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Jan. 16, 2025, David Mitchell — As a woman, minority and new physician, Shruti Javali, M.D., had plenty of options when pondering leadership roles at the AAFP’s National Conference of Constituency Leaders. But there was little doubt which group the Saba University School of Medicine graduate wanted to lead.
“I fall into many different constituencies,” said Javali, who will serve as the international medical graduate constituency co-convener during the annual leadership development event April 24-26 in Kansas City, Mo. “The one I wanted to represent was the IMG group because that’s how I identify. Some IMGs dissociate themselves from that label because there is a history of stigma related to the words, ‘international medical graduate.’ My take on that is to confront it head on and talk to people who may not understand that stigma comes from a lack of awareness or understanding of who we may be and what our lived experiences might be. This was an opportunity to tell my story and to elevate the stories of others. It’s easy to relegate somebody to one label or one bucket as opposed to seeing all the things they are, including being excellent family physicians.”
More than 9,000 IMGs matched in accredited U.S. GME programs across all specialties in 2024, an increase of 8% from the previous year, according to the Educational Commission for Foreign Medical Graduates. IMGs comprised more than one-quarter of all matched applicants, including nearly 3,200 U.S. citizens.
“A majority of the international medical graduates that I trained and worked with are either Canadian or American or have had significant North American medical experience, not to mention extremely worthwhile international experiences that may get overlooked,” said Javali, who completed her clinical rotations at St Luke’s Hospital of Kansas City alongside University of Missouri-Kansas City School of Medicine medical students.
Javali, who completed her training at the Mercy Health Grand Rapids Family Medicine Residency in Michigan in 2020, said she was a “trifecta candidate” as a Canadian needing a visa and an international medical graduate who was couples-matching with her husband, family physician Adnaan Edun, M.D.
She was on the other side of Match interviews this winter during her first year as director of the Adventist Health Hanford/Sonora Family Medicine Residency.
“A new part for me has been the holistic review of applications,” said Javali, who had been core faculty at the program since 2021. “We’ve tried to do that this year and really look at not just scores but also at their lived experience. It’s a little bit more cumbersome in terms of the application review, but I think we’ve gotten some excellent candidates.”
Javali understands valuing the “lived experience” of applicants who might have taken a circuitous route to medical school. During a break from her fourth year of undergraduate studies at McMaster University, Javali was touring India with a Toronto-based dance company when everything changed.
“I hadn’t really planned to apply to medical school,” said Javali, who pursued a health science degree to appease her parents but was focused on classical dance as a long-term career. “I remember living a month and a half of what my life would have been like, which was eight hours of dancing each day. I was in the rehearsal studio. I was performing four times a week.”
Her rehearsal studio was near an orphanage, where she would see children come outside to play.
“I remember being at rehearsal and thinking, ‘OK, this can’t be all I contribute to the world,’” she said. “’This can’t be it.’ For lack of a better word, it felt a little self-indulgent. It was a huge trajectory shift for me.”
Registration is open for the National Conference of Constituency Leaders, which is a leadership development event for these underrepresented member constituencies: women; new physicians; international medical graduates; members who are Black, indigenous and people of color; and LGBTQ+ physicians and allies. The April 24-26 event in Kansas City, Mo., coincides with the Annual Chapter Leader Forum, which is a developmental program for chapter-elected leaders and chapter staff.
Javali spent an extra year in undergraduate school before applying to medical school. Her interest in global health led her to family medicine and ultimately to a rural, underserved community in California.
“My husband and I feel strongly about working with the underserved, as well in global health and resource-limited settings,” said Javali, who joined a group of U.S. health care workers on a 2023 disaster relief trip to Turkey following an earthquake. “It’s just another way we remind ourselves of why we went into family medicine. We’ve had the privilege of being able to serve on multiple medical trips overseas, both in residency and since we have been out.”
Javali is a member of the California AFP’s executive committee and president of its Fresno chapter. Her involvement in her state chapter led her to NCCL, where she wrote and advocated for a resolution that was adopted as a first-time attendee.
“When people are not involved or have never been to NCCL, it’s easy to think, ‘It’s just me. I’m just a family doc in my community, in my clinic. What impact can I truly have?’” she said. “I have never felt as empowered as I did at NCCL, and that’s why I keep pushing people, including my faculty, colleagues and residents, to attend NCCL so they can have that experience.”
Javali completed residency during the pandemic and wondered what she had gotten herself into.
“I was working in the hospital during the Delta wave as a brand-new hospitalist attending,” said Javali, who also served as a member constituency alternate delegate to the AAFP Congress of Delegates last fall in Phoenix. “It was just a disaster for so many physicians across the country. It didn’t look like what I had in mind when I set out to be a family physician. My connections to CAFP, AAFP and NCCL really helped. I don’t think a lot of people realize how the Academy and these type of activities can really help to fill your cup, rejuvenate you and remind you why you might have gone into family medicine to begin with.”