Well, I’ve officially finished medical school. I’ve been thinking about what I could possibly write to mark the end of this crazy train, and then I thought, I’ll just write about everything! What follows will be my most significant summarized chapters from start to finish of the insane, stressful, rewarding journey of being a medical student at the American University of the Caribbean SOM.
Pre Island Jitters
Before Tylor and I began this grand adventure, we were living together in our first apartment in Manchester Center, Vermont. I had graduated from Castleton University over a year ago with a Bachelor of Science degree and was working as an Emergency Department Scribe, gaining experience for my next pursuit: medical school. I had filled out all of the applications, taken the MCAT, and received rejection letters from everywhere I applied to, except for AUC and SGU.
Obviously I knew about the stigmas associated with Caribbean medical schools, and a lot of research went into my decision. I found that AUC was one of the “top 4” Caribbean medical schools to attend. All have impressive residency attainment rates, and because of student success, federal loans are available. AUC’s residency match rate fluctuates between 80-90 percent. I knew with those odds, I could push myself to achieve my dream of becoming a physician. Of course, my opinion might change if I don’t actually match into a residency, but we’ll cross that bridge when we come to it.
Anyway, AUC and SGU had both offered interviews, but because AUC offered smaller class sizes and I preferred St. Maarten’s living conditions vs. Grenada, I chose AUC. Living conditions may seem like a trivial thing to a lot of people, but where I studied medicine for the next two years had a huge influence on me. I wanted paradise, and St. Maarten was ultimately the perfect choice. After a brief interview in NYC and an acceptance letter 2 weeks later, Tylor and I prepared to leave behind everything and everyone we had come to know and love to move to a foreign country.
Arriving to St. Maarten
As I’ve mentioned in previous blog posts, I do NOT like change. I prefer a strict daily and longitudinal schedule, and variation from that schedule creates anxiety. Well, lets just say leaving the state I was raised in and moving to a foreign country with a different climate and culture was not exactly my cup of tea. Tylor, on the other hand, is always up for adventure. Granted he had some hesitation leaving Vermont, but after a few Google searches of St. Maarten he threw himself whole-heartedly into an “early retirement plan”.
When we first arrived, I was convinced we made a mistake. I walked out of the airport and was hit with a wave of humidity (something I would grow to love by the way) and the hustle and bustle of local taxi drivers. Like shark drawn to chum, they were frantic to stuff as many tourists into their mini-vans as possible before the next flight arrived. As a result, the drive to our new apartment in Arbor Estates was NOT smooth. The mantra from Dodgeball comes to mind – Dodge, Duck, Dip, Dive, and Dodge – an entirely accurate statement considering I almost threw up in the backseat. Finally, green in the face and accompanied by an unsympathetic Tylor laughing hysterically, we arrived to our new Caribbean home for the next 2 years.
Arbor Estates is a gated community about 3-4 minutes walking distance from AUC. We paid $1250 per month for a 1-bedroom apartment. Looking back, I probably would not have rented an apartment on the ground floor, because mosquitoes were a huge issue. Every time you opened the door, a swarm hovering nearby would be swept into the apartment by the draft and proceed to keep you up at night sucking sweetly off your blood. They didn’t like Tylor much, but hot damn did they like me. I tried everything from spraying myself with Off! multiple times per night to duct-taping probable holes in the screen door, to buying an indoor mosquito device that drew them in using UV light. Nothing worked. Would not recommend. Other than the mosquitos, Arbor Estates was a decent place to be. It was close to the school and Mullet Beach and that was all I needed. A tall gate surrounded the entire community and there was a security guard present 24/7.
Once medical school classes started, there wasn’t much time to get used to my new surroundings. I soon found myself fully immersed in material and trying not to drown. The first month of medical school was basically figuring out whether I was cut out for this gig. I walked in with so much confidence and was immediately torn down. I studied my butt off, and after the first round of examinations, I knew I had a chance to excel.
Here’s the general outline of courses for Semesters 1-5
- Molecular Cell Biology I
- Molecular Cell Biology II
- Physiology I
- Physiology II
- Pathology I
- Pathology II
- Introduction to Clinical Medicine
- Behavioral Sciences
Each semester had trials and tribulations. Whether a student found a class easier or harder was entirely up to personal preference. Everyone seemed to struggle with different material. The important part was finding the perseverance to keep pushing even after a subpar grade. As Tylor can attest, I had a few meltdowns. My lowest test score was a 52% in physiology II. I couldn’t believe it. I went home, turned on my shower, and curled up in a fetal position in the tub, convincing myself beyond all reasonable doubt that I would fail. Tylor joined me and comforted me for several minutes telling me everything would be ok. I didn’t believe him at the time, but after working my booty off and focusing on my weak areas in Physiology, I walked away from that class with an 80%.
I definitely wasn’t the smartest student there, and it was incredibly frustrating to study so hard for the block exams while others put in a fraction of the time and aced every test. You must learn early to let go of the habit of comparing yourself to others; it’s not good for your mental wellbeing. There will always be someone who will academically out-perform you in medical school, that’s just the nature of the beast. After all was said and done, I ended up with an 84%, placing me somewhere in the top 1/3 of the class.
5th semester is a relatively light schedule because of all the time necessary to prepare for the comprehensive or “comp” exam. Students must pass AUC’s comprehensive exam with at least a 69% (when I was there) to take the USMLE Step 1 exam. The comp exam is through Becker, where the questions are notoriously more difficult than those on the Step 1 exam. If you don’t pass the comp exam, students must take a pathology and a physiology examination, and pass both. If you do not pass pathology and physiology, AUC sends you to a Step 1 review course in Texas to prepare you adequately for Step 1. Luckily for me, I passed comp on the first attempt and had 3 weeks to explore and enjoy the island.
There are many wonderful activities to do on St. Maarten when you come across some rare but precious downtime.
First of all, the area is loaded with restaurants serving cuisine from all over the world. For such a small island, it really does have some good food. If you’re in the mood for something, more than likely you’ll be able to find it. Close to campus is Barcode, a popular and convenient place for students to have a sit down meal. BBs is also a very popular and cheaper option, especially if you’re trying to just pick up food and go back to studying. Now that I’ve returned to the island, many more restaurants have sprung up around campus. I have my work cut out for me!
Tylor basically became a beach bum while we were there, complete with growing his curly hair down to his shoulders. He spent his days lounging on the beach working on his nonexistent tan, swimming, and eventually spearfishing. Be careful though! Larger tropical fish bio-accumulate ciguatoxins, which can result in Ciguatera fish poisoning when consumed. Ciguatera fish poisoning can cause nausea, vomiting, and diarrhea, and is often followed by some neurological issues as well. Not a very fun thing to have, which is why I just flat out refused Tylor’s catch of the day, much to his dismay.
It was a sad day when we left, especially after spending 3 weeks with no medical school classes, just roaming and exploring our island together. There was so much that I hadn’t seen, and still after all of our adventures I missed so much more. But, life goes on and it was time to begin learning about the clinical aspect of medical school. Thus, we planned the next chapter of our lives in England.
The United Kingdom
I decided to do my OBGYN and Surgery clinical rotations in Epsom, UK because:
- I wanted exposure to another healthcare system
- I knew I wasn’t applying to OBGYN or surgery, so doing those rotations in the US wasn’t necessary
- The UK has a ton of hands on experience for medical students compared to the US, and I wanted to involved as much as possible!
Tylor and I found a cozy place in Epsom Downs, UK. It was a 10-minute bus ride to the hospital, or if you’re up for it, a 10-minute bike ride down a beautiful little trail. Epsom hospital was quaint and old, like everything else in England, but I had a great experience there.
The rotations themselves were pretty relaxed. You were responsible for your own learning, which I believe is how it should be. No one was there to document your attendance and you weren’t expected to adhere to a strict schedule.
At the beginning of my OBGYN rotation, I was given a handbook with the entire schedule for the month. I was able to pick and choose which events I wanted to attend, and tailor my schedule according to my interests. Turns out, I’m a huge fan of C-sections, and because they are scheduled, it was easier to plan my attendance compared to a spontaneous vaginal delivery. During the C-sections, the residents and attendings allowed me to scrub in and actively participate. They were great teachers and big fans of “pimping” the medical students. I learned and did a ton during my time there. I have no interest whatsoever in Surgery, so my time in that rotation seemed to drag on. I did see many interesting cases, but those were LONG days of just standing there observing.
Living in the UK for 6 months provided Tylor and I the opportunity to travel anywhere for cheap. Tylor visited about 15 countries while he was there. London is a fantastic (and cheap!) hub for travel. Ryanair often had flights for 30 dollars, and with hostels to stay in we barely spent anything while traveling. We spent about 1500 dollars total during a 15 day trip to Paris, Prague, Rome, Venice, and Barcelona and it was one of the greatest adventures of my life.
With a fiancé and dog in tow, I decided to settle down in Queens, NY at Moda Apartments with reasonable access to 3 different hospitals: Bronx Lebanon, NUMC, and Flushing. This way we could sign a 1-year lease at a pet-friendly apartment (so difficult to find in NYC!) and have some measure of consistency for a while. Now that Tylor was able to work, he found a great job serving tables at District Social in Manhattan. With a little more financial security we were finally able to enjoy ourselves a little more and ease up on the penny pushing.
Although only 15 miles from Bronx Lebanon hospital, it took me nearly 2 hours to get there in the morning for a 6am shift. The commute definitely had a negative impact on how I viewed the rotation, but overall, it was a rewarding experience and further reinforced my interest in Family Medicine. The surrounding community is very diverse and many of their patients do not have access to health insurance. The family medicine team didn’t turn anyone away because of lack of insurance, so I saw a variety of ailments during my time in both an inpatient and outpatient setting.
The majority of my rotations were spent at NUMC, including psychiatry, pediatrics, developmental pediatrics, emergency medicine, infectious disease, rheumatology, internal medicine sub-internship, and radiology. I love the hospital, the surrounding area, and the staff. With each rotation, I learned something vital that shaped my perspective as a medical student. I became competent in many procedures during emergency medicine. My knowledge in pharmacology was reinforced (and reinforced again) during infectious disease. I gained a firm understanding of autism and ADHD in children during developmental pediatrics.
My last rotation was Radiology (I saved the best for last!) and on my last day it was very surreal walking out of the hospital completely finished with everything. I had completed 2 years of basic sciences on St. Maarten, taken Step 1, Step 2 CK, and Step 2 CS USMLE examinations, and finished 2 years of clinical rotations spanning over the UK and the US. Now all that’s left is to apply for residency and wait the day I match into my future program.
Last day in our New York apartment! Brutie looks so confused.
Preparing for Residency
At the moment I’m preparing my residency application through ERAS and waiting for the interview season to begin. I’m applying to family medicine programs mainly because I’m in love with all fields of medicine and I simply can’t choose just one! I’m a big procedure person and particularly like OBGYN and Emergency Medicine, so I’m looking for programs with an emphasis in those fields. Also, any programs with Global Health electives are a plus, because the majority of my family is still in the Philippines and it would be great to set up a healthcare outreach program.
August 1st – 4th was the Annual Family Medicine Conference hosted by AAFP (American Academy of Family Physicians) in Kansas City, Missouri. I presented my case report there and spent many hours in the EXPO hall, where almost 400 family medicine residency programs complete with program directors and current residents were in attendance. It was a great place to network with potential residency programs, but make sure to come with a game plan! Otherwise, the whole experience can be very overwhelming.
In the meantime, I’m back in St. Maarten all set to work as an introduction to clinical medicine (ICM) fellow during interview season. It’s a pretty sweet gig and Tylor and I were both anxious to get back to island life. I wanted to do something productive with the 10 months I have until residency begins, and the Caribbean is the perfect place to spend them. It’s a great opportunity for both teaching and research, and the program is flexible enough to let me travel for interviews. AUC provides fellows with a 1-bedroom apartment as part of the contract, and Tylor and I have been living it up in Jordan Village for the last 3 weeks. Once I start I’ll be able to explain what I’m actually doing a little better, so stay tuned!
Our new home in St. Maarten!