regard ourselves as a part of a continuing legacy of medical professionals. In 2020, 24.7% of US physicians were international medical graduates (IMGs).⁵ These doctors have a great influence on medicine in the United States, employing their unique experiences from abroad by treating patients with different backgrounds. Like us, many IMGs have many challenges to overcome as medical doctors in the United States. Thankfully, the core principles of diversity, equity, and inclusion are deeply engraved within the US healthcare system. Diverse patients require a special approach to providing care that best addresses their physical and mental issues.

According to the Educational Commission for Foreign Medical Graduates, 10 Ukrainian physicians were selected for positions in US training programs in 2022.⁶ Kateryna and I are highly honored to be among them. For us, being physicians is an honor and privilege that allows us to make a difference in people’s lives as we provide help, care, and support. The knowledge we received in Ukraine and our unique perspective as refugees allow us to implement the latest standards of medicine as well as care for underserved populations and those with limited resources. We have also increased and improved our areas of expertise in ways too numerous to mention here. We are confident that someday our experiences in the United States will allow us to give back to our homeland and positively impact Ukrainian healthcare. We see ourselves as solutions to the problems of lack of medical attention and hope that the example of our success will encourage others in the future.