Extradition Repatriation

Things don't always work out as planned.

As the end of my second year of medical school hurtles imminently towards its electrifying conclusion (I say this only to stave off the dread of another firestorm of shelf exams), my placement for 5th semester has become increasingly pressing. I had three choices - stay here in Dominica and complete my 5th semester AICM (advanced introduction to clinical medicine) here at Princess Margaret Hospital in Roseau, Synergy somewhere in Michigan, or Miami - the ol' standby. Our choices were due sometime last week, and Nicole and I both chose to stay here. On my part, there were several reasons for this - perhaps the lion's share of which were summed up in the simple fact that I hate moving. Seriously...I think I have a type IV hypersensitivity reaction to placing things in boxes and bags only to remove them again in a few days or weeks. Another reason I wanted to stay was because it would give me more time to study for the comprehensive final exam, essentially the mother of all shelf exams, handed down by the NBME (National Board of Medical Examiners). It's supposed to give a fair estimate of performance on USMLE: Step 1 - perhaps the single most important test I'll ever take. Also, this is a third world country - I knew that I'd be allowed to partake in procedures that I'd only be able to watch on TV back in the states. Tied to that was my major reservation about staying down here - that I'd be learning third-world medicine and therefor be at a serious disadvantage when I went into clinicals, but that didn't really bother me; I can always look things up.

There was a little catch in the process, though - for those of us intent upon remaining in Dominica for the 5th semester, there was an option to do Peds and OB rotations down here. Now, these are rumored to be notoriously difficult to schedule in the states, and so the idea of getting them out of the way was quite appealing. However, Texas' requirements for FMGs (foreign medical grads - the term that applies to US citizens , such as myself who graduate from medical schools stationed outside of the US, used to differentiate from complete foreign IMGs - international medical grads) are strict indeed, and I wouldn't commit to doing rotations that may jeopardize my licensure in Texas. Thus, on my application, I told them that I'd like to if I could, but that I'd have to check with the Texas Medical Board to see if those rotations were approved. I haven't heard back from the yet, but I received an e-mail yesterday saying that preference for staying here would be given to those folks who committed to those extra rotations. Bummer, dude.

Or not - you see, that wasn't told to us. I thought it was based predominantly upon GPA - in which case, I'd have been able to go wherever I wanted. Something else they didn't tell us was that, if you committed to one of the special rotations and were chosen to remain in Dominica, and you changed your mind, you'd be subject to disciplinary action. Funny how they forgot to mention that little tidbit, isn't it? So I'm sure there were colleagues of mine thinking to themselves "I really want to stay, so I'll tell them whatever they need to hear - I'll just back out if I need to". Sucks for those folks. This is one of those things though that reminds me of one truth I've learned about Ross:

"If something looks like it harms students or doesn't make sense from an academic standpoint, it makes Ross more money." Let me add in this disclaimer, though - I do not lump together the faculty and the administration. I have the utmost respect for the basic sciences professors down here, and have been truly blown away by their intelligence and committment to the students.

I don't say this to be incendiary or bitter, but it is quite true. You see, this is a for-profit medical school that want to make money. Now, they make money by selling a product - medical degrees. If that product is faulty, the business fails, so it must be a fantastic product - Ross grads are just as good -if not better - than US grads. Some might say, then - if they were so good, why didn't they get into a US med school? Those of us who make it out of here are willing to fight and claw our way through all of the hoops before us; we all have chips on our shoulders - as the underdogs, we've got something to prove. We've had to fight every step of the way, and by the time we get to clinical rotations with our US peers, we're used to getting up earlier, staying up later, and working harder, because we're expected to not be as good, so we'll prove that we're better.

So Ross does provide a quality product. However, on the other hand, we have things that don't make sense. Why take people who, for whatever reason, didn't make it into a US med school, and give them shorter semesters and less time to learn the information? By doing so, Ross can squeeze in 3 semesters a year - adding millions to their bottom line.

There are more like this, but I only bring that up to make a point - why would Ross decide to surprise us with disciplinary action for backing out of doing rotations down here at PMH? Well, clinical rotations are difficult to come by for any medical school - it's not just us. However, the more rotations Ross can schedule down here, they fewer people they'll have to fill spots in the states. That means less overflow - fewer people complaining. If Ross can schedule more rotations down here, the shortage of clinical spots will not be as severe. And so, any student who increased the burden for clinical spots will be punished. Now we're all adults - we shouldn't commit to something we don't intend to complete, but the fact remains; I don't ever remember hearing about disciplinary action until after I'd submitted my application.

Nevertheless, I'm going to be back in the United States of America a few months earlier than I'd planned. I didn't want to go through the hassle of finding a car and housing, but it won't be that difficult to do - just a very small monkey-wrench in my plans. It'll get done, and I'll get to enjoy south Miami while I learn more about the practice of medicine - I'll get to go back to LA Fitness, the gym I fell in love with; Nicole and I will get to go back to Bacchus, the little jazz and wine-bar owned by the charming Columbian couple; and I'll get to see my family.

This is all for the best, I suppose - I've learned that if I ask God to give me His best, instead of what I want, things tend to work out better. So, I'm going to make the most of it.

Speaking of things working out, this past exam was the worst one I can remember, as far as the material is concerned. I can't remember being so stressed by the mountain of information - but in the end, it turned into my best exam ever. Let's hope I continue the trend.

Tonight, we've got the fourth semester banquet. It'll be nice to relax - kidney pathology is already too hectic. I spent the morning working out and teaching second semester kids about the abdominal organs and bloodflow. Pamplona has the running of the Bulls? Well, we've got the running of the bowel. Take your pick.