I had over 60 publications. My resume was stacked, and I had my eye on the most prestigious Ivy League fellowship.

This was the dream I had worked towards for years. Sleepless nights, constant research, endless revisions. I was more than ready to stand out in the competitive world of academic medicine. Or at least, I thought I was.

When the interview day finally arrived, I was excited—really excited. Out of the 20+ places I was interviewing, this one was special. The chance to join the elite. It felt like the culmination of everything I had done.

But nothing prepared me for what came next.

The Interview That Made Me Feel Small

As the interview progressed, it became painfully clear: things weren’t going as planned. The questions were sharper, the tone more scrutinizing. Each answer I gave seemed to invite even more skepticism.

By the time it ended, I walked out feeling… crushed. Small. Really small.

Like I had somehow failed, despite all my hard work.

I blamed everything I could think of:

• I was an International Medical Graduate.
• English wasn’t my first language.
• My medical residency wasn’t from a prestigious university, but a community hospital.
• I lacked the guidance of a well-known mentor in rheumatology.
• And despite my 60+ publications, they questioned whether I had compromised my clinical training for the sake of research.

The voices in my head were relentless: Maybe I’m not good enough. Maybe I don’t belong here.

The Missing Piece I Had Overlooked

For days, I wallowed in self-doubt. I replayed the interview in my mind, over and over, wondering what I could have done differently.

After I was done blaming everything under the sun. Then one day as I was discussing how I felt with a close friend of mine, I stumbled upon something that I had not thought of before. I kept coming back to one glaring omission—something I had overlooked.

You see, during my residency, I had rotated at Johns Hopkins. It was a career highlight, one I was proud of. But despite all the hard work and the relationships I’d built there, I had never secured a letter of recommendation from my supervisor.

Could this have been the missing piece?

It was the kind of letter that would have spoken volumes about my experience, my skills, my potential. And I didn’t have it.

Then it was painfully obvious that the lack of it had played a big part in creating that doubt.

The Relentless Pursuit of a Letter That Changed Everything

I had no choice. I had to go after it. I had to find a way to get that letter.

So, I started emailing. I reached out to the fellows at Hopkins I had worked with. I tried every contact I could think of, every angle I could pursue. But nothing seemed to work. Days turned into weeks, and my inbox remained empty.

It felt like I was hitting one wall after another.

But I wasn’t ready to give up. I wasn’t going to let this one oversight derail everything. So, I kept digging, kept searching for a way in.

And then, finally, I had a breakthrough.

I discovered the attending’s secretary online and decided to make a bold move: I picked up the phone and called. I was nervous. What if they didn’t remember me? What if this didn’t work either?

But to my surprise, the attending did remember me—and more than that, he was more than happy to write me a strong letter. We had even published together during my rotation, and that connection made all the difference.

The Unexpected Outcome That Changed My Path

With the letter in hand, I felt a renewed sense of hope. Maybe things would turn around after all.

But then came the match day. No, I didn’t get into that Ivy League program. That door had closed.

But here’s the twist: I got into the Mayo Clinic. A place that I hadn’t even dreamed of before. And I’m certain that letter played a major role in getting me there.

Looking back now, I realize that my path wasn’t defined by the setbacks—it was shaped by how I responded to those obstacles.

The Truth About Our Journeys

Here’s what I learned, and what I want to share with you:

• We don’t all start from the same place.
• Our paths aren’t the same. Our challenges are different.
• But within those challenges lie hidden opportunities, ones that we can’t always see right away.

When we stop blaming external circumstances, and instead focus on what we can control, we unlock a power far greater than any roadblock in our way.

It’s not about where you begin—it’s about how relentless you are in overcoming the obstacles that stand between you and your goals.

Embrace Setbacks, Create Your Own Path

I know the feeling of failure. The crushing weight of thinking, What did I do wrong? Why wasn’t I enough?

But I also know the power of perseverance. The ability to rise, even when the odds seem stacked against you. And sometimes, when you embrace those setbacks, you end up somewhere far better than you could have ever imagined.

So, I leave you with this question:

Are you ready to take ownership of your journey?

Focus on what you can control, pursue what seems out of reach, and let the rest fall into place. Your path may lead you somewhere you didn’t expect—somewhere even better.