My mother tells me that she bought me my first doctor’s kit, complete with little plastic stethoscope and hammer when I was five years old. Thereafter, she might have still been Mommy, but she was also my patient. Years (and years) later, at the end of undergrad, I was faced with a difficult decision. I still wanted to be a doctor, but did I want it bad enough to leave the city I was familiar with, my family and friends, and move off the continent to follow my dream?

Faced with stiff competition for few spots, a former Varsity writer followed the footsteps of growing numbers of North American students by heading for med school in the Caribbean

Thousands of Canadian students every year choose to leave the country for further education. There are seventeen medical schools in Canada, including a new school in northern Ontario. In 2005, of the over 14,000 applicants, only 40 per cent were accepted in total. And the rest? Some accept other positions in the medical field. Many head to the States, some head to Europe, and in recent years, many Canadian graduates have been flying south to Caribbean islands to pursue professional degrees, particularly medicine.

Like many who attend off-shore schools, I heard about the school I attended from a friend. She described a tiny island 15 square kilometres in its entirety. An island where there was no mall, no movie theatre, no coffee shop. Where there are about 10,000 inhabitants (which may or may not have included the goats). An island I had to fly to on a plane that looked like a flying school bus and seated no more than twenty people.

I was not entirely sure what to expect when I arrived, but was pleasantly surprised. The island was much like any other developing nation, with a fascinating dichotomy that somehow peacefully co-existed. There were the trappings of modern life: large SUVs on the road, brand-name clothing available in the stores, and Coke available at every street corner. At the same time, the SUV passed children walking barefoot home from school, the bank that closed at lunch time for an hour and again at 2 p.m., as though the day’s business should have been completed by then.

The dorms were like any university dorm, with two beds, two desks, two chairs, a bar fridge, a microwave, but with a killer view of the Caribbean Sea. And the school itself, although small, had a anatomy lab, library (yes, with books!), a cafeteria, and air conditioned classrooms. Was it on par with Canadian universities? No. Was it better than I expected? Unequivocally, yes.

A quick query on your favourite internet search engine will net you hundreds of results regarding both Caribbean and international medical schools. Each one paints a picture of studying on the beach, with your toes in the sand or in exotic locales. Who wouldn’t want to get their med school education at the beach?!

There are at least 20 medical schools in the Caribbean islands, some which have been there as long as 25 years, others which started less than two years ago. Each is a “for profit” medical school-essentially a business proposition for the individuals who enrol. Each promises a medical education on a warm Caribbean island that is comparable to the content of American medical schools.

Okay, so what’s the catch?

The catch is: not all medical schools are created equal. While each promises an American-style education, not all schools are accredited and do not follow through with quality of education and teaching staff that they promise. In addition, not all schools offer clinical rotations in the United States or Canada, forcing students to move to Europe for two years in addition to the time spent down on the islands.

In addition, the picture painted of studying on the beach, sipping cocktails is that just that-a picture. Training on a Caribbean island is an accelerated program, with a rigurous schedule. Exam are administered every three weeks, with students required with a 70 per cent or above. Class are held five days a week, often eight hours a day. Those who expect to spend their time on the beach will be unpleasantly surprised.

Dr. Thomas Ferguson has seen his share of medical students in his 28 years as chief of Internal Medicine at Chabert Medical Center, in Houma, Louisiana. He has also been working with off-shore medical students for nine years. Initially, he says, he accepted many students from different schools, but, he noticed that certain schools sent students with a stronger work ethic and stronger basic science background. Now, Chabert is affiliated exclusively with two schools

Does Ferguson feel that students from offshore schools are disadvantaged in comparison to American students? Not at all-in fact, he says that “off-shore students often have a stronger work ethic and a willingness to work hard that American students sometimes lack.” He feels that the Caribbean students that rotate through Chabert hold their own against their American counterparts.

For many I have spoken to, classmates, professors who taught me, and residents I have met who have been through Caribbean schools, they all say that same thing-that the experience was worth it. They are quick to add, however, that their decision was not without sacrifice and hardship. It is a long way to go and a long time to be away to achieve your dream. And research is essential in choosing the school that will give you the quality of education you desire. But is it worth it?

Yes. It is. And I can say that, because I have done it. I packed up my life, left my family and friends in Toronto, and moved to a tiny rock in the middle of the ocean. I spent just under two years there and am now in the United States, nearly finished my third year of medical school. I don’t know if I will end up in the U.S., or if I will come home to practice. What I do know is that it was worth it. The heat, the exhaustion, the rooster crowing every hour on the hour throughout the night, the long months away from home, studying by candlelight and flashlights when the power went out the night before an exam, and then waking up to study and seeing the sunrise over Antigua-it was all worth it and that I wouldn’t change a single moment of my decision.

Leena Khendari, a student at the Medical University of the Americas, is doing her clinical rotations in Houma, Louisiana

ILLUSTRATION BY JONATHAN GOTFRYD