Answers to Readers’ Questions
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Loading ...At long last, here are the answers to the questions commenters asked in a post last month. I know I’m inexcusably late in posting these, but I had an international move with a baby, organizing the house and the start of a new semester. I know, there’s always something…
Rather than spend pointless time editing the answers (I tend to write spontaneously and whack away repetitively), I’ll get these out. Perhaps the “extra” information helps you know me a bit better. It’s a long read, so to save space on my home page, there’s a “more” link if you’re seeing this from there; otherwise, you’ve gotten the whole kahuna. Without further ado…
Punchberry asks:
1. What brought you to medical school and specifically to medical school in Mexico?
Medicine was always an interest, but I never took it as seriously as I did chemistry and other sciences. By the time I may have been able to change gears (I had thought very seriously about changing majors to pharmacy from chemical engineering) to a pre-med curriculum, I was already soured by the cutthroat-passive-aggressive-ever-approval-seeking premeds I was surrounded by in early undergraduate science classes. After getting involved with research, graduating, more research, etc., I eventually got a computer consulting job in the Real Worldtm. After being away from school for a few years, I decided that I really did like it after all, and I was just being a whiny baby. I took a leave of absence from work, and moved back home to figure out what I was going to do next.
I got to know a surgeon very well during this time, and he provided me with lots of exposure, as much as I wanted (which was a lot since I wasn’t working at the time). I was literally following patients from pre-op workup to OR to post-op managment, getting a very large picture at an early stage of deciding if this was what I wanted to do. Once I was in the OR, I was hooked on pursuing medicine–and that’s with me not scrubbed in, just getting peeks every now and then and helping the circulating nurse.
Why Mexico? I grew up on the border, so the culture and idea of Mexico wasn’t strange; a large % of doctors along the Texas border went to med school in Latin America. Being in Mexico is hard, but Guadalajara is a big city with lots to do and explore. I could not survive on an island, as much as I love the water, with such limited resources. I never even considered med school overseas. More on why not a US school later.
2. What advice would you give to an incoming student about to start at your school in the fall?
Fantastic question. I’ll skip all the academic stuff, because that’s nearly universal. Instead I’ll list a few things specifically about my school and living here in Mexico:
- Take the time you are used to for getting something done, multiply it by 2 (by 3 if it’s a Friday)
- While things are computerized here at school and in general here in Mexico for official things, they still obsessively shuffle papers and stamp things to make things official. Most secretaries have blue fingers because of obsessive stamping. Expect to wait in line to do just this to make it official, even though the transaction is already “done.”
- Waiting in line is like breathing air. So many Mexicans spend probably 1/4 their life in lines and think nothing of it. It’s an excuse to socialize, collect thoughts, talk on the cell phone, etc. To Type-A personalities who want things yesterday (like yours truly), this fact alone may necessitate benzodiazepene and/or ACE inhibitor therapy. You’ll get used to it, but nobody ever likes it.
- The international program obviously recruits and caters to Americans, but make no mistake–this is not the United States. The school is firmly rooted in patriarchal, old-school traditions: don’t challenge authority (ideally, and if need be, be gushingly respectful), expect to do things a different way, and expect to have your time wasted. Often.
- People assume that Mexico is cheap to live in, and that’s true–if you live like a Mexican. If you want any semblance of US lifestyle, food products, etc. be prepared to pay. I’m not talking about having to do without Crunch Berries (although it’s available for $6/box at specialty stores), I’m talking getting decent cuts of meat, various household products one takes for granted, etc. If you are willing to go to the fruit/vegetable stand for your produce, then the meat market for your meat, etc. etc., then yes, you can get things cheap. You just won’t have much time for anything else.
There’s more, but I don’t want to seem overly negative. There are good things about being here too, but you get a ton of that in all the school literature. Most of all the good stuff they say about the city and school is true, but it takes the perspective of having been here to understand if such-and-such really makes a difference in the end.
3. How did you meet your wife, and how long have you been married?
We met through a mutual friend at a gathering. We dated for about 7 months before getting engaged and continued on for two long years of postponed weddings, school prep, deaths in family, etc. before finally getting married in January of 2004.
lyndal asks:
1. What is it that you hate / love about medicine so far?
That’s hard to say, since I haven’t done my clinical clerkships yet, but I love the fact that I’m in a field that is always discovering new things, helping others, and holds unlimited learning potential. They say the net pay is going down, but as a doctor, it’s not like my family and I will be starving after I’m done, something that definitely helps when paying the dues (in almost every way) right now. However, I do see things I don’t like from my general exposure, and that’s increasing liability and litigation, increasing power and scope of the “business” end of medicine, and other things that I’d rather not deal with or I’d have gone to MBA/law school.
2. What are your aspirations?
To feel like I can go to work [most] every day feeling I’m moving forward, feeling fulfilled in my work and family life. I hope to strike a comfortable balance between the two, since I don’t think it’s possible for me to be happy overall without feeling fulfilled in both. As to details of what I’ll practice or where, all that will work itself out in the coming years and I’m not stressing over it. I can say almost certainly that I won’t do primary care and won’t be in a predominantly rural area–both do not suit my temperament. I’m also pretty sure I would never do OB/GYN. Many medicine subspecialties have some appeal (cardiology, infectious disease), but they all fellowship-level training, requiring 3+ years of vanilla internal medicine, which currently doesn’t interest me. Right now top potential careers are surgery (if I can stomach the training), anesthesiology and radiology (primarily for interventional radiology).
3. Who in your current medical life do you look up to and why?
I have a surgeon friend who has served as my mentor in many things medical. He’s triple boarded in anesthesiology, critical care, and surgery. He was originally an anesthesiologist who decided he wanted to be on the other side of the ether screen (after he already had two children and a successful practice). He entered a surgical residency and hasn’t looked back. If I had just a fraction of his work energy and focus, I’d be happy. He has cautioned me not to look at his life now–a successful, multi-faceted surgeon, comfortable in his practice–as the basis for the decision to go into surgery, since it took him a LONG time to get to where he is today.
Kim Says:
1. Who’s your favorite rock band? (Hey, I had to ask!)
Please don’t hate me, but I don’t listen to much rock music, and I especially don’t listen to the “pop flavor of the month” (aka American Idols, Next Great Band-type shows). I grew up primarily listening to classical music since classical piano was my first endeavor. It has stayed with me (although I don’t play much these days except when I go home) and is a HUGE part of my life.
To answer your questions somewhat, since I haven’t completely lived in a cave, I did like Rush a lot during their prime (”Moving Pictures” is one of the greatest albums ever), but stopped listening to them once they started getting weird and overly synthy. The first album I ever bought was “KC and the Sunshine Band,” emptying coins on the counter of JC Penney’s (that dates me!). I was a disco child, and one of the things that gives me the greatest pleasure is annoying people by belting out Bee Gees lyrics (although as a baritone, I couldn’t get to the Gibbs’ falsetto no matter how cold the water). I also like Soundgarten, RH Chili Peppers (Flea!), the Foo Fighters, and Sarah McLachlan.
2. Where will you practice after you receive your MD?
I hate heat, but I love Texas culture/food/etc., so I’m always torn about coming back to Texas. I have also lived in the Washington DC area (Reston/Herndon VA) and I *loved* the climate, but I have no family or connections there. I always said I’d like to live in the Pacific Northwest, but we’ll see. The midwest is right out, sorry.
3. How does medical school in Mexico differ from the USA or other countries?
Well, since I have not attended a US school personally, I’m going by what I know through my cousin (who graduated a year+ ago) and other friends from whom I got a good idea. Mainly, the biggest difference is the student population: the US weeds out the students before the get into the door, and attrition/failure is very low. By contrast, the flimsy requirements of many international schools, such as mine, allow entry of people that either shouldn’t be here or that haven’t quite “gotten it” yet (hopefully they will) of what needs to change to do well. As such, you have students that range from brilliant, ace-ing everything (props to them) to good, hard-working (by far the majority), to those that seem destined to not make it. There aren’t any quotas for passing/failing, but the M.O. is that you are thrown into the deep end, and you have to sink or swim primarily of your own merit; there are no retention/tutoring/special programs to help, and most of the faculty teach their own notes with little correlation of what’s “on par” with a LCME-accredited school–you make up that difference yourself.
It’s also impossible to separate culture from where you go to school in a foreign country, and unless you are familiar with the Mexican culture (I was raised on the border, and even I had quite a bit of adjustment), it can be daunting. I know people that left not because they couldn’t hack the academics, but they refused to assimilate and go with the flow here–you aren’t going to change an institution as a whiny foreigner. There is a strong patriarchal, “what I know is right and to hell with what the American journals say” kind of attitude at times, but thankfully, one sees that more in the older physicians who will hopefully retire soon and stop endangering patients.
Also, it’s not that hard to be a doctor here–just keep going to school, pass, and take a not-that-difficult test when you’re done. That’s it; you’re set for as long as you like. Residency here is famously hard to get into, and most doctors just stay with their GP status, even though they’ll advertise treating everything under the sun. Personally, I’m always wary of who I see as a physician here, because I know that Dr. So-and-so could have done only the four years I’d do (plus intern and social service), or they could have done a residency/fellowship,etc. Believe me, I run for the hills if I see the former, especially when it’s been years since they’ve opened a book or read a journal. This doesn’t describe most general doctors who try to at least stay somewhat current on recent findings, but there is very little oversight to help find out who isn’t that way or to what degree.
And finally, from an anonymous coward poster in my class whose entire comment wasn’t worth approving, but it’s a valid and common question (although usually phrased more eloquently):
if u think u sooooooo smart what the f$@k u doing at UAG?
Quite simply, my undergrad GPA sucked (less than 2.6) and shut me out of US med schools. I never thought I’d go to med school and I took a typical non-competitive/gradstudent approach to my classes, with my own dash of slackerdom thrown in. I took a year of additional undergrad coursework in 2002-3 trying to raise my undergrad GPA, but even admissions directors (2) told me that short of getting a new degree, there’s not much I could do in the way of taking individual courses to convince them I was worthy of serious consideration; in their view, it was my lack of “sticktoitiveness” that was my biggest downfall. My MCAT was in the 30s, so that wasn’t the problem, even as per the committees. Even looking at my trasncript and coursework would show not a marginal student but an inconsistent one, getting As, Cs and drops in the same semester. They never regarded me as someone who wasn’t capable, just someone who, statistically, screamed “high risk.” Whatever. I’m done crying over spilled milk, and to be fair, it’s not like I have a better solution to the smart-student-but-irreconcilably-blemished-on-paper applicant problem. Admissions people gotta do what they gotta do; I did what I had to do–go to medical school elsewhere.
If you are reading this sentence, you are a special reader indeed for making it this far–thank you! 
Hopefully this post answers the above questions and sheds more light onto who I am. Thanks again for stopping by!
Medical School, Personal | enrico | 
July 30, 2006 5:25 pm
By Punchberry, August 3, 2006 @ 9:15 am
Thoughtful answers and another great post! Good luck with the upcoming year!
By M Carnalla, August 12, 2006 @ 1:22 pm
Hi, I read an interview in Medscape Med Students and I got here. I think you chose the worst(well, maybe not the worst, but a pretty bad) university to study medicine. I’m a med student myself, I’m in UNAM, believe me it’s different there. I just think you made a bad choice, you could have gone to UNAM o the Universidad Autonoma de San Luis Potosi (UAP), anyway.. that’s just me. If you ever come to the medicine’s faculty of unam, I’ll gladly give you a tour. bye.
By Rose, December 28, 2006 @ 10:18 am
Just a quick question how old do you have to be before you start med school in Mexico? What is the typical age you start? Is it possible for an 18 year old to start medical school?
By Bryce, March 14, 2007 @ 10:59 am
Hi you are my first hope at an answer.. My ex who is from Guadalajara is currently living in San Francisco and as of January began having symptoms of Acute Chronic pain. It has developed so badly that he is now wheel chair bound and the doctors after Thousands of texts are stumped…. I am writing pleading if anyone In Mexico has heard of symptoms like this? If you have heard similar cases please help…. He is 24 yrs old was very fit until this year.
Thank you!
By Alyssa, March 23, 2007 @ 12:06 pm
I have really enjoyed searching through your page. My husband is seriously considering going to UAG. I’ve read that you’re married as well, but from what I’ve read it sounds like your wife and daughter live in Texas. If so why did you both decide to take that route?
By Noma Khumalo, April 8, 2007 @ 1:13 pm
I’m a south african student wanting to study medicine away from south africa. Do you think Mexico is a good idea?
By mapisa2381, April 29, 2007 @ 4:36 pm
I dont have anything incredibly insightful to say, but I wanted to leave a comment because I was particularly impressed at your answer to the last personal question. I have just moved to Dominica to attend Ross University for practically identical reasons that you have explained. For a long time I was embarrassed of my decision to attend a foreign medical school because some people reacted so negatively to the idea and instantly judged me as “second rate”. Thankfully I have gotten over that and I am so happy to be here pursuing my dream. However, I know there will always be people out there (including potential employers) who will believe that I am not a smart doctor because of where I received my degree. It is nice to be reminded that there are intelligent, driven people out there (like you) who will make excellent physicians without the ivy league medical degree.
By medschoolmom, May 5, 2007 @ 5:39 am
I applaud you for pursuing your dream, and wish you the best in completing medical school and getting to a great place where you can practice medicine. You probably know the old joke: What do you call a med student who graduated last in his class? Doctor. (Pre-USMLE) My new version: What do you call a Mexico med student who passes the US medical boards? Doctor. As a resident of rural Oregon, I can tell you, if a doctor knows what he’s doing, treats patients with dignity, and shows up sober, he can have a thriving practice. Most patients don’t care where you went to medical school, because we know about the licensing exam.
As our daughter paced herself through undergrad to achieve her dream of med school (atypically, through a math and philosophy major), we, her parents, encouraged her to not obsess about being admitted to an American school. We believed that if her dream was to be doctor, she should be willing to go to Mexico, Italy or the Caribbean in order to achieve it. In fact, we kinda liked the idea of visiting her there. She was admitted to an American school as it happens (what a crapshoot THAT is) but I would NEVER have thought of her, or anyone else attending a foreign school, as “second rate”. How can that be, when they’re handling not only med school, but a new culture?
I encourage you, and mapisa2381 to stay proud, and work hard. Good luck.
By Rosemary, December 7, 2007 @ 1:38 pm
so far so good. I’ve read a bit here and your blog seems interesting enough to post as one of my favorites on my blog. Good luck to you and your family. I really admire your determination and I believe there will be some great places for you in the world.
By Lyn, August 18, 2008 @ 4:23 pm
I need Enrico to contact me. I am student at UAG. Please contact me by email.
By Julian J Alfaro MD, December 6, 2008 @ 12:24 pm
I attended Universidad de Montemorelos in Nuevo Leon Mexico and graduated in 1994, passing the Mexican National Exam for Residency training is not that difficult, that’s why I don’t agree with Enrico, I took mine for Emergency Medicine without preparing myself and I ended up being the first one of 400 candidates, most of the Mexican Medical Grads pass this test, of course there are other that can’t, same as in the US. Residency training in Mexico is very different from the US,is very intensive, they are on call q2 or q3, no hours restrictions,if in Grand Rounds you don’t know an asnwer from an attendin question then be prepared to stay on call for another night.Those guys from US come here and do only 4 years without completing the whole 5 years in Med School plus the 2 extra years for internship and social service,so they don’t get their Med School Diploma and the chance to obtain their Mexican Medical License,but what the heck, they only want the transcripts to move to the US to continue their journey there, in my case I came to the US in 1997, I took the USMLE’s, passed them and did my Residency Training at UCLA. I really enjoyed the US Residency Training system it is very complete and is pretty much settle to make you a stronger medical professional once you done with your training.