Any advice for an international applicant?

Hello all,
For a few days I’ve been browsing through your forum, and it has really caught my interest for obvious reasons. Well, yes, the reason is that just now, at 36, after working as an engineer for 10 years, I am finally in the process of researching where, and how, can I go to med school. So, basically all your stories and comments give me the so-needed support!
Anyway, I finally quitted my job over 2 years ago (big step), and since then I have been working as logistics field volunteer with an international medical NGO (my dream). Their line of work is what drives me, and this is why I particularly chose to work with them all this time, but in my dream I want to work as a doctor and not only as a logistician… does it sound familiar?
Now the thing is that I am not a US citizen, so I am looking at all my options internationally. My initial goal is to study in your country due to the vast technological advance in the medical field, no doubt about it, but also because I enjoyed so much living there in the past. I have already gone to high school there for a couple of years and I also worked there recently, so I could say that I am familiar with the environment, and I like it not only as holiday destination.
At the same time many doctors working with me tell me that I should strongly consider going to school somewhere else, in a place where I could get more clinical hands-on experience, and specially in clinical tropical medicine under non-favourable conditions, which is what they struggle with in the areas where we usually work. They say that the US has all the technology but the education mostly revolves around the inmediate access to this technology, it is mostly geared towards the HMO environment, and more important, it is mostly focused on the western medical problems. Frankly their logic makes a whole lot of sense to me, in my education I’d like to be exposed, clinicaly as much as possible, and from the beginning, to the problems that affect the areas where I will be working, the tropical diseases. But I am not convinced yet, I still have the US as my primary goal. I have heard several times that there are schools with very good curriculum in tropical medicine, for example Brasil or others in South and Central America for MDs, and also the UK and Belgium for Master Degrees in Tropical Medicine. But I really have not heard or done any research on the US schools regarding this topic and I will certainly have to do it.
At the moment, I am just having fun researching in the internet and figuring out which tests I have to take, or which courses to fulfill, in order to be able to take the MCAT and start an application process. From what I have seen, and understood, I would either need to start a post-bac or get some independent biology and chemistry lab work done before taking the test and applying to a med school. I am more inclined to a Post-Bac since that will give me the time to get back into ‘student’ mode in the proper environment and even then I would have the time to evaluate where I’d have more chances of getting accepted. So I am now preparing myself to take a GRE, and I think I will also have to translate my engineering title and transcripts into an international standard for easiness in the application process. Yes, yes, lots of things to do, and this is not even the stage to take the MCAT yet… or the stage to apply, and apply, and apply…
Anyway, I am sorry to talk so much at this ‘stage’ and to bother you with my story, but I’m excited; I feel that finally I am on the track, and perhaps I hope to find some encouragement in your forum. I guess I feel good writing to a forum made by people with similar struggles.
So, if you feel like, please share anything you would like to share with me, any ideas, any particular advice, anything you can tell me will be appreciated. In the meantime, I wish you all the best and all the luck, thanks in advance, and take care!
Mao
’Strive to be happy… Max Ehrmann, 1927’

Mao, welcome to OPM. Please don’t interpret the silence to your query as a lack of interest. You have raised some VERY interesting questions and I am not sure any of us (at least not those of us who participate regularly) feel qualified to answer these questions.
I would say, keep talking to people and keep getting more information about the benefits and problems associated with medical school outside the U.S. A big question is, are you likely to want to do residency training in the United States? If so, it is definitely to your advantage to try and do your schooling in the U.S. because it will be much easier to get a position.
also, I’m not sure I follow the logic of the people who are advocating that you go to school in the “tropics” since you have an interest in tropical diseases. There are any number of schools in the U.S. where you would certainly be able to pursue that interest. As a student, you can also do away rotations and trips to further pursue that interest. Just for example, my school (George Washington University in Washington DC) has a good tropical medicine department and folks have done some pretty amazing field trips to China, the Amazon, etc.
I hope you’ll share what you learn with all of us. Welcome, and good luck to you!

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At the same time many doctors working with me tell me that I should strongly consider going to school somewhere else, in a place where I could get more clinical hands-on experience, and specially in clinical tropical medicine under non-favourable conditions, which is what they struggle with in the areas where we usually work.


You may want to consider a university in Australia. The northern parts of Queensland and the Northern Territory are tropical and would give you some of the experience that you are after. It is also a nice place to be while studying!
Craig

Craig is correct. While going the standard route, vis-a-vis, St. George’s, Ross, and even Britain, you will not get the exposure to Tropical Medicine in eithe of those venues. The former are mainly arena’s to by-pass the US application system and just get a residency in IM, Peds, OB, or FP. While I am in Britain, I am not real familiar with any programs dealing with Tropical Medicine here.
Australia on the other hand, would be right up your alley, and while you would NOT be preparing directly for the USMLE, with a little extra effort, you could pass it without too much trouble.
Good luck

but Joe, as a student at Ross, St. George, St. Christopher’s etc., do you not have the same ability as U.S. students to do away rotations during your fourth year? For example, I have a classmate at GWU who MOVED AWAY in September - except for the required two-week “internship training” we have in March, and graduation, he is outta here in a big way. I have lots of classmates who are spending at least as much time in other clinical locations as they are close to home. (Yeah, fourth year is great!)
I can’t think of any reason why the international schools’ students would have any restrictions on their ability to arrange cool electives, but I don’t really know much about how it works. Having run into some Ross students here in the D.C. area, I’d gotten the impression that those students had a lot of control about where they did both third year required rotations and fourth year electives.
Which would mean, going back to the original question, that someone at a non-U.S. school with an interest in Tropical Medicine could try to arrange to do his/her third-year required medicine rotation at a place that’s strong in the field.
Again, this isn’t something I know a lot about so I hope others will chime in.

Quote:

Hello all,

At the same time many doctors working with me tell me that I should strongly consider going to school somewhere else, in a place where I could get more clinical hands-on experience, and specially in clinical tropical medicine under non-favourable conditions, which is what they struggle with in the areas where we usually work. They say that the US has all the technology but the education mostly revolves around the inmediate access to this technology, it is mostly geared towards the HMO environment, and more important, it is mostly focused on the western medical problems. Frankly their logic makes a whole lot of sense to me, in my education I’d like to be exposed, clinicaly as much as possible, and from the beginning, to the problems that affect the areas where I will be working, the tropical diseases. But I am not convinced yet, I still have the US as my primary goal. I have heard several times that there are schools with very good curriculum in tropical medicine, for example Brasil or others in South and Central America for MDs, and also the UK and Belgium for Master Degrees in Tropical Medicine. But I really have not heard or done any research on the US schools regarding this topic and I will certainly have to do it.

Mao
’Strive to be happy… Max Ehrmann, 1927’



Hi there,
Both GW and Howard have very strong infectious disease departments with specialists in Tropical Medicine. Howard has several overseas clinical rotations that are available for fourth year medical students in Clinical Tropical Medicine and have a track for Infectious Disease fellows who want to concentrate in Tropical Medicine. Howard also has one of the premier laboratory that studies malaria too. The ID fellows on the Tropical Diseases track spend some time doing bench research in this lab during their fellowship.
I also know that Dr. Fox at GW is one the leading experts in Tropical Medicine in Washington, DC and the United States. He is also a collaborator at Howard which is where I met him.
Here in the United States, as a fourth year medical student and as a medical student researcher between your first and second years, you have the ability to do research and rotations in Tropical Medicine. Here in DC, you can even spend some time at NIH and the CDC studying Infectious Diseases. Several of my classmates at Howard spent time at the CDC and have written several papers.
The thing that you have to understand is that once you have been accepted to medical school here in the US, you have plenty of options for further study during the summer between first and second year, after taking USMLE Step I and during your fourth year as an elective. At Howard, I had classmates who spent time in Cuba, Peru, Ghana, South Africa and Bangladesh studying Infectious Diseases in both adult and pediatric patients.
Good luck!
Natalie

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but Joe, as a student at Ross, St. George, St. Christopher’s etc., do you not have the same ability as U.S. students to do away rotations during your fourth year? For example, I have a classmate at GWU who MOVED AWAY in September - except for the required two-week “internship training” we have in March, and graduation, he is outta here in a big way. I have lots of classmates who are spending at least as much time in other clinical locations as they are close to home. (Yeah, fourth year is great!)
I can’t think of any reason why the international schools’ students would have any restrictions on their ability to arrange cool electives, but I don’t really know much about how it works.


Yeah Mary you are right. I was trying to be too succinct and didn’t get in all my thoughts. yes you are right, I can do virtually the same thing you do. Yes you are also correct that I, as well as many others can arrange for clinicals in 4th yr wherever I wish. What I was trying to get to without writing a book was the focus of some schools. For instance, UM has a good focus in research on Spinal Injury and Tropical disease and would make a good arena to get into clinically, while other places focus on FP, OB, Peds, et al. (Good god am I stepping in it again?)
Anyway, there are locations where that is emphasized, but I was aware a year ago of one or two Aussie school proclivity for that type of thing. I hope that is clearer.
I was thinking mainly from my standpoint where we have 4 clinical centers in Atlanta, LSU Hospitals, Chicago, and Colorado, where we can do all our rotations in one city and NOT have to move.
Although I did promise Nat I would come to UVa to do my surgery rotation…

OK, I think I see where our viewpoints diverged now, Joe. Thanks for confirming my thoughts on your ability to choose rotation sites - I think you’ve probably actually got a lot more leeway than I do.
Anyway, back to the original question, I guess the thing is whether you choose your entire med school experience because of your interest in one particular field. Sometimes, you do. If you have done work in a field in the past, if you’ve got some sort of really strong pull to a particular thing, if you’ve done research with folks at an institution and being in that med school would enable you to continue to do that work - then yeah, it would make sense to try and find a med school where you can further pursue that interest.
I just wanted to make sure it was clear that you CAN pursue a particular interest in some field regardless of where you go to school - because your undergraduate medical education is meant to give you the broad picture, it’s usually not necessary or advisable to pick with an eye toward a specialty interest.