Dr. Harkinder Khangura is a Harvard-trained, double board certified medical doctor who practices in the Vancouver area and is a clinical instructor at the University of British Columbia. In this episode, Dr. Khangura shares her experiences of moving away for medical school including the cultural, societal, and professional barriers to she had to overcome in the process. We had a great chat touching on various topics from education, spirituality, mental health, and personal growth.
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Dr. Harkinder Khangura on The Grind of Medical School, Training at Harvard, and Importance of Being Kind to Yourself
Thank you for joining me again. I know there are a million other things you could be doing right now, so I truly appreciate you spending this time with me here. As always, I'm trying to bring on guests that can inspire us and show us aspirational goals for us to grow personally and professionally. Our guest definitely hits the target on that. She is a double Board-Certified Doctor in Internal Medicine and Geriatrics in the US. Here in Canada, she is Royal College-Certified in Internal Medicine.
After studying abroad at St. George's University, she did her Internal Medicine Residency at the Albert Einstein School of Medicine in New York and then her Geriatrics Fellowship at Harvard Medical School in Boston. She's a full-time Internal Medicine Staff Doctor here in the Vancouver area and a Clinical Instructor here at The University of British Columbia. She also happens to be an avid traveler. Please welcome Dr. Harkinder Khangura. Thank you for coming to the show.
It's quite the intro. Thank you.
It's all fact and well-deserved. You've done incredible things already. When you read off a list of accomplishments like that, certifications, and all these things it's deserved, then it's easy for somebody to say, “She's done a lot. She's achieved a lot. She must have been a smart person who followed a direct line to med school and beyond.” The reason you're here is because you did not follow that direct line. In fact, it was anything but.
It's valuable for aspiring doctors and any professionals to know your story and learn that there may be setbacks or detours along the way. It's important not to get discouraged and to try to make the most of it, which is one thing I know you do, is make the most of all your experiences. Why don't we start with where that path to medicine began? We discussed high school is where you wanted to begin that. I'd love for you to start to share that with us.
I've always been an ambitious, driven person. I always strive to be the best in everything I did. That came with good grades all throughout high school. I played a lot of sports.
High school athlete of the year, is that right?
Yes. Is that something to be proud of now?
You’d be humble not to mention it.
When you're so young, you decide your career path. I loved Sciences, so I thought, “What are my options in Sciences?” Children these days have a lot more options than we did. It was being a doctor, lawyer, being a cop or those kinds of options. For me, I was like, “I can get these grades. I should be one of these things.” I loved Sciences and I loved helping people. I thought that going into the medical profession was a career for me. I was at a young age. I was sixteen when I said, “What I do in life in my career is going to dictate my happiness if I choose the right path.”
That's a heavy insight at sixteen. I was not thinking about that at sixteen years old.
I went for it. The only inspiration I had at that time was my family doctor. We had a good relationship with him. He's now retired, but he was such a kind soul. He always listened to us as a family and he loved learning about our culture. He was almost like a father figure in a way. He was the only person I knew that was in the field. I looked up to him and I thought, “This is probably what I do as a career.”
I set a goal and was going for it. I graduated as one of the top of my class. I did have some scholarships. I had an entrance scholarship. I was lucky that I had a couple of years of my undergrad paid for. My plan was to go to SFU and then go to UBC for med school to change it up because I thought if I went to UBC right off the bat, I might get bored.
First of all, a common theme throughout Harkinder’s life is, “I would do things, so I don't get bored and make decisions.” That's good, too. SFU is Simon Fraser University. There are two main major universities here. There are a couple of others that have grown up as well. Simon Fraser is where I went for undergrad. The University of British Columbia is the bigger university out here. Your thought was to go to SFU for a few years, get that experience, and then go to UBC. There's only one medical school in this area and that's at UBC.
At the time, it had 125 seats. That's it. I graduated from Simon Fraser with a major in Cell and Molecular Biology and a minor in Kinesiology, and then I tried for UBC. I was coaching Friday night basketball. I was volunteering at all these different places. I was in the Big Sister program. I also had a job. When my colleagues in med school talked about their college experience, it was different from mine. It was a lot of hard work. It's not easy getting into a Canadian medical school here.
Only knowing my family doctor and not having any guidance from anywhere else, I did feel lost. I was like, “If I don't get into UBC, then what? I should have maybe gone to UBC for my undergrad and I maybe should have gone to a different province because then I would have had a competitive playing field in both these provinces.” All these thoughts were going through my mind. It was then I started to look at other options but didn't know anyone that had left Canada to go to school abroad. People had said, “You can kiss Canada goodbye if you do leave.”
Being that young and being from a small town, the thought of leaving your family, your loved ones, and your support circle to go somewhere to pursue this passion or career of mine was definitely frightening. I remember sitting there and asking myself questions like, “Why do I want to do this?” That sixteen-year-old girl picked this. “Am I doing it because I told people I wanted to go to med school and I didn't want them to think I failed? Am I doing this for the financial benefit, the reward? No, there are so many other things I can do to achieve that. Am I doing this because I truly want to be a doctor and I truly want to help people?” When I dove down and answered those questions, I was like, “This is definitely something I want to do,” and then figuring out how to go about doing that.
That's incredibly insightful. How old were you when you ask yourself those questions?
I was in my early twenties. When I was struggling with the fact that getting into UBC was difficult and it didn't matter if I had all these grades or all this volunteer work, I may still not get it. What made me sit down and explore other options was I had graduated from Simon Fraser and my male cousin had just gotten married. My dad sat me down like a good Indian parent would and he was like, “What are your plans? Are you getting married or are you going to med school?” I was like, “Oh my god.”
Those are the options. There's nothing in between.
I was like, “I am going to med school,” and then I went.
It was no longer gray like, “Should I leave the country or not?”
I was like, “I'm going.”
There's so much there that I want to touch on. Number one, that's about as well-rounded of a student as you can think of. Volunteering to multiple places, good grades, active athlete, and all these kinds of things and yet, it's still such a struggle to get into a good medical school here in Canada. It's something that's irked me for a long time because there are extremely talented, educated, motivated people.
Medical School: Pushing yourself to the limits allows you to experience what every place has to offer. This connects you with other people in a different way.
For many years and probably still now, there's a stigma about going abroad. Young people are feeling this incredible stress because they're like, “Clearly, I'm not worthy for some reason to get into a school here.” I'm seriously frustrated with the Canadian system here. I don't know who's ever going to read this. Somebody who's going to make some big change at UBC, “Harbir said we have to add more people.”
This unnecessary stress on extremely educated, talented people who then say, “I'm going to look like I'm not as worthy because I went to school abroad,” they decide not to follow their passion and their career path is incredible to me. One of the reasons that I am so excited to have you on is because you are a shining example of the fact that there's nothing less about going to school abroad.
In fact, I'll say this because you won't. You're significantly more certified in everything else more than other people who went to school here. I'm not trying to put anybody else down. It's more to say for that student who is looking at those options, you're a good example of that. Your options are to get married or go to school and you decided to go to school abroad.
I looked into it a little bit more. Right after that question, I was like, “I don't even know if my parents are going to support this. The tuition is more and here I am asking to leave the country for at least four years.” It's funny because I didn't even know that we have to do a residency after. When I sat down and asked my dad, “I'm thinking about this and I want to go abroad for med school because I don't know when I'm going to get into.” It wasn't if. It was when I was going to get into UBC. I didn't know what he was going to say. My parents are amazing. They've never shut down any opportunities for us.
I remember feeling scared because I thought, “What if my dad says no, then I have to get married?” He said, “You've worked extremely hard. This is what you want to do. This is what you've always wanted to do. We support you.” I even said, “People are saying, ‘You could kiss Canada goodbye.’ I may not be able even to come back here.” He was like, “We'll cross that bridge when we get there.” He's like, “If you have good intentions, you will always achieve what you're intended to achieve.” I didn't think about it. I packed my bags and I went.
That takes a lot of guts to do that. It takes knowing what your end goal is and accepting what happens next. First of all, to touch on the cultural side of things here, we're in 2020 and now you're telling this story. There's probably a lot of people who are like, “You have to ask your dad if you can go to med school.” That was many years ago. There are cultural traditions and beliefs in place that you were breaking. Now, people are coming after you, so you had also to put that weight on your shoulders. It's amazing that your parents were so open to you doing that. You first moved to the UK, right?
Yes. I started off my med school in Newcastle. Every time I meet someone from England, when I tell them that and they're not from Newcastle, we joke about the accent. No one can understand that accent. I remember I was this ambitious child. I was the first one there. None of my other med school colleagues showed up.
I took this overnight bus from London and I got there early in the morning. I'm hungry. There are no iPhones. There are no Google Maps. I remember sitting in this room and being like, “I'm hungry and I want to eat.” Finally, my roommate wakes up and she's Geordie. I want to ask her where I can go to get groceries and food. I don't honestly understand a single word she says.
I'm not a girl that cries but I remember sitting in that room back there hungry and tired, miles away from my family and being like, “Did I make the right decision?” I definitely had that fear kick in and be like, “So far, I've committed and this isn't maybe going as planned.” Shortly after that, I wiped those tears and I walked out of that building and figured it out. It was such an interesting time where you didn't have access to the internet like we do now. You had to ask people and figure things out. My colleagues came, and then it was one of the best experiences of my life afterward. Med school is memorable for me.
I wonder if we can somehow share some of the stories along your medical path at some point. Can you go back to that moment when you're sitting in the room and you're upset and crying? Do you know what happened there at that moment when you flipped the switch? Can you guesstimate what you're thinking and what helped? I guarantee there's a lot of people who go through that in different scenarios.
You make a big decision and my parents are supporting this decision, so self-doubt kicked in. I’m thinking about, “Was this the right thing or the wrong thing? I'm so far from my family.” Going back and being like, “I'm here for a purpose. I'm here because I wanted to do this. Let's get out, wipe these tears, and get it done.” I needed to cry it out for a little bit, and then I did go out there and figure it out. It wasn't as bad as I imagined it to be. Kids that leave their support system and go somewhere to a different country at such a young age, you grow so much. Even at that moment, I grew as a person. That's admirable to be able to then go to med school and come back.
Overcoming that fear and being able to tell yourself, “Take that first step,” is so key because a lot of times you realize the thing you're afraid of wasn't that bad after all. In fact, because you overcame it, now things are amazing. That often applies. The UK to the Caribbean to New York.
I made the most of every experience. I traveled to the UK. In Grenada, I got scuba certified and I barely know how to swim. I love a good challenge. I pushed myself to the limits and experienced everything that every place had to offer. It allows me to connect with my patients, connect with different people and do well in my interviews. There’s the stigma of going to school abroad, but the experiences that I got from them made me a better candidate in some of these places.
Instead of taking that straight line, there was a different path laid out for you. I want to go somewhere with this a little bit and this spirituality as much as you're comfortable. Tell me about that. Instead of a straight line, it was a different path. How do you feel about that now?
I'm a believer that everything happens for a reason. I am religious. I do pray and I do think there's someone above us. That's maybe dictating certain things. You do have to work hard. I had this plan of me graduating from high school, going to SFU, and going to UBC. The plan was made so that I wouldn't get bored and I would experience different universities. It looks like the guy up above had a way different plan and a better scenic plan for me. I got to live in three different countries before coming back to Canada and doing exactly what I would have done had I gone to school here.
Instead, I got to travel, meet people from different parts of the world, do things that I would have never considered doing here like getting scuba certified, and then living in such an amazing big city like New York. You meet all sorts of people from all over the world. Also, what was amazing about it is when you're so far away from your family, your friends become your family. You see the good in people and you see people be there for you when your family was so far. It is also important to realize at a younger age, so you can then give back and do the same thing for someone else.
It's a great insight. You can get that if you stay locally, but it's easier to get that if you leave the bubble. That was my experience, too when I moved to Boston to meet new people. It pushes your boundaries because you get so comfortable. You surround yourself with people that you know and think like you, and then when you leave, all of a sudden, you're coming across people who think differently.
Medical School: When you're focused on a goal, you typically have tunnel vision. Always take a step back and look at your life at the bigger picture.
It forces you to adapt and to learn how to deal with those people. Tell me about New York. We’ll shift gears away from medical. I want to talk a bit more about lifestyle. If somebody is going to New York, what are the 3 to 5 most important things they got to do? You haven't lived there for a few years, but from your experience when you lived there.
Be open-minded and talk to all those randoms that are trying to have a conversation with you. That's got a little annoying when I lived there. You're like, “I'm trying to have a conversation with my girlfriend.” You learn so much about different people. New York is so in your face. The energy is so amazing and people want to have a good conversation. It's completely random, but there's a lot to be taken from those random conversations.
Go to New York and eat. The food is one of the best, the cocktails, of course, and then shop. For me, it’s the people. Every day, you meet someone new from somewhere different. Doing something different and cool. Most of these people were ambitious and driven. They came there to achieve this goal or dream of theirs. It was fascinating to get to know these random people that you ran into. It could be on the street. It was everywhere.
I want too quickly share this story. I was like, “It's going to take up times interviews about you.” This is about you though. I was in New York a few years back. I happened to be there on my birthday and we went to watch a Giant football game. We got back into the city and it was late midnight. We were going to grab a drink at a bar and Harkinder disappeared randomly. The rest of us went into the bar to grab a drink.
By the time we've got a beer and we sit down, Harkinder is walking in the door with five random people and a birthday cake singing happy birthday in 4 or 5 different languages. Apparently, in the time that we grabbed a beer and sat down, Harkinder ran to a store and bought a cake and candle, which was still open at 1:00 AM. As she's lighting the candles on the sidewalk outside this random bar, a bunch of random people walk by and ask her what she was doing.
They started one of those conversations, and then they all decided, “We can sing happy birthday in German, Dutch, and Danish.” They all came and sang happy birthday to me in all these different languages. That was the day that I started to love New York. That 100% sums up everything you just said. New York is amazing. We've established how incredible it can be and have visited five times. I am finally a fan of New York City, not the football team.
Of course, you’re not. I’m a fan of Giants. I do have to mention this. He’s a Patriots fan. I don't blame you. It’s a perfect record streak. Brady can never beat Eli Manning in this Super Bowl. It’s one of those things. I totally understand.
I'll let you do it. It's fine. It's your interview. I want you to enjoy this. I'm not going to get bogged down in how Brady's the greatest quarterback in history and we won six championships in that period of time. It's all good. You then moved to Boston and you were there for a year. What was that experience like? You were training and you're doing a fellowship at Harvard at Beth Israel or Brigham and Women's?
Both. It’s a combined program at Beth Israel, Deaconess Medical Center, and then also Brigham and Women's. When I moved there, it’s a new city and I had to take my internal medicine boards. The summertime was stressful for me, and then the winter was one of the worst winters I’ve ever had. It was amazing being around such intellectual people.
My professors and my mentors were all amazing people that wanted to do so much more than just be a doctor. It was good to get that exposure. That's what I took from there. Boston is a lovely city but it made me realize that where your friends and family are is what makes the city amazing, so I would find myself in New York often over the weekend.
It’s not that long of a drive.
It’s 4 to 5-hour.
It’s longer than it used to be. You had a great experience there training at one of the most prestigious institutions in the field, and then you came back home. You've been away for 8 or 9 years and not the four years you told your dad. What was it like coming back home personally and professionally? Somebody told you to kiss goodbye to coming back to Canada as a medical doctor. Yet, of course, here you are. What was that like?
When I first came back here, I was like, “Why did I want to come back?” Sometimes, when you're focused on a goal, you have this tunnel vision. It's important always to take a step back, look at your life, the bigger picture, and ask yourself along the way, “Why am I doing this? Why am I wanting to come back home?” When you do that, then it makes sense.
To leave two big cities and move back to my smaller town city was definitely challenging. I was a different person and my circle of friends grew in different ways. Before coming back to my internal medicine residency, I did a four-week rotation at Vancouver General Hospital. There, they told me, “We need you to come back. You’re a female Punjabi doctor. There's a huge need for you back here.” I assumed I was going to walk in and get a job. I didn't have a lot of time to look into it.
I had prepared the college licensure with the Royal College. When I got back here, I realized the market was saturated for internal medicine. There were no jobs. Even though there was a need, I was like, “Now I have to work even harder than I probably ever had to get a job.” To go through all that, be back here, and be jobless was probably one of the hardest things I had to deal with.
I emailed every head of the department and knocked on a lot of doors. Whenever I got an opportunity, I went in there with a big smile with my work ethic. I was there late and I was there early. I did what I could to secure a job. It wasn't an easy transition, but it doesn't have to be that hard either. My timing was probably not the best. There are opportunities now. It goes to show you that if you work hard, you can always get what you want to end up getting. It did take a lot of hard work and it wasn't easy. I probably worked harder than I did in residency. If anyone is in residency, you can imagine how much work.
Medical School: The reward you get after a hard work is truly indescribable and offers an amazing experience.
That might ring some alarm bells for some people right there. I'll speak for myself, if you think of a medical doctor who goes to school and does a residency, you get a job. What else is there? Clearly, there was a lot of other stuff that had to go in there, like knocking on doors, cold calling people, and cold emails. That's not the type of stuff you think of when you think of a medical doctor, but it’s applicable to anybody in other professions as well.
Whether you're an entrepreneur or starting another business, a big part of it in the beginning is putting yourself out there and being humble. That work ethic side of things is important. Before we fully wrap up, I usually ask a couple of big questions in the end. I want to ask you a couple of quick light ones. You travel lots and I know you have a map. How many countries have you visited?
It's 23.
Which one is your favorite right off the top?
When I travel, I crave experience and I crave culture. I want to learn something without having to open up another book through people and through conversations. Morocco was my recent trip because it was in Africa. There were lots of cultures there. The food was different. The architecture was beautiful and their way of life was different. It was amazing being there. Without going online and reading about it, you learn so much through the people. We sat with the people and interacted with them a lot and heard about their stories. They got to know us, too. That would be one of my favorite recent trips, but there are lots.
Because that's the more recent one, it's off the top. With work, what's the longest shift you've ever put in over your residency, whatever period of time?
We do 48-hour calls still.
Even now?
Yeah. Those calls can be busy with about three hours of sleep sometimes. You get naps in here and there. That would be the longest. In a week, there can be tons of hours of work.
You then get to go to sleep after that 48 hours usually. What would you say is a common misconception with what you do workwise? As an internal medicine doctor, what would you say is something that you would clarify as what you do as an internist?
DN. I get lots of phone calls and lots of questions. We all have our areas of expertise. Mine is more like internal medicine, like if you have heart disease, diabetes or if you're in the ICU, and things like that, so people come to me with a little bump. I think people don't understand what I do.
Random questions here to get checked off my mental list here. You have been an athlete your whole life. What's your sport of choice?
I haven't played recently, but it's been basketball. I played basketball throughout high school. I even played on men's intramurals in med school. I played street ball with the guys in Brooklyn. Basketball is definitely the sport. It's difficult to do team sports and organized sports now. I ran a half marathon and I did a 200-kilometer bike race for Ride to Conquer Cancer. I definitely still live an active lifestyle. I went on a one-week kayaking trip one summer.
I find different ways to be active and it's important because I often will tell my patients to exercise. I say, “If you lose the weight, we can get you off your blood pressure or diabetes medications.” It's a big part of who I am, so it's easier for me to preach that. Sometimes, they'll turn around and be like, “Do you exercise?” I'm like, “Yes, I do. Even when I'm on a 24-hour call, I get my 30 minutes in.” I'm proud to say that. You have to lead by example in order for people to do what you want them to do and to follow. I still try my hardest. I’m not perfect, so there are periods where I might slip off and not exercise for a little while, but I will always try to do active things.
The bigger questions that I like to ask at the end, number one is, if we could hop in a time machine and you could go back to any point, you don't have to tell me specifically, it could be general, what advice would you give yourself?
If I went back, I would go back to my early twenties before med school, where I was doing everything right but not getting the outcome that I was hoping for. Working extremely hard, getting good grades, and volunteering to have this application for med school but still feeling like it wasn't enough. I've always been ambitious and driven, so little type A self-critical personality there.
I was so self-critical during that time like, “I should have done this. I should have done that.” It was a lot of that and it provoked a lot of anxiety because the future was so uncertain. I had to work so hard for this one goal. I would tell myself that I'm doing a great job, which is so rare to be kind to yourself. As long as you work hard and you have your goal in mind to keep focused.
Medical School: In any profession, nothing comes easy. Be sure to take advantage of a good support system whenever you can get it.
I was lucky I had such a good support system. I take that moment and apply it to my life now. I wanted to go to med school and I did go to med school, maybe not the way I wanted to. I'm doing exactly what I wanted to do but I've had this enriching experience. It turned out okay anyways. It's unfortunate that I was feeling all those things at that time. Hindsight, it’s 2020. That's a good learning experience for me because now I can be like, “Life is not perfect, but be happy with the cards you’re dealt with. If you stay focused, things will always turn out the way you envisioned them to.”
That anxiety side of things is all too common. Unfortunately, people get down when things don't feel like they're going according to plan. That's great advice. Of course, for anybody else out there who might be in that position, remind yourself that you're doing all the right things and you're doing a good job, and eventually, things will pan out. The last question is everything you've achieved and you have achieved a lot now already, how much of that would you say is due to luck, and how much of that is due to hard work?
I'm lucky in the sense that I have amazing parents as my backbone that believed in me when I didn't believe in myself. I have an amazing set of siblings that are my cheerleader. I'm lucky in that sense, but when it comes to my career, I've had to grind and work extremely hard to get what I have. By hard work, I mean if I knew what I had to do, I don't think I would have done it.
I've written seven board exams, at least they range from 1 to 3 months of studying for each. This last one I took, I also didn't give myself a lot of time to prep for it. I would wake up at 8:00, have breakfast, study until lunch, and then study some more until a coffee break, study until dinner, and then keep going until 12:00 or 1:00 and do it all over again. It's a lot of hard work but the reward after that is indescribable. To work so hard for something and then to attain it is an amazing experience. I'm grateful for doing the grind and being here now. It definitely was a lot of hard work. I had a good support system behind me.
We have covered a lot of different topics and there’s so much value in there. Not just for somebody who's going to medical school or any other school, but anybody who's trying to build and grow professionally and personally. Before I officially sign off, where can people find you and reach out to you?
I’m no longer on Facebook, so Instagram.
Any last words or any other last bits of advice or shout-outs?
Anyone that's thinking about medicine, it is truly a rewarding career. The first time I realized that this is exactly what I wanted to do was when a stranger holds your hand and says thank you. It's so gratifying to be able to help people in this way. We certainly need more doctors. You do have to work hard. If you're thinking about it and you're wondering how to go about doing it, reach out to anyone you know that's done it and you can reach out to me. In any profession, nothing comes easy and you do have to put in the hard work.
Thank you very much. Wise words. As always, thank you for reading. I truly appreciate the support and the time that you take out of your day to spend with me here. If you took some value from this because I know there was a lot of value here, please feel free to share with some friends, take a screenshot, put it up on your Instagram Story, tag us, and let us know what you thought. On YouTube, hit subscribe and leave a comment. On the podcast app, hit subscribe and leave a rating. Thank you again and we'll see you back soon for another episode.
Important Links
YouTube - Dr. Harbir Sian
About Dr. Harkinder Khangura
Dr. Harkinder Khangura is a Harvard-trained, double board certified medical doctor who practices in the Vancouver area and is a clinical instructor at the University of British Columbia.
In this episode, Dr. Khangura shares her experiences of moving away for medical school including the cultural, societal, and professional barriers to she had to overcome in the process. We had a great chat touching on various topics from education, spirituality, mental health, and personal growth.