This time last year I was counting down the days until I’d be leaving for Grenada. One year later, I’m dreading the return to the island (less than one week before term 3 begins). I was very excited to pursue this adventure, and I am still stoked to be earning a medical degree, but I’d be lying if I said I enjoyed every second that I was on that island. I had no idea what to expect from medical school, and I read many blogs before starting this journey (Shout out to Kevin Ly – https://kevinlymd.com). My hope in writing this blog, is to help prepare future students for St. George’s University Medical School.

So, how did I prepare for medical school before it began? My friend Amy, a nurse that I met at St. John’s Medical Center and now a year four medical student, recommended that I take a medical school prep course before heading to SGU. It is called MSAP – Medical School Assessment Program. MSAP may be required, by SGU, for some students to complete, before starting school. I decided to take it to help me get my head back in the game, and it definitely helped me in my first year of medical school. MSAP is a four week program that covers a lot of different medical subjects. If I recall correctly, we had ten lectures a week, and then a 25 question test each week. The most beneficial part of taking that course, is that you get to see the material AGAIN when you are in med school. It definitely gave me an advantage in the FTM module. If you are nervous about starting school, I would wholeheartedly recommend doing this course beforehand.

I made it out of year one of med school with an A average. When I started medical school, I was definitely scared. At SGU, you end up taking out close to $80,000 your FIRST YEAR of med school, so I felt a great pressure to be successful due to financial obligations. I also had my low MCAT score hanging over my head, and was definitely worried that I may not be cut out for medicine, since I never did above average on my MCAT. Not to mention, I had been out of school for nearly three years! I remember the first month of med school, I kept telling myself, “failure is not an option.” Not only could I not afford to fail, my pride would have had a hard time recovering from the sting of both a low MCAT and failing out of Caribbean medicine. So, with my dry erase board and markers I headed to Lower Modica study hall (South side), where I would spend the majority of my “free” time studying for the exams of term one.

This is the view from Open Modica – shout out to Liv for the pic! Not a bad view for a study break!

Term One at St. George’s University is organized into modules. Module 1 is FTM or foundations to medicine where you learn everything you learned in undergrad, plus some more, and it is super fast and really detailed. FTM is split into two tests. Module 2 is MSK – or musculoskeletal where you learn all the body’s muscles, nerves, vasculature, etc. Its a 3-4 week anatomy course with many cadavers and lots of Grey’s Anatomy practice questions. From this point on until the end of term 2, you will not only be responsible for lecture exams, but also cadaver exams on the same day of your lecture tests. Module 3 is CPR – Cardiopulmonary renal. It’s split into two separate tests, one is cardiovascular, and the second one is pulmonary and renal combined. I forgot to mention, everything is cumulative, so cramming will not be effective. The information that you learn, never goes away, and you will forever be responsible for every word on every slide. On top of five major exams throughout the year, we were also responsible for a weekly quiz of twenty questions.

Before school began, some of the students were chosen to be placed into AEP – academic enhancement program, which is another requirement to maintain. AEP is a program for the students of SGU; it requires that one night a week, you attend an AEP session. At AEP, you have 1-2 peers, that are ahead of you in the program, guiding you through your first term of med school. At first, I felt ashamed that I was in AEP, but it actually turned out to be very beneficial, and now I teach my own cohort with Gabriel Scally! I still reach out to my AEP cohort leaders, and I am grateful that they helped me better understand how to prepare for each exam.

We started class on August 21, 2017, and I was so excited the night before that I could hardly sleep. I was FINALLY going to start med school. A journey I’d been fantasizing about for YEARS! The first day of lecture was four hours long and started at 1 pm and lasted until 5 pm. That’s a lot of lecture to sit through straight. I do not have it in me to listen and sit still for that long. But that doesn’t make or break me; most of the information you need is on the slides. So, after grabbing a bite to eat after lecture, I would go to Modica, where I would sit in a cubicle and whiteboard until I had the slides memorized. I would be in Modica on the weekdays from 6 pm to nearly 1 am, most mornings from 8 am to 12:15 pm, if I didn’t have small group, and on the weekends all day long.

Oh yea, small groups are held weekly (1-4x a week, depending on the week). Small group consists of 8 students and a faculty member, and you cover different material at each one. At most small groups you have to present material that you have previously learned. So far, I have really enjoyed all my small groups, and because you are responsible for the material presented, it helped me feel more prepared for my exams, especially with histology labs. It is a great way to network, and it’s an enjoyable way to learn from your peers.  I also met my current AEP partner in our first term small group. And I met my study buddy, Olivia Brooks, through another small group member. Speaking of studying in groups – I personally believe three is a crowd. One on one, seems to work best for me, with another human, drilling the shit out of each other. More than two people has proven to be distracting, but everyone is different!! You have to find what works for you!

The way I learned in my undergraduate career was NOTHING like the way I have learned in medical school. In order for me to learn long term (because everything is cumulative), I have to view the material multiple times, do practice questions, white board, make my own notes, etc. I never worked that hard in undergrad, and would often cram the night before. Medical school is definitely some next level shit. For each module, I had to adjust my studying style, in order to be successful. For FTM, I mainly did white boarding, few practice questions, and writing out my own notes. For MSK, I white boarded, made review sheets, and did LOTS of practice questions form the Grey’s Anatomy textbook. For CPR, I white boarded and did more questions from physiology books such as Guyton and Hall, Pretest, and BRS physiology. What works for one human, may not work for the next. I know a lot of my classmates used the USMLE STEP book to prepare for tests, and I personally never looked at the book until much later in term 2 to study for our cumulative BSCE test. I have never had to worry about resources at SGU, if anything, it’s easier to get bogged down in resources than it is to find them. My piece of advice is to stick to the slides, first and foremost, because that is what you are going to be tested over on your SGU tests. Preparing for step is a different ballgame, but as far as I am concerned, you will do well on SGU tests, if you study their powerpoints and do their practice questions.

Above are pictures of my review sheets I would make on the weekends.

During term one, you also have the worry about preparing for the OSCE throughout the semester. At your small groups, you will learn how to perform various patient tests and physical exams. The OSCE, Objective Structured Clinical Examination, occurs at the end of each term. It is essentially a big clinical exam with multiple stations, where you read clinical vignettes and are asked to perform different medical tests on standardized patients. Before coming to medical school, I worked as a certified nurse assistant, and I felt very comfortable touching patients (you honestly can’t be a CNA and not feel comfy touching patients, you wipe a whole lot of buttholes). However, the first time we learned how to do physical exams on patients, I remember being so excited and nervous that my hands were shaking. It’s different learning how to be doc, than it is being the CNA, that’s for sure. With each small group, you get more and more comfortable and confident. I would definitely not wait til the night before to prepare for your OSCE. So far, I would say the first OSCE is the worst, because you have to get over that initial fear/anxiety. Definitely go to the practice OSCE, so you know what to expect.

Lastly, the most challenging aspect of medical school – BALANCE. How do you find time for yourself, time for you family/friends, time for you laundry, time for your OSCE practice, time for sleeping and eating, and time for your studies? Well, I still mess that up on the reg. It’s all ever changing and requires adjusting. Some weeks, you have more time than others. One of my favorite parts about going to school in Grenada, is that my family and friends are not around. It is less distracting, and I honestly do not think I would be keeping my As if I were at med school in OK. Margaritas and queso are way too convenient in my car that can get from point a to point b. However, that is also my least favorite part about living on the island, because I really do miss them.

All within the first month of med school, you learn 40 something lectures, have several small groups, attend professionalism sessions, and get your white coat!! My parents came and visited me for my white coat ceremony, and I was so glad they did. We got to explore the island, go scuba diving, and celebrate my birthday. They gave me a nice break from school, but it definitely made me nervous to not be studying hard core. Throughout my time at SGU, I have learned that it is difficult not to feel guilty when you aren’t studying, which goes back to the challenge of balance.

What do I miss most? I definitely miss having a car and not having to rely on strangers for public transportation. I also miss my family and friends, cold milk, all kinds of cheeses, an abundance of bread, and fast food/restaurants. Oh, I forgot, I miss seasons. I never realized how much I enjoyed heat then cool, then colder, then warmer, then summer, but after months of straight humid heat, I really miss the changes in weather (especially in Oklahoma where you can experience all four seasons in a day). There are also many things I love about the island – the ocean, scuba diving, fresh coconut water, banana trees everywhere, and the rainforest. Lastly, I have a love/hate relationship with “island time.” On one hand, it’s nice that everything seems carefree and steady going, but it can also be a huge inconvenience when you are pressed for time (say you are preparing for your upcoming exams – which you are, every single day). It’s hard to put into words what a year of island life is like, and its even more challenging to stay positive about it when you are trying to do your best in medical school. I left America last year thinking I was going to have the time of my life on this island, and after a year of living there, I soon discovered that I love America, and it is honestly such a privilege to live in America. Maybe if I wasn’t trying to tackle both medical school and the island at the same time I would appreciate the island more, but currently, I count down the days until I am home in the states, where there is an abundance of resources and easy access food/coffee and customer service actually exists.

This is a picture of the lecture hall – Patrick F Adams. Our class size is close to 900.