Dr. Hamid Fazal — Professional Journey
Clinical training, research immersion, and a cross-cultural passage that shaped a career
A physician's formation does not happen in one country, one institution, or one season of life. Mine took me across an ocean — through the streets of New York, the corridors of research institutes in West Virginia, and the quiet discipline of preparing for examinations that would test everything I knew. This is that chapter.
I had already cleared the USMLE Step 1 and was awaiting Step 2 results when I began the process of applying for a US visa — with the intent to sit the Clinical Knowledge exam in Philadelphia. The US Embassy in Karachi was not conducting visa interviews at the time, which meant a separate journey to Islamabad for the interview. After the process concluded, I was granted a five-year, multiple-entry B1/B2 visa. The door to America was open.
My first American address was in the Bronx — rent-shared with fellow Pakistanis, modest and functional. New York was a proper initiation: its scale, its diversity, its rhythm that asks something of everyone who enters it. Living in one of the most competitive cities on earth, navigating daily life as a foreign-trained physician preparing for certification examinations, was an education in itself — far beyond any textbook.
I would return to New York more than once, each time with clearer purpose and deeper familiarity with the city and the medical landscape it sits within.
A detour away from the metropolitan corridor brought me to Pine Bluff, a quieter corner of America — and a genuinely different clinical environment. I undertook an internship at the Arkansas Surgery and Endoscopy Center, an ambulatory surgery center where the pace was disciplined and the clinical culture was notably different from anything I had encountered in Karachi.
This brief placement reinforced something important: the ability to adapt — clinically and culturally — across very different American settings, not just the well-resourced academic centres that tend to feature on a CV.
Charleston marked the deepest immersion of the American chapter. Over the course of roughly a year, I participated in clinical research at the CAMC (Charleston Area Medical Center) Research Institute — one of the region's leading clinical research centers. The work involved FDA-regulated drug and device clinical trials, conducted under the rigorous standards of Good Clinical Practice.
Working within the US regulatory framework for clinical research — FDA oversight, IRB protocols, informed consent procedures — was a formative experience that has informed how I approach evidence and patient safety ever since. The relationships and methodological discipline built here remain part of how I think as a clinician.
Returning to New York with the experience of Charleston behind me, I joined the Aging and Dementia Research Center at NYU Medical Center — a world-class academic institution with a distinguished research program in neuroscience and geriatric medicine. The fellowship deepened my understanding of academic medicine in the American context and placed me alongside researchers at the frontiers of their fields.
It was during this return that I also completed preparation for and passed the USMLE Step 3 — the final licensing examination — formally completing the full trilogy of USMLE certification.
A Defining Juncture
After completing the USMLE trilogy, I applied for residency training in Psychiatry and received an acceptance from Harlem Hospital Center in New York City — a municipal teaching hospital affiliated with Columbia University, with a strong tradition in urban medicine and psychiatry.
The process of converting a B1/B2 visitor visa to a J1 Exchange Visitor visa required returning to Pakistan — a standard procedural step. However, the visa conversion was not approved despite multiple applications and consistent effort to satisfy the requirements of the consular process. This was a chapter that did not conclude the way I had planned.
In time, I chose to redirect that energy rather than exhaust it on a closed door. The clinical acumen, research grounding, and professional formation built across those American years became the foundation on which I rebuilt a career in Pakistan — one that has now spanned nephrology, psychiatry, critical care, and community medicine across more than two decades of practice.
Steps 1, 2 CK, and Step 3 — all completed. Full US medical licensing eligibility established through the standard pathway.
Hands-on participation in regulated clinical trials at CAMC Research Institute — drug and device studies under full FDA and GCP protocols.
Research fellowship at NYU Medical Center's Aging and Dementia Research Center, one of the premier academic environments in the country.
Years of daily life across New York, Arkansas, and West Virginia — a practical, ground-level understanding of American culture, institutions, and professional norms.
A visual record of places, moments, and the everyday texture of an American life in medicine.
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