Dr Lisa WillettAbove: Dr. Pongtawat Lertwilaiwittaya, PGY-1

by Drs. Lizzie Francis and Bella Kalayilparampil

Q: Everyone’s all-time favorite question—Tell me about yourself!

A: สวัสดีครับ (Sa-was-dee-krub; Hi!) My name is Pongtawat Lertwilaiwittaya. "Hong" is my Thai nickname, but I decided to go by "Pong." I’m originally from Bangkok, Thailand, the capital city of Thailand famous for its elaborate temple and local Thai cuisine. I graduated from Siriraj Hospital, Mahidol University, Thailand. My U.S. residency dream started in 2018 after an inspirational visit as a Medical Genetics aspirant at the NIH (hence Maryland was my first state!). It has been a great pleasure to be part of the four-year Combined Internal Medicine-Medical Genetics Residency program at UAB.

Q: What was it like moving from Thailand to the US?

A: Thailand is a country located directly on the opposite side of the globe with 12 hours difference in time zone. Many things run backward. For example, the Thai language is read from right-to-left rather than left-to-right, and people drive on the left side of the road in Thailand while people in the U.S. drive on the right. So I would say the transition has been challenging in a funny way. In Thailand, there are only 3 seasons: hot (winter), humid hot (rainy/monsoon), and hyperthermic hot (summer). There was no tornado or snow; thus emergency alerts on my iPhone make me palpitate from time to time.

Q: What are the best three travel spots in the U.S.?

  1. National Mall in DC (The Smithsonian, especially the Natural History museum)
  2. Seattle, WA (Pike Market Place, Mount Rainer)
  3. Smoky Mountains, TN

Q: What are some things you miss about home?

A: Definitely Thai food. "Which Thai place is the best in Birmingham?" is the third most commonly asked question of me, and I would say that none is comparable to the real Thai food. What I loved even more is the abundance of fusion food that made Thai-Japanese or Italian-Thai food taste great. Being able to cook authentic Thai dishes is my short-term goal here. Watch out for my spontaneous dishes throughout the stay!

Q: What has starting residency here in the states been like for you?

A: Very challenging but it has been pleasant to see myself grow. I have learned "how to ask smart questions" from my attendings, "how to be more efficient" from my senior residents, and "bedside manner tricks" from my co-interns. The system encourages me to ask more questions than ever, be more evidence-based than routine practice, and have more faith in teamwork. I have grown to love and trust myself more in the past year. Residency here has been one of the best choices I made in my life, and I have been grateful for all the trust I receive from everyone in the program.

Q: You did a residency in Thailand right? How is it different from internal medicine residency at UAB?

A: Half-true. I did have a year of internship in a tropical disease institute after I graduated, and then a few months of internal medicine internship before I decided to do a two-year medical genetics apprenticeship in Thailand.

Internal medicine in Thailand has its foundation in the American system. Harrison's Internal Medicine textbook is very famous in Thailand and can be found in all physician rooms. In my opinion, the key difference between Thailand and U.S. residency is the healthcare system itself. Thailand has a "Universal Health Care Coverage" system (literally everyone is born with the equivalent of Medicaid/Medicare/VA support), and sometimes a single doctor was expected to run an entire hospital. It is not infrequent that a third-year Thai resident has done more than 100 intubations or 100 thoracenteses. Also, the prevalence of tropical and infectious diseases was higher. Dengue fever is endemic and malaria is not uncommon, so it was required to master the peripheral blood smear. Also, tuberculosis was the great mimicker. When in doubt, do IRZE.

Overall, I think the differences complement the training experience really well, and I am more than willing to help us bridge the opportunity to try something new in Thailand.

Q: What drew you to medical genetics?

A: I actually found my love in internal medicine before medical genetics. In the internal medicine realm, the diagnostic odyssey has been the most attractive aspect to me, and medical genetics helps navigate that odyssey. I first met a clinical geneticist and my lifelong mentor in my fifth year of medical school, and since then I have been drawn deeper and deeper into the field. Genetic disease hides in a differential of rapidly progressive dementia, "idiopathic" liver failure, multisystem organ inflammation/failure, and it has been very satisfying to discover something rare every other day. Genetics, and also genomics, will transform medicine in the next five years. It should be fun to work as an internist-geneticist in the near future.

Q: What has been the weirdest thing about American culture so far?

A: This is a tough one. The American culture has been very nice to me so far. I appreciate the culture of mutual respect here. It was more hierarchical in Thailand. The attendings and faculty treating us as colleagues is a whole new concept to me, and it is lovely. Ask Dr. Heudebert, I had a very hard time walking in front of him during rounds at the VA. In Thailand, juniors are supposed to walk after seniors and elders.

Q: What tradition have you enjoyed during your time here?

A: I think the time from Thanksgiving to Christmas is very special here. I did join one American Thanksgiving, and it was heartwarming (plus the food was delicious). Kenny and Ian brought the dinner for the on-call Thanksgiving teams, and it was very special for us all to eat together. My Tinsley month in December was also very festive (thanks to Bella K. and M. Fister who made it happen). I was one of the few to be on Tinsley long call both Thanksgiving and Christmas, but the tradition made the call wonderful, and yes very educational.

Q: Do you see yourself staying in the U.S. after residency?

A: I hope I will be granted the opportunity to stay. I am still undecided about which fellowship I should do. I will leave the door open at the moment, give it my best shot, and enjoy this precious moment at UAB.