The Rumors Were True: An American Describes Med School in Grenada

Nicholas Genes, MD, PhD


November 09, 2006

Not getting into one's top choice for medical school is a scenario that every applicant must consider. But what about not getting into any medical school in the country? Some people who want to be a doctor badly enough turn to schools in the Caribbean. So what is it like to learn medicine on a tropical island? One such student, "Topher," writes on his Web-log about being a Midwest transplant to Grenada. As he likes to say, "The Rumors Were True."

Dr. Genes: After reading your blog, the non-US med school track is looking better all the time. You are pretty honest about not doing great in college, but you also come across as a thoughtful writer and student, an intelligent observer, and thus, probably a good medical student and future physician. Any regrets about this path so far?

Topher: I cannot speak for [other US citizens studying medicine outside the United States], but I have this feeling that the US system missed us, that we somehow fell through the cracks and should have been accepted. Looking around at my classmates and being floored by how bright they are and how interesting, I feel like they, too, were missed. One of the running jokes during orientation week was, "I got a 34 on my MCAT...that's how much fun I had in school." This student was obviously brilliant but was too busy at night to carry a GPA by day. Rejected. Many people here have the brains but weren't serious students when it mattered, so when it came time to compete against people who had been diligent throughout college, they understandably lost out.

But eventually these people are so serious about their education that they leave the country and take on a $150,000 debt to prove it. As a consequence, you get to meet some amazing people just as they're realizing their potential. They also know that when they return to the States, they're going to have to prove themselves to anyone who looks down on a Caribbean student. I've had the opportunity to be a voice for my school and to attract students to the Caribbean who might have thought medicine was a closed world to them. I've done some interesting research on cadavers, and I've met some of the authors of my medical texts at a research congress. It's tempting to think that I would have accomplished similar things if I had been accepted to a school in the United States, but I know that's not true. This was a special place for me to start medicine. No regrets.


"Topher" at The Rumors Were True hosts Grand Rounds
November 14, 2006

Dr. Genes: Do you anticipate future prejudice from doctors who graduated from American schools? Back when applying, we heard some negative comments about the Caribbean; are those rumors true?

Topher: The "rumors were true" is my little joke about the expectations and prejudices that I'm going to face. The truth is, I don't know the punch line yet. I expect to face prejudice both in and outside of medicine, but I don't expect any of it to be sincere. Prejudice is a shortcut around nuance. People know that it's harder to get into medical school in the United States than it is in the Caribbean, so you can assume that I was somehow inferior to other applicants. Fair enough, but you cannot know how I was inferior, and that matters. In my case, it was largely an issue of an uninspiring GPA and global immaturity. My grades have since risen and I've matured, so what's the difference now? In 2 more years, I will have passed the Boards, earned an MD, and matched into a residency. After accomplishing so much, it will be frustrating to have people still judge me on what amounts to my grades in college.

Before deciding to come to Saint George's University, I researched it, met with alumni, asked the doctors in the hospital what they thought about the school, and so on. I had a lot of information in front of me before I made the decision that the school was worth the trip. I don't expect everyone to do the same, so I can understand that people have a prejudice. The best thing that any of us can do is to become positive representatives for the school, and I hope that I'm doing my part to help that along.

Dr. Genes: Your blog started out like a collection of letters home, before turning out gems like Anne and Cracked Lips. How did you get your start, and why did your writing change?

Topher: I actually started the blog as a place to hold my letters home. It was originally all done by email, but I ran into the problems of people accidentally deleting them, or others hearing about the letters and wanting me to send them all the ones they had missed. The blog was just the best solution. So, I would write these letters home once every 2 weeks and fill them with the best of my experiences and try to keep them funny and light.

It was then that I discovered [defunct medical student blog] "Purrty Gud," and everything changed. It's a dead blog now, but the archives are still up, and it remains one of the best and most achingly honest blogs about what it is to be a person in medical school. Reading it was like being in high school all over again and finishing Catcher in the Rye: I felt like a phony.

So, I soured on trying to write for a laugh, and "Anne" was one of the first things that I wrote where the goal was to just let go and be honest about how bad I felt. "Cracked Lips" was another one. Since those heady days, I've tried to find my own balance between showing the rust and the shine of medical school. I've had some success and failure with it, but I have no idea which is which.

The "Welcome to Grenada" document represents the best of what I've done. Students considering Saint George's University and attending the school have told me that it helped them make some of their decisions; it's now a part of the admissions materials and occasionally funny. Out of everything, it's made the most difference to other people.

Dr. Genes: This week, Grenada becomes the center of the medical blogging world, when Rumors Were True hosts Grand Rounds, the collection of the best in online healthcare writing (the link to Grand Rounds goes "live" on November 14, 2006). Be sure to check out Topher's archives, and enjoy his portraits of medicine from the eyes of a foreigner, as well as his insightful letters home.

Around the Blogosphere

Of course, Grand Rounds features writers from every corner of healthcare, but with this week's host being an American attending school abroad, we'd be remiss if we didn't catch up with Mexico Medical Student, who hosted Grand Rounds this past summer. He recently wrote more on his frustrations with his school and reflected on a vacation to the beach at Manzanillo.

Another place to turn for insight into the life of medical students is Medscape's own The Differential. Recent entries include a new member's impressions of her Caribbean medical school. Another notable post details how Iranian medical student Ali Tabatabaey took some solace from the pages of Harrison's:


No greater opportunity or obligation can fall the lot of a human being than to be a physician. In the care of the suffering, he needs technical skill, scientific knowledge, and human understanding. He who uses these with courage, humility, and wisdom will provide a unique service for his fellow man and will build an enduring edifice of character within himself. The physician should ask of his destiny no more than this, and he should be content with no less.

Those words still ring true, and are especially inspiring as we read the thoughts and observations of this new generation of medical students on their journey to becoming doctors.


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