While many students are heading out to the bars on their 21st birthday, when Neeharika Muppa, a third-year UC Davis student, turns 21-years-old this upcoming November, she will need to have her F-1 visa by the time her current H-4 visa expires. This is a fact she stumbled upon only after beginning at UC Davis during her second year while talking to an advisor. And it is one that has changed the course of everything for her.

Unlike most of the 3,445 international students at UC Davis who started out with their F-1 visas, Neeharika started with an H-4 visa. Unlike the F-1 visa, which is issued to international students attending a university or college in the United States, the H-4 visa is issued to dependent family members of those with H-1B visas due to employment in the U.S. At 20-years-old, she remains classified as a dependent under her father, who is the holder of the H-1B visa and the sole provider in her family, but that will soon change.

“I had my whole life planned out,” she said as we sat in one of the offices at the Health Professions Advising Center. “But I learned that reality isn’t so easy.” For Neeharika, that was especially true.

While born in India in the city of Ongole, Andhra Pradesh, Neeharika has lived in both the U.S. and India, switching back and forth between the two countries for most of her childhood. After moving from India to Lake Erie, Pennsylvania, she lived there from the ages of three to five before moving back to India until halfway through second grade. She then moved to California until halfway through fourth grade, moved back to India for about a year and a half, and finally moved back to California where her family now resides in the Silicon Valley.

For most, the constant moves and inconsistencies would have been confusing and distressing. For her, her experiences in both the U.S. and India are what kept her childhood dream of becoming a physician alive. The lack of progress in India and the health disparities in both countries drive her to be the change she feels is needed. However, her change in status seems to threaten her dream. As many people know, getting into medical school isn’t easy. You have to have good metrics, meaningful experiences, and the right attributes for a school to consider you as a competitive candidate. Even then, during the 2017-2018 application cycle, only 21,338 individuals out of a total of 51,680 applicants, about 40 percent, actually matriculated to medical school.

It is definitely possible to get into medical school, but for international students, the process is that much harder because only a limited number of schools accept international students.

To get in, international students must be very competitive. Out of about 150 seats, there may only be a handful of international students. Furthermore, while non-international students only require about a 3.50 GPA to be considered competitive in most medical schools, they do not absolutely need research and can choose any major they’d like to study, which isn’t the case for international students. Neeharika must get a high GPA, be a science major, which dictates the types of experiences she can get, and do research within the hard sciences to be considered competitive.

While many international students understand that it will be a bit more competitive for them and take that into consideration from the very beginning, Neeharika didn’t even know that she’d be considered an international student when applying to medical school. “I thought I’d get my Green Card by the time I applied,” she told me, shaking her head as the murmur of students talking drifted through the door. However, according to her father, they wouldn’t be able to get their Green Cards, also known as Permanent Resident Cards, for the next four to five years. The card, which allows individuals to live and work permanently in the U.S., would have allowed Neeharika to apply like any other U.S. citizen. Unfortunately, it was too late to get one by the time she found out.

Her circumstances differentiate her from the typical U.S. applicant and the international applicant. Having not found out about her status and change in status, she didn’t prepare as most international students had since the beginning of college. It meant having to work that much harder to bring her GPA up and working at a faster pace than most, all while managing the normal challenges of being a college student and applying for her F-1 visa.

With so much pressure to succeed, much of which she placed upon herself, it wasn’t surprising to learn that she was stressed beyond imagination.

Her voice cracked as she spoke about the reality of finding out about her status. “International students have this high bar they have to reach, and I didn’t know I had to reach that bar until my second year,” she said, her eyes wide. “Knowing this, along with everything I have to do and with everything going on, I went through a lot of depression.”

Often, she felt alone in her situation, feeling as if she lost herself in the process. She wasn’t like normal students, yet she also wasn’t like most international students. In a university of thousands of students, this was a daunting and isolating feeling. The single person she knew in the same situation, her roommate, had cut her off for some unknown reasons not too long after she found out. And while she had her family only a couple of hours away, they didn’t understand the pressure she was under.

The loneliness, plus the challenges of her circumstances, caused her health to go down the drain. “I was gaining so much weight and losing hair from stress,” she explains. “But the thing was, I wasn’t even consciously aware of the stress.”

“It was a mess during my first two years,” she continues. “I was trying to handle everything at the same time with what I found out, and I just didn’t know how.” Knowing that she needed help, she sought out Anne Han, LPCC, LMFT, a counselor at the UC Davis Student Health and Counseling Services. While it did help her in a way, the sessions simply took too much time out of her schedule. With classes, studying for the MCAT, and her extracurriculars, she just didn’t have the time. “I kept telling her next week, next week, but I never went in again. The time it takes is a lot more than what I can put in.”

Now, she simply manages her depression on her own, knowing when to take a break from things when she’s stressed, a skill she had to develop over time. Yet, every once in awhile, episodes of depression sometimes still affect her and hinder her from her studies. As someone who knows her metrics aren’t the best, this can be a challenge at times.

Perhaps, if she had known about her circumstances earlier, things may have been different, but unfortunately, that just isn’t the case. However, despite being, as she claims, a pessimistic person,  she eventually realized she wasn’t the person she thought she was. “I didn’t see how capable and strong I am until I talked about my situation to others. It made me realize that I’m not dumb, but rather, it’s my situation.”

Ultimately, through her circumstances, she has slowly realized exactly what she wants to do in her life and continues to traverse every day with an open mind, something she had to develop along the way.

Speaking to her and watching as she managed the front desk at Health Professions Advising, greeting each student with a smile as they walked in, I’d say she is definitely right about one thing: she is a very strong woman. And this strength will surely continue to grow over the years.

When I asked about her plans now as she applies for medical school as an international student going straight through, she replied, “Honestly, at this point, I just hope to get in somewhere, and I’ll be happy.” And for now, that is enough because, with the constant ups and downs of the past two years, she has realized that you can never take anything for granted as you never know when life will set up hurdles. And as she put it, “Sometimes you just have to whack those unexpected hurdles out of the way.”